Insights into Sexism: Male Status and Performance Moderates Female-Directed Hostile and Amicable Behaviour.

PubMed

Kasumovic, Michael M; Kuznekoff, Jeffrey H

2015-01-01

Gender inequality and sexist behaviour is prevalent in almost all workplaces and rampant in online environments. Although there is much research dedicated to understanding sexist behaviour, we have almost no insight into what triggers this behaviour and the individuals that initiate it. Although social constructionist theory argues that sexism is a response towards women entering a male dominated arena, this perspective doesn't explain why only a subset of males behave in this way. We argue that a clearer understanding of sexist behaviour can be gained through an evolutionary perspective that considers evolved differences in intra-sexual competition. We hypothesised that female-initiated disruption of a male hierarchy incites hostile behaviour from poor performing males who stand to lose the most status. To test this hypothesis, we used an online first-person shooter video game that removes signals of dominance but provides information on gender, individual performance, and skill. We show that lower-skilled players were more hostile towards a female-voiced teammate, especially when performing poorly. In contrast, lower-skilled players behaved submissively towards a male-voiced player in the identical scenario. This difference in gender-directed behaviour became more extreme with poorer focal-player performance. We suggest that low-status males increase female-directed hostility to minimize the loss of status as a consequence of hierarchical reconfiguration resulting from the entrance of a woman into the competitive arena. Higher-skilled players, in contrast, were more positive towards a female relative to a male teammate. As higher-skilled players have less to fear from hierarchical reorganization, we argue that these males behave more positively in an attempt to support and garner a female player's attention. Our results provide the clearest picture of inter-sexual competition to date, highlighting the importance of considering an evolutionary perspective when exploring the factors that affect male hostility towards women.

Insights into Sexism: Male Status and Performance Moderates Female-Directed Hostile and Amicable Behaviour

PubMed Central

Kasumovic, Michael M.; Kuznekoff, Jeffrey H.

2015-01-01

Gender inequality and sexist behaviour is prevalent in almost all workplaces and rampant in online environments. Although there is much research dedicated to understanding sexist behaviour, we have almost no insight into what triggers this behaviour and the individuals that initiate it. Although social constructionist theory argues that sexism is a response towards women entering a male dominated arena, this perspective doesn’t explain why only a subset of males behave in this way. We argue that a clearer understanding of sexist behaviour can be gained through an evolutionary perspective that considers evolved differences in intra-sexual competition. We hypothesised that female-initiated disruption of a male hierarchy incites hostile behaviour from poor performing males who stand to lose the most status. To test this hypothesis, we used an online first-person shooter video game that removes signals of dominance but provides information on gender, individual performance, and skill. We show that lower-skilled players were more hostile towards a female-voiced teammate, especially when performing poorly. In contrast, lower-skilled players behaved submissively towards a male-voiced player in the identical scenario. This difference in gender-directed behaviour became more extreme with poorer focal-player performance. We suggest that low-status males increase female-directed hostility to minimize the loss of status as a consequence of hierarchical reconfiguration resulting from the entrance of a woman into the competitive arena. Higher-skilled players, in contrast, were more positive towards a female relative to a male teammate. As higher-skilled players have less to fear from hierarchical reorganization, we argue that these males behave more positively in an attempt to support and garner a female player’s attention. Our results provide the clearest picture of inter-sexual competition to date, highlighting the importance of considering an evolutionary perspective when exploring the factors that affect male hostility towards women. PMID:26176699

Procedure for analysis and design of weaving sections : volume 2, users guide.

DOT National Transportation Integrated Search

1983-12-01

This research was performed to complete and advance the status of recently developed procedures for analysis and design of weaving sections (known as the Leisch method and-initially published in the 1979 issue of ITE Journal). The objective was to en...

Etiologies of altered mental status in patients with presumed ethanol intoxication.

PubMed

Martel, Marc L; Klein, Lauren R; Lichtenheld, Andrew J; Kerandi, Allan M; Driver, Brian E; Cole, Jon B

2018-06-01

Altered mental status is a commonly evaluated problem in the ED. Ethanol intoxication is common, and prehospital history may bias emergency physicians to suspect this as the cause of altered mental status. Quantitative ethanol measurement can rapidly confirm the diagnosis, or if negative, prompt further evaluation. Our objective was to identify the etiologies of altered mental status in ED patients initially presumed to be intoxicated with ethanol but found to have negative quantitative ethanol levels. This was a 5-year (2012-2016) electronic medical record review of ED patients presenting with altered mental status. Patients were included if they presented with presumed ethanol intoxication and had an initial ethanol concentration of zero. Etiologies of altered mental status were categorized into medical, traumatic, psychiatric, and drug-related causes. 29,322 patients presented during the study period with presumed alcohol intoxication, 1875 patients had negative ethanol levels. The etiology of altered mental status was due to illicit substances in 1337 patients (71%), psychiatric causes in 354 patients (19%), medical causes in 166 patients (9%) and trauma in 18 patients (1%). A total of 179 patients (10%) were admitted to the hospital; 19 patients (1%) to the ICU. The presumptive diagnosis of ethanol intoxication in patients presenting to the ED with altered mental status was inaccurate in 5% of patients. The etiology of altered mental status was serious and required hospitalization in 10% of the cohort. Rapid assessment of quantitative ethanol levels should be performed, breathalyzers may be preferred over serum testing. Copyright © 2018 Elsevier Inc. All rights reserved.

Trajectories of Symptom Clusters, Performance Status, and Quality of Life During Concurrent Chemoradiotherapy in Patients With High-Grade Brain Cancers.

PubMed

Kim, Sang-Hee; Byun, Youngsoon

Symptom clusters must be identified in patients with high-grade brain cancers for effective symptom management during cancer-related therapy. The aims of this study were to identify symptom clusters in patients with high-grade brain cancers and to determine the relationship of each cluster with the performance status and quality of life (QOL) during concurrent chemoradiotherapy (CCRT). Symptoms were assessed using the Memorial Symptom Assessment Scale, and the performance status was evaluated using the Karnofsky Performance Scale. Quality of life was assessed using the Functional Assessment of Cancer Therapy-General. This prospective longitudinal survey was conducted before CCRT and at 2 to 3 weeks and 4 to 6 weeks after the initiation of CCRT. A total of 51 patients with newly diagnosed primary malignant brain cancer were included. Six symptom clusters were identified, and 2 symptom clusters were present at each time point (ie, "negative emotion" and "neurocognitive" clusters before CCRT, "negative emotion and decreased vitality" and "gastrointestinal and decreased sensory" clusters at 2-3 weeks, and "body image and decreased vitality" and "gastrointestinal" clusters at 4-6 weeks). The symptom clusters at each time point demonstrated a significant relationship with the performance status or QOL. Differences were observed in symptom clusters in patients with high-grade brain cancers during CCRT. In addition, the symptom clusters were correlated with the performance status and QOL of patients, and these effects could change during CCRT. The results of this study will provide suggestions for interventions to treat or prevent symptom clusters in patients with high-grade brain cancer during CCRT.

Self-reported discrimination and mental health status among African descendants, Mexican Americans, and other Latinos in the New Hampshire REACH 2010 Initiative: the added dimension of immigration.

PubMed

Gee, Gilbert C; Ryan, Andrew; Laflamme, David J; Holt, Jeanie

2006-10-01

We examined whether self-reported racial discrimination was associated with mental health status and whether this association varied with race/ethnicity or immigration status. We performed secondary analysis of a community intervention conducted in 2002 and 2003 for the New Hampshire Racial and Ethnic Approaches to Community Health 2010 Initiative, surveying African descendants, Mexican Americans, and other Latinos. We assessed mental health status with the Mental Component Summary (MCS12) of the Medical Outcomes Study Short Form 12, and measured discrimination with questions related to respondents' ability to achieve goals, discomfort/anger at treatment by others, and access to quality health care. Self-reported discrimination was associated with a lower MCS12 score. Additionally, the strength of the association between self-reported health care discrimination and lower MCS12 score was strongest for African descendants, then Mexican Americans, then other Latinos. These patterns may be explained by differences in how long a respondent has lived in the United States. Furthermore, the association of health care discrimination with lower MCS12 was weaker for recent immigrants. Discrimination may be an important predictor of poor mental health status among Black and Latino immigrants. Previous findings of decreasing mental health status as immigrants acculturate might partly be related to experiences with racial discrimination.

Implementation of a formulary management process.

PubMed

Karel, Lauren I; Delisle, Dennis R; Anagnostis, Ellena A; Wordell, Cindy J

2017-08-15

The application of lean methodology in an initiative to redesign the formulary maintenance process at an academic medical center is described. Maintaining a hospital formulary requires clear communication and coordination among multiple members of the pharmacy department. Using principles of lean methodology, pharmacy department personnel within a multihospital health system launched a multifaceted initiative to optimize formulary management systemwide. The ongoing initiative began with creation of a formulary maintenance redesign committee consisting of pharmacy department personnel with expertise in informatics, automation, purchasing, drug information, and clinical pharmacy services. The committee met regularly and used lean methodology to design a standardized process for management of formulary additions and deletions and changes to medications' formulary status. Through value stream analysis, opportunities for process and performance improvement were identified; staff suggestions on process streamlining were gathered during a series of departmental kaizen events. A standardized template for development and dissemination of monographs associated with formulary additions and status changes was created. In addition, a shared Web-based checklist was developed to facilitate information sharing and timely initiation and completion of tasks involved in formulary status changes, and a permanent formulary maintenance committee was established to monitor and refine the formulary management process. A clearly defined, standardized process within the pharmacy department was developed for tracking necessary steps in enacting formulary changes to encourage safe and efficient workflow. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Dexamethasone exacerbates cerebral edema and brain injury following lithium-pilocarpine induced status epilepticus☆

PubMed Central

Duffy, B.A.; Chun, K.P.; Ma, D.; Lythgoe, M.F.; Scott, R.C.

2014-01-01

Anti-inflammatory therapies are the current most plausible drug candidates for anti-epileptogenesis and neuroprotection following prolonged seizures. Given that vasogenic edema is widely considered to be detrimental for outcome following status epilepticus, the anti-inflammatory agent dexamethasone is sometimes used in clinic for alleviating cerebral edema. In this study we perform longitudinal magnetic resonance imaging in order to assess the contribution of dexamethasone on cerebral edema and subsequent neuroprotection following status epilepticus. Lithium-pilocarpine was used to induce status epilepticus in rats. Following status epilepticus, rats were either post-treated with saline or with dexamethasone sodium phosphate (10 mg/kg or 2 mg/kg). Brain edema was assessed by means of magnetic resonance imaging (T2 relaxometry) and hippocampal volumetry was used as a marker of neuronal injury. T2 relaxometry was performed prior to, 48 h and 96 h following status epilepticus. Volume measurements were performed between 18 and 21 days after status epilepticus. Unexpectedly, cerebral edema was worse in rats that were treated with dexamethasone compared to controls. Furthermore, dexamethasone treated rats had lower hippocampal volumes compared to controls 3 weeks after the initial insult. The T2 measurements at 2 days and 4 days in the hippocampus correlated with hippocampal volumes at 3 weeks. Finally, the mortality rate in the first week following status epilepticus increased from 14% in untreated rats to 33% and 46% in rats treated with 2 mg/kg and 10 mg/kg dexamethasone respectively. These findings suggest that dexamethasone can exacerbate the acute cerebral edema and brain injury associated with status epilepticus. PMID:24333865

Procedure for analysis and design of weaving sections : volume 1, research findings and development of techniques for application.

DOT National Transportation Integrated Search

1983-12-01

This research was performed to complete and advance the status of recently developed : procedures for analysis and design of weaving sections (known as the Leisch method and-initially published in the 1979 issue of ITE Journal). The objective was to ...

The direct and indirect effects of initial job status on midlife psychological distress in Japan: evidence from a mediation analysis.

PubMed

Oshio, Takashi; Inagaki, Seiichi

2015-01-01

In the current study, we investigated how initial job status at graduation from school is associated with midlife psychological distress, using microdata from a nationwide Internet survey of 3,117 men and 2,818 women aged 30-60 yr. We measured psychological distress using the Kessler 6 (K6) score (range: 0-24) and the binary variable of K6 score ≥5. We found that unstable initial job status substantially raised midlife K6 scores and the probability of a K6 score ≥5 for both men and women. Furthermore, our mediation analysis showed that for men, slightly less than 60% of the effect was mediated by current job status, household income, and marital status. For women, the effect of initial job status was somewhat lesser than that for men, and only 20-30% of it was mediated. Despite these gender asymmetries, the results indicated that initial job status was a key predictor of midlife mental health. The association between job status and mental health should be further investigated with special reference to the institutional attributes of the labor market and their socio-economic/demographic outcomes.

The direct and indirect effects of initial job status on midlife psychological distress in Japan: evidence from a mediation analysis

PubMed Central

OSHIO, Takashi; INAGAKI, Seiichi

2015-01-01

In the current study, we investigated how initial job status at graduation from school is associated with midlife psychological distress, using microdata from a nationwide Internet survey of 3,117 men and 2,818 women aged 30–60 yr. We measured psychological distress using the Kessler 6 (K6) score (range: 0–24) and the binary variable of K6 score ≥5. We found that unstable initial job status substantially raised midlife K6 scores and the probability of a K6 score ≥5 for both men and women. Furthermore, our mediation analysis showed that for men, slightly less than 60% of the effect was mediated by current job status, household income, and marital status. For women, the effect of initial job status was somewhat lesser than that for men, and only 20–30% of it was mediated. Despite these gender asymmetries, the results indicated that initial job status was a key predictor of midlife mental health. The association between job status and mental health should be further investigated with special reference to the institutional attributes of the labor market and their socio-economic/demographic outcomes. PMID:25752251

The Advanced Photovoltaic Solar Array (APSA) technology status and performance

NASA Technical Reports Server (NTRS)

Stella, Paul M.; Kurland, Richard M.

1991-01-01

In 1985, the Jet Propulsion Laboratory initiated the Advanced Photovoltaic Solar Array (APSA) program. The program objective is to demonstrate a producible array system by the early 1990s with a specific performance of at least 130 W/kG (beginning-of-life) as an intermediate milestone towards the long range goal of 300 W/kG. The APSA performance represents an approximately four-fold improvement over existing rigid array technology and a doubling of the performance of the first generation NASA/OAST SAFE flexible blanket array of the early 1980s.

FAST: A fully asynchronous and status-tracking pattern for geoprocessing services orchestration

NASA Astrophysics Data System (ADS)

Wu, Huayi; You, Lan; Gui, Zhipeng; Gao, Shuang; Li, Zhenqiang; Yu, Jingmin

2014-09-01

Geoprocessing service orchestration (GSO) provides a unified and flexible way to implement cross-application, long-lived, and multi-step geoprocessing service workflows by coordinating geoprocessing services collaboratively. Usually, geoprocessing services and geoprocessing service workflows are data and/or computing intensive. The intensity feature may make the execution process of a workflow time-consuming. Since it initials an execution request without blocking other interactions on the client side, an asynchronous mechanism is especially appropriate for GSO workflows. Many critical problems remain to be solved in existing asynchronous patterns for GSO including difficulties in improving performance, status tracking, and clarifying the workflow structure. These problems are a challenge when orchestrating performance efficiency, making statuses instantly available, and constructing clearly structured GSO workflows. A Fully Asynchronous and Status-Tracking (FAST) pattern that adopts asynchronous interactions throughout the whole communication tier of a workflow is proposed for GSO. The proposed FAST pattern includes a mechanism that actively pushes the latest status to clients instantly and economically. An independent proxy was designed to isolate the status tracking logic from the geoprocessing business logic, which assists the formation of a clear GSO workflow structure. A workflow was implemented in the FAST pattern to simulate the flooding process in the Poyang Lake region. Experimental results show that the proposed FAST pattern can efficiently tackle data/computing intensive geoprocessing tasks. The performance of all collaborative partners was improved due to the asynchronous mechanism throughout communication tier. A status-tracking mechanism helps users retrieve the latest running status of a GSO workflow in an efficient and instant way. The clear structure of the GSO workflow lowers the barriers for geospatial domain experts and model designers to compose asynchronous GSO workflows. Most importantly, it provides better support for locating and diagnosing potential exceptions.

Biochemical evaluation of disease activity after pituitary surgery in acromegaly: a critical analysis of patients who spontaneously change disease status.

PubMed

Espinosa-de-Los-Monteros, Ana Laura; Sosa, Ernesto; Cheng, Sonia; Ochoa, Raquel; Sandoval, Carolina; Guinto, Gerardo; Mendoza, Victoria; Hernández, Irma; Molina, Mario; Mercado, Moisés

2006-03-01

The definition of biochemical cure in acromegaly involves both the normalization of IGF-1 and a glucose-suppressed GH level of < 1 ng/ml. These criteria were reached by several consensus meetings, although no evidence-based recommendations as to the optimal time to perform biochemical evaluations were made, nor was the fact that several patients may change biochemically upon long-term follow-up taken into consideration. To identify and characterize biochemical changes in the follow-up of acromegaly. One hundred and twenty-six acromegalic patients seen at a referral centre were followed prospectively (6-108 months) with regard to glucose-suppressed GH levels and IGF-1 concentrations. Eighty-nine patients did not change biochemical status, whereas in 37 (29.3%), one or more changes were identified, mostly during the first year. When glucose-suppressed GH values were discordant with the IGF-1 results, the likelihood of biochemical status modification was significantly greater than when such results were concordant [concordant 19.4%, discordant 57.6%, odds ratio (OR) = 5.6, 95% confidence interval (CI) = 2.3-13.3, P = 0.0001]. Among the changing patients, four out of the nine subjects initially considered as cured remained so at the last follow-up, whereas five became discordant; of the nine initially categorized as active, only three kept such a status at the last evaluation, whereas five became GH discordant and one achieved full biochemical criteria of cure; of 17 initially GH-discordant patients, seven remained so upon the last evaluation, whereas six became concordantly active and four concordantly cured. A significant proportion of acromegalic patients change biochemical status upon long-term follow-up after surgery. Most of these changes occur within the first postoperative year and are more likely to take place if the initial GH postglucose and IGF-1 levels are discordant.

Possible role of IL-6 and TIE2 gene polymorphisms in predicting the initial high transport status in patients with peritoneal dialysis: an observational study.

PubMed

Ding, Li; Shao, Xinghua; Cao, Liou; Fang, Wei; Yan, Hao; Huang, Jiaying; Gu, Aiping; Yu, Zanzhe; Qi, Chaojun; Chang, Xinbei; Ni, Zhaohui

2016-10-26

The aim of this study was to investigate the effect of interleukin (IL)-6 and TIE2 gene polymorphisms on baseline peritoneal transport property. An observational study. Renji Hospital in Shanghai, China. This study included 220 patients with continuous ambulatory peritoneal dialysis (PD). Patients were divided into 2 groups based on the results of an initial peritoneal equilibration test performed within 3 months of starting PD therapy: group 1 consisted of low/low average transporters (n=123), and group 2 consisted of high/high average transporters (n=97). We genotyped TIE2 and IL-6 polymorphisms and analysed their effects on baseline transport status. The genotype AT in IL-6 Rs13306435 and the genotype CC in TIE2 Rs639225 were both negatively associated with a higher initial peritoneal transport status (IL-6 Rs13306435: OR=0.408, 95% CI 0.227 to 0.736; TIE2 Rs639225: OR=0.188, 95% CI 0.044 to 0.806). IL-6 and TIE2 polymorphisms are associated with baseline peritoneal transport property. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Creating a Government That Works Better & Costs Less. Status Report. Report of the National Performance Review.

ERIC Educational Resources Information Center

Gore, Al

This publication reports on progress 1 year into the Clinton Administration's "Reinventing Government" initiative, a long-term effort at significantly revamping the federal government's operations. A preliminary chapter notes the culture change involved in the reinvention process. Individual chapters then report progress for each of the…

Comparative energy storage assessment item

NASA Astrophysics Data System (ADS)

Giudici, B.

1984-11-01

This analysis, a Space Station application study, rediscovered Integrated Power and Attitude Control (IPAC) and found the approach to have lower initial and resupply weight and lower initial and resupply cost than either battery/CMG or regenerative fuel cell/CMG systems. Preliminary trade studies were performed comparing (IPAC) with equivalent independent electrochemical power and control moment gyro (CMG) control approaches. Technologies considered to have adequate status for an initial Space Station were: (1) nickel cadmium batteries (NiCd batteries), (2) regenerative fuel cells (RFC), (3) Skylab class CMG's, and (4) state of the art IPAC using metal wheels and ball bearing suspension (SOA-IPAC). An advanced IPAC (ADV-IPAC) employing composite rotor material and magnetic suspension was included in the comparisons to illustrate a possible range of performance and cost of inertial systems. The candidates were compared on the basis of initial weight and cost and on the basis of resupply weight and cost for a 15 year mission. Thus, SOA-IPAC would appear to be an attractive approach for the initial Space Station and possible technology improvements would further the appeal for the initial and/or growth Space Station.

Comparative energy storage assessment item

NASA Technical Reports Server (NTRS)

Giudici, B.

1984-01-01

This analysis, a Space Station application study, rediscovered Integrated Power and Attitude Control (IPAC) and found the approach to have lower initial and resupply weight and lower initial and resupply cost than either battery/CMG or regenerative fuel cell/CMG systems. Preliminary trade studies were performed comparing (IPAC) with equivalent independent electrochemical power and control moment gyro (CMG) control approaches. Technologies considered to have adequate status for an initial Space Station were: (1) nickel cadmium batteries (NiCd batteries), (2) regenerative fuel cells (RFC), (3) Skylab class CMG's, and (4) state of the art IPAC using metal wheels and ball bearing suspension (SOA-IPAC). An advanced IPAC (ADV-IPAC) employing composite rotor material and magnetic suspension was included in the comparisons to illustrate a possible range of performance and cost of inertial systems. The candidates were compared on the basis of initial weight and cost and on the basis of resupply weight and cost for a 15 year mission. Thus, SOA-IPAC would appear to be an attractive approach for the initial Space Station and possible technology improvements would further the appeal for the initial and/or growth Space Station.

Chemotherapy-induced (febrile) neutropenia prophylaxis with biosimilar filgrastim in elderly versus non-elderly cancer patients: Patterns, outcomes, and determinants (MONITOR-GCSF study).

PubMed

Aapro, Matti; Bokemeyer, Carsten; Ludwig, Heinz; Gascón, Pere; Boccadoro, Mario; Denhaerynck, Kris; Gorray, Michael; Krendyukov, Andriy; MacDonald, Karen; Abraham, Ivo

2017-03-01

Myelotoxic chemotherapy is associated with chemotherapy-induced (febrile) neutropenia (CIN/FN). The MONITOR-GCSF study evaluated biosimilar filgrastim (Zarzio®) prophylaxis patterns, associated outcomes, and determinants. We performed stratified analyses comparing elderly and non-elderly patients. Comparative (elderly/non-elderly) analysis of demographics and clinical status, prophylaxis, associated CIN/FN outcomes (CIN grade 4 [CIN4], FN, CIN/FN-related hospitalizations and chemodisturbances, composite), and, per hierarchical modeling, determinants thereof evaluated at the patient- and cycle-level. There were no significant differences between both cohorts in prophylaxis initiation/duration and associated outcomes, but proportionately more elderly patients were correctly-prophylacted and fewer over-prophylacted. Common determinants of poor CIN/FN outcomes included concomitant antibiotic prophylaxis, impaired performance status, and any grade CIN in a previous cycle, whereas common determinants of good outcomes included over-prophylaxis and prophylaxis initiation within 24-72h. In the elderly, female gender, liver/renal/cardiovascular disease, secondary prophylaxis, and under-prophylaxis were associated with poorer outcomes. In the non-elderly, CIN4 at baseline or in a prior cycle was associated with poorer CIN/FN outcomes, and higher biosimilar filgrastim dose and, perhaps counter-intuitively, under-prophylaxis with better outcomes. Adequate GCSF support is essential for all patients, but especially for elderly patients with serious chronic disease, certainly, if concomitant antibiotic prophylaxis is indicated and if a CIN4 episode occurred in a prior cycle. The potential impact of impaired performance status, especially ECOG≥2 at chemotherapy start or a worsening to such during chemotherapy; under-prophylaxis, including inadequate secondary prophylaxis, should be considered in elderly patients. Timely GCSF initiation and over-prophylaxis is associated with lower rates of adverse CIN/FN events in elderly and non-elderly patients, and should be further evaluated in prospective randomized trials. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Compression strength of composite primary structural components

NASA Technical Reports Server (NTRS)

Johnson, Eric R.

1992-01-01

A status report of work performed during the period May 1, 1992 to October 31, 1992 is presented. Research was conducted in three areas: delamination initiation in postbuckled dropped-ply laminates; stiffener crippling initiated by delamination; and pressure pillowing of an orthogonally stiffened cylindrical shell. The geometrically nonlinear response and delamination initiation of compression-loaded dropped-ply laminates is analyzed. A computational model of the stiffener specimens that includes the capability to predict the interlaminar response at the flange free edge in postbuckling is developed. The distribution of the interacting loads between the stiffeners and the shell wall, particularly at the load transfer at the stiffener crossing point, is determined.

Factors Associated with PMTCT Cascade Completion in Four African Countries.

PubMed

Dionne-Odom, Jodie; Welty, Thomas K; Westfall, Andrew O; Chi, Benjamin H; Ekouevi, Didier Koumavi; Kasaro, Margaret; Tih, Pius M; Tita, Alan T N

2016-01-01

Background. Many countries are working to reduce or eliminate mother-to-child transmission (MTCT) of HIV. Prevention efforts have been conceptualized as steps in a cascade but cascade completion rates during and after pregnancy are low. Methods. A cross-sectional survey was performed across 26 communities in Cameroon, Cote d'Ivoire, South Africa, and Zambia. Women who reported a pregnancy within two years were enrolled. Participant responses were used to construct the PMTCT cascade with all of the following steps required for completion: at least one antenatal visit, HIV testing performed, HIV testing result received, initiation of maternal prophylaxis, and initiation of infant prophylaxis. Factors associated with cascade completion were identified using multivariable logistic regression modeling. Results. Of 976 HIV-infected women, only 355 (36.4%) completed the PMTCT cascade. Although most women (69.2%) did not know their partner's HIV status; awareness of partner HIV status was associated with cascade completion (aOR 1.4, 95% CI 1.01-2.0). Completion was also associated with receiving an HIV diagnosis prior to pregnancy compared with HIV diagnosis during or after pregnancy (aOR 14.1, 95% CI 5.2-38.6). Conclusions. Pregnant women with HIV infection in Africa who were aware of their partner's HIV status and who were diagnosed with HIV before pregnancy were more likely to complete the PMTCT cascade.

Factors Associated with PMTCT Cascade Completion in Four African Countries

PubMed Central

Welty, Thomas K.; Westfall, Andrew O.; Chi, Benjamin H.; Ekouevi, Didier Koumavi; Tih, Pius M.; Tita, Alan T. N.

2016-01-01

Background. Many countries are working to reduce or eliminate mother-to-child transmission (MTCT) of HIV. Prevention efforts have been conceptualized as steps in a cascade but cascade completion rates during and after pregnancy are low. Methods. A cross-sectional survey was performed across 26 communities in Cameroon, Cote d'Ivoire, South Africa, and Zambia. Women who reported a pregnancy within two years were enrolled. Participant responses were used to construct the PMTCT cascade with all of the following steps required for completion: at least one antenatal visit, HIV testing performed, HIV testing result received, initiation of maternal prophylaxis, and initiation of infant prophylaxis. Factors associated with cascade completion were identified using multivariable logistic regression modeling. Results. Of 976 HIV-infected women, only 355 (36.4%) completed the PMTCT cascade. Although most women (69.2%) did not know their partner's HIV status; awareness of partner HIV status was associated with cascade completion (aOR 1.4, 95% CI 1.01–2.0). Completion was also associated with receiving an HIV diagnosis prior to pregnancy compared with HIV diagnosis during or after pregnancy (aOR 14.1, 95% CI 5.2–38.6). Conclusions. Pregnant women with HIV infection in Africa who were aware of their partner's HIV status and who were diagnosed with HIV before pregnancy were more likely to complete the PMTCT cascade. PMID:27872760

Effect of socioeconomic status disparity on child language and neural outcome: how early is early?

PubMed

Hurt, Hallam; Betancourt, Laura M

2016-01-01

It is not news that poverty adversely affects child outcome. The literature is replete with reports of deleterious effects on developmental outcome, cognitive function, and school performance in children and youth. Causative factors include poor nutrition, exposure to toxins, inadequate parenting, lack of cognitive stimulation, unstable social support, genetics, and toxic environments. Less is known regarding how early in life adverse effects may be detected. This review proposes to elucidate "how early is early" through discussion of seminal articles related to the effect of socioeconomic status on language outcome and a discussion of the emerging literature on effects of socioeconomic status disparity on brain structure in very young children. Given the young ages at which such outcomes are detected, the critical need for early targeted interventions for our youngest is underscored. Further, the fiscal reasonableness of initiating quality interventions supports these initiatives. As early life adversity produces lasting and deleterious effects on developmental outcome and brain structure, increased focus on programs and policies directed to reducing the impact of socioeconomic disparities is essential.

Outcome and prognostic factors in patients with brain metastases from small-cell lung cancer treated with whole brain radiotherapy.

PubMed

Bernhardt, Denise; Adeberg, Sebastian; Bozorgmehr, Farastuk; Opfermann, Nils; Hoerner-Rieber, Juliane; König, Laila; Kappes, Jutta; Thomas, Michael; Herth, Felix; Heußel, Claus Peter; Warth, Arne; Debus, Jürgen; Steins, Martin; Rieken, Stefan

2017-08-01

The purpose of this study was to evaluate prognostic factors associated with overall survival (OS) and neurological progression free survival (nPFS) in small-cell lung cancer (SCLC) patients with brain metastases who received whole-brain radiotherapy (WBRT). From 2003 to 2015, 229 SCLC patients diagnosed with brain metastases who received WBRT were analyzed retrospectively. In this cohort 219 patients (95%) received a total photon dose of 30 Gy in 10 fractions. The prognostic factors evaluated for OS and nPFS were: age, Karnofsky Performance Status (KPS), number of brain metastases, synchronous versus metachronous disease, initial response to chemotherapy, the Radiation Therapy Oncology Group recursive partitioning analysis (RPA) class and thoracic radiation. Median OS after WBRT was 6 months and the median nPFS after WBRT was 11 months. Patients with synchronous cerebral metastases had a significantly better median OS with 8 months compared to patients with metachronous metastases with a median survival of 3 months (p < 0.0001; HR 0.46; 95% CI 0.31-0.67). Based on RPA classification median survival after WBRT was 17 months in RPA class I, 7 months in class II and 3 months in class III (p < 0.0001). Karnofsky performance status scale (KPS < 70%) was significantly associated with OS in both univariate (HR 2.84; p < 0.001) and multivariate analyses (HR 2.56; p = 0.011). Further, metachronous brain metastases (HR 1.8; p < 0.001), initial response to first-line chemotherapy (HR 0.51, p < 0.001) and RPA class III (HR 2.74; p < 0.001) were significantly associated with OS in univariate analysis. In multivariate analysis metachronous disease (HR 1.89; p < 0.001) and initial response to chemotherapy (HR 0.61; p < 0.001) were further identified as significant prognostic factors. NPFS was negatively significantly influenced by poor KPS (HR 2.56; p = 0.011), higher number of brain metastases (HR 1.97; p = 0.02), and higher RPA class (HR 2.26; p = 0.03) in univariate analysis. In this series, the main prognostic factors associated with OS were performance status, time of appearance of intracranial disease (synchronous vs. metachronous), initial response to chemotherapy and higher RPA class. NPFS was negatively influenced by poor KPS, multiplicity of brain metastases, and higher RPA class in univariate analysis. For patients with low performance status, metachronous disease or RPA class III, WBRT should be weighed against supportive therapy with steroids alone or palliative chemotherapy.

Changes in physical functioning in the Active Living Every Day program of the Active for Life Initiative®.

PubMed

Baruth, Meghan; Wilcox, Sara; Wegley, Stacy; Buchner, David M; Ory, Marcia G; Phillips, Alisa; Schwamberger, Karen; Bazzarre, Terry L

2011-09-01

Physical activity can prevent or delay the onset of physical functional limitations in older adults. There are limited data that evidence-based physical activity interventions can be successfully translated into community programs and result in similar benefits for physical functioning. The purpose of this study is to measure the effects of the Active Living Every Day program on physical functioning and physical functional limitations in a diverse sample of older adults. As a part of the Active for Life initiative, the Council on Aging of Southwestern Ohio implemented Active Living Every Day (ALED), a group-based lifestyle behavior change program designed to increase physical activity. Performance-based physical functioning tests (30-s Chair Stand Test, eight Foot Up-and-Go Test, Chair Sit-and-Reach Test, 30-Foot Walk Test) were administered to participants at baseline and posttest. Baseline to post-program changes in physical functioning and impairment status were examined with repeated measures analysis of covariance. Interactions tested whether change over time differed according to race/ethnicity, body mass index (BMI), and baseline impairment status. Participants significantly increased their performance in all four physical functioning tests. The percentage of participants classified as "impaired" according to normative data significantly decreased over time. Physical functioning improved regardless of BMI, race/ethnicity, or baseline impairment status. ALED is an example of an evidenced-based physical activity program that can be successfully translated into community programs and result in significant and clinically meaningful improvements in performance-based measures of physical functioning.

Parent's social status and children's nutrition influence on the university entrance of young adults in the last two decades in Brazil.

PubMed

Baraldi, Larissa Galastri; Conde, Wolney Lisboa

2014-01-01

The analysis of social indicators and health status of parents and children is a preferred way to estimate the potential for social mobility in different societies or different periods in the same society. To analyze the evolution of educational and nutritional status of the Brazilian families by an intergenerational approach. A representative sample of the Brazilian population, consisting of parents (35 to 65 years old) and young adults (20 to 24 years old) obtained from three national surveys NHNS (1989), HBS (2003 and 2009). We performed a descriptive analysis and, for the sons, we calculated the probability of starting college using the multilevel logistic regression with random intercept model. The advance of the nutritional status of young people was statistically higher than to their parents (p < 0.005). Social conditions experienced in childhood and family status had great influence on their later school success. These data indicate improvements in social status controlled by the nutritional status, initiated in the period of 1989-2003. Although inequality persists in the country, the family's influence declined in the period 2003-2009.

Differences in breast-feeding initiation and continuation by maternal diabetes status.

PubMed

Oza-Frank, Reena; Chertok, Ilana; Bartley, Adam

2015-03-01

To examine (i) the prevalence of and associations between breast-feeding initiation and continuation by maternal diabetes status and (ii) the reasons for not initiating and/or continuing breast-feeding by maternal diabetes status. Secondary data analyses of a population-based cross-sectional study were conducting using data from the US Centers for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System (PRAMS), 2009-2011. Multivariable logistic regression was used to investigate the associations between breast-feeding initiation and continuation by diabetes status. Thirty states and New York City, USA. Mothers of recently live-born infants, selected by birth certificate sampling. Among 72755 women, 8.8 % had gestational diabetes mellitus (GDM) and 1.7 % had pregestational diabetes mellitus (PDM). Breast-feeding initiation was similar among GDM and no diabetes mellitus (NDM) women (80.8 % v. 82.2 %, respectively, P=0.2), but continuation was lower among GDM (65.7 % v. 68.8 %, respectively, P=0.01). PDM women had lower initiation and continuation compared with NDM (78.2 %, P=0.03 and 60.4 %, P<0.01, respectively). In adjusted analyses, current smoking status was a significant effect modifier for initiation, but not for continuation. Differences in breast-feeding initiation and continuation prevalence by maternal diabetes status may reflect differences in prenatal education, indicating the need for increased efforts among PDM women. Additionally, non-smoking women with PDM or GDM would benefit from additional breast-feeding education.

SUPREM-DSMC: A New Scalable, Parallel, Reacting, Multidimensional Direct Simulation Monte Carlo Flow Code

NASA Technical Reports Server (NTRS)

Campbell, David; Wysong, Ingrid; Kaplan, Carolyn; Mott, David; Wadsworth, Dean; VanGilder, Douglas

2000-01-01

An AFRL/NRL team has recently been selected to develop a scalable, parallel, reacting, multidimensional (SUPREM) Direct Simulation Monte Carlo (DSMC) code for the DoD user community under the High Performance Computing Modernization Office (HPCMO) Common High Performance Computing Software Support Initiative (CHSSI). This paper will introduce the JANNAF Exhaust Plume community to this three-year development effort and present the overall goals, schedule, and current status of this new code.

Effect of educational status on performance of older adults in digital cognitive tasks: A systematic review.

PubMed

de Carvalho, Lucas Pelegrini Nogueira; Monteiro, Diana Quirino; Orlandi, Fabiana de Souza; Zazzetta, Marisa Silvana; Pavarini, Sofia Cristina Iost

2017-01-01

As people age, cognitive abilities may decline resulting in serious disabilities. Neuropsychological instruments can provide information on the cognitive state of older adults. Researchers worldwide have been using digital cognitive tests to assess cognitive domains. To determine whether educational status affects the performance of older adults on digital cognitive tasks. A systematic review of articles in English, Portuguese, or Spanish published in the last 5 years was conducted. The databases searched were SCOPUS, PubMed, Lilacs, Scielo and PsychInfo. The PRISMA method was used. A total of 7,089 articles were initially retrieved. After search and exclusion with justification, seven articles were selected for further review. The findings revealed that researchers using digital tasks generally employed paper-based tests to compare results. Also, no association between years of education and test performance was found. Finally, a dearth of studies using digital tests published by Brazilian researchers was evident.

Fluorescence spectroscopy for assessment of liver transplantation grafts concerning graft viability and patient survival

NASA Astrophysics Data System (ADS)

Vollet Filho, José D.; da Silveira, Marina R.; Castro-e-Silva, Orlando; Bagnato, Vanderlei S.; Kurachi, Cristina

2015-06-01

Evaluating transplantation grafts at harvest is essential for its success. Laser-induced fluorescence spectroscopy (LIFS) can help monitoring changes in metabolic/structural conditions of tissue during transplantation. The aim of the present study is to correlate LIFSobtained spectra of human hepatic grafts during liver transplantation with post-operative patients' mortality rate and biochemical parameters, establishing a method to exclude nonviable grafts before implantation. Orthotopic liver transplantation, piggyback technique was performed in 15 patients. LIFS was performed under 408nm excitation. Collection was performed immediately after opening donor's abdominal cavity, after cold perfusion, end of back-table period, and 5 min and 1 h after warm perfusion at recipient. Fluorescence information was compared to lactate, creatinine, bilirubin and INR levels and to survival status. LIFS was sensitive to liver changes during transplantation stages. Study-in-progress; initial results indicate correlation between fluorescence and life/death status of patients.

Factors influencing the distribution of metastases and survival in metastatic breast carcinoma.

PubMed

Barişta, I; Baltali, E; Güllü, I H; Güler, N; Celik, I; Saraçbaşi, O; Tekuzman, G; Kars, A; Ozişik, Y; Ruacan, S; Atahan, I L; Firat, D

1996-12-01

A total of 370 patients with metastatic breast, carcinoma who had been followed at Hacettepe Oncology Department between 1980 and 1991 were retrospectively analyzed for the factors influencing the distribution of metastases and survival. Median age was 47 years. Radical or modified radical mastectomies were performed in 199 (53.8%). Infiltrative ductal carcinoma was the most common pathologic subtype (69.4%). In 191 patients who were evaluated for estrogen receptor (ER) status, 101 (52.9%) were positive and 90 (47.1%) were negative. The distribution of first metastases did not differ between the soft tissue, bone, and visceral sites. The second, third, and fourth metastases were more common in visceral sites (p < 0.05). ER and menopausal status did not affect distribution. Mortality rate was significantly lower in the group having the first metastasis to the bone (p < 0.05). Of interest, first metastases were predominantly found in visceral sites in patients having radical or modified radical mastectomies (p < 0.05). Response to therapy, presence of initial metastases, axillary status, and age were the important factors influencing the overall survival in univariate analysis, whereas response to therapy, ER status, age, and presence of initial metastases were the important factors according to the multivariate analysis.

Towards acute pediatric status epilepticus intervention teams: Do we need "Seizure Codes"?

PubMed

Stredny, Coral M; Abend, Nicholas S; Loddenkemper, Tobias

2018-05-01

To identify areas of treatment delay and barriers to care in pediatric status epilepticus, review ongoing quality improvement initiatives, and provide suggestions for further innovations to improve and standardize these patient care processes. Narrative review of current status epilepticus management algorithms, anti-seizure medication administration and outcomes associated with delays, and initiatives to improve time to treatment. Articles reviewing or reporting quality improvement initiatives were identified through a PubMed search with keywords "status epilepticus," "quality improvement," "guideline adherence," and/or "protocol;" references of included articles were also reviewed. Rapid initiation and escalation of status epilepticus treatment has been associated with shortened seizure duration and more favorable outcomes. Current evidence-based guidelines for management of status epilepticus propose medication algorithms with suggested times for each management step. However, time to antiseizure medication administration for pediatric status epilepticus remains delayed in both the pre- and in-hospital settings. Barriers to timely treatment include suboptimal preventive care, inaccurate seizure detection, infrequent or restricted use of home rescue medications by caregivers and pre-hospital emergency personnel, delayed summoning and arrival of emergency personnel, and use of inappropriately dosed medications. Ongoing quality improvement initiatives in the pre- and in-hospital settings targeting these barriers are reviewed. Improved preventive care, seizure detection, and rescue medication education may advance pre-hospital management, and we propose the use of acute status epilepticus intervention teams to initiate and incorporate in-hospital interventions as time-sensitive "Seizure Code" emergencies. Copyright © 2018 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Status of the assessment phase of the ESA M3 mission candidate LOFT

NASA Astrophysics Data System (ADS)

Corral van Damme, Carlos; Ayre, Mark; Lumb, David; Short, Alexander D.; Rando, Nicola

2012-09-01

LOFT (Large Observatory For x-ray Timing) is one of four candidates for the M3 slot (launch in 2024, with the option of a launch in 2022) of ESAs Cosmic Vision 2015 - 2025 Plan, and as such it is currently undergoing an initial assessment phase lasting one year. The objective of the assessment phase is to provide the information required to enable the down selection process, in particular: the space segment definition for meeting the assigned science objectives; consideration of and initial definition of the implementation schedule; an estimate of the mission Cost at Completion (CaC); an evaluation of the technology readiness evaluation and risk assessment. The assessment phase is divided into two interleaved components: (i) A payload assessment study, performed by teams funded by member states, which is primarily intended for design, definition and programmatic/cost evaluation of the payload, and (ii) A system industrial study, which has essentially the same objectives for the space segment of the mission. This paper provides an overview of the status of the LOFT assessment phase, both for payload and platform. The initial focus is on the payload design status, providing the reader with an understanding of the main features of the design. Then the space segment assessment study status is presented, with an overview of the principal challenges presented by the LOFT payload and mission requirements, and a presentation of the expected solutions. Overall the mission is expected to enable cutting-edge science, is technically feasible, and should remain within the required CaC for an M3 candidate.

Demonstration program for Omega receiver prototype microcomputer data processing

NASA Technical Reports Server (NTRS)

Lilley, R. W.

1976-01-01

The JOLT (TM) commercial microcomputer, based on the MOS Technology 6502 processor chip, for use in Omega navigation system is evaluated. A computer program was prepared in hand-assembled code to demonstrate receiver operation. The processor provides binary processing with interrupts enabled, a carriage return is given to initialize the teleprinter, and a jump is performed to enter the program loop to wait for an interrupt. The program loop operates continuously testing the interrupt flag. The interrupt routine reads the receiver status word and determines whether the current time-slot is the A slot. If so, the interrupt flag, which is also the data index pointer, is reset to zero. The status word is stored in the status buffer. If the time-slot is not A, the interrupt flag/pointer is incremented by one to index the phase and status to the proper buffer words for later use by the print routine.

13 CFR 124.1006 - Can SBA initiate a review of the SDB status of a firm claiming to be an SDB?

Code of Federal Regulations, 2013 CFR

2013-01-01

... SDB status of a firm claiming to be an SDB? 124.1006 Section 124.1006 Business Credit and Assistance... § 124.1006 Can SBA initiate a review of the SDB status of a firm claiming to be an SDB? SBA may initiate an SDB determination on any firm that has been certified to be an SDB by a procuring agency or that...

13 CFR 124.1006 - Can SBA initiate a review of the SDB status of a firm claiming to be an SDB?

Code of Federal Regulations, 2012 CFR

2012-01-01

... SDB status of a firm claiming to be an SDB? 124.1006 Section 124.1006 Business Credit and Assistance... § 124.1006 Can SBA initiate a review of the SDB status of a firm claiming to be an SDB? SBA may initiate an SDB determination on any firm that has been certified to be an SDB by a procuring agency or that...

13 CFR 124.1006 - Can SBA initiate a review of the SDB status of a firm claiming to be an SDB?

Code of Federal Regulations, 2011 CFR

2011-01-01

... SDB status of a firm claiming to be an SDB? 124.1006 Section 124.1006 Business Credit and Assistance... § 124.1006 Can SBA initiate a review of the SDB status of a firm claiming to be an SDB? SBA may initiate an SDB determination on any firm that has been certified to be an SDB by a procuring agency or that...

13 CFR 124.1006 - Can SBA initiate a review of the SDB status of a firm claiming to be an SDB?

Code of Federal Regulations, 2010 CFR

2010-01-01

... SDB status of a firm claiming to be an SDB? 124.1006 Section 124.1006 Business Credit and Assistance... § 124.1006 Can SBA initiate a review of the SDB status of a firm claiming to be an SDB? SBA may initiate an SDB determination on any firm that has been certified to be an SDB by a procuring agency or that...

13 CFR 124.1006 - Can SBA initiate a review of the SDB status of a firm claiming to be an SDB?

Code of Federal Regulations, 2014 CFR

2014-01-01

... SDB status of a firm claiming to be an SDB? 124.1006 Section 124.1006 Business Credit and Assistance... § 124.1006 Can SBA initiate a review of the SDB status of a firm claiming to be an SDB? SBA may initiate an SDB determination on any firm that has been certified to be an SDB by a procuring agency or that...

Status of the NASA Balloon Program

NASA Astrophysics Data System (ADS)

Needleman, H. C.; Nock, R. S.; Bawcom, D. W.

1993-02-01

In the early 1980's the U.S. National Aeronautics and Space Administration (NASA) Balloon Program was faced with a problem of catastrophic balloon failures. In 1986 a balloon recovery program was initiated. This program included qualification of new balloon films, and investigations into materials, processing, structures and performance of balloons. This recovery program has been very successful. To date, more than 100 balloons manufactured of newly developed films have been flown with unprecedented success. There has been much progress made across the spectrum of balloon related disciplines. A new design philosophy has been developed and is being used for all NASA balloons. An updated balloon reliability and quality assurance program is in effect. The long duration balloon development project has been initiated with the first flight test having been conducted in December 1989 from Antarctica. A comprehensive research and development (R&D) effort has been initiated and is progressing well. The progress, status and future plans for these and other aspects of the NASA program, along with a description of the comprehensive balloon R&D activity, will be presented.

An initial evaluation of newly proposed biomarker of zinc status in humans - linoleic acid: dihomo-γ-linolenic acid (LA:DGLA) ratio.

PubMed

Knez, Marija; Stangoulis, James C R; Zec, Manja; Debeljak-Martacic, Jasmina; Pavlovic, Zoran; Gurinovic, Mirjana; Glibetic, Maria

2016-10-01

Zinc is an essential micronutrient for humans with important physiological functions. A sensitive and specific biomarker for assessing Zn status is still needed. The major aim of this study was to examine if the changes in the content of plasma phospholipid LA, DGLA and LA: DGLA ratio can be used to efficiently predict the dietary Zn intake and plasma Zn status of humans. The study was performed on healthy human volunteers, 25-55 years of age. The dietary Zn intake was assessed using 24 h recall questionnaires. Plasma phospholipid fatty acid analysis was done by gas chromatography, and plasma analysis of minerals by atomic absorption spectrometry. Biochemical, anthropometrical and hematological parameters were assessed. No significant relationship was found between the dietary and plasma zinc status (r = 0.07; p = 0.6). There was a statistically significant correlation between DGLA and plasma Zn (r = 0.39, p = 0.00). No relationship was observed between the linoleic acid and plasma Zn, while there was a significant negative correlation between LA: DGLA ratio and plasma Zn status (r = -0.35, p = 0.01). Similarly, there were statistically significant difference in DGLA status (p = 0.004) and LA: DGLA ratio (p = 0.042) between the Zn formed groups. This study is an initial step in evaluating LA: DGLA ratio as a biomarker of Zn status in humans. The results are encouraging as they show that concentration of DGLA is decreased and LA: DGLA ratio increased in people with lower dietary Zn intake. However, additional studies are needed to fully examine the sensitivity of this biomarker. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Initiator Status and the Divorce Transition.

ERIC Educational Resources Information Center

Buehler, Cheryl

1987-01-01

Examined effect of initiator status on well-being and stress in 80 divorced parents at 6 to 12 (T1) and 18 to 24 (T2) months after the divorce. Found that initiators and noninitiators shared similar emotional responses to divorce but that initiators reported more change, stress, and personal growth at (T1), while noninitiators reported higher…

Status of the NOAO evaluation of the Hughes 20x64 Si:As impurity band conduction array. [for ground and space-based astronomy

NASA Technical Reports Server (NTRS)

Fowler, A. M.; Joyce, R. R.

1990-01-01

The Hughes 20 x 64 Si:As impurity band conduction arrays designed for ground-based and spaceborne astronomy observations is described together with experiments performed at NOAO to test these arrays. Special attention is given to the design and the characteristics of the test system and to the test methods. The initial tests on two columns of one array indicate that the array is easy to operate and performed satisfactorily.

[Support Team for Investigator-Initiated Clinical Research].

PubMed

Fujii, Hisako

2017-07-01

Investigator-initiated clinical research is that in which investigators plan and carry out their own clinical research in academia. For large-scale clinical research, a team should be organized and implemented. This team should include investigators and supporting staff, who will promote smooth research performance by fulfilling their respective roles. The supporting staff should include project managers, administrative personnel, billing personnel, data managers, and clinical research coordinators. In this article, I will present the current status of clinical research support and introduce the research organization of the Dominantly Inherited Alzheimer Network (DIAN) study, an investigator-initiated international clinical research study, with particular emphasis on the role of the project management staff and clinical research coordinators.

Longitudinal study of objective and subjective cognitive performance and psychological distress in OEF/OIF Veterans with and without traumatic brain injury.

PubMed

Donnelly, Kerry; Donnelly, James P; Warner, Gary C; Kittleson, C James; King, Paul R

2018-04-01

To describe changes in post-deployment objective and subjective cognitive performance in combat Veterans over 18 months, relative to traumatic brain injury (TBI) status and psychological distress. This prospective cohort study examined 500 Veterans from Upstate New York at four time points, six months apart. TBI status was determined by a structured clinical interview. Neuropsychological instruments focused on attention, memory, and executive functions. Subjective cognitive complaints were assessed with the Neurobehavioral Symptom Inventory (NSI). A psychological distress composite included measures of post-traumatic stress disorder (PTSD), depression, and generalized anxiety. Forty-four percent of the sample was found to have sustained military-related TBI, 97% of which were classified as mild (mTBI), with a mean time since injury of 41 months. Veterans with TBI endorsed moderate cognitive symptoms on the NSI. In contrast to these subjective complaints, mean cognitive test performance was within normal limits at each time point in all domains, regardless of TBI status. Multilevel models examined effects of TBI status, time, and psychological distress. Psychological distress was a strong predictor of all cognitive domains, especially the subjective domain. Substantial proportions of both TBI+ and TBI- groups remained in the clinically significant range at the initial and final assessment for all three distress measures, but the TBI+ group had higher proportions of clinically significant cases. Objective cognitive performance was generally within normal limits for Veterans with mTBI across all assessments. Psychological distress was elevated and significantly related to both objective and subjective cognitive performance.

Tailored instructor feedback leads to more effective virtual-reality laparoscopic training.

PubMed

Paschold, M; Huber, T; Zeißig, S R; Lang, H; Kneist, Werner

2014-03-01

Laparoscopic novices begin at different performance levels, and studies on tailored training concepts are warranted. The effect of verbal instructor feedback has been investigated with varying results, and its effectiveness in virtual-reality laparoscopic (VRL) simulations still is unclear. This study aimed to determine whether laparoscopic novices with lower initial performance statuses may profit from training with intensive instructor feedback. A prospective, single-blinded study was performed within a week-long curricular course. In this study, 20 medical students performed a complex bimanual maneuver on a VRL simulator. There was a division in performance levels, with a high-performer group (HPG) that received a better median score and a low-performer group (LPG). During the training phase, only the initial LPG received standardized instructor feedback in a one-to-one setting. The final assessment of skills for both groups involved performing the task without feedback at the end of the course. The HPG and LPG showed significantly different initial performance levels according global and categorized (time, economics, error) scores (p < 0.005). This difference disappeared quickly throughout the instructor feedback phase. The final assessment demonstrated that both groups were at the same level of performance. This is the first study to use a tailored training concept with instructor feedback limited to the LPG. The tailored training was effective and economic for the laparoscopic novices and their teachers.

A descriptive analysis of change in eligibility status for the USDA Forest Service Economic Recovery Program

Treesearch

Krista M. Gebert; Susan L. Odell

2007-01-01

This report summarizes the results of a 2004 analysis of county-level eligibility for financial and technical assistance through the USDA Forest Service Economic Recovery program and contrasts those results to the initial eligibility analysis performed in 1993. County-level eligibility was based on three criteria: (1) proximity to a National Forest or National...

40 CFR 63.8480 - What notifications must I submit and when?

Code of Federal Regulations, 2010 CFR

2010-07-01

... start up your affected source before May 16, 2003, you must submit an Initial Notification not later than 120 calendar days after May 16, 2003. (c) As specified in § 63.9(b)(3), if you start up your new... Status, including the performance test results, before the close of business on the 60th calendar day...

EOS Aura MLS, first year post-launch engineering assessment

NASA Technical Reports Server (NTRS)

Lee, Karen A.; Lay, Richard R.; Jarnot, Robert F.; Cofield, Richard E.; Flower, Dennis A.; Pickett, Herbert M.

2005-01-01

This paper discusses the current status of the MLS instrument which now continuously provides data to produce global maps of targeted chemical species as well as temperature, cloud ice, and gravity wave activity. Performance trends are assessed with respect to characterization during initial on-orbit activiation of the instrument, and with data from ground test verification prior to launch.

The Educational Technology Centre: A Window to View the Progress of Chinese ICT-Based Higher Education

ERIC Educational Resources Information Center

Zhou, Rong; Xie, Baizhi

2010-01-01

In China, after many years, the current status and challenges of e-learning development in higher education have been gradually understood. The educational technology centre (ECT) serves as the key unit to promote e-learning initiatives, but the performance of some centres still trails their foreign counterparts. Under such conditions, the project…

Dramatic intracranial response to osimertinib in a poor performance status patient with lung adenocarcinoma harboring the epidermal growth factor receptor T790M mutation: A case report.

PubMed

Uemura, Takehiro; Oguri, Tetsuya; Okayama, Minami; Furuta, Hiromi; Kanemitsu, Yoshihiro; Takakuwa, Osamu; Ohkubo, Hirotsugu; Takemura, Masaya; Maeno, Ken; Ito, Yutaka; Niimi, Akio

2017-04-01

We herein report a case of dramatic intracranial response to osimertinib in a poor performance status patient with lung adenocarcinoma harboring the epidermal growth factor receptor ( EGFR ) T790M mutation encoded in exon 20. The patient was a 59-year-old woman with EGFR exon 19 deletion-positive lung adenocarcinoma, who relapsed with multiple brain metastases. Computed tomography-guided biopsy of the left pleural tumor revealed adenocarcinoma harboring an EGFR exon 19 deletion and an EGFR T790M mutation encoded in exon 20. The patient was treated with osimertinib, a third-generation EGFR tyrosine kinase inhibitor. Two days after treatment initiation, the patient displayed profound disturbance of consciousness, possibly due to carcinomatous meningitis, and treatment had to be discontinued due to difficulty in taking osimertinib. However, the patient gradually started to recover consciousness and, after 3 days, she was again able to take osimertinib. One month after the initiation of osimertinib treatment, magnetic resonance imaging revealed an apparent reduction in brain metastases. The patient is currently under continued treatment with osimertinib. At the last follow-up (February, 2017) she exhibited partial response to the treatment.

Lasting effect of an oral hygiene care program for patients with stroke during in-hospital rehabilitation: a randomized single-center clinical trial.

PubMed

Kim, Eun-Kyong; Park, Eun Young; Sa Gong, Jung-Whan; Jang, Sung-Ho; Choi, Youn-Hee; Lee, Hee-Kyung

2017-11-01

Because the oral hygiene is poorly prioritized in the immediate post-stroke period, we implemented an oral hygiene care program (OHCP) for stroke in-patients and evaluated its persistence after discharge. In all, 62 patients with stroke who were admitted to the rehabilitation ward were randomly assigned to two groups: 33 patients to the intervention group and 29 to the control group. The OHCP, including tooth brushing education and professional tooth cleaning, was administered to the intervention group twice a week six times during in-hospital rehabilitation. Oral health status was examined both at baseline and three months after discharge from the hospital. Oral hygiene status was examined at three- to four-day intervals five times during the hospitalization period. After OHCP, oral hygiene status including the plaque index, calculus index, and O'Leary plaque index improved significantly in the intervention group, compared to the control group (p < 0.05). In the intervention group, after administration of the OHCP for the fourth time, the O'Leary index improved significantly, and remained high when checked three months after discharge (p < 0.001). An OHCP conducted during in-hospital rehabilitation was effective in improving oral health and plaque control performance among patients with stroke, with effects still seen three months after discharge from the hospital. Implications for Rehabilitation Initial oral hygiene status and plaque control performance were poor in stroke patients who were in rehabilitation center. An oral hygiene care program during in-hospital rehabilitation was effective in improving oral hygiene status and plaque control performance among stroke patients at three months after discharge. Repeated tooth brushing education and professional tooth cleaning were necessary to improve plaque control performance of stroke patients.

37 CFR 11.29 - Reciprocal transfer or initial transfer to disability inactive status.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 37 Patents, Trademarks, and Copyrights 1 2013-07-01 2013-07-01 false Reciprocal transfer or initial transfer to disability inactive status. 11.29 Section 11.29 Patents, Trademarks, and Copyrights..., Sanctions, Investigations, and Proceedings § 11.29 Reciprocal transfer or initial transfer to disability...

37 CFR 11.29 - Reciprocal transfer or initial transfer to disability inactive status.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 37 Patents, Trademarks, and Copyrights 1 2014-07-01 2014-07-01 false Reciprocal transfer or initial transfer to disability inactive status. 11.29 Section 11.29 Patents, Trademarks, and Copyrights..., Sanctions, Investigations, and Proceedings § 11.29 Reciprocal transfer or initial transfer to disability...

37 CFR 11.29 - Reciprocal transfer or initial transfer to disability inactive status.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Reciprocal transfer or initial transfer to disability inactive status. 11.29 Section 11.29 Patents, Trademarks, and Copyrights..., Sanctions, Investigations, and Proceedings § 11.29 Reciprocal transfer or initial transfer to disability...

37 CFR 11.29 - Reciprocal transfer or initial transfer to disability inactive status.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 37 Patents, Trademarks, and Copyrights 1 2012-07-01 2012-07-01 false Reciprocal transfer or initial transfer to disability inactive status. 11.29 Section 11.29 Patents, Trademarks, and Copyrights..., Sanctions, Investigations, and Proceedings § 11.29 Reciprocal transfer or initial transfer to disability...

Prospective quality initiative to maximize dysphagia screening reduces hospital-acquired pneumonia prevalence in patients with stroke.

PubMed

Titsworth, W Lee; Abram, Justine; Fullerton, Amy; Hester, Jeannette; Guin, Peggy; Waters, Michael F; Mocco, J

2013-11-01

Dysphagia can lead to pneumonia and subsequent death after acute stroke. However, no prospective study has demonstrated reduced pneumonia prevalence after implementation of a dysphagia screen. We performed a single-center prospective interrupted time series trial of a quality initiative to improve dysphagia screening. Subjects included all patients with ischemic or hemorrhagic stroke admitted to our institution over 42 months with a 31-month (n=1686) preintervention and an 11-month (n=648) postintervention period. The intervention consisted of a dysphagia protocol with a nurse-administered bedside dysphagia screen and a reflexive rapid clinical swallow evaluation by a speech pathologist. The dysphagia initiative increased the percentage of patients with stroke screened from 39.3% to 74.2% (P<0.001). Furthermore, this initiative coincided with a drop in hospital-acquired pneumonia from 6.5% to 2.8% among patients with stroke (P<0.001). Patients admitted postinitiative had 57% lower odds of pneumonia, after controlling for multiple confounds (odds ratio=0.43; confidence interval, 0.255-0.711; P=0.0011). The best predictors of pneumonia were stroke type (P<0.0001), oral intake status (P<0.0001), dysphagia screening status (P=0.0037), and hospitalization before the beginning of the quality improvement initiative (P=0.0449). A quality improvement initiative using a nurse-administered bedside screen with rapid bedside swallow evaluation by a speech pathologist improves screening compliance and correlates with decreased prevalence of pneumonia among patients with stroke.

Pilot Performance With Predictive System Status Information

NASA Technical Reports Server (NTRS)

Trujillo, Anna C.

1997-01-01

Research has shown a strong pilot preference for predictive information of aircraft system status in the flight deck. However, the benefits of predictive information have not been quantitatively demonstrated. The study described here attempted to identify and quantify these benefits if they existed. In this simulator experiment, three types of predictive information (none, whether a parameter was changing abnormally, and the time for a parameter to reach an alert range) and four initial times to an alert (1 minute, 5 minutes, 15 minutes, and ETA+ 45 minutes) were found to affect when subjects accomplished certain actions, such as accessing pertinent checklists, declaring emergencies, diverting, and calling the flight attendant and dispatch.

Assessing Advanced Airway Management Performance in a National Cohort of Emergency Medical Services Agencies.

PubMed

Wang, Henry E; Donnelly, John P; Barton, Dustin; Jarvis, Jeffrey L

2018-05-01

Although often the focus of quality improvement efforts, emergency medical services (EMS) advanced airway management performance has few national comparisons, nor are there many assessments with benchmarks accounting for differences in agency volume or patient mix. We seek to assess variations in advanced airway management and conventional intubation performance in a national cohort of EMS agencies. We used EMS data from ESO Solutions, a national EMS electronic health record system. We identified EMS emergency responses with attempted advanced airway management (conventional intubation, rapid sequence intubation, sedation-assisted intubation, supraglottic airway insertion, and cricothyroidotomy). We also separately examined cases with initial conventional intubation. We determined EMS agency risk-standardized advanced airway management and initial conventional intubation success rates by using mixed-effects regression models, fitting agency as a random intercept, adjusting for patient age, sex, race, cardiac arrest, or trauma status, and use of rapid sequence or sedation-assisted intubation, and accounting for reliability variations from EMS agency airway volume. We assessed changes in agency advanced airway management and initial conventional intubation performance rank after risk and reliability adjustment. We also identified high and low performers (reliability-adjusted and risk-standardized success confidence intervals falling outside the mean). During 2011 to 2015, 550 EMS agencies performed 57,209 advanced airway management procedures. Among 401 EMS agencies with greater than or equal to 10 advanced airway management procedures, there were a total of 56,636 procedures. Median reliability-adjusted and risk-standardized EMS agency advanced airway management success was 92.9% (interquartile range 90.1% to 94.8%; minimum 58.2%; maximum 99.0%). There were 56 advanced airway management low-performing and 38 high-performing EMS agencies. Among 342 agencies with greater than or equal to 10 initial conventional intubations, there were a total of 37,360 initial conventional intubations. Median reliability-adjusted and risk-standardized EMS agency initial conventional intubation success was 77.3% (interquartile range 70.9% to 83.6%; minimum 47.1%; maximum 95.8%). There were 64 initial conventional intubation low-performing and 45 high-performing EMS agencies. In this national series, EMS advanced airway management and initial conventional intubation performance varied widely. Reliability adjustment and risk standardization may influence EMS airway management performance assessments. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Generational status and social factors predicting initiation of partnered sexual activity among Latino/a youth.

PubMed

Cabral, Patricia; Wallander, Jan L; Song, Anna V; Elliott, Marc N; Tortolero, Susan R; Reisner, Sari L; Schuster, Mark A

2017-02-01

Examine the longitudinal association of generational status (first = child and parent born outside the United States; second = child born in the United States, parent born outside the United States; third = child and parent born in the United States) and parent and peer social factors considered in 5th grade with subsequent oral, vaginal, and anal intercourse initiation by 7th and 10th grade among Latino/a youth. Using data from Latino/a participants (N = 1,790) in the Healthy Passages™ study, the authors measured generational status (first = 18.4%, second = 57.3%, third-generation = 24.3%) and parental (i.e., monitoring, involvement, nurturance) and peer (i.e., friendship quality, social interaction, peer norms) influences in 5th grade and oral, vaginal, and anal intercourse initiation by 7th and 10th (retention = 89%) grade. Among girls, parental monitoring, social interaction, friendship quality, and peer norms predicted sexual initiation. Among boys, parental involvement, social interaction, and peer norms predicted sexual initiation (ps < .05). When ≥1 friend was perceived to have initiated sexual intercourse, third-generation Latinas were more than twice as likely as first- and second-generation Latinas (ps < .05) to initiate vaginal intercourse by 10th grade and almost 5 times as likely as first-generation Latinas to initiate oral intercourse by 7th grade. Among Latina youth, generational status plays a role in social influences on vaginal and oral intercourse initiation. Moreover, Latinas and Latinos differ in which social influences predict sexual intercourse initiation. Preventive efforts for Latino/a youth may need to differ by gender and generational status. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Heroes and Holidays: The Status of Diversity Initiatives at Liberal Arts College Libraries

ERIC Educational Resources Information Center

Gilbert, Julie

2016-01-01

Studies about diversity initiatives in academic libraries have primarily focused on large research libraries. But what kinds of diversity work occur at smaller libraries? This study examines the status of diversity initiatives, especially those aimed at students, at national liberal arts college libraries. Results from a survey of library…

Status Cataplecticus as Initial Presentation of Late Onset Narcolepsy

PubMed Central

Panda, Samhita

2014-01-01

Narcolepsy, one of the important causes of hypersomnia, is an under diagnosed sleep disorder. It has a bimodal age of onset around 15 and 35 years. It is characterized by the tetrad of excessive daytime sleepiness, cataplexy, hypnagogic/ hypnopompic hallucinations, and sleep paralysis. Cataplexy is by far the most predictive feature of narcolepsy. Status cataplecticus is the occurrence of cataplexy repeatedly for hours or days, a rare presentation of narcolepsy. This report describes an elderly gentleman with late onset narcolepsy in the sixth decade of life presenting with initial and chief symptom of status cataplecticus. Citation: Panda S. Status cataplecticus as initial presentation of late onset narcolepsy. J Clin Sleep Med 2014;10(2):207-209. PMID:24533005

Education and Cognitive Decline in Older Americans: Results From the AHEAD Sample

PubMed Central

Alley, Dawn; Suthers, Kristen; Crimmins, Eileen

2009-01-01

Although education is consistently related to better cognitive performance, findings on the relationship between education and age-associated cognitive change have been conflicting. Using measures of multiple cognitive domains from four waves of the Asset and Health Dynamics of the Oldest Old study, a representative sample of Americans aged 70 years and older, the authors performed growth curve modeling to examine the relationships between education, initial cognitive score, and the rate of decline in cognitive function. More years of education were linked to better initial performance on each of the cognitive tests, and higher levels of education were linked to slower decline in mental status. However, more education was unrelated to the rate of decline in working memory, and education was associated with somewhat faster cognitive decline on measures of verbal memory. These findings highlight the role of early-life experiences not only in long-term cognitive performance but also in old-age cognitive trajectories. PMID:19830260

Effect of educational status on performance of older adults in digital cognitive tasks: A systematic review

PubMed Central

de Carvalho, Lucas Pelegrini Nogueira; Monteiro, Diana Quirino; Orlandi, Fabiana de Souza; Zazzetta, Marisa Silvana; Pavarini, Sofia Cristina Iost

2017-01-01

As people age, cognitive abilities may decline resulting in serious disabilities. Neuropsychological instruments can provide information on the cognitive state of older adults. Researchers worldwide have been using digital cognitive tests to assess cognitive domains. Objective To determine whether educational status affects the performance of older adults on digital cognitive tasks. Methods A systematic review of articles in English, Portuguese, or Spanish published in the last 5 years was conducted. The databases searched were SCOPUS, PubMed, Lilacs, Scielo and PsychInfo. The PRISMA method was used. Results A total of 7,089 articles were initially retrieved. After search and exclusion with justification, seven articles were selected for further review. Conclusion The findings revealed that researchers using digital tasks generally employed paper-based tests to compare results. Also, no association between years of education and test performance was found. Finally, a dearth of studies using digital tests published by Brazilian researchers was evident. PMID:29213502

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

Summary of semi-initiative and initiative control automobile engine vibration

NASA Astrophysics Data System (ADS)

Qu, Wei; Qu, Zhou

2009-07-01

Engine vibration accounts for around 55% of automobile vibration, separating the engine vibration from transmitting to automobile to the utmost extent is significant for improving NVH performance. Semi-initiative and initiative control of engine vibration is one of the hot spots of technical research in domestic and foreign automobile industry, especially luxury automobiles which adopt this technology to improve amenity and competitiveness. This article refers to a large amount of domestic and foreign related materials, fully introduces the research status of semi-initiative and initiative control suspension of engine vibration suspension and many kinds of structural style, and provides control policy and method of semi-initiative and initiative control suspension system. Compare and analyze the structural style of semi-initiative and initiative control and merits and demerits of current structures of semi-initiative and initiative control of mechanic electrorheological, magnetorheological, electromagnetic actuator, piezoelectric ceramics, electrostriction material, pneumatic actuator etc. Models of power assembly mounting system was classified.Calculation example indicated that reasonable selection of engine mounting system parameters is useful to reduce engine vibration transmission and to increase ride comfort. Finally we brought forward semi-initiative and initiative suspension which might be applied for automobiles, and which has a promising future.

Insulin initiation status of primary care physicians in Turkey, barriers to insulin initiation and knowledge levels about insulin therapy: A multicenter cross-sectional study.

PubMed

Ates, Elif; Set, Turan; Saglam, Zuhal; Tekin, Nil; Karatas Eray, Irep; Yavuz, Erdinc; Sahin, Mustafa Kursat; Selcuk, Engin Burak; Cadirci, Dursun; Cubukcu, Mahcube

2017-10-01

Our aim was to evaluate the insulin initiation status, barriers to insulin initiation and knowledge levels about treatment administered by primary care physicians (PCP). We conducted our study in accordance with a multicenter, cross-sectional design in Turkey, between July 2015 and July 2016. A questionnaire inquiring demographic features, status of insulin initiation, obstacles to insulin initiation and knowledge about therapy of the PCPs was administered during face-to-face interviews. 84 PCPs (19%) (n=446, mean age=41.5±8.4years, 62.9% male and 90.0% ministry certified family physicians) initiated insulin therapy in the past. Most of the stated primary barriers (51.9%, n=230) were due to the physicians. The most relevant barrier was "lack of clinical experience" with a rate of 19% (n=84 of the total). The average total knowledge score was 5.7±2.0 for the family medicine specialist, and 3.8±2.1 for the ministry certified family physicians (p=0.000, maximum knowledge score could be 10). The status of insulin initiation in Turkey by the primary care physicians is inadequate. Medical education programs and health care systems may require restructuring to facilitate insulin initiation in primary care. Copyright © 2017 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Changes in food insecurity, nutritional status, and physical health status after antiretroviral therapy initiation in rural Uganda.

PubMed

Weiser, Sheri D; Gupta, Reshma; Tsai, Alexander C; Frongillo, Edward A; Grede, Nils; Kumbakumba, Elias; Kawuma, Annet; Hunt, Peter W; Martin, Jeffrey N; Bangsberg, David R

2012-10-01

To investigate whether time on antiretroviral therapy (ART) is associated with improvements in food security and nutritional status, and the extent to which associations are mediated by improved physical health status. The Uganda AIDS Rural Treatment Outcomes study, a prospective cohort of HIV-infected adults newly initiating ART in Mbarara, Uganda. Participants initiating ART underwent quarterly structured interview and blood draws. The primary explanatory variable was time on ART, constructed as a set of binary variables for each 3-month period. Outcomes were food insecurity, nutritional status, and PHS. We fit multiple regression models with cluster-correlated robust estimates of variance to account for within-person dependence of observations over time, and analyses were adjusted for clinical and sociodemographic characteristics. Two hundred twenty-eight ART-naive participants were followed for up to 3 years, and 41% were severely food insecure at baseline. The mean food insecurity score progressively declined (test for linear trend P < 0.0001), beginning with the second quarter (b = -1.6; 95% confidence interval: -2.7 to -0.45) and ending with the final quarter (b = -6.4; 95% confidence interval: -10.3 to -2.5). PHS and nutritional status improved in a linear fashion over study follow-up (P < 0.001). Inclusion of PHS in the regression model attenuated the relationship between ART duration and food security. Among HIV-infected individuals in Uganda, food insecurity decreased and nutritional status and PHS improved over time after initiation of ART. Changes in food insecurity were partially explained by improvements in PHS. These data support early initiation of ART in resource-poor settings before decline in functional status to prevent worsening food insecurity and its detrimental effects on HIV treatment outcomes.

Loss to Follow-Up in a Community Clinic in South Africa – Roles of Gender, Pregnancy and CD4 count

PubMed Central

Wang, Bingxia; Losina, Elena; Stark, Ruth; Munro, Alison; Walensky, Rochelle P.; Wilke, Marisa; Martin, Des; Lu, Zhigang; Freedberg, Kenneth A.; Wood, Robin

2013-01-01

Background Faith-based organizations have expanded access to antiretroviral therapy (ART) in community clinics across South Africa. Loss to follow-up (LTFU), however, limits both the potential individual and population treatment benefits and is an obstacle to optimal care. Objective To identify patient characteristics associated with LTFU six months after starting ART in patients in a large South African community clinic. Methods Patients initiating ART between April 2004 and October 2006 in one Catholic Relief Services HIV treatment clinic who had at least one follow-up visit were included in the analysis. Standardized instruments were used for data collection. Routine monitoring was performed every 6 months following ART initiation. Rates of LTFU over time were estimated by the Kaplan-Meier method. The log-rank test was used to examine the impact of age, baseline CD4 count, HIV RNA, gender and pregnancy status for women on LTFU. Cox proportional hazard regression was performed to analyze hazard ratios for LTFU. Results Data from 925 patients (age > 14 years), median age 36 years, 70% female (16% pregnant) were included in the analysis. Fifty one patients (6%) were lost to follow-up six months after ART initiation. When stratified by baseline CD4 count, gender and pregnancy status, pregnant women with lower baseline CD4 count (≤200 /μl) had 6.06 times (95% CI: 2.20 – 16.71) the hazard of LTFU compared to men. Conclusions HIV-infected pregnant women initiating ART are significantly more likely to be lost to follow-up in a community clinic in South Africa. Interventions to successfully retain pregnant women in care are urgently needed. PMID:21786730

2003 status report on transit intelligent vehicle initiative studies

DOT National Transportation Integrated Search

2003-06-01

This 2003 Status Report provides an overview and updates on studies in the transit Intelligent Vehicle Initiative (IVI) area. IVI emphasizes the significant and continuing role of drivers in roadway safety. IVI is aimed at accelerating the developmen...

(U) Status of Trinity and Crossroads Systems

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

Archer, Billy Joe; Lujan, James Westley; Hemmert, K. S.

2017-01-10

(U) This paper provides a general overview of current and future plans for the Advanced Simulation and Computing (ASC) Advanced Technology (AT) systems fielded by the New Mexico Alliance for Computing at Extreme Scale (ACES), a collaboration between Los Alamos Laboratory and Sandia National Laboratories. Additionally, this paper touches on research of technology beyond traditional CMOS. The status of Trinity, ASCs first AT system, and Crossroads, anticipated to succeed Trinity as the third AT system in 2020 will be presented, along with initial performance studies of the Intel Knights Landing Xeon Phi processors, introduced on Trinity. The challenges and opportunitiesmore » for our production simulation codes on AT systems will also be discussed. Trinity and Crossroads are a joint procurement by ACES and Lawrence Berkeley Laboratory as part of the Alliance for application Performance at EXtreme scale (APEX) http://apex.lanl.gov.« less

78 FR 8185 - Endangered and Threatened Wildlife and Plants; Initiation of 5-Year Status Reviews of 44 Species...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-05

...-FF01E00000] Endangered and Threatened Wildlife and Plants; Initiation of 5- Year Status Reviews of 44 Species....C. 1531 et seq.), we maintain Lists of Endangered and Threatened Wildlife and Plants (which we... 17.12 (for plants). Section 4(c)(2)(A) of the Act requires us to review each listed species' status...

Engineering analysis of ERTS data for rice in the Philippines

NASA Technical Reports Server (NTRS)

Mcnair, A. J. (Principal Investigator); Heydt, H. L.

1973-01-01

The author has identified the following significant results. Rice is an important food worldwide. Worthwhile goals, particularly for developing nations, are the capability to recognize from satellite imagery: (1) areas where rice is grown, and (2) growth status (irrigation, vigor, yield). A two-step procedure to achieve this is being investigated. Ground truth, and ERTS-1 imagery (four passes) covering 80% of a rice growth cycle for some Philippine sites, have been analyzed. One-D and three-D signature extraction, and synthesis of an initial site recognition/status algorithm have been performed. Results are encouraging. but additional passes and sites must be analyzed. Good position information for extracted data is a must.

Re-evaluating the Fistula First Initiative in Octogenarians on Hemodialysis.

PubMed

Vachharajani, Tushar J; Moossavi, Shahriar; Jordan, Jean R; Vachharajani, Vidula; Freedman, Barry I; Burkart, John M

2011-07-01

Octogenarians frequently require maintenance hemodialysis (HD) for treatment of stage renal disease ESRD. Although the Fistula First Initiative recommends creating an arteriovenous fistula as the preferred dialysis access method, vascular access selection should be based on life expectancy and functional status at treatment initiation. This is a retrospective analysis of 4-year outpatient data (January 1, 2004 through December 31, 2007) of incident octogenarian dialysis population in an academic institution. Thirty-nine of 268 patients were octogenarians with a mean (± SD) age of 83.4 ± 3.4 years, and 25 were men. Kaplan-Meier survival and Fisher's post hoc statistical analyses were performed. Thirty-seven octogenarian patients selected HD and two selected peritoneal dialysis. Among the 37 HD patients, 29 initiated dialysis with a tunneled cuffed catheter, 6 with an arteriovenous fistula, and 2 with an arteriovenous graft. Three patients regained renal function after an average 112 days and one was lost to follow-up. Of the 33 remaining on HD, 8 required nursing home admission and 25 were discharged home after initiating HD. Among these 33, 19 died and 14 remained on HD at the end of study period. Days on dialysis (mean ± SEM) before death in those discharged to a nursing facility versus home were 52.6 ± 14.7 versus 386.1 ± 90.7 (P < 0.05), respectively. Vascular access planning should include assessment of functional status and life expectancy in octogenarian HD patients.

Dramatic intracranial response to osimertinib in a poor performance status patient with lung adenocarcinoma harboring the epidermal growth factor receptor T790M mutation: A case report

PubMed Central

Uemura, Takehiro; Oguri, Tetsuya; Okayama, Minami; Furuta, Hiromi; Kanemitsu, Yoshihiro; Takakuwa, Osamu; Ohkubo, Hirotsugu; Takemura, Masaya; Maeno, Ken; Ito, Yutaka; Niimi, Akio

2017-01-01

We herein report a case of dramatic intracranial response to osimertinib in a poor performance status patient with lung adenocarcinoma harboring the epidermal growth factor receptor (EGFR) T790M mutation encoded in exon 20. The patient was a 59-year-old woman with EGFR exon 19 deletion-positive lung adenocarcinoma, who relapsed with multiple brain metastases. Computed tomography-guided biopsy of the left pleural tumor revealed adenocarcinoma harboring an EGFR exon 19 deletion and an EGFR T790M mutation encoded in exon 20. The patient was treated with osimertinib, a third-generation EGFR tyrosine kinase inhibitor. Two days after treatment initiation, the patient displayed profound disturbance of consciousness, possibly due to carcinomatous meningitis, and treatment had to be discontinued due to difficulty in taking osimertinib. However, the patient gradually started to recover consciousness and, after 3 days, she was again able to take osimertinib. One month after the initiation of osimertinib treatment, magnetic resonance imaging revealed an apparent reduction in brain metastases. The patient is currently under continued treatment with osimertinib. At the last follow-up (February, 2017) she exhibited partial response to the treatment. PMID:28413660

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.

Chronic Subdural Hematoma Treated by Small or Large Craniotomy with Membranectomy as the Initial Treatment

PubMed Central

Kim, Jae-Hong; Kim, Jung-Hee; Kong, Min-Ho; Song, Kwan-Young

2011-01-01

Objective There are few studies comparing small and large craniotomies for the initial treatment of chronic subdural hematoma (CSDH) which had non-liquefied hematoma, multilayer intrahematomal loculations, or organization/calcification on computed tomography and magnetic resonance imaging. These procedures were compared to determine which would produce superior postoperative results. Methods Between 2001 and 2009, 317 consecutive patients were surgically treated for CSDH at our institution. Of these, 16 patients underwent a small craniotomy with partial membranectomy and 42 patients underwent a large craniotomy with extended membranectomy as the initial treatment. A retrospective review was performed to compare the postoperative outcomes of these two techniques, focusing on improvement of neurological status, complications, reoperation rate, and days of post-operative hospitalization. Results The mean ages were 69.4±12.1 and 55.6±9.3 years in the small and large craniotomy groups, respectively. The recurrence of hematomas requiring reoperation occurred in 50% and 10% of the small and large craniotomy patients, respectively (p<0.001). There were no significant differences in postoperative neurological status, complications, or days of hospital stay between these two groups. Conclusion Among the cases of CSDH initially requiring craniotomy, the large craniotomy with extended membranectomy technique reduced the reoperation rate, compared to that of the small craniotomy with partial membranectomy technique. PMID:22053228

Uveal Melanoma Regression after Brachytherapy: Relationship with Chromosome 3 Monosomy Status.

PubMed

Salvi, Sachin M; Aziz, Hassan A; Dar, Suhail; Singh, Nakul; Hayden-Loreck, Brandy; Singh, Arun D

2017-07-01

The objective was to evaluate the relationship between the regression rate of ciliary body melanoma and choroidal melanoma after brachytherapy and chromosome 3 monosomy status. We conducted a prospective and consecutive case series of patients who underwent biopsy and brachytherapy for ciliary/choroidal melanoma. Tumor biopsy performed at the time of radiation plaque placement was analyzed with fluorescence in situ hybridization to determine the percentage of tumor cells with chromosome 3 monosomy. The regression rate was calculated as the percent change in tumor height at months 3, 6, and 12. The relationship between regression rate and tumor location, initial tumor height, and chromosome 3 monosomy (percentage) was assessed by univariate linear regression (R version 3.1.0). Of the 75 patients included in the study, 8 had ciliary body melanoma, and 67 were choroidal melanomas. The mean tumor height at the time of diagnosis was 5.2 mm (range: 1.90-13.00). The percentage composition of chromosome 3 monosomy ranged from 0-20% (n = 35) to 81-100% (n = 40). The regression of tumor height at months 3, 6, and 12 did not statistically correlate with tumor location (ciliary or choroidal), initial tumor height, or chromosome 3 monosomy (percentage). The regression rate of choroidal melanoma following brachytherapy did not correlate with chromosome 3 monosomy status.

PKIX Certificate Status in Hybrid MANETs

NASA Astrophysics Data System (ADS)

Muñoz, Jose L.; Esparza, Oscar; Gañán, Carlos; Parra-Arnau, Javier

Certificate status validation is a hard problem in general but it is particularly complex in Mobile Ad-hoc Networks (MANETs) because we require solutions to manage both the lack of fixed infrastructure inside the MANET and the possible absence of connectivity to trusted authorities when the certification validation has to be performed. In this sense, certificate acquisition is usually assumed as an initialization phase. However, certificate validation is a critical operation since the node needs to check the validity of certificates in real-time, that is, when a particular certificate is going to be used. In such MANET environments, it may happen that the node is placed in a part of the network that is disconnected from the source of status data at the moment the status checking is required. Proposals in the literature suggest the use of caching mechanisms so that the node itself or a neighbour node has some status checking material (typically on-line status responses or lists of revoked certificates). However, to the best of our knowledge the only criterion to evaluate the cached (obsolete) material is the time. In this paper, we analyse how to deploy a certificate status checking PKI service for hybrid MANET and we propose a new criterion based on risk to evaluate cached status data that is much more appropriate and absolute than time because it takes into account the revocation process.

Understanding the mathematics and science achievement and growth trajectories of high ability high school students using hierarchical linear modeling

NASA Astrophysics Data System (ADS)

Belen-Ferrer, Bellasanta

2009-12-01

This study used longitudinal data and individual, family, and academic-related matriculation variables to examine trends in initial status and growth trajectories in overall academics, mathematics, and science achievement among 224 high ability high school Asian students. Results indicate that females have an advantage in both initial status and growth rates in overall academics and science. None of the family variables entered in the models were found to be significantly related to overall academics grade point average. All available matriculation variables entered into the models explained less than or at most about half the variance in initial achievement status and growth rate in overall academics and science but not in mathematics. These results strongly imply that other factors, notably family and school and/or classroom-related variables, not measured by the ones used in the models could explain the expected variance in initial status and growth rate of the students especially in Mathematics.

Performance and Fabrication Status of TREAT LEU Conversion Conceptual Design Concepts

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

IJ van Rooyen; SR Morrell; AE Wright

2014-10-01

Resumption of transient testing at the TREAT facility was approved in February 2014 to meet U.S. Department of Energy (DOE) objectives. The National Nuclear Security Administration’s Global Threat Reduction Initiative Convert Program is evaluating conversion of TREAT from its existing highly enriched uranium (HEU) core to a new core containing low enriched uranium (LEU). This paper describes briefly the initial pre-conceptual designs screening decisions with more detailed discussions on current feasibility, qualification and fabrication approaches. Feasible fabrication will be shown for a LEU fuel element assembly that can meet TREAT design, performance, and safety requirements. The statement of feasibility recognizesmore » that further development, analysis, and testing must be completed to refine the conceptual design. Engineering challenges such as cladding oxidation, high temperature material properties, and fuel block fabrication along with neutronics performance, will be highlighted. Preliminary engineering and supply chain evaluation provided confidence that the conceptual designs can be achieved.« less

Examining Predictive Validity of Oral Reading Fluency Slope in Upper Elementary Grades Using Quantile Regression.

PubMed

Cho, Eunsoo; Capin, Philip; Roberts, Greg; Vaughn, Sharon

2017-07-01

Within multitiered instructional delivery models, progress monitoring is a key mechanism for determining whether a child demonstrates an adequate response to instruction. One measure commonly used to monitor the reading progress of students is oral reading fluency (ORF). This study examined the extent to which ORF slope predicts reading comprehension outcomes for fifth-grade struggling readers ( n = 102) participating in an intensive reading intervention. Quantile regression models showed that ORF slope significantly predicted performance on a sentence-level fluency and comprehension assessment, regardless of the students' reading skills, controlling for initial ORF performance. However, ORF slope was differentially predictive of a passage-level comprehension assessment based on students' reading skills when controlling for initial ORF status. Results showed that ORF explained unique variance for struggling readers whose posttest performance was at the upper quantiles at the end of the reading intervention, but slope was not a significant predictor of passage-level comprehension for students whose reading problems were the most difficult to remediate.

Eleventh interim status report: Model 9975 O-Ring fixture long-term leak performance

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

Daugherty, W.

2016-08-01

A series of experiments to monitor the aging performance of Viton® GLT O-rings used in the Model 9975 package has been ongoing since 2004 at the Savannah River National Laboratory. One approach has been to periodically evaluate the leak performance of O-rings being aged in mock-up 9975 Primary Containment Vessels (PCVs) at elevated temperature. Other methods such as compression-stress relaxation (CSR) tests and field surveillance are also on-going to evaluate O-ring behavior. Seventy tests using PCV mock-ups were assembled and heated to temperatures ranging from 200 to 450 ºF. They were leak-tested initially and have been tested periodically to determinemore » if they continue to meet the leak-tightness criterion defined in ANSI standard N14.5-97. Due to material substitution, fourteen additional tests were initiated in 2008 with GLT-S O-rings heated to temperatures ranging from 200 to 400 ºF.« less

Tenth interim status report: Model 9975 O-ring fixture long-term leak performance

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

Daugherty, W. L.

2015-08-26

A series of experiments to monitor the aging performance of Viton ® GLT O-rings used in the Model 9975 package has been ongoing since 2004 at the Savannah River National Laboratory. One approach has been to periodically evaluate the leak performance of O-rings being aged in mock-up 9975 Primary Containment Vessels (PCVs) at elevated temperatures. Other methods such as compression-stress relaxation (CSR) tests and field surveillance are also on-going to evaluate O-ring behavior. Seventy tests using PCV mock-ups were assembled and heated to temperatures ranging from 200 to 450 °F. They were leak-tested initially and have been tested periodically tomore » determine if they continue to meet the leak-tightness criterion defined in ANSI standard N14.5-97. Due to material substitution, fourteen additional tests were initiated in 2008 with GLT-S O-rings heated to temperatures ranging from 200 to 400 °F.« less

Notification: Fieldwork for CIGIE Cloud Computing Initiative – Status of Cloud-Computing Within the Federal Government

EPA Pesticide Factsheets

Project #OA-FY14-0126, January 15, 2014. The EPA OIG is starting fieldwork on the Council of the Inspectors General on Integrity and Efficiency (CIGIE) Cloud Computing Initiative – Status of Cloud-Computing Environments Within the Federal Government.

Status Report on the MCNP 2020 Initiative

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

Brown, Forrest B.; Rising, Michael Evan

2017-10-02

The discussion below provides a status report on the MCNP 2020 initiative. It includes discussion of the history of MCNP 2020, accomplishments during 2013-17, priorities for near-term development, other related efforts, a brief summary, and a list of references for the plans and work accomplished.

The association between continuous antibiotic prophylaxis and UTI from birth until initial postnatal imaging evaluation among newborns with antenatal hydronephrosis.

PubMed

Varda, B K; Finkelstein, J B; Wang, H-H; Logvinenko, T; Nelson, C P

2018-05-29

There is a lack of consensus regarding the use of continuous antibiotic prophylaxis (CAP) during the interval between birth and initial postnatal imaging in infants with a history of antenatal urinary tract dilation (AUTD). To determine the incidence of urinary tract infection (UTI), and the association between CAP use and UTI during the interval between birth and the first postnatal renal ultrasound (RUS) in infants with AUTD. A single-institution, retrospective cohort study of newborns with a history of AUTD. Infants undergoing RUS within 3 months of birth for an indication of 'hydronephrosis' between 2012 and 2014 were identified. A random sample of 500 infants was selected; six were excluded for concomitant congenital anomalies. Baseline patient (sex, race, insurance) and clinical characteristics (circumcision status, UTD risk score, receipt of CAP, UTI prior to RUS, age at UTI, and age at RUS) were collected via retrospective chart review. Descriptive statistics were calculated. To adjust for receipt of CAP, propensity score adjusted univariate logistic regression for UTI based on CAP status was performed. Among the 494 infants with AUTD, 157 (32%) received CAP. Infants with normal/low-risk UTD scores were less likely to receive CAP than those with medium/high-risk UTD (23% vs 77%; P < 0.001). There was no difference in CAP based on sex, insurance, or circumcision status (among 260/365 males with known circumcision status). Overall, seven infants (1.4%) developed UTI prior to imaging: six (1.8%) without CAP vs one (0.64%) with CAP (P = 0.44). The median age at UTI was 59 days (range 2-84); among those with UTI, initial imaging occurred significantly later (66 vs 28 days; P = 0.001). The propensity score adjusted odds of developing UTI with CAP (vs without) was 0.93 (95% CI 0.10-8.32; P = 0.95). The Summary Figure describes the infants with UTI. The incidence of UTI prior to initial neonatal imaging in newborns with AUTD was low. Use of CAP was not associated with UTI incidence after adjusting for UTD severity. Routine use of CAP in newborns with AUTD prior to initial imaging may be of limited benefit in most patients. Copyright © 2018 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Unmanned Aircraft Systems (UAS) Integration in the National Airspace System (NAS) Project

NASA Technical Reports Server (NTRS)

Griner, James H.

2013-01-01

NASA's UAS Integration in the NAS project, has partnered with Rockwell Collins to develop a concept Control and Non-Payload Communication system prototype radio, operating on recently allocated UAS frequency spectrum bands. The prototype radio will be used to validate initial proposed performance requirements for UAS control communications. This presentation will give an overview of the current status of the design, development, and flight test planning for this prototype radio.

No Child Left Behind Act: States Face Challenges Measuring Academic Growth That Education's Initiatives May Help Address. Report to Congressional Requesters. GAO-06-661

ERIC Educational Resources Information Center

Shaul, Marnie S.

2006-01-01

The No Child Left Behind Act (NCLBA) requires that states improve academic performance so that all students reach proficiency in reading and math by 2014 and that achievement gaps close among student groups. States set annual proficiency targets using an approach known as a status model, which calculates test scores 1 year at a time. Some states…

The High Power Electric Propulsion (HiPEP) Ion Thruster

NASA Technical Reports Server (NTRS)

Foster, John E.; Haag, Tom; Patterson, Michael; Williams, George J., Jr.; Sovey, James S.; Carpenter, Christian; Kamhawi, Hani; Malone, Shane; Elliot, Fred

2004-01-01

Practical implementation of the proposed Jupiter Icy Moon Orbiter (JIMO) mission, which would require a total delta V of approximately 38 km/s, will require the development of a high power, high specific impulse propulsion system. Initial analyses show that high power gridded ion thrusters could satisfy JIMO mission requirements. A NASA GRC-led team is developing a large area, high specific impulse, nominally 25 kW ion thruster to satisfy both the performance and the lifetime requirements for this proposed mission. The design philosophy and development status as well as a thruster performance assessment are presented.

Social Capital, Information, and Socioeconomic Disparities in Math Coursework

PubMed Central

Crosnoe, Robert; Schneider, Barbara

2011-01-01

Analysis of the National Education Longitudinal Study revealed that socioeconomically advantaged students persist in high school math at higher rates than their disadvantaged peers, even when they have the same initial placements and skill levels. These disparities are larger among students with prior records of low academic status because students from more privileged backgrounds persist in math coursework even when their prior performance predicts they will not. Among students with low middle school math performance, those from socioeconomically disadvantaged families appear to benefit from having consultants for coursework decisions, so that they make up ground with their socioeconomically advantaged peers. PMID:21743762

The differential effects of full-time and part-time work status on breastfeeding.

PubMed

Mandal, Bidisha; Roe, Brian Eric; Fein, Sara Beck

2010-09-01

Return to work is associated with diminished breastfeeding. Although more mothers breastfeed after returning to work compared to a decade ago, research has not documented the variations in breastfeeding initiation and duration based on full-time and part-time (less than 35h/week) work status. In this study, we clarify these differences. Longitudinal data from the Infant Feeding Practices Study II, collected between 2005 and 2007, for over 1400 mothers are used. In analyzing initiation, mother's work status was categorized by the expected number of hours she planned to work postpartum. In the duration model, work status was categorized based on the actual number of hours worked upon mother's return to employment after controlling for baby's age when she returned to work. Covariates in logistic and censored regressions included demographics, maternity leave, parity, past breastfeeding experience, hospital experience, and social support. Compared with expecting not to work, expecting to work <35h/week was not associated with breastfeeding initiation while expecting to work full-time decreased breastfeeding initiation. Compared with breastfeeding mothers who did not work, returning to work within 12 weeks regardless of work status and returning to work after 12 weeks while working more than 34h/week were associated with significantly shorter breastfeeding duration. Part-time work and increased amount of leave taken promote breastfeeding initiation and duration.

Accounting for the Relationship between Initial Status and Growth in Regression Models

ERIC Educational Resources Information Center

Kelly, Sean; Ye, Feifei

2017-01-01

Educational analysts studying achievement and other educational outcomes frequently encounter an association between initial status and growth, which has important implications for the analysis of covariate effects, including group differences in growth. As explicated by Allison (1990), where only two time points of data are available, identifying…

The Association of Couples' Relationship Status and Quality with Breastfeeding Initiation

ERIC Educational Resources Information Center

Gibson-Davis, Christina M.; Brooks-Gunn, Jeanne

2007-01-01

Using data from the Fragile Families and Child Wellbeing Survey (N= 3,567), we examine the links between relationship status, relationship quality, and race and ethnicity in breastfeeding initiation. We consider four relationship types: married, cohabiting, romantically involved but not cohabiting (termed visiting), and nonromantically involved…

Node Immunization with Time-Sensitive Restrictions.

PubMed

Cui, Wen; Gong, Xiaoqing; Liu, Chen; Xu, Dan; Chen, Xiaojiang; Fang, Dingyi; Tang, Shaojie; Wu, Fan; Chen, Guihai

2016-12-15

When we encounter a malicious rumor or an infectious disease outbreak, immunizing k nodes of the relevant network with limited resources is always treated as an extremely effective method. The key challenge is how we can insulate limited nodes to minimize the propagation of those contagious things. In previous works, the best k immunised nodes are selected by learning the initial status of nodes and their strategies even if there is no feedback in the propagation process, which eventually leads to ineffective performance of their solutions. In this paper, we design a novel vaccines placement strategy for protecting much more healthy nodes from being infected by infectious nodes. The main idea of our solution is that we are not only utilizing the status of changing nodes as auxiliary knowledge to adjust our scheme, but also comparing the performance of vaccines in various transmission slots. Thus, our solution has a better chance to get more benefit from these limited vaccines. Extensive experiments have been conducted on several real-world data sets and the results have shown that our algorithm has a better performance than previous works.

Node Immunization with Time-Sensitive Restrictions

PubMed Central

Cui, Wen; Gong, Xiaoqing; Liu, Chen; Xu, Dan; Chen, Xiaojiang; Fang, Dingyi; Tang, Shaojie; Wu, Fan; Chen, Guihai

2016-01-01

When we encounter a malicious rumor or an infectious disease outbreak, immunizing k nodes of the relevant network with limited resources is always treated as an extremely effective method. The key challenge is how we can insulate limited nodes to minimize the propagation of those contagious things. In previous works, the best k immunised nodes are selected by learning the initial status of nodes and their strategies even if there is no feedback in the propagation process, which eventually leads to ineffective performance of their solutions. In this paper, we design a novel vaccines placement strategy for protecting much more healthy nodes from being infected by infectious nodes. The main idea of our solution is that we are not only utilizing the status of changing nodes as auxiliary knowledge to adjust our scheme, but also comparing the performance of vaccines in various transmission slots. Thus, our solution has a better chance to get more benefit from these limited vaccines. Extensive experiments have been conducted on several real-world data sets and the results have shown that our algorithm has a better performance than previous works. PMID:27983680

Case-mix adjustment and the comparison of community health center performance on patient experience measures.

PubMed

Johnson, M Laura; Rodriguez, Hector P; Solorio, M Rosa

2010-06-01

To assess the effect of case-mix adjustment on community health center (CHC) performance on patient experience measures. A Medicaid-managed care plan in Washington State collected patient survey data from 33 CHCs over three fiscal quarters during 2007-2008. The survey included three composite patient experience measures (6-month reports) and two overall ratings of care. The analytic sample includes 2,247 adult patients and 2,859 adults reporting for child patients. We compared the relative importance of patient case-mix adjusters by calculating each adjuster's predictive power and variability across CHCs. We then evaluated the impact of case-mix adjustment on the relative ranking of CHCs. Important case-mix adjusters included adult self-reported health status or parent-reported child health status, adult age, and educational attainment. The effects of case-mix adjustment on patient reports and ratings were different in the adult and child samples. Adjusting for race/ethnicity and language had a greater impact on parent reports than adult reports, but it impacted ratings similarly across the samples. The impact of adjustment on composites and ratings was modest, but it affected the relative ranking of CHCs. To ensure equitable comparison of CHC performance on patient experience measures, reports and ratings should be adjusted for adult self-reported health status or parent-reported child health status, adult age, education, race/ethnicity, and survey language. Because of the differential impact of case-mix adjusters for child and adult surveys, initiatives should consider measuring and reporting adult and child scores separately.

Dish concentrators for solar thermal energy - Status and technology development

NASA Technical Reports Server (NTRS)

Jaffe, L. D.

1981-01-01

Comparisons are presented of point-focusing, or 'dish' solar concentrator system features, development status, and performance levels demonstrated to date. In addition to the requirements of good optical efficiency and high geometric concentration ratios, the most important future consideration in solar thermal energy dish concentrator design will be the reduction of installed and lifetime costs, as well as the materials and labor costs of production. It is determined that technology development initiatives are needed in such areas as optical materials, design wind speeds and wind loads, structural configuration and materials resistance to prolonged exposure, and the maintenance of optical surfaces. The testing of complete concentrator systems, with energy-converting receivers and controls, is also necessary. Both reflector and Fresnel lens concentrator systems are considered.

Oral Reading Fluency Development for Children with Emotional Disturbance or Learning Disabilities

PubMed Central

Wanzek, Jeanne; Al Otaiba, Stephanie; Petscher, Yaacov

2012-01-01

This study used a large state-wide database to examine the oral reading fluency development of second and third grade students with emotional disturbance or learning disabilities and their general education peers. Oral reading fluency measures were administered to 185,367 students without disabilities (general education), 2,146 students identified with an emotional disturbance, and 10,339 students with a learning disability. Student status and growth trends were examined in a piecewise model at each grade level for the full sample as well as for a subsample with reading difficulties. Data suggested students with disabilities performed significantly below students without disabilities in initial status and growth. Gender was also examined as a moderator of outcomes for each of the study groups. PMID:24532848

Heat Melt Compactor Development Progress

NASA Technical Reports Server (NTRS)

Lee, Jeffrey M.; Fisher, John W.; Pace, Gregory

2017-01-01

The status of the Heat Melt Compactor (HMC) development project is reported. HMC Generation 2 (Gen 2) has been assembled and initial testing has begun. A baseline mission use case for trash volume reduction, water recovery, trash sterilization, and the venting of effluent gases and water vapor to space has been conceptualized. A test campaign to reduce technical risks is underway. This risk reduction testing examines the many varied operating scenarios and conditions needed for processing trash during a space mission. The test results along with performance characterization of HMC Gen 2 will be used to prescribe requirements and specifications for a future ISS flight Technology Demonstration. We report on the current status, technical risks, and test results in the context of an ISS vent-to-space Technology Demonstration.

Pelvic radiation therapy for gynecologic malignancy in geriatric patients

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

Grant, P.T.; Jeffrey, J.F.; Fraser, R.C.

Thirty-one patients, aged 75 years or older, who received pelvic radiation therapy as part of primary treatment for a gynecologic malignancy, were reviewed. Ten patients (32%) failed to complete their treatment and 4 patients (13%) died of treatment-related complications. The treatment-related complications were independent of increasing age, but did correlate closely with the patients' pretreatment ECOG performance status. Ten patients with performance levels of 2 or higher had a mortality rate of 30%, while 70% failed to complete treatment. Treatment fractions of greater than 220 cGy per day also resulted in unacceptably high complication rates. Alternative treatment formats should bemore » considered in geriatric patients with poor initial performance levels.« less

The status of paediatric medicines initiatives around the world--What has happened and what has not?

PubMed

Hoppu, Kalle; Anabwani, Gabriel; Garcia-Bournissen, Facundo; Gazarian, Madlen; Kearns, Gregory L; Nakamura, Hidefumi; Peterson, Robert G; Sri Ranganathan, Shalini; de Wildt, Saskia N

2012-01-01

This review was conducted to examine the current status of paediatric medicines initiatives across the globe. The authors made a non-systematic descriptive review of current world situation. Two regions, the United States (US) and the European Union (EU), and the World Health Organization (WHO) have introduced strong paediatric initiatives to improve children's health through improving access to better paediatric medicines. The experience from the US initiative indicates that it is possible to stimulate development and study of paediatric medicines and provide important new information for improvement of paediatric therapy. The early results from the EU initiative are similarly encouraging. In Canada, Japan, Australia and other developed countries, specific paediatric medicines initiatives have been less extensive and weaker, with modest results. Disappointingly, current evidence suggests that results from clinical trials outside the US often do not benefit children in the country in which the trials were largely conducted. Pharmaceutical companies that have derived a financial benefit commensurate with the cost of doing the paediatric trials in one country do not seem to be making the results of these trials available to all countries if there is no financial incentive to the company. The WHO campaign 'make medicines child size' has produced substantive accomplishments in building improved foundations to improve mechanisms that will enhance children's access to critical medicines in resource-limited settings. However, practically all of this work has been performed using an amalgamation of short-term funding from a variety of sources as opposed to a sustained, programmatic commitment. Although much still needs to be done, it's clear that with concerted efforts and appropriate resources, change is possible but slow. Retaining and fostering public and political interest in paediatric medicines is challenging, but pivotal for success.

Undernutrition status and associated factors in under-5 children, in Tigray, Northern Ethiopia.

PubMed

Alemayehu, Mussie; Tinsae, Fitiwi; Haileslassie, Kiday; Seid, Oumer; Gebregziabher, Gebremedhin; Yebyo, Henock

2015-01-01

The aim of this study was to assess the nutritional status and associated factors in children <5 y in the Medebay Zana District, northern Ethiopia. A community-based cross-sectional study was conducted in the Medebay Zana District from September 8 to 29, 2013. A two-stage cluster-sampling technique was used to select 605 children age <5 y. Descriptive, binary, and multiple logistic regression analyses were performed. The results of this study demonstrated that the level of stunting was 56.6%, underweight 45.3%, and wasting 34.6%. Stunting was predicted by having mothers who attended high school (adjusted odds ratio [AOR], 0.75; 95% confidence interval [CI], 0.09-0.85), living in a household where providing priority food was given to the father (AOR, 4.32; 95% CI, 2.10-9.05), and water was taken from unprotected sources (AOR, 2.13; 95% CI, 1.09-4.14). In all children, initiation of breast-feeding within 1 to 3 h after birth (AOR, 4.06; 95% CI, 1.77-9.33), having mothers who could make financial decisions (AOR, 0.09; 95% CI, 0.02-0.51), and being breast-fed for 12 to 23 mo (AOR, 0.07; 95% CI, 0.01-0.40) were predictors of wasting. Moreover, in girls (AOR, 1.84; 95% CI, 1.25, 2.69), initiation of breast-feeding 6 h after birth (AOR, 12.94; 95% CI, 4.04-41.49) and having mothers who could make financial decisions (AOR, 0.33; 95% CI, 0.15-0.74) were predictors of being underweight. The undernutrition status among children <5 y was high. Children's age group, time initiation of breast-feeding, child's sex, source of water, parents' educational status, type of food used for starting of complementary feeding, and mothers' financial decision-making ability could have an influence in undernutrition of children in this age group. Copyright © 2015 Elsevier Inc. All rights reserved.

Rocket Propulsion 21 Steering Committee Meeting (RP21) NASA In-Space Propulsion Update

NASA Technical Reports Server (NTRS)

Klem, Mark

2015-01-01

In-house Support of NEXT-C Contract Status Thruster NEXT Long Duration Test post-test destructive evaluation in progress Findings will be used to verify service life models identify potential design improvements Cathode heater fabrication initiated for cyclic life testing Thruster operating algorithm definition verification initiated to provide operating procedures for mission users High voltage propellant isolator life test voluntarily terminated after successfully operating 51,200 h Power processor unit (PPU) Replaced all problematic stacked multilayer ceramic dual inline pin capacitors within PPU Test bed Rebuilt installed discharge power supply primary power board Completed full functional performance characterization Final test report in progress Transferred PPU Testbed to contractor to support prototype design effort.

SOCIOECONOMIC STATUS AND LEARNING PROFICIENCY IN YOUNG CHILDREN.

ERIC Educational Resources Information Center

ROHWER, WILLIAM D., JR.; AND OTHERS

THIS STUDY WAS INITIATED TO DETERMINE WHY CHILDREN OF LOWER SOCIOECONOMIC STATUS, WHO DO INFERIOR WORK ON SCHOOL-RELATED LEARNING TASKS WHEN COMPARED TO UPPER SOCIOECONOMIC STATUS CHILDREN, LEARN AS EFFICIENTLY AS UPPER LEVEL CHILDREN ON PAIRED-ASSOCIATE TASKS. THE SAMPLE CONSISTED OF 120 LOWER STATUS CHILDREN AND 120 UPPER STATUS CHILDREN,…

The AlpArray Seismic Network: current status and next steps

NASA Astrophysics Data System (ADS)

Hetényi, György; Molinari, Irene; Clinton, John; Kissling, Edi

2016-04-01

The AlpArray initiative (http://www.alparray.ethz.ch) is a large-scale European collaboration to study the entire Alpine orogen at high resolution and in 3D with a large variety of geoscientific methods. The core element of the initiative is an extensive and dense broadband seismological network, the AlpArray Seismic Network (AASN), which complements the permanent seismological stations to ensure homogeneous coverage of the greater Alpine area. The some 260 temporary stations of the AlpArray Seismic Network are operated as a joint effort by a number of institutions from Austria, Bosnia-Herzegovina, Croatia, Czech Republic, France, Germany, Hungary, Italy, Slovakia and Switzerland. The first stations were installed in Spring 2015 and the full AASN is planned to be operational by early Summer 2016. In this poster we present the actual status of the deployment, the effort undertaken by the contributing groups, station performance, typical noise levels, best practices in installation as well as in data management, often encountered challenges, and planned next steps including the deployment of ocean bottom seismometers in the Ligurian Sea.

The AlpArray Seismic Network: status and operation

NASA Astrophysics Data System (ADS)

Hetényi, György; Molinari, Irene; Clinton, John; Kissling, Edi

2017-04-01

The AlpArray initiative (http://www.alparray.ethz.ch) is a large-scale European collaboration to study the entire Alpine orogen at high resolution and in 3D with a large variety of geoscientific methods. The core element of the initiative is an extensive and dense broadband seismological network, the AlpArray Seismic Network (AASN). Over 300 temporary stations complement the permanent seismological stations to ensure homogeneous coverage of the greater Alpine area. The AASN has officially started operation in January 2016 and is now complete on land. It is operated in a joint effort by a number of institutions from Austria, Bosnia-Herzegovina, Croatia, Czech Republic, France, Germany, Hungary, Italy, Slovakia and Switzerland. In the Ligurian Sea, a 32-station OBS campaign is planned from June 2017 until March 2018. This will complete the coverage of the greater Alpine area at an unprecedented resolution. In this poster we present the actual status of the deployment, the effort undertaken by the contributing groups, station performance, best practices, data management as well as often encountered challenges, and provide a meeting and discussion point during the conference.

Benchmarking MARS (accident management software) with the Browns Ferry fire

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

Dawson, S.M.; Liu, L.Y.; Raines, J.C.

1992-01-01

The MAAP Accident Response System (MARS) is a userfriendly computer software developed to provide management and engineering staff with the most needed insights, during actual or simulated accidents, of the current and future conditions of the plant based on current plant data and its trends. To demonstrate the reliability of the MARS code in simulatng a plant transient, MARS is being benchmarked with the available reactor pressure vessel (RPV) pressure and level data from the Browns Ferry fire. The MRS software uses the Modular Accident Analysis Program (MAAP) code as its basis to calculate plant response under accident conditions. MARSmore » uses a limited set of plant data to initialize and track the accidnt progression. To perform this benchmark, a simulated set of plant data was constructed based on actual report data containing the information necessary to initialize MARS and keep track of plant system status throughout the accident progression. The initial Browns Ferry fire data were produced by performing a MAAP run to simulate the accident. The remaining accident simulation used actual plant data.« less

Iodine intake and status during pregnancy and lactation before and after government initiatives to improve iodine status, in Palmerston North, New Zealand: a pilot study.

PubMed

Brough, Louise; Jin, Ying; Shukri, Nurul Husna; Wharemate, Zirsha Roimata; Weber, Janet L; Coad, Jane

2015-10-01

Iodine deficiency during pregnancy and lactation may adversely affect fetal and infant development. Two initiatives were introduced in New Zealand to prevent deficiency: (1) mandatory fortification of bread with iodised salt; and (2) provision of a subsidised iodine supplement (150 μg) for all pregnant and breastfeeding women. The aim of this study was to assess iodine intake and status among a self-selecting sample of pregnant and lactating women in Palmerston North, both before and after the two initiatives. Pregnant and breastfeeding women were recruited before (n = 25 and 32; 2009) and after (n = 34 and 36; 2011) the initiatives. Iodine concentration was determined in 24-h urine and breast milk samples using inductively-coupled plasma mass spectrometry. Use of supplements and salt, knowledge of iodine deficiency, and awareness of the initiatives were determined by questionnaire. Median urine iodine concentration (UIC) was higher in 2011 compared with 2009 for both pregnant (85 and 47 μg L(-1) ) and breastfeeding (74 and 34 μg L(-1) ) participants; median UIC were below the cut-offs for adequate iodine status. However, in 2011, the estimated daily iodine intake during pregnancy was 217 μg day(-1) ; 74% of women achieved the Estimated Average Requirement. Knowledge of the initiatives was low, only 28-56% were aware of the need for iodine supplements and only 15-22% were aware of the mandatory addition of iodised salt to bread. Despite initiatives, UIC of these women indicates iodine deficiency, however, dietary intakes appear adequate. Ongoing surveillance of supplement use and iodine status among pregnant and lactating women throughout New Zealand is needed to fully assess the efficacy of the initiatives. Alternative strategies may require evaluation to ensure all women have adequate iodine during pregnancy and breastfeeding. © 2013 John Wiley & Sons Ltd.

Sex Differences in Mortality Based on United Network for Organ Sharing Status While Awaiting Heart Transplantation.

PubMed

Hsich, Eileen M; Blackstone, Eugene H; Thuita, Lucy; McNamara, Dennis M; Rogers, Joseph G; Ishwaran, Hemant; Schold, Jesse D

2017-06-01

There are sex differences in mortality while awaiting heart transplantation, and the reason remains unclear. We included all adults in the Scientific Registry of Transplant Recipients placed on the heart transplant active waitlist from 2004 to 2015. The primary end point was all-cause mortality. Multivariable Cox proportional hazards models were performed to evaluate survival by United Network for Organ Sharing (UNOS) status at the time of listing. Random survival forest was used to identify sex interactions for the competing risk of death and transplantation. There were 33 069 patients (25% women) awaiting heart transplantation. This cohort included 7681 UNOS status 1A (26% women), 13 027 UNOS status 1B (25% women), and 12 361 UNOS status 2 (26% women). During a median follow-up of 4.3 months, 1351 women and 4052 men died. After adjusting for >20 risk factors, female sex was associated with a significant risk of death among UNOS status 1A (adjusted hazard ratio, 1.14; 95% confidence interval, 1.01-1.29) and UNOS status 1B (adjusted hazard ratio, 1.17; 95% confidence interval, 1.05-1.30). In contrast, female sex was significantly protective for time to death among UNOS status 2 (adjusted hazard ratio, 0.85; 95% confidence interval, 0.76-0.95). Sex differences in probability of transplantation were present for every UNOS status, and >20 sex interactions were identified for mortality and transplantation. When stratified by initial UNOS status, women had a higher mortality than men as UNOS status 1 and a lower mortality as UNOS status 2. With >20 sex interactions for mortality and transplantation, further evaluation is warranted to form a more equitable allocation system. © 2017 American Heart Association, Inc.

SPARTAN: An Instructional High Resolution Land Combat Model

DTIC Science & Technology

1992-03-01

being: Next Event Time Advance - this method initializes the time clock at zero and updates the clock to the time of the next most imminent event and...whenever the soldier’s movement attribute switch is on and his speed is greater than zero . When startmove is called, it begins by performing several...status attribute goes to zero , his movement goes to zero , and his posture goes to prone. Lastly, the "killsoldier" subprogram is called which removes

Alterations of Mental Status and Thyroid Hormones after Thermal Injury

DTIC Science & Technology

1985-01-01

steroid, dopamine, or iodine treatment . At to weeks before death, this association N~ing~ndependent ofeach sa pling, the level of obtundation (LO...was deter ined on treatment with drugs dcting on mental s as or thyroi func- a 6-point scale from normal to deep coma. Whereas initially low tion. (J...other types of nonthyroidal illnes,. of wounds were performed when indicated. Treatment did not (NTI) (4, 5). Previous studies of a variety of NTI

Cognitive Performance Scores for the Pediatric Automated Neuropsychological Assessment Metrics in Childhood-Onset Systemic Lupus Erythematosus.

PubMed

Vega-Fernandez, Patricia; Vanderburgh White, Shana; Zelko, Frank; Ruth, Natasha M; Levy, Deborah M; Muscal, Eyal; Klein-Gitelman, Marisa S; Huber, Adam M; Tucker, Lori B; Roebuck-Spencer, Tresa; Ying, Jun; Brunner, Hermine I

2015-08-01

To develop and initially validate a global cognitive performance score (CPS) for the Pediatric Automated Neuropsychological Assessment Metrics (PedANAM) to serve as a screening tool of cognition in childhood lupus. Patients (n = 166) completed the 9 subtests of the PedANAM battery, each of which provides 3 principal performance parameters (accuracy, mean reaction time for correct responses, and throughput). Cognitive ability was measured by formal neurocognitive testing or estimated by the Pediatric Perceived Cognitive Function Questionnaire-43 to determine the presence or absence of neurocognitive dysfunction (NCD). A subset of the data was used to develop 4 candidate PedANAM-CPS indices with supervised or unsupervised statistical approaches: PedANAM-CPSUWA , i.e., unweighted averages of the accuracy scores of all PedANAM subtests; PedANAM-CPSPCA , i.e., accuracy scores of all PedANAM subtests weighted through principal components analysis; PedANAM-CPSlogit , i.e., algorithm derived from logistic models to estimate NCD status based on the accuracy scores of all of the PedANAM subtests; and PedANAM-CPSmultiscore , i.e., algorithm derived from logistic models to estimate NCD status based on select PedANAM performance parameters. PedANAM-CPS candidates were validated using the remaining data. PedANAM-CPS indices were moderately correlated with each other (|r| > 0.65). All of the PedANAM-CPS indices discriminated children by NCD status across data sets (P < 0.036). The PedANAM-CPSmultiscore had the highest area under the receiver operating characteristic curve (AUC) across all data sets for identifying NCD status (AUC >0.74), followed by the PedANAM-CPSlogit , the PedANAM-CPSPCA , and the PedANAM-CPSUWA , respectively. Based on preliminary validation and considering ease of use, the PedANAM-CPSmultiscore and the PedANAM-CPSPCA appear to be best suited as global measures of PedANAM performance. © 2015, American College of Rheumatology.

Changes in the EGFR amplification and EGFRvIII expression between paired primary and recurrent glioblastomas

PubMed Central

Gao, Ya; Kerkhof, Melissa; Kros, Johan M.; Gorlia, Thierry; van Zwieten, Kitty; Prince, Jory; van Duinen, Sjoerd; Sillevis Smitt, Peter A.; Taphoorn, Martin; French, Pim J.

2015-01-01

Abstract Background The efficacy of novel targeted therapies is often tested at the time of tumor recurrence. However, for glioblastoma (GBM) patients, surgical resections at recurrence are performed only in a minority of patients; therefore, molecular data are predominantly derived from the initial tumor. Molecular data of the initial tumor for patient selection into personalized medicine trials can therefore be used only when the specific genetic change is retained in the recurrent tumor. Methods In this study we determined whether EGFR amplification and expression of the most common mutation in GBMs (EGFRvIII) is retained at tumor recurrence. Because retention of genetic changes may be dependent on the initial treatment, we only used a cohort of GBM samples that were uniformly treated according to the current standard of care (ie, chemo-irradiation with temozolomide). Results Our data show that, in spite of some quantitative differences, the EGFR amplification status remains stable in the majority (84%) of tumors evaluated. EGFRvIII expression remained similar in 79% of GBMs. However, within the tumors expressing EGFRvIII at initial diagnosis, approximately one-half lose their EGFRvIII expression at tumor recurrence. Conclusions The relative stability of EGFR amplification indicates that molecular data obtained in the primary tumor can be used to predict the EGFR status of the recurrent tumor, but care should be taken in extrapolating EGFRvIII expression from the primary tumor, particularly when expressed at first diagnosis. PMID:25691693

Association between Functional Capacity Decline and Nutritional Status Based on the Nutrition Screening Initiative Checklist: A 2-Year Cohort Study of Japanese Community-Dwelling Elderly.

PubMed

Sugiura, Yumiko; Tanimoto, Yoshimi; Imbe, Ayumi; Inaba, Yuiko; Sakai, Satoshi; Shishikura, Kanako; Tanimoto, Keiji; Hanafusa, Toshiaki

2016-01-01

To assess whether nutritional status based on the Nutrition Screening Initiative Checklist is useful for predicting functional capacity decline in community-dwelling Japanese elderly. This two-year observational cohort study included 536 community-dwelling Japanese (65 years and older at baseline) who were independent in both activities and instrumental activities of daily living. Demographic attributes, chronic illness, lifestyle-related habits, nutritional status, functional capacity, and anthropometric measurements were assessed, with decline in functional capacity used as the outcome measure. Subjects were classified into three groups as follows based on the Nutrition Screening Initiative Checklist: low (59.5%), moderate (23.7%), and high (16.8%) nutritional risk. Significant differences were found between nutritional status and the following four baseline variables: age, hypertension, cerebrovascular diseases, and current smoking. However, no significant differences were evident between nutritional status and sex, body mass index, diabetes, drinking habit, or exercise habit. Logistic regression analysis adjusted for age, sex, body mass index, hypertension, cerebrovascular diseases and smoking habit showed that the high nutritional risk group was significantly associated with a decline in both activities of daily living (odds ratio: 4.96; 95% confidence interval (CI): 1.59-15.50) and instrumental activities of daily living (OR: 2.58; 95% CI: 1.31-5.06) compared with the low nutritional risk group. Poor nutritional status based on the Nutrition Screening Initiative Checklist was associated with a decline in functional capacity over a 2-year period in community-dwelling Japanese elderly. These results suggest that the Nutrition Screening Initiative Checklist is a suitable tool for predicting functional capacity decline in community-dwelling elderly.

Comprehensive assessment of nutritional status and associated factors in the healthy, community-dwelling elderly.

PubMed

Iizaka, Shinji; Tadaka, Etsuko; Sanada, Hiromi

2008-03-01

Malnutrition among the elderly has become a serious problem as their population increases in Japan. To approach the risk of malnutrition in the healthy, community-dwelling elderly is important for early prevention of malnutrition. The nutritional status and mutable associated factors with poor nutritional status specific to the healthy elderly were examined comprehensively. One hundred and thirty healthy elderly people from a senior college in Tokyo, Japan were eligible for this study. Nutritional status was evaluated by Mini-Nutritional Assessment (MNA). The demographic status and potential correlates with poor nutritional status, including the physical factors (mobility, cognitive impairment and oral status) and the psychosocial factors (depression, self-efficacy, attitudes toward health, instrumental activities of daily living, public health service knowledge, and difficulty and dissatisfaction with meal preparation) were investigated. The multiple linear regression analysis using a stepwise procedure adjusted for demographic status was performed to detect independent associated factors. There were 16 participants (12.6%) at risk of malnutrition. The independent associated factors with lower MNA scores were depression (beta = -0.27, P = 0.005), lower self-efficacy (beta = 0.25, P = 0.009), lower attitudes toward health scores (beta = 0.21, P = 0.02) and difficulty with meal preparation (beta = -0.18, P = 0.03). The prevalence of the healthy elderly at the initial risk of malnutrition was relatively high and should not be overlooked. The comprehensive geriatric screening and intervention including mental health, health management and life-situation will be important for the healthy, community-dwelling elderly.

Run II of the LHC: The Accelerator Science

NASA Astrophysics Data System (ADS)

Redaelli, Stefano

2015-04-01

In 2015 the Large Hadron Collider (LHC) at the European Organization for Nuclear Research (CERN) starts its Run II operation. After the successful Run I at 3.5 TeV and 4 TeV in the 2010-2013 period, a first long shutdown (LS1) was mainly dedicated to the consolidation of the LHC magnet interconnections, to allow the LHC to operate at its design beam energy of 7 TeV. Other key accelerator systems have also been improved to optimize the performance reach at higher beam energies. After a review of the LS1 activities, the status of the LHC start-up progress is reported, addressing in particular the status of the LHC hardware commissioning and of the training campaign of superconducting magnets that will determine the operation beam energy in 2015. Then, the plans for the Run II operation are reviewed in detail, covering choice of initial machine parameters and strategy to improve the Run II performance. Future prospects of the LHC and its upgrade plans are also presented.

Do repeated assessments of performance status improve predictions for risk of death among patients with cancer? A population-based cohort study.

PubMed

Su, Jiandong; Barbera, Lisa; Sutradhar, Rinku

2015-06-01

Prior work has utilized longitudinal information on performance status to demonstrate its association with risk of death among cancer patients; however, no study has assessed whether such longitudinal information improves the predictions for risk of death. To examine whether the use of repeated performance status assessments improve predictions for risk of death compared to using only performance status assessment at the time of cancer diagnosis. This was a population-based longitudinal study of adult outpatients who had a cancer diagnosis and had at least one assessment of performance status. To account for each patient's changing performance status over time, we implemented a Cox model with a time-varying covariate for performance status. This model was compared to a Cox model using only a time-fixed (baseline) covariate for performance status. The regression coefficients of each model were derived based on a randomly selected 60% of patients, and then, the predictive ability of each model was assessed via concordance probabilities when applied to the remaining 40% of patients. Our study consisted of 15,487 cancer patients with over 53,000 performance status assessments. The utilization of repeated performance status assessments improved predictions for risk of death compared to using only the performance status assessment taken at diagnosis. When studying the hazard of death among patients with cancer, if available, researchers should incorporate changing information on performance status scores, instead of simply baseline information on performance status. © The Author(s) 2015.

High blood glucose independent of pre-existing diabetic status predicts mortality in patients initiating peritoneal dialysis therapy.

PubMed

Chung, Sung Hee; Han, Dong Cheol; Noh, Hyunjin; Jeon, Jin Seok; Kwon, Soon Hyo; Lindholm, Bengt; Lee, Hi Bahl

2015-06-01

Poor glycemic control associates with increased mortality in diabetic (DM) dialysis patients, but it is less well established whether high blood glucose (BG) independent of pre-existing diabetic status associates with mortality in dialysis patients. We assessed factors affecting BG at the start of peritoneal dialysis (PD) and its mortality-predictive impact in Korean PD patients. In 174 PD patients (55 % males, 56 % DM), BG, nutritional status, comorbidity (CMD), and residual renal function (RRF) were assessed in conjunction with dialysis initiation. Determinants of BG and its association with mortality after a mean follow-up period of 30 ± 24 months were analyzed. On Cox proportional hazards analysis comprising all patients, old age, high CMD score, presence of protein energy wasting, and low serum albumin (Salb) concentration were independent predictors of mortality but not a high-BG level, while in patients without pre-existing diabetic status, high BG, together with old age and high CMD score, was an independent predictor of mortality. After adjustment for age, CMD score, and Salb, the risk ratio for mortality increased by 12 % per 1 mg/dL increase in BG in the non-DM patients. Patient survival in patients without pre-existing diabetic status with high BG did not differ from DM patients, but the survival of patients with high BG was significantly lower than in patients with low BG. In patients without pre-existing diabetic status, in multiple regression analysis, high BG at initiation of PD associated with high age, high body mass index, and low RRF. High blood glucose at initiation of PD associated with an increased mortality risk in PD patients without pre-existing diabetic status suggesting that blood glucose monitoring and surveillance of factors contributing to poor glycemic control are warranted in patients initiating PD therapy.

Helicobacter pylori Eradication Therapy Is Effective as the Initial Treatment for Patients with H. pylori-Negative and Disseminated Gastric Mucosa-Associated Lymphoid Tissue Lymphoma.

PubMed

Gong, Eun Jeong; Ahn, Ji Yong; Jung, Hwoon-Yong; Park, Hyungchul; Ko, Young Bo; Na, Hee Kyong; Jung, Kee Wook; Kim, Do Hoon; Lee, Jeong Hoon; Choi, Kee Don; Song, Ho June; Lee, Gin Hyug; Kim, Jin-Ho

2016-09-15

We investigated the effectiveness of Helicobacter pylori eradication therapy for gastric mucosaassociated lymphoid tissue (MALT) lymphoma regardless of the H. pylori infection status or disease stage. From November 1995 to September 2014, 345 subjects who were diagnosed with gastric MALT lymphoma and had received eradication therapy as their first-line treatment were eligible for inclusion in this study. A retrospective review was performed using the medical records. Of the 345 patients, H. pylori infection was detected in 317 patients (91.9%). The complete remission (CR) rate after eradication therapy was 82.3%, which was higher in H. pylori -positive patients than in H. pylori-negative patients (84.5% vs 57.1%, p=0.001). CR rates after eradication did not present significant differences between stages, and the CR rate was 83.3% for stage IE1 and 74.4% for stage IE2 or above (p=0.167). The overall CR rate was 87.2% after additional treatment, and neither H. pylori infection status nor stage showed differences according to the treatment response. Eradication therapy led to CR in 57.1% of H. pylori-negative patients and in 74.4% of patients with stage IE2 or above. Eradication therapy is worthwhile as an initial treatment for gastric MALT lymphoma regardless of the H. pylori infection status and stage.

Risk factors for positive margins in conservative surgery for breast cancer after neoadjuvant chemotherapy.

PubMed

Bouzón, Alberto; Acea, Benigno; García, Alejandra; Iglesias, Ángela; Mosquera, Joaquín; Santiago, Paz; Seoane, Teresa

2016-01-01

Breast conservative surgery after neoadjuvant chemotherapy intends to remove any residual tumor with negative margins. The purpose of this study was to analyze the preoperative clinical-pathological factors influencing the margin status after conservative surgery in breast cancer patients receiving neoadjuvant chemotherapy. A retrospective study of 91 breast cancer patients undergoing neoadjuvant chemotherapy (92 breast lesions) during the period 2006 to 2013. A Cox regression analysis to identify baseline tumor characteristics associated with positive margins after breast conservative surgery was performed. Of all cases, 71 tumors were initially treated with conservative surgery after neoadjuvant chemotherapy. Pathologic exam revealed positive margins in 16 of the 71 cases (22.5%). The incidence of positive margins was significantly higher in cancers with initial size >5cm (P=.021), in cancers with low tumor grade (P=.031), and in patients with hormone receptor-positive cancer (P=.006). After a median follow-up of 45.2 months, 7 patients of the 71 treated with conservative surgery had disease recurrence (9.8%). There was no significant difference in terms of disease-free survival according to the margin status (P=.596). A baseline tumor size >5cm, low tumor grade and hormone receptor-positive status increase the risk for surgical margin involvement in breast conservative surgery after neoadjuvant chemotherapy. Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Addition of long-distance heart procurement promotes changes in heart transplant waiting list status.

PubMed

Atik, Fernando Antibas; Couto, Carolina Fatima; Tirado, Freddy Ponce; Moraes, Camila Scatolin; Chaves, Renato Bueno; Vieira, Nubia W; Reis, João Gabbardo

2014-01-01

Evaluate the addition of long-distance heart procurement on a heart transplant program and the status of heart transplant recipients waiting list. Between September 2006 and October 2012, 72 patients were listed as heart transplant recipients. Heart transplant was performed in 41 (57%), death on the waiting list occurred in 26 (36%) and heart recovery occurred in 5 (7%). Initially, all transplants were performed with local donors. Long-distance, interstate heart procurement initiated in February 2011. Thirty (73%) transplants were performed with local donors and 11 (27%) with long-distance donors (mean distance=792 km±397). Patients submitted to interstate heart procurement had greater ischemic times (212 min ± 32 versus 90 min±18; P<0.0001). Primary graft dysfunction (distance 9.1% versus local 26.7%; P=0.23) and 1 month and 12 months actuarial survival (distance 90.1% and 90.1% versus local 90% and 86.2%; P=0.65 log rank) were similar among groups. There were marked incremental transplant center volume (64.4% versus 40.7%, P=0.05) with a tendency on less waiting list times (median 1.5 month versus 2.4 months, P=0.18). There was a tendency on reduced waiting list mortality (28.9% versus 48.2%, P=0.09). Incorporation of long-distance heart procurement, despite being associated with longer ischemic times, does not increase morbidity and mortality rates after heart transplant. It enhances viable donor pool, and it may reduce waiting list recipient mortality as well as waiting time.

Smoking in movies and adolescent smoking initiation: longitudinal study in six European countries.

PubMed

Morgenstern, Matthis; Sargent, James D; Engels, Rutger C M E; Scholte, Ron H J; Florek, Ewa; Hunt, Kate; Sweeting, Helen; Mathis, Federica; Faggiano, Fabrizio; Hanewinkel, Reiner

2013-04-01

Longitudinal studies from the U.S. suggest a causal relationship between exposure to images of smoking in movies and adolescent smoking onset. This study investigates whether adolescent smoking onset is predicted by the amount of exposure to smoking in movies across six European countries with various cultural and regulatory approaches to tobacco. Longitudinal survey of 9987 adolescent never-smokers recruited in the years 2009-2010 (mean age=13.2 years) in 112 state-funded schools from Germany, Iceland, Italy, The Netherlands, Poland, and the United Kingdom (UK), and followed up in 2011. Exposure to movie smoking was estimated from 250 top-grossing movies in each country. Multilevel mixed-effects Poisson regressions were performed in 2012 to assess the relationship between exposure at baseline and smoking status at follow-up. During the observation period (M=12 months), 17% of the sample initiated smoking. The estimated mean exposure to on-screen tobacco was 1560 occurrences. Overall, and after controlling for age; gender; family affluence; school performance; TV screen time; personality characteristics; and smoking status of peers, parents, and siblings, exposure to each additional 1000 tobacco occurrences increased the adjusted relative risk for smoking onset by 13% (95% CI=8%, 17%, p<0.001). The crude relationship between movie smoking exposure and smoking initiation was significant in all countries; after covariate adjustment, the relationship remained significant in Germany, Iceland, The Netherlands, Poland, and UK. Seeing smoking in movies is a predictor of smoking onset in various cultural contexts. The results confirm that limiting young people's exposure to movie smoking might be an effective way to decrease adolescent smoking onset. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Smoking in Movies and Adolescent Smoking Initiation

PubMed Central

Morgenstern, Matthis; Sargent, James D.; Engels, Rutger C.M.E.; Scholte, Ron H.J.; Florek, Ewa; Hunt, Kate; Sweeting, Helen; Mathis, Federica; Faggiano, Fabrizio; Hanewinkel, Reiner

2013-01-01

Background Longitudinal studies from the U.S. suggest a causal relationship between exposure to images of smoking in movies and adolescent smoking onset. Purpose This study investigates whether adolescent smoking onset is predicted by the amount of exposure to smoking in movies across six European countries with various cultural and regulatory approaches to tobacco. Methods Longitudinal survey of 9987 adolescent never-smokers recruited in the years 2009–2010 (mean age 13.2 years) in 112 state-funded schools from Germany, Iceland, Italy, The Netherlands, Poland, and the United Kingdom (UK), and followed-up in 2011. Exposure to movie smoking was estimated from 250 top-grossing movies in each country. Multilevel mixed-effects Poisson regressions were performed in 2012 to assess the relationship between exposure at baseline and smoking status at follow-up. Results During the observation period (M=12 months), 17% of the sample initiated smoking. The estimated mean exposure to on-screen tobacco was 1560 occurrences. Overall, and after controlling for age; gender; family affluence; school performance; TVscreen time; personality characteristics; and smoking status of peers, parents, and siblings, exposure to each additional 1000 tobacco occurrences increased the adjusted relative risk for smoking onset by 13% (95% CI=8%, 17%, p<0.001). The crude relationship between movie smoking exposure and smoking initiation was significant in all countries; after covariate adjustment, the relationship remained significant in Germany, Iceland, The Netherlands, Poland, and UK. Conclusions Seeing smoking in movies is a predictor of smoking onset in various cultural contexts. The results confirm that limiting young people’s exposure to movie smoking might be an effective way to decrease adolescent smoking onset. PMID:23498098

Decision Trees Predicting Tumor Shrinkage for Head and Neck Cancer: Implications for Adaptive Radiotherapy.

PubMed

Surucu, Murat; Shah, Karan K; Mescioglu, Ibrahim; Roeske, John C; Small, William; Choi, Mehee; Emami, Bahman

2016-02-01

To develop decision trees predicting for tumor volume reduction in patients with head and neck (H&N) cancer using pretreatment clinical and pathological parameters. Forty-eight patients treated with definitive concurrent chemoradiotherapy for squamous cell carcinoma of the nasopharynx, oropharynx, oral cavity, or hypopharynx were retrospectively analyzed. These patients were rescanned at a median dose of 37.8 Gy and replanned to account for anatomical changes. The percentages of gross tumor volume (GTV) change from initial to rescan computed tomography (CT; %GTVΔ) were calculated. Two decision trees were generated to correlate %GTVΔ in primary and nodal volumes with 14 characteristics including age, gender, Karnofsky performance status (KPS), site, human papilloma virus (HPV) status, tumor grade, primary tumor growth pattern (endophytic/exophytic), tumor/nodal/group stages, chemotherapy regimen, and primary, nodal, and total GTV volumes in the initial CT scan. The C4.5 Decision Tree induction algorithm was implemented. The median %GTVΔ for primary, nodal, and total GTVs was 26.8%, 43.0%, and 31.2%, respectively. Type of chemotherapy, age, primary tumor growth pattern, site, KPS, and HPV status were the most predictive parameters for primary %GTVΔ decision tree, whereas for nodal %GTVΔ, KPS, site, age, primary tumor growth pattern, initial primary GTV, and total GTV volumes were predictive. Both decision trees had an accuracy of 88%. There can be significant changes in primary and nodal tumor volumes during the course of H&N chemoradiotherapy. Considering the proposed decision trees, radiation oncologists can select patients predicted to have high %GTVΔ, who would theoretically gain the most benefit from adaptive radiotherapy, in order to better use limited clinical resources. © The Author(s) 2015.

Modeling Heterogeneity of Latent Growth Depending on Initial Status

ERIC Educational Resources Information Center

Klein, Andreas G.; Muthen, Bengt O.

2006-01-01

In this article, a heterogeneous latent growth curve model for modeling heterogeneity of growth rates is proposed. The suggested model is an extension of a conventional growth curve model and a complementary tool to mixed growth modeling. It allows the modeling of heterogeneity of growth rates as a continuous function of latent initial status and…

Current Status of Diversity Initiatives in Selected Multinational Corporations. Diversity in the Workforce Series Report #3.

ERIC Educational Resources Information Center

Wentling, Rose Mary; Palma-Rivas, Nilda

The current status of diversity initiatives in eight U.S.-based multinational corporations was examined through a process involving semistructured interviews of diversity managers and analysis of their annual reports for fiscal 1996 and related documents. The 8 corporations were randomly selected from the 30 multinational corporations in Illinois.…

40 CFR Table 42 to Subpart Uuu of... - Additional Information for Initial Notification of Compliance Status

Code of Federal Regulations, 2010 CFR

2010-07-01

... Notification of Compliance Status 42 Table 42 to Subpart UUU of Part 63 Protection of Environment ENVIRONMENTAL... Refineries: Catalytic Cracking Units, Catalytic Reforming Units, and Sulfur Recovery Units Pt. 63, Subpt. UUU, Table 42 Table 42 to Subpart UUU of Part 63—Additional Information for Initial Notification of...

40 CFR Table 42 to Subpart Uuu of... - Additional Information for Initial Notification of Compliance Status

Code of Federal Regulations, 2011 CFR

2011-07-01

... Notification of Compliance Status 42 Table 42 to Subpart UUU of Part 63 Protection of Environment ENVIRONMENTAL... Refineries: Catalytic Cracking Units, Catalytic Reforming Units, and Sulfur Recovery Units Pt. 63, Subpt. UUU, Table 42 Table 42 to Subpart UUU of Part 63—Additional Information for Initial Notification of...

Change of Nutritional Status Assessed Using Subjective Global Assessment Is Associated With All-Cause Mortality in Incident Dialysis Patients.

PubMed

Kwon, Young Eun; Kee, Youn Kyung; Yoon, Chang-Yun; Han, In Mee; Han, Seung Gyu; Park, Kyoung Sook; Lee, Mi Jung; Park, Jung Tak; Han, Seung H; Yoo, Tae-Hyun; Kim, Yong-Lim; Kim, Yon Su; Yang, Chul Woo; Kim, Nam-Ho; Kang, Shin-Wook

2016-02-01

Subjective global assessment (SGA) is associated with mortality in end-stage renal disease (ESRD) patients. However, little is known whether improvement or deterioration of nutritional status after dialysis initiation influences the clinical outcome. We aimed to elucidate the association between changes in nutritional status determined by SGA during the first year of dialysis and all-cause mortality in incident ESRD patients. This was a multicenter, prospective cohort study. Incident dialysis patients with available SGA data at both baseline and 12 months after dialysis commencement (n = 914) were analyzed. Nutritional status was defined as well nourished (WN, SGA A) or malnourished (MN, SGA B or C). The patients were divided into 4 groups according to the change in nutritional status between baseline and 12 months after dialysis commencement: group 1, WN to WN; group 2, MN to WN; group 3, WN to MN; and group 4, MN to MN. Cox proportional hazard analysis was performed to clarify the association between changes in nutritional status and mortality. Being in the MN group at 12 months after dialysis initiation, but not at baseline, was a significant risk factor for mortality. There was a significant difference in the 3-year survival rates among the groups (group 1, 92.2%; group 2, 86.0%; group 3, 78.2%; and group 4, 63.5%; log-rank test, P < 0.001). Multivariate Cox regression analysis revealed that the mortality risk was significantly higher in group 3 than in group 1 (hazard ratio [HR] 2.77, 95% confidence interval [CI] 1.27-6.03, P = 0.01) whereas the mortality risk was significantly lower in group 2 compared with group 4 (HR 0.35, 95% CI 0.17-0.71, P < 0.01) even after adjustment for confounding factors. Moreover, mortality risk of group 3 was significantly higher than in group 2 (HR 2.89, 95% CI 1.22-6.81, P = 0.02); there was no significant difference between groups 1 and 2. The changes in nutritional status assessed by SGA during the first year of dialysis were associated with all-cause mortality in incident ESRD patients.

Happiness and its relation to psychological well-being of adolescents.

PubMed

Heizomi, Haleh; Allahverdipour, Hamid; Asghari Jafarabadi, Mohammad; Safaian, Abdolrasul

2015-08-01

In the present decade, adolescents' mental problems are known as critical problems which have many destructive consequences. This study aimed to measure students' happiness and psychological well-being status in a sample of high school students. The cross sectional study consisted of 403 randomly selected high school students in Tabriz, Iran. Numerous variables including general health status, happiness, self-efficacy, perceived stress, hopefulness and life satisfaction were measured by using self-reported written questionnaires. Significant relation observed between happiness and psychological well-being (r=0.48). Those students with good relationship and those who had reported to enjoy attending social events indicated better mental health status. No causal inferences were investigated due to the non-experimental nature of the study. The findings also revealed that students with higher happiness score have a better school performance. Integration of happiness promotion initiatives into the comprehensive school health programs is recommended to have pleasant environments for a healthy population of adolescents. Copyright © 2015 Elsevier B.V. All rights reserved.

Prolonged Hypocalcemia Following a Single Dose of Denosumab for Diffuse Bone Metastasis of Gastric Cancer after Total Gastrectomy.

PubMed

Iizumi, Sakura; Shimoi, Tatsunori; Nishikawa, Tadaaki; Kitano, Atsuko; Sasada, Shinsuke; Shimomura, Akihiko; Noguchi, Emi; Yunokawa, Mayu; Yonemori, Kan; Shimizu, Chikako; Fujiwara, Yasuhiro; Tamura, Kenji

2017-11-01

Hypocalcemia is a significant adverse effect of denosumab. We herein report a case of prolonged hypocalcemia in a patient with multiple risk factors for hypocalcemia, including gastrectomy, increased bone turnover, and a poor performance status. Hypocalcemia developed after denosumab treatment for diffuse bone metastasis of gastric cancer, despite oral supplementation with vitamin D and calcium. To avoid serious prolonged hypocalcemia, a thorough assessment of the bone calcium metabolism is required before initiating denosumab treatment.

Prolonged Hypocalcemia Following a Single Dose of Denosumab for Diffuse Bone Metastasis of Gastric Cancer after Total Gastrectomy

PubMed Central

Iizumi, Sakura; Shimoi, Tatsunori; Nishikawa, Tadaaki; Kitano, Atsuko; Sasada, Shinsuke; Shimomura, Akihiko; Noguchi, Emi; Yunokawa, Mayu; Yonemori, Kan; Shimizu, Chikako; Fujiwara, Yasuhiro; Tamura, Kenji

2017-01-01

Hypocalcemia is a significant adverse effect of denosumab. We herein report a case of prolonged hypocalcemia in a patient with multiple risk factors for hypocalcemia, including gastrectomy, increased bone turnover, and a poor performance status. Hypocalcemia developed after denosumab treatment for diffuse bone metastasis of gastric cancer, despite oral supplementation with vitamin D and calcium. To avoid serious prolonged hypocalcemia, a thorough assessment of the bone calcium metabolism is required before initiating denosumab treatment. PMID:28943574

Status report on nuclear electric propulsion systems

NASA Technical Reports Server (NTRS)

Stearns, J. W.

1975-01-01

Progress in nuclear electric propulsion (NEP) systems for a multipayload multimission vehicle needed in both deep-space missions and a variety of geocentric missions is reviewed. The space system power level is a function of the initial launch vehicle mass, but developments in out-of-core nuclear thermionic direct conversion have broadened design options. Cost, design, and performance parameters are compared for reusable chemical space tugs and NEP reusable space tugs. Improvements in heat pipes, ion engines, and magnetoplasmadynamic arc jet thrust subsystems are discussed.

Post-event processing in social anxiety disorder: Examining the mediating roles of positive metacognitive beliefs and perceptions of performance.

PubMed

Gavric, Dubravka; Moscovitch, David A; Rowa, Karen; McCabe, Randi E

2017-04-01

Post-event processing (PEP) is defined as repetitive negative thinking following anxiety provoking social events. PEP is thought to maintain anxiety symptoms in Social Anxiety Disorder (SAD) but little is known about the specific factors that contribute to the maintenance of PEP. The current study investigated how perceptions of performance and positive metacognitive beliefs might contribute to the persistence of PEP. Participants with SAD (n = 24) as well as anxious (n = 24) and healthy (n = 25) control participants completed a standardized social performance task in the lab. Their engagement in PEP and perceptions of performance were assessed in the week that followed. Immediately following the social task, individuals with SAD rated their performance more negatively and endorsed a greater number of positive metacognitive beliefs about PEP than did participants in both control groups. Importantly, both metacognitive beliefs and initial negative self-ratings of performance mediated the relationship between group status and PEP in the days following the event. These results are consistent with cognitive and metacognitive models of SAD and enhance our understanding of the cognitive processes which may function to initiate and maintain negative thinking patterns in SAD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Long-lasting active lifestyle and successful cognitive aging in a healthy elderly population: The PROOF cohort.

PubMed

Saint Martin, M; Sforza, E; Barthélémy, J C; Roche, F; Lefèvre, P; Liénard, G; Thomas-Anterion, C

2017-12-01

The aim of this study was to determine whether cognitive reserve in the elderly affects the evolution of cognitive performance and what its relationship is with active lifestyles in later life. Cognitive performance was evaluated at baseline and 8 years later in 543 participants of the PROOF cohort, initially aged 67 years. Subjects were categorized as Cognitively Elite (CE), Cognitively Normal (CN) or Cognitively Impaired (CI) at each evaluation. At follow-up, demographic data and lifestyle, including social, intellectual and physical behaviors, were collected by questionnaires. As much as 69% (n=375) remained unchanged, while 25.5% (n=138) decreased and 5.5% (n=30) improved. When present, the reduction in cognitive status was most often limited to one level, but was dependent on the initial level, affecting up to 73% of the initially CN, but only 58% of the initially CE. Cognitive stability was significantly associated with the degree of social engagement at follow-up (CE: P=0.009; CN: P=0.025). In the healthy elderly, high cognitive ability predicts both cognitive ability and social involvement in later life. Cognitive decline by only one level may also extend the time to reach impairment, underlining the importance of the so-called cognitive reserve. Copyright © 2017. Published by Elsevier Masson SAS.

Health care utilization of refugee children after resettlement.

PubMed

Watts, Delma-Jean; Friedman, Jennifer F; Vivier, Patrick M; Tompkins, Christine E A; Alario, Anthony J

2012-08-01

Refugee children can have significant health problems. Our objective was to describe health status and health care utilization of refugee children after resettlement. A retrospective chart review of refugee children was performed. Initial laboratory data was extracted. Primary care visits, emergency room visits, and subspecialty referrals in the first 15 months from arrival were recorded. The sample included 198 refugees, many with positive initial screening tests. After arrival, 21% had an emergency department visit, 40% had a primary care sick visit, and 71% had a primary care follow-up. Mean number of visits ranged from 0.3 for emergency department to 1.9 for follow-up. Fifty-seven percent were referred to at least one subspecialist. Refugee children had substantial disease burden at arrival. Most had primary care follow-up visits and subspecialty referral after resettlement. These visits were largely for problems identified on initial screening and for general pediatric illnesses.

Salvage treatment for recurrent oropharyngeal squamous cell carcinoma.

PubMed

Röösli, Christof; Studer, Gabriela; Stoeckli, Sandro J

2010-08-01

This study evaluates the oncological outcome of patients with recurrent oropharyngeal squamous cell carcinoma (OPSCC) after primary radiation therapy +/- chemotherapy, primary surgical therapy, and surgical therapy followed by radiation therapy +/- chemotherapy. A total of 156 patients (36%) of a cohort of 427 treated for OPSCC between 1990 and 2006 developed recurrent disease. Fifty-one patients (12%) qualified for salvage treatment. Study endpoints were 5-year overall survival (OS) and disease-specific survival (DSS). The 5-year OS and DSS rates after salvage treatment were 29% and 40%; after initial primary radiation therapy, 25% and 40%; after initial surgery followed by radiation therapy, 40% and 40%; and after initial surgery alone, 20% and 40%. Patients with an advanced OPSCC have a considerable risk for recurrence. Despite poor ultimate outcome, salvage treatment should be attempted in patients with resectable disease, good performance status, and absence of distant metastases. 2009 Wiley Periodicals, Inc. Head Neck, 2010.

Prognostic factors for survival in 676 consecutive patients with newly diagnosed primary glioblastoma.

PubMed

Filippini, Graziella; Falcone, Chiara; Boiardi, Amerigo; Broggi, Giovanni; Bruzzone, Maria G; Caldiroli, Dario; Farina, Rita; Farinotti, Mariangela; Fariselli, Laura; Finocchiaro, Gaetano; Giombini, Sergio; Pollo, Bianca; Savoiardo, Mario; Solero, Carlo L; Valsecchi, Maria G

2008-02-01

Reliable data on large cohorts of patients with glioblastoma are needed because such studies differ importantly from trials that have a strong bias toward the recruitment of younger patients with a higher performance status. We analyzed the outcome of 676 patients with histologically confirmed newly diagnosed glioblastoma who were treated consecutively at a single institution over a 7-year period (1997-2003) with follow-up to April 30, 2006. Survival probabilities were 57% at 1 year, 16% at 2 years, and 7% at 3 years. Progression-free survival was 15% at 1 year. Prolongation of survival was significantly associated with surgery in patients with a good performance status, whatever the patient's age, with an adjusted hazard ratio of 0.55 (p < 0.001) or a 45% relative decrease in the risk of death. Radiotherapy and chemotherapy improved survival, with adjusted hazard ratios of 0.61 (p = 0.001) and 0.89 (p = 0.04), respectively, regardless of age, performance status, or residual tumor volume. Recurrence occurred in 99% of patients throughout the follow-up. Reoperation was performed in one-fourth of these patients but was not effective, whether performed within 9 months (hazard ratio, 0.86; p = 0.256) or after 9 months (hazard ratio, 0.98; p = 0.860) of initial surgery, whereas second-line chemotherapy with procarbazine, lomustine, and vincristine (PCV) or with temozolomide improved survival (hazard ratio, 0.77; p = 0.008). Surgery followed by radiotherapy and chemotherapy should be considered in all patients with glioblastoma, and these treatments should not be withheld because of increasing age alone. The benefit of second surgery at recurrence is uncertain, and new trials are needed to assess its effectiveness. Chemotherapy with PCV or temozolomide seems to be a reasonable option at tumor recurrence.

Prognostic factors for survival in 676 consecutive patients with newly diagnosed primary glioblastoma

PubMed Central

Filippini, Graziella; Falcone, Chiara; Boiardi, Amerigo; Broggi, Giovanni; Bruzzone, Maria G.; Caldiroli, Dario; Farina, Rita; Farinotti, Mariangela; Fariselli, Laura; Finocchiaro, Gaetano; Giombini, Sergio; Pollo, Bianca; Savoiardo, Mario; Solero, Carlo L.; Valsecchi, Maria G.

2008-01-01

Reliable data on large cohorts of patients with glioblastoma are needed because such studies differ importantly from trials that have a strong bias toward the recruitment of younger patients with a higher performance status. We analyzed the outcome of 676 patients with histologically confirmed newly diagnosed glioblastoma who were treated consecutively at a single institution over a 7-year period (1997 – 2003) with follow-up to April 30, 2006. Survival probabilities were 57% at 1 year, 16% at 2 years, and 7% at 3 years. Progression-free survival was 15% at 1 year. Prolongation of survival was significantly associated with surgery in patients with a good performance status, whatever the patient’s age, with an adjusted hazard ratio of 0.55 (p < 0.001) or a 45% relative decrease in the risk of death. Radiotherapy and chemotherapy improved survival, with adjusted hazard ratios of 0.61 (p = 0.001) and 0.89 (p = 0.04), respectively, regardless of age, performance status, or residual tumor volume. Recurrence occurred in 99% of patients throughout the follow-up. Reoperation was performed in one-fourth of these patients but was not effective, whether performed within 9 months (hazard ratio, 0.86; p = 0.256) or after 9 months (hazard ratio, 0.98; p = 0.860) of initial surgery, whereas second-line chemotherapy with procarbazine, lomustine, and vincristine (PCV) or with temozolomide improved survival (hazard ratio, 0.77; p = 0.008). Surgery followed by radiotherapy and chemotherapy should be considered in all patients with glioblastoma, and these treatments should not be withheld because of increasing age alone. The benefit of second surgery at recurrence is uncertain, and new trials are needed to assess its effectiveness. Chemotherapy with PCV or temozolomide seems to be a reasonable option at tumor recurrence. PMID:17993634

Correlation of immunohistochemical mismatch repair protein status between colorectal carcinoma endoscopic biopsy and resection specimens.

PubMed

O'Brien, Odharnaith; Ryan, Éanna; Creavin, Ben; Kelly, Michael E; Mohan, Helen M; Geraghty, Robert; Winter, Des C; Sheahan, Kieran

2018-02-01

Microsatellite instability is reflective of a deficient mismatch repair system (dMMR), which may be due to either sporadic or germline mutations in the relevant mismatch repair (MMR) gene. MMR status is frequently determined by immunohistochemistry (IHC) for mismatch repair proteins (MMRPs) on colorectal cancer (CRC) resection specimens. However, IHC testing performed on endoscopic biopsy may be as reliable as that performed on surgical resections. We aimed to evaluate the reliability of MMR IHC staining on preoperative CRC endoscopic biopsies compared with matched-surgical resection specimens. A retrospective search of our institution's histopathology electronic database was performed. Patients with CRC who had MMR IHC performed on both their preoperative endoscopic biopsy and subsequent resection from January 2010 to January 2016 were included. Concordance of MMR staining between biopsy and resection specimens was assessed. From 2000 to 2016, 53 patients had MMR IHC performed on both their preoperative colorectal endoscopic biopsy and resection specimens; 10 patients (18.87%) demonstrated loss of ≥1 MMRP on their initial endoscopic tumour biopsy. The remainder (81.13%) showed preservation of staining for all MMRPs. There was complete agreement in MMR IHC status between the preoperative endoscopic biopsies and corresponding resection specimens in all cases (κ=1.000, P<0.000) with a sensitivity of 100% (95% CI 69.15 to 100) and specificity of 100% (95% CI 91.78 to 100) for detection of dMMR. Endoscopic biopsies are a suitable source of tissue for MMR IHC analysis. This may provide a number of advantages to both patients and clinicians in the management of CRC. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Three or More Courses of Stereotactic Radiosurgery for Patients with Multiply Recurrent Brain Metastases.

PubMed

Kotecha, Rupesh; Damico, Nicholas; Miller, Jacob A; Suh, John H; Murphy, Erin S; Reddy, Chandana A; Barnett, Gene H; Vogelbaum, Michael A; Angelov, Lilyana; Mohammadi, Alireza M; Chao, Samuel T

2017-06-01

Although patients with brain metastasis are treated with primary stereotactic radiosurgery (SRS), the use of salvage therapies and their consequence remains understudied. To study the intracranial recurrence patterns and salvage therapies for patients who underwent multiple SRS courses. A retrospective review was performed of 59 patients with brain metastases who underwent ≥3 SRS courses for new lesions. Cox regression analyzed factors predictive for overall survival. The median age at diagnosis was 52 years. Over time, patients underwent a median of 3 courses of SRS (range: 3-8) to a total of 765 different brain metastases. The 6-month risk of distant intracranial recurrence after the first SRS treatment was 64% (95% confidence interval: 52%-77%). Overall survival was 40% (95% confidence interval: 28%-53%) at 24 months. Only 24 patients (41%) had a decline in their Karnofsky Performance Status ≤70 at last office visit. Quality of life was preserved among 77% of patients at 12 months, with 45% experiencing clinically significant improvement during clinical follow-up. Radiation necrosis developed in 10 patients (17%). On multivariate analysis, gender (males, Hazard Ratio [HR]: 2.0, P < .05), Karnofsky Performance Status ≤80 (HR 3.2, P < .001), extracranial metastases (HR: 3.6, P < .001), and a distant intracranial recurrence ≤3 months from initial to repeat SRS (HR: 3.8, P < .001) were associated with a poorer survival. In selected patients, performing ≥3 SRS courses controls intracranial disease. Patients may need salvage SRS for distant intracranial relapse, but focal retreatments are associated with modest toxicity, do not appear to negatively affect a patient's performance status, and help preserve quality of life. Copyright © 2017 by the Congress of Neurological Surgeons

Auditory Contagious Yawning in Humans: An Investigation into Affiliation and Status Effects

PubMed Central

Massen, Jorg J. M.; Church, Allyson M.; Gallup, Andrew C.

2015-01-01

While comparative research on contagious yawning has grown substantially in the past few years, both the interpersonal factors influencing this response and the sensory modalities involved in its activation in humans remain relatively unknown. Extending upon previous studies showing various in-group and status effects in non-human great apes, we performed an initial study to investigate how the political affiliation (Democrat vs. Republican) and status (high vs. low) of target stimuli influences auditory contagious yawning, as well as the urge to yawn, in humans. Self-report responses and a subset of video recordings were analyzed from 118 undergraduate students in the US following exposure to either breathing (control) or yawning (experimental) vocalizations paired with images of former US Presidents (high status) and their respective Cabinet Secretaries of Commerce (low status). The overall results validate the use of auditory stimuli to prompt yawn contagion, with greater response in the experimental than the control condition. There was also a negative effect of political status on self-reported yawning and the self-reported urge to yawn irrespective of the condition. In contrast, we found no evidence for a political affiliation bias in this response. These preliminary findings are discussed in terms of the existing comparative evidence, though we highlight limitations in the current investigation and we provide suggestions for future research in this area. PMID:26617557

The association of insurance status on the probability of transfer for pediatric trauma patients.

PubMed

Hamilton, Emma C; Miller, Charles C; Cotton, Bryan A; Cox, Charles; Kao, Lillian S; Austin, Mary T

2016-12-01

The purpose of this study was to evaluate the association of insurance status on the probability of transfer of pediatric trauma patients to level I/II centers after initial evaluation at lower level centers. A retrospective review of all pediatric trauma patients (age<16years) registered in the 2007-2012 National Trauma Data Bank was performed. Multiple regression techniques controlling for clustering at the hospital level were used to determine the impact of insurance status on the probability of transfer to level I/II trauma centers. Of 38,205 patients, 33% of patients (12,432) were transferred from lower level centers to level I/II trauma centers. Adjusting for demographics and injury characteristics, children with no insurance had a higher likelihood of transfer than children with private insurance. Children with public or unknown insurance status were no more likely to be transferred than privately insured children. There were no variable interactions with insurance status. Among pediatric trauma patients, lack of insurance is an independent predictor for transfer to a major trauma center. While burns, severely injured, and younger patients remain the most likely to be transferred, these findings suggest a triage bias influenced by insurance status. Additional policies may be needed to avoid unnecessary transfer of uninsured pediatric trauma patients. Case-control study, level III. Copyright © 2016 Elsevier Inc. All rights reserved.

Kolmogorov-Smirnov statistical test for analysis of ZAP-70 expression in B-CLL, compared with quantitative PCR and IgV(H) mutation status.

PubMed

Van Bockstaele, Femke; Janssens, Ann; Piette, Anne; Callewaert, Filip; Pede, Valerie; Offner, Fritz; Verhasselt, Bruno; Philippé, Jan

2006-07-15

ZAP-70 has been proposed as a surrogate marker for immunoglobulin heavy-chain variable region (IgV(H)) mutation status, which is known as a prognostic marker in B-cell chronic lymphocytic leukemia (CLL). The flow cytometric analysis of ZAP-70 suffers from difficulties in standardization and interpretation. We applied the Kolmogorov-Smirnov (KS) statistical test to make analysis more straightforward. We examined ZAP-70 expression by flow cytometry in 53 patients with CLL. Analysis was performed as initially described by Crespo et al. (New England J Med 2003; 348:1764-1775) and alternatively by application of the KS statistical test comparing T cells with B cells. Receiver-operating-characteristics (ROC)-curve analyses were performed to determine the optimal cut-off values for ZAP-70 measured by the two approaches. ZAP-70 protein expression was compared with ZAP-70 mRNA expression measured by a quantitative PCR (qPCR) and with the IgV(H) mutation status. Both flow cytometric analyses correlated well with the molecular technique and proved to be of equal value in predicting the IgV(H) mutation status. Applying the KS test is reproducible, simple, straightforward, and overcomes a number of difficulties encountered in the Crespo-method. The KS statistical test is an essential part of the software delivered with modern routine analytical flow cytometers and is well suited for analysis of ZAP-70 expression in CLL. (c) 2006 International Society for Analytical Cytology.

Gaps and opportunities in refractory status epilepticus research in children: a multi-center approach by the Pediatric Status Epilepticus Research Group (pSERG).

PubMed

Sánchez Fernández, Iván; Abend, Nicholas S; Agadi, Satish; An, Sookee; Arya, Ravindra; Carpenter, Jessica L; Chapman, Kevin E; Gaillard, William D; Glauser, Tracy A; Goldstein, David B; Goldstein, Joshua L; Goodkin, Howard P; Hahn, Cecil D; Heinzen, Erin L; Mikati, Mohamad A; Peariso, Katrina; Pestian, John P; Ream, Margie; Riviello, James J; Tasker, Robert C; Williams, Korwyn; Loddenkemper, Tobias

2014-02-01

Status epilepticus (SE) is a life-threatening condition that can be refractory to initial treatment. Randomized controlled studies to guide treatment choices, especially beyond first-line drugs, are not available. This report summarizes the evidence that guides the management of refractory convulsive SE (RCSE) in children, defines gaps in our clinical knowledge and describes the development and works of the 'pediatric Status Epilepticus Research Group' (pSERG). A literature review was performed to evaluate current gaps in the pediatric SE and RCSE literature. In person and online meetings helped to develop and expand the pSERG network. The care of pediatric RCSE is largely based on extrapolations of limited evidence derived from adult literature and supplemented with case reports and case series in children. No comparative effectiveness trials have been performed in the pediatric population. Gaps in knowledge include risk factors for SE, biomarkers of SE and RCSE, second- and third-line treatment options, and long-term outcome. The care of children with RCSE is based on limited evidence. In order to address these knowledge gaps, the multicenter pSERG was established to facilitate prospective collection, analysis, and sharing of de-identified data and biological specimens from children with RCSE. These data will allow identification of treatment strategies associated with better outcomes and delineate evidence-based interventions to improve the care of children with SE. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

37 CFR 11.29 - Reciprocal transfer or initial transfer to disability inactive status.

Code of Federal Regulations, 2010 CFR

2010-07-01

... until reinstated to active status. (h) Confidentiality of proceeding; Orders to be public—(1... section may resume active status except by order of the OED Director. (2) Petition. A practitioner... Director for transfer to active status once a year, or at whatever shorter intervals the USPTO Director may...

Functional Outcome of Neurologic-Controlled HAL-Exoskeletal Neurorehabilitation in Chronic Spinal Cord Injury: A Pilot With One Year Treatment and Variable Treatment Frequency.

PubMed

Jansen, Oliver; Schildhauer, Thomas A; Meindl, Renate C; Tegenthoff, Martin; Schwenkreis, Peter; Sczesny-Kaiser, Matthias; Grasmücke, Dennis; Fisahn, Christian; Aach, Mirko

2017-12-01

Longitudinal prospective study. Whether 1-year HAL-BWSTT of chronic spinal cord injured patients can improve independent ambulated mobility further as a function of training frequency, after an initial 3-month training period. Eight patients with chronic SCI were enrolled. They initially received full standard physical therapy and neurorehabilitation in the acute/subacute posttrauma phase. During this trial, all patients first underwent a daily (5 per week) HAL-BWSTT for 12 weeks. Subsequently, these patients performed a 40-week HAL-BWSTT with a training session frequency of either 1 or 3 to 5 sessions per week. The patients' functional status including HAL-associated treadmill-walking time, -distance, and -speed with additional analysis of gait pattern, and their independent (without wearing the robot suit) functional mobility improvements, were assessed using the 10-Meter-Walk Test (10MWT), Timed-Up-and-Go Test (TUG) and 6-Minute-Walk Test (6MinWT) on admission, at 6 weeks, 12 weeks, and 1 year after enrollment. The data were analyzed separately for the 2 training frequency subgroups after the initial 12-week training period, which was identical in both groups. During the 1-year follow-up, HAL-associated walking parameters and independent functional improvements were maintained in all the patients. This result held irrespective of the training frequency. Long-term 1-year maintenance of HAL-associated treadmill walking parameters and of improved independent walking abilities after initial 12 weeks of daily HAL-BWSTT is possible and depends mainly on the patients' ambulatory status accomplished after initial training period. Subsequent regular weekly training, but not higher frequency training, seems to be sufficient to preserve the improvements accomplished.

Functional Outcome of Neurologic-Controlled HAL-Exoskeletal Neurorehabilitation in Chronic Spinal Cord Injury: A Pilot With One Year Treatment and Variable Treatment Frequency

PubMed Central

Schildhauer, Thomas A.; Meindl, Renate C.; Tegenthoff, Martin; Schwenkreis, Peter; Sczesny-Kaiser, Matthias; Grasmücke, Dennis; Fisahn, Christian; Aach, Mirko

2017-01-01

Study Design: Longitudinal prospective study. Objectives: Whether 1-year HAL-BWSTT of chronic spinal cord injured patients can improve independent ambulated mobility further as a function of training frequency, after an initial 3-month training period. Methods: Eight patients with chronic SCI were enrolled. They initially received full standard physical therapy and neurorehabilitation in the acute/subacute posttrauma phase. During this trial, all patients first underwent a daily (5 per week) HAL-BWSTT for 12 weeks. Subsequently, these patients performed a 40-week HAL-BWSTT with a training session frequency of either 1 or 3 to 5 sessions per week. The patients’ functional status including HAL-associated treadmill-walking time, -distance, and -speed with additional analysis of gait pattern, and their independent (without wearing the robot suit) functional mobility improvements, were assessed using the 10-Meter-Walk Test (10MWT), Timed-Up-and-Go Test (TUG) and 6-Minute-Walk Test (6MinWT) on admission, at 6 weeks, 12 weeks, and 1 year after enrollment. The data were analyzed separately for the 2 training frequency subgroups after the initial 12-week training period, which was identical in both groups. Results: During the 1-year follow-up, HAL-associated walking parameters and independent functional improvements were maintained in all the patients. This result held irrespective of the training frequency. Conclusions: Long-term 1-year maintenance of HAL-associated treadmill walking parameters and of improved independent walking abilities after initial 12 weeks of daily HAL-BWSTT is possible and depends mainly on the patients’ ambulatory status accomplished after initial training period. Subsequent regular weekly training, but not higher frequency training, seems to be sufficient to preserve the improvements accomplished. PMID:29238636

40 CFR Table 42 to Subpart Uuu of... - Additional Information for Initial Notification of Compliance Status

Code of Federal Regulations, 2013 CFR

2013-07-01

... Notification of Compliance Status 42 Table 42 to Subpart UUU of Part 63 Protection of Environment ENVIRONMENTAL..., Subpt. UUU, Table 42 Table 42 to Subpart UUU of Part 63—Additional Information for Initial Notification... source or vent associated with an affected source not subject to the requirements of subpart UUU. 2...

40 CFR Table 42 to Subpart Uuu of... - Additional Information for Initial Notification of Compliance Status

Code of Federal Regulations, 2012 CFR

2012-07-01

... Notification of Compliance Status 42 Table 42 to Subpart UUU of Part 63 Protection of Environment ENVIRONMENTAL..., Subpt. UUU, Table 42 Table 42 to Subpart UUU of Part 63—Additional Information for Initial Notification... source or vent associated with an affected source not subject to the requirements of subpart UUU. 2...

40 CFR Table 42 to Subpart Uuu of... - Additional Information for Initial Notification of Compliance Status

Code of Federal Regulations, 2014 CFR

2014-07-01

... Notification of Compliance Status 42 Table 42 to Subpart UUU of Part 63 Protection of Environment ENVIRONMENTAL..., Subpt. UUU, Table 42 Table 42 to Subpart UUU of Part 63—Additional Information for Initial Notification... source or vent associated with an affected source not subject to the requirements of subpart UUU. 2...

War zone veterans returning to treatment: effects of social functioning and psychopathology.

PubMed

Fontana, Alan; Rosenheck, Robert

2010-10-01

Patients with mental illness often return for further treatment after an initial episode of care. Two processes that may contribute to the return for further treatment are the severity of patients' initial social and clinical status; and/or deterioration in their status over time, regardless of their initial status. This study examined these processes in an administrative database of war zone veterans who had received outpatient treatment from a Veterans Affairs specialized posttraumatic stress disorder program. The results suggest that both initial severity and deterioration of status contribute to return to treatment and involve changes in both social functioning and psychopathology. Determination of the direction of effects between social functioning and psychopathology showed that psychopathology in the form of PTSD, other Axis I disorder or violent behavior generally affected subsequent social functioning, but not vice versa. Psychopathology in the form of alcohol or drug abuse/dependence, however, showed reciprocal effects with social functioning. These results point to the importance of emphasizing interventions that address social dysfunction and that address psychopathology, from the beginning of treatment as a way of maximizing the benefits and minimizing the need for recurrent care.

A rate-based transcutaneous CO2 sensor for noninvasive respiration monitoring.

PubMed

Chatterjee, M; Ge, X; Kostov, Y; Luu, P; Tolosa, L; Woo, H; Viscardi, R; Falk, S; Potts, R; Rao, G

2015-05-01

The pain and risk of infection associated with invasive blood sampling for blood gas measurements necessitate the search for reliable noninvasive techniques. In this work we developed a novel rate-based noninvasive method for a safe and fast assessment of respiratory status. A small sampler was built to collect the gases diffusing out of the skin. It was connected to a CO2 sensor through gas-impermeable tubing. During a measurement, the CO2 initially present in the sampler was first removed by purging it with nitrogen. The gases in the system were then recirculated between the sampler and the CO2 sensor, and the CO2 diffusion rate into the sampler was measured. Because the measurement is based on the initial transcutaneous diffusion rate, reaching mass transfer equilibrium and heating the skin is no longer required, thus, making it much faster and safer than traditional method. A series of designed experiments were performed to analyze the effect of the measurement parameters such as sampler size, measurement location, subject positions, and movement. After the factor analysis tests, the prototype was sent to a level IV NICU for clinical trial. The results show that the measured initial rate of increase in CO2 partial pressure is linearly correlated with the corresponding arterial blood gas measurements. The new approach can be used as a trending tool, making frequent blood sampling unnecessary for respiratory status monitoring.

Disclosure History Among Persons Initiating Antiretroviral Treatment at Six HIV Clinics in Oromia, Ethiopia, 2012-2013.

PubMed

Gadisa, Tsigereda; Tymejczyk, Olga; Kulkarni, Sarah Gorrell; Hoffman, Susie; Lahuerta, Maria; Remien, Robert H; Yigzaw, Muluneh; Daba, Shalo; Elul, Batya; Nash, Denis; Melaku, Zenebe

2017-01-01

HIV status disclosure can help patients obtain support which may influence treatment adherence and subsequent healthcare needs. We examined the extent of disclosure and correlates of non-disclosure among 1180 adults newly initiating antiretroviral treatment (ART). While 91 % of those in a relationship shared their status with their partners, 14 % of the overall sample had not disclosed to anyone. Non-disclosure was positively associated with older age; control over household resources; and concerns about unintended disclosure, life disruptions, and family reactions. Knowing other HIV-positive people and longer time since diagnosis were associated with lower odds of non-disclosure. Most respondents reporting disclosure experienced supportive responses, frequently including decision to get an HIV test by confidants who had not known their own status. Although HIV status disclosure prior to ART initiation was high, some individuals cited concerns about unintended disclosure, gossip, and partner violence, and may benefit from additional disclosure support.

Disclosure History Among Persons Initiating Antiretroviral Treatment at Six HIV Clinics in Oromia, Ethiopia, 2012–2013

PubMed Central

Gadisa, Tsigereda; Kulkarni, Sarah Gorrell; Hoffman, Susie; Lahuerta, Maria; Remien, Robert H.; Yigzaw, Muluneh; Daba, Shalo; Elul, Batya; Nash, Denis; Melaku, Zenebe

2016-01-01

HIV status disclosure can help patients obtain support which may influence treatment adherence and subsequent healthcare needs. We examined the extent of disclosure and correlates of non-disclosure among 1180 adults newly initiating antiretroviral treatment (ART). While 91 % of those in a relationship shared their status with their partners, 14 % of the overall sample had not disclosed to anyone. Non- disclosure was positively associated with older age; control over household resources; and concerns about unintended disclosure, life disruptions, and family reactions. Knowing other HIV-positive people and longer time since diagnosis were associated with lower odds of non-disclosure. Most respondents reporting disclosure experienced supportive responses, frequently including decision to get an HIV test by confidants who had not known their own status. Although HIV status disclosure prior to ART initiation was high, some individuals cited concerns about unintended disclosure, gossip, and partner violence, and may benefit from additional disclosure support. PMID:26781869

40 CFR 63.10400 - How do I demonstrate initial compliance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... CATEGORIES (CONTINUED) National Emission Standards for Hospital Ethylene Oxide Sterilizers Initial Compliance... submitting an Initial Notification of Compliance Status certifying that you are venting the ethylene oxide...

The Effects of Residency and Body Size on Contest Initiation and Outcome in the Territorial Dragon, Ctenophorus decresii

PubMed Central

Umbers, Kate D. L.; Osborne, Louise; Keogh, J. Scott

2012-01-01

Empirical studies of the determinants of contests have been attempting to unravel the complexity of animal contest behaviour for decades. This complexity requires that experiments incorporate multiple determinants into studies to tease apart their relative effects. In this study we examined the complex contest behaviour of the tawny dragon (Ctenophorus decresii), a territorial agamid lizard, with the specific aim of defining the factors that determine contest outcome. We manipulated the relative size and residency status of lizards in contests to weight their importance in determining contest outcome. We found that size, residency and initiating a fight were all important in determining outcomes of fights. We also tested whether residency or size was important in predicting the status of lizard that initiated a fight. We found that residency was the most important factor in predicting fight initiation. We discuss the effects of size and residency status in context of previous studies on contests in tawny dragons and other animals. Our study provides manipulative behavioural data in support of the overriding effects of residency on initiation fights and winning them. PMID:23077558

ALSSAT Development Status

NASA Technical Reports Server (NTRS)

Yeh, H. Y. Jannivine; Brown, Cheryl B.; Jeng, Frank F.; Anderson, Molly; Ewert, Michael K.

2009-01-01

The development of the Advanced Life Support (ALS) Sizing Analysis Tool (ALSSAT) using Microsoft(Registered TradeMark) Excel was initiated by the Crew and Thermal Systems Division (CTSD) of Johnson Space Center (JSC) in 1997 to support the ALS and Exploration Offices in Environmental Control and Life Support System (ECLSS) design and studies. It aids the user in performing detailed sizing of the ECLSS for different combinations of the Exploration Life support (ELS) regenerative system technologies. This analysis tool will assist the user in performing ECLSS preliminary design and trade studies as well as system optimization efficiently and economically. The latest ALSSAT related publication in ICES 2004 detailed ALSSAT s development status including the completion of all six ELS Subsystems (ELSS), namely, the Air Management Subsystem, the Biomass Subsystem, the Food Management Subsystem, the Solid Waste Management Subsystem, the Water Management Subsystem, and the Thermal Control Subsystem and two external interfaces, including the Extravehicular Activity and the Human Accommodations. Since 2004, many more regenerative technologies in the ELSS were implemented into ALSSAT. ALSSAT has also been used for the ELS Research and Technology Development Metric Calculation for FY02 thru FY06. It was also used to conduct the Lunar Outpost Metric calculation for FY08 and was integrated as part of a Habitat Model developed at Langley Research Center to support the Constellation program. This paper will give an update on the analysis tool s current development status as well as present the analytical results of one of the trade studies that was performed.

Which Assessment Method of Malnutrition in Head and Neck Cancer?

PubMed

Saroul, Nicolas; Pastourel, Rémy; Mulliez, Aurélien; Farigon, Nicolas; Dupuch, Vincent; Mom, Thierry; Boirie, Yves; Gilain, Laurent

2018-06-01

Objective To assess the value of several diagnostic methods of nutritional status during the initial management of a head and neck cancer. Study Design Single-center prospective study. Setting Tertiary referral center. Subjects and Methods Ninety patients with head and neck cancer participated in the study. Assessment of their nutritional status was made with anthropometric, biological, body, and muscle measurements (the last by computed tomography: L3 muscle mass index [L3MMI]). Assessment of muscle performance (functional reflection of nutritional status) was made via the Short Physical Performance Battery test. The malnutrition thresholds were set according to the literature. Results Mean body mass index (BMI) was 24.6 ± 5.4 kg/m 2 . Mean weight loss and albumin levels were -4.5 ± 10.5 kg and 37.1 ± 5.2 g/L, respectively. Fourteen percent of patients were diagnosed as malnourished on the basis of BMI, 54% according to the Nutritional Risk Index (NRI), and 58% by L3MMI. There was 64% agreement between NRI and L3MMI ( P < .001). All patients identified as malnourished by BMI were considered as such by the other assessment methods; however, many malnourished patients had normal or high BMI. The Short Physical Performance Battery score was low particularly among patients considered to be the most undernourished by the other methods. Conclusion NRI and L3MMI are the best methods to identify patients as being malnourished. Functional muscle assessment can determine the severity of malnutrition.

How to perform Subjective Global Nutritional assessment in children.

PubMed

Secker, Donna J; Jeejeebhoy, Khursheed N

2012-03-01

Subjective Global Assessment (SGA) is a method for evaluating nutritional status based on a practitioner's clinical judgment rather than objective, quantitative measurements. Encompassing historical, symptomatic, and physical parameters, SGA aims to identify an individual's initial nutrition state and consider the interplay of factors influencing the progression or regression of nutrition abnormalities. SGA has been widely used for more than 25 years to assess the nutritional status of adults in both clinical and research settings. Perceiving multiple benefits of its use in children, we recently adapted and validated the SGA tool for use in a pediatric population, demonstrating its ability to identify the nutritional status of children undergoing surgery and their risk of developing nutrition-associated complications postoperatively. Objective measures of nutritional status, on the other hand, showed no association with outcomes. The purpose of this article is to describe in detail the methods used in conducting nutrition-focused physical examinations and the medical history components of a pediatric Subjective Global Nutritional Assessment tool. Guidelines are given for performing and interpreting physical examinations that look for evidence of loss of subcutaneous fat, muscle wasting, and/or edema in children of different ages. Age-related questionnaires are offered to guide history taking and the rating of growth, weight changes, dietary intake, gastrointestinal symptoms, functional capacity, and any metabolic stress. Finally, the associated rating form is provided, along with direction for how to consider all components of a physical exam and history in the context of each other, to assign an overall rating of normal/well nourished, moderate malnutrition, or severe malnutrition. With this information, interested health professionals will be able to perform Subjective Global Nutritional Assessment to determine a global rating of nutritional status for infants, children, and adolescents, and use this rating to guide decision making about what nutrition-related attention is necessary. Dietetics practitioners and other clinicians are encouraged to incorporate physical examination for signs of protein-energy depletion when assessing the nutritional status of children. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Initial water deficit effects on Lupinus albus photosynthetic performance, carbon metabolism, and hormonal balance: metabolic reorganization prior to early stress responses.

PubMed

Pinheiro, Carla; António, Carla; Ortuño, Maria Fernanda; Dobrev, Petre I; Hartung, Wolfram; Thomas-Oates, Jane; Ricardo, Cândido Pinto; Vanková, Radomira; Chaves, M Manuela; Wilson, Julie C

2011-10-01

The early (2-4 d) effects of slowly imposed soil water deficit on Lupinus albus photosynthetic performance, carbon metabolism, and hormonal balance in different organs (leaf blade, stem stele, stem cortex, and root) were evaluated on 23-d-old plants (growth chamber assay). Our work shows that several metabolic adjustments occurred prior to alteration of the plant water status, implying that water deficit is perceived before the change in plant water status. The slow, progressive decline in soil water content started to be visible 3 d after withholding water (3 DAW). The earliest plant changes were associated with organ-specific metabolic responses (particularly in the leaves) and with leaf conductance and only later with plant water status and photosynthetic rate (4 DAW) or photosynthetic capacity (according to the Farquhar model; 6 DAW). Principal component analysis (PCA) of the physiological parameters, the carbohydrate and the hormone levels and their relative values, as well as leaf water-soluble metabolites full scan data (LC-MS/MS), showed separation of the different sampling dates. At 6 DAW classically described stress responses are observed, with plant water status, ABA level, and root hormonal balance contributing to the separation of these samples. Discrimination of earlier stress stages (3 and 4 DAW) is only achieved when the relative levels of indole-3-acetic acid (IAA), cytokinins (Cks), and carbon metabolism (glucose, sucrose, raffinose, and starch levels) are taken into account. Our working hypothesis is that, in addition to single responses (e.g. ABA increase), the combined alterations in hormone and carbohydrate levels play an important role in the stress response mechanism. Response to more advanced stress appears to be associated with a combination of cumulative changes, occurring in several plant organs. The carbohydrate and hormonal balance in the leaf (IAA to bioactive-Cks; soluble sugars to IAA and starch to IAA; relative abundances of the different soluble sugars) flag the initial responses to the slight decrease in soil water availability (10-15% decrease). Further alterations in sucrose to ABA and in raffinose to ABA relative values (in all organs) indicate that soil water availability continues to decrease. Such alterations when associated with changes in the root hormone balance indicate that the stress response is initiated. It is concluded that metabolic balance (e.g. IAA/bioactive Cks, carbohydrates/IAA, sucrose/ABA, raffinose/ABA, ABA/IAA) is relevant in triggering adjustment mechanisms.

Feasibility of objectively measured physical activity and sedentary behavior in patients with malignant pleural effusion.

PubMed

Jeffery, Emily; Lee, Yc Gary; McVeigh, Joanne; Straker, Leon; Wooding, Troy; Newton, Robert U; Peddle-McIntyre, Carolyn

2017-10-01

Malignant pleural effusion (MPE) affects 1 million people worldwide annually and can significantly impair physical activity. Accelerometry is a validated method of objectively assessing physical activity. The purpose of this study was to determine the compliance in patients with MPE to accelerometry and describe their activity. Patients with MPE wore an Actigraph GT3X accelerometer over a 7-day continuous wear protocol. Compliance was measured as the percent of patients who had ≥4 valid days (i.e., 8-h/day of waking wear-time). Eastern Cooperative Oncology Group performance status was documented the day of actigraphy initialization. Forty-six patients with MPE received accelerometers; 44 (95.7%) returned their device. No complications were reported on their use. Forty subjects (90.9%) had ≥4 valid days of wear-time. Patients spent most of their waking hours sedentary [mean 11.0 h (SD 1.95)], with limited participation in moderate and vigorous physical activity [mean 9.5 min (SD 14.16)]. Compared to patients with better performance status (n = 32), patients with poorer performance status (n = 11) spent significantly more hours/day sedentary [mean difference 2.1 (CI 0.86-3.32); p = 0.001], as did those who survived <3 months (n = 5) compared to >12 months (n = 27) [mean difference 2.6 (CI 0.49-4.77); p = 0.013). Accelerometry was applied successfully in patients with MPE with high compliance and no adverse events. This is the first reported objectively measured physical activity in patients with MPE and revealed high sedentary behavior and low physical activity. The data reflected patient performance status and discriminated between survival groups. Accelerometry can provide a useful measure for future interventional studies in patients with MPE.

47 CFR 101.533 - Regulatory status.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Regulatory status. 101.533 Section 101.533 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES 24 GHz Service and Digital Electronic Message Service § 101.533 Regulatory status. (a) Initial...

Resistance training status and effectiveness of low frequency resistance training on upper-body strength and power in highly trained soccer players.

PubMed

Hertzog, Maxime; Rumpf, Michael Clemens; Hader, Karim

2017-08-26

Soccer is classified as a contact/collision sport with many player-to-player duels. Winning these duels, shielding the ball or fending off an opponent requires upper-body strength and power. Therefore this study aimed, a) to examine the time-related effect of an upper-body RT on maximal strength and power changes in highly trained soccer players, b) to investigate if the resistance-training (RT) status influences these changes throughout a competitive season. Twenty-eight soccer players participated in this study and were divided into an untrained (UG) and a trained (TG) group, according to their RT status. Both groups performed the same upper-body RT once a week, over 30 weeks. Maximal strength (1RM) and maximal power (MP) were assessed before, during and after the competitive season. Both groups significantly improved 1RM and MP over the entire competitive season, with a moderate (TG, 13%) to very large (UG, 21%) magnitude in 1RM and with a small (TG, 8%) to moderate (UG, 13%) magnitude in MP. After the initial 10 weeks of RT, UG presented significant and slightly (1RM) to moderately (MP) greater improvements than TG. For all other time intervals, the between-groups changes in 1RM were rated as similar. For the last 20 weeks of the RT, the change in MP was significantly lower for UG compared to TG. One upper-body RT-session per week will provide sufficient stimulus to enable an almost certain improvement in strength and power throughout a competitive season for all players disregarding their initial RT status.

Self-disclosure of HIV status, disclosure counseling, and retention in HIV care in Cameroon.

PubMed

Breger, Tiffany L; Newman, Jamie E; Mfangam Molu, Brigitte; Akam, Wilfred; Balimba, Ashu; Atibu, Joseph; Kiumbu, Modeste; Azinyue, Innocent; Hemingway-Foday, Jennifer; Pence, Brian W

2017-07-01

Poor retention in care is common among HIV-positive adults in sub-Saharan Africa settings and remains a key barrier to HIV management. We quantify the associations of disclosure of HIV status and referral to disclosure counseling with successful retention in care using data from three Cameroon clinics participating in the Phase 1 International epidemiologic Databases to Evaluate AIDS Central Africa cohort. Of 1646 patients newly initiating antiretroviral therapy between January 2008 and January 2011, 43% were retained in care following treatment initiation. Self-disclosure of HIV status to at least one person prior to treatment initiation was associated with a minimal increase in the likelihood of being retained in care (risk ratio [RR] = 1.14; 95% confidence interval (CI): 0.94, 1.38). However, referral to disclosure counseling was associated with a moderate increase in retention (RR = 1.37; 95% CI: 1.21, 1.55) and was not significantly modified by prior disclosure status (p = .3). Our results suggest that while self-disclosure may not significantly improve retention among patients receiving care at these Cameroon sites, counseling services may play an important role regardless of prior disclosure status.

Upfront chemotherapy and subsequent resection for molecularly defined gliomas.

PubMed

Sasaki, Hikaru; Hirose, Yuichi; Yazaki, Takahito; Kitamura, Yohei; Katayama, Makoto; Kimura, Tokuhiro; Fujiwara, Hirokazu; Toda, Masahiro; Ohira, Takayuki; Yoshida, Kazunari

2015-08-01

Functional preservation is critical in glioma surgery, and the extent of resection influences survival outcome. Neoadjuvant chemotherapy is a promising option because of its potential to facilitate tumor shrinkage and maximum tumor resection. The object of this study was to assess the utility of the neoadjuvant strategy in a prospective series of gliomas with favorable molecular status. Twenty-six consecutive cases of diffuse gliomas of WHO grade II or III with either 1p19q codeletion or MGMT methylation were treated with upfront chemotherapy following maximal safe removal. In cases of incomplete initial surgery, second-look resection was intended after tumor volume decrease by chemotherapy. Among 22 evaluable cases, chemotherapy led to a median change in the sum of the product of perpendicular diameters of -35 %, and 14 out of the 22 cases (64 %) showed objective response. Second-look resection after tumor volume decrease was performed in 12 out of 19 cases of incomplete initial surgery (GTR/STR 9, removal of residual methionine PET uptake 3). The median progression-free survival among the 22 patients with grade II tumors was 57 months, with some cases showing durable progression-free survival after second-look resection. MIB-1 indices of the second-look resected tumors were lower than those of the initial tumors, and the methylation status of the MGMT gene was unchanged. Neoadjuvant chemotherapy based on molecular guidance often produces significant volume decrease of incompletely resected gliomas. Radical second-look resection is an optional advantage of upfront chemotherapy for chemosensitive gliomas compared with initial radiotherapy.

Social status determines how we monitor and evaluate our performance

PubMed Central

Kostermans, Evelien; Milivojevic, Branka; De Cremer, David

2012-01-01

Since people with low status are more likely to experience social evaluative threat and are therefore more inclined to monitor for these threats and inhibit approach behaviour, we expected that low-status subjects would be more engaged in evaluating their own performance, compared with high-status subjects. We created a highly salient social hierarchy based on the performance of a simple time estimation task. Subjects could achieve high, middle or low status while performing this task simultaneously with other two players who were either higher or lower in status. Subjects received feedback on their own performance, as well as on the performance of the other two players simultaneously. Electroencephalography (EEG) was recorded from all three participants. The results showed that medial frontal negativity (an event-related potential reflecting performance evaluation) was significantly enhanced for low-status subjects. Implications for status-related differences in goal-directed behaviour are discussed. PMID:21421733

Status cataplecticus as initial presentation of late onset narcolepsy.

PubMed

Panda, Samhita

2014-02-15

Narcolepsy, one of the important causes of hypersomnia, is an under diagnosed sleep disorder. It has a bimodal age of onset around 15 and 35 years. It is characterized by the tetrad of excessive daytime sleepiness, cataplexy, hypnagogic/ hypnopompic hallucinations, and sleep paralysis. Cataplexy is by far the most predictive feature of narcolepsy. Status cataplecticus is the occurrence of cataplexy repeatedly for hours or days, a rare presentation of narcolepsy. This report describes an elderly gentleman with late onset narcolepsy in the sixth decade of life presenting with initial and chief symptom of status cataplecticus.

Mid-life socioeconomic status, depressive symptomatology and general cognitive status among older adults: inter-relationships and temporal effects.

PubMed

Chiao, Chi; Weng, Li-Jen

2016-04-20

Few longitudinal studies have analyzed how socioeconomic status (SES) influences both depressive and cognitive development over an individual's life course. This study investigates the change trajectories of both depressive symptomatology and general cognitive status, as well as their associations over time, focusing on the effects of mid-life SES. Data were obtained from the Taiwan Longitudinal Study on Aging (1993-2007), a nationally representative cohort study of older adults in Taiwan. The short form of the Center of Epidemiological Studies-Depression (CES-D) scale that measures depressive symptomatology in two domains (negative affect and lack of positive affect) was used. General cognitive status was assessed using the brief Short Portable Mental Status Questionnaire scale. Assessments of the subjects' mid-life SES included measurement of the participant's education and occupation. Analyses were conducted by the parallel latent growth curve modeling. The participants' initial levels of depressive symptomatology and general cognitive status were significantly and negatively correlated; furthermore, any changes in these two outcomes were also correlated over time. The initial assessment of general cognitive status significantly contributed to any advancement towards more severe depressive symptomatology over time, particularly when this occurred in a negative manner. Furthermore, a mid-life SES advantage resulted in a significant reduction in late-life depressive symptomatology and also produced a slower decline in general cognitive status during later life. In contrast, lower mid-life SES exacerbated depressive symptomatology during old age, both at the initial assessment and in terms of the change over time. In addition, female gender was significantly associated with lower general cognitive status and more severe depressive symptomatology in negative affect. These findings suggest a complex and longitudinal association between depressive symptomatology and general cognitive status in later life and this complicated relationship seems to be affected by mid-life SES over time.

US/UK Loan Account Project Status PMOD477

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

Stevens, Patrice A.

2012-07-12

The viewgraphs describe the status of PMOD477 for LANL. The meeting will occur at DOE-HQ with NA-11 and Military Applications personnel in attendance. Serves to repatriate material with a balance to zero by December 2012. Phase 1 -- Establish formality of operations for War Reserve (WR): Complete surrogate taskings to A90 through a Materials Channel and perform US/UK lessons learned; Complete the US/UK agreed Quality Acceptance Plan, Materials Plan, Shipping procedure, and establish the formal UK/US point of contacts. Phase 2 -- Metal Manufacture (WR): Process material and store material as electrorefined metal (ER) rings, with initial assay and isotopicmore » analysis, prior to manufacturing. Material is cast into accepted configuration and appropriate acceptance document for each aliquot will be generated. Phase 3 -- Intermediate Material Manufacture, Packaging and Shipping (WR): Continue processing of the material in accepted configuration with appropriate acceptance documentation for each aliquot. Provide an initial tasking of the material owed to UK including appropriate quality acceptance documentation. Phase 4 -- Complete Tasking (WR). Phase 5 -- Residue Processing (Non-WR): Complete processing of residue material and waste into accepted configuration with appropriate acceptance document for disposal.« less

Dried Blood Spot Test for HIV Exposed Infants and Children and Their Anti-Retro Viral Treatment Status in Selected Hospitals in Ethiopia.

PubMed

Wondafrash, Beyene; Hiko, Desta

2016-01-01

Infants and children living with HIV receive antiretroviral treatment often late, are exposed to opportunistic infection and quickly develop AIDS. Few hospitals are providing ART service after Dried Blood Spot (DBS)test.The objective of this study is to assess the status of infants and children linked to ART. Descriptive cross-sectional study was conducted in hospitals. Data of 138 infants and children exposed to HIV were collected from registration books and data bases from 2009 to 2011. Data were analyzed using SPSS version 16. Chi-squared test and p-value were computed. In-depth interviews were conducted with key informants. Ninety-eight (71%) infants and children exposed to HIV were diagnosed for HIV infection of which 68(69.4%) initiated ART. Twenty four (35.3%) initiated ART one month after HIV screening results. Thirty-three (50.0%) and 23(35.3%) infants and children dropped from and adhered to ART respectively. Eleven (16.2%) of them who initiated ART died within the study period. HIV infection status (p-value=0.003), dropping from ART (p-value=0.002) and death after ART initiation (p-value=0.010) showed significance with mothers' PMTCT service status. Seven in ten HIV-exposed infants and children were diagnosed with HIV, and almost all of them initiated ART. The overall turnaround time was 10 days. Based up on mothers' PMTCT service status, there was a significant difference among HIV-exposed infants and children in acquiring HIV infection from mothers during pregnancy (p-value=0.003) and dropping from ART (p-value=0.010). There were challenges in sample collection and transportation. Early HIV screening during pregnancy and PMTCT service should be strengthened.

Differences in Human Papillomavirus Vaccination Among Adolescent Girls in Metropolitan Versus Non-metropolitan Areas: Considering the Moderating Roles of Maternal Socioeconomic Status and Health Care Access.

PubMed

Monnat, Shannon M; Rhubart, Danielle C; Wallington, Sherrie Flynt

2016-02-01

This study is among the first to examine metropolitan status differences in human papillomavirus (HPV) vaccine initiation and completion among United States adolescent girls and is unique in its focus on how maternal socioeconomic status and health care access moderate metropolitan status differences in HPV vaccination. Using cross-sectional data from 3573 girls aged 12-17 in the U.S. from the 2008-2010 Behavioral Risk Factor Surveillance System, we estimate main and interaction effects from binary logistic regression models to identify subgroups of girls for which there are metropolitan versus non-metropolitan differences in HPV vaccination. Overall 34 % of girls initiated vaccination, and 19 % completed all three shots. On average, there were no metropolitan status differences in vaccination odds. However, there were important subgroup differences. Among low-income girls and girls whose mothers did not complete high school, those in non-metropolitan areas had significantly higher probability of vaccine initiation than those in metropolitan areas. Among high-income girls and girls whose mothers completed college, those in metropolitan areas had significantly higher odds of vaccine initiation than those in non-metropolitan areas. Moreover, among girls whose mothers experienced a medical cost barrier, non-metropolitan girls were less likely to initiate vaccination compared to metropolitan girls. Mothers remain essential targets for public health efforts to increase HPV vaccination and combat cervical cancer. Public health experts who study barriers to HPV vaccination and physicians who come into contact with mothers should be aware of group-specific barriers to vaccination and employ more tailored efforts to increase vaccination.

Simulation experience enhances physical therapist student confidence in managing a patient in the critical care environment.

PubMed

Ohtake, Patricia J; Lazarus, Marcilene; Schillo, Rebecca; Rosen, Michael

2013-02-01

Rehabilitation of patients in critical care environments improves functional outcomes. This finding has led to increased implementation of intensive care unit (ICU) rehabilitation programs, including early mobility, and an associated increased demand for physical therapists practicing in ICUs. Unfortunately, many physical therapists report being inadequately prepared to work in this high-risk environment. Simulation provides focused, deliberate practice in safe, controlled learning environments and may be a method to initiate academic preparation of physical therapists for ICU practice. The purpose of this study was to examine the effect of participation in simulation-based management of a patient with critical illness in an ICU setting on levels of confidence and satisfaction in physical therapist students. A one-group, pretest-posttest, quasi-experimental design was used. Physical therapist students (N=43) participated in a critical care simulation experience requiring technical (assessing bed mobility and pulmonary status), behavioral (patient and interprofessional communication), and cognitive (recognizing a patient status change and initiating appropriate responses) skill performance. Student confidence and satisfaction were surveyed before and after the simulation experience. Students' confidence in their technical, behavioral, and cognitive skill performance increased from "somewhat confident" to "confident" following the critical care simulation experience. Student satisfaction was highly positive, with strong agreement the simulation experience was valuable, reinforced course content, and was a useful educational tool. Limitations of the study were the small sample from one university and a control group was not included. Incorporating a simulated, interprofessional critical care experience into a required clinical course improved physical therapist student confidence in technical, behavioral, and cognitive performance measures and was associated with high student satisfaction. Using simulation, students were introduced to the critical care environment, which may increase interest in working in this practice area.

A multicenter phase II study of carboplatin in advanced ovarian carcinoma: final report.

PubMed

Kjorstad, K; Harris, A; Bertelsen, K; Slevin, M; Schultz, H; Hellman, K; Janssens, N; Martin, A; Canetta, R

1992-03-01

A phase II trial of single-agent carboplatin in advanced ovarian cancer was performed by 19 institutions from 10 European countries. A total of 260 patients were treated, with a median age of 55 (range: 20-79) years. Karnofsky performance status was 80-100 in about two-thirds of the patients. Prior therapy consisted of surgery only in 31 patients, irradiation in 9, chemotherapy without cisplatin in 45, and with cisplatin in 175. Carboplatin was administered as second-line therapy in about one-half and as third-line or more in one additional third of the study population. Initial dose was 400 mg/m2 in 90, 360 mg/m2 in 152, and 320 mg/m2 or less in 18 patients. A total of 971 courses (mean 3.7, median 2, range: 1-13) of therapy were administered. A total of 16 complete and 46 partial responses were observed in 226 evaluable patients, for an objective response rate of 27%. Efficacy was greater in chemotherapy-untreated patients (51% vs. 23%, p = 0.002). In cisplatin-pretreated patients activity was significantly higher in non-refractory patients (26% vs. 4%, p = 0.015). Myelosuppression was the most significant side effect. However, low hematologic counts seldom translated into clinically significant complications. Patients with impaired baseline creatinine clearance and poor performance status were at higher risk of developing severe myelosuppression during the initial course of treatment. Non hematologic side effects were rare and mild, except for emesis. Carboplatin has a definite role in the treatment of ovarian cancer, but almost complete cross-resistance with the parent compound was observed clinically.

78 FR 67168 - Sixth Annual Sentinel Initiative; Public Workshop

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-08

...] Sixth Annual Sentinel Initiative; Public Workshop AGENCY: Food and Drug Administration, HHS. ACTION... workshop entitled ``Sixth Annual Sentinel Initiative.'' Convened by the Engelberg Center for Health Care... product surveillance. Topics will include an overview of the status of FDA's Sentinel Initiative and...

Helicobacter pylori Eradication Therapy Is Effective as the Initial Treatment for Patients with H. pylori-Negative and Disseminated Gastric Mucosa-Associated Lymphoid Tissue Lymphoma

PubMed Central

Gong, Eun Jeong; Ahn, Ji Yong; Jung, Hwoon-Yong; Park, Hyungchul; Ko, Young Bo; Na, Hee Kyong; Jung, Kee Wook; Kim, Do Hoon; Lee, Jeong Hoon; Choi, Kee Don; Song, Ho June; Lee, Gin Hyug; Kim, Jin-Ho

2016-01-01

Background/Aims We investigated the effectiveness of Helicobacter pylori eradication therapy for gastric mucosa-associated lymphoid tissue (MALT) lymphoma regardless of the H. pylori infection status or disease stage. Methods From November 1995 to September 2014, 345 subjects who were diagnosed with gastric MALT lymphoma and had received eradication therapy as their first-line treatment were eligible for inclusion in this study. A retrospective review was performed using the medical records. Results Of the 345 patients, H. pylori infection was detected in 317 patients (91.9%). The complete remission (CR) rate after eradication therapy was 82.3%, which was higher in H. pylori-positive patients than in H. pylori-negative patients (84.5% vs 57.1%, p=0.001). CR rates after eradication did not present significant differences between stages, and the CR rate was 83.3% for stage IE1 and 74.4% for stage IE2 or above (p=0.167). The overall CR rate was 87.2% after additional treatment, and neither H. pylori infection status nor stage showed differences according to the treatment response. Conclusions Eradication therapy led to CR in 57.1% of H. pylori-negative patients and in 74.4% of patients with stage IE2 or above. Eradication therapy is worthwhile as an initial treatment for gastric MALT lymphoma regardless of the H. pylori infection status and stage. PMID:27114423

SHARP: Automated monitoring of spacecraft health and status

NASA Technical Reports Server (NTRS)

Atkinson, David J.; James, Mark L.; Martin, R. Gaius

1991-01-01

Briefly discussed here are the spacecraft and ground systems monitoring process at the Jet Propulsion Laboratory (JPL). Some of the difficulties associated with the existing technology used in mission operations are highlighted. A new automated system based on artificial intelligence technology is described which seeks to overcome many of these limitations. The system, called the Spacecraft Health Automated Reasoning Prototype (SHARP), is designed to automate health and status analysis for multi-mission spacecraft and ground data systems operations. The system has proved to be effective for detecting and analyzing potential spacecraft and ground systems problems by performing real-time analysis of spacecraft and ground data systems engineering telemetry. Telecommunications link analysis of the Voyager 2 spacecraft was the initial focus for evaluation of the system in real-time operations during the Voyager spacecraft encounter with Neptune in August 1989.

Skylab reuse study, reference data, part 1. [habitability of the orbital workshop and airlock modules for the space transportation system

NASA Technical Reports Server (NTRS)

1978-01-01

The accommodations provided by the airlock module and the orbital workshop were completely examined with the thought of total reactivation as an enhancement to the STS long duration missions. Each subsystem is described and a summary of subsystem performance during the Skylab missions is presented. End-of-mission status and the status of today for each subsystem is shown together with refurbishment/resupply requirements and refurb kit descriptions to restore Skylab to full operational capability. An inspection/refurbishment and operations plan for Skylab is included. The initial Shuttle-tended operational activity would provide a safe, effective phase of Skylab rehabilitation while simultaneously benefitting the Orbiter crew through the addition of private accommodations, off-duty recreation area, and physical conditioning equipment. This period would also permit exercising selected onboard experiments.

SHARP - Automated monitoring of spacecraft health and status

NASA Technical Reports Server (NTRS)

Atkinson, David J.; James, Mark L.; Martin, R. G.

1990-01-01

Briefly discussed here are the spacecraft and ground systems monitoring process at the Jet Propulsion Laboratory (JPL). Some of the difficulties associated with the existing technology used in mission operations are highlighted. A new automated system based on artificial intelligence technology is described which seeks to overcome many of these limitations. The system, called the Spacecraft Health Automated Reasoning Prototype (SHARP), is designed to automate health and status analysis for multi-mission spacecraft and ground data systems operations. The system has proved to be effective for detecting and analyzing potential spacecraft and ground systems problems by performing real-time analysis of spacecraft and ground data systems engineering telemetry. Telecommunications link analysis of the Voyager 2 spacecraft was the initial focus for evaluation of the system in real-time operations during the Voyager spacecraft encounter with Neptune in August 1989.

Multivariate Analysis of the Relationship of Psychosocial Crisis Variables to Ego Identity Status

ERIC Educational Resources Information Center

Rothman, Kenneth M.

1978-01-01

Correlations were investigated between Erikson's psychosocial crisis stages (trust, autonomy, initiative, industry, identity, and intimacy) and Marcia's four identity statuses (achievement, moratorium, foreclosure, and diffusion). Erikson's theory of prosocial development and Marcia's ego identity status concept were supported. Coping with the…

Healthy Food Financing Initiative

THOMAS, 113th Congress

Rep. Schwartz, Allyson Y. [D-PA-13

2013-06-12

House - 06/25/2013 Referred to the Subcommittee on Department Operations, Oversight, and Nutrition. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Do not overlook acute isoniazid poisoning in children with status epilepticus.

PubMed

Caksen, Hüseyin; Odabas, Dursun; Erol, Mehmet; Anlar, Omer; Tuncer, Oguz; Atas, Bülent

2003-02-01

A previously healthy 2-year-old girl was admitted with generalized convulsive status epilepticus. She was in a stupor and could respond only to painful stimuli. She also had severe metabolic acidosis. Although initial liver function tests were normal, they were found to be moderately high on the fifth day of admission; however, they dropped to their normal ranges on the twelfth day of admission. Initially, the patient was diagnosed as having idiopathic status epilepticus, and classic anticonvulsant agents, including diazepam, phenytoin, and then phenobarbital, were given. However, her seizures did not subside, and diazepam infusion was initiated. After initiation of diazepam infusion, the seizures were completely controlled. On the fourth day of admission, her parents said that she had accidentally received 20 tablets (a total dose of 2000 mg) of isoniazid just before admission to our hospital. Later, we injected 200 mg of pyridoxine intravenously. During follow-up, her general condition improved, and anticonvulsant agents were discontinued because an electroencephalogram was found to be norma. She was discharged from the hospital on the twelfth day of admission. At the fourth month of follow-up, she was seizure free. Because of this case, we would like to re-emphasize that acute isoniazid poisoning should also be considered in a child with unexplained status epilepticus.

The DoD's High Performance Computing Modernization Program - Ensuing the National Earth Systems Prediction Capability Becomes Operational

NASA Astrophysics Data System (ADS)

Burnett, W.

2016-12-01

The Department of Defense's (DoD) High Performance Computing Modernization Program (HPCMP) provides high performance computing to address the most significant challenges in computational resources, software application support and nationwide research and engineering networks. Today, the HPCMP has a critical role in ensuring the National Earth System Prediction Capability (N-ESPC) achieves initial operational status in 2019. A 2015 study commissioned by the HPCMP found that N-ESPC computational requirements will exceed interconnect bandwidth capacity due to the additional load from data assimilation and passing connecting data between ensemble codes. Memory bandwidth and I/O bandwidth will continue to be significant bottlenecks for the Navy's Hybrid Coordinate Ocean Model (HYCOM) scalability - by far the major driver of computing resource requirements in the N-ESPC. The study also found that few of the N-ESPC model developers have detailed plans to ensure their respective codes scale through 2024. Three HPCMP initiatives are designed to directly address and support these issues: Productivity Enhancement, Technology, Transfer and Training (PETTT), the HPCMP Applications Software Initiative (HASI), and Frontier Projects. PETTT supports code conversion by providing assistance, expertise and training in scalable and high-end computing architectures. HASI addresses the continuing need for modern application software that executes effectively and efficiently on next-generation high-performance computers. Frontier Projects enable research and development that could not be achieved using typical HPCMP resources by providing multi-disciplinary teams access to exceptional amounts of high performance computing resources. Finally, the Navy's DoD Supercomputing Resource Center (DSRC) currently operates a 6 Petabyte system, of which Naval Oceanography receives 15% of operational computational system use, or approximately 1 Petabyte of the processing capability. The DSRC will provide the DoD with future computing assets to initially operate the N-ESPC in 2019. This talk will further describe how DoD's HPCMP will ensure N-ESPC becomes operational, efficiently and effectively, using next-generation high performance computing.

Feasibility Study of Economics and Performance of Solar Photovoltaics at Johnson County Landfill

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

Salasovich, J.; Mosey, G.

2012-01-01

The U.S. Environmental Protection Agency (EPA), in accordance with the RE-Powering America's Land initiative, selected the Johnson County Landfill in Shawnee, Kansas, for a feasibility study of renewable energy production. Citizens of Shawnee, city planners, and site managers are interested in redevelopment uses for landfills in Kansas that are particularly well suited for grid-tied solar photovoltaic (PV) installation. This report assesses the Johnson County Landfill for possible grid-tied PV installations and estimates the cost, performance, and site impacts of three different PV options: crystalline silicon (fixed tilt), crystalline silicon (single-axis tracking), and thin film (fixed tilt). Each option represents amore » standalone system that can be sized to use an entire available site area. In addition, the report outlines financing options that could assist in the implementation of a system. The feasibility of PV systems installed on landfills is highly impacted by the available area for an array, solar resource, operating status, landfill cap status, distance to transmission lines, and distance to major roads. The report findings are applicable to other landfills in the surrounding area.« less

Within-Family Discussion on Harmful Effects of Smoking and Intention to Initiate Smoking Among European Adolescents.

PubMed

Masood, Mohd; Masood, Yaghma; Md Sabri, Budi Aslinie; Younis, Luay Thanoon; Yusof, Norashikin; Reidpath, Daniel; Petti, Stefano

2015-01-01

The main objective of this study was to determine the impact of discussion within family about the harmful effects of smoking on intention to initiate smoking in the long term among nonsmoking adolescents. Data from Global Youth Tobacco Survey for 25 European countries were used. The outcomes of interest were, therefore, the intention to initiate smoking 1 and 5 years after the survey. Discussion within family about harmful effect of smoking was the main predictor with age, sex, and smoking status of parents, friends, and classmates as covariates. The association between predictors and outcomes was assessed through multiple regression analysis. A total of 118,703 nonsmoking adolescents were included. Within-family discussion significantly reduced the odds of intention to initiate smoking 1 and 5 years later. Intention to initiate smoking also was significantly associated with the smoking status of friends, classmates, and parents, except for father's smoking status, which was not associated with intention to initiate 1 year later. This study demonstrated that within-family discussion about the harmful effects of smoking may contribute to reduce the intention to start smoking among adolescents in the long term. Such a discussion was associated with reduced intention to smoke even when adjusting for parent/friend and classmate smoking.

Driving with Mild Cognitive Impairment or Dementia: Cognitive Test Performance and Proxy Report of Daily Life Function in Older Women.

PubMed

Vaughan, Leslie; Hogan, Patricia E; Rapp, Stephen R; Dugan, Elizabeth; Marottoli, Richard A; Snively, Beverly M; Shumaker, Sally A; Sink, Kaycee M

2015-09-01

To investigate associations between proxy report of cognitive and functional limitations and cognitive performance and current or former driving status in older women with mild cognitive impairment (MCI) and all-cause dementia. Cross-sectional data analysis of retrospectively identified older women with adjudicated MCI and all-cause dementia in the Women's Health Initiative Memory Study-Epidemiology of Cognitive Health Outcomes (WHIMS-ECHO). Academic medical center. Women (mean age ± standard deviation 83.7 ± 3.5) adjudicated with MCI or dementia during Year 1, 2, 3, or 4 of the WHIMS-ECHO follow-up period (N = 385). The telephone-administered cognitive battery included tests of attention, verbal learning and memory, verbal fluency, executive function, working memory, and global cognitive function plus self-report measures of depressive symptomatology. The Dementia Questionnaire (DQ) was administered to a knowledgeable proxy (family member, friend). Sixty percent of women with MCI and 40% of those with dementia are current drivers. Proxy reports of functional limitations in instrumental activities of daily living (IADLs) are associated with current driving status in women with MCI, whereas performance-based cognitive tests are not. In women with dementia, proxy reports of functional limitations in IADLs and performance-based cognitive tests are associated with current driving status, as expected. These findings have clinical implications for the importance of evaluating driving concurrently with other instrumental functional abilities in MCI and dementia. Additional work is needed to determine whether proxy report of cognitive and functional impairments should help guide referrals for driving assessment and rehabilitation or counseling for driving transition. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Career Decision Status as a Predictor of Resignation Behavior Five Years Later

ERIC Educational Resources Information Center

Earl, Joanne K.; Minbashian, Amirali; Sukijjakhamin, Aun; Bright, Jim E. H.

2011-01-01

This paper extends earlier research exploring the relationship between career decision status and work outcomes by examining resignation behavior in a group of new graduates five years after initial appointment. On appointment various measures were collected including career decision status variables. Earlier research identified a significant…

Patterns of relapse and prognosis after bevacizumab failure in recurrent glioblastoma

PubMed Central

Iwamoto, F M.; Abrey, L E.; Beal, K; Gutin, P H.; Rosenblum, M K.; Reuter, V E.; DeAngelis, L M.; Lassman, A B.

2009-01-01

Background: Bevacizumab has recently been approved by the US Food and Drug Administration for recurrent glioblastoma (GBM). However, patterns of relapse, prognosis, and outcome of further therapy after bevacizumab failure have not been studied systematically. Methods: We identified patients at Memorial Sloan-Kettering Cancer Center with recurrent GBM who discontinued bevacizumab because of progressive disease. Results: There were 37 patients (26 men with a median age of 54 years). The most common therapies administered concurrently with bevacizumab were irinotecan (43%) and hypofractionated reirradiation (38%). The median overall survival (OS) after progressive disease on bevacizumab was 4.5 months; 34 patients died. At the time bevacizumab was discontinued for tumor progression, 17 patients (46%) had an increase in the size of enhancement at the initial site of disease (local recurrence), 6 (16%) had a new enhancing lesion outside of the initial site of disease (multifocal), and 13 (35%) had progression of predominantly nonenhancing tumor. Factors associated with shorter OS after discontinuing bevacizumab were lower performance status and nonenhancing pattern of recurrence. Additional salvage chemotherapy after bevacizumab failure was given to 19 patients. The median progression-free survival (PFS) among these 19 patients was 2 months, the median OS was 5.2 months, and the 6-month PFS rate was 0%. Conclusions: Contrast enhanced MRI does not adequately assess disease status during bevacizumab therapy for recurrent glioblastoma (GBM). A nonenhancing tumor pattern of progression is common after treatment with bevacizumab for GBM and is correlated with worse survival. Treatments after bevacizumab failure provide only transient tumor control. GLOSSARY CA9 = carbonic anhydrase 9; CI = confidence interval; FDG = [18F]fluorodeoxyglucose; FLAIR = fluid-attenuation inversion recovery; GBM = glioblastoma; HIF-1 α = hypoxia-inducible factor 1α; KPS = Karnofsky performance status; MR = magnetic resonance; OS = overall survival; PFS = progression-free survival; TMZ = temozolomide; VEGF = vascular endothelial growth factor; VEGFR = vascular endothelial growth factor receptor. PMID:19822869

The use of the Modified Telephone Interview for Cognitive Status (TICS-M) in the detection of amnestic mild cognitive impairment.

PubMed

Cook, Sarah E; Marsiske, Michael; McCoy, Karin J M

2009-06-01

Many screening tools for detecting cognitive decline require in-person assessment, which is often not cost-effective or feasible for those with physical limitations. The Modified Telephone Interview for Cognitive Status has been used for screening dementia, but little is known about its usefulness in detecting amnestic mild cognitive impairment. Community-dwelling participants (mean age=74.9, mean education = 16.1 years) were administered the Modified Telephone Interview for Cognitive Status during initial screening and subsequently given a multidomain neuropsychological battery. Participants were classified by consensus panel as cognitively normal older adult (noMCI, N=54) or amnestic mild cognitive impairment (N=17) based on neuropsychological performance and Clinical Dementia Rating Scale interview, but independent of Modified Telephone Interview for Cognitive Status score. There was a significant difference between groups in Modified Telephone Interview for Cognitive Status score (t=8.04, P<.01, noMCI range 32-43, mean [SD]=37.4 [2.5], amnestic mild cognitive impairment range 25-37, mean [SD]=31.2 [3.5]). Discriminant function analysis revealed that TICS-M alone correctly classified 85.9% of participants into their respective diagnostic classification (sensitivity=82.4%, specificity=87.0%). Receiver operating characteristics analysis resulted in cutoff score of 34 that optimized sensitivity and specificity of amnestic mild cognitive impairment classification. The Modified Telephone Interview for Cognitive Status is a brief, cost-effective screening measure for identifying those with and without amnestic mild cognitive impairment.

Status epilepticus in dogs and cats, part 1: etiopathogenesis, epidemiology, and diagnosis.

PubMed

Blades Golubovic, Susan; Rossmeisl, John H

2017-05-01

To review current knowledge of the etiopathogenesis, diagnosis, and consequences of status epilepticus (SE) in veterinary patients. Human and veterinary literature, including clinical and laboratory research and reviews. Status epilepticus is a common emergency in dogs and cats, and may be the first manifestation of a seizure disorder. It results from the failure of termination of an isolated seizure. Multiple factors are involved in SE, including initiation and maintenance of neuronal excitability, neuronal network synchronization, and brain microenvironmental contributions to ictogenesis. Underlying etiologies of epilepsy and SE in dogs and cats are generally classified as genetic (idiopathic), structural-metabolic, or unknown. Diagnosis of convulsive SE is usually made based on historical information and the nature of the seizures. Patient specific variables, such as the history, age of seizure onset, and physical and interictal neurological examination findings can help hone the rule out list, and are used to guide selection and prioritization of diagnostic tests. Electroencephalographic monitoring is routinely used in people to diagnose SE and guide patient care decisions, but is infrequently performed in veterinary medicine. Nonconvulsive status epilepticus has been recognized in veterinary patients; routine electroencephalography would aid in the diagnosis of this phenomenon in dogs and cats. Status epilepticus is a medical emergency that can result in life-threatening complications involving the brain and systemic organs. Status epilepticus often requires comprehensive diagnostic testing, treatment with multiple anticonvulsant agents, and intensive supportive care. © Veterinary Emergency and Critical Care Society 2017.

Healthy Food Financing Initiative

THOMAS, 111th Congress

Sen. Gillibrand, Kirsten E. [D-NY

2010-11-30

Senate - 11/30/2010 Read twice and referred to the Committee on Agriculture, Nutrition, and Forestry. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Healthy Food Financing Initiative

THOMAS, 112th Congress

Sen. Gillibrand, Kirsten E. [D-NY

2011-11-30

Senate - 11/30/2011 Read twice and referred to the Committee on Agriculture, Nutrition, and Forestry. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Healthy Food Financing Initiative

THOMAS, 113th Congress

Sen. Gillibrand, Kirsten E. [D-NY

2013-04-25

Senate - 04/25/2013 Read twice and referred to the Committee on Agriculture, Nutrition, and Forestry. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Rural Broadband Initiative Act

THOMAS, 112th Congress

Rep. Owens, William L. [D-NY-23

2011-03-15

House - 03/22/2011 Referred to the Subcommittee on Rural Development, Research, Biotechnology, and Foreign Agriculture. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Rural Broadband Initiative Act of 2010

THOMAS, 111th Congress

Rep. Murphy, Scott [D-NY-20

2010-01-27

House - 01/29/2010 Referred to the Subcommittee on Communications, Technology, and the Internet. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

75 FR 57804 - Safe Use Initiative; Public Workshop; Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-22

...] Safe Use Initiative; Public Workshop; Request for Comments AGENCY: Food and Drug Administration, HHS...) is announcing a public workshop entitled ``Safe Use Initiative.'' This public workshop, organized and hosted by FDA's Safe Use Initiative Team, will communicate the status of ongoing activities and the...

ironPhone: Mobile device-coupled point-of-care diagnostics for assessment of iron status by quantification of serum ferritin.

PubMed

Srinivasan, Balaji; O'Dell, Dakota; Finkelstein, Julia L; Lee, Seoho; Erickson, David; Mehta, Saurabh

2018-01-15

Iron deficiency (ID) is an urgent public health problem that has devastating effects on maternal and child health. However, due to poor access and affordability, screening and diagnosis for ID is often limited to proxy hemoglobin measurements alone. Here, we report the development and validation of ironPhone, a mobile-device coupled portable diagnostics for quantification of serum ferritin concentrations, an iron status biomarker, within a few minutes, from a drop of fingerprick blood. The ironPhone diagnostic platform comprises of a smartphone accessory, an app, and a disposable lateral flow immunoassay test strip to quantify serum ferritin. For initial validation in the lab, we optimized and evaluated the performance of ironPhone with known ferritin concentrations in spiked buffer and serum samples. Following lab validation, we performed a human validation by collecting fingerprick whole blood samples from 20 participants to assess iron status using ironPhone and compared the results with the laboratory standard IMMULITE 2000 analyzer. Findings from the ironPhone for the buffer and spiked serum samples provided a calibration curve with R 2 values of 0.97 (n=27) and 0.93 (n=12), respectively. On comparison with the laboratory standard IMMULITE analyzer in whole blood samples, a correlation of 0.92 (P<0.0001) was observed with a sensitivity of over 90% for predicting ID (ferritin<15.0µg/L) via the ironPhone, demonstrating its promise for iron status assessment at the point-of-care. Copyright © 2017 Elsevier B.V. All rights reserved.

Stratified charge rotary engine for general aviation

NASA Technical Reports Server (NTRS)

Mount, R. E.; Parente, A. M.; Hady, W. F.

1986-01-01

A development history, a current development status assessment, and a design feature and performance capabilities account are given for stratified-charge rotary engines applicable to aircraft propulsion. Such engines are capable of operating on Jet-A fuel with substantial cost savings, improved altitude capability, and lower fuel consumption by comparison with gas turbine powerplants. Attention is given to the current development program of a 400-hp engine scheduled for initial operations in early 1990. Stratified charge rotary engines are also applicable to ground power units, airborne APUs, shipboard generators, and vehicular engines.

A knowledge-based system for monitoring the electrical power system of the Hubble Space Telescope

NASA Technical Reports Server (NTRS)

Eddy, Pat

1987-01-01

The design and the prototype for the expert system for the Hubble Space Telescope's electrical power system are discussed. This prototype demonstrated the capability to use real time data from a 32k telemetry stream and to perform operational health and safety status monitoring, detect trends such as battery degradation, and detect anomalies such as solar array failures. This prototype, along with the pointing control system and data management system expert systems, forms the initial Telemetry Analysis for Lockheed Operated Spacecraft (TALOS) capability.

Unmanned Aircraft Systems (UAS) Integration in the National Airspace System (NAS) Project, UAS Control and Non-Payload Communication System Phase-1 Flight Test Results

NASA Technical Reports Server (NTRS)

Griner, James H.

2014-01-01

NASA's UAS Integration in the NAS project, has partnered with Rockwell Collins to develop a concept Control and Non-Payload Communication (CNPC) system prototype radio, operating on recently allocated UAS frequency spectrum bands. This prototype radio is being used to validate initial proposed performance requirements for UAS control communications. This presentation will give an overview of the current status of the prototype radio development, and results from phase 1 flight tests conducted during 2013.

Sensory polyneuropathy in human immunodeficiency virus-infected patients receiving tuberculosis treatment.

PubMed

Centner, C M; Carrara, H; Harrison, T B; Benatar, M; Heckmann, J M

2014-01-01

Human immunodeficiency virus (HIV) infection and treatments for HIV infection and tuberculosis (TB) are associated with the risk of developing sensory polyneuropathy (SPN). Vitamin B6 and genetically determined slow isoniazid (INH) acetylation are believed to play key roles in the development of SPN in a TB treatment setting. To investigate slow acetylation and risk factors for SPN in HIV-infected patients receiving TB treatment, and establish vitamin B6 status and its association with SPN. HIV-infected in-patients were prospectively assessed after initiating TB treatment and vitamin B6 supplementation, and monthly during hospitalisation. SPN was defined as ≥1 symptom plus ≥1 sign. NAT2 genotyping predicted acetylation status, and plasma high performance liquid chromatography estimated vitamin B6 status. A survival analysis estimated hazard ratios (HRs) for SPN during TB treatment. Of 116 participants, 56% had SPN at study entry. Participants developed SPN at a rate of 26/100 person-months (95%CI 18-35) during TB treatment, which was independently associated with slow acetylation (HR 2.5; 95%CI 1.1-5.9), as well as black race, previous TB and extra-pulmonary/disseminated TB. Vitamin B6 status was normal, irrespective of SPN. Risk factors for SPN suggest a multi-factorial pathogenesis related to INH and other potential nervous system insults. SPN developed despite normal vitamin B6 status, suggesting other mechanisms of injury.

Sleep in adolescents of different socioeconomic status: a systematic review

PubMed Central

Felden, Érico Pereira Gomes; Leite, Carina Raffs; Rebelatto, Cleber Fernando; Andrade, Rubian Diego; Beltrame, Thais Silva

2015-01-01

Objective: To analyze the sleep characteristics in adolescents from different socioeconomic levels. Data source: Original studies found in the MEDLINE/PubMed and SciELO databases without language and period restrictions that analyzed associations between sleep variables and socioeconomic indicators. The initial search resulted in 99 articles. After reading the titles and abstracts and following inclusion and exclusion criteria, 12 articles with outcomes that included associations between sleep variables (disorders, duration, quality) and socioeconomic status (ethnicity, family income, and social status) were analyzed. Data synthesis: The studies associating sleep with socioeconomic variables are recent, published mainly after the year 2000. Half of the selected studies were performed with young Americans, and only one with Brazilian adolescents. Regarding ethnic differences, the studies do not have uniform conclusions. The main associations found were between sleep variables and family income or parental educational level, showing a trend among poor, low social status adolescents to manifest low duration, poor quality of sleeping patterns. Conclusions: The study found an association between socioeconomic indicators and quality of sleep in adolescents. Low socioeconomic status reflects a worse subjective perception of sleep quality, shorter duration, and greater daytime sleepiness. Considering the influence of sleep on physical and cognitive development and on the learning capacity of young individuals, the literature on the subject is scarce. There is a need for further research on sleep in different realities of the Brazilian population. PMID:26298657

Advanced Broadband Infrastructure Bond Initiative of 2009

THOMAS, 111th Congress

Rep. Eshoo, Anna G. [D-CA-14

2009-01-28

House - 02/02/2009 Referred to the Subcommittee on Communications, Technology, and the Internet. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

National Neurotechnology Initiative Act

THOMAS, 111th Congress

Sen. Murray, Patty [D-WA

2009-03-12

Senate - 03/12/2009 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

ALOS-2 current status and operation plan

NASA Astrophysics Data System (ADS)

Suzuki, Shinichi; Kankaku, Yukihiro; Osawa, Yuji

2013-10-01

The Advanced Land Observing Satellite-2 (ALOS-2) carries the state-of-the-art L-band Synthetic Aperture Radar (SAR) called PALSAR-2 which succeeds to the ALOS / PALSAR. PALSAR-2 will have enhanced performance in both high resolution and wide swath compared to PALSAR. It will allow comprehensive monitoring of disasters. Wider bandwidth and shorter revisit time will give better conference for INSAR data analysis such as crustal deformation and deforestation. The Proto Flight Test (PFT) of ALOS-2 has been conducted since June 2012. In parallel, the PFT of PALSAR-2 has been conducted since March 2012. As of August 2013, ALOS-2 system has completed the interface test with ground system and is preparing for the Vibration test, Acoustic test and Electromagnetic Compatibility test. After completing these tests, ALOS-2 will be transported to JAXA Tanegashima Space Center for launch. The initial commissioning phase of ALOS-2 is planned for six months which are comprised of LEOP (Launch and Early Orbit Phase) and initial Cal/Val phase. During the LEOP, all components will be checked with direct downlink via Xband and with data relay communication via JAXA's DRTS (Data Relay Test Satellite). During the initial Cal/Val phase, the PALSAR-2 data will be verified and calibrated by using Corner Reflectors and Geometric Calibrator at ground. The data acquisition during the commissioning phase will be consistent with the systematic acquisition strategy prepared for the routine operation. This paper describes the current status and operation plan of ALOS-2.

Hierarchy stability moderates the effect of status on stress and performance in humans

PubMed Central

Knight, Erik L.; Mehta, Pranjal H.

2017-01-01

High social status reduces stress responses in numerous species, but the stress-buffering effect of status may dissipate or even reverse during times of hierarchical instability. In an experimental test of this hypothesis, 118 participants (57.3% female) were randomly assigned to a high- or low-status position in a stable or unstable hierarchy and were then exposed to a social-evaluative stressor (a mock job interview). High status in a stable hierarchy buffered stress responses and improved interview performance, but high status in an unstable hierarchy boosted stress responses and did not lead to better performance. This general pattern of effects was observed across endocrine (cortisol and testosterone), psychological (feeling in control), and behavioral (competence, dominance, and warmth) responses to the stressor. The joint influence of status and hierarchy stability on interview performance was explained by feelings of control and testosterone reactivity. Greater feelings of control predicted enhanced interview performance, whereas increased testosterone reactivity predicted worse performance. These results provide direct causal evidence that high status confers adaptive benefits for stress reduction and performance only when the social hierarchy is stable. When the hierarchy is unstable, high status actually exacerbates stress responses. PMID:27994160

Hierarchy stability moderates the effect of status on stress and performance in humans.

PubMed

Knight, Erik L; Mehta, Pranjal H

2017-01-03

High social status reduces stress responses in numerous species, but the stress-buffering effect of status may dissipate or even reverse during times of hierarchical instability. In an experimental test of this hypothesis, 118 participants (57.3% female) were randomly assigned to a high- or low-status position in a stable or unstable hierarchy and were then exposed to a social-evaluative stressor (a mock job interview). High status in a stable hierarchy buffered stress responses and improved interview performance, but high status in an unstable hierarchy boosted stress responses and did not lead to better performance. This general pattern of effects was observed across endocrine (cortisol and testosterone), psychological (feeling in control), and behavioral (competence, dominance, and warmth) responses to the stressor. The joint influence of status and hierarchy stability on interview performance was explained by feelings of control and testosterone reactivity. Greater feelings of control predicted enhanced interview performance, whereas increased testosterone reactivity predicted worse performance. These results provide direct causal evidence that high status confers adaptive benefits for stress reduction and performance only when the social hierarchy is stable. When the hierarchy is unstable, high status actually exacerbates stress responses.

Urban Area Security Initiative Modernization Act of 2011

THOMAS, 112th Congress

Rep. Stivers, Steve [R-OH-15

2011-12-16

House - 12/28/2011 Referred to the Subcommittee on Emergency Preparedness, Response and Communications. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Rural Broadband Initiative Act of 2009

THOMAS, 111th Congress

Sen. Gillibrand, Kirsten E. [D-NY

2009-12-14

Senate - 12/14/2009 Read twice and referred to the Committee on Agriculture, Nutrition, and Forestry. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Initial development of 5D COGENT

NASA Astrophysics Data System (ADS)

Cohen, R. H.; Lee, W.; Dorf, M.; Dorr, M.

2015-11-01

COGENT is a continuum gyrokinetic edge code being developed by the by the Edge Simulation Laboratory (ESL) collaboration. Work to date has been primarily focussed on a 4D (axisymmetric) version that models transport properties of edge plasmas. We have begun development of an initial 5D version to study edge turbulence, with initial focus on kinetic effects on blob dynamics and drift-wave instability in a shearless magnetic field. We are employing compiler directives and preprocessor macros to create a single source code that can be compiled in 4D or 5D, which helps to ensure consistency of physics representation between the two versions. A key aspect of COGENT is the employment of mapped multi-block grid capability to handle the complexity of diverter geometry. It is planned to eventually exploit this capability to handle magnetic shear, through a series of successively skewed unsheared grid blocks. The initial version has an unsheared grid and will be used to explore the degree to which a radial domain must be block decomposed. We report on the status of code development and initial tests. Work performed for USDOE, at LLNL under contract DE-AC52-07NA27344.

Sex Differences in Concomitant Trajectories of Self-Reported Disability and Measured Physical Capacity in Older Adults

PubMed Central

Allore, Heather G.; Mendes de Leon, Carlos F.; Gahbauer, Evelyne A.; Gill, Thomas M.

2016-01-01

Background: Despite documented age-related declines in self-reported functional status and measured physical capacity, it is unclear whether these functional indicators follow similar trajectories over time or whether the patterns of change differ by sex. Methods: We used longitudinal data from 687 initially nondisabled adults, aged 70 or older, from the Precipitating Events Project, who were evaluated every 18 months for nearly 14 years. Self-reported disability was assessed with a 12-item disability scale. Physical capacity was measured using grip strength and a modified version of Short Physical Performance Battery. Hierarchical linear models estimated the intra-individual trajectory of each functional indicator and differences in trajectories’ intercept and slope by sex. Results: Self-reported disability, grip strength, and Short Physical Performance Battery score declined over 13.5 years following nonlinear trajectories. Women experienced faster accumulation of self-reported disability, but slower declines in measured physical capacity, compared with men. Trajectory intercepts revealed that women had significantly weaker grip strength and reported higher levels of disability compared with men, with no differences in starting Short Physical Performance Battery scores. These findings were robust to adjustments for differences in sociodemographic characteristics, length-of-survival, health risk factors, and chronic-disease status. Conclusions: Despite the female disadvantage in self-reported disability, older women preserve measured physical capacity better than men over time. Self-reported and measured indicators should be viewed as complementary rather than interchangeable assessments of functional status for both clinical and research purposes, especially for sex-specific comparisons. PMID:27071781

Epicure: a European epidemiological study of patients with an advanced or metastatic Urothelial Carcinoma (UC) having progressed to a platinum-based chemotherapy.

PubMed

Houédé, N; Locker, G; Lucas, C; Parra, H Soto; Basso, U; Spaeth, D; Tambaro, R; Basterretxea, L; Morelli, F; Theodore, C; Lusuardi, L; Lainez, N; Guillot, A; Tonini, G; Bielle, J; Del Muro, X Garcia

2016-09-23

Platinum-based systemic chemotherapy is considered the backbone for management of advanced urothelial carcinomas. However there is a lack of real world data on the use of such chemotherapy regimens, on patient profiles and on management after treatment failure. Fifty-one randomly selected physicians from 4 European countries registered 218 consecutive patients in progression or relapse following a first platinum-based chemotherapy. Patient characteristics, tumor history and treatment regimens, as well as the considerations of physicians on the management of urothelial carcinoma were recorded. A systemic platinum-based regimen had been administered as the initial chemotherapy in 216 patients: 15 in the neoadjuvant setting, 61 in adjuvant therapy conditions, 137 in first-line advanced setting and 3 in other conditions. Of these patients, 76 (35 %) were initially considered as cisplatin-unfit, mainly because of renal impairment (52 patients). After platinum failure, renal impairment was observed in 44 % of patients, ECOG Performance Status ≥ 2 in 17 %, hemoglobinemia < 10 g/dL in 16 %, hepatic metastases in 13 %. 80 % of these patients received further anticancer therapy. Immediately after failure of adjuvant/neoadjuvant chemotherapy, most subsequent anticancer treatments were chemotherapy doublets (35/58), whereas after therapy failure in the advanced setting most patients receiving further anticancer drugs were treated with a single agent (80/114). After first progression to chemotherapy, treatment decisions were mainly driven by Performance Status and prior response to chemotherapy (>30 % patients). The most frequent all-settings second anticancer therapy regimen was vinflunine (70 % of single-agent and 42 % of all subsequent treatments), the main reasons evoked by physicians (>1 out of 4) being survival benefit, safety and phase III evidence. In this daily practice experience, a majority of patients with urothelial carcinoma previously treated with a platinum-based therapy received a second chemotherapy regimen, most often a single agent after an initial chemotherapy in the advanced setting and preferably a cytotoxic combination after a neoadjuvant or adjuvant chemotherapy. Performance Status and prior response to chemotherapy were the main drivers of further treatment decisions.

Types and predictors of partner reactions to HIV status disclosure among HIV-infected adult Nigerians in a tertiary hospital in the Niger Delta.

PubMed

Ogoina, Dimie; Ikuabe, Peter; Ebuenyi, Ikenna; Harry, Tubonye; Inatimi, Otonyo; Chukwueke, Ogechi

2015-03-01

Our aim was to describe the types and determinants of partner reactions to HIV-status disclosure among adults attending an antiretroviral therapy-(ART) clinic in the Bayelsa State, Nigeria. A cross-sectional study was undertaken between January and March 2013 among consecutive adult patients who had disclosed their HIV-status to their current sexual partner. Sociodemograhic data and types of initial and subsequent partner reactions to disclosure were obtained using interviewer-administered standardized-questionnaire. Independent determinants of reactions to disclosure were ascertained by unconditional logistic regression. Out of 123 study participants, 57.7% were females, 92% were receiving ART and 86.1% were currently married. Majority of the participants reported predominant positive or supportive initial (72.4%) and subsequent (89.5%) partner reactions to disclosure, with significant increase in positive reactions over time. Positive initial partner reactions were independently associated with prior post-test counselling-(Odds ratio [OR]-6.5, 95% Confidence interval [CI]-1.3-31.6-p=0.02), age>35 years-(OR-5.8, 95% CI-1.6-20.9-p=0.008) and being healthy at time of disclosure-(OR-7.8, 95% CI-1.7-35.4-p=0.008). Subsequent positive partner reactions were significantly associated with receiving antiretroviral therapy and having only one lifetime sexual partner. Our results indicate that partner reactions to HIV-status disclosure are predominantly supportive. Disclosure counselling and early initiation of ART may be effective in improving HIV-status disclosure in Nigeria.

Fail or flourish? Cognitive appraisal moderates the effect of solo status on performance.

PubMed

White, Judith B

2008-09-01

When everyone in a group shares a common social identity except one individual, the one who is different from the majority has solo status. Solo status increases one's visibility and performance pressure, which may result in stress. Stress has divergent effects on performance, and individuals' response to stressful situations is predicted by their cognitive appraisal (challenge or threat) of the situation. Two experiments test the hypothesis that cognitive appraisal moderates the effect of solo status on performance. Experiment 1 finds that at relatively high appraisal levels (resources exceed demands), solo status improves men's and women's performance; at relatively low appraisal levels, solo status hurts performance. Experiment 2 replicates this effect for solo status based on minimal group assignment. Results suggest that for individuals who feel challenged and not threatened by their work, it may help to be a solo.

Boys' and girls' weight status and math performance from kindergarten entry through fifth grade: a mediated analysis.

PubMed

Gable, Sara; Krull, Jennifer L; Chang, Yiting

2012-01-01

This study tests a mediated model of boys' and girls' weight status and math performance with 6,250 children from the Early Childhood Longitudinal Study. Five data points spanning kindergarten entry (mean age=68.46 months) through fifth grade (mean age=134.60 months) were analyzed. Three weight status groups were identified: persistent obesity, later onset obesity, and never obese. Multilevel models tested relations between weight status and math performance, weight status and interpersonal skills and internalizing behaviors, and interpersonal skills and internalizing behaviors and math performance. Interpersonal skills mediated the association between weight status and math performance for girls, and internalizing behaviors mediated the association between weight status and math performance for both sexes, with effects varying by group and time. © 2012 The Authors. Child Development © 2012 Society for Research in Child Development, Inc.

Los Alamos radiation transport code system on desktop computing platforms

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

Briesmeister, J.F.; Brinkley, F.W.; Clark, B.A.

The Los Alamos Radiation Transport Code System (LARTCS) consists of state-of-the-art Monte Carlo and discrete ordinates transport codes and data libraries. These codes were originally developed many years ago and have undergone continual improvement. With a large initial effort and continued vigilance, the codes are easily portable from one type of hardware to another. The performance of scientific work-stations (SWS) has evolved to the point that such platforms can be used routinely to perform sophisticated radiation transport calculations. As the personal computer (PC) performance approaches that of the SWS, the hardware options for desk-top radiation transport calculations expands considerably. Themore » current status of the radiation transport codes within the LARTCS is described: MCNP, SABRINA, LAHET, ONEDANT, TWODANT, TWOHEX, and ONELD. Specifically, the authors discuss hardware systems on which the codes run and present code performance comparisons for various machines.« less

Special Purpose Systems

DTIC Science & Technology

2017-01-30

Nontraditional Defense Contractor Participation, and Plans for Next Quarter. II. Business Status Report. The business status report shall provide...DoD & DoD Contractors only. E. FINAL BUSINESS STATUS REPORT At the completion of the Ordnance Technology Initiative Agreement, the...traditional Contractors to produce advanced machining techniques that are required by the SPS group. • Provide acquisition support for reducing

49 CFR 1515.5 - Appeal of Initial Determination of Threat Assessment based on criminal conviction, immigration...

Code of Federal Regulations, 2010 CFR

2010-10-01

... Assessment based on criminal conviction, immigration status, or mental capacity. 1515.5 Section 1515.5... criminal conviction, immigration status, or mental capacity. (a) Scope. This section applies to applicants... the immigration status requirements as described in 49 CFR 1572.105. (3) TSA has determined that an...

Choice Neighborhoods Initiative Act of 2011

THOMAS, 112th Congress

Sen. Menendez, Robert [D-NJ

2011-03-17

Senate - 03/17/2011 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Choice Neighborhoods Initiative Act of 2010

THOMAS, 111th Congress

Sen. Menendez, Robert [D-NJ

2010-12-22

Senate - 12/22/2010 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Choice Neighborhoods Initiative Act of 2013

THOMAS, 113th Congress

Sen. Menendez, Robert [D-NJ

2013-03-04

Senate - 04/22/2013 Referred to the Committee on Banking, Housing, and Urban Affairs by unanimous consent. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

National Nanotechnology Initiative Amendments Act of 2009

THOMAS, 111th Congress

Sen. Kerry, John F. [D-MA

2009-07-21

Senate - 07/21/2009 Read twice and referred to the Committee on Commerce, Science, and Transportation. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Nuclear Energy Research Initiative Improvement Act of 2011

THOMAS, 112th Congress

Sen. Udall, Mark [D-CO

2011-05-25

Senate - 08/30/2011 Placed on Senate Legislative Calendar under General Orders. Calendar No. 146. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Nuclear Energy Research Initiative Improvement Act of 2009

THOMAS, 111th Congress

Sen. Udall, Mark [D-CO

2009-10-29

Senate - 09/27/2010 Placed on Senate Legislative Calendar under General Orders. Calendar No. 598. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Northwest Straits Marine Conservation Initiative Reauthorization Act of 2009

THOMAS, 111th Congress

Sen. Murray, Patty [D-WA

2009-03-23

Senate - 10/21/2009 Placed on Senate Legislative Calendar under General Orders. Calendar No. 185. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Northwest Straits Marine Conservation Initiative Reauthorization Act of 2011

THOMAS, 112th Congress

Rep. Larsen, Rick [D-WA-2

2011-05-12

House - 05/24/2011 Referred to the Subcommittee on Fisheries, Wildlife, Oceans, and Insular Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Northwest Straits Marine Conservation Initiative Reauthorization Act of 2011

THOMAS, 112th Congress

Sen. Murray, Patty [D-WA

2011-05-12

Senate - 02/27/2012 Placed on Senate Legislative Calendar under General Orders. Calendar No. 330. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Cody Miller Initiative for Safer Prescriptions Act

THOMAS, 113th Congress

Sen. Gillibrand, Kirsten E. [D-NY

2013-04-17

Senate - 04/17/2013 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Cody Miller Initiative for Safer Prescriptions Act

THOMAS, 112th Congress

Sen. Gillibrand, Kirsten E. [D-NY

2012-05-22

Senate - 05/22/2012 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

You can’t teach speed: sprinters falsify the deliberate practice model of expertise

PubMed Central

Deaner, Robert O.

2014-01-01

Many scientists agree that expertise requires both innate talent and proper training. Nevertheless, the highly influential deliberate practice model (DPM) of expertise holds that talent does not exist or makes a negligible contribution to performance. It predicts that initial performance will be unrelated to achieving expertise and that 10 years of deliberate practice is necessary. We tested these predictions in the domain of sprinting. In Studies 1 and 2 we reviewed biographies of 15 Olympic champions and the 20 fastest American men in U.S. history. In all documented cases, sprinters were exceptional prior to initiating training, and most reached world class status rapidly (Study 1 median = 3 years; Study 2 = 7.5). In Study 3 we surveyed U.S. national collegiate championships qualifiers in sprinters (n = 20) and throwers (n = 44). Sprinters recalled being faster as youths than did throwers, whereas throwers recalled greater strength and throwing ability. Sprinters’ best performances in their first season of high school, generally the onset of formal training, were consistently faster than 95–99% of their peers. Collectively, these results falsify the DPM for sprinting. Because speed is foundational for many sports, they challenge the DPM generally. PMID:25024914

Immigration, race/ethnicity, and social and economic factors as predictors of breastfeeding initiation.

PubMed

Celi, Ann C; Rich-Edwards, Janet W; Richardson, Marcie K; Kleinman, Ken P; Gillman, Matthew W

2005-03-01

To determine the impact of immigration status as well as race/ethnicity and social and economic factors on breastfeeding initiation. Cohort. Multisite group practice in eastern Massachusetts. One thousand eight hundred twenty-nine pregnant women prospectively followed up in Project Viva. Whether the participant breastfed her infant. The overall breastfeeding initiation rate was 83%. In multivariate models that included race/ethnicity and social, economic, and demographic factors, foreign-born women were more likely to initiate breastfeeding than US-born women (odds ratio [OR], 3.2 [95% confidence interval (CI), 2.0-5.2]). In models stratified by both race/ethnicity and immigration status, and further adjusted for whether the mother herself was breastfed as an infant and the mother's parents' immigration status, US-born and foreign-born black and Hispanic women initiated breastfeeding at rates at least as high as US-born white women (US-born black vs US-born white women, OR, 1.2 [95% CI, 0.8-1.9], US-born Hispanic vs US-born white women, OR, 1.1 [95% CI, 0.6-1.9], foreign-born black vs US-born white women, OR, 2.6 [95% CI, 1.1-6.0], and foreign-born Hispanic vs US-born white women, OR, 1.8 [95% CI, 0.7-4.8]). Calculations of predicted prevalences showed that, for example, the 2.6-fold increase in odds for the foreign-born black vs US-born white women translated to an increase in probability of approximately 1.4. Higher maternal education and household income also predicted higher initiation rates. Immigration status was strongly associated with increased breastfeeding initiation in this cohort, implying that cultural factors are important in the decision to breastfeed. Immigrants of all races/ethnicities initiated breastfeeding more often than their US-born counterparts. In addition, US-born minority groups initiated breastfeeding at rates at least as high as their white counterparts, likely due in part to high levels of education and income as well as to access to a medical care system that explicitly supports breastfeeding.

Evaluation of the BT-1 serum assay for breast cancer.

PubMed

Whitehurst, M M; Aldenderfer, P H; Sooy, M M; Strelkauskas, A J

1999-01-01

The BT-1 assay which identifies a novel breast tumor associated serum analyte was performed for 143 patients previously diagnosed with breast cancer. Mucin tumor markers CA15-3/CA27-29 values were available for 50 patients and there was very minor overlap between patients positive by both tests. Patients' follow-up clinical status at sample draw was compared to BT-1 assay results. 27% of patients originally diagnosed as Stage II and 20% patients originally diagnosed as Stage III who were evaluated 'no disease' had positive BT-1 values. 8% patients diagnosed as Stage II had negative BT-1 results in samples drawn within 90 days of chemotherapy initiation, whereas 23% of patients diagnosed as Stage III cancer were BT-1 test positive within 90 days of chemotherapy initiation. 50% of patients tested before initial breast cancer surgery had positive BT-1 values, suggesting that the BT-1 assay may be useful in identification women with more advanced disease at diagnosis.

Emerging Infections Program Efforts to Address Health Equity

PubMed Central

Vugia, Duc J.; Bennett, Nancy M.; Moore, Matthew R.

2015-01-01

The Emerging Infections Program (EIP), a collaboration between (currently) 10 state health departments, their academic center partners, and the Centers for Disease Control and Prevention, was established in 1995. The EIP performs active, population-based surveillance for important infectious diseases, addresses new problems as they arise, emphasizes projects that lead to prevention, and develops and evaluates public health practices. The EIP has increasingly addressed the health equity challenges posed by Healthy People 2020. These challenges include objectives to increase the proportion of Healthy People–specified conditions for which national data are available by race/ethnicity and socioeconomic status as a step toward first recognizing and subsequently eliminating health inequities. EIP has made substantial progress in moving from an initial focus on monitoring social determinants exclusively through collecting and analyzing data by race/ethnicity to identifying and piloting ways to conduct population-based surveillance by using area-based socioeconomic status measures. PMID:26291875

Monitoring methods and predictive models for water status in Jonathan apples.

PubMed

Trincă, Lucia Carmen; Căpraru, Adina-Mirela; Arotăriţei, Dragoş; Volf, Irina; Chiruţă, Ciprian

2014-02-01

Evaluation of water status in Jonathan apples was performed for 20 days. Loss moisture content (LMC) was carried out through slow drying of wholes apples and the moisture content (MC) was carried out through oven drying and lyophilisation for apple samples (chunks, crushed and juice). We approached a non-destructive method to evaluate LMC and MC of apples using image processing and multilayer neural networks (NN) predictor. We proposed a new simple algorithm that selects the texture descriptors based on initial set heuristically chosen. Both structure and weights of NN are optimised by a genetic algorithm with variable length genotype that led to a high precision of the predictive model (R(2)=0.9534). In our opinion, the developing of this non-destructive method for the assessment of LMC and MC (and of other chemical parameters) seems to be very promising in online inspection of food quality. Copyright © 2013 Elsevier Ltd. All rights reserved.

A multi-institutional survey of interventional radiology for type II endoleaks after endovascular aortic repair: questionnaire results from the Japanese Society of Endoluminal Metallic Stents and Grafts in Japan.

PubMed

Ogawa, Yukihisa; Nishimaki, Hiroshi; Osuga, Keigo; Ikeda, Osamu; Hongo, Norio; Iwakoshi, Shinichi; Kawasaki, Ryota; Woodhams, Reiko; Yamaguchi, Masato; Kamiya, Mika; Kanematsu, Masayuki; Honda, Masanori; Kaminou, Toshio; Koizumi, Jun; Kichikawa, Kimihiko

2016-08-01

To investigate the current status of interventional radiology (IR) procedures for a type II endoleak (T2EL) in Japan, and to identify the technical aspects that affect treatment results. A retrospective survey was conducted by distributing questionnaires to 25 institutions. The eligibility criteria were endovascular aortic repair (EVAR) performed using commercial stent grafts and IR performed for T2EL between January 2007 and December 2013. Technical success was defined as disappearance of the EL on digital subtraction angiography immediately after embolization, and imaging success was defined as no EL on contrast-enhanced computed tomography within 6 months. Statistical comparisons of the number of involved branches, embolization level, embolic material, and changes in aneurysm size were made between the imaging success and imaging failure groups. The technical and imaging success rates were also compared between the initial therapy and repeat groups. A total of 166 cases were investigated. Initial therapy was performed in 147 cases (88.6 %), with repeat therapy in 19 cases (11.4 %). Transcatheter arterial embolization (TAE) was used most frequently, in 161 cases (97 %), with direct puncture (DP) used in 5 cases (3 %). Both coil embolization for the branches and NBCA embolization for the sac were frequently chosen. The technical success rate was 83.2 % (TAE group), and the imaging success rate was 46.5 % (TAE + DP groups). Branch + sac embolization was performed more frequently in the imaging success group. There was no significant difference in the number of involved branches or embolic material between the imaging success and imaging failure groups. Enlargement of the aneurysm was more frequently seen in the imaging failure group. There were no significant differences in the technical success and imaging success rates between the initial therapy and repeat groups. This is the first report of a multi-institutional questionnaire survey of IR procedures for T2EL after EVAR in Japan that was conducted to determine the current status. Enlargement of aneurysm size after embolization was more frequently seen in the imaging failure group. It is important to embolize both branch and sac to achieve imaging success, regardless of embolic material. Long-term outcomes need to be investigated.

Associations between Forced Sexual Initiation, HIV Status, Sexual Risk Behavior, Life Stressors, and Coping Strategies among Adolescents in Nigeria

PubMed Central

Folayan, Morenike Oluwatoyin

2016-01-01

Objectives Some individuals experience their first sexual intercourse through physically forced sex, which affects the way they experience and cope with stress. We examined differences in sexual risk behavior, experience of stressors, and use of stress-coping strategies among adolescents in Nigeria based on their history of forced sexual initiation and HIV status. Methods We analyzed data from 436 sexually active 10–19-year-old adolescents recruited through a population-based survey from 12 Nigerian states. Using Lazarus and Folkman’s conceptual framework of stress and coping, we assessed if adolescents who reported forced sexual initiation were more likely to report HIV sexual risk practices, to report as stressors events related to social expectations, medical care and body images, and loss and grief, and to use more avoidance than adaptive coping strategies to manage stress. We also assessed if HIV status affected experience of stressors and use of coping strategies. Results Eighty-one adolescents (18.6%) reported a history of forced sexual initiation; these participants were significantly more likely to report anal sex practices (OR: 5.04; 95% CI: 2.14–11.87), and transactional sex (OR: 2.80; 95% CI: 1.56–4.95). Adolescents with no history of forced sexual initiation were more likely to identify as stressors, life events related to social expectations (OR: 1.03; 95% CI: 0.96–1.11) and loss and grief (OR: 1.34; 95% CI: 0.73–2.65), but not those related to medical care and body images (OR: 0.63; 95% CI: 0.34–1.18). They were also more likely to use adaptive responses (OR: 1.48; 95% CI: 0.62–3.50) than avoidance responses (OR: 0.90; 95% CI: 0.49–1.64) to cope with stress, though these differences were not significant. More adolescents with a history of forced sexual initiation who were HIV positive identified as stressors, life events related to medical care and body images (p = 0.03) and loss and grief (p = 0.009). Adolescents reporting forced sexual initiation and HIV-negative status were significantly less likely to use religion as a coping strategy (OR: 0.28; 95% CI: 0.09–0.83). Conclusion History of forced sexual initiation and HIV status affected perception of events as stressors and use of specific coping strategies. Our study findings could inform best practice interventions and policies to prevent and address forced sexual initiation among adolescents in Nigeria and other countries. PMID:27163436

Associations between Forced Sexual Initiation, HIV Status, Sexual Risk Behavior, Life Stressors, and Coping Strategies among Adolescents in Nigeria.

PubMed

Folayan, Morenike Oluwatoyin; Harrison, Abigail; Brown, Brandon; Odetoyinbo, Morolake; Stockman, Jamila K; Ajuwon, Ademola J; Cáceres, Carlos F

2016-01-01

Some individuals experience their first sexual intercourse through physically forced sex, which affects the way they experience and cope with stress. We examined differences in sexual risk behavior, experience of stressors, and use of stress-coping strategies among adolescents in Nigeria based on their history of forced sexual initiation and HIV status. We analyzed data from 436 sexually active 10-19-year-old adolescents recruited through a population-based survey from 12 Nigerian states. Using Lazarus and Folkman's conceptual framework of stress and coping, we assessed if adolescents who reported forced sexual initiation were more likely to report HIV sexual risk practices, to report as stressors events related to social expectations, medical care and body images, and loss and grief, and to use more avoidance than adaptive coping strategies to manage stress. We also assessed if HIV status affected experience of stressors and use of coping strategies. Eighty-one adolescents (18.6%) reported a history of forced sexual initiation; these participants were significantly more likely to report anal sex practices (OR: 5.04; 95% CI: 2.14-11.87), and transactional sex (OR: 2.80; 95% CI: 1.56-4.95). Adolescents with no history of forced sexual initiation were more likely to identify as stressors, life events related to social expectations (OR: 1.03; 95% CI: 0.96-1.11) and loss and grief (OR: 1.34; 95% CI: 0.73-2.65), but not those related to medical care and body images (OR: 0.63; 95% CI: 0.34-1.18). They were also more likely to use adaptive responses (OR: 1.48; 95% CI: 0.62-3.50) than avoidance responses (OR: 0.90; 95% CI: 0.49-1.64) to cope with stress, though these differences were not significant. More adolescents with a history of forced sexual initiation who were HIV positive identified as stressors, life events related to medical care and body images (p = 0.03) and loss and grief (p = 0.009). Adolescents reporting forced sexual initiation and HIV-negative status were significantly less likely to use religion as a coping strategy (OR: 0.28; 95% CI: 0.09-0.83). History of forced sexual initiation and HIV status affected perception of events as stressors and use of specific coping strategies. Our study findings could inform best practice interventions and policies to prevent and address forced sexual initiation among adolescents in Nigeria and other countries.

Trends in the Inactive Kidney Transplant Waitlist and Implications for Candidate Survival

PubMed Central

Grams, Morgan E.; Massie, Allan B.; Schold, Jesse D.; Chen, B. Po-Han; Segev, Dorry L.

2014-01-01

In November 2003, OPTN policy was amended to allow kidney transplant (KT) candidates to accrue waiting time while registered as status 7, or inactive. We evaluated trends in inactive listings and the association of inactive status with transplantation and survival, studying 262,824 adult first-time KT candidates listed between 2000–2011. The proportion of waitlist candidates initially listed as inactive increased from 2.3% pre-policy change to 31.4% in 2011. Candidates initially listed as inactive were older, more often female, African-American, and with higher body mass index. Post-policy change, conversion from initially inactive to active status generally occurred early if at all: at one year after listing, 52.7% of initially inactive candidates had been activated; at 3 years, only 66.3% had been activated. Inactive status was associated with a substantially higher waitlist mortality (aHR 2.21, 95%CI:2.15–2.28, p<0.001) and lower rates of eventual transplantation (aRR 0.68, 95%CI:0.67–0.70, p<0.001). In summary, waitlist practice has changed significantly since November 2003, with a sharp increase in the number of inactive candidates. Using the full waitlist to estimate organ shortage or as a comparison group in transplant outcome studies is less appropriate in the current era. PMID:23399028

The impact of social support and partner relationship dynamics on engagement in HIV care and antiretroviral treatment adherence among MSM in Latin America.

PubMed

Anderson, Kelsey; Biello, Katie; Rosenberger, Joshua G; Novak, David; Mayer, Kenneth; Carey, Kate; Mimiaga, Matthew J

2018-03-27

In Latin America (LA), HIV prevalence among MSM is estimated at thirty times greater than in the general male population. Little is known about the role of social support or disclosure status in relation to the HIV care continuum among LA MSM. Using multivariable logistic generalized estimation equations, we assessed the impact of social support satisfaction and disclosure status on engagement in HIV care, ART initiation, and ART adherence with data from an online, multinational sample of HIV infected MSM in Latin America (N = 2,350). 80.0% were engaged in HIV care, 71% initiated ART, and among those, 37% reported missing at least one dose in the past month. In multivariable models, compared to being very satisfied with social support, being somewhat satisfied (aOR = 0.73, 95% CI 0.56, 0.95) or somewhat dissatisfied (aOR = 0.83, 95% CI 0.70, 0.98) were associated with reduced odds of reporting 100% ART adherence. Disclosure of status was associated with a greater odds of HIV care engagement (OR = 1.63, 95% CI 1.28, 2.07) and ART initiation (OR = 1.55, 95% CI 1.30, 1.84). Greater satisfaction with social support and comfort disclosing HIV status to these sources were associated with improved engagement in HIV care and greater initiation of ART among MSM in LA.

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.

Prognostic role of initial pan-endoscopic tumor length at diagnosis in operable esophageal squamous cell carcinoma undergoing esophagectomy with or without neoadjuvant concurrent chemoradiotherapy

PubMed Central

Lin, Chen-Sung; Liu, Chao-Yu; Cheng, Chih-Tao; Tsai, Yu-Chen; Chiou, Lun-Wei; Lee, Ming-Yuan

2017-01-01

Background The objective of this study was to appraise the prognostic role of initial pan-endoscopic tumor length at diagnosis within or between operable esophageal squamous cell carcinoma (ESCC) undergoing upfront esophagectomy or neoadjuvant concurrent chemoradiotherapy (nCCRT) followed by esophagectomy. Methods Between Jan 2001 and Dec 2013 in Koo-Foundation Sun Yat-sen Cancer Center in Taiwan, 101 ESCC patients who underwent upfront esophagectomy (surgery group) and 128 nCCRT followed by esophagectomy (nCCRT-surgery group) were retrospectively collected. Prognostic variables, including initial pan-endoscopic tumor length at diagnosis (sub-grouped ≤3, 3–5 and >5 cm), status of circumferential resection margin (CRM), and pathological T/N/M-status and cancer stage, were appraised within or between surgery and nCCRT-surgery groups. Results Within surgery group, longer initial pan-endoscopic tumor length at diagnosis (≤3, 3–5 and >5 cm; HR =1.000, 1.688 and 4.165; P=0.007) was an independent prognostic factor that correlated with advanced T/N/M-status, late cancer stage, and CRM invasion (all’s P<0.001). Based on the initial pan-endoscopic tumor length at diagnosis ≤3, 3–5 and >5 cm, nCCRT-surgery group had a poorer (P=0.039), similar (P=0.447) and better (P<0.001) survivals than did surgery group, respectively. For those with initial pan-endoscopic tumor length at diagnosis >5 cm, nCCRT-surgery group had more percentage of T0/N0-status and stage 0 (all’s P<0.05), and fewer rate of CRM invasion (P=0.036) than did surgery group. Conclusions Initial pan-endoscopic tumor length at diagnosis could be a criterion to select proper ESCC cases for nCCRT followed by esophagectomy to improve survival and reduce CRM invasion. PMID:29221296

Sex differences in episodic memory in early midlife: impact of reproductive aging.

PubMed

Rentz, Dorene M; Weiss, Blair K; Jacobs, Emily G; Cherkerzian, Sara; Klibanski, Anne; Remington, Anne; Aizley, Harlyn; Goldstein, Jill M

2017-04-01

Few have characterized cognitive changes with age as a function of menopausal stage relative to men, or sex differences in components of memory in early midlife. The study aim was to investigate variation in memory function in early midlife as a function of sex, sex steroid hormones, and reproductive status. A total of 212 men and women aged 45 to 55 were selected for this cross-sectional study from a prenatal cohort of pregnancies whose mothers were originally recruited in 1959 to 1966. They underwent clinical and cognitive testing and hormonal assessments of menopause status. Multivariate general linear models for multiple memory outcomes were used to test hypotheses controlling for potential confounders. Episodic memory, executive function, semantic processing, and estimated verbal intelligence were assessed. Associative memory and episodic verbal memory were assessed using Face-Name Associative Memory Exam (FNAME) and Selective Reminding Test (SRT), given increased sensitivity to detecting early cognitive decline. Impacts of sex and reproductive stage on performance were tested. Women outperformed men on all memory measures including FNAME (β = -0.30, P < 0.0001) and SRT (β = -0.29, P < 0.0001). Furthermore, premenopausal and perimenopausal women outperformed postmenopausal women on FNAME (initial learning, β= 0.32, P = 0.01) and SRT (recall, β= 2.39, P = 0.02). Across all women, higher estradiol was associated with better SRT performance (recall, β = 1.96, P = 0.01) and marginally associated with FNAME (initial learning, β = 0.19, P = 0.06). This study demonstrated that, in early midlife, women outperformed age-matched men across all memory measures, but sex differences were attenuated for postmenopausal women. Initial learning and memory retrieval were particularly vulnerable, whereas memory consolidation and storage were preserved. Findings underscore the significance of the decline in ovarian estradiol production in midlife and its role in shaping memory function.

Higher Education in Nigeria: A Status Report.

ERIC Educational Resources Information Center

Saint, William; Hartnett, Teresa A.; Strassner, Erich

2003-01-01

Reports on the current status of higher education in Nigeria and reviews the country's new policy initiatives in this context. The discussion gives particular attention to issues of access, teaching/learning, finance, and governance/management. (EV)

National Autism Spectrum Disorders Initiative Act of 2011

THOMAS, 112th Congress

Sen. Menendez, Robert [D-NJ

2011-05-26

Senate - 05/26/2011 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Status report on pavement management.

DOT National Transportation Integrated Search

1984-01-01

This report traces the developments in pavement management in the Virginia Department of Highways and Transportation from the initial efforts in the mid-1970s through early 1984. Included are status reports on pavement management for the interstate, ...

Raytheon Stirling/pulse Tube Cryocooler Development

NASA Astrophysics Data System (ADS)

Kirkconnell, C. S.; Hon, R. C.; Kesler, C. H.; Roberts, T.

2008-03-01

The first generation flight-design Stirling/pulse tube "hybrid" two-stage cryocooler has entered initial performance and environmental testing. The status and early results of the testing are presented. Numerous improvements have been implemented as compared to the preceding brassboard versions to improve performance, extend life, and enhance launch survivability. This has largely been accomplished by incorporating successful flight-design features from the Raytheon Stirling one-stage cryocooler product line. These design improvements are described. In parallel with these mechanical cryocooler development efforts, a third generation electronics module is being developed that will support hybrid Stirling/pulse tube and Stirling cryocoolers. Improvements relative to the second generation design relate to improved radiation hardness, reduced parts count, and improved vibration cancellation capability. Progress on the electronics is also presented.

Randomized controlled trials in mild cognitive impairment

PubMed Central

Thomas, Ronald G.; Aisen, Paul S.; Mohs, Richard C.; Carrillo, Maria C.; Albert, Marilyn S.

2017-01-01

Objective: To examine the variability in performance among placebo groups in randomized controlled trials for mild cognitive impairment (MCI). Methods: Placebo group data were obtained from 2 National Institute on Aging (NIA) MCI randomized controlled trials, the Alzheimer's Disease Cooperative Study (ADCS) MCI trial and the Alzheimer's Disease Neuroimaging Initiative (ADNI), which is a simulated clinical trial, in addition to industry-sponsored clinical trials involving rivastigmine, galantamine, rofecoxib, and donepezil. The data were collated for common measurement instruments. The performance of the placebo participants from these studies was tracked on the Alzheimer's Disease Assessment Scale–cognitive subscale, Mini-Mental State Examination, and Clinical Dementia Rating–sum of boxes, and for progression on these measures to prespecified clinical study endpoints. APOE status, where available, was also analyzed for its effects. Results: The progression to clinical endpoints varied a great deal among the trials. The expected performances were seen for the participants in the 2 NIA trials, ADCS and ADNI, with generally worsening of performance over time; however, the industry-sponsored trials largely showed stable or improved performance in their placebo participants. APOE4 carrier status influenced results in an expected fashion on the study outcomes, including rates of progression and cognitive subscales. Conclusions: In spite of apparently similar criteria for MCI being adopted by the 7 studies, the implementation of the criteria varied a great deal. Several explanations including instruments used to characterize participants and variability among study populations contributed to the findings. PMID:28381516

Variations in Oncologist Recommendations for Chemotherapy for Stage IV Lung Cancer: What Is the Role of Performance Status?

PubMed

Tisnado, Diana; Malin, Jennifer; Kahn, Katherine; Landrum, Mary Beth; Fletcher, Robert; Klabunde, Carrie; Clauser, Steven; Rogers, Selwyn O; Keating, Nancy L

2016-07-01

Chemotherapy prolongs survival in patients with advanced non-small-cell lung cancer. However, few studies have included patients with poor performance status. This study examined rates of oncologists' recommendations for chemotherapy by patient performance status and symptoms and how physician characteristics influence chemotherapy recommendations. We surveyed medical oncologists involved in the care of a population-based cohort of patients with lung cancer from the CanCORS (Cancer Care Outcomes Research and Surveillance) study. Physicians were queried about their likelihood to recommend chemotherapy to patients with stage IV lung cancer with varying performance status (Eastern Cooperative Oncology Group performance status 0 [good] v 3 [poor]) and presence or absence of tumor-related pain. Repeated measures logistic regression was used to estimate the independent associations of patients' performance status and symptoms and physicians' demographic and practice characteristics with chemotherapy recommendations. Nearly all physicians (adjusted rate, 97% to 99%) recommended chemotherapy for patients with good performance status, and approximately half (adjusted rate, 38% to 53%) recommended chemotherapy for patients with poor performance status (P < .001). Compared with patient factors, physician and practice characteristics were less strongly associated with chemotherapy recommendations in adjusted analyses. Strong consensus among oncologists exists for chemotherapy in patients with advanced non-small-cell lung cancer and good performance status. However, the relatively high rate of chemotherapy recommendations for patients with poor performance status despite the unfavorable risk-benefit profile highlights the need for ongoing work to define high-value care in oncology and to implement and evaluate strategies to align incentives for such care. Copyright © 2016 by American Society of Clinical Oncology.

Impact of a trace element supplementation programme on health and performance of cross-breed (Bos indicus x Bos taurus) dairy cattle under tropical farming conditions: a double-blinded randomized field trial.

PubMed

Dermauw, V; Dierenfeld, E; Du Laing, G; Buyse, J; Brochier, B; Van Gucht, S; Duchateau, L; Janssens, G P J

2015-06-01

Small-scale urban dairy farms (n = 16) in and around Jimma, Ethiopia with cross-bred (Bos indicus × Bos taurus) cows were enrolled in a double-blinded intervention study to investigate the effect of a trace element supplementation programme on trace element status and milk concentrations as well as performance [body condition score (BCS), milk yield, leptin], milk composition, antioxidant status (ferric-reducing ability of plasma (FRAP), thiobarbituric acid-reactive substances (TBARS)], blood biochemistry, serum proteins and immune response (antibody titre upon rabies vaccination). The farms were allocated to a (1) placebo or (2) Cu, Zn, Se, Co and I supplementation treatment for 150 d. On days 0 and 120, four lactating cows per farm were sampled for milk and plasma, and on day 150 for serum, following primo-vaccination. Cu deficiency was present in 17% and marginal Se deficiency in 30% of initially sampled cows, while no Zn shortage was detected. Over 120 days, trace element supplementation caused a bigger increase in plasma Se and Cu concentrations, but also a larger decrease of plasma Fe concentrations. A larger increase in milk Se concentrations was observed in the supplemented group, whereas none of the other elements were affected. BCS decreased more over time in the supplemented group. None of the other parameters of performance and antioxidant status nor milk composition or blood biochemistry was affected by treatment. Antibody response to rabies vaccination did not differ between groups, whereas α1-globulins tended to be lower and β-globulins tended to be higher in the supplemented group. In conclusion, despite improved Cu and Se status and Se concentrations in milk, cows on tropical urban dairy farms did not seem to benefit from trace element supplementation, with respect to the parameters investigated. Journal of Animal Physiology and Animal Nutrition © 2014 Blackwell Verlag GmbH.

Effects of nutritional and psychological status of the patients with advanced stomach cancer on physical performance status.

PubMed

Tian, Jun; Chen, Zhen-chun; Hang, Li-Fang

2009-10-01

The aim of this study was to assess the associations between coping mode, nutritional status, and psychological status and performance status of the patients with advanced stomach cancer. An epidemiological survey was conducted among 233 patients with advanced stomach cancer in Fujian, China. In-person interviews were performed for the participants with respect to information of psychological status prior to chemotherapy, nutritional status during chemotherapy, and physical performance status after chemotherapy. Multivariate logistic regression analyses showed that the level of hemoglobin (HB), level of daily calorie intake, score of Depression Status Inventory (DSI), and score of confrontation subscale of Medical Coping Modes Questionnaire had a significant influence on performance status (P < 0.05). The relative risks (95% confidence interval) were 2.06 (1.12-3.79) for low level of hemoglobin versus normal level of hemoglobin, 1.16 (1.02-1.32) for low level of daily calorie intake versus normal level of daily calorie intake, 5.89 (2.00-17.31) for DSI score > or =40 versus DSI score <40, and 3.17 (1.73-5.78) for low score of confrontation versus high score of confrontation, respectively. Depression, low score of "Confrontation", low levels of HB, and low level of daily calorie intake may be the risk factors of poor performance status of the patients with advanced stomach cancer.

23 CFR 1215.6 - Review and notification of compliance status.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Review and notification of compliance status. 1215.6... FHWA will review appropriate State laws for compliance with 23 U.S.C. 153. States initially found to be... § 1215.6 Review and notification of compliance status. Review of each State's laws and notification of...

Using probabilistic record linkage methods to identify Australian Indigenous women on the Queensland Pap Smear Register: the National Indigenous Cervical Screening Project

PubMed Central

Diaz, Abbey; Baade, Peter; Garvey, Gail; Cunningham, Joan; Brotherton, Julia M L; Canfell, Karen; Valery, Patricia C; O'Connell, Dianne L; Taylor, Catherine; Moore, Suzanne P; Condon, John R

2016-01-01

Objective To evaluate the feasibility and reliability of record linkage of existing population-based data sets to determine Indigenous status among women receiving Pap smears. This method may allow for the first ever population measure of Australian Indigenous women's cervical screening participation rates. Setting/participants A linked data set of women aged 20–69 in the Queensland Pap Smear Register (PSR; 1999–2011) and Queensland Cancer Registry (QCR; 1997–2010) formed the Initial Study Cohort. Two extracts (1995–2011) were taken from Queensland public hospitals data (Queensland Hospital Admitted Patient Data Collection, QHAPDC) for women, aged 20–69, who had ever been identified as Indigenous (extract 1) and had a diagnosis or procedure code relating to cervical cancer (extract 2). The Initial Study Cohort was linked to extract 1, and women with cervical cancer in the initial cohort were linked to extract 2. Outcome measures The proportion of women in the Initial Cohort who linked with the extracts (true -pairs) is reported, as well as the proportion of potential pairs that required clerical review. After assigning Indigenous status from QHAPDC to the PSR, the proportion of women identified as Indigenous was calculated using 4 algorithms, and compared. Results There were 28 872 women (2.1%) from the Initial Study Cohort who matched to an ever Indigenous record in extract 1 (n=76 831). Women with cervical cancer in the Initial Study Cohort linked to 1385 (71%) records in extract 2. The proportion of Indigenous women ranged from 2.00% to 2.08% when using different algorithms to define Indigenous status. The Final Study Cohort included 1 372 823 women (PSR n=1 374 401; QCR n=1955), and 5 062 118 records. Conclusions Indigenous status in Queensland cervical screening data was successfully ascertained through record linkage, allowing for the crucial assessment of the current cervical screening programme for Indigenous women. Our study highlights the need to include Indigenous status on Pap smear request and report forms in any renewed and redesigned cervical screening programme in Australia. PMID:26873047

Geomechanical/Geochemical Modeling Studies Conducted within theInternational DECOVALEX Project

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

Birkholzer, J.T.; Rutqvist, J.; Sonnenthal, E.L.

2005-10-19

The DECOVALEX project is an international cooperative project initiated by SKI, the Swedish Nuclear Power Inspectorate, with participation of about 10 international organizations. The general goal of this project is to encourage multidisciplinary interactive and cooperative research on modeling coupled thermo-hydro-mechanical-chemical (THMC) processes in geologic formations in support of the performance assessment for underground storage of radioactive waste. One of the research tasks, initiated in 2004 by the U.S. Department of Energy (DOE), addresses the long-term impact of geomechanical and geochemical processes on the flow conditions near waste emplacement tunnels. Within this task, four international research teams conduct predictive analysismore » of the coupled processes in two generic repositories, using multiple approaches and different computer codes. Below, we give an overview of the research task and report its current status.« less

Geomechanical/ Geochemical Modeling Studies onducted Within the International DECOVALEX Project

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

J.T. Birkholzer; J. Rutqvist; E.L. Sonnenthal

2006-02-01

The DECOVALEX project is an international cooperative project initiated by SKI, the Swedish Nuclear Power Inspectorate, with participation of about 10 international organizations. The general goal of this project is to encourage multidisciplinary interactive and cooperative research on modeling coupled thermo-hydro-mechanical-chemical (THMC) processes in geologic formations in support of the performance assessment for underground storage of radioactive waste. One of the research tasks, initiated in 2004 by the U.S. Department of Energy (DOE), addresses the long-term impact of geomechanical and geochemical processes on the flow conditions near waste emplacement tunnels. Within this task, four international research teams conduct predictive analysismore » of the coupled processes in two generic repositories, using multiple approaches and different computer codes. Below, we give an overview of the research task and report its current status.« less

Motivation, description, and summary status of geomechanical andgeochemical modeling studies in Task D of the InternationalDECOVALEX-THMC Project

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

Birkholzer, J.T.; Barr, D.; Rutqvist, J.

2005-11-15

The DECOVALEX project is an international cooperativeproject initiated by SKI, the Swedish Nuclear Power Inspectorate, withparticipation of about 10 international organizations. The general goalof this project is to encourage multidisciplinary interactive andcooperative research on modelling coupledthermo-hydro-mechanical-chemical (THMC) processes in geologic formationsin support of the performance assessment for underground storage ofradioactive waste. One of the research tasks, initiated in 2004 by theU.S. Department of Energy (DOE), addresses the long-term impact ofgeomechanical and geochemical processes on the flow conditions near wasteemplacement tunnels. Within this task, four international research teamsconduct predictive analysis of the coupled processes in two genericrepositories, using multiple approaches andmore » different computer codes.Below, we give an overview of the research task and report its currentstatus.« less

Beamed Energy Propulsion: Research Status And Needs--Part 2

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

Birkan, Mitat

One promising solution to the operationally responsive space is the application of remote electromagnetic energy to propel a launch vehicle into orbit. With beamed energy propulsion, one can leave the power source stationary on the ground or space, and direct heat propellant on the spacecraft with a beam from a fixed station. This permits the spacecraft to leave its power source at home, saving significant amounts of mass, greatly improving performance. This concept, which removes the mass penalty of carrying the propulsion energy source on board the vehicle, was first proposed by Arthur Kantrowitz in 1972; he invoked an extremelymore » powerful ground based laser. The same year Michael Minovich suggested a conceptually similar 'in-space' laser rocket system utilizing a remote laser power station. In the late 1980's, Air Force Office of Scientific Research (AFOSR) funded continuous, double pulse laser and microwave propulsion while Strategic Defense Initiative Office (SDIO) funded ablative laser rocket propulsion. Currently AFOSR has been funding the concept initiated by Leik Myrabo, repetitively pulsed laser propulsion, which has been universally perceived, arguably, to be the closest for mid-term applications. This 2-part paper examines the investment strategies in beamed energy propulsion and technical challenges to be covers Part 2 covers the present research status and needs.« less

Spatiotemporal Gait Characteristics Associated with Cognitive Impairment: A Multicenter Cross-Sectional Study, the Intercontinental "Gait, cOgnitiOn & Decline" Initiative.

PubMed

Beauchet, Olivier; Blumen, Helena M; Callisaya, Michele L; De Cock, Anne-Marie; Kressig, Reto W; Srikanth, Velandai; Steinmetz, Jean-Paul; Verghese, Joe; Allali, Gilles

2018-01-23

The study aims to determine the spatiotemporal gait parameters and/or their combination(s) that best differentiate between cognitively healthy individuals (CHI), patients with mild cognitive impairment (MCI) and those with mild and moderate dementia, regardless of the etiology of cognitive impairment. A total of 2099 participants (1015 CHI, 478 patients with MCI, 331 patients with mild dementia and 275 with moderate dementia) were selected from the intercontinental "Gait, cOgnitiOn & Decline" (GOOD) initiative, which merged different databases from seven cross-sectional studies. Mean values and coefficients of variation (CoV) of spatiotemporal gait parameters were recorded during usual walking with the GAITRite® system. The severity of cognitive impairment was associated with worse performance on all gait parameters. Stride velocity had the strongest association with cognitive impairment, regardless of cognitive status. High mean value and CoV of stride length characterized moderate dementia, whereas increased CoV of stride time was specific to MCI status. The findings support the existence of specific cognitive impairment-related gait disturbances with differences related to stages of cognitive impairment, which may be used to screen individuals with cognitive impairment. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Using a Structured Checklist to Improve the Orthopedic Ward Round: A Prospective Cohort Study.

PubMed

Talia, Adrian J; Drummond, James; Muirhead, Cameron; Tran, Phong

2017-07-01

Comprehensive and timely documentation on orthopedic ward rounds continues to be problematic, leading to delayed or inappropriate patient care and miscommunication between health care providers. The authors introduced a simple checklist to improve the documentation on orthopedic ward rounds in their institution. A prospective cohort study was performed. Standard care was provided for cohort A. During a 2-week period, the documentation of patient care by physicians following a ward round was assessed in terms of venous thromboembolism prophylaxis, fasting status, wound or dressing plan, weight-bearing status, and important surgical details. The physicians were blinded to this initial review. For cohort B, a structured ward round checklist was introduced during a 2-week period. A total of 132 patient encounters were recorded in cohort A. Important issues that were rarely discussed included vital signs (11.4%), venous thromboembolism prophylaxis (9.8%), and bowel status (3.8%). Issues that were poorly documented included fasting status (9.1%), wound or dressing plan (6.8%), and weight-bearing status (11.4%). After introduction of the checklist, daily documentation of surgical details improved from 38.6% to 85.3% of patient encounters. Fasting status documentation improved from 9.1% to 70.6% of patient encounters. Venous thromboembolism prophylaxis discussion increased from 9.8% to 45.6% of the time, while its documentation improved from 6.8% to 92.6%. Documentation of weight-bearing status improved from 11.4% to 83.8% (all P<.0001). The use of a structured checklist during orthopedic ward rounds led to significant improvement in both the consideration and the documentation of key aspects of surgical care. [Orthopedics. 2017; 40(4):e663-e667.]. Copyright 2017, SLACK Incorporated.

National Hurricane Research Initiative Act of 2011

THOMAS, 112th Congress

Sen. Nelson, Bill [D-FL

2011-03-30

Senate - 01/02/2013 By Senator Rockefeller from Committee on Commerce, Science, and Transportation filed written report. Report No. 112-266. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

The NASA/DOE/DOD nuclear rocket propulsion project - FY 1991 status

NASA Technical Reports Server (NTRS)

Clark, John S.; Miller, Thomas J.

1991-01-01

NASA has initiated planning and critical technology development for nuclear rocket propulsion systems for Space Exploration Initiative missions to the moon and to Mars. Interagency agreements are being negotiated between NASA, the Department of Energy, and the Department of Defense for joint technology development activities. This paper summarizes the activities of the NASA project planning team in FY 1990 that led to the draft Nuclear Propulsion Project Plan, outlines the FY 1991 Interagency activities, and describes the current status of the project plan.

HIV status and treatment influence on fertility desires among women newly becoming eligible for antiretroviral therapy in western Kenya: insights from a qualitative study.

PubMed

Ayieko, James; Ti, Angeline; Hagey, Jill; Akama, Eliud; Bukusi, Elizabeth A; Cohen, Craig R; Patel, Rena C

2017-08-08

Factors influencing fertility desires among HIV-infected individuals remain poorly understood. With new recommendations for universal HIV treatment and increasing antiretroviral therapy (ART) access, we sought to evaluate how access to early ART influences fertility desires among HIV-infected ART-naïve women. Semi-structured in-depth interviews were conducted with a select subgroup of 20 HIV-infected ART-naïve women attending one of 13 HIV facilities in western Kenya between July and August 2014 who would soon newly become eligible to initiate ART based on the latest national policy recommendations. The interviews covered four major themes: 1) definitions of family and children's role in community; 2) personal, interpersonal, institutional, and societal factors influencing fertility desires; 3) influence of HIV-positive status on fertility desires; and 4) influence of future ART initiation on fertility desires. An iterative process of reading transcripts, applying inductive codes, and comparing and contrasting codes was used to identify convergent and divergent themes. The women indicated their HIV-positive status did influence-largely negatively-their fertility desires. Furthermore, initiating ART and anticipating improved health status did not necessarily translate to increased fertility desires. Instead, individual factors, such as age, parity, current health status, financial resources and number of surviving or HIV-infected children, played a crucial role in decisions about future fertility. In addition, societal influences, such as community norms and health providers' expectations of their fertility desires, played an equally important role in determining fertility desires. Initiating ART may not be the leading factor influencing fertility desires among previously ART-naïve HIV-infected women. Instead, individual and societal factors appear to be the major determinants of fertility desires among these women.

Evaluating the Impact of Feedback on Elementary Aged Students’ Fluency Growth in Written Expression: A Randomized Controlled Trial

PubMed Central

Truckenmiller, Adrea J.; Eckert, Tanya L.; Codding, Robin S.; Petscher, Yaacov

2016-01-01

The purpose of this randomized controlled trial was to evaluate elementary-aged students’ writing fluency growth in response to (a) instructional practices, (b) sex differences, and (c) student’s initial level of writing fluency. Third-grade students (n=133) in three urban elementary schools were randomly assigned to either an individualized performance feedback condition (n=46), a practice-only condition (i.e., weekly writing practice; n = 39), or an instructional control condition (n = 48) for 8 weeks. Findings included support for use of performance feedback as an instructional component in general education classrooms (Hedges’ g = 0.66), whereas simple practice with curriculum-based measurement in written expression did not produce growth significantly greater than standard instructional practices. The hypothesis that girls write significantly more than boys was supported. However, girls and boys did not differ in their rate of growth. Finally, students’ initial risk status in writing fluency did not differentially predict growth in writing fluency over the course of the study. Implications for incorporating feedback as a basic component of intervention in writing are discussed. PMID:25432270

Effect of protected research time on ABSITE scores during general surgery residency.

PubMed

Orkin, Bruce A; Poirier, Jennifer; Kowal-Vern, Areta; Chan, Edie; Ohara, Karen; Mendoza, Brian

2018-02-01

Objective - To determine whether residents with one or more years of dedicated research time (Research Residents, RR) improved their ABSITE scores compared to those without (Non-Research Residents, N-RR). A retrospective review of general surgery residents' ABSITE scores from 1995 to 2016 was performed. RR were compared to N-RR. Additional analysis of At Risk (AR) v Not At Risk residents (NAR) (35th percentile as PGY1-2) was also performed. Cohort - 147 residents (34 RR and 113 N-RR). There were no differences in initial ABSITE scores (p = 0.47). By definition, the AR group had lower scores than NAR. Overall, post-research RR v PGY-4 N-RR scores did not differ (p = 0.84). Only the AR residents improved their scores (p = 0.0009 v NAR p = 0.42), regardless of research group (p = 0.70). Protected research time did not improve residents' ABSITE scores, regardless of initial scores. At Risk residents improved regardless of research group status. Copyright © 2017 Elsevier Inc. All rights reserved.

Health-related quality of life, cognitive screening, and functional status in a randomized phase III trial (EF-14) of tumor treating fields with temozolomide compared to temozolomide alone in newly diagnosed glioblastoma.

PubMed

Zhu, Jay-Jiguang; Demireva, Petya; Kanner, Andrew A; Pannullo, Susan; Mehdorn, Maximilian; Avgeropoulos, Nicholas; Salmaggi, Andrea; Silvani, Antonio; Goldlust, Samuel; David, Carlos; Benouaich-Amiel, Alexandra

2017-12-01

We characterized health-related quality of life (HRQoL), cognitive, and functional status in newly diagnosed glioblastoma (GBM) patients receiving Tumor treating fields (TTFields) with temozolomide (TMZ) versus TMZ alone in a planned interim analysis of a randomized phase III trial [NCT00916409], which showed significant improvement in progression-free and overall survival with TTFields/TMZ. After radiotherapy with concomitant TMZ, newly diagnosed GBM patients were randomized (2:1) to TTFields/TMZ (n = 210) or TMZ (n = 105). Interim analysis was performed in 315 patients with ≥18 months of follow-up. HRQoL, a secondary endpoint, was evaluated in per-protocol patient population and expressed as change from baseline (CFB) at 3, 6, and 9 months for each subscale in the EORTC QLQ-C30/BN20. Karnofsky performance scores (KPS) and Mini-Mental State Examination scores (MMSE) were assessed. CFB in HRQoL was balanced in treatment groups at the 12-month time point. Initially, HRQoL improved in patients treated with TTFields/TMZ (CFB3: 24% and CFB6: 13%) versus TMZ (CFB3: -7% and CFB6: -17%), though this difference was no longer evident at the 9-month point. General scales, including physical and social functioning, showed no difference at 9 and 12 months. TTFields/TMZ group reported higher concerns of "itchy skin". KPS over 12 months was just below 90 in both groups. Cognitive status (MMSE) was stable over time. HRQoL, KPS, and MMSE were balanced in both groups over time. There was no preliminary evidence that HRQoL, cognitive, and functional status is adversely affected by the continuous use of TTFields.

Marital status as a predictor of survival in patients with human papilloma virus-positive oropharyngeal cancer.

PubMed

Rubin, Samuel J; Kirke, Diana N; Ezzat, Waleed H; Truong, Minh T; Salama, Andrew R; Jalisi, Scharukh

Determine whether marital status is a significant predictor of survival in human papillomavirus-positive oropharyngeal cancer. A single center retrospective study included patients diagnosed with human papilloma virus-positive oropharyngeal cancer at Boston Medical Center between January 1, 2010 and December 30, 2015, and initiated treatment with curative intent at Boston Medical Center. Demographic data and tumor-related variables were recorded. Univariate analysis was performed using a two-sample t-test, chi-squared test, Fisher's exact test, and Kaplan Meier curves with a log rank test. Multivariate survival analysis was performed using a Cox regression model. A total of 65 patients were included in the study with 24 patients described as married and 41 patients described as single. There was no significant difference in most demographic variables or tumor related variables between the two study groups, except single patients were significantly more likely to have government insurance (p=0.0431). Furthermore, there was no significant difference in 3-year overall survival between married patients and single patients (married=91.67% vs single=87.80%; p=0.6532) or 3-year progression free survival (married=79.17% vs single=85.37%; p=0.8136). After adjusting for confounders including age, sex, race, insurance type, smoking status, treatment, and AJCC combined pathologic stage, marital status was not a significant predictor of survival [HR=0.903; 95% CI (0.126,6.489); p=0.9192]. Although previous literature has demonstrated that married patients with head and neck cancer have a survival benefit compared to single patients with head and neck cancer, we were unable to demonstrate the same survival benefit in a cohort of patients with human papilloma virus-positive oropharyngeal cancer. Copyright © 2017 Elsevier Inc. All rights reserved.

Is there an occupational status gradient in the development of periodontal disease in Japanese workers? A 5-year prospective cohort study.

PubMed

Irie, Koichiro; Yamazaki, Toru; Yoshii, Saori; Takeyama, Hideo; Shimazaki, Yoshihiro

2017-02-01

Development of periodontal disease (PD) may be affected by socioeconomic status. This study examined the relationship between occupational status and PD in a 5-year prospective cohort of Japanese workers. In total, 19,633 participants had initial examinations at the Aichi Health Promotion Foundation, of whom 8210 participants aged 20 years or older did not have PD. Follow-up examinations were conducted for 3757 participants, accounting for 45.8% of baseline participants. Ultimately, 3390 participants were analyzed according to the criterion of job classification at baseline, which was based on the International Standard Classification of Occupations, 1987. Oral examinations were performed using the Community Periodontal Index (CPI). The CPI scores were coded as follows: healthy (score of 0); bleeding after probing (1); dental calculus (2); shallow pockets (3); and deep pockets (4). Participants with one or more sextants with a score >2 were diagnosed with PD. Poisson regression analysis was performed to adjust for age and other potential confounders. Overall, 31.6% of men and 23.8% of women had developed PD (CPI scores of 3 or 4). The adjusted relative risk (RR) for PD (CPI scores of 3 or 4) in men was not significant. On the other hand, the adjusted RRs for PD (CPI score of 4) in men were 2.52-, 2.39-, and 2.74-fold higher for skilled workers, sales persons, and drivers, respectively, than for professionals. In contrast, we found no gradient in women. We found a gradient related to the risk of developing PD according to occupational status among men in a Japanese worker population. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Continence and quality-of-life outcomes 6 months following an intensive pelvic-floor muscle exercise program for female stress urinary incontinence: a randomized trial comparing low- and high-frequency maintenance exercise.

PubMed

Borello-France, Diane F; Downey, Patricia A; Zyczynski, Halina M; Rause, Christine R

2008-12-01

Few studies have examined the effectiveness of pelvic-floor muscle (PFM) exercises to reduce female stress urinary incontinence (SUI) over the long term. This study: (1) evaluated continence and quality-of-life outcomes of women 6 months following formalized therapy and (2) determined whether low- and high-frequency maintenance exercise programs were equivalent in sustaining outcomes. Thirty-six women with SUI who completed an intensive PFM exercise intervention trial were randomly assigned to perform a maintenance exercise program either 1 or 4 times per week. Urine leaks per week, volume of urine loss, quality of life (Incontinence Impact Questionnaire [IIQ] score), PFM strength (Brink score), and prevalence of urodynamic stress incontinence (USI) were measured at a 6-month follow-up for comparison with postintervention status. Parametric and nonparametric statistics were used to determine differences in outcome status over time and between exercise frequency groups. Twenty-eight women provided follow-up data. Postintervention status was sustained at 6 months for all outcomes (mean [SD] urine leaks per week=1.2+/-2.1 versus 1.4+/-3.1; mean [SD] urine loss=0.2+/-0.5 g versus 0.2+/-0.8 g; mean [SD] IIQ score=17+/-20 versus 22+/-30; mean [SD] Brink score=11+/-1 versus 11+/-1; and prevalence of USI=48% versus 35%). Women assigned to perform exercises once or 4 times per week similarly sustained their postintervention status. Benefits of an initial intensive intervention program for SUI were sustained over 6 months. However, only 15 of the 28 women provided documentation of their exercise adherence, limiting conclusions regarding the need for continued PFM exercise during follow-up intervals of

24 CFR 125.103 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... HOUSING INITIATIVES PROGRAM § 125.103 Definitions. In addition to the definitions that appear at section... status as an FHO. FHIP means the Fair Housing Initiatives Program authorized by section 561 of the...

What physical performance measures predict incident cognitive decline among intact older adults? A 4.4year follow up study.

PubMed

Veronese, Nicola; Stubbs, Brendon; Trevisan, Caterina; Bolzetta, Francesco; De Rui, Marina; Solmi, Marco; Sartori, Leonardo; Musacchio, Estella; Zambon, Sabina; Perissinotto, Egle; Crepaldi, Gaetano; Manzato, Enzo; Sergi, Giuseppe

2016-08-01

Reductions in physical performance, cognitive impairment (CI) and decline (CD), are common in older age, but few prospective cohort studies have considered the relationship between these domains. In this study we investigated whether reduced physical performance and low handgrip/lower limbs strength, could predict a higher incidence of CI/CD during a 4-year follow-up among a cohort of elderly individuals. From 3099 older community-dwelling individuals initially enrolled in the Progetto Veneto Anziani (PRO.V.A.) study, 1249 participants without CI at the baseline were included (mean age 72.2years, 59.5% females). Physical performance measures included the Short Physical Performance Battery (SPPB), 4m gait speed, chair stands time, leg extension and flexion, handgrip strength, and 6-Minute Walking Test (6MWT), categorized in gender-specific tertiles. CI was defined as a Mini-Mental State Examination (MMSE) score below 24; CD a decline of 3 or more points in the MMSE without CI. At baseline, participants developing CI during follow-up scored significantly worse across all physical performance measures compared to those that retained normal cognitive status. After adjusting for potential confounders, a significant trend for MMSE changes was noted for all physical performance tests, except for the SPPB and chair stands time. Multinomial logistic regression revealed that slow gait speed at baseline significantly predicted CD at follow up. Poor SPPB performance and slower gait speed predicted the onset of CI at the follow-up. In conclusion, slow walking speed appears to be the best independent predictor of poor cognitive status over a 4.4-year follow-up, while other items of SPPB were also significantly associated with CI. Copyright © 2016 Elsevier Inc. All rights reserved.

40 CFR 63.2862 - What records must I keep?

Code of Federal Regulations, 2012 CFR

2012-07-01

...) initial startup period or the § 63.2850(e)(2) malfunction period. Complete both plans before the... such as normal operation, nonoperating, initial startup period, malfunction period, or exempt operation... inventory. (ii) The operating status of your source such as normal operation, nonoperating, initial startup...

40 CFR 63.2862 - What records must I keep?

Code of Federal Regulations, 2013 CFR

2013-07-01

...) initial startup period or the § 63.2850(e)(2) malfunction period. Complete both plans before the... such as normal operation, nonoperating, initial startup period, malfunction period, or exempt operation... inventory. (ii) The operating status of your source such as normal operation, nonoperating, initial startup...

40 CFR 63.2862 - What records must I keep?

Code of Federal Regulations, 2014 CFR

2014-07-01

...) initial startup period or the § 63.2850(e)(2) malfunction period. Complete both plans before the... such as normal operation, nonoperating, initial startup period, malfunction period, or exempt operation... inventory. (ii) The operating status of your source such as normal operation, nonoperating, initial startup...

40 CFR 63.2862 - What records must I keep?

Code of Federal Regulations, 2011 CFR

2011-07-01

...) initial startup period or the § 63.2850(e)(2) malfunction period. Complete both plans before the... such as normal operation, nonoperating, initial startup period, malfunction period, or exempt operation... inventory. (ii) The operating status of your source such as normal operation, nonoperating, initial startup...

40 CFR 63.2862 - What records must I keep?

Code of Federal Regulations, 2010 CFR

2010-07-01

...) initial startup period or the § 63.2850(e)(2) malfunction period. Complete both plans before the... such as normal operation, nonoperating, initial startup period, malfunction period, or exempt operation... inventory. (ii) The operating status of your source such as normal operation, nonoperating, initial startup...

National Nanotechnology Initiative Amendments Act of 2009

THOMAS, 111th Congress

Rep. Gordon, Bart [D-TN-6

2009-01-15

Senate - 02/12/2009 Received in the Senate and Read twice and referred to the Committee on Commerce, Science, and Transportation. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

Trait self-esteem moderates the effect of initiator status on emotional and cognitive responses to romantic relationship dissolution.

PubMed

Waller, Katherine L; MacDonald, Tara K

2010-08-01

We hypothesized that the effect of initiator status on post breakup distress would vary as a function of trait self-esteem, such that individuals with low self-esteem would experience more distress after being rejected by their partners, whereas, among individuals with high self-esteem, initiator status would not predict distress. We used a prospective design in which university students (N=66) were assessed for emotional responses following the dissolution of their real-life romantic relationships, as well as a laboratory design in which students (N=190) imagined breaking up with their partners. As predicted, participants with lower trait self-esteem exhibited greater distress after experiencing or imagining a romantic rejection than after ending or imagining themselves ending their relationships. Conversely, distress experienced by those with high trait self-esteem did not differ as a function of who ended the relationship. Implications for understanding self-esteem processes and the effects of romantic rejection are discussed.

Mayo registry for telemetry efficacy in arrest study: An evaluation of the feasibility of the do not intubate code status.

PubMed

Snipelisky, David; Dumitrascu, Adrian; Ray, Jordan; Roy, Archana; Matcha, Gautam; Harris, Dana; Vadeboncoeur, Tyler; Kusumoto, Fred; Burton, M Caroline

2017-12-06

Guidelines recommend discussing code status with patients on hospital admission. No study has evaluated the feasibility of a full code with do not intubate (DNI) status. A retrospective analysis of patients who experienced a cardiopulmonary arrest was performed between May 1, 2008 and June 20, 2014. A descriptive analysis was created based on whether patients required mechanical ventilatory support during the hospitalization and comparisons were made between both patient subsets. A total of 239 patients were included. Almost all (n = 218, 91.2%) required intubation during the hospitalization. Over half (n = 117, 53.7%) were intubated on the same day as the cardiopulmonary arrest and 91 patients (41.7%) were intubated at the time of arrest. Comparisons between intubated and non-intubated patients showed little differences in clinical characteristics, except for a higher proportion of medical cardiac etiology for admission in patients who did not require intubation (n = 10, 47.6% versus n = 55, 25.2%; p = 0.18) and initial arrest rhythm of ventricular tachycardia/fibrillation (n = 8, 38.1% versus n = 50, 22.9%; p = 0.37). No differences in 24-hour and posthospital survivals were present. Mechanical ventilatory support is commonly utilized in patients who experience a cardiopulmonary arrest. The DNI status may not be a feasible code status option for most patients.

[Sleep in adolescents of different socioeconomic status: a systematic review].

PubMed

Felden, Érico Pereira Gomes; Leite, Carina Raffs; Rebelatto, Cleber Fernando; Andrade, Rubian Diego; Beltrame, Thais Silva

2015-12-01

To analyze the sleep characteristics in adolescents from different socioeconomic levels. Original studies found in the Medline/PubMed and SciELO databases without language and period restrictions that analyzed associations between sleep variables and socioeconomic indicators. The initial search resulted in 99 articles. After reading the titles and abstracts and following inclusion and exclusion criteria, 12 articles with outcomes that included associations between sleep variables (disorders, duration, quality) and socioeconomic status (ethnicity, family income, and social status) were analyzed. The studies associating sleep with socioeconomic variables are recent, published mainly after the year 2000. Half of the selected studies were performed with young Americans, and only one with Brazilian adolescents. Regarding ethnic differences, the studies do not have uniform conclusions. The main associations found were between sleep variables and family income or parental educational level, showing a trend among poor, low social status adolescents to manifest low duration, poor quality of sleeping patterns. The study found an association between socioeconomic indicators and quality of sleep in adolescents. Low socioeconomic status reflects a worse subjective perception of sleep quality, shorter duration, and greater daytime sleepiness. Considering the influence of sleep on physical and cognitive development and on the learning capacity of young individuals, the literature on the subject is scarce. There is a need for further research on sleep in different realities of the Brazilian population. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

Health status in fibromyalgia--a followup study.

PubMed

Mengshoel, A M; Haugen, M

2001-09-01

To examine symptoms, physical function, and nutritional status in patients with fibromyalgia (FM) after 6 to 8 years. Of 51 women with FM initially included in exercise and patient education programs 6 and 8 years ago, 33 agreed to participate. Median (range) age was 45.5 years (33-64) and symptom duration 18 years (8-46). Symptoms (visual analog scales), cardiovascular capacity (Aastrand's test), and restriction on daily activities (Fibromyalgia Impact Questionnaire) were measured. Employment status and experience of coping with everyday life were addressed in an interview. Nutritional status was evaluated by anthropometric measurements and dietary intake. All the 33 participants had widespread chronic pain, and 79% had enough tender points to satisfy the FM classification criteria. Compared with initital data there were significant reductions in the number of tender points (p = 0.004) in the exercise group, and in fatigue (p = 0.008) and pain (p = 0.5) in the patient education group. Cardiovascular capacity was within normal limits in 33% of the participants. Currently, 26 performed regular physical activity and of these, 10 were engaged in organized exercise. Seventy-two percent reported regular use of dietary supplements and attached importance to a healthy diet. Still, there was a significant increase in weight and body fat, and 24% were obese (BMI > 30). The coping strategies adopted were adjustments to the new situation and distraction from symptoms. No worsening of symptoms and no change in employment status, as well as frequent participation in physical activities, suggests a benign longterm outcome in these patients with FM.

Status of the national transonic facility

NASA Technical Reports Server (NTRS)

Mckinney, L. W.; Gloss, B. B.

1982-01-01

The National Transonic Facility at NASA Langley Research Center, scheduled for completion in July, 1982, is described with emphasis on model and instrumentation activities, calibration plans and some initial research plans. Performance capabilities include a Mach number range of 0.2-1.2, a pressure range of 1-9 atmospheres, and a temperature range of 77-350 K, which will produce a maximum Reynolds number of 120 million at a Mach number of 1.0, based on a 0.25 m chord. A comprehensive tunnel calibration program is planned, which will cover basic tunnel calibration, data qualities, and data comparisons with other facilites and flights.

JTEC panel report on advanced composites in Japan

NASA Technical Reports Server (NTRS)

Diefendorf, R. J.; Grisaffe, S. J.; Hillig, W. B.; Perepezko, J. H.; Pipes, R. B.; Sheehan, J. E.

1991-01-01

The JTEC Panel on Advanced Composites visited Japan and surveyed the status and future directions of Japanese high performance ceramic and carbon fibers and their composites in metal, intermetallic, ceramic and carbon matrices. The panel's interests included not only what composite systems were chosen, but also how these systems were developed. A strong carbon and fiber industry makes Japan the leader in carbon fiber technology. Japan has initiated an oxidation resistant carbon/carbon composite program. The goals for this program are ambitious, and it is just starting, but its progress should be closely monitored in the United States.

Philanthropic endowments in general internal medicine.

PubMed

Murden, R A; Lamb, J F

1999-04-01

We performed two surveys to uncover the status of philanthropic endowments in general internal medicine divisions. The initial survey of U.S. medical school departments of medicine found that only 14.1% of general internal medicine divisions hold endowments versus 21.9% of all other divisions, and that endowment sources for general medicine are atypical. The second survey of successfully endowed divisions found that sympathetic administrators and active pursuit of endowments were associated with endowment success. Aggressive pursuit of endowments, publicizing successes of general medicine, and consideration of endowment sources noted in this study are recommended to improve philanthropic contributions to general internal medicine.

KSC-05PD-1086

NASA Technical Reports Server (NTRS)

2005-01-01

KENNEDY SPACE CENTER, FLA. At Launch Complex 39B, technicians in Space Shuttle Discovery's payload bay perform a borescope inspection of the retract link assembly on the orbiter's main landing gear door. The inspection is a precautionary measure after a small crack was found in a retract link assembly on the right-hand main landing gear on orbiter Atlantis. An initial review of the closeout photos of the link assembly on Discovery did not reveal any cracks. Discovery is scheduled to return the Space Shuttle fleet to operational status on mission STS-114. This additional work does not impact the launch planning window of July 13-31.

An integrated modeling and design tool for advanced optical spacecraft

NASA Technical Reports Server (NTRS)

Briggs, Hugh C.

1992-01-01

Consideration is given to the design and status of the Integrated Modeling of Optical Systems (IMOS) tool and to critical design issues. A multidisciplinary spacecraft design and analysis tool with support for structural dynamics, controls, thermal analysis, and optics, IMOS provides rapid and accurate end-to-end performance analysis, simulations, and optimization of advanced space-based optical systems. The requirements for IMOS-supported numerical arrays, user defined data structures, and a hierarchical data base are outlined, and initial experience with the tool is summarized. A simulation of a flexible telescope illustrates the integrated nature of the tools.

Space Transportation Propulsion Systems

NASA Technical Reports Server (NTRS)

Liou, Meng-Sing; Stewart, Mark E.; Suresh, Ambady; Owen, A. Karl

2001-01-01

This report outlines the Space Transportation Propulsion Systems for the NPSS (Numerical Propulsion System Simulation) program. Topics include: 1) a review of Engine/Inlet Coupling Work; 2) Background/Organization of Space Transportation Initiative; 3) Synergy between High Performance Computing and Communications Program (HPCCP) and Advanced Space Transportation Program (ASTP); 4) Status of Space Transportation Effort, including planned deliverables for FY01-FY06, FY00 accomplishments (HPCCP Funded) and FY01 Major Milestones (HPCCP and ASTP); and 5) a review current technical efforts, including a review of the Rocket-Based Combined-Cycle (RBCC), Scope of Work, RBCC Concept Aerodynamic Analysis and RBCC Concept Multidisciplinary Analysis.

Study of new anticoincidence systems design

NASA Astrophysics Data System (ADS)

Chabaud, J.; Laurent, P.; Baronick, J.-P.; Oger, R.; Prévôt, G.

2012-12-01

The scientific performances of future hard X-ray missions will necessitate a very low detector background level. This will imply thorough background simulations, and efficient background rejection systems. It necessitates also a very good knowledge of the detectors to be shielded. We got experience on these activities by conceiving and optimizing the active and passive background rejection system of the Simbol-X and IXO/HXI missions. Considering that this work may naturally be extended to other X-ray missions, we have initiated with CNES, in 2010, a R&T project on the study of background rejection systems, whose status will be presented in this paper.

Sensitivity and specificity of univariate MRI analysis of experimentally degraded cartilage

PubMed Central

Lin, Ping-Chang; Reiter, David A.; Spencer, Richard G.

2010-01-01

MRI is increasingly used to evaluate cartilage in tissue constructs, explants, and animal and patient studies. However, while mean values of MR parameters, including T1, T2, magnetization transfer rate km, apparent diffusion coefficient ADC, and the dGEMRIC-derived fixed charge density, correlate with tissue status, the ability to classify tissue according to these parameters has not been explored. Therefore, the sensitivity and specificity with which each of these parameters was able to distinguish between normal and trypsin- degraded, and between normal and collagenase-degraded, cartilage explants were determined. Initial analysis was performed using a training set to determine simple group means to which parameters obtained from a validation set were compared. T1 and ADC showed the greatest ability to discriminate between normal and degraded cartilage. Further analysis with k-means clustering, which eliminates the need for a priori identification of sample status, generally performed comparably. Use of fuzzy c-means (FCM) clustering to define centroids likewise did not result in improvement in discrimination. Finally, a FCM clustering approach in which validation samples were assigned in a probabilistic fashion to control and degraded groups was implemented, reflecting the range of tissue characteristics seen with cartilage degradation. PMID:19705467

Pregnant women with HIV in rural Nigeria have higher rates of antiretroviral treatment initiation, but similar loss to follow-up as non-pregnant women and men

PubMed Central

Aliyu, Muktar H.; Blevins, Meridith; Megazzini, Karen M.; Parrish, Deidra D.; Audet, Carolyn M.; Chan, Naomi; Odoh, Chisom; Gebi, Usman I.; Muhammad, Mukhtar Y.; Shepherd, Bryan E.; Wester, C. William; Vermund, Sten H.

2015-01-01

Background We examined antiretroviral therapy (ART) initiation and retention by sex and pregnancy status in rural Nigeria. Methods We studied HIV-infected ART-naïve patients aged ≥15 years entering care from June 2009 to September 2013. We calculated the probability of early ART initiation and cumulative incidence of loss to follow-up (LTFU) during the first year of ART, and examined the association between LTFU and sex/pregnancy using Cox regression. Results The cohort included 3813 ART-naïve HIV-infected adults (2594 women [68.0%], 273 [11.8%] of them pregnant). The proportion of pregnant clients initiating ART within 90 days of enrollment (78.0%, 213/273) was higher than among non-pregnant women (54.3%,1261/2321) or men (53.0%, 650/1219), both p<0.001. Pregnant women initiated ART sooner than non-pregnant women and men (median [IQR] days from enrollment to ART initiation for pregnant women=7 days [0–21] vs 14 days [7–49] for non-pregnant women and 14 days [7–42] for men; p<0.001). Cumulative incidence of LTFU during the first year post-ART initiation was high and did not differ by sex and pregnancy status. Persons who were unemployed, bedridden, had higher CD4+ counts, and/or in earlier WHO clinical stages were more likely to be LTFU. Conclusions Pregnant women with HIV in rural Nigeria were more likely to initiate ART but were no more likely to be retained in care. Our findings underscore the importance of effective retention strategies across all patient groups, regardless of sex and pregnancy status. PMID:26012740

Chemotherapy Use, Performance Status, and Quality of Life at the End of Life

PubMed Central

Prigerson, Holly G.; Bao, Yuhua; Shah, Manish A.; Paulk, M. Elizabeth; LeBlanc, Thomas W.; Schneider, Bryan J.; Garrido, Melissa M.; Reid, M. Carrington; Berlin, David A.; Adelson, Kerin B.; Neugut, Alfred I.; Maciejewski, Paul K.

2016-01-01

IMPORTANCE Although many patients with end-stage cancer are offered chemotherapy to improve quality of life (QOL), the association between chemotherapy and QOL amid progressive metastatic disease has not been well-studied. American Society for Clinical Oncology guidelines recommend palliative chemotherapy only for solid tumor patients with good performance status. OBJECTIVE To evaluate the association between chemotherapy use and QOL near death (QOD) as a function of patients’ performance status. DESIGN, SETTING, AND PARTICIPANTS A multi-institutional, longitudinal cohort study of patients with end-stage cancer recruited between September 2002 and February 2008. Chemotherapy use (n = 158 [50.6%]) and Eastern Cooperative Oncology Group (ECOG) performance status were assessed at baseline (median = 3.8 months before death) and patients with progressive metastatic cancer (N = 312) following at least 1 chemotherapy regimen were followed prospectively until death at 6 outpatient oncology clinics in the United States. MAIN OUTCOMES AND MEASURES Patient QOD was determined using validated caregiver ratings of patients’ physical and mental distress in their final week. RESULTS Chemotherapy use was not associated with patient survival controlling for clinical setting and patients’ performance status. Among patients with good (ECOG score = 1) baseline performance status, chemotherapy use compared with nonuse was associated with worse QOD (odds ratio [OR], 0.35; 95% CI, 0.17-0.75; P = .01). Baseline chemotherapy use was not associated with QOD among patients with moderate (ECOG score = 2) baseline performance status (OR, 1.06; 95% CI, 0.51-2.21; P = .87) or poor (ECOG score = 3) baseline performance status (OR, 1.34; 95% CI, 0.46-3.89; P = .59). CONCLUSIONS AND RELEVANCE Although palliative chemotherapy is used to improve QOL for patients with end-stage cancer, its use did not improve QOD for patients with moderate or poor performance status and worsened QOD for patients with good performance status. The QOD in patients with end-stage cancer is not improved, and can be harmed, by chemotherapy use near death, even in patients with good performance status. PMID:26203912

42 CFR 414.313 - Initial method of payment.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) Administration of hepatitis B vaccine. (c) Physician election of the initial method. (1) Each physician in a... examinations to review health status and treatment. (ii) Physician surgical services other than insertion of...

42 CFR 414.313 - Initial method of payment.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) Administration of hepatitis B vaccine. (c) Physician election of the initial method. (1) Each physician in a... examinations to review health status and treatment. (ii) Physician surgical services other than insertion of...

Mannan-MUC1-pulsed dendritic cell immunotherapy: a phase I trial in patients with adenocarcinoma.

PubMed

Loveland, Bruce E; Zhao, Anne; White, Shane; Gan, Hui; Hamilton, Kate; Xing, Pei-Xiang; Pietersz, Geoffrey A; Apostolopoulos, Vasso; Vaughan, Hilary; Karanikas, Vaios; Kyriakou, Peter; McKenzie, Ian F C; Mitchell, Paul L R

2006-02-01

Tumor antigen-loaded dendritic cells show promise for cancer immunotherapy. This phase I study evaluated immunization with autologous dendritic cells pulsed with mannan-MUC1 fusion protein (MFP) to treat patients with advanced malignancy. Eligible patients had adenocarcinoma expressing MUC1, were of performance status 0 to 1, with no autoimmune disease. Patients underwent leukapheresis to generate dendritic cells by culture ex vivo with granulocyte macrophage colony-stimulating factor and interleukin 4 for 5 days. Dendritic cells were then pulsed overnight with MFP and harvested for reinjection. Patients underwent three cycles of leukapheresis and reinjection at monthly intervals. Patients with clinical benefit were able to continue with dendritic cell-MFP immunotherapy. Ten patients with a range of tumor types were enrolled, with median age of 60 years (range, 33-70 years); eight patients were of performance status 0 and two of performance status 1. Dendritic cell-MFP therapy led to strong T-cell IFNgamma Elispot responses to the vaccine and delayed-type hypersensitivity responses at injection sites in nine patients who completed treatments. Immune responses were sustained at 1 year in monitored patients. Antibody responses were seen in three patients only and were of low titer. Side effects were grade 1 only. Two patients with clearly progressive disease (ovarian and renal carcinoma) at entry were stable after initial therapy and went on to further leukapheresis and dendritic cell-MFP immunotherapy. These two patients have now each completed over 3 years of treatment. Immunization produced T-cell responses in all patients with evidence of tumor stabilization in 2 of the 10 advanced cancer patients treated. These data support further clinical evaluation of this dendritic cell-MFP immunotherapy.

Cardio-respiratory responses of the 6-minute walk test in patients with refractory heart failure during the preoperative period for heart transplant surgery.

PubMed

Gerson, Cipriano; Bernardelli, Graziella França; Arena, Ross; Oliveira, Luis Vicente Franco; Valdez, Francisco; Branco, João Nelson Rodrigues

2010-06-01

The six-minute walk test (6MWT) has been used to assess functional capacity, clinical status and prognosis. There are a very few descriptions in the literature on the safety and metabolic impact of the test, especially in patients with severe heart failure, awaiting cardiac transplantation. The aim of the present study was to assess the cardiovascular responses and correlate the performance on the 6MWT with clinical status. From 15 initial candidates, twelve patients (10 males) aged 52 +/- 8 years were submitted to a comprehensive clinical evaluation. The patients performed the 6MWT with electrocardiographic and perceived exertion monitoring in addition to determination of blood lactate concentration. Patients were followed up for 12 months. The patients walked 399.4 +/- 122.5 meters, reaching a perceived exertion (PE) of 14.3 +/- 1.5 and an increase of 34% in resting heart rate. Two patients exhibited a greater severity of arrhythmia prior to the 6MWT, which did not increase during exertion. Four patients exhibited a significant increase in blood lactate levels (>5 mmol/dL) and three interrupted the test prematurely. The distance walked (D) revealed a correlation with the ejection fraction (%) and functional classification (NYHA). After 12 months of follow up, three patients died and seven were re-hospitalized due to heart failure decompensation. Clinical and electrocardiographic behavior suggests that the 6MWT is safe, but may be considered of high intensity for some patients with severe heart failure. Variables related to the performance on the 6MWT may be associated to worsening clinical status in this population.

Neurological failure in ICU patients with hematological malignancies: A prospective cohort study.

PubMed

Marzorati, Chiara; Mokart, Djamel; Pène, Frederic; Lemiale, Virginie; Kouatchet, Achille; Mayaux, Julien; Vincent, François; Nyunga, Martine; Bruneel, Fabrice; Rabbat, Antoine; Lebert, Christine; Perez, Pierre; Benoit, Dominique; Citerio, Giuseppe; Azoulay, Elie; Legriel, Stephane

2017-01-01

Epidemiological studies of neurological complications in patients with hematological malignancies are scant. The objective of the study was to identify determinants of survival in patients with hematological malignancy and neurological failure. Post hoc analysis of a prospective study of adults with hematological malignancies admitted for any reason to one of 17 university or university-affiliated participating ICUs in France and Belgium (2010-2012). The primary outcome was vital status at hospital discharge. Of the 1011 patients enrolled initially, 226 (22.4%) had neurological failure. Presenting manifestations were dominated by drowsiness or stupor (65%), coma (32%), weakness (26%), and seizures (19%). Neuroimaging, lumbar puncture, and electroencephalography were performed in 113 (50%), 73 (32%), and 63 (28%) patients, respectively. A neurosurgical biopsy was done in 1 patient. Hospital mortality was 50%. By multivariate analysis, factors independently associated with higher hospital mortality were poor performance status (odds ratio [OR], 3.99; 95%CI, 1.82-9.39; P = 0.0009), non-Hodgkin's lymphoma (OR, 2.60; 95%CI, 1.35-5.15; P = 0.005), shock (OR, 1.95; 95%CI, 1.04-3.72; P = 0.04), and respiratory failure (OR, 2.18; 95%CI, 1.14-4.25; P = 0.02); and factors independently associated with lower hospital mortality were GCS score on day 1 (OR, 0.88/point; 95%CI, 0.81-0.95; P = 0.0009) and autologous stem cell transplantation (OR, 0.25; 95%CI, 0.07-0.75; P = 0.02). In ICU patients with hematological malignancies, neurological failure is common and often fatal. Independent predictors of higher hospital mortality were type of underlying hematological malignancy, poor performance status, hemodynamic and respiratory failures, and severity of consciousness impairment. Knowledge of these risk factors might help to optimize management strategies.

The Adverse Survival Implications of Bland Thrombus in Renal Cell Carcinoma With Venous Tumor Thrombus.

PubMed

Hutchinson, Ryan; Rew, Charles; Chen, Gong; Woldu, Solomon; Krabbe, Laura-Maria; Meissner, Matthew; Sheth, Kunj; Singla, Nirmish; Shakir, Nabeel; Master, Viraj A; Karam, Jose A; Matin, Surena F; Borregales, Leonardo D; Wood, Christopher; Masterson, Timothy; Thompson, R Houston; Boorjian, Stephen A; Leibovich, Bradley C; Abel, E Jason; Bagrodia, Aditya; Margulis, Vitaly

2018-05-01

To characterize the presence of bland (nontumor) thrombus in advanced renal cell carcinoma and assess the impact of this finding on cancer-specific survival. A multi-institutional database of patients treated with nephrectomy with caval thrombectomy for locally-advanced renal tumors was assembled from 5 tertiary care medical centers. Using clinicopathologic variables including patient age, body mass index, Eastern Cooperative Oncology Group performance status, tumor stage, grade, nodal status and histology, and nearest-neighbor and multiple-matching propensity score matched cohorts of bland thrombus vs nonbland thrombus patients were assessed. Multivariable analysis for predictors of cancer-specific survival was performed. From an initial cohort of 579 patients, 446 met inclusion criteria (174 with bland thrombus, 272 without). At baseline, patients with bland thrombus had significantly worse performance status, higher tumor stage, higher prevalence of regional nodal metastases and higher nuclear grade (P < .01 for all). In both nearest-neighbor and multiple-matching propensity score matched cohorts, the presence of bland thrombus presence was associated with inferior median cancer-specific survival (28.1 months vs 156.8 months, and 28.1 months vs 76.7 months, P < .001 for both). The presence of bland thrombus remained independently associated with an increased risk of cancer-specific mortality on multivariable analysis (hazard ratio 4.33, 95% confidence interval 2.79-6.73, P < .001). Presence of bland thrombus is associated with adverse survival outcomes in patients treated surgically for renal tumors with venous tumor thrombus. These findings may have important implications in patient counseling, selection for surgery and inclusion in clinical trials. Copyright © 2018 Elsevier Inc. All rights reserved.

The impact of a school dental service on the periodontal health and oral hygiene status of 6-year-old Sowetan learners.

PubMed

Maraj, E; Kroon, J

2004-10-01

The public oral health sector offers essentially two types of services to learners viz, (i) clinical services, where curative and restorative treatment, and prophylactic care is provided, and (ii) school-based services which focus on a primary preventive approach to oral health that consists of health promotion and specific protection initiatives e.g. brushing programmes. Learners may be exposed to a combination of clinical and school-based services or to school-based services only. The objective of this study was to compare the impact of services delivered by the public oral health sector on periodontal health and oral hygiene status of 6-year-old Sowetan learners to a control group who were not exposed to any organised oral health programme. Follow-up visits were conducted every 6 months from baseline for a period of 18 months. A significant decrease in the percentage of learners with healthy periodontal tissues and a significant increase in the percentage of learners with gingival bleeding was observed for all three cohorts. Oral hygiene performance, assessed according to the Patient Hygiene Performance (PHP) index, demonstrated no improvement after 18 months, although the mean scores remained within the 'fair' interval. No significant benefit could be demonstrated in providing a clinical services component in combination with school-based services. No significant positive impact of the brushing programme on oral hygiene and periodontal health status of learners was observed after 18 months when compared to a control group.

Physical fitness of children and adolescents in the United States: status and secular change.

PubMed

Malina, Robert M

2007-01-01

The physical fitness of school-age children in the United States is considered from two perspectives--status and secular change. This chapter principally examines health-related fitness, including the BMI, though performance-related fitness is briefly considered. Concepts of reference data and standards and factors that may influence secular change are initially discussed. National data on the physical fitness status of school children in the continental United States are limited to the 1980s. Ethnic variation in physical fitness is not considered except for the prevalence of overweight and obesity. More recent physical fitness data, including examination of ethnic variation, are based on several statewide and more local surveys. Although results vary by test, the majority of American school children meet or exceed criterion-referenced standards, although sex differences are not consistent. Poor morphological fitness manifest in obesity is an exception. The prevalence of overweight and obesity has increased since the early 1980s. Secular data for specific fitness items are less extensive. Regression analyses suggest a recent decline in maximal aerobic power in girls, but fairly stable levels between the 1930s and today in boys. However, the highest values for boys occur in the 1960s and 1970s and more recent values are somewhat lower. The general trend may be consistent with the decline since the 1980s in aerobic performance assessed with the 20 m shuttle run. These trends highlight the need for updated national physical fitness data for American youth.

The Social Ecology of Adolescent-Initiated Parent Abuse: A Review of the Literature

ERIC Educational Resources Information Center

Hong, Jun Sung; Kral, Michael J.; Espelage, Dorothy L.; Allen-Meares, Paula

2012-01-01

This article provides an ecological framework for understanding adolescent-initiated parent abuse. We review research on adolescent-initiated parent abuse, identifying sociodemographic characteristics of perpetrators and victims (e.g., gender, age, race/ethnicity, and socioeconomic status [SES]). Bronfenbrenner's [1] ecological systems theory is…

Status Report on the Illinois Articulation Initiative.

ERIC Educational Resources Information Center

Illinois Community Coll. Board, Springfield.

The Illinois Articulation Initiative is a comprehensive statewide effort among colleges and universities to enhance the transfer process for students among all sectors of higher education in Illinois. One of the main features of the initiative is the general education core curriculum and a list of statewide articulated general education courses…

Margins in breast conserving surgery: The financial cost & potential savings associated with the new margin guidelines.

PubMed

Singer, Lauren; Brown, Eric; Lanni, Thomas

2016-08-01

In this study, we compare the indications for re-excision, the findings of additional tumor in the re-excision specimen as they relate to margin status, and costs associated with re-excision based on recent new consensus statements. A retrospective analysis was performed on 462 patients with invasive breast carcinoma who underwent at least one lumpectomy between January 2011 and December 2013. Postoperative data was analyzed based on where additional disease was found, as it relates to the margin status of the initial lumpectomy and the additional direct costs associated with additional procedures. Of the 462 patients sampled, 149 underwent a re-excision surgery (32.2%). Four patients underwent mastectomy as their second operation. In the 40 patients with additional disease found on re-excision, 36 (90.0%) of them had a positive margin on their initial lumpectomy. None of the four mastectomy patients had residual disease. The mean cost of the initial lumpectomy for all 462 patients was $2118.01 plus an additional $1801.92 for those who underwent re-excision. A positive margin was most predictive of finding residual tumor on re-excision as would be expected. Using old criteria only 0.07% (4/61) of patients who had undergone re-excision with a 'clear' margin, had additional tumor found, at a total cost of $106,354.11. Thus, the new consensus guidelines will lead to less overall cost, at no clinical risk to patients while reducing a patient's surgical risk and essentially eliminating delays in adjuvant care. Copyright © 2016 Elsevier Ltd. All rights reserved.

STATUS REPORT FOR AGING STUDIES OF EPDM O-RING MATERIAL FOR THE H1616 SHIPPING PACKAGE

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

Stefek, T.; Daugherty, W.; Skidmore, E.

This is an interim status report for tasks carried out per Task Technical Plan SRNL-STI-2011-00506. A series of tasks/experiments are being performed at the Savannah River National Laboratory to monitor the aging performance of ethylene propylene diene monomer (EPDM) Orings used in the H1616 shipping package. The data will support the technical basis to extend the annual maintenance of the EPDM O-rings in the H1616 shipping package and to predict the life of the seals at bounding service conditions. Current expectations are that the O-rings will maintain a seal at bounding normal temperatures in service (152 F) for at leastmore » 12 months. The baseline aging data review suggests that the EPDM O-rings are likely to retain significant mechanical properties and sealing force at bounding service temperatures to provide a service life of at least 2 years. At lower, more realistic temperatures, longer service life is likely. Parallel compression stress relaxation and vessel leak test efforts are in progress to further validate this assessment and quantify a more realistic service life prediction. The H1616 shipping package O-rings were evaluated for baseline property data as part of this test program. This was done to provide a basis for comparison of changes in material properties and performance parameters as a function of aging. This initial characterization was limited to physical and mechanical properties, namely hardness, thickness and tensile strength. These properties appear to be consistent with O-ring specifications. Three H1616-1 Containment Vessels were placed in test conditions and are aging at temperatures ranging from 160 to 300 F. The vessels were Helium leak-tested initially and have been tested at periodic intervals after cooling to room temperature to determine if they meet the criterion of leaktightness defined in ANSI standard N14.5-97 (< 1E-07 std cc air/sec at room temperature). To date, no leak test failures have occurred. The cumulative time at temperature ranges from 174 days for the 300 F vessel to 189 days for the 160 F vessel as of 8/1/2012. The compression stress-relaxation (CSR) behavior of H1616 shipping package O-rings is being evaluated to develop an aging model based on material properties. O-ring segments were initially aged at four temperatures (175 F, 235 F, 300 F and 350 F). These temperatures were selected to bound normal service temperatures and to challenge the seals within a reasonable aging period. Currently, samples aging at 300 F and 350 F have reached the mechanical failure point (end of life) which is defined in this study as 90% loss of initial sealing force. As a result, additional samples more recently began aging at {approx}270 F to provide additional data for the aging model. Aging and periodic leak testing of the full containment vessels, as well as CSR testing of O-ring segments is ongoing. Continued testing per the Task Technical Plan is recommended in order to validate the assumptions outlined in this status report and to quantify and validate the long-term performance of O-ring seals under actual service conditions.« less

National Water Research and Development Initiative Act of 2009

THOMAS, 111th Congress

Rep. Gordon, Bart [D-TN-6

2009-02-24

Senate - 04/23/2009 Received in the Senate and Read twice and referred to the Committee on Environment and Public Works. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

Expressing the sense of the House of Representatives in support of the Common Core State Standards Initiative.

THOMAS, 111th Congress

Rep. Fattah, Chaka [D-PA-2

2009-12-16

House - 02/23/2010 Referred to the Subcommittee on Early Childhood, Elementary, and Secondary Education. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

State Energy Race to the Top Initiative Act of 2013

THOMAS, 113th Congress

Sen. Warner, Mark R. [D-VA

2013-06-20

Senate - 06/25/2013 Committee on Energy and Natural Resources Subcommittee on Energy. Hearings held. With printed Hearing: S.Hrg. 113-70. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Northwest Straits Marine Conservation Initiative Reauthorization Act of 2009

THOMAS, 111th Congress

Rep. Larsen, Rick [D-WA-2

2009-03-23

Senate - 12/08/2009 Received in the Senate. Read twice. Placed on Senate Legislative Calendar under General Orders. Calendar No. 221. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

The effects of individual status and group performance on network ties among teammates in the National Basketball Association

PubMed Central

Aven, Brandy

2018-01-01

For individuals, status is derived both from their personal attributes and the groups with whom they are affiliated. Depending on the performance of their groups, the status of individuals may benefit or suffer from identifying closely with the group. When the group excels, high-status members potentially receive much of the credit and increased status. Conversely, high-status members of underperforming groups potentially suffer disproportionate declines in their status relative to the low-status group members. We therefore predict an interaction between group performance and individual status on the willingness to associate with the group and its members. We test our prediction by examining social media ties among teammates in the National Basketball Association. Specifically, we investigate the “following” ties of teammates on Twitter at the end of the 2014–2015 season. Elections to All-Star games are used to measure the status of players, and team performance is measured by recent success in the postseason playoffs. The results show that compared to high-status players on successful teams, high-status players on underperforming teams are less likely to follow their teammates. This result aligns with research on status inconsistency, suggesting that individuals deemphasize their group affiliation when it jeopardizes their individual status. An additional contribution is the advancement of the probit Social Relations Model for the analysis of binary ties in social networks. PMID:29708984

The effects of individual status and group performance on network ties among teammates in the National Basketball Association.

PubMed

Koster, Jeremy; Aven, Brandy

2018-01-01

For individuals, status is derived both from their personal attributes and the groups with whom they are affiliated. Depending on the performance of their groups, the status of individuals may benefit or suffer from identifying closely with the group. When the group excels, high-status members potentially receive much of the credit and increased status. Conversely, high-status members of underperforming groups potentially suffer disproportionate declines in their status relative to the low-status group members. We therefore predict an interaction between group performance and individual status on the willingness to associate with the group and its members. We test our prediction by examining social media ties among teammates in the National Basketball Association. Specifically, we investigate the "following" ties of teammates on Twitter at the end of the 2014-2015 season. Elections to All-Star games are used to measure the status of players, and team performance is measured by recent success in the postseason playoffs. The results show that compared to high-status players on successful teams, high-status players on underperforming teams are less likely to follow their teammates. This result aligns with research on status inconsistency, suggesting that individuals deemphasize their group affiliation when it jeopardizes their individual status. An additional contribution is the advancement of the probit Social Relations Model for the analysis of binary ties in social networks.

BFLCRM: A BAYESIAN FUNCTIONAL LINEAR COX REGRESSION MODEL FOR PREDICTING TIME TO CONVERSION TO ALZHEIMER’S DISEASE*

PubMed Central

Lee, Eunjee; Zhu, Hongtu; Kong, Dehan; Wang, Yalin; Giovanello, Kelly Sullivan; Ibrahim, Joseph G

2015-01-01

The aim of this paper is to develop a Bayesian functional linear Cox regression model (BFLCRM) with both functional and scalar covariates. This new development is motivated by establishing the likelihood of conversion to Alzheimer’s disease (AD) in 346 patients with mild cognitive impairment (MCI) enrolled in the Alzheimer’s Disease Neuroimaging Initiative 1 (ADNI-1) and the early markers of conversion. These 346 MCI patients were followed over 48 months, with 161 MCI participants progressing to AD at 48 months. The functional linear Cox regression model was used to establish that functional covariates including hippocampus surface morphology and scalar covariates including brain MRI volumes, cognitive performance (ADAS-Cog), and APOE status can accurately predict time to onset of AD. Posterior computation proceeds via an efficient Markov chain Monte Carlo algorithm. A simulation study is performed to evaluate the finite sample performance of BFLCRM. PMID:26900412

Study on the status of thyroid function and thyroid nodules in chinese breast cancer patients

PubMed Central

Xu, Zhou; Zhao, Chunxia; Wu, Yutuan; Wu, He; Chen, Haoran; Li, Hong-Yuan; Wu, Kai-Nan; Kong, Ling-Quan

2017-01-01

We performed a study to investigate the status of thyroid nodules and thyroid functions in Chinese breast cancer women. The clinical data of female patients with breast cancer or benign breast diseases and normal populace were evaluated. The thyroxine(T4) level in initially diagnosed breast cancer patients were significantly higher than those in benign breast diseases patients (7.68±1.51 vs 7.29±1.52ug/dl, p<0.001), while the TSH levels were slightly lower than in benign breast diseases patients(3.23±4.59 vs 3.60±6.74uIU/ml, p=0.302). The overall incidence of hypothyroidism in initially diagnosed breast cancer and benign breast diseases patients were 28.65% and 32.74%(p=0.195). During chemotherapy, the T4(7.08±1.69ug/dl), fT3(2.87±0.48pg/ml) and fT4(0.83±0.15ng/dl) levels were significantly lower than in initially diagnosed breast cancer patients(7.68±1.51ug/dl, 3.07±0.50pg/ml, 0.88±0.20ng/dl, p<0.05). The incidence of thyroid nodules in initially diagnosed breast cancer patients, benign breast diseases patients and healthy population were 56.17%, 43.64%, 34.49%(p<0.001). The incidence of TI-RADS≥4 TN in initially diagnosed breast cancer patients and benign breast diseases patients were significantly higher than in normal population(7.27% vs 9.45% vs 2.87%, p<0.001). The incidence of TI-RADS≥4 thyroid nodules in breast cancer patients receiving chemotherapy was significantly higher than in initially diagnosed breast cancer patients(11.71% vs 7.27%, p<0.05). These data indicate that the incidence of thyroid disease in breast disease patients is higher than in normal population in China, and the breast diseases, especially breast cancer, might be related to the high incidence of thyroid nodules. PMID:29113346

Breast surgery techniques: preoperative bracketing wire localization by surgeons.

PubMed

Burkholder, Hans C; Witherspoon, Laura E; Burns, R Phillip; Horn, Jeffrey S; Biderman, Michael D

2007-06-01

With the development of expertise in image guidance for breast surgery, many surgeons now perform preoperative wire localization themselves. Use of a single wire versus multiple wires to bracket a radiographic breast abnormality has previously been described, although benefits of this technique based on clinical outcomes such as margin status, tissue volume removed, and re-excision rates have not been established. This study is a retrospective analysis of wire-localized breast biopsies performed by 14 surgeons over 29 months; stereotactic and ultrasound guidance were used. During this time, 489 wire localizations were done, of which 159 used multiple wires. Two hundred eleven of these biopsies were done for malignant disease, 86 using multiple wires. After controlling for tumor node metastases stage, single and multiple wire placements were compared using endpoints of margin status, need for re-excision, and total volume of tissue removed. Neither margin status nor re-excision was related to the number of wires placed. However, the number of wires placed was significantly related to the total volume of tissue removed. Use of more than one localizing wire was associated with greater volume of tissue removal (measured in centimeters cubed) in benign disease (46 vs 25, P < 0.001), equivalent volumes in stage 0 disease (73 vs 67), less volume in stage 1 disease (113 vs 164), and less volume in stages 2 through 4 (158 vs 207, P = 0.03). Outcomes based on surgeon case volume during the study period demonstrated that low- (1-40), medium- (41-80), and high-volume (>80) surgeons did not differ in the type or stage of breast pathology treated. Surgeons with high case volumes were more likely to place multiple localizing wires (P < 0.001) and were more likely to do a breast-conserving procedure if re-excision was performed (P < 0.018). Surgeons with low case volumes were more likely to perform a re-excision (P < 0.025). Surgeon experience has a positive impact on quality outcome measures such as performance of a definitive procedure at the time of initial surgery and use of breast-conserving procedures at the time of re-excision. Multiple wire localization can be used to significantly reduce the volume of breast tissue removed in malignant disease without sacrificing margin status or increasing the need for future re-excision.

eGY-Africa: addressing the digital divide for science in Africa

NASA Astrophysics Data System (ADS)

Petitdidier, Monique; Barton, Charles; Chukwuma, Victor; Cottrell, Les

2010-05-01

As the world of science becomes increasingly Internet-dependent, so the African scientists become increasingly isolated. eGY-Africa is a bottom-up initiative by African scientists and their collaborators to try to reduce this digital divide by a campaign of advocacy for better institutional facilities. The present status of Internet services, problems, and plans are being mapped via a combination of a survey questionnaire-based survey and direct measurement of Internet performance (the PingER Project). Information is being gathered on policy statements and initiatives aimed at reducing the Digital Divide. eGY-Africa is establishing National groups of concerned scientists and engaging with those initiatives with related goals. Finally, and perhaps most important of all, eGY-Africa is seeking to engage with the many other programs, initiatives, and bodies that share the goal of reducing the Digital Divide - either as a direct policy objective, or indirectly as a means to an end, such as the development of capabilities in science and technology in Africa. The expectation is that informed opinion from the scientific community at the institutional, national, and international levels can be used to influence the decision makers and donors who are in a position to deliver better Internet capabilities.

Attention Deficit/Hyperactivity Disorder Symptoms and Depression Symptoms as Mediators in the Intergenerational Transmission of Smoking

PubMed Central

Zoloto, Alex; Nagoshi, Craig T.; Presson, Clark; Chassin, Laurie

2012-01-01

Background Attention deficit/hyperactivity disorder and depression have been found to be comorbid with smoking behaviors, and all three behavioral syndromes have been shown to be familially transmitted. The present paper reports on the results of analyses testing whether child attention deficit/hyperactivity disorder and depression symptoms were mediators in the intergenerational transmission of cigarette smoking. Method Path analyses using bootstrapped mediation procedures were conducted on data from a community sample of 764 families (one or both parents and one adolescent offspring) from the Indiana University Smoking Survey. Parents reported on their smoking behaviors, ADHD, and depression and their child’s ADHD, while offspring reported on their smoking behaviors and depression. Results Although fathers’ and mothers’ smoking status, depression, and ADHD were not significantly correlated with boys’ smoking initiation, there was a significant mediated (indirect) pathway from mothers’ depression to boys’ smoking initiation through boys’ depression. Several parental variables were significantly correlated with smoking initiation in girls, and the pathways from mothers’ smoking status, mothers’ ADHD, and fathers’ smoking status to girls’ smoking initiation were significantly mediated by girls’ ADHD. Conclusions For adolescent girls, the intergenerational transmission of ADHD appears to be important in understanding the intergenerational transmission of cigarette smoking. Sex differences in the intergenerational transmission of psychopathology as it leads to smoking initiation were also discussed. PMID:22682659

Potassium topping cycles for stationary power. [conceptual analysis

NASA Technical Reports Server (NTRS)

Rossbach, R. J.

1975-01-01

A design study was made of the potassium topping cycle powerplant for central station use. Initially, powerplant performance and economics were studied parametrically by using an existing steam plant as the bottom part of the cycle. Two distinct powerplants were identified which had good thermodynamic and economic performance. Conceptual designs were made of these two powerplants in the 1200 MWe size, and capital and operating costs were estimated for these powerplants. A technical evaluation of these plants was made including conservation of fuel resources, environmental impact, technology status, and degree of development risk. It is concluded that the potassium topping cycle could have a significant impact on national goals such as air and water pollution control and conservation of natural resources because of its higher energy conversion efficiency.

Neurocognitive performance enhanced by highly active antiretroviral therapy in HIV-infected women.

PubMed

Cohen, R A; Boland, R; Paul, R; Tashima, K T; Schoenbaum, E E; Celentano, D D; Schuman, P; Smith, D K; Carpenter, C C

2001-02-16

To determine whether highly active retroviral therapy (HAART) is associated with better neurocognitive outcome over time among HIV-infected women with severely impaired immune function. A semiannual neurocognitive examination on four tasks was administered: Color Trail Making, Controlled Oral Word Association, Grooved Pegboard and Four-Word Learning. This protocol was initiated in the HIV Epidemiological Research study (HERS) study when a woman's CD4 cell count fell to < 100 x 10(6) cells/l. Immune function (CD4), viral load status and depression severity (CESD) were also assessed semi-annually, along with an interview to determine medication intake and illicit drug use. HAART was not available to any participant at the time of enrollment (baseline), while 44% reported taking HAART at their most recent visit (mean duration of HAART 36.3 +/- 12.6 months). HAART-treated women had improved neurocognitive performance compared with those not treated with HAART. Women taking HAART for 18 months or more showed the strongest neurocognitive performance with improved verbal fluency, psychomotor and executive functions. These functions worsened among women not taking HAART. Substance abuse status, severity of depressive symptoms, age and educational level did not influence the HAART treatment effects on neurocognitive performance. Neurocognitive improvements were strongly associated with the magnitude of CD4 cell count increases. HAART appeared to produce beneficial effect on neurocognitive functioning in HIV-infected women with severely impaired immune systems. Benefits were greatest for women who reported receiving HAART for more than 18 months.

Caries and salivary status in young adults with type 1 diabetes.

PubMed

Edblad, E; Lundin, S A; Sjödin, B; Aman, J

2001-01-01

The aim of this study was to evaluate the salivary status, prevalence of caries and the status of primary dentition, when primary teeth were exfoliated, in 41 patients, 18-24 years of age, with type 1 diabetes since childhood in comparison with age- and sex-matched non-diabetic controls. The blood glucose and glycosylated haemoglobin concentration (HbA1c), dosage of daily insulin and retinal fundus photography was recorded for the diabetic group. According to the concentration of HbA1c, the diabetic patients were divided into well and poorly controlled groups. The study was based on three intra-oral photos, dental examination including intra-oral radiographs, flow rate and buffering capacity of the saliva and amount of Streptococcus mutans and Lactobacilli. Retrospective data regarding the primary dentition was found in the dental files of each patient, and are based on the last registration for respective tooth before exfoliation. The patients with type 1 diabetes, without any relationship to metabolic control, displayed more initial buccal caries compared to healthy controls (p<0.01). No significant differences concerning the status of saliva (neither flow rate, buffering capacity nor amount of Streptococcus mutans and Lactobacilli), manifest caries or the status of the primary dentition were seen. We conclude that initial, but not manifest caries seems to be overrepresented in young adults with type 1 diabetes. These patients, thus, need more intense efforts regarding dental health care to prevent the development from initial to manifest caries.

AMO EXPRESS: A Command and Control Experiment for Crew Autonomy Onboard the International Space Station

NASA Technical Reports Server (NTRS)

Stetson, Howard K.; Haddock, Angie T.; Frank, Jeremy; Cornelius, Randy; Wang, Lui; Garner, Larry

2015-01-01

NASA is investigating a range of future human spaceflight missions, including both Mars-distance and Near Earth Object (NEO) targets. Of significant importance for these missions is the balance between crew autonomy and vehicle automation. As distance from Earth results in increasing communication delays, future crews need both the capability and authority to independently make decisions. However, small crews cannot take on all functions performed by ground today, and so vehicles must be more automated to reduce the crew workload for such missions. NASA's Advanced Exploration Systems Program funded Autonomous Mission Operations (AMO) project conducted an autonomous command and control experiment on-board the International Space Station that demonstrated single action intelligent procedures for crew command and control. The target problem was to enable crew initialization of a facility class rack with power and thermal interfaces, and involving core and payload command and telemetry processing, without support from ground controllers. This autonomous operations capability is enabling in scenarios such as initialization of a medical facility to respond to a crew medical emergency, and representative of other spacecraft autonomy challenges. The experiment was conducted using the Expedite the Processing of Experiments for Space Station (EXPRESS) rack 7, which was located in the Port 2 location within the U.S Laboratory onboard the International Space Station (ISS). Activation and deactivation of this facility is time consuming and operationally intensive, requiring coordination of three flight control positions, 47 nominal steps, 57 commands, 276 telemetry checks, and coordination of multiple ISS systems (both core and payload). Utilization of Draper Laboratory's Timeliner software, deployed on-board the ISS within the Command and Control (C&C) computers and the Payload computers, allowed development of the automated procedures specific to ISS without having to certify and employ novel software for procedure development and execution. The procedures contained the ground procedure logic and actions as possible to include fault detection and recovery capabilities. The autonomous operations concept includes a reduction of the amount of data a crew operator is required to verify during activation or de-activation, as well as integration of procedure execution status and relevant data in a single integrated display. During execution, the auto-procedures (via Timerliner) provide a step-by-step messaging paradigm and a high-level status upon termination. This messaging and high-level status is the only data generated for operator display. To enhance situational awareness of the operator, the Web-based Procedure Display (WebPD) provides a novel approach to the issues of procedure display and execution tracking. WebPD is a web based application that serves as the user interface for electronic procedure execution. It incorporates several aspects of the HTML5 standard. Procedures are written in a dialect of XML called Procedure Representation Language (PRL). WebPD tracks execution status in the procedure or procedures being displayed. WebPD aggregates and simplifies the auto-sequence execution status information, and formatted to be easily followed and understood by an operator who is not dedicated to actively monitoring the task. WebPD also provides an integrated data and control interface to pause or halt the execution in order to provide a check point of operation and to examine progress before starting the next sequence of activities. For this demonstration, the procedure was initiated and monitored from the ground. As the Timeliner sequences executed, their high-level execution status was written to PLMDM memory. This memory is read and downlinked via Ku-Band at a 1 Hz rate. The data containing the high-level execution status is de-commutated on the ground, and rebroadcast for WebPD consumption. A future demonstration will be performed onboard, with ISS astronauts initiating the operations instead of ground controllers. The AMO EXPRESS experiment demonstrated activation and de-activation of EXPRESS rack 7, providing the capability of future single button activations and deactivations of facility class racks. The experiment achieved numerous technical and operations 'firsts' for the ISS

STATUS AND PROGRESS IN PARTICULATE MATTER FORECASTING: INITIAL APPLICATION OF THE ETA- CMAQ FORECAST MODEL

EPA Science Inventory

This presentation reviews the status and progress in forecasting particulate matter distributions. The shortcomings in representation of particulate matter formation in current atmospheric chemistry/transport models are presented based on analyses and detailed comparisons with me...

Guantanamo Detainees: Habeas Corpus Challenges in Federal Court

DTIC Science & Technology

2005-12-07

Separation of Powers Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Eliminating Federal Court Jurisdiction Where There is No State Court Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 1 The amendment refers to both the Combatant Status Review Tribunals (“ CSRTs” ), the initial administrative procedure to confirm the detainees’ status as enemy

A Perspective on the Use of Storable Propellants for Future Space Vehicle Propulsion

NASA Technical Reports Server (NTRS)

Boyd, William C.; Brasher, Warren L.

1989-01-01

Propulsion system configurations for future NASA and DOD space initiatives are driven by the continually emerging new mission requirements. These initiatives cover an extremely wide range of mission scenarios, from unmanned planetary programs, to manned lunar and planetary programs, to earth-oriented (Mission to Planet Earth) programs, and they are in addition to existing and future requirements for near-earth missions such as to geosynchronous earth orbit (GEO). Increasing space transportation costs, and anticipated high costs associated with space-basing of future vehicles, necessitate consideration of cost-effective and easily maintainable configurations which maximize the use of existing technologies and assets, and use budgetary resources effectively. System design considerations associated with the use of storable propellants to fill these needs are presented. Comparisons in areas such as complexity, performance, flexibility, maintainability, and technology status are made for earth and space storable propellants, including nitrogen tetroxide/monomethylhydrazine and LOX/monomethylhydrazine.

Embedded Thermal Control for Spacecraft Subsystems Miniaturization

NASA Technical Reports Server (NTRS)

Didion, Jeffrey R.

2014-01-01

Optimization of spacecraft size, weight and power (SWaP) resources is an explicit technical priority at Goddard Space Flight Center. Embedded Thermal Control Subsystems are a promising technology with many cross cutting NSAA, DoD and commercial applications: 1.) CubeSatSmallSat spacecraft architecture, 2.) high performance computing, 3.) On-board spacecraft electronics, 4.) Power electronics and RF arrays. The Embedded Thermal Control Subsystem technology development efforts focus on component, board and enclosure level devices that will ultimately include intelligent capabilities. The presentation will discuss electric, capillary and hybrid based hardware research and development efforts at Goddard Space Flight Center. The Embedded Thermal Control Subsystem development program consists of interrelated sub-initiatives, e.g., chip component level thermal control devices, self-sensing thermal management, advanced manufactured structures. This presentation includes technical status and progress on each of these investigations. Future sub-initiatives, technical milestones and program goals will be presented.

Transverse single-spin asymmetries for direct photon and neutral pion production in midrapidity at PHENIX

NASA Astrophysics Data System (ADS)

Lewis, Nicole; Phenix Collaboration

2017-09-01

Large transverse single spin asymmetries for hadron production in proton-proton collisions were some of the first indicators of significant nonperturbative spin-momentum correlations in the proton. They have been found to persist up to collision energies of 510 GeV, yet their origin remains poorly understood. Measurements of different final-state particles in a wide variety of collision systems over a range of kinematics can help to identify and separate contributions from the proton versus hadronization, and from different parton flavors. Depending on the rapidity pion production can provide access to both initial- and final-state effects for a mix of parton flavors, while direct photons depend only on initial-state effects and are particularly sensitive to gluon dynamics in RHIC kinematics. The status of transverse single spin measurements for neutral pions and direct photons performed for p+p, p+Al, and p+Au collisions at PHENIX will be presented.

Education for eHealth--a status analysis.

PubMed

Herzog, Juliane; Pohn, Birgit; Forjan, Mathias; Sauermann, Stefan; Urbauer, Philipp

2014-01-01

eHealth is not only a growing market, but also an important factor for new healthcare systems. National and European initiatives implicitly demand a higher level of knowledge in the areas of healthcare, engineering and management. As part of the eLearning4eHealth project an initial web based study was performed concentrating on European and global eHealth related educational programs. The results show that eHealth related courses do not evenly exist for the identified professions. 43% of the offered programs are focused on the engineering sector, whereas only 21% are available for the management sector. In order to offer compatible and comparable state of knowledge in the identified fields of profession and knowledge, further educational programs may be necessary. Despite the found shortcomings, results have shown that international activities have started in order to close the gaps and improve the quality of knowledge in the interdisciplinary field of eHealth.

"Top Performing" US Hospitals and the Health Status of Counties they Serve.

PubMed

Maraccini, Amber M; Yang, Wei; Slonim, Anthony D

2018-06-01

This study (a) examined the relationships between "top performing" US hospitals and the health status of counties they serve and (b) compared the health status of "top performing" US hospital counties versus that of remaining US counties. Statistical analyses considered US News and World Report Honor Roll ranking data, as a measure of hospital performance, and County Health Rankings (CHR) data, as a measure of county health status. "Top performing" hospital Honor Roll scores were correlated with measures of Clinical Care (p < 0.001). Counties with "top performing" US hospitals presented greater health status with regard to All Health Outcomes (p < 0.001), Length of Life (p < 0.001), Quality of Life (p < 0.001), All Health Factors (p < 0.001), Health Behaviors (p < 0.001), and Clinical Care (p < 0.001), than compared to remaining US counties. Hospital impact on county health status remains primarily recognized in clinical care and not in overall health. Also, counties that contain a "top performing" US hospital tend to present lower health risks to their citizens than compared to other US counties.

Inpatient Hospitalization in Addiction Treatment for Patients with a History of Suicide Attempt: A Case of Support for Treatment Performance Measures†

PubMed Central

Glass, Joseph E.; Ilgen, Mark A.; Winters, Jamie J.; Murray, Regan L.; Perron, Brian E.; Chermack, Stephen T.

2010-01-01

This study attempts to validate substance use disorder (SUD) treatment performance measures (PM) in a naturalistic treatment setting. Despite its significance in healthcare systems and in SUD populations, suicidality is one patient characteristic that remains unexplored in the context of SUD PMs. The current study focused on the extent to which the care processes encouraged by SUD PMs were associated with improved outcomes in patients with a prior suicide attempt as compared to those without. We abstracted Addiction Severity Index and health services data from the VA medical record for 381 veterans who initiated outpatient SUD treatment and completed baseline intake measures at a Midwestern VA hospital. Cox proportional hazard regressions examined how baseline characteristics, prior suicide attempts, and PM status predicted the time until hospitalization for psychiatric or substance use problems. Prior suicide attempts significantly interacted with treatment engagement, and hospitalization risk was significantly higher among individuals with a prior suicide attempt who did not meet PMs. This study provides initial observational evidence that past suicide attempts may be a factor that should be considered when defining performance standards that influence the processes of SUD treatment. Future research on PMs should take into account the differences on indicators of high risk and poor treatment outcomes. PMID:21053754

Metabolomic responses to lumacaftor/ivacaftor in cystic fibrosis.

PubMed

Kopp, Benjamin T; McCulloch, Scott; Shrestha, Chandra L; Zhang, Shuzhong; Sarzynski, Lisa; Woodley, Frederick W; Hayes, Don

2018-05-01

Cystic fibrosis (CF) is a life-limiting disease caused by a defect in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Lumacaftor/Ivacaftor is a novel CFTR modulator approved for patients that are homozygous for Phe508del CFTR, but its clinical effectiveness varies amongst patients, making it difficult to determine clinical responders. Therefore, identifying biochemical biomarkers associated with drug response are clinically important for follow-up studies. Serum metabolomics was performed on twenty patients with CF pre- and 6-month post-Lumacaftor/Ivacaftor response via Ultrahigh Performance Liquid Chromatography-Tandem Mass Spectroscopy (UPLC-MS/MS). Correlation with clinical variables was performed. Metabolomics analysis demonstrated 188 differentially regulated metabolites between patients pre- and post-Lumacaftor/Ivacaftor initiation, with a predominance of lipid and amino acid alterations. The top 30 metabolites were able to differentiate pre- and post-Lumacaftor/Ivacaftor status in greater than 90% of patients via a random-forest confusion matrix. Alterations in bile acids, phospholipids, and bacteria-associated metabolites were the predominant changes associated with drug response. Importantly, changes in metabolic patterns were associated with clinical responders. Selected key lipid and amino acid metabolic pathways were significantly affected by Lumacaftor/Ivacaftor initiation and similar pathways were affected in clinical responders. Targeted metabolomics may provide useful and relevant biomarkers of CFTR modulator responses. © 2018 Wiley Periodicals, Inc.

Infidelity, initiation, and the emotional climate of divorce: are there implications for mental health?

PubMed

Sweeney, M M; Horwitz, A V

2001-09-01

A large literature has examined the role of "secondary" stressors, such as problems with finances, social support, residential mobility, and children, in producing the well-documented association between divorce and a variety of psychopathological conditions. Much less attention, however, has been paid to variation in the "primary" disruption experience. We address this omission using data from the National Survey of Families and Households to investigate the interrelationships among depression, initiator status, and spousal infidelity. While we find little evidence of direct effects of initiator status or spousal infidelity on post-divorce depression, the importance of these characteristics emerges when they are considered in an interactive context. Specifically, while divorce initiation is associated with reduced depression among individuals with unfaithful spouses, initiation is associated with increased depression in the absence of spousal infidelity. Taken together, our findings suggest that characteristics of the divorce experience may interact in complex ways to produce variation in mental health outcomes.

Is there a relationship between high-quality performance in major teaching hospitals and residents' knowledge of quality and patient safety?

PubMed

Pingleton, Susan K; Horak, Bernard J; Davis, David A; Goldmann, Donald A; Keroack, Mark A; Dickler, Robert M

2009-11-01

The relationship of the quality of teaching hospitals' clinical performance to resident education in quality and patient safety is unclear. The authors studied residents' knowledge of these areas in major teaching hospitals with higher- and lower-quality performance rankings. They assessed the presence of formal and informal quality curricula to determine whether programmatic differences exist. The authors used qualitative research methodology with purposeful sampling. They gathered data from individual structured interviews with residents and key educational and quality leaders in six medical schools and teaching hospitals, which represented a range of quality performance rankings, geographic regions, and public or private status. No relationship emerged between a hospital's quality status, residents' curriculum, and the residents' understanding of quality. Residents' definitions of quality and safety and their knowledge of the practice-based learning and systems-based practice competencies were indistinguishable between hospitals. Residents in all programs had extensive patient safety knowledge acquired through an informal curriculum in the hospital setting. A formal curriculum existed in only two programs, both of them ambulatory settings. Residents' learning about quality and patient safety is extensive, largely through a positive informal curriculum in the teaching hospital and, less frequently, via a formal curriculum. No relationship was found between the quality performance of the teaching hospital and the residents' curriculum or understanding of quality or safety. Residents seem to learn through an informal curriculum provided by hospital initiatives and resources, and thus these data suggest the importance of major teaching hospitals in quality education.

Relation of Age and Health-Related Quality of Life to Invasive Versus Ischemia-Guided Management of Patients with Non-ST Elevation Myocardial Infarction.

PubMed

Patel, Krishna K; Arnold, Suzanne V; Jones, Philip G; Qintar, Mohammed; Alexander, Karen P; Spertus, John A

2018-04-01

In older patients with non-ST-elevation myocardial infarction, an initial invasive strategy reduces cardiovascular events compared with an ischemia-guided approach; however its association with health status outcomes is unknown. Among patients with non-ST-elevation myocardial infarction from 2 multicenter US acute myocardial infarction (AMI) registries, health status was assessed at baseline and at 1, 6, and 12 months after AMI using the Seattle Angina Questionnaire (SAQ) and the 12-item Short-Form Health Survey (SF-12). Routine invasive management was defined as coronary angiography within 72 hours of admission without a preceding stress test. Among 3,559 patients with NSTEMI, 2,455 (69.0%) were treated with routine invasive treatment, which was more common in younger patients. In propensity-adjusted analyses, invasive treatment was associated with higher SAQ physical limitation, angina frequency, and summary scores over the year after AMI; however, the differences were small (<5 points, all p <0.05). Although there was a trend toward worse health status in patients aged ≥85 years treated with an initial invasive treatment, the interaction between age and treatment for any health status measure (all p ≥0.09) was not significant, except for SF-12 physical component score (p = 0.02), where worse scores were observed with invasive treatment in patients 85 years or older. In conclusion, an initial invasive treatment for patients with NSTEMI is associated with a small benefit in health status of marginal clinical significance, mainly in younger patients. The oldest old group trended toward less health status benefit from a routine invasive strategy-results that will need to be confirmed in a larger study. Copyright © 2018 Elsevier Inc. All rights reserved.

Intravenous Lacosamide in Pediatric Status Epilepticus: An Open-Label Efficacy and Safety Study.

PubMed

Poddar, Karan; Sharma, Rohan; Ng, Yu-Tze

2016-08-01

Lacosamide is an antiepilepsy drug approved by the Food and Drug Administration for patients aged 17 years and older for partial-onset seizures as monotherapy or adjunctive therapy. We reviewed the use of intravenous lacosamide in children aged less than 17 years with status epilepticus. Children who received at least one dose of intravenous lacosamide for status epilepticus at our tertiary care children's hospital from December 2011 to March 2014 were studied. Status epilepticus was defined as continuous seizure activity for longer than 20 minutes or two or more recurrent seizures without regaining baseline level of awareness. Efficacy was defined as seizure freedom or more than 50% reduction of seizures within 24 hours of administering lacosamide. Nine children with a mean age of 5.7 years (range: three months to 16 years) were included. The mean initial or loading dose was 8.7 mg/kg, with seven of nine patients receiving a dose of 10 mg/kg. The average total amount of intravenous lacosamide administered within the initial 24 hours was 13.8 mg/kg. Lacosamide was found to be efficacious in seven of nine (77.8%) patients. Four patients (44.4%) became seizure free. Two patients continued to have status epilepticus within 24 hours of lacosamide administration. Bradycardia was observed in one patient. In children with status epilepticus, intravenous lacosamide was efficacious in 78% of the patients and 44% become seizure free. In addition, no significant adverse reactions were observed. An appropriate safe, effective initial, or loading dose may be 10 mg/kg. Copyright © 2016 Elsevier Inc. All rights reserved.

A two-year follow-up study of the PCV2 status of a Danish pig herd that was initially assumed to be PCV2-free.

PubMed

Kristensen, Charlotte S; Hjulsager, Charlotte K; Larsen, Lars E

2015-01-01

A longitudinal study was carried out to investigate whether a herd that had previously tested negative for porcine circovirus type 2 (PCV2) by polymerase chain reaction (PCR) was free of PCV2 or whether the negative profiles indicate that the level of PCV2 varies over time. In eight Danish herds that had initially tested negative for PCV2 by quantitative polymerase chain reaction (PCR), additional sampling was performed. Only one of the herds was still PCV2-negative in the additional sampling and was included in the study. The herd was a finishing herd, subclinically infected with PCV2, but vaccinated against PCV2 to improve performance. The herd was monitored by taking blood samples every seventh week over a period of two years and was not found to be continuously negative for PCV2 by PCR. The first time PCV2 was detected by PCR, in May 2010, PCV2 vaccination had been withdrawn from the herd, and at the same time the herd was infected with porcine reproductive and respiratory syndrome virus (PRRS). The PCV2-negative status, measured by PCR, was obtained in the first sampling after the PCV2 vaccination had been reintroduced. When PCV2 vaccination was withdrawn again in September 2011, the herd tested positive for PCV2 by PCR, and this time it continued to be PCV2-positive, even though PCV2 vaccination had been reintroduced. A Danish finishing herd that appeared to be PCV2-free from the start of a period of two years was not free of PCV2 during the entire period.

Trajectories of sleep disturbance and daytime sleepiness in women before and after surgery for breast cancer.

PubMed

Van Onselen, Christina; Paul, Steven M; Lee, Kathryn; Dunn, Laura; Aouizerat, Bradley E; West, Claudia; Dodd, Marylin; Cooper, Bruce; Miaskowski, Christine

2013-02-01

Sleep disturbance is a problem for oncology patients. To evaluate how sleep disturbance and daytime sleepiness (DS) changed from before to six months following surgery and whether certain characteristics predicted initial levels and/or the trajectories of these parameters. Patients (n=396) were enrolled prior to surgery and completed monthly assessments for six months following surgery. The General Sleep Disturbance Scale was used to assess sleep disturbance and DS. Using hierarchical linear modeling, demographic, clinical, symptom, and psychosocial adjustment characteristics were evaluated as predictors of initial levels and trajectories of sleep disturbance and DS. All seven General Sleep Disturbance Scale scores were above the cutoff for clinically meaningful levels of sleep disturbance. Lower performance status; higher comorbidity, attentional fatigue, and physical fatigue; and more severe hot flashes predicted higher preoperative levels of sleep disturbance. Higher levels of education predicted higher sleep disturbance scores over time. Higher levels of depressive symptoms predicted higher preoperative levels of sleep disturbance, which declined over time. Lower performance status; higher body mass index; higher fear of future diagnostic tests; not having had sentinel lymph node biopsy; having had an axillary lymph node dissection; and higher depression, physical fatigue, and attentional fatigue predicted higher DS prior to surgery. Higher levels of education, not working for pay, and not having undergone neo-adjuvant chemotherapy predicted higher DS scores over time. Sleep disturbance is a persistent problem for patients with breast cancer. The effects of interventions that can address modifiable risk factors need to be evaluated. Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

The relevance of timing in nonconvulsive status epilepticus: A series of 38 cases.

PubMed

Gutiérrez-Viedma, Álvaro; Parejo-Carbonell, Beatriz; Cuadrado, María-Luz; Serrano-García, Irene; Abarrategui, Belén; García-Morales, Irene

2018-05-01

Timing in the management of nonconvulsive status epilepticus (NCSE) seems to be one of the most important modifiable prognostic factors. We aimed to determine the precise relationship between timing in NCSE management and its outcome. We performed a cross-sectional study in which clinical data were prospectively obtained from all consecutive adults with NCSE admitted to our hospital from 2014 to 2016. Univariate and multivariable regression analyses were performed to identify clinical and timing variables associated with NCSE prognosis. Among 38 NCSE cases, 59.9% were women, and 39.5% had prior epilepsy history. The median time to treatment (TTT) initiation and the median time to assessment by a neurologist (TTN) were 5h, and the median time to first electroencephalography assessment was 18.5h; in the cases with out-of-hospital onset (n=24), the median time to hospital (TTH) arrival was 2.8h. The median time to NCSE control (TTC) was 16.5h, and it positively correlated with both the TTH (Spearman's rho: 0.439) and the TTT (Spearman's rho: 0.683). In the multivariable regression analyses, the TTC was extended 1.7h for each hour of hospital arrival delay (p=0.01) and 2.7h for each hour of treatment delay (p<0.001). Recognition delay was more common in the episodes with in-hospital onset, which also had longer TTN and TTC, and increased morbidity. There were pervasive delays in all phases of NCSE management. Delays in hospital arrival or treatment initiation may result in prolonged TTC. Recognition of in-hospital episodes may be more delayed, which may lead to poorer prognosis in these cases. Copyright © 2018 Elsevier Inc. All rights reserved.

Status of the DIRAC Project

NASA Astrophysics Data System (ADS)

Casajus, A.; Ciba, K.; Fernandez, V.; Graciani, R.; Hamar, V.; Mendez, V.; Poss, S.; Sapunov, M.; Stagni, F.; Tsaregorodtsev, A.; Ubeda, M.

2012-12-01

The DIRAC Project was initiated to provide a data processing system for the LHCb Experiment at CERN. It provides all the necessary functionality and performance to satisfy the current and projected future requirements of the LHCb Computing Model. A considerable restructuring of the DIRAC software was undertaken in order to turn it into a general purpose framework for building distributed computing systems that can be used by various user communities in High Energy Physics and other scientific application domains. The CLIC and ILC-SID detector projects started to use DIRAC for their data production system. The Belle Collaboration at KEK, Japan, has adopted the Computing Model based on the DIRAC system for its second phase starting in 2015. The CTA Collaboration uses DIRAC for the data analysis tasks. A large number of other experiments are starting to use DIRAC or are evaluating this solution for their data processing tasks. DIRAC services are included as part of the production infrastructure of the GISELA Latin America grid. Similar services are provided for the users of the France-Grilles and IBERGrid National Grid Initiatives in France and Spain respectively. The new communities using DIRAC started to provide important contributions to its functionality. Among recent additions can be mentioned the support of the Amazon EC2 computing resources as well as other Cloud management systems; a versatile File Replica Catalog with File Metadata capabilities; support for running MPI jobs in the pilot based Workload Management System. Integration with existing application Web Portals, like WS-PGRADE, is demonstrated. In this paper we will describe the current status of the DIRAC Project, recent developments of its framework and functionality as well as the status of the rapidly evolving community of the DIRAC users.

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

PubMed

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

2018-05-22

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

An approach for estimating item sensitivity to within-person change over time: An illustration using the Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog).

PubMed

Dowling, N Maritza; Bolt, Daniel M; Deng, Sien

2016-12-01

When assessments are primarily used to measure change over time, it is important to evaluate items according to their sensitivity to change, specifically. Items that demonstrate good sensitivity to between-person differences at baseline may not show good sensitivity to change over time, and vice versa. In this study, we applied a longitudinal factor model of change to a widely used cognitive test designed to assess global cognitive status in dementia, and contrasted the relative sensitivity of items to change. Statistically nested models were estimated introducing distinct latent factors related to initial status differences between test-takers and within-person latent change across successive time points of measurement. Models were estimated using all available longitudinal item-level data from the Alzheimer's Disease Assessment Scale-Cognitive subscale, including participants representing the full-spectrum of disease status who were enrolled in the multisite Alzheimer's Disease Neuroimaging Initiative. Five of the 13 Alzheimer's Disease Assessment Scale-Cognitive items demonstrated noticeably higher loadings with respect to sensitivity to change. Attending to performance change on only these 5 items yielded a clearer picture of cognitive decline more consistent with theoretical expectations in comparison to the full 13-item scale. Items that show good psychometric properties in cross-sectional studies are not necessarily the best items at measuring change over time, such as cognitive decline. Applications of the methodological approach described and illustrated in this study can advance our understanding regarding the types of items that best detect fine-grained early pathological changes in cognition. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Organizational performance and regulatory compliance as measured by clinical pertinence indicators before and after implementation of Anesthesia Information Management System (AIMS).

PubMed

Choi, Clark K; Saberito, Darlene; Tyagaraj, Changa; Tyagaraj, Kalpana

2014-01-01

Previous studies have suggested that electronic medical records (EMR) can lead to a greater reduction of medical errors and better adherence to regulatory compliance than paper medical records (PMR). In order to assess the organizational performance and regulatory compliance, we tracked different clinical pertinence indicators (CPI) in our anesthesia information management system (AIMS) for 5 years. These indicators comprised of the protocols from the Surgical Care Improvement Project (SCIP), elements of performance (EP) from The Joint Commission (TJC), and guidelines from the Centers for Medicare and Medicaid Services (CMS). A comprehensive AIMS was initiated and the CPI were collected from October 5, 2009 to December 31, 2010 (EMR period) and from January 1, 2006 to October 4, 2009 (PMR period). Fourteen CPI were found to be common between the EMR and PMR periods. Based on the statistical analysis of the 14 common CPI, there was a significant increase (p < 0.001) in overall compliance after the introduction of EMR compared to the PMR period. The increase in overall compliance was significantly progressive (p = 0.013) from year to year over 2006 and 2010. Of the 14 CPI, Documentation of a) medication doses, and b) monitoring of postoperative physiological status, mental status, and pain scores showed significant improvement (p < 0.001) during the EMR period compared to the PMR period.

NEP systems engineering efforts in FY-92: Plans and status

NASA Technical Reports Server (NTRS)

Doherty, Michael P.; Gilland, James H.

1992-01-01

A system engineering effort has been initiated by NASA in FY-92 to define, address, and resolve issues associated with the use of Nuclear Electric Propulsion (NEP) for megawatt (MW) space propulsion applications associated with the Space Exploration Initiative (SEI). It is intended that key technical issues will be addressed by activities conducted in the early years of a project in NEP, with the objective of resolving such issues. Also, in response to more recent programmatic direction, a concept definition activity for 100 kilowatt NEP is being initiated. This paper will present key issues associated with megawatt NEP, and the plans and status for their resolution, and present the scope and rationale for the 100 kilowatt concept definition activity.

Human papillomavirus in oropharyngeal cancer in Canada: analysis of 5 comprehensive cancer centres using multiple imputation

PubMed Central

Habbous, Steven; Chu, Karen P.; Lau, Harold; Schorr, Melissa; Belayneh, Mathieos; Ha, Michael N.; Murray, Scott; O’Sullivan, Brian; Huang, Shao Hui; Snow, Stephanie; Parliament, Matthew; Hao, Desiree; Cheung, Winson Y.; Xu, Wei; Liu, Geoffrey

2017-01-01

BACKGROUND: The incidence of oropharyngeal cancer has risen over the past 2 decades. This rise has been attributed to human papillomavirus (HPV), but information on temporal trends in incidence of HPV-associated cancers across Canada is limited. METHODS: We collected social, clinical and demographic characteristics and p16 protein status (p16-positive or p16-negative, using this immunohistochemistry variable as a surrogate marker of HPV status) for 3643 patients with oropharyngeal cancer diagnosed between 2000 and 2012 at comprehensive cancer centres in British Columbia (6 centres), Edmonton, Calgary, Toronto and Halifax. We used receiver operating characteristic curves and multiple imputation to estimate the p16 status for missing values. We chose a best-imputation probability cut point on the basis of accuracy in samples with known p16 status and through an independent relation between p16 status and overall survival. We used logistic and Cox proportional hazard regression. RESULTS: We found no temporal changes in p16-positive status initially, but there was significant selection bias, with p16 testing significantly more likely to be performed in males, lifetime never-smokers, patients with tonsillar or base-of-tongue tumours and those with nodal involvement (p < 0.05 for each variable). We used the following variables associated with p16-positive status for multiple imputation: male sex, tonsillar or base-of-tongue tumours, smaller tumours, nodal involvement, less smoking and lower alcohol consumption (p < 0.05 for each variable). Using sensitivity analyses, we showed that different imputation probability cut points for p16-positive status each identified a rise from 2000 to 2012, with the best-probability cut point identifying an increase from 47.3% in 2000 to 73.7% in 2012 (p < 0.001). INTERPRETATION: Across multiple centres in Canada, there was a steady rise in the proportion of oropharyngeal cancers attributable to HPV from 2000 to 2012. PMID:28808115

78 FR 27113 - Generic Drug User Fee Amendments of 2012; Regulatory Science Initiatives Public Hearing; Request...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-09

.... FDA-2013-N-0402] Generic Drug User Fee Amendments of 2012; Regulatory Science Initiatives Public... public meeting that will provide an overview of the current status of the regulatory science initiatives... societies, and other interested stakeholders-- as it fulfills its statutory requirement under the Generic...

Civil Space Technology Initiative: a First Step

NASA Technical Reports Server (NTRS)

1988-01-01

This is the first published overview of OAST's focused program, the Civil Space Technology Initiative, (CSTI) which started in FY88. This publication describes the goals, technical approach, current status, and plans for CSTI. Periodic updates are planned.

Circumcision Status and Time to Sexual Debut Among Youth in Sub-Saharan Africa: Evidence from Six Demographic and Health Surveys.

PubMed

Kangmennaang, Joseph; Osei, Lydia; Mkandawire, Paul; Luginaah, Isaac

2016-11-01

This paper examines the relationship between circumcision status and timing of sexual debut among unmarried youth in Sub-Saharan Africa using Demographic and Health Surveys. Results from survival analysis indicate that the association between circumcision and timing of first sex is place and context specific. Compared to uncircumcised, circumcised men in Rwanda, Uganda and Namibia hasten sexual initiation, whilst circumcised youth in Ethiopia and Mali delayed sex initiation. In Togo however, we found parity in timing to sexual debut. Our multivariate results reveal that, knowledge of HIV/AIDS risk and educational level also feed into the association between circumcision and timing of sex initiation- implying that efforts to prevent new HIV infection through circumcision could benefit from a proper understanding of how diverse set of factors interact in specific contexts to shape youth's decisions to initiate early sex.

Sequence learning in Parkinson's disease: Focusing on action dynamics and the role of dopaminergic medication.

PubMed

Ruitenberg, Marit F L; Duthoo, Wout; Santens, Patrick; Seidler, Rachael D; Notebaert, Wim; Abrahamse, Elger L

2016-12-01

Previous studies on movement sequence learning in Parkinson's disease (PD) have produced mixed results. A possible explanation for the inconsistent findings is that some studies have taken dopaminergic medication into account while others have not. Additionally, in previous studies the response modalities did not allow for an investigation of the action dynamics of sequential movements as they unfold over time. In the current study we investigated sequence learning in PD by specifically considering the role of medication status in a sequence learning task where mouse movements were performed. The focus on mouse movements allowed us to examine the action dynamics of sequential movement in terms of initiation time, movement time, movement accuracy, and velocity. PD patients performed the sequence learning task once on their regular medication, and once after overnight withdrawal from their medication. Results showed that sequence learning as reflected in initiation times was impaired when PD patients performed the task ON medication compared to OFF medication. In contrast, sequence learning as reflected in the accuracy of movement trajectories was enhanced when performing the task ON compared to OFF medication. Our findings suggest that while medication enhances execution processes of movement sequence learning, it may at the same time impair planning processes that precede actual execution. Overall, the current study extends earlier findings on movement sequence learning in PD by differentiating between various components of performance, and further refines previous dopamine overdose effects in sequence learning. Copyright © 2016 Elsevier Ltd. All rights reserved.

Using probabilistic record linkage methods to identify Australian Indigenous women on the Queensland Pap Smear Register: the National Indigenous Cervical Screening Project.

PubMed

Whop, Lisa J; Diaz, Abbey; Baade, Peter; Garvey, Gail; Cunningham, Joan; Brotherton, Julia M L; Canfell, Karen; Valery, Patricia C; O'Connell, Dianne L; Taylor, Catherine; Moore, Suzanne P; Condon, John R

2016-02-12

To evaluate the feasibility and reliability of record linkage of existing population-based data sets to determine Indigenous status among women receiving Pap smears. This method may allow for the first ever population measure of Australian Indigenous women's cervical screening participation rates. A linked data set of women aged 20-69 in the Queensland Pap Smear Register (PSR; 1999-2011) and Queensland Cancer Registry (QCR; 1997-2010) formed the Initial Study Cohort. Two extracts (1995-2011) were taken from Queensland public hospitals data (Queensland Hospital Admitted Patient Data Collection, QHAPDC) for women, aged 20-69, who had ever been identified as Indigenous (extract 1) and had a diagnosis or procedure code relating to cervical cancer (extract 2). The Initial Study Cohort was linked to extract 1, and women with cervical cancer in the initial cohort were linked to extract 2. The proportion of women in the Initial Cohort who linked with the extracts (true -pairs) is reported, as well as the proportion of potential pairs that required clerical review. After assigning Indigenous status from QHAPDC to the PSR, the proportion of women identified as Indigenous was calculated using 4 algorithms, and compared. There were 28,872 women (2.1%) from the Initial Study Cohort who matched to an ever Indigenous record in extract 1 (n=76,831). Women with cervical cancer in the Initial Study Cohort linked to 1385 (71%) records in extract 2. The proportion of Indigenous women ranged from 2.00% to 2.08% when using different algorithms to define Indigenous status. The Final Study Cohort included 1,372,823 women (PSR n=1,374,401; QCR n=1955), and 5,062,118 records. Indigenous status in Queensland cervical screening data was successfully ascertained through record linkage, allowing for the crucial assessment of the current cervical screening programme for Indigenous women. Our study highlights the need to include Indigenous status on Pap smear request and report forms in any renewed and redesigned cervical screening programme in Australia. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Epidermal growth factor receptor (EGFr) status associated with failure of primary endocrine therapy in elderly postmenopausal patients with breast cancer.

PubMed Central

Nicholson, S.; Halcrow, P.; Sainsbury, J. R.; Angus, B.; Chambers, P.; Farndon, J. R.; Harris, A. L.

1988-01-01

We have used primary endocrine therapy for 61 elderly women with operable breast cancer (median age 77 years). Eleven patients (18%) had complete and 24 (39%) partial tumour regression, 12 (20%) had stable disease for a minimum of six months and 14 (23%) no response. Salvage surgery was undertaken in the 14 with no response and 8/9 with progressive disease following initial response, thus samples were available from relapse patients only. Assays for EGFr (two point radioreceptor assay) and oestrogen receptors (ER) (dextran coated charcoal method and an immunohistochemical method) were performed on 20/22 patients. Ten of these 20 tumours were EGFr+ (greater than 10 fmol mg-1 binding) and 9/13 patients progressing within six months had EGFr+ tumours. 15/22 were available for ER evaluation and there was no such association with ER status. EGFr status was also associated with early recurrence after surgery and death in the endocrine failure group (P less than 0.005 and P less than 0.05 respectively). Of a control population of 33 patients (median age 72 years) treated by primary surgery, only 6 were EGFr+. In this group early relapse was predicted by EGFr status, but not by ER status (median disease free survival for EGFr+ patients 15 months, and for EGFr- patients 40 months, P less than 0.01, logrank test). There was a significantly higher proportion of EGFr+ tumours in the endocrine failure group compared with the control population (P less than 0.001). EGFr status is a marker for rapid early progression on primary endocrine therapy and the development of non-excisional methods of EGFr analysis would allow better directed therapeutic decisions. PMID:3224082

Effect of oil source and peroxidation status on broiler performance and oxidative stress

USDA-ARS?s Scientific Manuscript database

Oil source has been shown to affect broiler performance and oxidative status. Lipid peroxidation may also affect animal performance and oxidative status through the generation and degradation of peroxidation compounds which differ according to oil source and temperature and length of heating. The ob...

[A school-level longitudinal study of clinical performance examination scores].

PubMed

Park, Jang Hee

2015-06-01

This school-level longitudinal study examined 7 years of clinical performance data to determine differences (effects) in students and annual changes within a school and between schools; examine how much their predictors (characteristics) influenced the variation in student performance; and calculate estimates of the schools' initial status and growth. A school-level longitudinal model was tested: level 1 (between students), level 2 (annual change within a school), and level 3 (between schools). The study sample comprised students who belonged to the CPX Consortium (n=5,283 for 2005~2008 and n=4,337 for 2009~2011). Despite a difference between evaluation domains, the performance outcomes were related to individual large-effect differences and small-effect school-level differences. Physical examination, clinical courtesy, and patient education were strongly influenced by the school effect, whereas patient-physician interaction was not affected much. Student scores are influenced by the school effect (differences), and the predictors explain the variation in differences, depending on the evaluation domain.

Small Manufacturers Export Initiative Act

THOMAS, 111th Congress

Rep. Larsen, Rick [D-WA-2

2010-07-20

House - 07/23/2010 Referred to the Subcommittee on Technology and Innovation. (All Actions) Notes: For further action, see H.R.5297, which became Public Law 111-240 on 9/27/2010. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

The Impact of Family Migration and Family Life Cycle on the Employment Status of Married, College-Educated Women.

ERIC Educational Resources Information Center

Yu, Lucy C.; And Others

1993-01-01

Data from 204 female faculty or faculty wives show that family life cycle (number and ages of children) and family migration significantly affect wives' employment status. Only extremely highly educated women initiate family relocation. (SK)

Association between sports participation, motor competence and weight status: A longitudinal study.

PubMed

Henrique, Rafael S; Ré, Alessandro H N; Stodden, David F; Fransen, Job; Campos, Carolina M C; Queiroz, Daniel R; Cattuzzo, Maria T

2016-10-01

The aim of this study was to investigate if baseline motor competence, weight status and sports participation in early childhood predict sports participation two years later. longitudinal study. In 2010, motor competence (object control and locomotor skills), weight status and sports participation were assessed in 292 children between three and five years-of-age. In 2012, sports participation was re-evaluated in 206 of the original 292 children. Logistic regression was implemented to examine if initial sports participation, motor competence and weight status would predict sports participation two years later. In the final model, sports participation in 2010 (OR=9.68, CI: 3.46 to 27.13) and locomotor skills (OR=1.21, CI: 1.01 to 1.46) significantly predicted sports participation after two years. These results suggest that initial sports participation and more advanced locomotor skills in preschool years may be important to promote continued participation in sports across childhood. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Utilization of Mental Health Services and Mental Health Status Among Children Placed in Out-of-Home Care: A Parallel Process Latent Growth Modeling Approach.

PubMed

Yampolskaya, Svetlana; Sharrock, Patty J; Clark, Colleen; Hanson, Ardis

2017-10-01

This longitudinal study examined the parallel trajectories of mental health service use and mental health status among children placed in Florida out-of-home care. The results of growth curve modeling suggested that children with greater mental health problems initially received more mental health services. Initial child mental health status, however, had no effect on subsequent service provision when all outpatient mental health services were included. When specific types of mental health services, such as basic outpatient, targeted case management, and intensive mental health services were examined, results suggested that children with compromised functioning during the baseline period received more intensive mental health services over time. However, this increased provision of intensive mental health services did not improve mental health status, rather it was significantly associated with progressively worse mental health functioning. These findings underscore the need for regular comprehensive mental health assessments focusing on specific needs of the child.

Nonconvulsive status epilepticus disguising as hepatic encephalopathy.

PubMed

Jo, Yong Min; Lee, Sung Wook; Han, Sang Young; Baek, Yang Hyun; Ahn, Ji Hye; Choi, Won Jong; Lee, Ji Young; Kim, Sang Ho; Yoon, Byeol A

2015-04-28

Nonconvulsive status epilepticus has become an important issue in modern neurology and epileptology. This is based on difficulty in definitively elucidating the condition and its various clinical phenomena and on our inadequate insight into the intrinsic pathophysiological processes. Despite nonconvulsive status epilepticus being a situation that requires immediate treatment, this disorder may not be appreciated as the cause of mental status impairment. Although the pathophysiology of nonconvulsive status epilepticus remains unknown, this disorder is thought to lead to neuronal damage, so its identification and treatment are important. Nonconvulsive status epilepticus should be considered in the differential diagnosis of patients with liver cirrhosis presenting an altered mental status. We report a case of a 52-year-old male with liver cirrhosis presenting an altered mental status. He was initially diagnosed with hepatic encephalopathy but ultimately diagnosed with nonconvulsive status epilepticus by electroencephalogram.

Technical and financial feasibility of an inferior vena cava filter retrieval program at a level one trauma center.

PubMed

Charlton-Ouw, Kristofer M; Leake, Samuel S; Sola, Cristina N; Sandhu, Harleen K; Albarado, Rondel; Holcomb, John B; Miller, Charles C; Safi, Hazim J; Azizzadeh, Ali

2015-01-01

Considering new guidelines for retrievable inferior vena cava filters (IVCFs), we examine our initial experience after establishing a comprehensive filter removal program in our level 1 trauma center. We evaluated the technical and financial feasibility of this program and barriers to IVCF retrieval, including insurance status and costs, in trauma patients. Trauma patients receiving IVCFs from May 2011 to 2013 were consented and prospectively enrolled in the study program. Retrieval rates were assessed for the years before study initiation. Primary outcome was IVCF retrieval. Hospital financial data for retrieval were examined and univariate analysis performed. Hospital cost-to-charge and payment-to-charge ratios were assessed. Before study initiation from April 2009 to 2011, 66 IVCFs were placed in trauma patients with only 2 retrievals in 2 years. During the study period, 247 trauma patients had IVCF placement of which 111 (45%) were enrolled. The main reason for nonenrollment was lack of referral by the implanting team. Retrieval was attempted in 100 outpatients with success in 85 (85%). Patients enrolled in the program were more likely to have their filters removed (73% vs. 18%; odds ratio, 12.6; 95% confidence interval, 6.6-24.3; P < 0.001). Mean time from placement to attempt was 6.2 ± 4.0 months (range, 0.5-31.8). Of the total attempts, 29% were nonresource patients, 11% had Medicaid, and 60% had commercial insurance including Medicare patients. Chances of successful retrieval were higher if performed later during the study (P = 0.03). Successful retrieval was not related to insurance status (P = not significant). The mean total hospital charges related to retrieval were $4,493 (range, $2,510-$9,106). Successful retrieval contributed to lower total charges (P < 0.01). Factors contributing to higher total charges were retrieval attempt later in study period (P = 0.01) and commercial insurance status (P = 0.04). The rate of IVCF placement in trauma patients increased 4-fold over 4 years. The rate of IVCF retrieval increased more than 14-fold during the same period after establishment of the retrieval program. Elective outpatient retrieval of IVCFs in all eligible trauma patients is financially feasible without loss to the health care system even in regions with high rates of uninsured. A major barrier to successful filter retrieval was lack of patient referral into the program by implanting physicians. Hospital administration and physician outreach are important determinants of successful IVCF retrieval in trauma patients. Published by Elsevier Inc.

Iron nutrition and premenopausal women: effects of poor iron status on physical and neuropsychological performance.

PubMed

McClung, James P; Murray-Kolb, Laura E

2013-01-01

Iron is a nutritionally essential trace element that functions through incorporation into proteins and enzymes, many of which contribute to physical and neuropsychological performance. Poor iron status, including iron deficiency (ID; diminished iron stores) and iron deficiency anemia (IDA; poor iron stores and diminished hemoglobin), affects billions of people worldwide. This review focuses on physical and neuropsychological outcomes associated with ID and IDA in premenopausal women, as the prevalence of ID and IDA is often greater in premenopausal women than other population demographics. Recent studies addressing the physiological effects of poor iron status on physical performance, including work productivity, voluntary activity, and athletic performance, are addressed. Similarly, the effects of iron status on neurological performance, including cognition, affect, and behavior, are summarized. Nutritional countermeasures for the prevention of poor iron status and the restoration of decrements in performance outcomes are described.

Patients living in impoverished areas have more severe ischemic strokes.

PubMed

Kleindorfer, Dawn; Lindsell, Christopher; Alwell, Kathleen A; Moomaw, Charles J; Woo, Daniel; Flaherty, Matthew L; Khatri, Pooja; Adeoye, Opeolu; Ferioli, Simona; Kissela, Brett M

2012-08-01

Initial stroke severity is one of the strongest predictors of eventual stroke outcome. However, predictors of initial stroke severity have not been well-described within a population. We hypothesized that poorer patients would have a higher initial stroke severity on presentation to medical attention. We identified all cases of hospital-ascertained ischemic stroke occurring in 2005 within a biracial population of 1.3 million. "Community" socioecomic status was determined for each patient based on the percentage below poverty in the census tract in which the patient resided. Linear regression was used to model the effect of socioeconomic status on stroke severity. Models were adjusted for race, gender, age, prestroke disability, and history of medical comorbidities. There were 1895 ischemic stroke events detected in 2005 included in this analysis; 22% were black, 52% were female, and the mean age was 71 years (range, 19-104). The median National Institutes of Health Stroke Scale was 3 (range, 0-40). The poorest community socioeconomic status was associated with a significantly increased initial National Institutes of Health Stroke Scale by 1.5 points (95% confidence interval, 0.5-2.6; P<0.001) compared with the richest category in the univariate analysis, which increased to 2.2 points after adjustment for demographics and comorbidities. We found that increasing community poverty was associated with worse stroke severity at presentation, independent of other known factors associated with stroke outcomes. Socioeconomic status may impact stroke severity via medication compliance, access to care, and cultural factors, or may be a proxy measure for undiagnosed disease states.

Approximate Arithmetic Training Improves Informal Math Performance in Low Achieving Preschoolers

PubMed Central

Szkudlarek, Emily; Brannon, Elizabeth M.

2018-01-01

Recent studies suggest that practice with approximate and non-symbolic arithmetic problems improves the math performance of adults, school aged children, and preschoolers. However, the relative effectiveness of approximate arithmetic training compared to available educational games, and the type of math skills that approximate arithmetic targets are unknown. The present study was designed to (1) compare the effectiveness of approximate arithmetic training to two commercially available numeral and letter identification tablet applications and (2) to examine the specific type of math skills that benefit from approximate arithmetic training. Preschool children (n = 158) were pseudo-randomly assigned to one of three conditions: approximate arithmetic, letter identification, or numeral identification. All children were trained for 10 short sessions and given pre and post tests of informal and formal math, executive function, short term memory, vocabulary, alphabet knowledge, and number word knowledge. We found a significant interaction between initial math performance and training condition, such that children with low pretest math performance benefited from approximate arithmetic training, and children with high pretest math performance benefited from symbol identification training. This effect was restricted to informal, and not formal, math problems. There were also effects of gender, socio-economic status, and age on post-test informal math score after intervention. A median split on pretest math ability indicated that children in the low half of math scores in the approximate arithmetic training condition performed significantly better than children in the letter identification training condition on post-test informal math problems when controlling for pretest, age, gender, and socio-economic status. Our results support the conclusion that approximate arithmetic training may be especially effective for children with low math skills, and that approximate arithmetic training improves early informal, but not formal, math skills. PMID:29867624

Approximate Arithmetic Training Improves Informal Math Performance in Low Achieving Preschoolers.

PubMed

Szkudlarek, Emily; Brannon, Elizabeth M

2018-01-01

Recent studies suggest that practice with approximate and non-symbolic arithmetic problems improves the math performance of adults, school aged children, and preschoolers. However, the relative effectiveness of approximate arithmetic training compared to available educational games, and the type of math skills that approximate arithmetic targets are unknown. The present study was designed to (1) compare the effectiveness of approximate arithmetic training to two commercially available numeral and letter identification tablet applications and (2) to examine the specific type of math skills that benefit from approximate arithmetic training. Preschool children ( n = 158) were pseudo-randomly assigned to one of three conditions: approximate arithmetic, letter identification, or numeral identification. All children were trained for 10 short sessions and given pre and post tests of informal and formal math, executive function, short term memory, vocabulary, alphabet knowledge, and number word knowledge. We found a significant interaction between initial math performance and training condition, such that children with low pretest math performance benefited from approximate arithmetic training, and children with high pretest math performance benefited from symbol identification training. This effect was restricted to informal, and not formal, math problems. There were also effects of gender, socio-economic status, and age on post-test informal math score after intervention. A median split on pretest math ability indicated that children in the low half of math scores in the approximate arithmetic training condition performed significantly better than children in the letter identification training condition on post-test informal math problems when controlling for pretest, age, gender, and socio-economic status. Our results support the conclusion that approximate arithmetic training may be especially effective for children with low math skills, and that approximate arithmetic training improves early informal, but not formal, math skills.

The Effects of Solo Status on Women's and Men's Success: The Moderating Role of the Performance Context

ERIC Educational Resources Information Center

Viallon, Marie-Laure; Martinot, Delphine

2009-01-01

A considerable body of research has shown that being the only representative of one's gender group (solo status) when performing an activity affects women more than men. The aim of our two experiments was to show that the performance context can moderate the effects of numerical status (majority vs. solo) on performance and that men can also be…

Risk factors and global cognitive status related to brain arteriolosclerosis in elderly individuals

PubMed Central

Ighodaro, Eseosa T; Abner, Erin L; Fardo, David W; Lin, Ai-Ling; Katsumata, Yuriko; Schmitt, Frederick A; Kryscio, Richard J; Jicha, Gregory A; Neltner, Janna H; Monsell, Sarah E; Kukull, Walter A; Moser, Debra K; Appiah, Frank; Bachstetter, Adam D; Van Eldik, Linda J

2016-01-01

Risk factors and cognitive sequelae of brain arteriolosclerosis pathology are not fully understood. To address this, we used multimodal data from the National Alzheimer's Coordinating Center and Alzheimer's Disease Neuroimaging Initiative data sets. Previous studies showed evidence of distinct neurodegenerative disease outcomes and clinical-pathological correlations in the “oldest-old” compared to younger cohorts. Therefore, using the National Alzheimer's Coordinating Center data set, we analyzed clinical and neuropathological data from two groups according to ages at death: < 80 years (n = 1008) and ≥80 years (n = 1382). In both age groups, severe brain arteriolosclerosis was associated with worse performances on global cognition tests. Hypertension (but not diabetes) was a brain arteriolosclerosis risk factor in the younger group. In the ≥ 80 years age at death group, an ABCC9 gene variant (rs704180), previously associated with aging-related hippocampal sclerosis, was also associated with brain arteriolosclerosis. A post-hoc arterial spin labeling neuroimaging experiment indicated that ABCC9 genotype is associated with cerebral blood flow impairment; in a convenience sample from Alzheimer's Disease Neuroimaging Initiative (n = 15, homozygous individuals), non-risk genotype carriers showed higher global cerebral blood flow compared to risk genotype carriers. We conclude that brain arteriolosclerosis is associated with altered cognitive status and a novel vascular genetic risk factor. PMID:26738751

[Maternal depressive symptoms and anxiety and interference in the mother/child relationship based on a prenatal cohort: an approach with structural equations modeling].

PubMed

Morais, Adriana Oliveira Dias de Sousa; Simões, Vanda Maria Ferreira; Rodrigues, Lívia Dos Santos; Batista, Rosângela Fernandes Lucena; Lamy, Zeni Carvalho; Carvalho, Carolina Abreu de; Silva, Antônio Augusto Moura da; Ribeiro, Marizélia Rodrigues Costa

2017-07-13

This study aimed to investigate the association between maternal depressive symptoms and anxiety and interference in the mother/child relationship, using structural equations modeling. Data were used from a prospective cohort study initiated during the prenatal period with 1,140 mothers in São Luís, Maranhão State, Brazil. Data were collected during prenatal care and when the children reached two years of age. Interference in the mother/child relationship was measured with the Postpartum Bonding Questionnaire - PBQ (N = 1,140). In the initial theoretical model, socioeconomic status determined the maternal demographic, psychosocial, and social support factors, which determined the outcome, i.e., the mother/child relationship. Adjustments were performed by structural equations modeling, using Mplus 7.0. The final model showed good fit (RMSEA = 0.047; CFI = 0.984; TLI = 0.981). Depressive symptoms in pregnancy and the postpartum were associated with higher PBQ scores, indicating interference in the mother/child relationship. The greatest effect was from depressive symptoms in pregnancy. Other factors associated with higher PBQ scores were lower social support, unfavorable socioeconomic status, and living without a partner, by indirect association. Anxiety symptoms and maternal age were not associated with the mother/child relationship. The results suggest that identifying and treating depression in pregnancy and postpartum can improve mother/child bonding in childhood.

Changes in Pilot Behavior with Predictive System Status Information

NASA Technical Reports Server (NTRS)

Trujillo, Anna C.

1998-01-01

Research has shown a strong pilot preference for predictive information of aircraft system status in the flight deck. However, changes in pilot behavior associated with using this predictive information have not been ascertained. The study described here quantified these changes using three types of predictive information (none, whether a parameter was changing abnormally, and the time for a parameter to reach an alert range) and three initial time intervals until a parameter alert range was reached (ITIs) (1 minute, 5 minutes, and 15 minutes). With predictive information, subjects accomplished most of their tasks before an alert occurred. Subjects organized the time they did their tasks by locus-of-control with no predictive information and for the 1-minute ITI, and by aviatenavigate-communicate for the time for a parameter to reach an alert range and the 15-minute conditions. Overall, predictive information and the longer ITIs moved subjects to performing tasks before the alert actually occurred and had them more mission oriented as indicated by their tasks grouping of aviate-navigate-communicate.

Aircraft Capability Management

NASA Technical Reports Server (NTRS)

Mumaw, Randy; Feary, Mike

2018-01-01

This presentation presents an overview of work performed at NASA Ames Research Center in 2017. The work concerns the analysis of current aircraft system management displays, and the initial development of an interface for providing information about aircraft system status. The new interface proposes a shift away from current aircraft system alerting interfaces that report the status of physical components, and towards displaying the implications of degradations on mission capability. The proposed interface describes these component failures in terms of operational consequences of aircraft system degradations. The research activity was an effort to examine the utility of different representations of complex systems and operating environments to support real-time decision making of off-nominal situations. A specific focus was to develop representations that provide better integrated information to allow pilots to more easily reason about the operational consequences of the off-nominal situations. The work is also seen as a pathway to autonomy, as information is integrated and understood in a form that automated responses could be developed for the off-nominal situations in the future.

Limb/trunk lean mass ratio as a risk factor for mortality in peritoneal dialysis patients.

PubMed

Kang, Seok Hui; Park, Jong Won; Yoon, Kyung Woo; Do, Jun Young

2013-07-01

This study was performed to determine the clinical relevance of limb/trunk lean mass ratio (LTLM) in continuous ambulatory peritoneal dialysis (CAPD) patients. This retrospective cohort study included 534 CAPD patients. Body compositions were measured using a dual-energy X-ray absorptiometry apparatus. In males, the sensitivity and specificity for the diagnosis of sarcopenia were 70.3% and 85.9%, respectively. Respective values in females were 62.3% and 83.8%. The initial low LTLM tertile was associated with mortality in male CAPD patients and in female CAPD patients. Among patients who maintained CAPD for a year, the maintenance of low LTLM tertile was associated with mortality. LTLM is associated with other lean mass indices, nutritional status, and mortality in CAPD patients. Therefore, LTLM is a novel marker that is useful for the prediction of the nutritional status and mortality in patients with CAPD. Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Factors affecting the healing of the perineum following surgery.

PubMed

Ip, B; Jones, M; Bassett, P; Phillips, R

2013-05-01

The aim of this study was to establish patient and procedural factors associated with the development of an unhealed perineum in patients undergoing a proctectomy or excision of an ileoanal pouch. A review of 194 case notes for procedures performed between 1997 and 2009 was carried out. All patients had at least 12 months' follow-up. Univariate and multivariate analyses were performed in 16 parameters. For those patients who developed an unhealed perineum, Cox regression analysis was performed to establish healing over a 12-month period. Two hundred patients were included in the study, of which six had unknown wound status and were subsequently excluded. This left 194 study patients. Of these, 86 (44%) achieved primary wound healing with a fully healed perineum and 108 (56%) experienced primary wound failure. With reference to the latter, 63 (58%) healed by 12 months. Comparing patients with an initially intact perineum with those with initial wound failure showed pre-existing sepsis was highly relevant (odds ratio: 4.32, 95% confidence interval [CI]: 2.16-8.62, p<0.001). In patients who had an unhealed perineum initially, perineal sepsis and surgical treatment were both significantly associated with time to healing (hazard ratio [HR]: 0.54, 95% CI: 0.31-0.93, p=0.03; and HR: 0.42, 95% CI: 0.21-0.84, p=0.01). The presence of pre-existing perineal sepsis is associated with an unhealed perineum following proctectomy in inflammatory bowel disease (IBD) and non-IBD surgery. Further studies are indicated to establish perineal sepsis as a causative factor.

State Small Business Credit Initiative Act of 2010

THOMAS, 111th Congress

Rep. Peters, Gary C. [D-MI-9

2010-05-13

House - 05/13/2010 Referred to the House Committee on Financial Services. (All Actions) Notes: For further action, see H.R.5297, which became Public Law 111-240 on 9/27/2010. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Violence against Deaf Women: Effect of Partner Hearing Status

ERIC Educational Resources Information Center

Anderson, Melissa L.; Kobek Pezzarossi, Caroline M.

2014-01-01

Using a sample of Deaf female undergraduate students, the current study sought to investigate the prevalence, correlates, and characteristics of intimate partner violence victimization in hearing-Deaf and Deaf-Deaf relationships. Initial results suggest that similarities in hearing status and communication preference are associated with increased…

Spinal epidural hematomas: personal experience and literature review of more than 1000 cases.

PubMed

Domenicucci, Maurizio; Mancarella, Cristina; Santoro, Giorgio; Dugoni, Demo Eugenio; Ramieri, Alessandro; Arezzo, Maria Felice; Missori, Paolo

2017-08-01

OBJECTIVE The goal of this study was to identify factors that contribute to the formation of acute spinal epidural hematoma (SEH) by correlating etiology, age, site, clinical status, and treatment with immediate results and long-term outcomes. METHODS The authors reviewed their series of 15 patients who had been treated for SEH between 1996 and 2012. In addition, the authors reviewed the relevant international literature from 1869 (when SEH was first described) to 2012, collecting a total of 1010 cases. Statistical analysis was performed in 959 (95%) cases that were considered valid for assessing the incidence of age, sex, site, and clinical status at admission, correlating each of these parameters with the treatment results. Statistical analysis was also performed in 720 (71.3%) cases to study the incidence of etiological factors that favor SEH formation: coagulopathy, trauma, spinal puncture, pregnancy, and multifactorial disorders. The clinical status at admission and long-term outcome were studied for each group. Clinical status was assessed using the Neuro-Grade (NG) scale. RESULTS The mean patient age was 47.97 years (range 0-91 years), and a significant proportion of patients were male (60%, p < 0.001). A bimodal distribution has been reported for age at onset with peaks in the 2nd and 6th decades of life. The cause of the SEH was not reported in 42% of cases. The etiology concerned mainly iatrogenic factors (18%), such as coagulopathy or spinal puncture, rather than noniatrogenic factors (29%), such as genetic or metabolic coagulopathy, trauma, and pregnancy. The etiology was multifactorial in 11.1% of cases. The most common sites for SEH were C-6 (n = 293, 31%) and T-12 (n = 208, 22%), with maximum extension of 6 vertebral bodies in 720 cases (75%). At admission, 806 (84%) cases had moderate neurological impairment (NG 2 or 3), and only lumbar hematoma was associated with a good initial clinical neurological status (NG 0 or 1). Surgery was performed in 767 (80%) cases. Mortality was greater in patients older than 40 years of age (9%; p < 0.01). Sex did not influence any of these data (p > 0.05). CONCLUSIONS Factors that contribute to the formation of acute SEH are iatrogenic, not iatrogenic, or multifactorial. The treatment of choice is surgery, and the results of treatment are influenced by the patient's clinical and neurological status at admission, age, and the craniocaudal site.

Impact of poor oral health on children's school attendance and performance.

PubMed

Jackson, Stephanie L; Vann, William F; Kotch, Jonathan B; Pahel, Bhavna T; Lee, Jessica Y

2011-10-01

We examined school days missed for routine dental care versus dental pain or infection to determine the relationship between children's oral health status and school attendance and performance. We used 2008 data from the North Carolina Child Health Assessment and Monitoring Program. The study sample, weighted to reflect the state's population, included 2183 schoolchildren. Variables assessed included school absences and performance, oral health status, parental education, health insurance coverage, race, and gender. Children with poor oral health status were nearly 3 times more likely (odds ratio = 3.89; 95% confidence interval = 1.96, 7.75) than were their counterparts to miss school as a result of dental pain. Absences caused by pain were associated with poorer school performance (P < .05), but absences for routine care were not. Mediation analyses revealed that oral health status was associated with performance independent of absence for pain. Children with poorer oral health status were more likely to experience dental pain, miss school, and perform poorly in school. These findings suggest that improving children's oral health status may be a vehicle to enhancing their educational experience.

Dramatic response to alectinib in a patient of ALK-rearranged lung cancer with poor performance status.

PubMed

Tanaka, Hisashi; Taima, Kageaki; Morimoto, Takeshi; Nakamura, Kunihiko; Tanaka, Yoshihito; Itoga, Masamichi; Takanashi, Shingo; Okumura, Ken

2016-03-17

Lung cancers with anaplastic lymphoma kinase rearrangements are highly sensitive to anaplastic lymphoma kinase tyrosine kinase inhibition, underscoring the notion that such cancers are addicted to anaplastic lymphoma kinase activity. Several anaplastic lymphoma kinase inhibitors have been identified and are being evaluated in clinical trials. However patients with poor performance status (3 or 4) were not involved in these clinical trials, it has been unclear to use anaplastic lymphoma kinase-tyrosine kinase inhibitors for these patients. Here, we report an anaplastic lymphoma kinase-positive non small cell lung cancer patient with performance status 4, who was successfully treated with alectinib. We report on a 52-year-old patient diagnosed as non small cell lung cancer harboring echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase fusion gene. His performance status was 4 because of severe respiratory failure. We treated this patient with alectinib as the first line therapy. Dramatic response was obtained and his performance status improved from 4 to 1 without severe adverse events. Alectinib is a therapeutic option for the anaplastic lymphoma kinase positive patients with poor performance status.

Impact of Poor Oral Health on Children's School Attendance and Performance

PubMed Central

Vann, William F.; Kotch, Jonathan B.; Pahel, Bhavna T.; Lee, Jessica Y.

2011-01-01

Objectives. We examined school days missed for routine dental care versus dental pain or infection to determine the relationship between children's oral health status and school attendance and performance. Methods. We used 2008 data from the North Carolina Child Health Assessment and Monitoring Program. The study sample, weighted to reflect the state's population, included 2183 schoolchildren. Variables assessed included school absences and performance, oral health status, parental education, health insurance coverage, race, and gender. Results. Children with poor oral health status were nearly 3 times more likely (odds ratio = 3.89; 95% confidence interval = 1.96, 7.75) than were their counterparts to miss school as a result of dental pain. Absences caused by pain were associated with poorer school performance (P < .05), but absences for routine care were not. Mediation analyses revealed that oral health status was associated with performance independent of absence for pain. Conclusions. Children with poorer oral health status were more likely to experience dental pain, miss school, and perform poorly in school. These findings suggest that improving children's oral health status may be a vehicle to enhancing their educational experience. PMID:21330579

40 CFR 63.9535 - What notifications must I submit and when?

Code of Federal Regulations, 2010 CFR

2010-07-01

...(b)(2), if you start up your affected source before October 18, 2002, you must submit your initial... start up your new affected source on or after October 18, 2002, you must submit your initial... status before the close of business on the 30th calendar day following the completion of the initial...

Timing of the initiation of parenteral nutrition in critically ill children.

PubMed

Jimenez, Lissette; Mehta, Nilesh M; Duggan, Christopher P

2017-05-01

To review the current literature evaluating clinical outcomes of early and delayed parenteral nutrition initiation among critically ill children. Nutritional management remains an important aspect of care among the critically ill, with enteral nutrition generally preferred. However, inability to advance enteral feeds to caloric goals and contraindications to enteral nutrition often leads to reliance on parenteral nutrition. The timing of parenteral nutrition initiation is varied among critically ill children, and derives from an assessment of nutritional status, energy requirements, and physiologic differences between adults and children, including higher nutrient needs and lower body reserves. A recent randomized control study among critically ill children suggests improved clinical outcomes with avoiding initiation of parenteral nutrition on day 1 of admission to the pediatric ICU. Although there is no consensus on the optimal timing of parenteral nutrition initiation among critically ill children, recent literature does not support the immediate initiation of parenteral nutrition on pediatric ICU admission. A common theme in the reviewed literature highlights the importance of accurate assessment of nutritional status and energy expenditure in deciding when to initiate parenteral nutrition. As with all medical interventions, the initiation of parenteral nutrition should be considered in light of the known benefits of judiciously provided nutritional support with the known risks of artificial, parenteral feeding.

Timing of the initiation of parenteral nutrition in critically ill children

PubMed Central

Jimenez, Lissette; Mehta, Nilesh M.; Duggan, Christopher

2018-01-01

Purpose of Review To review the current literature evaluating clinical outcomes of early and delayed parenteral nutrition initiation among critically ill children. Recent Findings Nutritional management remains an important aspect of care among the critically ill, with enteral nutrition (EN) generally preferred. However, inability to advance enteral feeds to caloric goals and contraindications to EN often leads to reliance on parenteral nutrition (PN). The timing of PN initiation is varied among critically ill children, and derives from an assessment of nutritional status, energy requirements, and physiologic differences between adults and children, including higher nutrient needs and lower body reserves. A recent randomized control study among critically ill children suggests improved clinical outcomes with postponing initiation of PN to 1 week after admission to the pediatric intensive care unit (PICU). Summary Although there is no consensus on the optimal timing of PN initiation among critically ill children, recent literature does not support the immediate initiation of PN on PICU admission. A common theme in the reviewed literature highlights the importance of accurate assessment of nutritional status and energy expenditure in deciding when to initiate PN. As with all medical interventions, the initiation of PN should be considered in light of the known benefits of judiciously provided nutritional support with the known risks of artificial, parenteral feeding. PMID:28376054

GPIM AF-M315E Propulsion System

NASA Technical Reports Server (NTRS)

Spores, Ronald A.; Masse, Robert; Kimbrel, Scott; McLean, Chris

2014-01-01

The NASA Space Technology mission Directorate's (STMD) Green Propellant Infusion Mission (GPIM) Technology Demonstration Mission (TDM) will demonstrate an operational AF-M315E green propellant propulsion system. Aerojet-Rocketdyne is responsible for the development of the propulsion system payload. This paper statuses the propulsion system module development, including thruster design and system design; Initial test results for the 1N engineering model thruster are presented. The culmination of this program will be high-performance, green AF-M315E propulsion system technology at TRL 7+, with components demonstrated to TRL 9, ready for direct infusion to a wide range of applications for the space user community.

Philanthropic Endowments in General Internal Medicine

PubMed Central

Murden, Robert A; Lamb, James F

1999-01-01

We performed two surveys to uncover the status of philanthropic endowments in general internal medicine divisions. The initial survey of U.S. medical school departments of medicine found that only 14.1% of general internal medicine divisions hold endowments versus 21.9% of all other divisions, and that endowment sources for general medicine are atypical. The second survey of successfully endowed divisions found that sympathetic administrators and active pursuit of endowments were associated with endowment success. Aggressive pursuit of endowments, publicizing successes of general medicine, and consideration of endowment sources noted in this study are recommended to improve philanthropic contributions to general internal medicine. PMID:10203639

Childhood immunization: one HMO's experience in benchmarking and improving plan performance.

PubMed

Keitel, C

1995-01-01

In 1994, Health Net initiated a childhood immunization campaign and research project to improve health plan member immunization rates by motivating and educating parents of children 20-32 months old as to the importance of fully immunizing their child. The findings indicate that 88 percent of those parents with children who were not fully immunized believed their child had been fully immunized by age two. This lack of awareness may explain the unreliability of self-reported immunization status. Future immunization campaigns must include ongoing member reminder systems, educate members as to the immunization schedule, and must take into consideration the barriers, real and perceived, that block full immunization.

KSC-05PD-1084

NASA Technical Reports Server (NTRS)

2005-01-01

KENNEDY SPACE CENTER, FLA. At Launch Complex 39B, a technician in Space Shuttle Discovery's payload bay performs a borescope inspection of the retract link assembly on the orbiter's main landing gear door. The inspection is a precautionary measure after a small crack was found in a retract link assembly on the right-hand main landing gear on orbiter Atlantis. An initial review of the closeout photos of the link assembly on Discovery did not reveal any cracks. Discovery is scheduled to return the Space Shuttle fleet to operational status on mission STS-114. This additional work does not impact the launch planning window of July 13-31.

Satellite triangulation in Europe from WEST and ISAGEX data. [computer programs

NASA Technical Reports Server (NTRS)

Leick, A.; Arur, M.

1975-01-01

Observational data that was acquired during the West European Satellite Triangulation (WEST) program and the International Satellite Geodesy Experiment (ISAGEX) campaign was obtained for the purpose of performing a geometric solution to improve the present values of coordinates of the European stations in the OSU WN14 solutions, adding some new stations and assessing the quality of the WN14 solution with the help of the additional data available. The status of the data as received, the preprocessing required and the preliminary tests carried out for the initial screening of the data are described. The adjustment computations carried out and the results of the adjustments are discussed.

HSR Aerodynamic Performance Status and Challenges

NASA Technical Reports Server (NTRS)

Gilbert, William P.; Antani, Tony; Ball, Doug; Calloway, Robert L.; Snyder, Phil

1999-01-01

This paper describes HSR (High Speed Research) Aerodynamic Performance Status and Challenges. The topics include: 1) Aero impact on HSR; 2) Goals and Targets; 3) Progress and Status; and 4) Remaining Challenges. This paper is presented in viewgraph form.

Direct and indirect relationships of physical fitness, weight status, and learning duration to academic performance in Japanese schoolchildren.

PubMed

Ishihara, Toru; Morita, Noriteru; Nakajima, Toshihiro; Okita, Koichi; Yamatsu, Koji; Sagawa, Masato

2018-03-01

The purpose of this study was to determine, using structural equation modelling (SEM), the direct and indirect influence of daily behaviours (i.e. exercise/learning durations), weight status, and physical fitness on academic performance among seventh-grade schoolchildren, after controlling for socioeconomic status. We analysed cross-sectional data from 274 schoolchildren (159 males and 115 females; 12-13 years old). Academic performance was assessed using the total grade points in eight academic subjects. Physical fitness was evaluated using the total score of eight physical fitness tests and weight status using body mass index. The daily behaviours and socioeconomic status were assessed by the questionnaire. The SEM showed an adequate fit to the data (χ 2  = 0.684, p = .710, RMSEA = .000). Physical fitness and learning durations had direct effects on academic performance (β = .301, p < .001; β = .132, p = .037, respectively) after controlling for confounders. Healthy weight status and exercise habits positively indirectly influenced academic performance via physical fitness. These findings suggest that, independent of socioeconomic status and learning durations, exercise habits and maintaining healthy weight status may indirectly contribute to academic success via better physical fitness in children.

Current Status and Future Trends of Diversity Initiatives in the Workplace: Diversity Experts' Perspective.

ERIC Educational Resources Information Center

Wentling, Rose Mary; Palma-Rivas, Nilda

1998-01-01

In-depth interviews with 12 diversity experts identified organizational and individual barriers inhibiting development of a diverse workforce. Primary reasons for diversity initiatives included improving productivity, enhancing social responsibility, and addressing legal concerns. (SK)

Early Post Traumatic Seizures in Military Personnel Result in Long Term Disability

DTIC Science & Technology

2013-10-01

contusional versus non-contusional). The seizures occurred repeatedly in nearly ¼ of patients are 1/3 of those with seizures had status epilepticus . In...a seizure or status epilepticus occurs within the initial 3 days. Electrographic epileptiform activity will be categorized as follows: Type of...increases of 50% above the baseline value of any of these quantitative measures. A standardized protocol to treat status epilepticus as well as dosage

The Limitations of Diazepam as a Treatment for Nerve Agent-Induced Seizures and Neuropathology in Rats: Comparison with UBP302

DTIC Science & Technology

2014-11-01

to nerve agents induces prolonged status epilepticus (SE), causing brain damage or death. Diazepam (DZP) is the cur- rent US Food and Drug... status epilepticus (SE), which are initiated by the excessive stimulation of cholinergic receptors. If immediate death is prevented by adequate...5-yl)ethyl] decahydroisoquinoline-3-carboxylic acid; PBS, phosphate-buffered saline; SE, status epilepticus ; UBP302, (S)-3-(2-carboxybenzyl

Status Report on Speech Research: A Report on the Status and Progress of Studies on the Nature of Speech, Instrumentation for Its Investigation, and Practical Applications, January 1-March 31, 1977.

ERIC Educational Resources Information Center

Haskins Labs., New Haven, CT.

This report is one of a regular series about the status and progress of studies on the nature of speech, instrumentation for its investigation, and practical applications. The 11 papers discuss the dissociation of spectral and temporal cues to the voicing distinction in initial stopped consonants; perceptual integration and selective attention in…

Electrically heated particulate filter restart strategy

DOEpatents

Gonze, Eugene V [Pinckney, MI; Ament, Frank [Troy, MI

2011-07-12

A control system that controls regeneration of a particulate filter is provided. The system generally includes a propagation module that estimates a propagation status of combustion of particulate matter in the particulate filter. A regeneration module controls current to the particulate filter to re-initiate regeneration based on the propagation status.

77 FR 64959 - Endangered and Threatened Species; Initiation of 5-Year Review for the Southern Distinct...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-24

... North American Green Sturgeon AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and...: Chris Yates, ATTN: Green Sturgeon Status Review, National Marine Fisheries Service, Southwest Region... determination or most recent status review. Categories of requested information include: (1) Species biology...

75 FR 39957 - Extension of the Initial Registration Period for Haitians Under the Temporary Protected Status...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-13

... DEPARTMENT OF HOMELAND SECURITY U.S. Citizenship and Immigration Services [CIS No. 2491-10; DHS... the Temporary Protected Status Program AGENCY: U.S. Citizenship and Immigration Services, DHS. ACTION..., Service Center Operations Directorate, U.S. Citizenship and Immigration Services, Department of Homeland...

8 CFR 245a.33 - Filing.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS ADJUSTMENT OF STATUS TO THAT OF PERSONS ADMITTED FOR LAWFUL TEMPORARY OR PERMANENT RESIDENT STATUS UNDER SECTION 245A OF THE IMMIGRATION AND... notice to appear until 90 days from the date of the initial denial, to allow the alien the opportunity to...

Prehospital Use of Plasma for Traumatic Hemorrhage

DTIC Science & Technology

2013-06-01

Treatment Trials Network which h as trialed pre-hospital use of midazolam autoinjection for status epilepticus and is tria ling the use of in travenous...history and current status . J Trauma 2011; 70:811-12. 48. Ogilvie MP, Ryan ML, Proctor KG. Hetastarch during initial resuscitation from trauma. J

78 FR 70525 - Endangered and Threatened Wildlife and Plants; Initiation of Status Review of Arctic Grayling in...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-26

... Arctic grayling on or before September 30, 2014. For additional information on the biology or previous...: (1) General information concerning the taxonomy, biology, ecology, genetics, and status of the Arctic...) Habitat requirements for feeding, breeding, and sheltering, including particular physical or biological...

Status, Endorsement and the Legitimacy of Deviance

ERIC Educational Resources Information Center

Younts, C. Wesley

2008-01-01

This research investigates one process through which deviance becomes legitimate and therefore expected of individuals within a group. On the one hand, the status of an individual initially suggesting deviance affects others' personal beliefs that deviance is proper, and in turn the likelihood that they will enact and transmit deviance to new…

Held in contempt: the psychological, interpersonal, and performance consequences of contempt in a work context.

PubMed

Melwani, Shimul; Barsade, Sigal G

2011-09-01

Guided by a social function of emotions perspective, the authors examined a model of the psychological, interpersonal, and performance consequences of contempt in a series of 3 experiments that tested the outcomes of being a recipient of contempt in the work domain. In these experiments, participants engaged in a business strategy simulation with a virtual partner-a computer programmed to give contemptuous and other types of feedback. In Study 1, which examined the task performance and interpersonal outcomes of contempt, recipients of contempt had significantly better task performance but also significantly more interpersonal aggressiveness toward their virtual partners compared with recipients of failure, angry, or neutral feedback. Study 2 examined 3 psychological outcomes mediating the contempt-task performance/aggression relationship: self-esteem, returned feelings of contempt, and activation levels. Lowered levels of implicit self-esteem and greater levels of activation significantly mediated the relationship between receiving contempt and task performance, whereas the contempt-aggression relationship was mediated by lowered implicit self-esteem and increased feelings of returned contempt. Study 3 examined status as a moderator of these relationships. Low-status recipients had significantly better task performance than did equal-status recipients, who performed significantly better than did the high-status recipients of contempt. In addition, low-status recipients displayed significantly lower levels of aggression in response to contempt than did equal-status and high-status recipients. PsycINFO Database Record (c) 2011 APA, all rights reserved.

A national cohort study of parental socioeconomic status and non-fatal suicidal behaviour-the mediating role of school performance

PubMed Central

2012-01-01

Background A link between low parental socioeconomic status and mental health problems in offspring is well established in previous research. The mechanisms that explain this link are largely unknown. The present study investigated whether school performance was a mediating and/or moderating factor in the path between parental socioeconomic status and the risk of hospital admission for non-fatal suicidal behaviour. Methods A national cohort of 447 929 children born during 1973-1977 was followed prospectively in the National Patient Discharge Register from the end of their ninth and final year of compulsory school until 2001. Multivariate Cox proportional hazards and linear regression analyses were performed to test whether the association between parental socioeconomic status and non-fatal suicidal behaviour was mediated or moderated by school performance. Results The results of a series of multiple regression analyses, adjusted for demographic variables, revealed that school performance was as an important mediator in the relationship between parental socioeconomic status and risk of non-fatal suicidal behaviour, accounting for 60% of the variance. The hypothesized moderation of parental socioeconomic status-non-fatal suicidal behaviour relationship by school performance was not supported. Conclusions School performance is an important mediator through which parental socioeconomic status translates into a risk for non-fatal suicidal behaviour. Prevention efforts aimed to reduce socioeconomic inequalities in non-fatal suicidal behaviour among young people will need to consider socioeconomic inequalities in school performance. PMID:22230577

Treatment strategies in colorectal cancer patients with initially unresectable liver-only metastases, a study protocol of the randomised phase 3 CAIRO5 study of the Dutch Colorectal Cancer Group (DCCG).

PubMed

Huiskens, Joost; van Gulik, Thomas M; van Lienden, Krijn P; Engelbrecht, Marc R W; Meijer, Gerrit A; van Grieken, Nicole C T; Schriek, Jonne; Keijser, Astrid; Mol, Linda; Molenaar, I Quintus; Verhoef, Cornelis; de Jong, Koert P; Dejong, Kees H C; Kazemier, Geert; Ruers, Theo M; de Wilt, Johanus H W; van Tinteren, Harm; Punt, Cornelis J A

2015-05-06

Colorectal cancer patients with unresectable liver-only metastases may be cured after downsizing of metastases by neoadjuvant systemic therapy. However, the optimal neoadjuvant induction regimen has not been defined, and the lack of consensus on criteria for (un)resectability complicates the interpretation of published results. CAIRO5 is a multicentre, randomised, phase 3 clinical study. Colorectal cancer patients with initially unresectable liver-only metastases are eligible, and will not be selected for potential resectability. The (un)resectability status is prospectively assessed by a central panel consisting of at least one radiologist and three liver surgeons, according to predefined criteria. Tumours of included patients will be tested for RAS mutation status. Patients with RAS wild type tumours will be treated with doublet chemotherapy (FOLFOX or FOLFIRI) and randomised between the addition of either bevacizumab or panitumumab, and patients with RAS mutant tumours will be randomised between doublet chemotherapy (FOLFOX or FOLFIRI) plus bevacizumab or triple chemotherapy (FOLFOXIRI) plus bevacizumab. Radiological evaluation to assess conversion to resectability will be performed by the central panel, at an interval of two months. The primary study endpoint is median progression-free survival. Secondary endpoints are the R0/1 resection rate, median overall survival, response rate, toxicity, pathological response of resected lesions, postoperative morbidity, and correlation of baseline and follow-up evaluation with respect to outcomes by the central panel. CAIRO5 is a prospective multicentre trial that investigates the optimal systemic induction therapy for patients with initially unresectable, liver-only colorectal cancer metastases. CAIRO 5 is registered at European Clinical Trials Database (EudraCT) (2013-005435-24). CAIRO 5 is registered at ClinicalTrials.gov: NCT02162563 , June 10, 2014.

Spatiotemporal, kinematic, and kinetic effects of a peroneal nerve stimulator versus an ankle foot orthosis in hemiparetic gait.

PubMed

Sheffler, Lynne R; Bailey, Stephanie Nogan; Wilson, Richard D; Chae, John

2013-06-01

The relative effect of a transcutaneous peroneal nerve stimulator (tPNS) and an ankle foot orthosis (AFO) on spatiotemporal, kinematic, and kinetic parameters of hemiparetic gait has not been well described. To compare the relative neuroprosthetic effect of a tPNS with the orthotic effect of an AFO using quantitative gait analysis (QGA). In all, 12 stroke survivors underwent QGA under 3 device conditions: (1) no device (ND), (2) AFO, and (3) tPNS. A series of repeated-measures analyses of variance (rmANOVAs) were performed with dorsiflexion status (presence or absence of volitional dorsiflexion) as a covariate to compare selected spatiotemporal, kinematic, and kinetic parameters for each device condition. Post hoc pairwise comparisons and/or subset analysis by dorsiflexion status were performed for significant effect. Stride length was improved with both the AFO (P = .035) and the tPNS (P = .029) relative to ND. Those with absent dorsiflexion had longer stride length with the tPNS relative to ND (P = .034) and a higher walking velocity with a tPNS relative to the AFO (P = .015). There was no device effect on dorsiflexion angle at initial contact; however, a significant Device × Dorsiflexion status interaction effect favored the AFO relative to ND (P = .025) in those with dorsiflexion present. This study suggests that level of motor impairment may influence the relative effects of the tPNS and AFO devices in chronic hemiparetic gait; however, the small sample size limits generalizability. Future studies are necessary to determine if motor impairment level should be considered in the clinical prescription of these devices.

New method for predicting estrogen receptor status utilizing breast MRI texture kinetic analysis

NASA Astrophysics Data System (ADS)

Chaudhury, Baishali; Hall, Lawrence O.; Goldgof, Dmitry B.; Gatenby, Robert A.; Gillies, Robert; Drukteinis, Jennifer S.

2014-03-01

Magnetic Resonance Imaging (MRI) of breast cancer typically shows that tumors are heterogeneous with spatial variations in blood flow and cell density. Here, we examine the potential link between clinical tumor imaging and the underlying evolutionary dynamics behind heterogeneity in the cellular expression of estrogen receptors (ER) in breast cancer. We assume, in an evolutionary environment, that ER expression will only occur in the presence of significant concentrations of estrogen, which is delivered via the blood stream. Thus, we hypothesize, the expression of ER in breast cancer cells will correlate with blood flow on gadolinium enhanced breast MRI. To test this hypothesis, we performed quantitative analysis of blood flow on dynamic contrast enhanced MRI (DCE-MRI) and correlated it with the ER status of the tumor. Here we present our analytic methods, which utilize a novel algorithm to analyze 20 volumetric DCE-MRI breast cancer tumors. The algorithm generates post initial enhancement (PIE) maps from DCE-MRI and then performs texture features extraction from the PIE map, feature selection, and finally classification of tumors into ER positive and ER negative status. The combined gray level co-occurrence matrices, gray level run length matrices and local binary pattern histogram features allow quantification of breast tumor heterogeneity. The algorithm predicted ER expression with an accuracy of 85% using a Naive Bayes classifier in leave-one-out cross-validation. Hence, we conclude that our data supports the hypothesis that imaging characteristics can, through application of evolutionary principles, provide insights into the cellular and molecular properties of cancer cells.

Overcoming Bias: Cognitive Control Reduces Susceptibility to Framing Effects in Evaluating Musical Performance.

PubMed

Aydogan, Gökhan; Flaig, Nicole; Ravi, Srekar N; Large, Edward W; McClure, Samuel M; Margulis, Elizabeth Hellmuth

2018-04-18

Prior expectations can bias evaluative judgments of sensory information. We show that information about a performer's status can bias the evaluation of musical stimuli, reflected by differential activity of the ventromedial prefrontal cortex (vmPFC). Moreover, we demonstrate that decreased susceptibility to this confirmation bias is (a) accompanied by the recruitment of and (b) correlated with the white-matter structure of the executive control network, particularly related to the dorsolateral prefrontal cortex (dlPFC). By using long-duration musical stimuli, we were able to track the initial biasing, subsequent perception, and ultimate evaluation of the stimuli, examining the full evolution of these biases over time. Our findings confirm the persistence of confirmation bias effects even when ample opportunity exists to gather information about true stimulus quality, and underline the importance of executive control in reducing bias.

Evaluation of performance of the MACAO systems at the VLTI

NASA Astrophysics Data System (ADS)

Rengaswamy, Sridharan; Haguenauer, Pierre; Brillant, Stephane; Cortes, Angela; Girard, Julien H.; Guisard, Stephane; Paufique, Jérôme; Pino, Andres

2010-07-01

Multiple Application Curvature Adaptive Optics (MACAO) systems are used at the coudé focus of the unit telescopes (UTs) at the La-Silla Paranal Observatory, Paranal, to correct for the wave-front aberrations induced by the atmosphere. These systems are in operation since 2005 and are designed to provide beams with 10 mas residual rms tip-tilt error to the VLTI laboratory. We have initiated several technical studies such as measuring the Strehl ratio of the images recorded at the guiding camera of the VLTI, establishing the optimum setup of the MACAO to get collimated and focused beam down to the VLTI laboratory and to the instruments, and ascertaining the data generated by the real time computer, all aimed at characterizing and improving the overall performance of these systems. In this paper we report the current status of these studies.

Pregnant women with HIV in rural Nigeria have higher rates of antiretroviral treatment initiation, but similar loss to follow-up as non-pregnant women and men.

PubMed

Aliyu, Muktar H; Blevins, Meridith; Megazzini, Karen M; Parrish, Deidra D; Audet, Carolyn M; Chan, Naomi; Odoh, Chisom; Gebi, Usman I; Muhammad, Mukhtar Y; Shepherd, Bryan E; Wester, C William; Vermund, Sten H

2015-11-01

We examined antiretroviral therapy (ART) initiation and retention by sex and pregnancy status in rural Nigeria. We studied HIV-infected ART-naïve patients aged ≥15 years entering care from June 2009 to September 2013. We calculated the probability of early ART initiation and cumulative incidence of loss to follow-up (LTFU) during the first year of ART, and examined the association between LTFU and sex/pregnancy using Cox regression. The cohort included 3813 ART-naïve HIV-infected adults (2594 women [68.0%], 273 [11.8%] of them pregnant). The proportion of pregnant clients initiating ART within 90 days of enrollment (78.0%, 213/273) was higher than among non-pregnant women (54.3%,1261/2321) or men (53.0%, 650/1219), both p<0.001. Pregnant women initiated ART sooner than non-pregnant women and men (median [IQR] days from enrollment to ART initiation for pregnant women=7 days [0-21] vs 14 days [7-49] for non-pregnant women and 14 days [7-42] for men; p<0.001). Cumulative incidence of LTFU during the first year post-ART initiation was high and did not differ by sex and pregnancy status. Persons who were unemployed, bedridden, had higher CD4+ counts, and/or in earlier WHO clinical stages were more likely to be LTFU. Pregnant women with HIV in rural Nigeria were more likely to initiate ART but were no more likely to be retained in care. Our findings underscore the importance of effective retention strategies across all patient groups, regardless of sex and pregnancy status. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[Quo vadis Therapeutic Health Care Professionals--What do Occupational and Physical Therapists Think about their Future? Results of a Survey throughout Germany].

PubMed

Ketels, G; Schön, G; van den Bussche, H; Barzel, A

2015-11-01

The introduction of occupational and physical therapy as academic disciplines is evidence of radical changes in the therapeutic health care professions. Therapists' professional associations are planning and negotiating both with health insurance companies and with other branches of the health care professions concerning future spheres of activity. In order to find out what the therapists in these professions think about their future, we conducted a survey of physical and occupational therapists through-out Germany. Our findings regarding professional life, job satisfaction, competition and cooperation have already been published. This article presents therapists' assessments of the future of their professions. From May until December 2008 we performed a cross-sectional survey, interviewing physical and occupational therapists throughout Germany. Statements were answered on a 6-step Likert scale; open questions were answered in free-text fields. The evaluation was performed quantitatively; the free texts were also evaluated qualitatively. A total of 3,506 questionnaires were evaluated; 1,273 were completed by occupational therapists and 2,233 by physical therapists. Nearly half of the therapists (n=1,687; 48.4%) used the opportunity to emphasise the need for change. We identified 4,026 statements about 8 general topics: remuneration, employee co-determination, professional recognition, continuing education, cooperation, initial access to the professions, and their academic status. Therapists illustrated certain items in the questionnaire with examples from their professional experience, suggested additional topics, and proposed concrete changes. We document a broad range of opinions and concerns, especially in regard to such subjects concerning the future of the professions as their new academic status and initial access. Physical and occupational therapists are concerned about the future development of their professions. They see a need for change in the following areas: remuneration, employee co-determination, initial access and cooperation as well as in the development of their profession as an academic discipline. Policy makers need to heed therapists' assessments of the state of their professions and their calls for its increased professionalisation. © Georg Thieme Verlag KG Stuttgart · New York.

Smoking Habits of Patients Undergoing Treatment for Intermittent Claudication in the Vascular Quality Initiative.

PubMed

Gabel, Joshua; Jabo, Brice; Patel, Sheela; Kiang, Sharon; Bianchi, Christian; Chiriano, Jason; Teruya, Theodore; Abou-Zamzam, Ahmed M

2017-10-01

Society for Vascular Surgery practice guidelines for the medical treatment of intermittent claudication give a GRADE 1A recommendation for smoking cessation. Active smoking is therefore expected to be low in patients suffering from intermittent claudication selected for vascular surgical intervention. The aim of this study is to evaluate the prevalence of smoking in patients undergoing intervention for intermittent claudication at the national level and to determine the relationship between smoking status and intervention. The Vascular Quality Initiative (VQI) registries for infra-inguinal bypass, supra-inguinal bypass, and peripheral vascular intervention (PVI) were queried to identify patients who underwent invasive treatment for intermittent claudication. Patient factors, procedure type (bypass versus PVI), and level of disease (supra-inguinal versus infra-inguinal) were evaluated for associations with smoking status (active smoking or nonsmoking) by univariate and covariate analysis. Between 2010 and 2015, 101,055 procedures were entered in the 3 registries, with 40,269 (40%) performed for intermittent claudication. Complete data for analysis were present in 37,632 cases. At the time of intervention, 44% of patients were active smokers, with wide variation by regional quality group (16-53%). In covariate analysis, active smoking at treatment was associated with age <70 years (prevalence ratio [PR] 2.42), male gender (PR 1.03), chronic obstructive pulmonary disease (PR 1.35), absence of prior cardiovascular procedures (PR 1.15), poor medication usage (PR 1.10), preoperative ankle-brachial index (ABI) <0.9 (PR 1.19), and supra-inguinal disease (PR 1.14). Invasiveness of treatment (PVI versus bypass procedures) was not significantly associated with smoking status. During follow-up, 36% of patients had quit smoking. Predictors of smoking cessation included age ≥70 years (RR 1.45), ABI ≥0.9 (RR 1.12), and bypass procedures (RR 1.22). At the time of treatment, 44% of patients undergoing intervention for intermittent claudication in the VQI were active smokers and there was a wide regional variation. Prevalence of active smoking was greater in the presence of younger age, fewer comorbidities, lower ABI, and supra-inguinal disease. Type of procedure performed, and in turn level of invasiveness required, did not appear to be influenced by smoking status. Elderly patients and those undergoing open procedures were more likely to quit smoking during follow up. These findings suggest opportunities for greater smoking cessation efforts before invasive therapies for intermittent claudication. Copyright © 2017 Elsevier Inc. All rights reserved.

Factors associated with retention in Option B+ in Malawi: a case control study.

PubMed

Hoffman, Risa M; Phiri, Khumbo; Parent, Julie; Grotts, Jonathan; Elashoff, David; Kawale, Paul; Yeatman, Sara; Currier, Judith S; Schooley, Alan

2017-04-27

There are limited data on factors associated with retention in Option B+. We sought to explore the characteristics of women retained in Option B+ in Malawi, with a focus on the role of HIV disclosure, awareness of partner HIV status, and knowledge around the importance of Option B+ for maternal-child health. Methods We performed a case-control study of HIV-infected women in Malawi initiated on antiretroviral therapy (ART) under Option B+. Cases were enrolled if they met criteria for default from Option B+ (out of ART for >60 days), and controls were enrolled in approximately 3:1 ratio if they were retained in care for at least 12 months. We surveyed socio-demographic characteristics, HIV disclosure and awareness of partner HIV status, self-report about receiving pre-ART education, and knowledge of Option B+. Univariate logistic regression was performed to determine factors associated with retention. Multivariate logistic regression model was used to evaluate the relationship between HIV disclosure, Option B+ knowledge, and retention after adjusting for age, schooling, and travel time to clinic. We enrolled 50 cases and 153 controls. Median age was 30 years (interquartile range (IQR) 25-34), and the majority (82%) initiated ART during pregnancy at a median gestational age of 24 weeks (IQR 16-28). Ninety-one per cent of the cases (39/43) who started ART during pregnancy defaulted by three months postpartum. HIV disclosure to the primary sex partner was more common among women retained in care (100% versus 78%, p  < 0.001). Odds of retention were significantly higher among women with: age >25 years (odds ratio (OR) 2.44), completion of primary school (OR 3.06), awareness of partner HIV status (OR 5.20), pre-ART education (OR 6.17), higher number of correct answers to Option B+ knowledge questions (OR 1.82), and support while taking ART (OR 3.65). Pre-ART education and knowledge were significantly correlated ( r  = 0.43, p  < 0.001). In multivariate analysis, awareness of partner HIV status (OR 4.07, 95% confidence interval (CI) 1.51-10.94, p  = 0.02) and Option B+ knowledge (OR 1.60, 95% CI 1.15-2.23, p  = 0.004) remained associated with retention. Interventions that address partner disclosure and strengthen pre-ART education around the benefits of ART for maternal and child health should be evaluated to improve retention in Malawi's Option B+ programme.

Factors associated with retention in Option B+ in Malawi: a case control study

PubMed Central

Hoffman, Risa M; Phiri, Khumbo; Parent, Julie; Grotts, Jonathan; Elashoff, David; Kawale, Paul; Yeatman, Sara; Currier, Judith S; Schooley, Alan

2017-01-01

Abstract Introduction: There are limited data on factors associated with retention in Option B+. We sought to explore the characteristics of women retained in Option B+ in Malawi, with a focus on the role of HIV disclosure, awareness of partner HIV status, and knowledge around the importance of Option B+ for maternal–child health. Methods: We performed a case-control study of HIV-infected women in Malawi initiated on antiretroviral therapy (ART) under Option B+. Cases were enrolled if they met criteria for default from Option B+ (out of ART for >60 days), and controls were enrolled in approximately 3:1 ratio if they were retained in care for at least 12 months. We surveyed socio-demographic characteristics, HIV disclosure and awareness of partner HIV status, self-report about receiving pre-ART education, and knowledge of Option B+. Univariate logistic regression was performed to determine factors associated with retention. Multivariate logistic regression model was used to evaluate the relationship between HIV disclosure, Option B+ knowledge, and retention after adjusting for age, schooling, and travel time to clinic. Results: We enrolled 50 cases and 153 controls. Median age was 30 years (interquartile range (IQR) 25–34), and the majority (82%) initiated ART during pregnancy at a median gestational age of 24 weeks (IQR 16–28). Ninety-one per cent of the cases (39/43) who started ART during pregnancy defaulted by three months postpartum. HIV disclosure to the primary sex partner was more common among women retained in care (100% versus 78%, p < 0.001). Odds of retention were significantly higher among women with: age >25 years (odds ratio (OR) 2.44), completion of primary school (OR 3.06), awareness of partner HIV status (OR 5.20), pre-ART education (OR 6.17), higher number of correct answers to Option B+ knowledge questions (OR 1.82), and support while taking ART (OR 3.65). Pre-ART education and knowledge were significantly correlated (r = 0.43, p < 0.001). In multivariate analysis, awareness of partner HIV status (OR 4.07, 95% confidence interval (CI) 1.51–10.94, p = 0.02) and Option B+ knowledge (OR 1.60, 95% CI 1.15–2.23, p = 0.004) remained associated with retention. Conclusions: Interventions that address partner disclosure and strengthen pre-ART education around the benefits of ART for maternal and child health should be evaluated to improve retention in Malawi’s Option B+ programme. PMID:28453243

Social cognition and African American men: The roles of perceived discrimination and experimenter race on task performance.

PubMed

Nagendra, Arundati; Twery, Benjamin L; Neblett, Enrique W; Mustafic, Hasan; Jones, Tevin S; Gatewood, D'Angelo; Penn, David L

2018-01-01

The Social Cognition Psychometric Evaluation (SCOPE) study consists of a battery of eight tasks selected to measure social-cognitive deficits in individuals with schizophrenia. The battery is currently in a multisite validation process. While the SCOPE study collects basic demographic data, more nuanced race-related factors might artificially inflate cross-cultural differences in social cognition. As an initial step, we investigated whether race, independent of mental illness status, affects performance on the SCOPE battery. Thus, we examined the effects of perceived discrimination and experimenter race on the performance of 51 non-clinical African American men on the SCOPE battery. Results revealed that these factors impacted social cognitive task performance. Specifically, participants performed better on a skills-based task factor in the presence of Black experimenters, and frequency of perceived racism predicted increased perception of hostility in negative interpersonal situations with accidental causes. Thus, race-related factors are important to identify and explore in the measurement of social cognition in African Americans. Copyright © 2017 Elsevier B.V. All rights reserved.

Supervision and computerized neurocognitive baseline test performance in high school athletes: an initial investigation.

PubMed

Kuhn, Andrew Warren; Solomon, Gary S

2014-01-01

Computerized neuropsychological testing batteries have provided a time-efficient and cost-efficient way to assess and manage the neurocognitive aspects of patients with sport-related concussion. These tests are straightforward and mostly self-guided, reducing the degree of clinician involvement required by traditional clinical neuropsychological paper-and-pencil tests. To determine if self-reported supervision status affected computerized neurocognitive baseline test performance in high school athletes. Retrospective cohort study. Supervised testing took place in high school computer libraries or sports medicine clinics. Unsupervised testing took place at the participant's home or another location with computer access. From 2007 to 2012, high school athletes across middle Tennessee (n = 3771) completed computerized neurocognitive baseline testing (Immediate Post-Concussion Assessment and Cognitive Testing [ImPACT]). They reported taking the test either supervised by a sports medicine professional or unsupervised. These athletes (n = 2140) were subjected to inclusion and exclusion criteria and then matched based on age, sex, and number of prior concussions. We extracted demographic and performance-based data from each de-identified baseline testing record. Paired t tests were performed between the self-reported supervised and unsupervised groups, comparing the following ImPACT baseline composite scores: verbal memory, visual memory, visual motor (processing) speed, reaction time, impulse control, and total symptom score. For differences that reached P < .05, the Cohen d was calculated to measure the effect size. Lastly, a χ(2) analysis was conducted to compare the rate of invalid baseline testing between the groups. All statistical tests were performed at the 95% confidence interval level. Self-reported supervised athletes demonstrated better visual motor (processing) speed (P = .004; 95% confidence interval [0.28, 1.52]; d = 0.12) and faster reaction time (P < .001; 95% confidence interval [-0.026, -0.014]; d = 0.21) composite scores than self-reported unsupervised athletes. Speed-based tasks were most affected by self-reported supervision status, although the effect sizes were relatively small. These data lend credence to the hypothesis that supervision status may be a factor in the evaluation of ImPACT baseline test scores.

Seizures and epilepsy in hypoglycaemia caused by inborn errors of metabolism.

PubMed

Gataullina, Svetlana; Delonlay, Pascale; Lemaire, Eric; Boddaert, Nathalie; Bulteau, Christine; Soufflet, Christine; Laín, Gemma Aznar; Nabbout, Rima; Chiron, Catherine; Dulac, Olivier

2015-02-01

The aim of the study was to characterize seizures and epilepsy related to hypoglycaemia. We analyzed the files of 170 consecutive patients referred for hypoglycaemia (onset 1h to 4y) caused by inborn errors of metabolism (glycogen storage disease type I, fatty acid β-oxidation disorders, and hyperinsulinism). Ninety patients (42 males and 48 females; 38 neonates and 52 infants/children) had brief hypoglycaemic seizures (68%) or status epilepticus (32%). Status epilepticus occurred earlier (mean 1.4d) than brief neonatal seizures (4.3d, p=0.02). Recurrent status epilepticus followed initial status epilepticus and was often triggered by fever. Epilepsy developed in 21 patients. In 18 patients, epilepsy followed hypoglycaemic status epilepticus and began with shorter delay when associated with grey matter lesions (1.9mo, standard error of the mean [SEM] 1mo) than with white matter damage (3.3y [SEM 1y], p=0.003). Three patients with hyperinsulinism developed idiopathic epilepsy following brief neonatal seizures. Brief neonatal hyperinsulinaemic hypoglycaemic seizures have characteristics of idiopathic neonatal seizures. Neonatal status epilepticus should be prevented by the systematic measurement of glucose blood level. Recurrent seizures never consist of status epilepticus when following brief initial seizures. Epilepsy is symptomatic of brain damage with shorter delay in the case of grey rather than white matter lesions, except in a few idiopathic cases in which epilepsy and hyperinsulinism may share a common genetic background. © 2014 Mac Keith Press.

Brazilian version of the Functional Status Score for the ICU: translation and cross-cultural adaptation

PubMed Central

da Silva, Vinicius Zacarias Maldaner; de Araújo Neto, Jose Aires; Cipriano Jr., Gerson; Pinedo, Mariela; Needham, Dale M.; Zanni, Jennifer M.; Guimarães, Fernando Silva

2017-01-01

Objective The aim of the present study was to translate and cross-culturally adapt the Functional Status Score for the intensive care unit (FSS-ICU) into Brazilian Portuguese. Methods This study consisted of the following steps: translation (performed by two independent translators), synthesis of the initial translation, back-translation (by two independent translators who were unaware of the original FSS-ICU), and testing to evaluate the target audience's understanding. An Expert Committee supervised all steps and was responsible for the modifications made throughout the process and the final translated version. Results The testing phase included two experienced physiotherapists who assessed a total of 30 critical care patients (mean FSS-ICU score = 25 ± 6). As the physiotherapists did not report any uncertainties or problems with interpretation affecting their performance, no additional adjustments were made to the Brazilian Portuguese version after the testing phase. Good interobserver reliability between the two assessors was obtained for each of the 5 FSS-ICU tasks and for the total FSS-ICU score (intraclass correlation coefficients ranged from 0.88 to 0.91). Conclusion The adapted version of the FSS-ICU in Brazilian Portuguese was easy to understand and apply in an intensive care unit environment. PMID:28444070

Corticospinal tract integrity and lesion volume play different roles in chronic hemiparesis and its improvement through motor practice.

PubMed

Sterr, Annette; Dean, Phil J A; Szameitat, Andre J; Conforto, Adriana Bastos; Shen, Shan

2014-05-01

Initial evidence suggests that the integrity of the ipsilesional corticospinal tract (CST) after stroke is strongly related to motor function in the chronic state but not the treatment gain induced by motor rehabilitation. We examined the association of motor status and treatment benefit by testing patients with a wide range of severity of hemiparesis of the left and right upper extremity. Diffusion tensor imaging was performed in 22 patients beyond 12 months after onset of stroke with severe to moderate hemiparesis. Motor function was tested before and after 2 weeks of modified constraint-induced movement therapy. CST integrity, but not lesion volume, correlated with the motor ability measures of the Wolf Motor Function Test and the Motor Activity Log. No differences were found between left and right hemiparesis. Motor performance improved significantly with the treatment regime, and did so equally for patients with left and right arm paresis. However, treatment benefit was not associated with either CST integrity or lesion volume. CST integrity correlated best in this small trial with chronic long-term status but not treatment-induced improvements. The CST may play a different role in the mechanisms mediating long-term outcome compared to those underlying practice-induced gains after a chronic plateau in motor function.

Low vitamin D status is associated with reduced muscle mass and impaired physical performance in frail elderly people.

PubMed

Tieland, M; Brouwer-Brolsma, E M; Nienaber-Rousseau, C; van Loon, L J C; De Groot, L C P G M

2013-10-01

Serum 25-hydroxyvitamin D (25(OH)D) status has been associated with muscle mass, strength and physical performance in healthy elderly people. Yet, in pre-frail and frail elderly people this association has not been studied. The objective of this study was to explore the association between vitamin D intake and serum 25(OH)D status with muscle mass, strength and physical performance in a pre-frail and frail elderly population. This cross-sectional study included 127 pre-frail and frail elderly people in The Netherlands. Whole body and appendicular lean mass (ALM) (dual energy X-ray absorptiometry), leg strength (one repetition maximum), handgrip strength and physical performance (short physical performance battery) were measured, and blood samples were collected for the assessment of serum 25(OH)D status (liquid chromatography-tandem mass spectrometry). In addition, habitual dietary intake (3-day food records) and physical activity data (accelerometers) were collected. In total, 53% of the participants had a serum 25(OH)D level below 50  nmol/l. After adjustment for confounding factors, 25(OH)D status was associated with ALM (β=0.012, P=0.05) and with physical performance (β=0.020, P<0.05). Vitamin D intake was associated with physical performance (β=0.18, P<0.05) but not with ALM (P>0.05). In this frail elderly population, 25(OH)D status is low and suggests a modest association with reduced ALM and impaired physical performance. In addition, vitamin D intake tended to be associated with impaired physical performance. Our findings highlight the need for well-designed intervention trials to assess the impact of vitamin D supplementation on 25(OH)D status, muscle mass and physical performance in pre-frail and frail elderly people.

Influence of educational status on executive function and functional balance in individuals with Parkinson disease.

PubMed

Souza, Carolina de Oliveira; Voos, Mariana Callil; Francato, Débora Valente; Chien, Hsin Fen; Barbosa, Egberto Reis

2013-03-01

This study investigated whether educational status influenced how people with Parkinson disease (PD) performed on Parts A, B, and DELTA of the Trail Making Test (TMT) and on the Berg Balance Scale (BBS). Recent studies have shown that educational status may influence cognitive and motor test performance. We gave the TMT and the BBS to assess executive function and functional balance in 28 people with PD (Hoehn and Yahr score between 2 and 3) and 30 healthy elderly people. Participants reported their number of years of formal education. We divided each group of participants by educational status: low (4 to 10 years of education) or high (≥11 years). In both the PD (P=0.018) and control (P=0.003) groups, participants with low educational status performed worse on the TMT Part B than did those with high educational status. Within the PD group, the less-educated participants scored worse on the BBS than did the more educated (P<0.001); this difference was not significant between the more- and less-educated controls (P=0.976). Whether or not they had PD, less-educated people performed worse than more-educated people on the TMT Part B. Educational status affected executive function, but PD status did not. Among individuals with PD, educational status influenced functional balance.

A contemporary review of management and prognostic factors of upper tract urothelial carcinoma.

PubMed

Leow, Jeffrey J; Orsola, Anna; Chang, Steven L; Bellmunt, Joaquim

2015-04-01

Upper tract urothelial carcinoma (UTUC) accounts for <5% of all urothelial cancers. Although the main treatment is radical nephroureterectomy (NU), oncologic outcomes are not comparable to lower tract urothelial cancers. Identifying prognostic factors can help guide management and potentially improve outcomes. This article systematically reviews current literature on prognostic factors and management options for UTUC. A comprehensive literature search was performed to identify all studies examining prognostic factors and management options for UTUC. The search included the Medline, Embase, Cochrane Central Register of Controlled Trials databases, and abstracts from the American Society of Clinical Oncology meetings up to November 2014. An updated systematic review was performed. Preoperative prognostic factors for UTUC patients include age, race, performance status, obesity, smoking status, elevated fibrinogen levels, hydronephrosis, tumor size, multi-focality, location, clinical grade and previous/synchronous bladder cancer. Postoperative variables include tumor stage/grade, multifocality, nodal involvement, lympho-vascular invasion, initial ureteral location, necrosis, sessile architecture, variant histologies and presence of tissue ALDH1 and SOX2. Curative treatment of choice is NU, with lymphadenectomy conferring survival benefits. Minimally invasive surgery has equivalent oncologic and better peri-operative outcomes compared to open surgery. Conservative therapy includes adjuvant BCG and intravesical mitomycin C. Two randomized trials investigating postoperative instillation of mitomycin C suggest bladder recurrence benefits. Adjuvant chemo-radiotherapy may be useful for patients with advanced T3/4 and/or N+ disease. Gold-standard treatment for UTUC remains NU, increasingly performed using minimally invasive surgery. Nomograms including pre- and post-operative variables can aid prognostication and guide further therapy. Copyright © 2015 Elsevier Ltd. All rights reserved.

Initial blood storage experiment

NASA Technical Reports Server (NTRS)

Surgenor, Douglas MACN.

1988-01-01

The design of the Initial Blood Storage Experiment (IBSE) was based upon a carefully controlled comparison between identical sets of human blood cell suspensions - red cells, white cell, and platelets - one set of which was transported aboard the Columbia on a 6 day 11 hour mission, and the other held on the ground. Both sets were carried inside stainless steel dewars within specially fabricated flight hardware. Individual bags of cell suspensions were randomly assigned with respect to ground vs orbit status, dewar chamber, and specific location within the dewar. To foster optimal preservation, each cell type was held under specific optimal conditions of pH, ionic strength, solute concentration, gas tension, and temperature. An added variable in this initial experiment was provided by the use of three different polymer/plasticizer formulations for the sealed bags which held the blood cells. At termination of the experiment, aliquots of the suspensions, identified only by code, were distributed to be assayed. Assays were selected to constitute a broad survey of cellular properties and thereby maximize the chances of detection of gravitational effects. A total of 74 different outcome measurements were reported for statistical analysis. When the measurements were completed, the results were entered into the IBSE data base, at which time the data were matched with the original blood bag numbers to determine their status with respect to polymer/plasticizer type, orbit status (orbit or ground), and storage position within the experimental hardware. The data were studied by analysis of variance. Initially, type of bag and orbital status were main factors; later more detailed analyses were made on specific issues such as position in the hardware and specific plastic. If the analysis of variance indicated a statistical significance at the 5 percent level the corresponding p-value was reported.

Menopausal status and physical performance in middle aged women: a cross-sectional community-based study in Northeast Brazil.

PubMed

da Câmara, Saionara M A; Zunzunegui, Maria Victoria; Pirkle, Catherine; Moreira, Mayle A; Maciel, Álvaro C C

2015-01-01

To examine associations between menopausal status and physical performance in middle-aged women from the Northeast region of Brazil. Cross-sectional study of women between 40 to 65 years old living in Parnamirim. Women were recruited by advertisements in primary care neighborhood centers across the city. Physical performance was assessed by grip strength, gait speed and chair stands. Menopausal status was determined using the Stages of Reproductive Aging Workshop classification and women were classified in: premenopausal, perimenopausal or postmenopausal. Multiple linear regression analyses were performed to model the effect of menopausal status on each physical performance measure, adjusting for covariates (age, family income, education, body mass index, parity and age at first birth). The premenopausal women were significantly stronger and performed better in chair stands than perimenopausal and postmenopausal women. Gait speed did not vary significantly by menopausal status. In multivariate analyses, menopausal status remained statistically significant only for grip strength. In fully adjusted analyses, premenopausal women had grip strength mean of 2.226 Kgf (95% CI: 0.361 - 4.091) higher than the postmenopausal group. This study provides further evidence for the associations between menopause and physical performance in middle-aged women, since grip strength is weaker in peri and postmenopausal women compared to premenopausal, even adjusted for age and other covariates.

Early Post Traumatic Seizures in Military Personnel Result in Long Term Disability

DTIC Science & Technology

2012-10-01

occurred repeatedly in nearly ¼ of patients are 1/3 of those with seizures had status epilepticus . In over ½ of the patients, the seizures were...hours). Monitoring will be done for the initial 3 days if no seizures occur or as long as needed if a seizure or status epilepticus occurs within the...these quantitative measures. A standardized protocol to treat status epilepticus as well as dosage adjustment of anticonvulsants and duration of

Tocilizumab treatment leads to improvement in disease activity regardless of CCP status in rheumatoid arthritis.

PubMed

Cappelli, Laura C; Palmer, Judy Lynn; Kremer, Joel; Bingham, Clifton O

2017-10-01

Autoantibodies can be useful in predicting response to certain treatments in rheumatoid arthritis (RA). We aimed to evaluate initial response to tocilizumab (TCZ) by change in physician and patient-reported outcomes and laboratory parameters in a real-world cohort of patients with RA. We analyzed the data by autoantibody status to determine whether patients with seronegative RA had improved response to tocilizumab when compared to their seropositive counterparts. Data from the CORRONA RA registry were analyzed. Patients were included if they were started on TCZ and had data from a follow-up visit 4-8 months after initiation, as well as having information on serologic status. Serologic status was determined by presence of anti-cyclic citrullinated peptide (CCP) antibodies. Changes in disease activity measures from baseline to follow-up visit were evaluated. Both CCP-negative and -positive groups had statistically significant improvement in physician-reported measurements (physician rating of disease activity and joint counts), patient-reported measures (disease activity, pain, and fatigue), and acute phase reactants after 4-8 months of treatment with tocilizumab. The magnitude of improvement, however, did not differ significantly by CCP status. Tocilizumab led to statistically significant improvement in all patient- and physician-reported measures of disease activity evaluated in this cohort of patient with RA. The response to tocilizumab did not differ by CCP status. Copyright © 2017 Elsevier Inc. All rights reserved.

[Efficacy of intravenous phenobarbital treatment for status epilepticus].

PubMed

Muramoto, Emiko; Mizobuchi, Masahiro; Sumi, Yoshihiro; Sako, Kazuya; Nihira, Atsuko; Takeuchi, Akiko; Nakamura, Hirohiko

2013-08-01

Intravenous phenobarbital (IV-PB) therapy was launched in Japan in October 2008. We retrospectively investigated its efficacy and tolerability in patients with status epilepticus. Forty-three consecutive patients received IV-PB for status epilepticus between June 2009 and April 2011. Among them, 39 patients had underlying diseases, which included acute diseases in 19 patients and chronic conditions in 20 patients. Although 18 patients had been taking antiepileptic drugs (AEDs) before the occurrence of status epilepticus, the blood AED concentrations in 8 patients was below the therapeutic levels. Before the administration of IV-PB, 39 patients were treated with intravenous benzodiazepine, 17 patients were treated with intravenous phenytoin, and 15 patients with intravenous infusion of lidocaine. The initial doses of IV-PB ranged from 125 to 1,250 mg (1.9-20.0 mg/kg). Additional doses of IV-PB were required in 12 patients. Seizures were controlled in 35 patients (81%) after IV-PB administration. Cessation of status epilepticus was attained in 24 patients after the initial dose and in 11 patients after additional doses. There were no serious adverse effects, although respiratory suppression was observed in 3 patients and drug eruption was observed in 1 patient. IV-PB is relatively safe and effective for controlling status epilepticus. If the first dose is not effective, additional doses are required up to the recommended maximum dose.

Cognitive predictors of skilled performance with an advanced upper limb multifunction prosthesis: a preliminary analysis.

PubMed

Hancock, Laura; Correia, Stephen; Ahern, David; Barredo, Jennifer; Resnik, Linda

2017-07-01

Purpose The objectives were to 1) identify major cognitive domains involved in learning to use the DEKA Arm; 2) specify cognitive domain-specific skills associated with basic versus advanced users; and 3) examine whether baseline memory and executive function predicted learning. Method Sample included 35 persons with upper limb amputation. Subjects were administered a brief neuropsychological test battery prior to start of DEKA Arm training, as well as physical performance measures at the onset of, and following training. Multiple regression models controlling for age and including neuropsychological tests were developed to predict physical performance scores. Prosthetic performance scores were divided into quartiles and independent samples t-tests compared neuropsychological test scores of advanced scorers and basic scorers. Baseline neuropsychological test scores were used to predict change in scores on physical performance measures across time. Results Cognitive domains of attention and processing speed were statistically significantly related to proficiency of DEKA Arm use and predicted level of proficiency. Conclusions Results support use of neuropsychological tests to predict learning and use of a multifunctional prosthesis. Assessment of cognitive status at the outset of training may help set expectations for the duration and outcomes of treatment. Implications for Rehabilitation Cognitive domains of attention and processing speed were significantly related to level of proficiencyof an advanced multifunctional prosthesis (the DEKA Arm) after training. Results provide initial support for the use of neuropsychological tests to predict advanced learningand use of a multifunctional prosthesis in upper-limb amputees. Results suggest that assessment of patients' cognitive status at the outset of upper limb prosthetictraining may, in the future, help patients, their families and therapists set expectations for theduration and intensity of training and may help set reasonable proficiency goals.

System model development for nuclear thermal propulsion

NASA Technical Reports Server (NTRS)

Walton, James T.; Hannan, Nelson A.; Perkins, Ken R.; Buksa, John H.; Worley, Brian A.; Dobranich, Dean

1992-01-01

A critical enabling technology in the evolutionary development of nuclear thermal propulsion (NTP) is the ability to predict the system performance under a variety of operating conditions. This is crucial for mission analysis and for control subsystem testing as well as for the modeling of various failure modes. Performance must be accurately predicted during steady-state and transient operation, including startup, shutdown, and post operation cooling. The development and application of verified and validated system models has the potential to reduce the design, testing, and cost and time required for the technology to reach flight-ready status. Since Oct. 1991, the U.S. Department of Energy (DOE), Department of Defense (DOD), and NASA have initiated critical technology development efforts for NTP systems to be used on Space Exploration Initiative (SEI) missions to the Moon and Mars. This paper presents the strategy and progress of an interagency NASA/DOE/DOD team for NTP system modeling. It is the intent of the interagency team to develop several levels of computer programs to simulate various NTP systems. The first level will provide rapid, parameterized calculations of overall system performance. Succeeding computer programs will provide analysis of each component in sufficient detail to guide the design teams and experimental efforts. The computer programs will allow simulation of the entire system to allow prediction of the integrated performance. An interagency team was formed for this task to use the best capabilities available and to assure appropriate peer review.

The Influence of Chronic and Situational Social Status on Stereotype Susceptibility

PubMed Central

Pillaud, Vincent; Rigaud, David; Clémence, Alain

2015-01-01

We tested whether stereotypical situations would affect low-status group members' performance more strongly than high-status group members'. Experiment 1 and 2 tested this hypothesis using gender as a proxy of chronic social status and a gender-neutral task that has been randomly presented to favor boys (men superiority condition), favor girls (women superiority condition), or show no gender preference (control condition). Both experiments found that women’s (Experiment 1) and girls’ performance (Experiment 2) suffered more from the evoked stereotypes than did men's and boys’ ones. This result was replicated in Experiment 3, indicating that short men (low-status group) were more affected compared to tall men (high-status group). Additionally, men were more affected compared to women when they perceived height as a threat. Hence, individuals are more or less vulnerable to identity threats as a function of the chronic social status at play; enjoying a high status provides protection and endorsing a low one weakens individual performance in stereotypical situations. PMID:26645829

The Influence of Chronic and Situational Social Status on Stereotype Susceptibility.

PubMed

Pillaud, Vincent; Rigaud, David; Clémence, Alain

2015-01-01

We tested whether stereotypical situations would affect low-status group members' performance more strongly than high-status group members'. Experiment 1 and 2 tested this hypothesis using gender as a proxy of chronic social status and a gender-neutral task that has been randomly presented to favor boys (men superiority condition), favor girls (women superiority condition), or show no gender preference (control condition). Both experiments found that women's (Experiment 1) and girls' performance (Experiment 2) suffered more from the evoked stereotypes than did men's and boys' ones. This result was replicated in Experiment 3, indicating that short men (low-status group) were more affected compared to tall men (high-status group). Additionally, men were more affected compared to women when they perceived height as a threat. Hence, individuals are more or less vulnerable to identity threats as a function of the chronic social status at play; enjoying a high status provides protection and endorsing a low one weakens individual performance in stereotypical situations.

Comparing Medical and Recreational Cannabis Users on Socio-Demographic, Substance and Medication Use, and Health and Disability Characteristics.

PubMed

Goulet-Stock, Sybil; Rueda, Sergio; Vafaei, Afshin; Ialomiteanu, Anca; Manthey, Jakob; Rehm, Jürgen; Fischer, Benedikt

2017-01-01

While recreational cannabis use is common, medical cannabis programs have proliferated across North America, including a federal program in Canada. Few comparisons of medical and recreational cannabis users (RCUs) exist; this study compared these groups on key characteristics. Data came from a community-recruited sample of formally approved medical cannabis users (MCUs; n = 53), and a sub-sample of recreational cannabis users (RCUs; n = 169) from a representative adult survey in Ontario (Canada). Samples were telephone-surveyed on identical measures, including select socio-demographic, substance and medication use, and health and disability measures. Based on initial bivariate comparisons, multivariate logistical regression with a progressive adjustment approach was performed to assess independent predictors of group status. In bivariate analyses, older age, lower household income, lower alcohol use, higher cocaine, prescription opioid, depression and anxiety medication use, and lower health and disability status were significantly associated with medical cannabis use. In the multivariate analysis, final model, household income, alcohol use, and disability levels were associated with medical cannabis use. Conclusions/Scientific Significance: Compared to RCUs, medical users appear to be mainly characterized by factors negatively influencing their overall health status. Future studies should investigate the actual impact and net benefits of medical cannabis use on these health problems. © 2017 S. Karger AG, Basel.

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.

Influence of feeding thermally peroxidized soybean oil on oxidative status in growing pigs

USDA-ARS?s Scientific Manuscript database

The objectives of this study were to determine whether feeding thermally processed peroxidized soybean oil (SO) induces markers of oxidative stress and alters antioxidant status in pig tissue, blood, and urine. Fifty-six barrows (25.3 ± 3.3 kg initial BW) were randomly assigned to dietary treatments...

Adolescent Weight Status and Receptivity to Food TV Advertisements

ERIC Educational Resources Information Center

Adachi-Mejia, Anna M.; Sutherland, Lisa A.; Longacre, Meghan R.; Beach, Michael L.; Titus-Ernstoff, Linda; Gibson, Jennifer J.; Dalton, Madeline A.

2011-01-01

Objective: This study examined the relationship between adolescent weight status and food advertisement receptivity. Design: Survey-based evaluation with data collected at baseline (initial and at 2 months), and at follow-up (11 months). Setting: New Hampshire and Vermont. Participants: Students (n = 2,281) aged 10-13 in 2002-2005. Main Outcome…

Women's Lives, Mothers' Health. Children in the Tropics No. 159.

ERIC Educational Resources Information Center

Chauliac, M.; Masse-Raimbault, A. M.

1985-01-01

Part of a program of publications concerning the status and advancement of women coordinated in four journals by the Group for Initiatives on Women and Development, this issue of "Children in the Tropics" focuses on mothers' health. Section I describes factors conditioning the health and nutritional status of women and girls. Discussion…

A Survey on Clinical Research Training Status and Needs in Public Hospitals from Shenzhen

ERIC Educational Resources Information Center

Ji, Ping; Wang, Haibo; Zhang, Chao; Liu, Min; Zhou, Liping; Xiao, Ping; Wang, Yanfang; Wu, Yangfeng

2017-01-01

Objective: To obtain information on the current clinical research training status and evaluate the training needs comprehensively for medical staff in hospitals. Methods: This survey was initiated and conducted by the Health and Family Planning Commission of Shenzhen in conjunction with the Peking University Clinical Research Institute (Shenzhen)…

Assessing the Status of Entrepreneurship Education Courses in Higher Learning Institutions

ERIC Educational Resources Information Center

Fulgence, Katherine

2015-01-01

Purpose: The purpose of this paper is to assess the status of entrepreneurship courses offered in education schools. It provides recommendations for how to address the existing challenges by developing entrepreneurship initiatives in education schools. Design/Methodology/Approach: A survey was circulated to the management of all education schools…

A bill to amend the Homeland Security Act of 2002 to authorize the Securing the Cities Initiative of the Department of Homeland Security, and for other purposes.

THOMAS, 111th Congress

Sen. Gillibrand, Kirsten E. [D-NY

2010-05-05

Senate - 05/05/2010 Read twice and referred to the Committee on Homeland Security and Governmental Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

75 FR 78999 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Maternal...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-17

..., Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Maternal Vitamin D Status and..., discussion, and evaluation of ``Maternal Vitamin D Status and Preterm Birth, DP11-002, initial review.'' Contact Person for More Information: Donald Blackman, PhD, Scientific Review Officer, CDC, National Center...

To amend the Homeland Security Act of 2002 to authorize the Secretary of Homeland Security to award Urban Area Security Initiative grants to nonprofit organizations not located in high-risk urban areas.

THOMAS, 113th Congress

Rep. Titus, Dina [D-NV-1

2014-01-15

House - 01/22/2014 Referred to the Subcommittee on Emergency Preparedness, Response and Communications. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Proposing an amendment to the Constitution of the United States to give citizens of the United States the right to propose amendments to the Constitution by an initiative process.

THOMAS, 111th Congress

Rep. Hoekstra, Peter [R-MI-2

2010-01-21

House - 03/01/2010 Referred to the Subcommittee on the Constitution, Civil Rights, and Civil Liberties. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

A Theoretical Framework of the Relation between Socioeconomic Status and Academic Achievement of Students

ERIC Educational Resources Information Center

Lam, Gigi

2014-01-01

A socio-psychological analytical framework will be adopted to illuminate the relation between socioeconomic status and academic achievement. The framework puts the emphasis to incorporate micro familial factors into macro factor of the tracking system. Initially, children of the poor families always lack major prerequisite: diminution of cognitive…

India Needs International Standards in Accreditation Problems in Adoption and Implementation

ERIC Educational Resources Information Center

Naik, B. M.

2012-01-01

The paper outlines in brief, need and importance of introducing global quality standards in accreditation, prescribed by the international agreement "Washington Accord". This agreement is initially provisional and after scrutiny, if found fit, it is upgraded to Signatory status. It is this status which empowers students of engineering,…

22 CFR 224.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... limited to any advantage, preference, privilege, license, permit, favorable decision, ruling, status, or... United States Government. Individual means a natural person. Initial decision means the written decision of the ALJ required by § 224.10 or § 224.37, and includes a revised initial decision issued following...

38 CFR 42.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... advantage, preference, privilege, license, permit, favorable decision, ruling, status, or loan guarantee.... Initial Decision means the written decision of the ALJ required by § 42.10 or § 42.37 of this part, and includes a revised initial decision issued following a remand or a motion for reconsideration...

Visual-motor integration performance in children with severe specific language impairment.

PubMed

Nicola, K; Watter, P

2016-09-01

This study investigated (1) the visual-motor integration (VMI) performance of children with severe specific language impairment (SLI), and any effect of age, gender, socio-economic status and concomitant speech impairment; and (2) the relationship between language and VMI performance. It is hypothesized that children with severe SLI would present with VMI problems irrespective of gender and socio-economic status; however, VMI deficits will be more pronounced in younger children and those with concomitant speech impairment. Furthermore, it is hypothesized that there will be a relationship between VMI and language performance, particularly in receptive scores. Children enrolled between 2000 and 2008 in a school dedicated to children with severe speech-language impairments were included, if they met the criteria for severe SLI with or without concomitant speech impairment which was verified by a government organization. Results from all initial standardized language and VMI assessments found during a retrospective review of chart files were included. The final study group included 100 children (males = 76), from 4 to 14 years of age with mean language scores at least 2SD below the mean. For VMI performance, 52% of the children scored below -1SD, with 25% of the total group scoring more than 1.5SD below the mean. Age, gender and the addition of a speech impairment did not impact on VMI performance; however, children living in disadvantaged suburbs scored significantly better than children residing in advantaged suburbs. Receptive language scores of the Clinical Evaluation of Language Fundamentals was the only score associated with and able to predict VMI performance. A small subgroup of children with severe SLI will also have poor VMI skills. The best predictor of poor VMI is receptive language scores on the Clinical Evaluation of Language Fundamentals. Children with poor receptive language performance may benefit from VMI assessment and multidisciplinary management. © 2016 John Wiley & Sons Ltd.

Inequalities in maternal care in Italy: the role of socioeconomic and migrant status.

PubMed

Lauria, Laura; Bonciani, Manila; Spinelli, Angela; Grandolfo, Michele E

2013-01-01

Maternal care is affected by socioeconomic factors. This study analyses the effect of maternal education, employment and citizenship on some antenatal and postnatal care indicators in Italy. Data are from two population-based follow-up surveys conducted to evaluate the quality of maternal care in 25 Italian Local Health Units in 2008/9 and 2010/1 (6942 women). Logistic models were applied and interactions among independent variables were explored. Education and employment status affect antenatal and postnatal care indicators and migrant women are less likely to make use of health opportunities. Low education status exacerbates the initial social disadvantage of migrants. Migrant women are also more affected by socioeconomic pressure to restart working early, with negative impact on postnatal care. Interventions focusing on women's empowerment may tackle inequalities in maternal care for those women, Italians or migrants, who have a worse initial maternal health literacy due to their lower socioeconomic conditions.

The Quadratic Relationship between Socioeconomic Status and Learning Performance in China by Multilevel Analysis: Implications for Policies to Foster Education Equity

ERIC Educational Resources Information Center

Zhao, Ningning; Valcke, Martin; Desoete, Annemie; Verhaeghe, JeanPierre

2012-01-01

The purpose of the present study is to explore the relationship between family socioeconomic status and mathematics performance on the base of a multi-level analysis involving a large sample of Chinese primary school students. A weak relationship is found between socioeconomic status and performance in the Chinese context. The relationship does…

AMO EXPRESS: A Command and Control Experiment for Crew Autonomy

NASA Technical Reports Server (NTRS)

Stetson, Howard K.; Frank, Jeremy; Cornelius, Randy; Haddock, Angie; Wang, Lui; Garner, Larry

2015-01-01

NASA is investigating a range of future human spaceflight missions, including both Mars-distance and Near Earth Object (NEO) targets. Of significant importance for these missions is the balance between crew autonomy and vehicle automation. As distance from Earth results in increasing communication delays, future crews need both the capability and authority to independently make decisions. However, small crews cannot take on all functions performed by ground today, and so vehicles must be more automated to reduce the crew workload for such missions. NASA's Advanced Exploration Systems Program funded Autonomous Mission Operations (AMO) project conducted an autonomous command and control demonstration of intelligent procedures to automatically initialize a rack onboard the International Space Station (ISS) with power and thermal interfaces, and involving core and payload command and telemetry processing, without support from ground controllers. This autonomous operations capability is enabling in scenarios such as a crew medical emergency, and representative of other spacecraft autonomy challenges. The experiment was conducted using the Expedite the Processing of Experiments for Space Station (EXPRESS) rack 7, which was located in the Port 2 location within the U.S Laboratory onboard the International Space Station (ISS). Activation and deactivation of this facility is time consuming and operationally intensive, requiring coordination of three flight control positions, 47 nominal steps, 57 commands, 276 telemetry checks, and coordination of multiple ISS systems (both core and payload). The autonomous operations concept includes a reduction of the amount of data a crew operator is required to verify during activation or de-activation, as well as integration of procedure execution status and relevant data in a single integrated display. During execution, the auto-procedures provide a step-by-step messaging paradigm and a high level status upon termination. This messaging and high level status is the only data generated for operator display. To enhance situational awareness of the operator, the Web-based Procedure Display (WebPD) provides a novel approach to the issues of procedure display and execution tracking. For this demonstration, the procedure was initiated and monitored from the ground. As the Timeliner sequences executed, their high level execution status was transmitted to ground, for WebPD consumption.

Assessment of Lymph Nodes and Prostate Status Using Early Dynamic Curves with (18)F-Choline PET/CT in Prostate Cancer.

PubMed

Mathieu, Cédric; Ferrer, Ludovic; Carlier, Thomas; Colombié, Mathilde; Rusu, Daniela; Kraeber-Bodéré, Françoise; Campion, Loic; Rousseau, Caroline

2015-01-01

Dynamic image acquisition with (18)F-Choline [fluorocholine (FCH)] PET/CT in prostate cancer is mostly used to overcome the bladder repletion, which could obstruct the loco-regional analysis. The aim of our study was to analyze early dynamic FCH acquisitions to define pelvic lymph node or prostate pathological status. Retrospective analysis was performed on 39 patients for initial staging (n = 18), or after initial treatment (n = 21). Patients underwent 10-min dynamic acquisitions centered on the pelvis, after injection of 3-4 MBq/kg of FCH. Whole-body images were acquired about 1 h after injection using a PET/CT GE Discovery LS (GE-LS) or Siemens Biograph mCT (mCT). Maximum and mean SUV according to time were measured on nodal and prostatic lesions. SUVmean was corrected for partial volume effect (PVEC) with suitable recovery coefficients. The status of each lesion was based on histological results or patient follow-up (>6 months). A Mann-Whitney test and ANOVA were used to compare mean and receiver operating characteristic (ROC) curve analysis. The median PSA was 8.46 ng/mL and the median Gleason score was 3 + 4. Ninety-two lesions (43 lymph nodes and 49 prostate lesions) were analyzed, including 63 malignant lesions. In early dynamic acquisitions, the maximum and mean SUV were significantly higher, respectively, on mCT and GE-LS, in malignant versus benign lesions (p < 0.001, p < 0.001). Mean SUV without PVEC, allowed better discrimination of benign from malignant lesions, in comparison with maximum and mean SUV (with PVEC), for both early and late acquisitions. For patients acquired on mCT, area under the ROC curve showed a trend to better sensitivity and specificity for early acquisitions, compared with late acquisitions (SUVmax AUC 0.92 versus 0.85, respectively). Assessment of lymph nodes and prostate pathological status with early dynamic imaging using PET/CT FCH allowed prostate cancer detection in situations where proof of malignancy is difficult to obtain.

Gabapentin dose and the 30-day risk of altered mental status in older adults: A retrospective population-based study

PubMed Central

Dixon, Stephanie N.; Kuwornu, Paul John; Dev, Varun K.; Montero-Odasso, Manuel; Burneo, Jorge; Garg, Amit X.

2018-01-01

Gabapentin is an effective treatment for chronic neuropathic pain but may cause dizziness, drowsiness, and confusion in some older adults. The goal of this study was to assess the association between gabapentin dosing and adverse outcomes by obtaining estimates of the 30-day risk of hospitalization with altered mental status and mortality in older adults (mean age 76 years) in Ontario, Canada initiated on high dose (>600 mg/day; n = 34,159) compared to low dose (≤600 mg/day; n = 76,025) oral gabapentin in routine outpatient care. A population-based, retrospective cohort study assessing new gabapentin use between 2002 to 2014 was conducted. The primary outcome was 30-day hospitalization with an urgent head computed tomography (CT) scan in the absence of evidence of stroke (a proxy for altered mental status). The secondary outcome was 30-day all-cause mortality. The baseline characteristics measured in the two dose groups were similar. Initiation of a high versus low dose of gabapentin was associated with a higher risk of hospitalization with head CT scan (1.27% vs. 1.06%, absolute risk difference 0.21%, adjusted relative risk 1.29 [95% CI 1.14 to 1.46], number needed to treat 477) but not a statistically significant higher risk of mortality (1.25% vs. 1.16%, absolute risk difference of 0.09%, adjusted relative risk of 1.01 [95% CI 0.89 to 1.14]). Overall, the risk of being hospitalized with altered mental status after initiating gabapentin remains low, but may be reduced through the judicious use of gabapentin, use of the lowest dose to control pain, and vigilance for early signs of altered mental status. PMID:29538407

Status Report on the CEBAF IR and UV FELs

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

Leemann, Christoph; Bisognano, Joseph; Douglas, David

1993-07-01

The CEBAF five pass recirculating, superconducting linac, being developed as a high power electron source for nuclear physics, is also an ideal FEL driver.The 45 MeV front end linac is presently operational with a CW (low peak current) nuclear physics gun and has met all CEBAF performance specifications including low emittance and energy spread (< 1 * 10^-4). Progress will be reported in commissioning.This experience leads to predictions of excellent FEL performance.Initial designs reported last year have been advanced.Using the output of a high charge DC photoemission gun under development with a 6 cm period wiggler produces kilowatt output powersmore » in the 3.6 to 17 micrometer range in the fundamental.Third harmonic operation extends IR performance down to 1.2 micrometer.Beam at energies up to 400 MeV from the first full CEBAF linac will interact in a similar but longer wiggler to yield kilowatt UV light production at wavelengths as short as 0.15 micrometers.Full power FEL« less

Steps to Success: The African American Male Initiative. Summary Report of the Study Group of Experts Meeting

ERIC Educational Resources Information Center

Children's Aid Society, 2008

2008-01-01

In 2005, the Children's Aid Society launched The African American Male Initiative to respond to the growing concern for the status of African American males and to bring about change. The initiative aims to: (1) more fully understand the issues facing our Black male clients and (2) create new program strategies that will better address the needs…

40 CFR 63.707 - Reporting requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

...(c)(1) (material balance calculation) shall include with the notification of compliance status required by § 63.9(h) the results of the initial material balance calculation. (e) The owner or operator... nonregenerative carbon adsorber and demonstrating initial compliance in accordance with § 63.705(c)(6) shall...

40 CFR 63.707 - Reporting requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

...(c)(1) (material balance calculation) shall include with the notification of compliance status required by § 63.9(h) the results of the initial material balance calculation. (e) The owner or operator... nonregenerative carbon adsorber and demonstrating initial compliance in accordance with § 63.705(c)(6) shall...

40 CFR 63.707 - Reporting requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

...(c)(1) (material balance calculation) shall include with the notification of compliance status required by § 63.9(h) the results of the initial material balance calculation. (e) The owner or operator... nonregenerative carbon adsorber and demonstrating initial compliance in accordance with § 63.705(c)(6) shall...

40 CFR 63.707 - Reporting requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

...(c)(1) (material balance calculation) shall include with the notification of compliance status required by § 63.9(h) the results of the initial material balance calculation. (e) The owner or operator... nonregenerative carbon adsorber and demonstrating initial compliance in accordance with § 63.705(c)(6) shall...

40 CFR 63.707 - Reporting requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

...(c)(1) (material balance calculation) shall include with the notification of compliance status required by § 63.9(h) the results of the initial material balance calculation. (e) The owner or operator... nonregenerative carbon adsorber and demonstrating initial compliance in accordance with § 63.705(c)(6) shall...

Current Status of Diversity Initiatives in Selected Multinational Corporations.

ERIC Educational Resources Information Center

Wentling, Rose Mary; Palma-Rivas, Nilda

2000-01-01

Interviews with eight diversity managers in multinational corporations revealed a variety of domestic and international diversity initiatives, especially in leadership and management. Formal and informal methods were used to plan them. Business unit managers were responsible for implementation. Evaluation was difficult and time consuming. (SK)

Black Women and Career Advancement: Preparing for the New Workplace.

ERIC Educational Resources Information Center

Shields, Leslie

1992-01-01

Discusses the status of black women, and examines what they need to do to strengthen their positions in the workplace. In the face of existing career obstacles, both individual initiatives such as securing training and finding mentors, and public policy initiatives are needed. (SLD)

22 CFR 35.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., permit, favorable decision, ruling, status, or loan gurarantee. (e) Claim means any request, demand, or.... (k) Initial decision means the written decision of the ALJ required by § 35.10 or § 35.37, and includes a revised initial decision issued following a remand or a motion for reconsideration. (l...

Black health care in America: a political perspective.

PubMed Central

Rice, M. F.; Winn, M.

1990-01-01

Despite recent improvements in the health status of blacks, significant disparities continue to exist between blacks and whites in nearly every health status index. Contributing to these disparities are biases in the health system; economic bias being the most significant. This article assesses the competitive market strategy, the most recent federal initiative to promote equity in the access to health services in terms of the consequences for black health. Several policy actions are recommended to improve the health status of the black population. PMID:2362299

Relation Between Periodontal Status and Pre-Cancerous Condition (Oral Lichen Planus): A Pilot Study.

PubMed

Rai, Narendra Parkash; Kumar, Prafful; Mustafa, Shabil M; Divakar, Darshan D; Kheraif, Abdulaziz Al; Ramakrishnaiah, Ravikumar; Vellapally, Sajith; Dalati, M H N; Parine, Narashimha Reddy; Anil, Sukumaran

2016-01-01

Oral lichen planus (OLP) is a common chronic mucocutaneous disease mostly seen in middle aged and elderly females. Oral lichen planus can occur in different oral sites such as gingiva, labial, buccal mucosa and on the tongue. And can have an indirect effect on initiating periodontitis. The purpose of the study was to evaluate the periodontal status of OLP patients and compare it with that of healthy controls. The presence of erosive lesions among gingival tissues makes oral hygiene procedures difficult to perform for obvious reasons. Plaque control and rigorous oral hygiene are primary requisites for the treatment of any oro-mucosal disease. Thirty patients with the erosive and reticular form of OLP as a study group and 30 healthy subjects as a control group were selected. The periodontal status of all subjects including gingival index (GI), Russell's periodontal index (PI) and bleeding on probing (BOP) were evaluated in both groups. Finally, the data was analyzed by a paired t-test using SPSS software v. 22. The mean values of GI, PI and BOP were observed to be higher in the study group compared to the control group, and this was statistically significant (p < 0.05). The results shown are suggestive that periodontal status was poor in the study group as compared to the control group. Further studies need to investigate periodontal status in oral lichen planus patients with larger sample size, and careful follow-up of these will assure an increase in the quality of life of these patients. The patient should be informed regarding the risk of periodontal problems in OLP and should be advised to have regular dental checkups to avoid a worsening of the conditio.

Blood-brain barrier leakage after status epilepticus in rapamycin-treated rats I: Magnetic resonance imaging.

PubMed

van Vliet, Erwin A; Otte, Willem M; Wadman, Wytse J; Aronica, Eleonora; Kooij, Gijs; de Vries, Helga E; Dijkhuizen, Rick M; Gorter, Jan A

2016-01-01

The mammalian target of rapamycin (mTOR) pathway has received increasing attention as a potential antiepileptogenic target. Treatment with the mTOR inhibitor rapamycin after status epilepticus reduces the development of epilepsy in a rat model. To study whether rapamycin mediates this effect via restoration of blood-brain barrier (BBB) dysfunction, contrast-enhanced magnetic resonance imaging (CE-MRI) was used to determine BBB permeability throughout epileptogenesis. Imaging was repeatedly performed until 6 weeks after kainic acid-induced status epilepticus in rapamycin (6 mg/kg for 6 weeks starting 4 h after SE) and vehicle-treated rats, using gadobutrol as contrast agent. Seizures were detected using video monitoring in the week following the last imaging session. Gadobutrol leakage was widespread and extensive in both rapamycin and vehicle-treated epileptic rats during the acute phase, with the piriform cortex and amygdala as the most affected regions. Gadobutrol leakage was higher in rapamycin-treated rats 4 and 8 days after status epilepticus compared to vehicle-treated rats. However, during the chronic epileptic phase, gadobutrol leakage was lower in rapamycin-treated epileptic rats along with a decreased seizure frequency. This was confirmed by local fluorescein staining in the brains of the same rats. Total brain volume was reduced by this rapamycin treatment regimen. The initial slow recovery of BBB function in rapamycin-treated epileptic rats indicates that rapamycin does not reduce seizure activity by a gradual recovery of BBB integrity. The reduced BBB leakage during the chronic phase, however, could contribute to the decreased seizure frequency in post-status epilepticus rats treated with rapamycin. Furthermore, the data show that CE-MRI (using step-down infusion with gadobutrol) can be used as biomarker for monitoring the effect of drug therapy in rats. Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

Change in HER2 (ERBB2) gene status after taxane-based chemotherapy for breast cancer: polyploidization can lead to diagnostic pitfalls with potential impact for clinical management.

PubMed

Valent, Alexander; Penault-Llorca, Frédérique; Cayre, Anne; Kroemer, Guido

2013-01-01

The status of the HER2 (ERBB2) gene in breast cancer is not static and may change among the primary tumor, lymph node metastases, and distant metastases. This status change can be a consequence of the natural evolution of the tumor or can be induced by therapy. The HER2 gene status is, in the majority of cases, established at the moment of diagnosis. After chemotherapy, monitoring HER2 status can be a challenge because of ploidy changes induced by drugs. The cytogeneticist or the pathologist can face real difficulties in distinguishing between a true HER2 amplification and HER2 copy number increase by polyploidization. We performed a HER2 genetic examination by fluorescence in situ hybridization (FISH) of invasive breast cancers before and after taxane treatment. The majority of patients (91%) were HER2-negative both at diagnosis and after treatment. Thirty of 344 patients (9%) whose tumors were initially HER2-negative were found by FISH to have supernumerary HER2 gene copies (up to 15 copies) after neoadjuvant chemotherapy. This HER2 copy increase could not be attributed to true gene amplifications and instead reflected polyploidization events, which presumably affected all chromosomes. Indeed, when we used other FISH probes, we found other gene copy numbers to parallel those of HER2. We recommend careful checking of invasive breast carcinomas by supplementary FISH probes if the copy number of the HER2 gene is >6. This procedure allows the discrimination of specific HER2 gene amplifications and global increases in ploidy. Copyright © 2013 Elsevier Inc. All rights reserved.

Fatal Cerebral Edema With Status Epilepticus in Children With Dravet Syndrome: Report of 5 Cases.

PubMed

Myers, Kenneth A; McMahon, Jacinta M; Mandelstam, Simone A; Mackay, Mark T; Kalnins, Renate M; Leventer, Richard J; Scheffer, Ingrid E

2017-04-01

Dravet syndrome (DS) is a well-recognized developmental and epileptic encephalopathy associated with SCN1A mutations and 15% mortality by 20 years. Although over half of cases succumb to sudden unexpected death in epilepsy, the cause of death in the remainder is poorly defined. We describe the clinical, radiologic, and pathologic characteristics of a cohort of children with DS and SCN1A mutations who developed fatal cerebral edema causing mass effect after fever-associated status epilepticus. Cases were identified from a review of children with DS enrolled in the Epilepsy Genetics Research Program at The University of Melbourne, Austin Health, who died after fever-associated status epilepticus. Five children were identified, all of whom presented with fever-associated convulsive status epilepticus, developed severe brain swelling, and died. All had de novo SCN1A mutations. Fever of 40°C or greater was measured in all cases. Signs of brainstem dysfunction, indicating cerebral herniation, were first noted 3 to 5 days after initial presentation in 4 patients, though were apparent as early as 24 hours in 1 case. When MRI was performed early in a patient's course, focal regions of cortical diffusion restriction were noted. Later MRI studies demonstrated diffuse cytotoxic edema, with severe cerebral herniation. Postmortem studies revealed diffuse brain edema and widespread neuronal damage. Laminar necrosis was seen in 1 case. Cerebral edema leading to fatal brain herniation is an important, previously unreported sequela of status epilepticus in children with DS. This potentially remediable complication may be a significant contributor to the early mortality of DS. Copyright © 2017 by the American Academy of Pediatrics.

Differences in sexual behaviour and sexual practices of adolescents in Nigeria based on sex and self-reported HIV status.

PubMed

Folayan, Morenike O; Odetoyinbo, Morolake; Brown, Brandon; Harrison, Abigail

2014-12-06

Sexual behaviour and sexual practices affect the risk for acquisition and transmission of HIV infection. This study tries to identify differences in sexual behaviour (condom use with non-marital partners, multiple sexual partnerships transactional sex and age mixing in sexual relationships), sexual practices (oral, anal and vagina sex), and forced sexual initiation based on sex and HIV status of adolescents in Nigeria. Face to face interviewer-administered questionnaires were used to collect information from a nationally representative sample of 10-19 years old adolescents residing in Nigeria. Data included information on age of sexual debut, sexual behaviour and sexual practices. Association between HIV status, sex, sexual behaviour and sexual practices, and predictors of use of condoms during the last vaginal sexual intercourse were determined. More self-reported HIV positive than HIV negative females had experienced forced sexual initiation (p = 0.008). Significantly more female than male adolescents had engaged in transactional sex (p < 0.001) and had sex with partners who were older than them by 10 years or more (p < 0.001). Vaginal (95.2%), oral (26.6%) and anal (7.8%) sex were practiced by male and females irrespective of HIV status. More females reported oral sex (p = 0.001). Being a female (p = 0.001), having genital itching in the last 12 months (p = 0.04)and having engaged in anal sex in the last 12 months (p = 0.009) reduced the odds of using a condom at last vaginal intercourse. Having a HIV positive or negative status did not significantly increase the odds of using a condom at last vaginal intercourse. Differences in sexual behaviour and sexual practices of adolescents was observed based on sex and not on HIV status. History of forced sex initiation however differed by HIV status. Tailored interventions for male and female adolescents are required to reduce their risk of HIV infection. Tailored interventions are also required for adolescents living with HIV to improve their sexual and reproductive health.

Initiating technical refinements in high-level golfers: Evidence for contradictory procedures.

PubMed

Carson, Howie J; Collins, Dave; Richards, Jim

2016-01-01

When developing motor skills there are several outcomes available to an athlete depending on their skill status and needs. Whereas the skill acquisition and performance literature is abundant, an under-researched outcome relates to the refinement of already acquired and well-established skills. Contrary to current recommendations for athletes to employ an external focus of attention and a representative practice design,  Carson and  Collins' (2011) [Refining and regaining skills in fixation/diversification stage performers: The Five-A Model. International Review of Sport and Exercise Psychology, 4, 146-167. doi: 10.1080/1750984x.2011.613682 ] Five-A Model requires an initial narrowed internal focus on the technical aspect needing refinement: the implication being that environments which limit external sources of information would be beneficial to achieving this task. Therefore, the purpose of this paper was to (1) provide a literature-based explanation for why techniques counter to current recommendations may be (temporarily) appropriate within the skill refinement process and (2) provide empirical evidence for such efficacy. Kinematic data and self-perception reports are provided from high-level golfers attempting to consciously initiate technical refinements while executing shots onto a driving range and into a close proximity net (i.e. with limited knowledge of results). It was hypothesised that greater control over intended refinements would occur when environmental stimuli were reduced in the most unrepresentative practice condition (i.e. hitting into a net). Results confirmed this, as evidenced by reduced intra-individual movement variability for all participants' individual refinements, despite little or no difference in mental effort reported. This research offers coaches guidance when working with performers who may find conscious recall difficult during the skill refinement process.

Gross Olfaction Before and After Laparoscopic Gastric Bypass.

PubMed

Zerrweck, Carlos; Gallardo, Vannia Castañeda; Calleja, Carmen; Sepúlveda, Elisa; Guilber, Lizbeth

2017-11-01

Obesity leads to olfaction alterations, and this can further impact food choices, appetite, and nutritional status. Bariatric procedures induce weight loss and change in taste and smell perception, but more information is needed, especially using objective olfaction tests. A prospective study was conducted during 6 months, with candidates to laparoscopic gastric bypass at a single institution. A preoperative nasofibroscopy and gross smell identification test (The Pocket Smell Test ®) were performed in those meeting the inclusion criteria. After 6 months, a new test was performed, and the primary objective was to determine if there was an improvement in the olfaction score. Weight loss and comorbidities improvement were also analyzed. From the 30 patients with morbid obesity enrolled, 21 met the inclusion criteria and ENT evaluation. At baseline, 42.8% of patients scored 3 points, 53.3% scored 2 points, and 4.7% scored 1 point. After 6 months, there was a -81.1% of change. Seventeen patients scored 3 points (p = 0.002 vs initial) and two scored 2 points (p = 0.006 vs initial). There were no patients with less than 2 points. Weight and comorbidities had a significant improvement as well. Laparoscopic gastric bypass improves the olfaction scores of the Pocket Smell Test in morbidly obese patients 6 months after their procedure. More complex tests can be used in candidates to bariatric surgery if low scores are detected initially. Other causes of olfaction dysfunctions should be determined if there is no improvement after weight loss.

Pre-ART nutritional status and its association with mortality in adult patients enrolled on ART at Fiche Hospital in North Shoa, Oromia region, Ethiopia: a retrospective cohort study.

PubMed

Tesfamariam, Kokeb; Baraki, Negga; Kedir, Haji

2016-12-20

Human immunodeficiency virus (HIV) compromises the nutritional status of infected individuals and in turn, malnutrition worsens the effects of the infection itself by weakening the immune system consequently accelerating disease progression and death. However, few studies have examined the association between nutritional status at antiretroviral therapy (ART) initiation and early mortality. Therefore, this study assesses pre-ART nutritional status and other baseline characteristics and mortality among adult patients on ART at Fiche Hospital, Ethiopia. A retrospective cohort study was conducted among 489 ART enrolled adult patients between August 01, 2006 and September 30, 2013 in Fiche Hospital. Study participants were selected by using systematic random sampling method. Actuarial table was used to estimate survival of patients after ART initiation and log rank test was used to compare the survival curves. Cox proportional-hazard regression was used to determine independent predictors of time to death. Most of the study subjects were females 254 (51.9%). A total of 489 patients were included in the analysis, of whom 87 died during a median study follow-up of 22 months. The estimated mortality among malnourished was 21, 28, 33, and 38% at 5, 10, 15, and 25 months respectively with mortality incidence density of 5.63 deaths per 100 person years. The independent predictors of mortality were: BMI <18.5 kg/m 2 (AHR = 5.4 95% CI 3.03-9.58), baseline ambulatory functional status (AHR = 3.84; 95% CI 2.19-6.74), bedridden functional status (AHR = 4.78; 95% CI 2.14-10.65), WHO clinical stage III (AHR 2.21; 95% CI 1.16-4.21), WHO clinical stage IV (AHR 4.05; 95% CI 1.50-10.97) and CD4 count less than 200 cells/μl (AHR = 2.95; 95% CI 1.48-5.88), two and more opportunistic infections (AHR 2.30; 95% CI 1.11-4.75). Undernutrition at the time of ART initiation was associated with increased risk of death, particularly during the first 3 months after ART initiation. Interventions to promote earlier HIV diagnosis and treatment and integrating nutrition counseling at all stages of ART implementation may improve ART outcomes in this vulnerable population.

Marijuana Use, Recent Marijuana Initiation, and Progression to Marijuana Use Disorder Among Young Male and Female Adolescents Aged 12–14 Living in US Households

PubMed Central

Forman-Hoffman, Valerie L; Glasheen, Cristie; Batts, Kathryn R

2017-01-01

Marijuana initiation during adolescence, and early adolescence in particular, is associated with adverse health consequences. Our study used 2005–2014 data from the annual, cross-sectional National Survey on Drug Use and Health to study the prevalence and correlates of marijuana initiation, use, and marijuana use disorder (MUD; abuse or dependence) among 12- to 14-year olds living in civilian US households (n = 84 954). Examined correlates included age, sex, race/ethnicity, poverty status, metropolitan status, year of survey, depression, tobacco use, alcohol use, and fighting at school. Sex differences in the correlates of lifetime use and past year marijuana initiation were tested via interaction. Lifetime prevalence of marijuana use was 5.5%; 3.2% reported past year initiation. About 1 in 6 (16.8%) past year initiates progressed to MUD within 12 months of first use. Although men had higher prevalence of lifetime use than women, past year initiation did not differ by sex. On examining the sex*race/ethnicity interaction effects, findings determined that non-Hispanic black and Hispanic men had higher prevalence estimates of ever using marijuana and incidence of past year initiation as compared with non-Hispanic white men; these race/ethnicity differences were not found among women. Identifying correlates of initiation and progression to MUD among young adolescents is critical to improve prevention and treatment program targets. PMID:28615948

National Wind Tunnel Complex (NWTC)

NASA Technical Reports Server (NTRS)

1996-01-01

The National Wind Tunnel Complex (NWTC) Final Report summarizes the work carried out by a unique Government/Industry partnership during the period of June 1994 through May 1996. The objective of this partnership was to plan, design, build and activate 'world class' wind tunnel facilities for the development of future-generation commercial and military aircraft. The basis of this effort was a set of performance goals defined by the National Facilities Study (NFS) Task Group on Aeronautical Research and Development Facilities which established two critical measures of improved wind tunnel performance; namely, higher Reynolds number capability and greater productivity. Initial activities focused upon two high-performance tunnels (low-speed and transonic). This effort was later descoped to a single multipurpose tunnel. Beginning in June 1994, the NWTC Project Office defined specific performance requirements, planned site evaluation activities, performed a series of technical/cost trade studies, and completed preliminary engineering to support a proposed conceptual design. Due to budget uncertainties within the Federal government, the NWTC project office was directed to conduct an orderly closure following the Systems Design Review in March 1996. This report provides a top-level status of the project at that time. Additional details of all work performed have been archived and are available for future reference.

Neurological failure in ICU patients with hematological malignancies: A prospective cohort study

PubMed Central

Marzorati, Chiara; Mokart, Djamel; Pène, Frederic; Lemiale, Virginie; Kouatchet, Achille; Mayaux, Julien; Vincent, François; Nyunga, Martine; Bruneel, Fabrice; Rabbat, Antoine; Lebert, Christine; Perez, Pierre; Benoit, Dominique; Citerio, Giuseppe; Azoulay, Elie

2017-01-01

Background Epidemiological studies of neurological complications in patients with hematological malignancies are scant. The objective of the study was to identify determinants of survival in patients with hematological malignancy and neurological failure. Methods Post hoc analysis of a prospective study of adults with hematological malignancies admitted for any reason to one of 17 university or university-affiliated participating ICUs in France and Belgium (2010–2012). The primary outcome was vital status at hospital discharge. Results Of the 1011 patients enrolled initially, 226 (22.4%) had neurological failure. Presenting manifestations were dominated by drowsiness or stupor (65%), coma (32%), weakness (26%), and seizures (19%). Neuroimaging, lumbar puncture, and electroencephalography were performed in 113 (50%), 73 (32%), and 63 (28%) patients, respectively. A neurosurgical biopsy was done in 1 patient. Hospital mortality was 50%. By multivariate analysis, factors independently associated with higher hospital mortality were poor performance status (odds ratio [OR], 3.99; 95%CI, 1.82–9.39; P = 0.0009), non-Hodgkin’s lymphoma (OR, 2.60; 95%CI, 1.35–5.15; P = 0.005), shock (OR, 1.95; 95%CI, 1.04–3.72; P = 0.04), and respiratory failure (OR, 2.18; 95%CI, 1.14–4.25; P = 0.02); and factors independently associated with lower hospital mortality were GCS score on day 1 (OR, 0.88/point; 95%CI, 0.81–0.95; P = 0.0009) and autologous stem cell transplantation (OR, 0.25; 95%CI, 0.07–0.75; P = 0.02). Conclusions In ICU patients with hematological malignancies, neurological failure is common and often fatal. Independent predictors of higher hospital mortality were type of underlying hematological malignancy, poor performance status, hemodynamic and respiratory failures, and severity of consciousness impairment. Knowledge of these risk factors might help to optimize management strategies. PMID:28598990

NICER observations of highly magnetized neutron stars: Initial results

NASA Astrophysics Data System (ADS)

Enoto, Teruaki; Arzoumanian, Zaven; Gendreau, Keith C.; Nynka, Melania; Kaspi, Victoria; Harding, Alice; Guver, Tolga; Lewandowska, Natalia; Majid, Walid; Ho, Wynn C. G.; NICER Team

2018-01-01

The Neutron star Interior Composition Explorer (NICER) was launched on June 3, 2017, and attached to the International Space Station. The large effective area of NICER in soft X-rays makes it a powerful tool not only for its primary science objective (diagnostics of the nuclear equation state) but also for studying neutron stars of various classes. As one of the NICER science working groups, the Magnetars and Magnetospheres (M&M) team coordinates monitoring and target of opportunity (ToO) observations of magnetized neutron stars, including magnetars, high-B pulsars, X-ray dim isolated neutron stars, and young rotation-powered pulsars. The M&M working group has performed simultaneous X-ray and radio observations of the Crab and Vela pulsars, ToO observations of the active anomalous X-ray pulsar 4U 0142+61, and a monitoring campaign for the transient magnetar SGR 0501+4516. Here we summarize the current status and initial results of the M&M group.

Development of a three-dimensional transient code for reactivity-initiated events of BWRs (boiling water reactors) - Models and code verifications

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

Uematsu, Hitoshi; Yamamoto, Toru; Izutsu, Sadayuki

1990-06-01

A reactivity-initiated event is a design-basis accident for the safety analysis of boiling water reactors. It is defined as a rapid transient of reactor power caused by a reactivity insertion of over $1.0 due to a postulated drop or abnormal withdrawal of the control rod from the core. Strong space-dependent feedback effects are associated with the local power increase due to control rod movement. A realistic treatment of the core status in a transient by a code with a detailed core model is recommended in evaluating this event. A three-dimensional transient code, ARIES, has been developed to meet this need.more » The code simulates the event with three-dimensional neutronics, coupled with multichannel thermal hydraulics, based on a nonequilibrium separated flow model. The experimental data obtained in reactivity accident tests performed with the SPERT III-E core are used to verify the entire code, including thermal-hydraulic models.« less

Status of a Power Processor for the Prometheus-1 Electric Propulsion System

NASA Technical Reports Server (NTRS)

Pinero, Luis R.; Hill, Gerald M.; Aulisio, Michael; Gerber, Scott; Griebeler, Elmer; Hewitt, Frank; Scina, Joseph

2006-01-01

NASA is developing technologies for nuclear electric propulsion for proposed deep space missions in support of the Exploration initiative under Project Prometheus. Electrical power produced by the combination of a fission-based power source and a Brayton power conversion and distribution system is used by a high specific impulse ion propulsion system to propel the spaceship. The ion propulsion system include the thruster, power processor and propellant feed system. A power processor technology development effort was initiated under Project Prometheus to develop high performance and lightweight power-processing technologies suitable for the application. This effort faces multiple challenges including developing radiation hardened power modules and converters with very high power capability and efficiency to minimize the impact on the power conversion and distribution system as well as the heat rejection system. This paper documents the design and test results of the first version of the beam supply, the design of a second version of the beam supply and the design and test results of the ancillary supplies.

Normative neurocognitive data for National Football League players: an initial compendium.

PubMed

Solomon, Gary S; Lovell, Mark R; Casson, Ira R; Viano, David C

2015-03-01

The use of clinical neuropsychological tests in the evaluation of National Football League (NFL) players has been ongoing for more than two decades. Prior research has demonstrated that the NFL population may perform differently than the general population on standard paper and pencil neuropsychological tests. Given the increased interest in the longitudinal and long-term assessment of neurocognitive functioning in this group of athletes, we reviewed the published neuropsychological literature in an attempt to compile an initial compendium of available normative data on paper and pencil as well as computerized neuropsychological tests for this group of football players. Thirteen published studies met the inclusion criteria, and the results are presented by athlete status (active vs. retired) and classified by neuropsychological domain. Suggestions for potential core batteries with this population are discussed, as are directions for future research. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Laboratory findings in neurosyphilis patients with epileptic seizures alone as the initial presenting symptom.

PubMed

Tong, Man-Li; Liu, Li-Li; Zeng, Yan-Li; Zhang, Hui-Lin; Liu, Gui-Li; Zheng, Wei-Hong; Dong, Jie; Wu, Jing-Yi; Su, Yuan-Hui; Lin, Li-Rong; Yang, Tian-Ci

2013-04-01

A retrospective chart review was performed to characterize the clinical presentation, the characteristic combination of serologic and cerebrospinal fluid (CSF) abnormalities, and the neuroimaging findings of neurosyphilis (NS) patients who had epileptic seizures alone as an initial presenting symptom. In a 6.75-year period, 169 inpatients with NS were identified at Zhongshan Hospital (from June 2005 to February 2012). We demonstrated that 13 (7.7%) of the 169 NS patients had epileptic seizures alone as an initial presenting feature. Epileptic seizures occurred in NS patients with syphilitic meningitis (2 cases), meningovascular NS (5 cases), and general paresis (6 cases). The types of epileptic seizures included simple partial, complex partial with secondary generalization (including status epilepticus), and generalized seizures (no focal onset reported). Nine of NS patients with only epileptic seizures as primary symptom were misdiagnosed, and the original misdiagnosis was 69.23% (9/13). Ten (10/13, 76.9%) patients had an abnormal magnetic resonance imaging, and 7 (7/13 53.8%) patients had abnormal electroencephalogram recordings. In addition, the sera rapid plasma reagin (RPR) and Treponema pallidum particle agglutination (TPPA) from all 13 patients were positive. The overall positive rates of the CSF-RPR and CSF-TPPA were 61.5% and 69.2%, respectively. Three patients demonstrated CSF pleocytosis, and 9 patients exhibited elevated CSF protein levels. Therefore, NS with only epileptic seizures at the initial presentation exhibits a lack of specificity. It is recommended that every patient with clinically evident symptoms of epileptic seizures should have a blood test performed for syphilis. When the serology results are positive, all of the patients should undergo a CSF examination to diagnose NS. Copyright © 2013 Elsevier Inc. All rights reserved.

Maternal identification of dental caries lesions in their children aged 1-3 years.

PubMed

Fernandes, I B; Sá-Pinto, A C; Silva Marques, L; Ramos-Jorge, J; Ramos-Jorge, M L

2017-06-01

To analyse the maternal identification of different stages of dental caries in children aged 1-3 years. A cross-sectional study was conducted with 274 children and their mothers. The mothers answered a questionnaire on the occurrence of dental caries in their children and completed questions addressing their demographic/socio-economic status. The oral examination of the children was performed using the International Caries Detection and Assessment System. Descriptive, Chi square test and Poisson regression statistical analyses were performed. The prevalence of initial and established/severe dental caries lesions by age were: 1 year (23.2 and 24.2%), 2 years (17.9 and 55.7%) and 3 years (23.3 and 60.3%) respectively. Significant associations between clinical examinations and the mothers' reports were observed among children aged 1 year old who had initial stage caries lesions (p = 0.006) and in children aged 1, 2 and 3 years old who had established/severe stage caries lesions (p < 0.001). After adjustment for confounding variables it was found that mothers were more able to identify dental caries both at initial (PR 4.01, 95% CI 1.35-11.94) and established/severe stages (PR 9.14, 95% CI 2.49-33.56) in children aged 1 year old. In children aged 2 and 3 years, this identification was more evident in the established/severe stage (2 years, PR 2.98, 95% CI 1.42-6.26; 3 years, PR 2.75, 95% CI 1.09-6.93). Mothers of children aged 1 year old identified dental caries at initial and established/severe stages. Mothers of children aged 2 and 3 years identified dental caries only at established/severe stages.

78 FR 23983 - Endangered and Threatened Wildlife and Plants; Threatened Status for Eriogonum codium

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-23

... substrates that support these and other rare endemic plants (see Species Information sections) within the... large-scale rare plant surveys on the Hanford Site that were initiated in 1994 by TNC and the DOE, as... Service 50 CFR Part 17 Endangered and Threatened Wildlife and Plants; Threatened Status for Eriogonum...

The Coconstruction of Cross-Cultural Miscommunication: Conflicts in Perception, Negotiation, and Enactment of Participant Role and Status.

ERIC Educational Resources Information Center

Tyler, Andrea

1995-01-01

Examines the sources of miscommunication in a videotaped tutoring session involving a native speaker of Korean and a native speaker of English. Analysis revealed an initial nonmutual interpretation of participant role and status, resulting from the Korean tutor's transfer of a Korean conversational routine involving polite speaker modesty to the…

The Profile and Status of NAWDE Members

ERIC Educational Resources Information Center

Berry, Margaret C.; Fitzgerald, Laurine E.

1971-01-01

The purpose of this study was to gain a profile of the current membership of the National Association of Women Deans and Counselors and ascertain opinions of the members about present status and future directions o the organization. The typical member feels very free to express opinions but less free to initiate action; being a woman she perceives…

Low Dose Ferrous Gluconate Supplement Fails to Alter the Iron Status of Female Officers-In-Training

DTIC Science & Technology

2005-07-01

guidelines are that total dietary fat intake should contribute no more than 28% of dietary energy with no more than 10% being from saturated fatty...13 3.4 Does alcohol, dietary iron intake , initial iron status or inflammation influence the effect of the supplement...13 3.4.2 Dietary iron intake

Sociometric Stability and the Behavioral Correlates of Peer Acceptance in Early Childhood

ERIC Educational Resources Information Center

Walker, Sue

2009-01-01

The author presents findings from an Australian study examining the behavioral correlates and stability of social status among preschool-aged children. Using sociometric assessment, the author determined the social status of an initial sample of 187 preschool-aged children (94 boys, 93 girls; M age = 62.4 months, SD age = 4.22 months). The author…

75 FR 53978 - Endangered and Threatened Wildlife and Plants; 5-Year Status Reviews for Lomatium cookii (Cook's...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-02

...] Endangered and Threatened Wildlife and Plants; 5-Year Status Reviews for Lomatium cookii (Cook's Lomatium.... Fish and Wildlife Service, are initiating 5-year reviews for two plant species in Oregon under the... seq.), we maintain Lists of Endangered and Threatened Wildlife and Plants (which we collectively refer...

To amend the Homeland Security Act of 2002 to authorize the Securing the Cities Initiative of the Department of Homeland Security, and for other purposes.

THOMAS, 111th Congress

Rep. King, Peter T. [R-NY-3

2009-05-21

Senate - 01/21/2010 Received in the Senate and Read twice and referred to the Committee on Homeland Security and Governmental Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

AMON: Transition to real-time operations

NASA Astrophysics Data System (ADS)

Cowen, D. F.; Keivani, A.; Tešić, G.

2016-04-01

The Astrophysical Multimessenger Observatory Network (AMON) will link the world's leading high-energy neutrino, cosmic-ray, gamma-ray and gravitational wave observatories by performing real-time coincidence searches for multimessenger sources from observatories' subthreshold data streams. The resulting coincidences will be distributed to interested parties in the form of electronic alerts for real-time follow-up observation. We will present the science case, design elements, current and projected partner observatories, status of the AMON project, and an initial AMON-enabled analysis. The prototype of the AMON server has been online since August 2014 and processing archival data. Currently, we are deploying new high-uptime servers and will be ready to start issuing alerts as early as winter 2015/16.

Making every colonoscopy count: Ensuring quality in endoscopy.

PubMed

Bourke, Michael J

2009-10-01

The last few years have seen a burgeoning interest in the measurement of clinical performance and its impact on quality standards. The advent of the National Bowel Cancer Screening Program has highlighted the many deficiencies that exist in the provision of colonoscopy services in Australia. These include the absence of an agreed tool to measure the quality of colonoscopy on either an individual, departmental or regional basis and the absence of an endoscopic or colonoscopy training curriculum or an agreed standard for colonoscopy trainers. This review will discuss the current status and shortfalls of measuring quality in colonoscopy, highlight some recent initiatives by the Gastroenterological Society of Australia and articulate a direction for the future.

Vehicle Engineering Development Activities at the Marshall Space Flight Center

NASA Technical Reports Server (NTRS)

Fisher, Mark F.; Champion, Robert H., Jr.

1999-01-01

New initiatives in the Space Transportation Directorate at the Marshall Space Flight Center include an emphasis on Vehicle Engineering to enhance the strong commitment to the Directorate's projects in the development of flight hardware and flight demonstrators for the advancement of space transportation technology. This emphasis can be seen in the activities of a newly formed organization in the Transportation Directorate, The Vehicle Subsystems Engineering Group. The functions and type of activities that this group works on are described. The current projects of this group are outlined including a brief description of the status and type of work that the group is performing. A summary section is included to describe future activities.