Kinetic analysis of Legionella inactivation using ozone in wastewater.

PubMed

Li, Jun; Li, Kunquan; Zhou, Yan; Li, Xuebin; Tao, Tao

2017-02-01

Legionella inactivation using ozone was studied in wastewater using kinetic analysis and modeling. The experimental results indicate that the relationship between the ozone concentration, germ concentration, and chemical oxygen demand (COD) can be used to predict variations in germ and COD concentrations. The ozone reaction with COD and inactivation of Legionella occurred simultaneously, but the reaction with COD likely occurred at a higher rate than the inactivation, as COD is more easily oxidized by ozone than Legionella. Higher initial COD concentrations resulted in a lower inactivation rate and higher lnN/N 0 . Higher temperature led to a higher inactivation efficiency. The relationship of the initial O 3 concentration and Legionella inactivation rate was not linear, and thus, the Ct value required for a 99.99% reduction was not constant. The initial O 3 concentration was more important than the contact time, and a reduction of the initial O 3 concentration could not be compensated by increasing the contact time. The Ct values were compared over a narrow range of initial concentrations; the Ct values could only be contrasted when the initial O 3 concentrations were very similar. A higher initial O 3 concentration led to a higher inflection point value for the lnN/N 0 vs C 0 t curve. Energy consumption using a plasma corona was lower than when using boron-doped diamond electrodes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Intravenous heparin dosing strategy in hospitalized patients with atrial dysrhythmias.

PubMed

Roswell, Robert O; Greet, Brian; Shah, Sunny; Bernard, Samuel; Milin, Alexandra; Lobach, Iryna; Guo, Yu; Radford, Martha J; Berger, Jeffrey S

2016-08-01

Patients with non-valvular atrial fibrillation (AF) have an elevated stroke risk that is 2-7 times greater than in those without AF. Intravenous unfractionated heparin (UFH) is commonly used for hospitalized patients with atrial fibrillation and atrial flutter (AFL) to prevent stroke. Dosing strategies exist for intravenous anticoagulation in patients with acute coronary syndromes and venous thromboembolic diseases, but there are no data to guide providers on a dosing strategy for intravenous anticoagulation in patients with AF/AFL. 996 hospitalized patients with AF/AFL on UFH were evaluated. Bolus dosing and initial infusion rates of UFH were recorded along with rates of stroke, thromboemobolic events, and bleeding events as defined by the International Society on Thrombosis and Haemostasis criteria. Among 226 patients included in the analysis, 76 bleeding events occurred. Using linear regression analysis, initial rates of heparin infusion ranging from 9.7 to 11.8 units/kilogram/hour (U/kg/h) resulted in activated partial thromboplastin times that were within therapeutic range. The median initial infusion rate in patients with bleeding was 13.3 U/kg/h, while in those without bleeding it was 11.4 U/kg/h; p = 0.012. An initial infusion rate >11.0 U/kg/h yielded an OR 1.95 (1.06-3.59); p = 0.03 for any bleeding event. Using IV heparin boluses neither increased the probability of attaining a therapeutic aPTT (56.1 vs 56.3 %; p = 0.99) nor did it significantly increase bleeding events in the study (35.7 vs 31.3 %; p = 0.48). The results suggest that higher initial rates of heparin are associated with increased bleeding risk. From this dataset, initial heparin infusion rates of 9.7-11.0 U/kg/h without a bolus can result in therapeutic levels of anticoagulation in hospitalized patients with AF/AFL without increasing the risk of bleeding.

[Relationships between decomposition rate of leaf litter and initial quality across the alpine timberline ecotone in Western Sichuan, China].

PubMed

Yang, Lin; Deng, Chang-chun; Chen Ya-mei; He, Run-lian; Zhang, Jian; Liu, Yang

2015-12-01

The relationships between litter decomposition rate and their initial quality of 14 representative plants in the alpine forest ecotone of western Sichuan were investigated in this paper. The decomposition rate k of the litter ranged from 0.16 to 1.70. Woody leaf litter and moss litter decomposed much slower, and shrubby litter decomposed a little faster. Then, herbaceous litters decomposed fastest among all plant forms. There were significant linear regression relationships between the litter decomposition rate and the N content, lignin content, phenolics content, C/N, C/P and lignin/N. Lignin/N and hemicellulose content could explain 78.4% variation of the litter decomposition rate (k) by path analysis. The lignin/N could explain 69.5% variation of k alone, and the direct path coefficient of lignin/N on k was -0.913. Principal component analysis (PCA) showed that the contribution rate of the first sort axis to k and the decomposition time (t) reached 99.2%. Significant positive correlations existed between lignin/N, lignin content, C/N, C/P and the first sort axis, and the closest relationship existed between lignin/N and the first sort axis (r = 0.923). Lignin/N was the key quality factor affecting plant litter decomposition rate across the alpine timberline ecotone, with the higher the initial lignin/N, the lower the decomposition rate of leaf litter.

Decay Rates and Probability Estimatesfor Massive Dirac Particlesin the Kerr-Newman Black Hole Geometry

NASA Astrophysics Data System (ADS)

Finster, F.; Kamran, N.; Smoller, J.; Yau, S.-T.

The Cauchy problem is considered for the massive Dirac equation in the non-extreme Kerr-Newman geometry, for smooth initial data with compact support outside the event horizon and bounded angular momentum. We prove that the Dirac wave function decays in L∞ {loc} at least at the rate t-5/6. For generic initial data, this rate of decay is sharp. We derive a formula for the probability p that the Dirac particle escapes to infinity. For various conditions on the initial data, we show that p = 0, 1 or 0 < p < 1. The proofs are based on a refined analysis of the Dirac propagator constructed in [4].

Early Complications and Outcomes in Combat Injury Related Invasive Fungal Wound Infections: A Case-Control Analysis

PubMed Central

Lewandowski, Louis R.; Weintrob, Amy C.; Tribble, David R.; Rodriguez, Carlos J.; Petfield, Joseph; Lloyd, Bradley A.; Murray, Clinton K.; Stinner, Daniel; Aggarwal, Deepak; Shaikh, Faraz; Potter, Benjamin K.

2015-01-01

Objective Clinicians have anecdotally noted that combat-related invasive fungal wound infections (IFIs) lead to residual limb shortening, additional days and operative procedures prior to initial wound closure, and high early complication rates. We evaluated the validity of these observations and identified risk factors that may impact time to initial wound closure. Design Retrospective review and case-control analysis. Setting Military hospitals. Patients/Participants United States military personnel injured during combat operations (2009–2011). The IFI cases were identified based upon the presence of recurrent, necrotic extremity wounds with mold growth in culture and/or histopathologic fungal evidence. Non-IFI controls were matched on injury pattern and severity. In a supplemental matching analysis, non-IFI controls were also matched by blood volume transfused within 24 hours of injury. Intervention None. Main Outcome Measurements Amputation revision rate and loss of functional levels. Results Seventy-one IFI cases (112 fungal-infected extremity wounds) were identified and matched to 160 control patients (315 non-IFI extremity wounds). The IFI wounds resulted in significantly more changes in amputation level (p<0.001). Additionally, significantly (p<0.001) higher number of operative procedures and longer duration to initial wound closure was associated with IFI. A shorter duration to initial wound closure was significantly associated with wounds lacking IFIs (Hazard ratio: 1.53; 95% CI: 1.17, 2.01). The supplemental matching analysis found similar results. Conclusions Our analysis indicates that IFIs adversely impact wound healing and patient recovery, requiring more frequent proximal amputation revisions and leading to higher early complication rates. PMID:26360542

Innovative use of influential prenatal counseling may improve breastfeeding initiation rates among WIC participants.

PubMed

Hildebrand, Deana A; McCarthy, Pam; Tipton, Debi; Merriman, Connie; Schrank, Melody; Newport, Melinda

2014-01-01

To determine whether integrating influence strategies (reciprocation, consistency, consensus, feeling liked, authority, and scarcity) throughout Chickasaw Nation Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics (1) changed participants' perception of the WIC experience and (2) affected breastfeeding initiation rates. Two-part, quasi-experimental design. Four WIC clinics. Parents and caregivers of children birth to 3 years. Behavior change intervention based on Social Cognitive Theory using Caildini's Principles of Influence. Traditional-model groups (control) received services prior to the intervention; influence-model groups (experimental) received services after initiation of the intervention. The preliminary demonstration project surveyed 2 groups to measure changes in their perceptions of the WIC environment. Secondary data analysis measured changes in breastfeeding initiation in 2 groups of postpartum women. Frequency analysis, independent sample t tests, chi-square for independence, step-wise logistic regression. The demonstration project resulted in 5 improved influence measures (P < .02), aligning with the influence principle of "feeling liked." The model had a small effect (φ = 0.10) in distinguishing breastfeeding initiation; women in the influence model were 1.5 times more likely (95% CI, 1.19-1.86; P < .05) to initiate breastfeeding compared with women in the traditional model, controlling for parity, mother's age, and race. Consistent with Social Cognitive Theory, changing the WIC environment by integrating influence principles may positively affect women's infant feeding decisions and behaviors, specifically breastfeeding initiation rates. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

A Systematic Review and Meta-Analysis Comparing Pigtail Catheter and Chest Tube as the Initial Treatment for Pneumothorax.

PubMed

Chang, Su-Huan; Kang, Yi-No; Chiu, Hsin-Yi; Chiu, Yu-Han

2018-05-01

The optimal initial treatment approach for pneumothorax remains controversial. This systemic review and meta-analysis investigated the effectiveness of small-bore pigtail catheter (PC) drainage compared with that of large-bore chest tube (LBCT) drainage as the initial treatment approach for all subtypes of pneumothorax. PubMed and Embase were systematically searched for observational studies and randomized controlled trials published up to October 9, 2017, that compared PC and LBCT as the initial treatment for pneumothorax. The investigative outcomes included success rates, recurrence rates, complication rates, drainage duration, and hospital stay. Of the 11 included studies (875 patients), the success rate was similar in the PC (79.84%) and LBCT (82.87%) groups, with a risk ratio of 0.99 (95% CI, 0.93 to 1.05; I 2  = 0%). Specifically, PC drainage was associated with a significantly lower complication rate following spontaneous pneumothorax than LBCT drainage (Peto odds ratio: 0.49 [95% CI, 0.28 to 0.85]; I 2  = 29%). In the spontaneous subgroup, PC drainage was associated with a significantly shorter drainage duration (mean difference, -1.51 [95% CI, -2.93 to -0.09]) and hospital stay (mean difference: -2.54 [95% CI, -3.16 to -1.92]; P < .001) than the LBCT group. Collectively, results of the meta-analysis suggest PC drainage may be considered as the initial treatment option for patients with primary or secondary spontaneous pneumothorax. Ideally, randomized controlled trials are needed to compare PC vs LBCT among different subgroups of patients with pneumothorax, which may ultimately improve clinical care and management for these patients. PROSPERO; No.: CRD42017078481; URL: https://www.crd.york.ac.uk/prospero/. Copyright © 2018 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

A comparison of endoscopic localization error rate between operating surgeons and referring endoscopists in colorectal cancer.

PubMed

Azin, Arash; Saleh, Fady; Cleghorn, Michelle; Yuen, Andrew; Jackson, Timothy; Okrainec, Allan; Quereshy, Fayez A

2017-03-01

Colonoscopy for colorectal cancer (CRC) has a localization error rate as high as 21 %. Such errors can have substantial clinical consequences, particularly in laparoscopic surgery. The primary objective of this study was to compare accuracy of tumor localization at initial endoscopy performed by either the operating surgeon or non-operating referring endoscopist. All patients who underwent surgical resection for CRC at a large tertiary academic hospital between January 2006 and August 2014 were identified. The exposure of interest was the initial endoscopist: (1) surgeon who also performed the definitive operation (operating surgeon group); and (2) referring gastroenterologist or general surgeon (referring endoscopist group). The outcome measure was localization error, defined as a difference in at least one anatomic segment between initial endoscopy and final operative location. Multivariate logistic regression was used to explore the association between localization error rate and the initial endoscopist. A total of 557 patients were included in the study; 81 patients in the operating surgeon cohort and 476 patients in the referring endoscopist cohort. Initial diagnostic colonoscopy performed by the operating surgeon compared to referring endoscopist demonstrated statistically significant lower intraoperative localization error rate (1.2 vs. 9.0 %, P = 0.016); shorter mean time from endoscopy to surgery (52.3 vs. 76.4 days, P = 0.015); higher tattoo localization rate (32.1 vs. 21.0 %, P = 0.027); and lower preoperative repeat endoscopy rate (8.6 vs. 40.8 %, P < 0.001). Initial endoscopy performed by the operating surgeon was protective against localization error on both univariate analysis, OR 7.94 (95 % CI 1.08-58.52; P = 0.016), and multivariate analysis, OR 7.97 (95 % CI 1.07-59.38; P = 0.043). This study demonstrates that diagnostic colonoscopies performed by an operating surgeon are independently associated with a lower localization error rate. Further research exploring the factors influencing localization accuracy and why operating surgeons have lower error rates relative to non-operating endoscopists is necessary to understand differences in care.

Hepatitis A, B, and A/B vaccination series completion among US adults: a claims-based analysis.

PubMed

Ghaswalla, Parinaz K; Patterson, Brandon J; Cheng, Wendy Y; Duchesneau, Emilie; Macheca, Monica; Duh, Mei Sheng

2018-06-20

Hepatitis A and B disease burden persists in the US. We assessed hepatitis A and hepatitis B vaccination series completion rates among 350,240 commercial/Medicare and 12,599 Medicaid enrollees aged ≥19 years. A vaccination series was considered as completed provided that the minimum interval between doses, as defined by the CDC, and the minimum number of doses were reached. We stratified completion rates by vaccine type (i.e. monovalent or bivalent) at initial vaccination for each cohort. In the commercial/Medicare cohort, the series completion rate was 32.0% for hepatitis A and 39.6% for hepatitis B among those who initiated with a monovalent vaccine, and it was 36.2% for hepatitis A and 48.9% for hepatitis B among those who initiated with a bivalent vaccine. In the Medicaid cohort, the series completion rate was 21.0% for hepatitis A and 24.0% for hepatitis B among those who initiated with a monovalent vaccine, and it was 19.0% for hepatitis A and 24.6% for hepatitis B among those who initiated with a bivalent vaccine. In conclusion, hepatitis A and B vaccination series completion rates were low, and appeared to be lower among Medicaid than among commercial/Medicare enrollees. Commercial/Medicare enrollees who initiated with a bivalent vaccine had higher series completion rates than those who initiated with monovalent vaccines - an observation that was not made among Medicaid enrollees.

Startup analysis for a high temperature gas loaded heat pipe

NASA Technical Reports Server (NTRS)

Sockol, P. M.

1973-01-01

A model for the rapid startup of a high-temperature gas-loaded heat pipe is presented. A two-dimensional diffusion analysis is used to determine the rate of energy transport by the vapor between the hot and cold zones of the pipe. The vapor transport rate is then incorporated in a simple thermal model of the startup of a radiation-cooled heat pipe. Numerical results for an argon-lithium system show that radial diffusion to the cold wall can produce large vapor flow rates during a rapid startup. The results also show that startup is not initiated until the vapor pressure p sub v in the hot zone reaches a precise value proportional to the initial gas pressure p sub i. Through proper choice of p sub i, startup can be delayed until p sub v is large enough to support a heat-transfer rate sufficient to overcome a thermal load on the heat pipe.

Is there an ideal stimulation regimen for IVF for poor responders and does it change with age?

PubMed Central

Osianlis, Tiki; Catt, James

2008-01-01

Purpose To determine whether there is a superior treatment modality for ‘poor’ responders. Method Retrospective analysis of three stimulation regimens, with patients stratified based on age, stimulation regime and response in previous cycles (“poor’ responder or “non poor” responder). Fertilisation, embryo utilisation and clinical pregnancy rates were assessed. There were a total of 1,608 cycles in the ‘poor’ responder and 8,489 cycles in the ‘non poor’ responder groups. Results In ‘poor’ responders there was no significant difference in fertilisation rate, nor utilisation rate between the three stimulation regimes and no differences in the pregnancy rate/initiated cycle irrespective of age and stimulation regimen in any of the groups. ‘Non poor’ responders had a significantly greater pregnancy rate/initiated cycle for all stimulation regimens in both age groups compared with ‘poor’ responders. Conclusion This large retrospective study of ‘poor’ responders has not shown a difference in pregnancy rates/initiated cycle between stimulation regimens. PMID:18982442

The Impact of Institutional Context, Education and Labour Market Policies on Early School Leaving: A Comparative Analysis of EU Countries

ERIC Educational Resources Information Center

De Witte, Kristof; Nicaise, Ides; Lavrijsen, Jeroen; Van Landeghem, Georges; Lamote, Carl; Van Damme, Jan

2013-01-01

This article presents a comparative analysis of the determinants of early school leaving (ESL) at the country level. We decompose ESL rates into two components: a "primary" rate reflecting unqualified school leaving from initial education, and a second component accounting for early school leavers who participate in training programmes.…

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

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

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

1994-08-01

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

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

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

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

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

Nonlinear response of hail precipitation rate to environmental moisture content: A real case modeling study of an episodic midlatitude severe convective event

NASA Astrophysics Data System (ADS)

Li, Mingxin; Zhang, Fuqing; Zhang, Qinghong; Harrington, Jerry Y.; Kumjian, Matthew R.

2017-07-01

The dependence of hail production on initial moisture content in a simulated midlatitude episodic convective event occurred in northeast China on 10-11 June 2005 was investigated using the Weather Research and Forecasting (WRF) model with a double-moment microphysics scheme where both graupel and hail are considered. Three sensitivity experiments were performed by modifying the initial water vapor mixing ratio profile to 90% ("Q-10%"), 105% ("Q+5%"), and 110% ("Q+10%") of the initial conditions used for the control simulation. It was found that increasing the initial water vapor content caused the hail and total precipitation rates to increase during the first 5 h. The precipitation response to increasing water vapor content was monotonic for this first episode; however, for the event's second episode, the hail precipitation rate responds to the initial water vapor profile nonlinearly, while the total precipitation rate responds mostly monotonically. In particular, simulation Q+5% achieves the largest hail production rate while simulation Q+10% has the largest total precipitation rate. In contrast, during the second episode simulation Q-10% has the strongest vertical motion, produces the most cloud ice and snow, but has the lowest hail production. Analysis shows that increasing the initial moisture content directly increases the precipitation during the first episode, which subsequently induces a stronger, longer-lasting cold pool that limits the development of deep convection during the second episode.

Can pricing deter adolescents and young adults from starting to drink: An analysis of the effect of alcohol taxation on drinking initiation among Thai adolescents and young adults.

PubMed

Sornpaisarn, Bundit; Shield, Kevin D; Cohen, Joanna E; Schwartz, Robert; Rehm, Jürgen

2015-12-01

The objective of this study is to assess the relationship between alcohol taxation changes and drinking initiation among adolescents and young adults (collectively "youth") in Thailand (a middle-income country). Using a survey panel, this study undertook an age-period-cohort analysis using four large-scale national cross-sectional surveys of alcohol consumption performed in Thailand in 2001, 2004, 2007 and 2011 (n=87,176 Thai youth, 15-24 years of age) to test the hypothesis that changes in the inflation-adjusted alcohol taxation rates are associated with drinking initiation. Regression analyses were used to examine the association between inflation-adjusted taxation increases and the prevalence of lifetime drinkers. After adjusting for potential confounders, clear cohort and age effects were observed. Furthermore, a 10% increase of the inflation-adjusted taxation rate of the total alcohol market was significantly associated with a 4.3% reduction in the prevalence of lifetime drinking among Thai youth. In conclusion, tax rate changes in Thailand from 2001 to 2011 were associated with drinking initiation among youth. Accordingly, increases in taxation may prevent drinking initiation among youth in countries with a high prevalence of abstainers and may reduce the harms caused by alcohol. Copyright © 2015 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Series length used during trend analysis affects sensitivity to changes in progression rate in the ocular hypertension treatment study.

PubMed

Gardiner, Stuart K; Demirel, Shaban; De Moraes, Carlos Gustavo; Liebmann, Jeffrey M; Cioffi, George A; Ritch, Robert; Gordon, Mae O; Kass, Michael A

2013-02-15

Trend analysis techniques to detect glaucomatous progression typically assume a constant rate of change. This study uses data from the Ocular Hypertension Treatment Study to assess whether this assumption decreases sensitivity to changes in progression rate, by including earlier periods of stability. Series of visual fields (mean 24 per eye) completed at 6-month intervals from participants randomized initially to observation were split into subseries before and after the initiation of treatment (the "split-point"). The mean deviation rate of change (MDR) was derived using these entire subseries, and using only the window length (W) tests nearest the split-point, for different window lengths of W tests. A generalized estimating equation model was used to detect changes in MDR occurring at the split-point. Using shortened subseries with W = 7 tests, the MDR slowed by 0.142 dB/y upon initiation of treatment (P < 0.001), and the proportion of eyes showing "rapid deterioration" (MDR <-0.5 dB/y with P < 5%) decreased from 11.8% to 6.5% (P < 0.001). Using the entire sequence, no significant change in MDR was detected (P = 0.796), and there was no change in the proportion of eyes progressing (P = 0.084). Window lengths 6 ≤ W ≤ 9 produced similar benefits. Event analysis revealed a beneficial treatment effect in this dataset. This effect was not detected by linear trend analysis applied to entire series, but was detected when using shorter subseries of length between six and nine fields. Using linear trend analysis on the entire field sequence may not be optimal for detecting and monitoring progression. Nonlinear analyses may be needed for long series of fields. (ClinicalTrials.gov number, NCT00000125.).

Cumulative Risk for Early Sexual Initiation among American Indian Youth: A Discrete-Time Survival Analysis

ERIC Educational Resources Information Center

Mitchell, Christina M.; Whitesell, Nancy Rumbaugh; Spicer, Paul; Beals, Janette; Kaufman, Carol E.

2007-01-01

Approximately 3 million teens are diagnosed with a sexually transmitted disease (STD) annually; STDs rates for American Indian young adults are among the highest of any racial/ethnic group. An important risk factor for STDs is early initiation of sex. In this study, we examined risk for early initiation with 474 American Indian youth ages 14-18,…

A Benefit Cost Analysis of the South Carolina MDTA Program. Preliminary Report.

ERIC Educational Resources Information Center

South Carolina Univ., Columbia. Bureau of Business and Economic Research.

Manpower Development and Training Act (MDTA) programs completed in 1965 were evaluated by benefit-cost ratio and internal rate of return. Initial annual earnings differential figures at $525,650 and $719,629 were projected into the future at various rates of promotion and various rates of discount on the benefit stream. Resulting lifetime benefits…

Advanced bridge safety initiative : live load testing and load rating of the Evans Brook Bridge (#5506) and the Hastings Bridge (#5507) in Batchelders Grant, Maine.

DOT National Transportation Integrated Search

2014-01-01

The Advanced Structures and Composites Center at the University of Maine (UMaine) performed live load testing : and rating factor analysis for two bridges (No. 5506 and No. 5507) in Batchelders Grant, Maine. The bridge load : rating performed by cons...

Isothermal thermogravimetric data acquisition analysis system

NASA Technical Reports Server (NTRS)

Cooper, Kenneth, Jr.

1991-01-01

The description of an Isothermal Thermogravimetric Analysis (TGA) Data Acquisition System is presented. The system consists of software and hardware to perform a wide variety of TGA experiments. The software is written in ANSI C using Borland's Turbo C++. The hardware consists of a 486/25 MHz machine with a Capital Equipment Corp. IEEE488 interface card. The interface is to a Hewlett Packard 3497A data acquisition system using two analog input cards and a digital actuator card. The system provides for 16 TGA rigs with weight and temperature measurements from each rig. Data collection is conducted in three phases. Acquisition is done at a rapid rate during initial startup, at a slower rate during extended data collection periods, and finally at a fast rate during shutdown. Parameters controlling the rate and duration of each phase are user programmable. Furnace control (raising and lowering) is also programmable. Provision is made for automatic restart in the event of power failure or other abnormal terminations. Initial trial runs were conducted to show system stability.

Cyclic plasticity models and application in fatigue analysis

NASA Technical Reports Server (NTRS)

Kalev, I.

1981-01-01

An analytical procedure for prediction of the cyclic plasticity effects on both the structural fatigue life to crack initiation and the rate of crack growth is presented. The crack initiation criterion is based on the Coffin-Manson formulae extended for multiaxial stress state and for inclusion of the mean stress effect. This criterion is also applied for the accumulated damage ahead of the existing crack tip which is assumed to be related to the crack growth rate. Three cyclic plasticity models, based on the concept of combination of several yield surfaces, are employed for computing the crack growth rate of a crack plane stress panel under several cyclic loading conditions.

Resource utilization with insulin pump therapy for type 2 diabetes mellitus.

PubMed

Lynch, Peter M; Riedel, Aylin Altan; Samant, Navendu; Fan, Ying; Peoples, Tim; Levinson, Jennifer; Lee, Scott W

2010-01-01

To evaluate the effects of switching from multiple daily injection (MDI) therapy to insulin pump therapy, also called continuous subcutaneous insulin infusion (CSII), on antidiabetic drug and healthcare resource utilization. This study was a retrospective analysis of administrative claims data from a large geographically diverse health plan in the United States from January 1, 2005, through April 30, 2008. Changes in antidiabetic drug use, antidiabetic drug switching and augmentation, and healthcare utilization during the baseline period and after CSII initiation were assessed using paired t test. There were 3649 possible subjects, of whom 943 met the criteria for analysis. The mean number of antidiabetic drugs used decreased by 46% after CSII initiation, and the mean reduction in antidiabetic drug utilization was 0.67; both were statistically significant. More than one-third of subjects who were taking antidiabetic drugs before CSII initiation discontinued oral therapy after CSII initiation. The number of subjects using multiple antidiabetic drugs significantly decreased after CSII initiation by 58%, and rates of switching or augmenting significantly decreased from 42% at baseline to 25% after CSII initiation.The rates of emergency department visits and inpatient admissions significantly decreased, and the rate of ambulatory visits significantly increased. CSII was associated with significant decreases in antidiabetic drug and healthcare resource utilization, contributing to stability of care. The evidence from this study indicates that CSII should be considered as an option for patients with type 2 diabetes mellitus who are using MDI and are experiencing a high degree of antidiabetic drug and healthcare resource utilization.

Effect of loss control service on reported injury incidence.

PubMed

Nave, Michael E; Veltri, Anthony

2004-01-01

A retrospective analysis evaluated the effectiveness of an insurance carrier's flexible loss control service strategy in reducing workers' compensation policyholders' reported injury and illness claims. To assess the effects of a loss control service strategy on workers' compensation claim frequency rates, on medical-only claim rates, on severity-claim rates, and on claim cost among a group of California employers. Eighty-two small- and medium-sized companies with workers' compensation policies expiring in 1999 were randomly selected from a population of policyholders assigned to loss control consultants for two or more years. Claim performance data were obtained for each company's first expired in-force policy year and its 1999 expired policy year. The retrospective design was combined with a control component based on a randomly selected comparison group of 45 companies whose first policy year with the insurer expired in 1999 and who received safety services from the loss control staff. The flexible loss control consultation service strategy was associated with lower average claim rates and costs. Companies assigned to a loss control consultant for two or more years (the "outcome group") had an average claim rate of 1.24 per $10,000 premium, compared with a rate of 1.62 in the "initial group" and a rate of 1.60 in the "comparison group." The average severity-claim rate of the outcome group was 0.32, compared with the initial-year and comparison-group means of 0.48 and 0.46, respectively. The average medical-only claim rate was 0.92, compared with the initial- and comparison-group means of 1.14 and 1.14. The outcome group's average loss ratio was over 10% lower than that of the initial and comparison groups. Statistical analysis indicated that differences among the groups' claim rates and severity-claim rates were [F=(2,206) 4.938, P=0.008] and [F=(2,206) 8.208, P<0.001], respectively. A loss control service strategy that provides service flexibility and develops partnership between employer and consultant can help reduce the frequency and severity of workers' compensation claims. Barriers to consultation service flexibility, both internal and external, should be identified and removed to enhance service efficacy.

Kinetic Analysis of Benign and Malignant Breast Lesions With Ultrafast Dynamic Contrast-Enhanced MRI: Comparison With Standard Kinetic Assessment.

PubMed

Abe, Hiroyuki; Mori, Naoko; Tsuchiya, Keiko; Schacht, David V; Pineda, Federico D; Jiang, Yulei; Karczmar, Gregory S

2016-11-01

The purposes of this study were to evaluate diagnostic parameters measured with ultrafast MRI acquisition and with standard acquisition and to compare diagnostic utility for differentiating benign from malignant lesions. Ultrafast acquisition is a high-temporal-resolution (7 seconds) imaging technique for obtaining 3D whole-breast images. The dynamic contrast-enhanced 3-T MRI protocol consists of an unenhanced standard and an ultrafast acquisition that includes eight contrast-enhanced ultrafast images and four standard images. Retrospective assessment was performed for 60 patients with 33 malignant and 29 benign lesions. A computer-aided detection system was used to obtain initial enhancement rate and signal enhancement ratio (SER) by means of identification of a voxel showing the highest signal intensity in the first phase of standard imaging. From the same voxel, the enhancement rate at each time point of the ultrafast acquisition and the AUC of the kinetic curve from zero to each time point of ultrafast imaging were obtained. There was a statistically significant difference between benign and malignant lesions in enhancement rate and kinetic AUC for ultrafast imaging and also in initial enhancement rate and SER for standard imaging. ROC analysis showed no significant differences between enhancement rate in ultrafast imaging and SER or initial enhancement rate in standard imaging. Ultrafast imaging is useful for discriminating benign from malignant lesions. The differential utility of ultrafast imaging is comparable to that of standard kinetic assessment in a shorter study time.

The Isolation of Motivational, Motoric, and Schedule Effects on Operant Performance: A Modeling Approach

PubMed Central

Brackney, Ryan J; Cheung, Timothy H. C; Neisewander, Janet L; Sanabria, Federico

2011-01-01

Dissociating motoric and motivational effects of pharmacological manipulations on operant behavior is a substantial challenge. To address this problem, we applied a response-bout analysis to data from rats trained to lever press for sucrose on variable-interval (VI) schedules of reinforcement. Motoric, motivational, and schedule factors (effort requirement, deprivation level, and schedule requirements, respectively) were manipulated. Bout analysis found that interresponse times (IRTs) were described by a mixture of two exponential distributions, one characterizing IRTs within response bouts, another characterizing intervals between bouts. Increasing effort requirement lengthened the shortest IRT (the refractory period between responses). Adding a ratio requirement increased the length and density of response bouts. Both manipulations also decreased the bout-initiation rate. In contrast, food deprivation only increased the bout-initiation rate. Changes in the distribution of IRTs over time showed that responses during extinction were also emitted in bouts, and that the decrease in response rate was primarily due to progressively longer intervals between bouts. Taken together, these results suggest that changes in the refractory period indicate motoric effects, whereas selective alterations in bout initiation rate indicate incentive-motivational effects. These findings support the use of response-bout analyses to identify the influence of pharmacological manipulations on processes underlying operant performance. PMID:21765544

System analysis of the dynamic response of the coronary circulation to a sudden change in heart rate.

PubMed

Dankelman, J; Stassen, H G; Spaan, J A

1990-03-01

In this study the response of driving pressure/flow ration on an abrupt change in heart rate was analysed. The difference between the response obtained with constant pressure and constant flow perfusion was also studied. The responses show a fast initial reversed phase followed by a slow phase caused by regulation. To test whether the initial phase could be the result of mechanical changes in the coronary circulation, a model for regulation was extended by the addition of four different mechanical models originating from the literature. These extended models were able to explain the fast initial phase. However, the mechanical model consisting of an intramyocardial compliance (C = 0.08 ml mm Hg-1 100 g-1) with a variable venous resistance, and the model consisting of a waterfall and a small compliance (C = 0.007 ml mm Hg-1 100g-1) both explained these responses best. The analysis showed that there is no direct relationship between rate of change of vascular tone and rate of change of pressure/flow ratio. However, on the basis of the two extended models, it can be predicted that the half-time for the response of regulation to be complete is about 9s with constant pressure perfusion and 15 s with constant flow perfusion.

Validating the Effectiveness of Switching the Vancomycin TDM Analysis Software Based on the Predictive Accuracy.

PubMed

Imai, Shungo; Yamada, Takehiro; Ishiguro, Nobuhisa; Miyamoto, Takenori; Kagami, Keisuke; Tomiyama, Naoki; Niinuma, Yusuke; Nagasaki, Daisuke; Suzuki, Koji; Yamagami, Akira; Kasashi, Kumiko; Kobayashi, Masaki; Iseki, Ken

2017-01-01

Based on the predictive performance in our previous study, we switched the therapeutic drug monitoring (TDM) analysis software for dose setting of vancomycin (VCM) from "Vancomycin MEEK TDM analysis software Ver2.0" (MEEK) to "SHIONOGI-VCM-TDM ver.2009" (VCM-TDM) in January 2015. In the present study, our aim was to validate the effectiveness of the changing VCM TDM analysis software in initial dose setting of VCM. The enrolled patients were divided into two groups, each having 162 patients in total, who received VCM with the initial dose set using MEEK (MEEK group) or VCM-TDM (VCM-TDM group). We compared the rates of attaining the therapeutic range (trough value; 10-20 μg/mL) of serum VCM concentration between the groups. Multivariate logistic regression analysis was performed to confirm that changing the VCM TDM analysis software was an independent factor related to attaining the therapeutic range. Switching the VCM TDM analysis software from MEEK to VCM-TDM improved the rate of attaining the therapeutic range by 21.6% (MEEK group: 42.6% vs. VCM-TDM group: 64.2%, p<0.01). Patient age ≥65 years, concomitant medication (furosemide) and the TDM analysis software used VCM-TDM were considered to be independent factors for attaining the therapeutic range. These results demonstrated the effectiveness of switching the VCM TDM analysis software from MEEK to VCM-TDM for initial dose setting of VCM.

The influence of total flight time, recent flight time and age on pilot accident rates

DOT National Transportation Integrated Search

1983-06-30

This paper presents initial finding from a research effort conducted for the Safety Analysis Dvision, Office of Aviation Safety, Federal Aviation Administration (FAA). The analysis considers the influence of recent pilot flight time, total pilot flig...

Systematic review and meta-analysis of initial management of pneumothorax in adults: Intercostal tube drainage versus other invasive methods

PubMed Central

Park, Incheol; Kim, Kyung Hwan; Park, Junseok; Shin, Dong Wun

2017-01-01

Objectives The ideal invasive management as initial approach for pneumothorax (PTX) is still under debate. The purpose of this systematic review and meta-analysis was to examine the evidence for the effectiveness of intercostal tube drainage and other various invasive methods as the initial approach to all subtypes of PTX in adults. Methods Three databases were searched from inception to May 29, 2016: MEDLINE, EMBASE, and the Cochrane CENTRAL. Randomised controlled trials that evaluated intercostal tube drainage as the control and various invasive methods as the intervention for the initial approach to PTX in adults were included. The primary outcome was the early success rate of each method, and the risk ratios (RRs) were used for an effect size measure. The secondary outcomes were recurrence rate, hospitalization rate, hospital stay, and complications. Results Seven studies met our inclusion criteria. Interventions were aspiration in six studies and catheterization connected to a one-way valve in one study. Meta-analyses were conducted for early success rate, recurrence rate, hospitalization rate, and hospital stay. Aspiration was inferior to intercostal tube drainage in terms of early success rate (RR = 0.82, confidence interval [CI] = 0.72 to 0.95, I2 = 0%). While aspiration and intercostal tube drainage showed no significant difference in the recurrence rate (RR = 0.84, CI = 0.57 to 1.23, I2 = 0%), aspiration had shorter hospital stay than intercostal tube drainage (mean difference = -1.73, CI = -2.33 to -1.13, I2 = 0%). Aspiration had lower hospitalization rate than intercostal tube drainage, but marked heterogeneity was present (RR = 0.38, CI = 0.19 to 0.76, I2 = 85%). Conclusion Aspiration was inferior to intercostal tube drainage in terms of early resolution, but it had shorter hospital stay. The recurrence rate of aspiration and intercostal tube drainage did not differ significantly. The efficacy of catheterization connected to a one-way valve was inconclusive because of the small number of relevant studies. (Registration of study protocol: PROSPERO, CRD42016037866) PMID:28640890

Systematic review and meta-analysis of initial management of pneumothorax in adults: Intercostal tube drainage versus other invasive methods.

PubMed

Kim, Min Joung; Park, Incheol; Park, Joon Min; Kim, Kyung Hwan; Park, Junseok; Shin, Dong Wun

2017-01-01

The ideal invasive management as initial approach for pneumothorax (PTX) is still under debate. The purpose of this systematic review and meta-analysis was to examine the evidence for the effectiveness of intercostal tube drainage and other various invasive methods as the initial approach to all subtypes of PTX in adults. Three databases were searched from inception to May 29, 2016: MEDLINE, EMBASE, and the Cochrane CENTRAL. Randomised controlled trials that evaluated intercostal tube drainage as the control and various invasive methods as the intervention for the initial approach to PTX in adults were included. The primary outcome was the early success rate of each method, and the risk ratios (RRs) were used for an effect size measure. The secondary outcomes were recurrence rate, hospitalization rate, hospital stay, and complications. Seven studies met our inclusion criteria. Interventions were aspiration in six studies and catheterization connected to a one-way valve in one study. Meta-analyses were conducted for early success rate, recurrence rate, hospitalization rate, and hospital stay. Aspiration was inferior to intercostal tube drainage in terms of early success rate (RR = 0.82, confidence interval [CI] = 0.72 to 0.95, I2 = 0%). While aspiration and intercostal tube drainage showed no significant difference in the recurrence rate (RR = 0.84, CI = 0.57 to 1.23, I2 = 0%), aspiration had shorter hospital stay than intercostal tube drainage (mean difference = -1.73, CI = -2.33 to -1.13, I2 = 0%). Aspiration had lower hospitalization rate than intercostal tube drainage, but marked heterogeneity was present (RR = 0.38, CI = 0.19 to 0.76, I2 = 85%). Aspiration was inferior to intercostal tube drainage in terms of early resolution, but it had shorter hospital stay. The recurrence rate of aspiration and intercostal tube drainage did not differ significantly. The efficacy of catheterization connected to a one-way valve was inconclusive because of the small number of relevant studies. (Registration of study protocol: PROSPERO, CRD42016037866).

Numerical simulation of film-cooled ablative rocket nozzles

NASA Technical Reports Server (NTRS)

Landrum, D. B.; Beard, R. M.

1996-01-01

The objective of this research effort was to evaluate the impact of incorporating an additional cooling port downstream between the injector and nozzle throat in the NASA Fast Track chamber. A numerical model of the chamber was developed for the analysis. The analysis did not model ablation but instead correlated the initial ablation rate with the initial nozzle wall temperature distribution. The results of this study provide guidance in the development of a potentially lighter, second generation ablative rocket nozzle which maintains desired performance levels.

Evaluating the Impacts of "New" Performance Funding in Higher Education

ERIC Educational Resources Information Center

Hillman, Nicholas W.; Tandberg, David A.; Fryar, Alisa H.

2015-01-01

In 2007, Washington adopted the Student Achievement Initiative, a statewide performance accountability system designed to improve retention rates and degree productivity among community colleges. Using difference-in-differences analysis, we found that the policy change has had little immediate effect on retention rates or associate's degree…

Advanced bridge safety initiative, task 1 : development of improved analytical load rating procedures for flat-slab concrete bridges - a thesis and guidelines.

DOT National Transportation Integrated Search

2010-01-01

Current AASHTO provisions for the conventional load rating of flat slab bridges rely on the equivalent strip method : of analysis for determining live load effects, this is generally regarded as overly conservative by many professional : engineers. A...

Cost-effectiveness of competing strategies for management of recurrent Clostridium difficile infection: a decision analysis.

PubMed

Konijeti, Gauree G; Sauk, Jenny; Shrime, Mark G; Gupta, Meera; Ananthakrishnan, Ashwin N

2014-06-01

Clostridium difficile infection (CDI) is an important cause of morbidity and healthcare costs, and is characterized by high rates of disease recurrence. The cost-effectiveness of newer treatments for recurrent CDI has not been examined, yet would be important to inform clinical practice. The aim of this study was to analyze the cost effectiveness of competing strategies for recurrent CDI. We constructed a decision-analytic model comparing 4 treatment strategies for first-line treatment of recurrent CDI in a population with a median age of 65 years: metronidazole, vancomycin, fidaxomicin, and fecal microbiota transplant (FMT). We modeled up to 2 additional recurrences following the initial recurrence. We assumed FMT delivery via colonoscopy as our base case, but conducted sensitivity analyses based on different modes of delivery. Willingness-to-pay threshold was set at $50 000 per quality-adjusted life-year. At our base case estimates, initial treatment of recurrent CDI using FMT colonoscopy was the most cost-effective strategy, with an incremental cost-effectiveness ratio of $17 016 relative to oral vancomycin. Fidaxomicin and metronidazole were both dominated by FMT colonoscopy. On sensitivity analysis, FMT colonoscopy remained the most cost-effective strategy at cure rates >88.4% and CDI recurrence rates <14.9%. Fidaxomicin required a cost <$1359 to meet our cost-effectiveness threshold. In clinical settings where FMT is not available or applicable, the preferred strategy appears to be initial treatment with oral vancomycin. In this decision analysis examining treatment strategies for recurrent CDI, we demonstrate that FMT colonoscopy is the most cost-effective initial strategy for management of recurrent CDI.

Development and Optimization of HPLC Analysis of Metronidazole, Diloxanide, Spiramycin and Cliquinol in Pharmaceutical Dosage Forms Using Experimental Design.

PubMed

Elkhoudary, Mahmoud M; Abdel Salam, Randa A; Hadad, Ghada M

2016-11-01

A new simple, sensitive, rapid and accurate gradient reversed-phase high-performance liquid chromatography with photodiode array detector (RP-HPLC-DAD) was developed and validated for simultaneous analysis of Metronidazole (MNZ), Spiramycin (SPY), Diloxanidefuroate (DIX) and Cliquinol (CLQ) using statistical experimental design. Initially, a resolution V fractional factorial design was used in order to screen five independent factors: the column temperature (°C), pH, phosphate buffer concentration (mM), flow rate (ml/min) and the initial fraction of mobile phase B (%). pH, flow rate and initial fraction of mobile phase B were identified as significant, using analysis of variance. The optimum conditions of separation determined with the aid of central composite design were: (1) initial mobile phase concentration: phosphate buffer/methanol (50/50, v/v), (2) phosphate buffer concentration (50 mM), (3) pH (4.72), (4) column temperature 30°C and (5) mobile phase flow rate (0.8 ml min -1 ). Excellent linearity was observed for all of the standard calibration curves, and the correlation coefficients were above 0.9999. Limits of detection for all of the analyzed compounds ranged between 0.02 and 0.11 μg ml -1 ; limits of quantitation ranged between 0.06 and 0.33 μg ml -1 The proposed method showed good prediction ability. The optimized method was validated according to ICH guidelines. Three commercially available tablets were analyzed showing good % recovery and %RSD. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Assessing Police Classifications of Sexual Assault Reports: A Meta-Analysis of False Reporting Rates.

PubMed

Ferguson, Claire E; Malouff, John M

2016-07-01

The objective of the study was to determine, through meta-analysis, the rate of confirmed false reports of sexual assault to police. The meta-analysis initially involved a search for relevant articles. The search identified seven studies where researchers or their trained helpers evaluated reported sexual assault cases to determine the rate of confirmed false reports. The meta-analysis calculated an overall rate and tested for possible moderators of effect size. The meta-analytic rate of false reports of sexual assault was .052 (95 % CI .030, .089). The rates for the individual studies were heterogeneous, suggesting the possibility of moderators of rate. However, the four possible moderators examined-year of publication, whether the data set used had information in addition to police reports, whether the study was completed in the U.S. or elsewhere, and whether inter-rater reliabilities were reported-were all not significant. The meta-analysis of seven relevant studies shows that confirmed false allegations of sexual assault made to police occur at a significant rate. The total false reporting rate, including both confirmed and equivocal cases, would be greater than the 5 % rate found here.

Initial nonresponse and survey response mode biases in survey research.

PubMed

Chi, Donald L; Chen, Chao Ying

2015-01-01

We evaluated survey response factors (particularly initial nonresponse and survey mode) that may be associated with bias in survey research. We examined prevention-related beliefs and outcomes for initial mail survey responders (n=209), follow-up mail survey responders (n=78), and follow-up telephone survey responders (n=74). The Pearson chi-square test and analysis of variance identified beliefs and behavioral outcomes associated with survey response mode. Follow-up options to the initial mail survey improved response rates (22.0-38.0 percent). Initial mail survey responders more strongly believed topical fluoride protects teeth from cavities than others (P=0.04). A significantly larger proportion of parents completing a follow-up telephone survey (30.8 percent) refused topical fluoride for their child than those completing mail surveys (10.3-10.4 percent) (P<0.0001). Multiple mode surveys with follow-up improve response rates. Initial nonresponse and survey response mode may be associated with biases in survey research. © 2015 American Association of Public Health Dentistry.

A cost-effectiveness analysis of conservative versus surgical management for the initial treatment of stress urinary incontinence.

PubMed

Richardson, Monica L; Sokol, Eric R

2014-11-01

We sought to determine whether conservative or surgical therapy is more cost effective for the initial treatment of stress urinary incontinence (SUI). We created a decision tree model to compare costs and cost effectiveness of 3 strategies for the initial treatment of SUI: (1) continence pessary, (2) pelvic floor muscle therapy (PFMT), and (3) midurethral sling (MUS). We identified probabilities of SUI after 12 months of use of a pessary, PFMT, or MUS using published data. Parameter estimates included Health Utility Indices of no incontinence (.93) and persistent incontinence (0.7) after treatment. Morbidities associated with MUS included mesh erosion, retention, de novo urge incontinence, and recurrent SUI. Cost data were derived from Medicare in 2012 US dollars. One- and 2-way sensitivity analysis was used to examine the effect of varying rates of pursuing surgery if conservative management failed and rates of SUI cure with pessaries and PFMT. The primary outcome was an incremental cost-effectiveness ratio threshold <$50,000. Compared to PFMT, initial treatment of SUI with MUS was the more cost-effective strategy with an incremental cost-effectiveness ratio of $32,132/quality-adjusted life year. Initial treatment with PFMT was also acceptable as long as subjective cure was >35%. In 3-way sensitivity analysis, subjective cure would need to be >40.5% for PFMT and 43.5% for a continence pessary for the MUS scenario to not be the preferred strategy. At 1 year, MUS is more cost effective than a continence pessary or PFMT for the initial treatment for SUI. Copyright © 2014. Published by Elsevier Inc.

High-velocity frictional properties of gabbro

NASA Astrophysics Data System (ADS)

Tsutsumi, Akito; Shimamoto, Toshihiko

High-velocity friction experiments have been performed on a pair of hollow-cylindrical specimens of gabbro initially at room temperature, at slip rates from 7.5 mm/s to 1.8 m/s, with total circumferential displacements of 125 to 174 m, and at normal stresses to 5 MPa, using a rotary-shear high-speed friction testing machine. Steady-state friction increases slightly with increasing slip rate at slip rates to about 100 mm/s (velocity strengthening) and it decreases markedly with increasing slip rate at higher velocities (velocity weakening). Steady-state friction in the velocity weakening regime is lower for the non-melting case than the frictional melting case, due perhaps to severe thermal fracturing. A very large peak friction is always recognized upon the initiation of visible frictional melting, presumably owing to the welding of fault surfaces upon the solidification of melt patches. Frictional properties thus change dramatically with increasing displacement at high velocities, and such a non-linear effect must be incorporated into the analysis of earthquake initiation processes.

Making Sense of Global Reform in Initial Teacher Education: A Discussion Paper.

ERIC Educational Resources Information Center

1997

This is an analysis of the findings from three comparable national studies of current change in the provision of initial teacher education. These three studies are: the Mode of Teacher Education (MOTE) survey, covering England and Wales; the Research about Teacher Education (RATE) Project, covering the United States; and the Study of Initial…

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

Liang, Linyun; Mei, Zhi -Gang; Kim, Yeon Soo

A mesoscale model is developed by integrating the rate theory and phase-field models and is used to study the fission-induced recrystallization in U-7Mo alloy. The rate theory model is used to predict the dislocation density and the recrystallization nuclei density due to irradiation. The predicted fission rate and temperature dependences of the dislocation density are in good agreement with experimental measurements. This information is used as input for the multiphase phase-field model to investigate the fission-induced recrystallization kinetics. The simulated recrystallization volume fraction and bubble induced swelling agree well with experimental data. The effects of the fission rate, initial grainmore » size, and grain morphology on the recrystallization kinetics are discussed based on an analysis of recrystallization growth rate using the modified Avrami equation. Here, we conclude that the initial microstructure of the U-Mo fuels, especially the grain size, can be used to effectively control the rate of fission-induced recrystallization and therefore swelling.« less

Recruitment and Participation of Recreational Runners in a Large Epidemiological and Genetic Research Study: Retrospective Data Analysis

PubMed Central

Manzanero, Silvia; Kozlovskaia, Maria; Vlahovich, Nicole

2018-01-01

Background With the increasing capacity for remote collection of both data and samples for medical research, a thorough assessment is needed to determine the association of population characteristics and recruitment methodologies with response rates. Objective The aim of this research was to assess population representativeness in a two-stage study of health and injury in recreational runners, which consisted of an epidemiological arm and genetic analysis. Methods The cost and success of various classical and internet-based methods were analyzed, and demographic representativeness was assessed for recruitment to the epidemiological survey, reported willingness to participate in the genetic arm of the study, actual participation, sample return, and approval for biobank storage. Results A total of 4965 valid responses were received, of which 1664 were deemed eligible for genetic analysis. Younger age showed a negative association with initial recruitment rate, expressed willingness to participate in genetic analysis, and actual participation. Additionally, female sex was associated with higher initial recruitment rates, and ethnic origin impacted willingness to participate in the genetic analysis (all P<.001). Conclusions The sharp decline in retention through the different stages of the study in young respondents suggests the necessity to develop specific recruitment and retention strategies when investigating a young, physically active population. PMID:29792293

The slowly reacting mode of combustion of gaseous mixtures in spherical vessels. Part 1: Transient analysis and explosion limits

NASA Astrophysics Data System (ADS)

Liñán, Amable; Moreno-Boza, Daniel; Iglesias, Immaculada; Sánchez, Antonio L.; Williams, Forman A.

2016-11-01

Frank-Kamenetskii's analysis of thermal explosions is revisited, using also a single-reaction model with an Arrhenius rate having a large activation energy, to describe the transient combustion of initially cold gaseous mixtures enclosed in a spherical vessel with a constant wall temperature. The analysis shows two modes of combustion. There is a flameless slowly reacting mode for low wall temperatures or small vessel sizes, when the temperature rise resulting from the heat released by the reaction is kept small by the heat-conduction losses to the wall, so as not to change significantly the order of magnitude of the reaction rate. In the other mode, the slow reaction rates occur only in an initial ignition stage, which ends abruptly when very large reaction rates cause a temperature runaway, or thermal explosion, at a well-defined ignition time and location, thereby triggering a flame that propagates across the vessel to consume the reactant rapidly. Explosion limits are defined, in agreement with Frank-Kamenetskii's analysis, by the limiting conditions for existence of the slowly reacting mode of combustion. In this mode, a quasi-steady temperature distribution is established after a transient reaction stage with small reactant consumption. Most of the reactant is burnt, with nearly uniform mass fraction, in a subsequent long stage during which the temperature follows a quasi-steady balance between the rates of heat conduction to the wall and of chemical heat release. The changes in the explosion limits caused by the enhanced heat-transfer rates associated with buoyant motion are described in an accompanying paper.

Effect of a Home-Based Lifestyle Intervention on Breastfeeding Initiation Among Socioeconomically Disadvantaged African American Women with Overweight or Obesity.

PubMed

Lewkowitz, Adam K; López, Julia D; Stein, Richard I; Rhoades, Janine S; Schulz, Rosa C; Woolfolk, Candice L; Macones, George A; Haire-Joshu, Debra; Cahill, Alison G

2018-06-18

Socioeconomically disadvantaged (SED) African American women with overweight or obesity are less likely to breastfeed. To test whether a home-based lifestyle intervention impacts breastfeeding initiation rates in SED African American women with overweight or obesity. This was a secondary analysis of a randomized controlled trial from October 2012 to March 2016 at a university-based hospital within the LIFE-Moms consortium. SED African American women with overweight or obesity and singleton gestations were randomized by 16 weeks to Parents as Teachers (PAT)-a home-based parenting support and child development educational intervention-or PAT+, PAT with additional content on breastfeeding. Participants completed a breastfeeding survey. Outcomes included breastfeeding initiation and reasons for not initiating or not continuing breastfeeding. One hundred eighteen women were included: 59 in PAT+; 59 in PAT. Breastfeeding initiation rates were similar in each group (78.00% in PAT+; 74.58% in PAT). On a one to four scale, with four denoting "very important," women in PAT+ and PAT were equally likely to rate their beliefs that formula was better than breast milk or breastfeeding would be too inconvenient as the most important reasons to not initiate breastfeeding. On the same scale, women similarly rated their difficulty latching or concern for low milk supply as the most important reasons for breastfeeding cessation. SED African American women with overweight or obesity who received a home-based educational intervention had higher breastfeeding rates than is reported nationally for black women (59%). However, the intervention with more breastfeeding content did not further increase breastfeeding rates or impact reasons for breastfeeding cessation. ClinicalTrials.gov : NCT01768793.

Experimental analysis of quasi-static and dynamic fracture initiation toughness of gy4 armor steel material

NASA Astrophysics Data System (ADS)

Ren, Peng; Guo, Zitao

Quasi-static and dynamic fracture initiation toughness of gy4 armour steel material are investigated using three point bend specimen. The modified split Hopkinson pressure bar (SHPB) apparatus with digital image correlation (DIC) system is applied to dynamic loading experiments. Full-field deformation measurements are obtained by using DIC to elucidate on the strain fields associated with the mechanical response. A series of experiments are conducted at different strain rate ranging from 10-3 s-1 to 103 s-1, and the loading rate on the fracture initiation toughness is investigated. Specially, the scanning electron microscope imaging technique is used to investigate the fracture failure micromechanism of fracture surfaces. The gy4 armour steel material fracture toughness is found to be sensitive to strain rate and higher for dynamic loading as compared to quasi-static loading. This work is supported by National Nature Science Foundation under Grant 51509115.

A duration analysis of the role of cigarette prices on smoking initiation and cessation in developing countries.

PubMed

Kostova, Deliana; Chaloupka, Frank J; Shang, Ce

2015-04-01

This study evaluates the impact of cigarette prices on smoking initiation and cessation among adults in two pooled samples of 6 low- to lower-middle income countries (LMICs) and 8 upper-middle income countries (UMICs). We find that, while higher prices reduce smoking across the board, this reduction occurs through different behavioral mechanisms in lower versus higher income countries. Specifically, cigarette prices reduce smoking rates by deterring initiation in LMICs while in UMICs they act primarily by promoting cessation. Because current smoking rates are relatively lower in LMICs and relatively higher in UMICs, this differential mechanism underscores the adaptability of tobacco prices as a tool for regulating tobacco use across countries at different levels of development; it shows that prices can be used to sustain the relatively low rates of smoking in LMICs by preventing entry of new smokers, and can reduce the relatively high rates of smoking in UMICs by encouraging exit of existing smokers. Using split-population duration models and controlling for fixed and time-varying unobserved country characteristics, we estimate that the price elasticity of initiation in LMICs is -0.74 and the price elasticity of cessation in UMICs is 0.51.

Genome-Scale Analysis of Translation Elongation with a Ribosome Flow Model

PubMed Central

Meilijson, Isaac; Kupiec, Martin; Ruppin, Eytan

2011-01-01

We describe the first large scale analysis of gene translation that is based on a model that takes into account the physical and dynamical nature of this process. The Ribosomal Flow Model (RFM) predicts fundamental features of the translation process, including translation rates, protein abundance levels, ribosomal densities and the relation between all these variables, better than alternative (‘non-physical’) approaches. In addition, we show that the RFM can be used for accurate inference of various other quantities including genes' initiation rates and translation costs. These quantities could not be inferred by previous predictors. We find that increasing the number of available ribosomes (or equivalently the initiation rate) increases the genomic translation rate and the mean ribosome density only up to a certain point, beyond which both saturate. Strikingly, assuming that the translation system is tuned to work at the pre-saturation point maximizes the predictive power of the model with respect to experimental data. This result suggests that in all organisms that were analyzed (from bacteria to Human), the global initiation rate is optimized to attain the pre-saturation point. The fact that similar results were not observed for heterologous genes indicates that this feature is under selection. Remarkably, the gap between the performance of the RFM and alternative predictors is strikingly large in the case of heterologous genes, testifying to the model's promising biotechnological value in predicting the abundance of heterologous proteins before expressing them in the desired host. PMID:21909250

42 CFR 421.501 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... licensed medical professional, for a billed item or service identified by data analysis techniques or probe... rate based on the results of a probe review prior to the initiation of complex medical review. Medical... licensed medical professional, for a billed item or service identified by data analysis techniques or probe...

42 CFR 421.501 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... licensed medical professional, for a billed item or service identified by data analysis techniques or probe... rate based on the results of a probe review prior to the initiation of complex medical review. Medical... licensed medical professional, for a billed item or service identified by data analysis techniques or probe...

42 CFR 421.501 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... licensed medical professional, for a billed item or service identified by data analysis techniques or probe... rate based on the results of a probe review prior to the initiation of complex medical review. Medical... licensed medical professional, for a billed item or service identified by data analysis techniques or probe...

Doula care supports near-universal breastfeeding initiation among diverse, low-income women.

PubMed

Kozhimannil, Katy B; Attanasio, Laura B; Hardeman, Rachel R; O'Brien, Michelle

2013-01-01

Breastfeeding initiation rates in the United States have risen in recent years. However, there are notable disparities by socioeconomic status and race/ethnicity. Previous research has suggested that care from a doula (a trained professional who provides nonmedical support during the perinatal period) may increase breastfeeding initiation. The goal of this analysis was to study whether doula support may be associated with breastfeeding initiation among low-income, diverse women. We compared breastfeeding initiation rates (means and 95% confidence intervals) for 1069 women who received doula care from Everyday Miracles, a Minnesota-based organization that employs a diverse group of certified doulas, to a state-based sample of women with Medicaid coverage who gave birth in 2009 or 2010 and participated in the Minnesota Pregnancy Risk Assessment Monitoring System survey (weighted n = 51,721). Women who had doula-supported births had near-universal breastfeeding initiation (97.9%), compared with 80.8% of the general Medicaid population. Among African American women, 92.7% of those with doula support initiated breastfeeding, compared with 70.3% of the general Medicaid population. These results suggest that access to culturally appropriate doula care may facilitate higher rates of breastfeeding initiation. When supported in their nonmedical needs by birth doulas, the diverse, low-income patients of midwives and other maternity care providers may have a greater likelihood of initiating breastfeeding and experiencing the maternal and infant health benefits associated with breastfeeding. © 2013 by the American College of Nurse-Midwives.

Efficient resource allocation scheme for visible-light communication system

NASA Astrophysics Data System (ADS)

Kim, Woo-Chan; Bae, Chi-Sung; Cho, Dong-Ho; Shin, Hong-Seok; Jung, D. K.; Oh, Y. J.

2009-01-01

A visible-light communication utilizing LED has many advantagies such as visibility of information, high SNR (Signal to Noise Ratio), low installation cost, usage of existing illuminators, and high security. Furthermore, exponentially increasing needs and quality of LED have helped the development of visible-light communication. The visibility is the most attractive property in visible-light communication system, but it is difficult to ensure visibility and transmission efficiency simultaneously during initial access because of the small amount of initial access process signals. In this paper, we propose an efficient resource allocation scheme at initial access for ensuring visibility with high resource utilization rate and low data transmission failure rate. The performance has been evaluated through the numerical analysis and simulation results.

The 15 years of comet photometry: A comparative analysis of 80 comets

NASA Technical Reports Server (NTRS)

Osip, David J.; Schleicher, David G.; Millis, Robert L.; Ahearn, Michael F.; Birch, Peter V.

1991-01-01

In 1976, a program of narrowband photometry of comets was initiated that has encompassed well over 400 nights of observations. To date, the program has provided detailed information on 80 comets, 11 of which were observed during multiple apparitions. The filters (initially isolating CN, C2, and continuum and later including C3, OH, and NH) as well as the detectors used for the observations were changed over time, and the parameters adopted in the reduction and modeling of the data have likewise evolved. Accordingly, we have re-reduced the entire database and have derived production rates using current values for scalelengths and fluorescence efficiencies. Having completed this task, the results for different comets can now be meaningfully compared. The general characteristics that are discussed include ranges in composition (molecular production rate ratios) and dustiness (gas production compared with Af(rho)). Additionally an analysis of trends on how the production rates vary with heliocentric distance and on pre- and post-perihelion asymmetries in the production rates of individual comets. Possible taxonomic groupings are also described.

Biomass Content Governs Fermentation Rate in Nitrogen-Deficient Wine Musts

PubMed Central

Varela, Cristian; Pizarro, Francisco; Agosin, Eduardo

2004-01-01

Problematic fermentations are common in the wine industry. Assimilable nitrogen deficiency is the most prevalent cause of sluggish fermentations and can reduce fermentation rates significantly. A lack of nitrogen diminishes a yeast's metabolic activity, as well as the biomass yield, although it has not been clear which of these two interdependent factors is more significant in sluggish fermentations. Under winemaking conditions with different initial nitrogen concentrations, metabolic flux analysis was used to isolate the effects. We quantified yeast physiology and identified key metabolic fluxes. We also performed cell concentration experiments to establish how biomass yield affects the fermentation rate. Intracellular analysis showed that trehalose accumulation, which is highly correlated with ethanol production, could be responsible for sustaining cell viability in nitrogen-poor musts independent of the initial assimilable nitrogen content. Other than the higher initial maintenance costs in sluggish fermentations, the main difference between normal and sluggish fermentations was that the metabolic flux distributions in nitrogen-deficient cultures revealed that the specific sugar uptake rate was substantially lower. The results of cell concentration experiments, however, showed that in spite of lower sugar uptake, adding biomass from sluggish cultures not only reduced the time to finish a problematic fermentation but also was less likely to affect the quality of the resulting wine as it did not alter the chemistry of the must. PMID:15184136

Incidence and rates of visual field progression after longitudinally measured optic disc change in glaucoma.

PubMed

Chauhan, Balwantray C; Nicolela, Marcelo T; Artes, Paul H

2009-11-01

To determine whether glaucoma patients with progressive optic disc change have subsequent visual field progression earlier and at a faster rate compared with those without disc change. Prospective, longitudinal, cohort study. Eighty-one patients with open-angle glaucoma. Patients underwent confocal scanning laser tomography and standard automated perimetry every 6 months. The complete follow-up was divided into initial and subsequent periods. Two initial periods-first 3 years (Protocol A) and first half of the total follow-up (Protocol B)-were used, with the respective remainder being the subsequent follow-up. Disc change during the initial follow-up was determined with liberal, moderate, or conservative criteria of the Topographic Change Analysis. Subsequent field progression was determined with significant pattern deviation change in >or=3 locations (criterion used in the Early Manifest Glaucoma Trial). As a control analysis, field change during the initial follow-up was determined with significant pattern deviation change in >or=1, >or=2, or >or=3 locations. Survival time to subsequent field progression, rates of mean deviation (MD) change, and positive and negative likelihood ratios. The median (interquartile range) total follow-up was 11.0 (8.0-12.0) years with 22 (18-24) examinations. More patients had disc changes during the initial follow-up compared with field changes. The mean time to field progression was consistently shorter (protocol A, 0.8-1.7 years; protocol B, 0.3-0.7 years) in patients with prior disc change. In the control analysis, patients with prior field change had statistically earlier subsequent field progression (protocol A, 2.9-3.0 years; protocol B, 0.7-0.9). Similarly, patients with either prior disc or field change always had worse mean rates of subsequent MD change, although the distributions overlapped widely. Patients with subsequent field progression were up to 3 times more likely to have prior disc change compared with those without, and up to 5 times more likely to have prior field change compared with those without. Longitudinally measured optic disc change is predictive of subsequent visual field progression and may be an efficacious end point for functional outcomes in clinical studies and trials in glaucoma.

Analysis of Social Variables when an Initial Functional Analysis Indicates Automatic Reinforcement as the Maintaining Variable for Self-Injurious Behavior

ERIC Educational Resources Information Center

Kuhn, Stephanie A. Contrucci; Triggs, Mandy

2009-01-01

Self-injurious behavior (SIB) that occurs at high rates across all conditions of a functional analysis can suggest automatic or multiple functions. In the current study, we conducted a functional analysis for 1 individual with SIB. Results indicated that SIB was, at least in part, maintained by automatic reinforcement. Further analyses using…

Study of the initial transient in the one-dimensional analytical models of impurity segregation during melt crystallization in the presence of convection

NASA Astrophysics Data System (ADS)

Voloshin, A. E.

2013-11-01

The well-known one-dimensional Burton-Prim-Slichter and Ostrogorsky-Müller analytical models obtained for the stationary mass transfer regime describe in a simple form the dependence of the effective impurity segregation coefficient on the ratio of the crystal growth and convective flow rates. Solutions for the initial transient regime are found in both models. It is shown that the formulas obtained make it possible to determine both the crystal growth rate and the convective mixing intensity on the basis of the analysis of impurity segregation in crystal.

Effect of surface crystallographic orientation on the oxidation behavior of Ni-based alloy

NASA Astrophysics Data System (ADS)

Wang, Xu; Szpunar, J. A.; Zhang, Lina

2015-02-01

Dependence of initial oxidation behavior on crystalline orientation of Haynes 230 at 900 °C was investigated by a novel method. Analysis of oxidation rate reveals that the oxide thicknesses are different for grains having different orientations. Orientation mapping was performed on oxidized specimen and grains having near {1 1 1} were easily indexed by electron backscattered diffraction. We determined that planes with deviation angle lower than 20° were all well indexed after oxidation. Results demonstrate that substrate orientation plays an important role on oxidation rate during the initial stage.

A call for randomized controlled cost-effectiveness analysis of percutaneous transluminal coronary angioplasty.

PubMed

Holly, N

1988-01-01

A rapidly evolving technology, percutaneous transluminal coronary angioplasty, is increasingly favored over bypass surgery for treating some types of coronary stenosis because of its less traumatic invasion, better recovery response, and lower initial cost. However, substantially higher failure rates in initial procedures offset PTCA's savings to an unknown extent and cloud analysis of its overall impact. Lack of randomized clinical data precludes valid cost-effectiveness comparison of the technologies at this time. Criteria for establishing valid data and evaluations of currently available data are described in this paper.

Cost-effectiveness of Competing Strategies for Management of Recurrent Clostridium difficile Infection: A Decision Analysis

PubMed Central

Konijeti, Gauree G.; Sauk, Jenny; Shrime, Mark G.; Gupta, Meera; Ananthakrishnan, Ashwin N.

2014-01-01

Background. Clostridium difficile infection (CDI) is an important cause of morbidity and healthcare costs, and is characterized by high rates of disease recurrence. The cost-effectiveness of newer treatments for recurrent CDI has not been examined, yet would be important to inform clinical practice. The aim of this study was to analyze the cost effectiveness of competing strategies for recurrent CDI. Methods. We constructed a decision-analytic model comparing 4 treatment strategies for first-line treatment of recurrent CDI in a population with a median age of 65 years: metronidazole, vancomycin, fidaxomicin, and fecal microbiota transplant (FMT). We modeled up to 2 additional recurrences following the initial recurrence. We assumed FMT delivery via colonoscopy as our base case, but conducted sensitivity analyses based on different modes of delivery. Willingness-to-pay threshold was set at $50 000 per quality-adjusted life-year. Results. At our base case estimates, initial treatment of recurrent CDI using FMT colonoscopy was the most cost-effective strategy, with an incremental cost-effectiveness ratio of $17 016 relative to oral vancomycin. Fidaxomicin and metronidazole were both dominated by FMT colonoscopy. On sensitivity analysis, FMT colonoscopy remained the most cost-effective strategy at cure rates >88.4% and CDI recurrence rates <14.9%. Fidaxomicin required a cost <$1359 to meet our cost-effectiveness threshold. In clinical settings where FMT is not available or applicable, the preferred strategy appears to be initial treatment with oral vancomycin. Conclusions. In this decision analysis examining treatment strategies for recurrent CDI, we demonstrate that FMT colonoscopy is the most cost-effective initial strategy for management of recurrent CDI. PMID:24692533

Predicting temperature drop rate of mass concrete during an initial cooling period using genetic programming

NASA Astrophysics Data System (ADS)

Bhattarai, Santosh; Zhou, Yihong; Zhao, Chunju; Zhou, Huawei

2018-02-01

Thermal cracking on concrete dams depends upon the rate at which the concrete is cooled (temperature drop rate per day) within an initial cooling period during the construction phase. Thus, in order to control the thermal cracking of such structure, temperature development due to heat of hydration of cement should be dropped at suitable rate. In this study, an attempt have been made to formulate the relation between cooling rate of mass concrete with passage of time (age of concrete) and water cooling parameters: flow rate and inlet temperature of cooling water. Data measured at summer season (April-August from 2009 to 2012) from recently constructed high concrete dam were used to derive a prediction model with the help of Genetic Programming (GP) software “Eureqa”. Coefficient of Determination (R) and Mean Square Error (MSE) were used to evaluate the performance of the model. The value of R and MSE is 0.8855 and 0.002961 respectively. Sensitivity analysis was performed to evaluate the relative impact on the target parameter due to input parameters. Further, testing the proposed model with an independent dataset those not included during analysis, results obtained from the proposed GP model are close enough to the real field data.

[Analysis of 163 rib fractures by imaging examination].

PubMed

Song, Tian-fu; Wang, Chao-chao

2014-12-01

To explore the applications of imaging examination on rib fracture sites in forensic identification. Features including the sites, numbers of the processed imaging examination and the first radiological technology at diagnosis in 56 cases of rib fractures from 163 injuries were retrospectively analyzed. The detection rate of the rib fractures within 14 days was 65.6%. The initial detection rate of anterior rib fracture proceeded by X-ray was 76.2%, then 90.5% detected at a second time X-ray, while the detection rate of CT was 66.7% and 80.0%, respectively. The initial detec- tion rate of rib fracture in axillary section proceeded by X-ray was 27.6%, then 58.6% detected at a second time X-ray, while the detection rate of CT was 54.3% and 80.4%, respectively. The initial detection rate of posterior rib fracture proceeded by X-ray was 63.6%, then 81.8% detected at a second time X-ray, while the detection rate of CT was 50.0% and 70.0%, respectively. It is important to pay attention to the use of combined imaging examinations and the follow-up results. In the cases of suspicious for rib fracture in axillary section, CT examination is suggested in such false X-ray negative cases.

Direct visualization reveals kinetics of meiotic chromosome synapsis

DOE PAGES

Rog, Ofer; Dernburg, Abby  F.

2015-03-17

The synaptonemal complex (SC) is a conserved protein complex that stabilizes interactions along homologous chromosomes (homologs) during meiosis. The SC regulates genetic exchanges between homologs, thereby enabling reductional division and the production of haploid gametes. Here, we directly observe SC assembly (synapsis) by optimizing methods for long-term fluorescence recording in C. elegans. We report that synapsis initiates independently on each chromosome pair at or near pairing centers—specialized regions required for homolog associations. Once initiated, the SC extends rapidly and mostly irreversibly to chromosome ends. Quantitation of SC initiation frequencies and extension rates reveals that initiation is a rate-limiting step inmore » homolog interactions. Eliminating the dynein-driven chromosome movements that accompany synapsis severely retards SC extension, revealing a new role for these conserved motions. This work provides the first opportunity to directly observe and quantify key aspects of meiotic chromosome interactions and will enable future in vivo analysis of germline processes.« less

Theoretical Analysis of the Longitudinal Behavior of an Automatically Controlled Supersonic Interceptor During the Attack Phase

NASA Technical Reports Server (NTRS)

Gates, Ordway B., Jr.; Woodling, C. H.

1959-01-01

Theoretical analysis of the longitudinal behavior of an automatically controlled supersonic interceptor during the attack phase against a nonmaneuvering target is presented. Control of the interceptor's flight path is obtained by use of a pitch rate command system. Topics lift, and pitching moment, effects of initial tracking errors, discussion of normal acceleration limited, limitations of control surface rate and deflection, and effects of neglecting forward velocity changes of interceptor during attack phase.

Alterations to Functional Analysis Methodology to Clarify the Functions of Low Rate, High Intensity Problem Behavior

PubMed Central

Davis, Barbara J; Schmidt, Jonathan; Bowman, Lynn G; Boelter, Eric W

2012-01-01

Current research provides few suggestions for modifications to functional analysis procedures to accommodate low rate, high intensity problem behavior. This study examined the results of the extended duration functional analysis procedures of Kahng, Abt, and Schonbachler (2001) with six children admitted to an inpatient hospital for the treatment of severe problem behavior. Results of initial functional analyses (Iwata, Dorsey, Slifer, Bauman, & Richman, 1982/1994) were inconclusive for all children because of low levels of responding. The altered functional analyses, which changed multiple variables including the duration of the functional analysis (i.e., 6 or 7 hrs), yielded clear behavioral functions for all six participants. These results add additional support for the utility of an altered analysis of low rate, high intensity problem behavior when standard functional analyses do not yield differentiated results. PMID:23326628

Alterations to functional analysis methodology to clarify the functions of low rate, high intensity problem behavior.

PubMed

Davis, Barbara J; Kahng, Sungwoo; Schmidt, Jonathan; Bowman, Lynn G; Boelter, Eric W

2012-01-01

Current research provides few suggestions for modifications to functional analysis procedures to accommodate low rate, high intensity problem behavior. This study examined the results of the extended duration functional analysis procedures of Kahng, Abt, and Schonbachler (2001) with six children admitted to an inpatient hospital for the treatment of severe problem behavior. Results of initial functional analyses (Iwata, Dorsey, Slifer, Bauman, & Richman, 1982/1994) were inconclusive for all children because of low levels of responding. The altered functional analyses, which changed multiple variables including the duration of the functional analysis (i.e., 6 or 7 hrs), yielded clear behavioral functions for all six participants. These results add additional support for the utility of an altered analysis of low rate, high intensity problem behavior when standard functional analyses do not yield differentiated results.

Economic Analysis of Veterans Affairs Initiative to Prevent Methicillin-Resistant Staphylococcus aureus Infections.

PubMed

Nelson, Richard E; Stevens, Vanessa W; Khader, Karim; Jones, Makoto; Samore, Matthew H; Evans, Martin E; Douglas Scott, R; Slayton, Rachel B; Schweizer, Marin L; Perencevich, Eli L; Rubin, Michael A

2016-05-01

In an effort to reduce methicillin-resistant Staphylococcus aureus (MRSA) transmission through universal screening and isolation, the Department of Veterans Affairs (VA) launched the National MRSA Prevention Initiative in October 2007. The objective of this analysis was to quantify the budget impact and cost effectiveness of this initiative. An economic model was developed using published data on MRSA hospital-acquired infection (HAI) rates in the VA from October 2007 to September 2010; estimates of the costs of MRSA HAIs in the VA; and estimates of the intervention costs, including salaries of staff members hired to support the initiative at each VA facility. To estimate the rate of MRSA HAIs that would have occurred if the initiative had not been implemented, two different assumptions were made: no change and a downward temporal trend. Effectiveness was measured in life-years gained. The initiative resulted in an estimated 1,466-2,176 fewer MRSA HAIs. The initiative itself was estimated to cost $207 million during this 3-year period, while the cost savings from prevented MRSA HAIs ranged from $27 million to $75 million. The incremental cost-effectiveness ratios ranged from $28,048 to $56,944/life-years. The overall impact on the VA's budget was $131-$179 million. Wide-scale implementation of a national MRSA surveillance and prevention strategy in VA inpatient settings may have prevented a substantial number of MRSA HAIs. Although the savings associated with prevented infections helped offset some but not all of the cost of the initiative, this model indicated that the initiative would be considered cost effective. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Surface Creep Rate and Moment Accumulation Rate Along the Aceh Segment of the Sumatran Fault From L-band ALOS-1/PALSAR-1 Observations

NASA Astrophysics Data System (ADS)

Tong, X.; Sandwell, D. T.; Schmidt, D. A.

2018-04-01

We analyzed the interferometric synthetic aperture radar data from the ALOS-1/PALSAR-1 satellite to image the interseismic deformation along the Sumatran fault. The interferometric synthetic aperture radar time series analysis reveals up to 20 mm/year of aseismic creep on the Aceh segment along the Northern Sumatran fault. This is a large fraction of the total slip rate across this fault. The spatial extent of the aseismic creep extends for 100 km. The along-strike variation of the aseismic creep has an inverse "U" shape. An analysis of the moment accumulation rate shows that the central part of the creeping section accumulates moment at approximately 50% of the rate of the surrounding locked segments. An initial analysis of temporal variations suggests that the creep rate may be decelerating with time, suggesting that the creep rate is adjusting to a stress perturbation from nearby seismic activity. Our study has implications to the earthquake hazard along the northern Sumatran fault.

Impact of TRMM and SSM/I Rainfall Assimilation on Global Analysis and QPF

NASA Technical Reports Server (NTRS)

Hou, Arthur; Zhang, Sara; Reale, Oreste

2002-01-01

Evaluation of QPF skills requires quantitatively accurate precipitation analyses. We show that assimilation of surface rain rates derived from the Tropical Rainfall Measuring Mission (TRMM) Microwave Imager and Special Sensor Microwave/Imager (SSM/I) improves quantitative precipitation estimates (QPE) and many aspects of global analyses. Short-range forecasts initialized with analyses with satellite rainfall data generally yield significantly higher QPF threat scores and better storm track predictions. These results were obtained using a variational procedure that minimizes the difference between the observed and model rain rates by correcting the moist physics tendency of the forecast model over a 6h assimilation window. In two case studies of Hurricanes Bonnie and Floyd, synoptic analysis shows that this procedure produces initial conditions with better-defined tropical storm features and stronger precipitation intensity associated with the storm.

Utilization of cardiac computed tomography angiography and outpatient invasive coronary angiography in Ontario, Canada.

PubMed

Roifman, Idan; Rezai, Mohammad R; Wijeysundera, Harindra C; Chow, Benjamin J W; Wright, Graham A; Tu, Jack V

2015-01-01

Cardiac computed tomography angiography (coronary CTA) has emerged as a non-invasive method of diagnosing coronary artery disease. The extent of utilization and uptake of this technology since initiation of its funding by the government of Ontario is unknown. The aim of our study was to examine coronary CTA utilization and the rates of elective invasive coronary angiography and revascularization before and after funding initiation. We studied all coronary CTAs performed on adults in Ontario after initiation of funding. We also used an interrupted time series analysis to compare the average monthly rates of invasive angiography and revascularization before and after initiation of funding. There was an initial steep increase in age-and sex-standardized rates of coronary CTA from 5.0 to 11.4/100,000 over the first two quarters after funding initiation. Afterwards, there was a gradual increase in utilization from 11.4 to 17.1/100,000 over two subsequent calendar years. There was a significant reduction in both the mean monthly outpatient invasive coronary angiography (from 20.7 to 19.9 per 100,000 (p = 0.0004)) and revascularization (from 4.9 to 4.4 per 100,000 (p < 0.0001)) rates in the three years following introduction of the coronary CTA billing code as compared to the three prior to its introduction. Since the introduction of coronary CTA funding in Ontario, there has been a steady and controlled increase in its utilization. The increasing use of coronary CTA was associated with a reduction in both the rates of invasive angiography and revascularization. Copyright © 2015 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

Risk Factor Analysis for the Outcomes of Indirect Traumatic Optic Neuropathy with No Light Perception at Initial Visual Acuity Testing.

PubMed

Lai, I-Li; Liao, Han-Tsung

2018-04-26

The optimal management of indirect traumatic optic neuropathy (TON) is controversial. We aimed to compare the differences in visual improvement by treatment option in patients presenting with TON and no light perception (NLP). We also wanted to identify any patient-related factors that might favor the use of steroid pulse therapy or optic nerve decompression (OND). We retrospectively identified 46 consecutive patients with indirect TON treated at Chang Gung Memorial Hospital between 2007 and 2015. The outcome was the improvement in visual acuity by improvement rate and degree of improvement. Females had a better improvement rate than did males. Compared with delayed treatment, patients receiving steroid pulse therapy within 14 hours or receiving OND within 26 hours had a better improvement rate/degree. In patients with an initial intraocular pressure (IOP) of 17-23 mm Hg, the improvement rate/degree was significantly better than for patients with an IOP outside this range. For patients treated by OND, an initially normal IOP (11-21 mm Hg) suggested a significantly better prognosis in the improvement rate/degree. For patients with indirect TON, initial NLP implies a poor prognosis, but steroid pulse therapy or OND are both feasible treatment options. These results emphasize the importance of timely treatment for patients with indirect TON and NLP. Females and patients with an initial IOP of 17-23 mm Hg were more likely to recover. The results of our study indicate that normal initial IOP (11-21 mm Hg) is good prognostic factor for patients with indirect TON treated with OND. Copyright © 2018 Elsevier Inc. All rights reserved.

Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services.

PubMed

Leal, Maria do Carmo; Esteves-Pereira, Ana Paula; Nakamura-Pereira, Marcos; Torres, Jacqueline Alves; Domingues, Rosa Maria Soares Madeira; Dias, Marcos Augusto Bastos; Moreira, Maria Elizabeth; Theme-Filha, Mariza; da Gama, Silvana Granado Nogueira

2016-01-01

A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk. This is a sub-analysis of a national population-based survey of postpartum women entitled "Birth in Brazil", performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services. Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s) and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8%) when compared to the ones receiving public services (rate of 2.4%), regardless of obstetric risk-adjusted OR of 2.3 (CI 1.5-3.6) for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1-2.3) for women of high obstetric risk. The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care.

Recruitment and Participation of Recreational Runners in a Large Epidemiological and Genetic Research Study: Retrospective Data Analysis.

PubMed

Manzanero, Silvia; Kozlovskaia, Maria; Vlahovich, Nicole; Hughes, David C

2018-05-23

With the increasing capacity for remote collection of both data and samples for medical research, a thorough assessment is needed to determine the association of population characteristics and recruitment methodologies with response rates. The aim of this research was to assess population representativeness in a two-stage study of health and injury in recreational runners, which consisted of an epidemiological arm and genetic analysis. The cost and success of various classical and internet-based methods were analyzed, and demographic representativeness was assessed for recruitment to the epidemiological survey, reported willingness to participate in the genetic arm of the study, actual participation, sample return, and approval for biobank storage. A total of 4965 valid responses were received, of which 1664 were deemed eligible for genetic analysis. Younger age showed a negative association with initial recruitment rate, expressed willingness to participate in genetic analysis, and actual participation. Additionally, female sex was associated with higher initial recruitment rates, and ethnic origin impacted willingness to participate in the genetic analysis (all P<.001). The sharp decline in retention through the different stages of the study in young respondents suggests the necessity to develop specific recruitment and retention strategies when investigating a young, physically active population. ©Silvia Manzanero, Maria Kozlovskaia, Nicole Vlahovich, David C Hughes. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 23.05.2018.

White Dwarf Asteroseismology and the 12C(α,γ)16O Rate

NASA Astrophysics Data System (ADS)

Metcalfe, Travis S.

2003-04-01

Due to a new global analysis method, it is now possible to measure the internal composition of pulsating white dwarf stars, even with relatively simple theoretical models. The precise internal mixture of carbon and oxygen is the largest single source of uncertainty in ages derived from white dwarf cosmochronometry, and it contains information about the rate of the astrophysically important, but experimentally uncertain, 12C(α,γ)16O nuclear reaction. Recent determinations of the internal composition and structure of two helium-atmosphere variable (DBV) white dwarf stars, GD 358 and CBS 114, initially led to conflicting implied rates for the 12C(α,γ)16O reaction. If both stars were formed through single-star evolution, then the initial analyses of their pulsation frequencies must have differed in some systematic way. I present improved fits to the two sets of pulsation data, resolving the tension between the initial results and leading to a value for the 12C(α,γ)16O reaction rate that is consistent with recent laboratory measurements.

Effect of strain rate and dislocation density on the twinning behavior in Tantalum

DOE PAGES

Florando, Jeffrey N.; El-Dasher, Bassem S.; Chen, Changqiang; ...

2016-04-28

The conditions which affect twinning in tantalum have been investigated across a range of strain rates and initial dislocation densities. Tantalum samples were subjected to a range of strain rates, from 10 –4/s to 10 3/s under uniaxial stress conditions, and under laser-induced shock-loading conditions. In this study, twinning was observed at 77K at strain rates from 1/s to 103/s, and during laser-induced shock experiments. The effect of the initial dislocation density, which was imparted by deforming the material to different amounts of pre-strain, was also studied, and it was shown that twinning is suppressed after a given amount ofmore » pre-strain, even as the global stress continues to increase. These results indicate that the conditions for twinning cannot be represented solely by a critical global stress value, but are also dependent on the evolution of the dislocation density. Additionally, the analysis shows that if twinning is initiated, the nucleated twins may continue to grow as a function of strain, even as the dislocation density continues to increase.« less

Determining next steps in a hand hygiene improvement initiative by examining variation in hand hygiene compliance rates.

PubMed

Homa, Karen; Kirkland, Kathryn B

2011-01-01

Health care worker hand hygiene (HH) is a major quality and safety concern since poor hand hygiene has been linked with hospital associated infections. Dartmouth-Hitchcock Medical Center has been involved in a 4-year initiative to improve hand hygiene. In 2006, HH compliance occurred 41% of the time and by 2009, it had improved to 91%. We wanted to understand some of the unexplained variability in HH to help determine where to target more specific strategies. To help determine where some of the variability in HH compliance rates occurred, an analysis of means chart was used to determine whether role type of the health care worker and hospital areas had significantly different HH rates compared with the overall HH rate. The overall HH rate between March 2008 and December 2009 was 87%. There was a wide and significant variation between the 16 groups of 2 types of health care workers in 8 hospital areas from the lowest rate of 64% to a high of 96%. Analysis of means revealed significant differences in HH rates relative to the type of worker and hospital areas. Although the method does not inform the organization of what type of intervention will work where and why, it allows high and low performing groups to be identified, so that organizations can learn from them to generate and test theories.

Improving timeliness for acute asthma care for paediatric ED patients using a nurse driven intervention: an interrupted time series analysis.

PubMed

Brown, Kathleen; Iqbal, Sabah; Sun, Su-Lin; Fritzeen, Jennifer; Chamberlain, James; Mullan, Paul C

2016-01-01

Asthma is the most common chronic paediatric disease treated in the emergency department (ED). Rapid corticosteroid administration is associated with improved outcomes, but our busy ED setting has made it challenging to achieve this goal. Our primary aim was to decrease the time to corticosteroid administration in a large, academic paediatric ED. We conducted an interrupted time series analysis for moderate to severe asthma exacerbations of one to 18 year old patients. A multidisciplinary team designed the intervention of a bedside nurse initiated administration of oral dexamethasone, to replace the prior system of a physician initiated order for oral prednisone. Our baseline and intervention periods were 12 month intervals. Our primary process measure was the time to corticosteroid administration. Other process measures included ED length of stay, admission rate, and rate of emesis. The balance measures included rate of return visits to the ED or clinic within five days, as well as the proportion of discharged patients who were admitted within five days. No special cause variation occurred in the baseline period. The mean time to corticosteroid administration decreased significantly, from 98 minutes in the baseline period to 59 minutes in the intervention period (p < 0.01), and showed special cause variation improvement within two months after the intervention using statistical process control methodology. We sustained the improvement and demonstrated a stable process. The intervention period had a significantly lower admission rate (p<0.01) and emesis rate (p<0.01), with no unforeseen harm to patients found with any of our balance measures. In summary, the introduction of a nurse initiated, standardized protocol for corticosteroid therapy for asthma exacerbations in a paediatric ED was associated with decreased time to corticosteroid administration, admission rates, and post-corticosteroid emesis.

Feasibility and efficacy of sepsis management guidelines in a pediatric intensive care unit in Saudi Arabia: a quality improvement initiative.

PubMed

Hasan, Gamal M; Al-Eyadhy, Ayman A; Temsah, Mohamed-Hani A; Al-Haboob, Ali A; Alkhateeb, Mohammad A; Al-Sohime, Fahad

2018-04-25

Evaluation of feasibility and effectiveness of Surviving Sepsis Campaign (SSC) Guidelines implementation at a Pediatric Intensive Care Unit (PICU) in Saudi Arabia to reduce severe sepsis associated mortality. Retrospective data analysis for a prospective quality improvement (QI) initiative. PICU at King Saud University Medical City, Saudi Arabia. Children ≤14 years of age admitted to the PICU from July 2010 to March 2011 with suspected or proven sepsis. Comparisons were made to a previously admitted group of patients with sepsis from October 2009 to June 2010. Adaptation and implementation of the Surviving Sepsis Campaign-Clinical Practice Guidelines (SSC-CPGs) through AGREE instrument and ADAPTE process. We reported pre- and post-implementation outcome of interest for this QI initiative, annual sepsis-related mortality rate. Furthermore, we reported follow-up of annual mortality rate until December 2016. Sixty-five patients was included in the study (42 in post-guidelines implementation group and 23 in pre-guidelines implementation group). Mortality was insignificantly lower in the post-implementation group (26.2% vs. 47.8%; P = 0.079). However, when adjusted for severity, identified by number of failing organs in the multivariate regression analysis, the mortality difference was favorable for the post-implementation group (P = 0.006). The lower sepsis-related mortality rate was also sustained, with an average mortality rate of 15.11% for the subsequent years (2012-16). Adaptation and implementation of SSC Guidelines in our setting support its feasibility and potential benefits. However, a larger study is recommended to explore detailed compliance rates.

Mesoscale model for fission-induced recrystallization in U-7Mo alloy

DOE PAGES

Liang, Linyun; Mei, Zhi -Gang; Kim, Yeon Soo; ...

2016-08-09

A mesoscale model is developed by integrating the rate theory and phase-field models and is used to study the fission-induced recrystallization in U-7Mo alloy. The rate theory model is used to predict the dislocation density and the recrystallization nuclei density due to irradiation. The predicted fission rate and temperature dependences of the dislocation density are in good agreement with experimental measurements. This information is used as input for the multiphase phase-field model to investigate the fission-induced recrystallization kinetics. The simulated recrystallization volume fraction and bubble induced swelling agree well with experimental data. The effects of the fission rate, initial grainmore » size, and grain morphology on the recrystallization kinetics are discussed based on an analysis of recrystallization growth rate using the modified Avrami equation. Here, we conclude that the initial microstructure of the U-Mo fuels, especially the grain size, can be used to effectively control the rate of fission-induced recrystallization and therefore swelling.« less

Rapid and accurate prediction of degradant formation rates in pharmaceutical formulations using high-performance liquid chromatography-mass spectrometry.

PubMed

Darrington, Richard T; Jiao, Jim

2004-04-01

Rapid and accurate stability prediction is essential to pharmaceutical formulation development. Commonly used stability prediction methods include monitoring parent drug loss at intended storage conditions or initial rate determination of degradants under accelerated conditions. Monitoring parent drug loss at the intended storage condition does not provide a rapid and accurate stability assessment because often <0.5% drug loss is all that can be observed in a realistic time frame, while the accelerated initial rate method in conjunction with extrapolation of rate constants using the Arrhenius or Eyring equations often introduces large errors in shelf-life prediction. In this study, the shelf life prediction of a model pharmaceutical preparation utilizing sensitive high-performance liquid chromatography-mass spectrometry (LC/MS) to directly quantitate degradant formation rates at the intended storage condition is proposed. This method was compared to traditional shelf life prediction approaches in terms of time required to predict shelf life and associated error in shelf life estimation. Results demonstrated that the proposed LC/MS method using initial rates analysis provided significantly improved confidence intervals for the predicted shelf life and required less overall time and effort to obtain the stability estimation compared to the other methods evaluated. Copyright 2004 Wiley-Liss, Inc. and the American Pharmacists Association.

Correlates of human papillomavirus vaccine coverage: a state-level analysis.

PubMed

Moss, Jennifer L; Reiter, Paul L; Brewer, Noel T

2015-02-01

We tested the hypothesis that states with higher rates of cancers associated with human papillomavirus (HPV) would have lower HPV vaccine coverage. We gathered state-level data on HPV-related cancer rates and HPV vaccine initiation coverage for girls and boys, separately, and HPV vaccine follow-through (i.e., receipt of 3 doses among those initiating the series) for girls only. In addition, we gathered state-level data on demographic composition and contact with the health care system. We calculated Pearson correlations for these ecological relationships. Human papillomavirus vaccine initiation among girls was lower in states with higher levels of cervical cancer incidence and mortality (r = -0.29 and -0.46, respectively). In addition, vaccine follow-through among girls was lower in states with higher levels of cervical cancer mortality (r = -0.30). Other cancer rates were associated with HPV vaccine initiation and follow-through among girls, but not among boys. Human papillomavirus vaccine initiation among girls was lower in states with higher proportions of non-Hispanic black residents and lower proportions of higher-income residents. Human papillomavirus vaccine follow-through was higher in states with greater levels of adolescents' contact with the health care system. Human papillomavirus vaccine coverage for girls was lower in states with higher HPV-related cancer rates. Public health efforts should concentrate on geographic areas with higher cancer rates. Strengthening adolescent preventive health care use may be particularly important to increase vaccine follow-through. Cost-effectiveness analyses may overestimate the benefits of current vaccination coverage and underestimate the benefits of increasing coverage.

Risk of thromboembolism in women taking ethinylestradiol/drospirenone and other oral contraceptives.

PubMed

Seeger, John D; Loughlin, Jeanne; Eng, P Mona; Clifford, C Robin; Cutone, Jennifer; Walker, Alexander M

2007-09-01

The oral contraceptive ethinylestradiol 0.03 mg/drospirenone 3 mg contains a progestin component that differs from other oral contraceptives. Case reports and prescription event monitoring suggested that ethinylestradiol/drospirenone might be associated with an elevated risk of thromboembolism. We sought to estimate the association between ethinylestradiol/drospirenone and risk of thromboembolism relative to the association among other oral contraceptives. We identified ethinylestradiol/drospirenone initiators and a twofold larger group of other oral contraceptive initiators between June 2001 and June 2004 within a U.S. health insurer database. The comparison group was selected to have demographic and health care characteristics preceding oral contraceptive initiation that were similar to ethinylestradiol/drospirenone initiators. Thromboembolism during the follow-up of the cohorts was identified through claims for medical services, and only medical record-confirmed cases were included in analyses. The primary (as-matched) analysis used proportional hazards regression, whereas a secondary (as-treated) analysis accounted for changes in oral contraceptives during follow-up using Poisson regression. The 22,429 ethinylestradiol/drospirenone initiators and 44,858 other oral contraceptive initiators were followed for an average of 7.6 months, and there were 18 cases of thromboembolism in ethinylestradiol/drospirenone initiators and 39 in the comparators (rate ratio 0.9, 95% confidence interval 0.5-1.6). More than 9,000 women would need to be prescribed oral contraceptives to observe a difference of one case of thromboembolism. Results of the as-treated analysis were similar to those of the as-matched analysis. Ethinylestradiol/drospirenone initiators and initiators of other oral contraceptives are similarly likely to experience thromboembolism. II.

Epidemiological analysis of factors influencing rate of progress in Echinococcus granulosus control in New Zealand.

PubMed Central

Burridge, M. J.; Schwabe, C. W.

1977-01-01

The factors influencing the rate of progress in Echinococcus granulosus control in New Zealand were analysed by hydatid control area using stepwise multiple regression techniques. The results indicated that the rate of progress was related positively to initial E. granulosus prevalence in dogs and the efficiency with which local authorities implemented national control policy, and negatively to the Maori proportion in the local population and the number of dogs per owner. Problems in analysis of the New Zealand data are discussed and improved methods of monitoring progress in hydatid disease control programmes are described. Images Fig. 1 PMID:265340

Switching stable patients with schizophrenia from their oral antipsychotics to aripiprazole lauroxil: a post hoc safety analysis of the initial 12-week crossover period.

PubMed

Weiden, Peter J; Du, Yangchun; Liu, Chih-Chin; Stanford, Arielle D

2018-06-26

Switching antipsychotic medications is common in patients with schizophrenia who are experiencing persistent symptoms or tolerability issues associated with their current drug regimen. This analysis assessed the safety of switching from an oral antipsychotic to the long-acting injectable antipsychotic aripiprazole lauroxil (AL). This was a post hoc analysis of outpatients with schizophrenia who were prescribed an oral antipsychotic and who enrolled in an international, open-label, long-term (52-week) safety study of AL. The analysis focused on the first 3 injections of AL 882 mg over 12 weeks, divided into the immediate 4-week crossover period between the first and second AL injections (initiation phase) and the subsequent 8 weeks (stabilization phase). Patients were grouped by preswitch oral antipsychotic medication, and safety and clinical symptoms were assessed. In total, 190 patients had switched from one of the following oral antipsychotic medications: aripiprazole, conventional antipsychotics, risperidone/paliperidone, olanzapine, or quetiapine. The 12-week completion rate was high (92.1%) and similar across the different preswitch oral antipsychotic groups. Overall, adverse event (AE) rates experienced over 12 weeks were modest; no AEs were considered serious. The most common AEs in the initiation phase were injection site pain (5.8%), insomnia (5.8%), and akathisia (3.2%). No apparent relationship was observed between preswitch medication and early-onset AEs. Mean Positive and Negative Syndrome Scale total scores remained stable during this period across preswitch antipsychotic groups. Switching from an oral antipsychotic to AL was feasible in an outpatient setting for patients with schizophrenia, and the 12-week retention rate was favorable.

Transarterial Onyx Embolization of Intracranial Dural Fistulas: A Prospective Cohort, Systematic Review, and Meta-Analysis.

PubMed

Sadeh-Gonike, Udi; Magand, Nicolas; Armoiry, Xavier; Riva, Roberto; Labeyrie, Paul Emile; Lamy, Bernadette; Lukaszewicz, Anne-Claire; Lehot, Jean-Jacques; Turjman, Francis; Gory, Benjamin

2018-06-01

Onyx is important embolic material in the endovascular treatment of intracranial dural arteriovenous fistula (DAVF). However, its impact on DAVF occlusion rates, morbidity, mortality, and complication rates is not fully examined. To improve understanding of safety and effectiveness profiles associated with transarterial endovascular treatment using Onyx for intracranial DAVF. We analyzed data from our prospective clinical registry and conducted a systematic review of all previous transarterial embolization studies using Onyx published between January 2005 and December 2015 in MEDLINE and EMBASE. In the prospective study, 41 transarterial procedures were performed in 33 consecutive patients harboring 36 DAVFs. Complete initial exclusion was obtained in 32 of 36 (88.9%) fistulas; 31 fistulas were followed up showing 4 (12.9%) recurrences. Procedure-related morbidity and mortality were 3% and 0%, respectively. The literature review identified 19 studies involving a total of 425 patients with 463 DAVFs. Meta-analysis, including our registry data, showed an initial complete occlusion rate of 82% (95% confidence interval [CI]: 74%, 88%; I2, 70.6%), and recurrence rate at midterm of 2% (95% CI: 0%, 5%; I2, 21.5%). Pooled postoperative neurological deficit, procedure-related morbidity, and mortality rates were 4% (95% CI: 2%, 6%; I2, 0%), 3% (95% CI: 1%, 5%; I2, 0%), and 0%, respectively. This meta-analysis suggests that transarterial embolization with Onyx is a safe treatment modality for DAVFs. Although Onyx showed a low recurrence rate at midterm, the long-term risk is poorly addressed in our study and should warrant a longer follow-up.

Breastfeeding among the Ontario James Bay Cree: a retrospective study.

PubMed

Black, Ray; Godwin, Marshall; Ponka, David

2008-01-01

Although previous unpublished research has demonstrated low breastfeeding rates among the James Bay Cree of Northern Ontario, the reasons for this are not immediately clear. A retrospective medical chart review of women who had given birth at the Weeneebayko General Hospital in Moose Factory, Ontario in the seven-year period 1997 to 2003 was performed. A variety of demographic variables were documented and overall breastfeeding initiation rates and yearly variations were assessed. Univariate chi-square analysis of the data indicated that young maternal age (mean=23; p=0.001), maternal smoking (average rate=52.1%; p=0.03), living location (in a small coastal community; p=0.001); and low education status (not completing high school; p<0.001) were risk factors for a mother choosing not to breastfeed. Regression analysis revealed that only living in small coastal communities and not having post-secondary education were independently associated with not breastfeeding. Absence of a partner nearly reached statistical significance on regression analysis (p=0.056). The overall breastfeeding initiation rates (51.9%, 95% CI: 49.3-54.5) were confirmed to be lower than the national average (78%), and the rate has remained low over the seven years of the study. These results should help clarify why some mothers in the Moose Factory region are at risk of not breastfeeding. This information will be useful in directing future research on the differences in breastfeeding rates among different Aboriginal Peoples' communities, and assist in the development of program policies specific to women who have one or more of the identified risk factors.

Human papillomavirus vaccine initiation in Asian Indians and Asian subpopulations: a case for examining disaggregated data in public health research.

PubMed

Budhwani, H; De, P

2017-12-01

Vaccine disparities research often focuses on differences between the five main racial and ethnic classifications, ignoring heterogeneity of subpopulations. Considering this knowledge gap, we examined human papillomavirus (HPV) vaccine initiation in Asian Indians and Asian subpopulations. National Health Interview Survey data (2008-2013), collected by the National Center for Health Statistics, were analyzed. Multiple logistic regression analysis was conducted on adults aged 18-26 years (n = 20,040). Asian Indians had high income, education, and health insurance coverage, all positive predictors of preventative health engagement and vaccine uptake. However, we find that Asian Indians had comparatively lower rates of HPV vaccine initiation (odds ratio = 0.41; 95% confidence interval = 0.207-0.832), and foreign-born Asian Indians had the lowest rate HPV vaccination of all subpopulations (2.3%). Findings substantiate the need for research on disaggregated data rather than evaluating vaccination behaviors solely across standard racial and ethnic categories. We identified two populations that were initiating HPV vaccine at abysmal levels: foreign-born persons and Asian Indians. Development of culturally appropriate messaging has the potential to improve these initiation rates and improve population health. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

In situ detection of porosity initiation during aluminum thin film anodizing

NASA Astrophysics Data System (ADS)

Van Overmeere, Quentin; Nysten, Bernard; Proost, Joris

2009-02-01

High-resolution curvature measurements have been performed in situ during aluminum thin film anodizing in sulfuric acid. A well-defined transition in the rate of internal stress-induced curvature change is shown to allow for the accurate, real-time detection of porosity initiation. The validity of this in situ diagnostic tool was confirmed by a quantitative analysis of the spectral density distributions of the anodized surfaces. These were obtained by analyzing ex situ atomic force microscopy images of surfaces anodized for different times, and allowed to correlate the in situ detected transition in the rate of curvature change with the appearance of porosity.

Using specific volume increment (SVI) for quantifying growth responses in trees - theoretical and practical considerations

Treesearch

Eddie Bevilacqua

2002-01-01

Comparative analysis of growth responses among trees following natural or anthropogenic disturbances is often confounded when comparing trees of different size because of the high correlation between growth and initial tree size: large trees tend to have higher absolute grow rates. Relative growth rate (RGR) may not be the most suitable size-dependent measure of growth...

[Relational database for urinary stone ambulatory consultation. Assessment of initial outcomes].

PubMed

Sáenz Medina, J; Páez Borda, A; Crespo Martinez, L; Gómez Dos Santos, V; Barrado, C; Durán Poveda, M

2010-05-01

To create a relational database for monitoring lithiasic patients. We describe the architectural details and the initial results of the statistical analysis. Microsoft Access 2002 was used as template. Four different tables were constructed to gather demographic data (table 1), clinical and laboratory findings (table 2), stone features (table 3) and therapeutic approach (table 4). For a reliability analysis of the database the number of correctly stored data was gathered. To evaluate the performance of the database, a prospective analysis was conducted, from May 2004 to August 2009, on 171 stone free patients after treatment (EWSL, surgery or medical) from a total of 511 patients stored in the database. Lithiasic status (stone free or stone relapse) was used as primary end point, while demographic factors (age, gender), lithiasic history, upper urinary tract alterations and characteristics of the stone (side, location, composition and size) were considered as predictive factors. An univariate analysis was conducted initially by chi square test and supplemented by Kaplan Meier estimates for time to stone recurrence. A multiple Cox proportional hazards regression model was generated to jointly assess the prognostic value of the demographic factors and the predictive value of stones characteristics. For the reliability analysis 22,084 data were available corresponding to 702 consultations on 511 patients. Analysis of data showed a recurrence rate of 85.4% (146/171, median time to recurrence 608 days, range 70-1758). In the univariate and multivariate analysis, none of the factors under consideration had a significant effect on recurrence rate (p=ns). The relational database is useful for monitoring patients with urolithiasis. It allows easy control and update, as well as data storage for later use. The analysis conducted for its evaluation showed no influence of demographic factors and stone features on stone recurrence.

Terminal navigation analysis for the 1980 comet Encke slow flyby mission

NASA Technical Reports Server (NTRS)

Jacobson, R. A.; Mcdanell, J. P.; Rinker, G. C.

1973-01-01

The initial results of a terminal navigation analysis for the proposed 1980 solar electric slow flyby mission to the comet Encke are presented. The navigation technique employs onboard optical measurements with the scientific television camera, groundbased observations of the spacecraft and comet, and groundbased orbit determination and thrust vector update computation. The knowledge and delivery accuracies of the spacecraft are evaluated as a function of the important parameters affecting the terminal navigation. These include optical measurement accuracy, thruster noise level, duration of the planned terminal coast period, comet ephemeris uncertainty, guidance initiation time, guidance update frequency, and optical data rate.

Smear Conversion, Treatment Outcomes and the Time of Default in Registered Tuberculosis Patients on RNTCP DOTS in Puducherry, Southern India

PubMed Central

Jayakumar, Niranjana; Gnanasekaran, Dhivyalakshmi

2014-01-01

Background: Revised National Tuberculosis Control Programme (RNTCP) in India has achieved improved cure rates. Objectives: This study describes the achievements under RNTCP in terms of conversion rates, treatment outcomes and pattern of time of default in patients on directly observed short-course treatment for Tuberculosis in Puducherry, Southern India. Settings: Retrospective cohort study; Tuberculosis Unit in District Tuberculosis Centre, Puducherry, India. Materials and Methods: Cohort analysis of patients of registered at the Tuberculosis Unit during 1st and 2nd quarter of the year 2011. Details about sputum conversion, treatment outcome and time of default were obtained from the tuberculosis register. Statistical Analysis: Kaplan-Meier plots & log rank tests. Results: RNTCP targets with respect to success rate (85.7%), death rate (2.7%) and failure rate (2.1%) in new cases have been achieved but the sputum conversion rate (88%) and default rate (5.9%) targets have not been achieved. The overall default rate for all registered TB patients was 7.4%; significantly higher in category II. In retreatment cases registered as treatment after default, the default rate was high (9%). The cumulative default rate; though similar in the initial two months of treatment; was consistently higher in category II as compared to that in category I. Nearly 40% of all defaulters interrupted treatment between the second and fourth month after treatment initiation. Conclusion: Defaulting from treatment is more common among the retreatment cases and usually occurs during the transition phase from intensive phase to continuation phase. PMID:25478371

Evaluating the 'Focus on Normal Birth and Reducing Caesarean section Rates Rapid Improvement Programme': A mixed method study in England.

PubMed

Marshall, Joyce L; Spiby, Helen; McCormick, Felicia

2015-02-01

caesarean section plays an important role in ensuring safety of mother and infant but rising rates are not accompanied by measurable improvements in maternal or neonatal mortality or morbidity. The 'Focus on Normal Birth and Reducing Caesarean section Rates Rapid Improvement Programme' was a facilitative initiative developed to promote opportunities for normal birth and reduce caesarean section rates in England. to evaluate the 'Focus on Normal Birth and Reducing Caesarean section Rates' programme, by assessment of: impact on caesarean section rates, use of service improvements tools and participants׳ perceptions of factors that sustain or hinder work within participating maternity units. a mixed methods approach included analysis of mode of birth data, web-based questionnaires and in-depth semi-structured telephone interviews. twenty Hospital Trusts in England (selected from 68 who applied) took part in the 'Focus on Normal Birth and Reducing Caesarean section Rates Rapid Improvement Programme' initiative. In each hospital Trust, the head of midwifery, an obstetrician, the relevant lead for organisational development, a supervisor of midwives, or a clinical midwife and a service user representative were invited to participate in the independent evaluation. collection and analysis of mode of birth data from 20 participating hospital Trusts, web-based questionnaires administered to key individuals in all 20 Trusts and in-depth semi-structured telephone interviews conducted with key individuals in a sample of six Trusts. there was a marginal decline of 0.5% (25.9% from 26.4%) in mean total caesarean section rate in the period 1 January 2009 to 31 January 2010 compared to the baseline period (1 July-31 December 2008). Reduced total caesarean section rates were achieved in eight trusts, all with higher rates at the beginning of the initiative. Features associated with lower caesarean section rates included a shared philosophy prioritising normal birth, clear communication across disciplines and strong leadership at a range of levels, including executive support and clinical leaders within each discipline. it is important that the philosophy and organisational context of care are examined to identify potential barriers and facilitative factors. Copyright © 2014 Elsevier Ltd. All rights reserved.

FECAL INDICATOR BACTERIA MEASUREMENTS BY QUANTITATIVE POLYMERASE CHAIN REACTION (QPCR) ANALYSIS IN FRESH ARCHIVED DNA EXTRACT OF WATER SAMPLE FILTRATES

EPA Science Inventory

The U.S. EPA has initiated a new recreational water study to evaluate the correlation between illness rates in swimmers and Enterococcus concentrations determined by the mEI agar membrane filter (MF) method and several new technologies including QPCR analysis. Results of this stu...

Heart rate changes during electroconvulsive therapy

PubMed Central

2013-01-01

Background This observational study documented heart rate over the entire course of electrically induced seizures and aimed to evaluate the effects of stimulus electrode placement, patients' age, stimulus dose, and additional predictors. Method In 119 consecutive patients with 64 right unilateral (RUL) and 55 bifrontal (BF) electroconvulsive treatments, heart rate graphs based on beat-to-beat measurements were plotted up to durations of 130 s. Results In RUL stimulation, the initial drop in heart rate lasted for 12.5 ± 2.6 s (mean ± standard deviation). This depended on stimulus train duration, age, and baseline heart rate. In seizures induced with BF electrode placement, a sympathetic response was observed within the first few seconds of the stimulation phase (median 3.5 s). This was also the case with subconvulsive stimulations. The mean peak heart rate in all 119 treatments amounted to 135 ± 20 bpm and depended on baseline heart rate and seizure duration; electrode placement, charge dose, and age were insignificant in regression analysis. A marked decline in heart rate in connection with seizure cessation occurred in 71% of treatments. Conclusions A significant independent effect of stimulus electrode positioning on cardiac action was evident only in the initial phase of the seizures. Electrical stimulation rather than the seizure causes the initial heart rate increase in BF treatments. The data reveal no rationale for setting the stimulus doses as a function of intraictal peak heart rates (‘benchmark method’). The marked decline in heart rate at the end of most seizures is probably mediated by a baroreceptor reflex. PMID:23764036

Heterosexual HIV-1 transmission after initiation of antiretroviral therapy: a prospective cohort analysis.

PubMed

Donnell, Deborah; Baeten, Jared M; Kiarie, James; Thomas, Katherine K; Stevens, Wendy; Cohen, Craig R; McIntyre, James; Lingappa, Jairam R; Celum, Connie

2010-06-12

High plasma HIV-1 RNA concentrations are associated with increased risk of HIV-1 transmission. Initiation of antiretroviral therapy (ART) reduces plasma HIV-1 concentrations. We aimed to assess the effect of ART use by patients infected with HIV-1 on risk of transmission to their uninfected partners. Participants in our prospective cohort analysis were from a randomised placebo-controlled trial that enrolled heterosexual African adults who were seropositive for both HIV-1 and herpes simplex virus type 2, and their HIV-1 seronegative partners. At enrolment, HIV-1 infected participants had CD4 counts of 250 cells per microL or greater and did not meet national guidelines for ART initiation; during 24 months of follow-up, CD4 counts were measured every 6 months and ART was initiated in accordance with national guidelines. Uninfected partners were tested for HIV-1 every 3 months. The primary outcome was genetically-linked HIV-1 transmission within the study partnership. We assessed rates of HIV-1 transmission by ART status of infected participants. 3381 couples were eligible for analysis. 349 (10%) participants with HIV-1 initiated ART during the study, at a median CD4 cell count of 198 (IQR 161-265) cells per microL. Only one of 103 genetically-linked HIV-1 transmissions was from an infected participant who had started ART, corresponding to transmission rates of 0.37 (95% CI 0.09-2.04) per 100 person-years in those who had initiated treatment and 2.24 (1.84-2.72) per 100 person-years in those who had not-a 92% reduction (adjusted incidence rate ratio 0.08, 95% CI 0.00-0.57, p=0.004). In participants not on ART, the highest HIV-1 transmission rate (8.79 per 100 person-years) was from those with CD4 cell counts lower than 200 cells per microL. In couples in whom the untreated HIV-1 infected partner had a CD4 cell count greater than 200 cells per microL, 66 (70%) of 94 transmissions occurred when plasma HIV-1 concentrations exceeded 50 000 copies per mL. Low CD4 cell counts and high plasma HIV-1 concentrations might guide use of ART to achieve an HIV-1 prevention benefit. Provision of ART to HIV-1 infected patients could be an effective strategy to achieve population-level reductions in HIV-1 transmission. Bill & Melinda Gates Foundation; US National Institutes of Health. Copyright 2010 Elsevier Ltd. All rights reserved.

One-year contraceptive continuation and pregnancy in adolescent girls and women initiating hormonal contraceptives.

PubMed

Raine, Tina R; Foster-Rosales, Anne; Upadhyay, Ushma D; Boyer, Cherrie B; Brown, Beth A; Sokoloff, Abby; Harper, Cynthia C

2011-02-01

To assess contraceptive discontinuation, switching, factors associated with method discontinuation, and pregnancy among women initiating hormonal contraceptives. This was a 12-month longitudinal cohort study of adolescent girls and women (n=1,387) aged 15 to 24 years attending public family planning clinics who did not desire pregnancy for at least 1 year and selected to initiate the patch, ring, depot medroxyprogesterone acetate, or pills. Participants completed follow-up assessments at 3, 6, and 12 months after baseline. Life table analysis was used to estimate survival rates for contraceptive continuation. Cox proportional hazards models were used to estimate factors associated with method discontinuation. The continuation rate (per 100 person-years) at 12 months was low for all methods; however, it was lowest for patch and depot medroxyprogesterone acetate initiators, 10.9 and 12.1 per 100 person years, respectively (P≤.003); continuation among ring initiators was comparable to pill initiators, 29.4 and 32.7 per 100 person-years, respectively (P=.06). Discontinuation was independently associated with method initiated and younger age. The only factors associated with lower risk of discontinuation were greater intent to use the method and being in school or working. The pregnancy rate (per 100 person-years) was highest for patch and ring initiators (30.1 and 30.5) and comparable for pill and depot medroxyprogesterone acetate initiators (16.5 and 16.1; P<.001). The patch and the ring may not be better options than the pill or depot medroxyprogesterone acetate for women at high risk for unintended pregnancy. This study highlights the need for counseling interventions to improve contraceptive continuation, education about longer-acting methods, and developing new contraceptives that women may be more likely to continue. II.

Ceftaroline fosamil use in hospitalized patients with acute bacterial skin and skin structure infections: Budget impact analysis from a hospital perspective.

PubMed

Huang, Xingyue; Beresford, Eric; Lodise, Thomas; Friedland, H David

2013-06-15

The budgetary impact of adding ceftaroline fosamil to a hospital formulary for the treatment of acute bacterial skin and skin structure infections (ABSSSIs) was evaluated. A three-year hospital budget impact model was constructed with three initial treatment options for ABSSSIs: ceftaroline fosamil, vancomycin plus aztreonam, and other vancomycin-containing regimens. The target population was hospitalized adult patients with an ABSSSI. Clinical cure rates with initial treatment were assumed to be similar to those from ceftaroline fosamil clinical trials. Patients who did not respond to initial treatment were assumed to be treated successfully with second-line antimicrobial therapy. Length of stay and cost per hospital day (by success or failure with initial treatment) were estimated based on a large database from more than 100 U.S. hospitals. Other model inputs included the annual number of ABSSSI admissions, projected annual case growth rate, proportion of ABSSSI target population receiving vancomycin-containing regimen, expected proportion of ABSSSI target population to be treated with ceftaroline fosamil, drug acquisition cost, cost of antibiotic administration, and cost of vancomycin monitoring. Sensitivity analysis using 95% confidence limits of clinical cure rates was also performed. The estimated total cost of care for treating a patient with an ABSSSI was $395 lower with ceftaroline fosamil ($15,087 versus $15,482) compared with vancomycin plus aztreonam and $72 lower ($15,087 versus $15,159) compared with other vancomycin-containing regimens. Model estimates indicated that adding ceftaroline fosamil to the hospital formulary would not have a negative effect on a hospital's budget for ABSSSI treatment.

Fast repetition rate (FRR) flasher

DOEpatents

Kolber, Zbigniew; Falkowski, Paul

1997-02-11

A fast repetition rate (FRR) flasher suitable for high flash photolysis including kinetic chemical and biological analysis. The flasher includes a power supply, a discharge capacitor operably connected to be charged by the power supply, and a flash lamp for producing a series of flashes in response to discharge of the discharge capacitor. A triggering circuit operably connected to the flash lamp initially ionizes the flash lamp. A current switch is operably connected between the flash lamp and the discharge capacitor. The current switch has at least one insulated gate bipolar transistor for switching current that is operable to initiate a controllable discharge of the discharge capacitor through the flash lamp. Control means connected to the current switch for controlling the rate of discharge of the discharge capacitor thereby to effectively keep the flash lamp in an ionized state between Successive discharges of the discharge capacitor. Advantageously, the control means is operable to discharge the discharge capacitor at a rate greater than 10,000 Hz and even up to a rate greater than about 250,000 Hz.

Modelling of the hole-initiated impact ionization current in the framework of hydrodynamic equations

NASA Astrophysics Data System (ADS)

Lorenzini, Martino; Van Houdt, Jan

2002-02-01

Several research papers have shown the feasibility of the hydrodynamic transport model to investigate impact ionization in semiconductor devices by means of mean-energy-dependent generation rates. However, the analysis has been usually carried out for the case of the electron-initiated impact ionization process and less attention has been paid to the modelling of the generation rate due to impact ionization events initiated by holes. This paper therefore presents an original model for the hole-initiated impact ionization in silicon and validates it by comparing simulation results with substrate currents taken from p-channel transistors manufactured in a 0.35 μm CMOS technology having three different channel lengths. The experimental data are successfully reproduced over a wide range of applied voltages using only one fitting parameter. Since the impact ionization of holes triggers the mechanism responsible for the back-bias enhanced gate current in deep submicron nMOS devices, the model can be exploited in the development of non-volatile memories programmed by secondary electron injection.

Age patterns of smoking initiation among Kuwait university male students.

PubMed

Sugathan, T N; Moody, P M; Bustan, M A; Elgerges, N S

1998-12-01

The present study is a detailed evaluation of age at smoking initiation among university male students in Kuwait based on a random sample of 664 students selected from all students during 1993. The Acturial Life Table analysis revealed that almost one tenth of the students initiated cigarette smoking between ages 16 and 17 with the rate of initiation increasing rapidly thereafter and reaching 30% by age 20 and almost 50% by the time they celebrate their 24th birthday. The most important environmental risk factor positively associated for smoking initiation was observed to be the history of smoking among siblings with a relative risk of 1.4. Compared to students of medicine and engineering, the students of other faculties revealed a higher risk in smoking initiation with an RR = 1.77 for sciences and commerce and 1.61 for other faculties (arts, law, education and Islamic studies). The analysis revealed a rising generation trend in cigarette smoking. There is a need for reduction of this trend among young adults in Kuwait and throughout other countries in the region.

Temporal Trends in Late Preterm and Early Term Birth Rates in 6 High-Income Countries in North America and Europe and Association With Clinician-Initiated Obstetric Interventions.

PubMed

Richards, Jennifer L; Kramer, Michael S; Deb-Rinker, Paromita; Rouleau, Jocelyn; Mortensen, Laust; Gissler, Mika; Morken, Nils-Halvdan; Skjærven, Rolv; Cnattingius, Sven; Johansson, Stefan; Delnord, Marie; Dolan, Siobhan M; Morisaki, Naho; Tough, Suzanne; Zeitlin, Jennifer; Kramer, Michael R

2016-07-26

Clinicians have been urged to delay the use of obstetric interventions (eg, labor induction, cesarean delivery) until 39 weeks or later in the absence of maternal or fetal indications for intervention. To describe recent trends in late preterm and early term birth rates in 6 high-income countries and assess association with use of clinician-initiated obstetric interventions. Retrospective analysis of singleton live births from 2006 to the latest available year (ranging from 2010 to 2015) in Canada, Denmark, Finland, Norway, Sweden, and the United States. Use of clinician-initiated obstetric intervention (either labor induction or prelabor cesarean delivery) during delivery. Annual country-specific late preterm (34-36 weeks) and early term (37-38 weeks) birth rates. The study population included 2,415,432 Canadian births in 2006-2014 (4.8% late preterm; 25.3% early term); 305,947 Danish births in 2006-2010 (3.6% late preterm; 18.8% early term); 571,937 Finnish births in 2006-2015 (3.3% late preterm; 16.8% early term); 468,954 Norwegian births in 2006-2013 (3.8% late preterm; 17.2% early term); 737,754 Swedish births in 2006-2012 (3.6% late preterm; 18.7% early term); and 25,788,558 US births in 2006-2014 (6.0% late preterm; 26.9% early term). Late preterm birth rates decreased in Norway (3.9% to 3.5%) and the United States (6.8% to 5.7%). Early term birth rates decreased in Norway (17.6% to 16.8%), Sweden (19.4% to 18.5%), and the United States (30.2% to 24.4%). In the United States, early term birth rates decreased from 33.0% in 2006 to 21.1% in 2014 among births with clinician-initiated obstetric intervention, and from 29.7% in 2006 to 27.1% in 2014 among births without clinician-initiated obstetric intervention. Rates of clinician-initiated obstetric intervention increased among late preterm births in Canada (28.0% to 37.9%), Denmark (22.2% to 25.0%), and Finland (25.1% to 38.5%), and among early term births in Denmark (38.4% to 43.8%) and Finland (29.8% to 40.1%). Between 2006 and 2014, late preterm and early term birth rates decreased in the United States, and an association was observed between early term birth rates and decreasing clinician-initiated obstetric interventions. Late preterm births also decreased in Norway, and early term births decreased in Norway and Sweden. Clinician-initiated obstetric interventions increased in some countries but no association was found with rates of late preterm or early term birth.

Sustainable streets and highways : an analysis of green roads rating systems.

DOT National Transportation Integrated Search

2012-05-01

As sustainability increasingly becomes a concern to society, it is in state transportation : agencies best interests to embrace and adopt initiatives that will both educate their : employees and the communities they serve on how transportation sys...

Effect of cigarette prices on smoking initiation and cessation in China: a duration analysis.

PubMed

Kostova, Deliana; Husain, Muhammad J; Chaloupka, Frank J

2016-09-01

China is the world's largest producer and consumer of cigarettes. The status of tobacco as both a contributor to China's economy and a liability for the health of its population may complicate the use of taxes for addressing smoking in the country. Understanding how cigarette prices affect transitions in smoking behaviour in China can increase understanding of how China's high smoking rates can be influenced by tax policy. In order to estimate the effect of cigarette prices on smoking initiation and cessation in China, we construct pseudo-longitudinal samples for duration analysis using data from the Global Adult Tobacco Survey China 2010. We use the historical variation in prices representative of 4 China regions over a 20-year period to identify the average price effect on the hazards of initiation and cessation while controlling for unobserved fixed and time-varying region characteristics. We find that initiation rates fall in response to higher prices (with a price elasticity of initiation estimated at -0.95 for men and -1.07 overall). The effect of prices on smoking in China is likely to occur through averting initiation over time. At the population level, cessation behaviour may be less responsive to price increases as the wide range of cigarette prices in China may provide relatively high opportunity for switching to lower priced brands. 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/.

Many Districts Left Behind: An Individual Change Analysis of Inequity in the Kenyan Primary Educational Opportunities (2001-2007)

ERIC Educational Resources Information Center

Bagaka's, Joshua Gisemba

2010-01-01

The study examined variations in district performance in KCPE national examination in Kenya between 2001 and 2007. The individual change model revealed that district poverty rate was not a significant predictor of either the initial district performance (2001) or the rate of change over the seven-year period. The regional context of North Eastern…

Morphology and developmental rate of blowflies Chrysomya megacephala and Chrysomya rufifacies in Thailand: application in forensic entomology.

PubMed

Sukontason, Kom; Piangjai, Somsak; Siriwattanarungsee, Sirisuda; Sukontason, Kabkaew L

2008-05-01

The larval morphology and developmental rate of Chrysomya megacephala (F.) and Chrysomya rufifacies (Macquart), the two most forensically important blowfly species in Thailand, are presented. Morphological comparison of the third instar of both species revealed different characteristics (e.g., body appearance, cephalopharyngeal skeleton, dorsal cuticular spines between the prothorax and mesothorax, and feature of the posterior spiracle), thereby, allowing correct identification. A data analysis was conducted in Chiang Mai province, Northern Thailand during 2000-2001 on the developmental rate of both flies under natural ambient temperature and a natural light-dark photoperiod. The results indicated that larvae of C. megacephala developed more rapidly in April, pupariation initiated at 84 h at temperatures averaging 31.4 degrees C, and the larvae grew slower in the rainy season and winter. Similarly, rapid development of C. rufifacies larvae appeared in the summer, with a pupariation period as short as 96 h in June (average temperature 27.4 degrees C). Analysis of the median body length of C. megacephala and C. rufifacies larvae in different seasons of the years 2000-2001 in Thailand revealed that both species developed rapidly in the summer; pupariation of C. rufifacies initiated at 144 h, while C. megacephala initiated pupariation at 156 h. This information is potentially useful for estimating the postmortem interval of a corpse in forensic investigations, where the corpse becomes infesting with these fly species.

Dynamics of slow-moving landslides from permanent scatterer analysis.

PubMed

Hilley, George E; Bürgmann, Roland; Ferretti, Alessandro; Novali, Fabrizio; Rocca, Fabio

2004-06-25

High-resolution interferometric synthetic aperture radar (InSAR) permanent scatterer data allow us to resolve the rates and variations in the rates of slow-moving landslides. Satellite-to-ground distances (range changes) on landslides increase at rates of 5 to 7 millimeters per year, indicating average downslope sliding velocities from 27 to 38 millimeters per year. Time-series analysis shows that displacement occurs mainly during the high-precipitation season; during the 1997-1998 El Niño event, rates of range change increased to as much as 11 millimeters per year. The observed nonlinear relationship of creep and precipitation rates suggests that increased pore fluid pressures within the shallow subsurface may initiate and accelerate these features. Changes in the slope of a hill resulting from increases in the pore pressure and lithostatic stress gradients may then lead to landslides.

Role of the Axon Initial Segment in the Control of Spontaneous Frequency of Nigral Dopaminergic Neurons In Vivo.

PubMed

Meza, Rodrigo C; López-Jury, Luciana; Canavier, Carmen C; Henny, Pablo

2018-01-17

The spontaneous tonic discharge activity of nigral dopamine neurons plays a fundamental role in dopaminergic signaling. To investigate the role of neuronal morphology and architecture with respect to spontaneous activity in this population, we visualized the 3D structure of the axon initial segment (AIS) along with the entire somatodendritic domain of adult male mouse dopaminergic neurons, previously recorded in vivo We observed a positive correlation of the firing rate with both proximity and size of the AIS. Computational modeling showed that the size of the AIS, but not its position within the somatodendritic domain, is the major causal determinant of the tonic firing rate in the intact model, by virtue of the higher intrinsic frequency of the isolated AIS. Further mechanistic analysis of the relationship between neuronal morphology and firing rate showed that dopaminergic neurons function as a coupled oscillator whose frequency of discharge results from a compromise between AIS and somatodendritic oscillators. Thus, morphology plays a critical role in setting the basal tonic firing rate, which in turn could control striatal dopaminergic signaling that mediates motivation and movement. SIGNIFICANCE STATEMENT The frequency at which nigral dopamine neurons discharge action potentials sets baseline dopamine levels in the brain, which enables activity in motor, cognitive, and motivational systems. Here, we demonstrate that the size of the axon initial segment, a subcellular compartment responsible for initiating action potentials, is a key determinant of the firing rate in these neurons. The axon initial segment and all the molecular components that underlie its critical function may provide a novel target for the regulation of dopamine levels in the brain. Copyright © 2018 the authors 0270-6474/18/380733-12$15.00/0.

Kinetics of initiation, propagation, and termination for the [rac-(C(2)H(4)(1-indenyl)(2))ZrMe][MeB(C(6)F(5))(3)]-catalyzed polymerization of 1-hexene.

PubMed

Liu, Z; Somsook, E; White, C B; Rosaaen, K A; Landis, C R

2001-11-14

Metallocene-catalyzed polymerization of 1-alkenes offers fine control of critical polymer attributes such as molecular weight, polydispersity, tacticity, and comonomer incorporation. Enormous effort has been expended on the synthesis and discovery of new catalysts and activators, but elementary aspects of the catalytic processes remain unclear. For example, it is unclear how the catalyst is distributed among active and dormant sites and how this distribution influences the order in monomer for the propagation rates, for which widely varying values are reported. Similarly, although empirical relationships between average molecular weights and monomer have been established for many systems, the underlying mechanisms of chain termination are unclear. Another area of intense interest concerns the role of ion-pairing in controlling the activity and termination mechanisms of metallocene-catalyzed polymerizations. Herein we report the application of quenched-flow kinetics, active site counting, polymer microstructure analysis, and molecular weight distribution analysis to the determination of fundamental rate laws for initiation, propagation, and termination for the polymerization of 1-hexene in toluene solution as catalyzed by the contact ion-pair, [rac-(C(2)H(4)(1-indenyl)(2))ZrMe][MeB(C(6)F(5))(3)] (1) over the temperature range of -10 to 50 degrees C. Highly isotactic (>99% mmmm) poly-1-hexene is produced with no apparent enchained regioerrors. Initiation and propagation processes are first order in the concentrations of 1-hexene and 1 but independent of excess borane or the addition of the contact ion-pair [PhNMe(3)][MeB(C(6)F(5))(3)]. Active site counting and the reaction kinetics provide no evidence of catalyst accumulation in dormant or inactive sites. Initiation is slower than propagation by a factor of 70. The principal termination process is the formation of unsaturates of two types: vinylidene end groups that arise from termination after a 1,2 insertion and vinylene end groups that follow 2,1 insertions. The rate law for the former termination process is independent of the 1-hexene concentration, whereas the latter is first order. Analysis of (13)C-labeled polymer provides support for a mechanism of vinylene end group formation that is not chain transfer to monomer. Deterministic modeling of the molecular weight distributions using the fundamental rate laws and kinetic constants demonstrates the robustness of the kinetic analysis. Comparisons of insertion frequencies with estimated limits on the rates of ion-pair symmetrization obtained by NMR suggest that ion-pair separation prior to insertion is not required, but the analysis requires assumptions that cannot be validated.

Effect of strain rate and dislocation density on the twinning behavior in tantalum

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

Florando, Jeffrey N., E-mail: florando1@llnl.gov; Swift, Damian C.; Barton, Nathan R.

2016-04-15

The conditions which affect twinning in tantalum have been investigated across a range of strain rates and initial dislocation densities. Tantalum samples were subjected to a range of strain rates, from 10{sup −4}/s to 10{sup 3}/s under uniaxial stress conditions, and under laser-induced shock-loading conditions. In this study, twinning was observed at 77 K at strain rates from 1/s to 10{sup 3}/s, and during laser-induced shock experiments. The effect of the initial dislocation density, which was imparted by deforming the material to different amounts of pre-strain, was also studied, and it was shown that twinning is suppressed after a givenmore » amount of pre-strain, even as the global stress continues to increase. These results indicate that the conditions for twinning cannot be represented solely by a critical global stress value, but are also dependent on the evolution of the dislocation density. In addition, the analysis shows that if twinning is initiated, the nucleated twins may continue to grow as a function of strain, even as the dislocation density continues to increase.« less

Analysis of reliability of professor recommendation letters based on concordance with self-introduction letter.

PubMed

Kim, Sang Hyun

2013-12-01

The purpose of this study was to examine the concordance between a checklist's categories of professor recommendation letters and characteristics of the self-introduction letter. Checklists of professor recommendation letters were analyzed and classified into cognitive, social, and affective domains. Simple correlation was performed to determine whether the characteristics of the checklists were concordant with those of the self-introduction letter. The difference in ratings of the checklists by pass or fail grades was analyzed by independent sample t-test. Logistic regression analysis was performed to determine whether a pass or fail grade was influenced by ratings on the checklists. The Cronbach alpha value of the checklists was 0.854. Initiative, as an affective domain, in the professor's recommendation letter was highly ranked among the six checklist categories. Self-directed learning in the self-introduction letter was influenced by a pass or fail grade by logistic regression analysis (p<0.05). Successful applicants received higher ratings than those who failed in every checklist category, particularly in problem-solving ability, communication skills, initiative, and morality (p<0.05). There was a strong correlation between cognitive and affective characteristics in the professor recommendation letters and the sum of all characteristics in the self-introduction letter.

Stability of urea in solution and pharmaceutical preparations.

PubMed

Panyachariwat, Nattakan; Steckel, Hartwig

2014-01-01

The stability of urea in solution and pharmaceutical preparations was analyzed as a function of temperature (25°-60°C), pH (3.11-9.67), and initial urea concentration (2.5%-20%). This study was undertaken to (i) obtain more extensive, quantitative information relative to the degradation of urea in both aqueous and non-aqueous solutions and in pharmaceutical preparations, and (ii) test the effects of initial urea concentration, pH, buffer, and temperature values on urea degradation. The stability analysis shows that urea is more stable at the pH range of 4-8 and the stability of urea decreases by increase in temperature for all pH values. Within the experimental range of temperature and initial urea concentration values, the lowest urea degradation was found with lactate buffer pH 6.0. The urea decomposition rate in solution and pharmaceutical preparations shows the dependence of the initial urea concentrations. At higher initial urea concentrations, the rate of degradation is a decreasing function with time. This suggests that the reverse reaction is a factor in the degradation of concentrated urea solution. For non-aqueous solvents, isopropanol showed the best effort in retarding the decomposition of urea. Since the losses in urea is directly influenced by its stability at a given temperature and pH, the stability analysis of urea by the proposed model can be used to prevent the loss and optimize the operating condition for urea-containing pharmaceutical preparations.

Analysis of cerebrovascular disease mortality trends in Andalusia (1980-2014).

PubMed

Cayuela, A; Cayuela, L; Rodríguez-Domínguez, S; González, A; Moniche, F

2017-03-15

In recent decades, mortality rates for cerebrovascular diseases (CVD) have decreased significantly in many countries. This study analyses recent tendencies in CVD mortality rates in Andalusia (1980-2014) to identify any changes in previously observed sex and age trends. CVD mortality and population data were obtained from Spain's National Statistics Institute database. We calculated age-specific and age-standardised mortality rates using the direct method (European standard population). Joinpoint regression analysis was used to estimate the annual percentage change in rates and identify significant changes in mortality trends. We also estimated rate ratios between Andalusia and Spain. Standardised rates for both males and females showed 3 periods in joinpoint regression analysis: an initial period of significant decline (1980-1997), a period of rate stabilisation (1997-2003), and another period of significant decline (2003-2014). Between 1997 and 2003, age-standardised rates stabilised in Andalusia but continued to decrease in Spain as a whole. This increased in the gap between CVD mortality rates in Andalusia and Spain for both sexes and most age groups. Copyright © 2017 The Author(s). Publicado por Elsevier España, S.L.U. All rights reserved.

76 FR 25328 - New Mexico Green Initiatives, LLC; Supplemental Notice That Initial Market-Based Rate Filing...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-04

... Mexico Green Initiatives, LLC's application for market-based rate authority, with an accompanying rate... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. ER11-3431-000] New Mexico Green Initiatives, LLC; Supplemental Notice That Initial Market-Based Rate Filing Includes Request for...

Polar Ozone Loss Rates: Comparison Of Match Observations With Simulations Of 3-D Chemical Transport Model And Box Model

NASA Astrophysics Data System (ADS)

Tripathi, O. P.; Godin-Beekmann, S.; Lefevre, F.; Marchand, M.; Pazmino, A.; Hauchecorne, A.

2005-12-01

Model simulations of ozone loss rates during recent arctic and Antarctic winters are compared with the observed ozone loss rates from the match technique. Arctic winters 1994/1995, 1999/2000, 2002/2003 and the Antarctic winter 2003 were considered for the analysis. We use a high resolution chemical transport model MIMOSA-CHIM and REPROBUS box model for the calculation of ozone loss rates. Trajectory model calculations show that the ozone loss rates are dependent on the initialization fields. On the one hand when chemical fields are initialized by UCAM (University of Cambridge SLIMCAT model simulated fields) the loss rates were underestimated by a factor of two whereas on the other hand when it is initialized by UL (University of Leeds) fields the model loss rates are in a very good agreement with match loss rates at lower levels. The study shows a very good agreement between MIMOSA-CHIM simulation and match observation in 1999/2000 winter at both levels, 450 and 500 K, except slight underestimation in March at 500 K. But in January we have a very good agreement. This is also true for 1994/1995 when we consider simulated ozone loss rate in view of the ECMWF wind deficiency assuming that match observations were not made on isolated trajectories. Sensitivity tests, by changing JCl2O2 value, particle number density and heating rates, performed for the arctic winter 1999/2000 shows that we need to improve our understanding of particle number density and heating rate calculation mechanism. Burkholder JCl2O2 has improved the comparison of MIMOSA-CHIM model results with observations (Tripathi et al., 2005). In the same study the comparison results were shown to improved by changing heating rates and number density through NAT particle sedimentation.

Effect of initiator concentration to low-density polyethylene production in a tubular reactor

NASA Astrophysics Data System (ADS)

Azmi, A.; Aziz, N.

2016-11-01

Low-density polyethylene (LDPE) is one of the most widely used polymers in the world, which is produced in high-capacity tubular and autoclave reactors. As the LDPE industry turn into more competitive and its market profit margins become tighter, manufacturers have to develop solutions to debottleneck the reactor output while abiding to the stringent product specification. A single polyolefin plant producing ten to forty grades of LDPE with various melt flow index (MFI), therefore understanding the reaction mechanism, the operating conditions as well as the dynamic behavior of tubular reactor is essential before any improvement can take place. In the present work, a steady state mathematical model representing a tubular reactor for the production of LDPE is simulated using MATLAB R2015a®. The model developed is a function of feed inlet, reactor jacket, single initiator injector and outlet stream. Analysis on the effect of initiator concentration (CI) shows sudden declining trend of initiator's concentration which indicates that all of the initiators are exhausted after polymerization reaction and no further reaction occur from this point onwards. Furthermore, the results demonstrate that the concentration of initiator gives significant impact on reactor temperature's profile and monomer conversion rate, since higher initiator concentration promotes greater polymerization rate, and therefore leads to higher monomer conversion throughput.

Seminoma at Roswell Park, 1970 to 1979. An analysis of treatment failures.

PubMed

Huben, R P; Williams, P D; Pontes, J E; Panahon, A M; Murphy, G P

1984-04-01

A retrospective study of all cases of seminoma treated at Roswell Park Memorial Institute from 1970 through 1979 was conducted. Fifty-six evaluable patients treated initially with radiation therapy were seen during this period, and the overall survival rate at an average follow-up period of 52 months was 82%. The survival rate in patients with bulky abdominal or supradiaphragmatic metastases was only 33% (4 of 12 patients). Treatment failures were analyzed to determine their apparent causes and the implication of such failures to the future management of seminoma. The use of combination chemotherapy as the initial treatment modality in advanced seminoma is discussed in light of these results.

Use of concept mapping to characterize relationships among implementation strategies and assess their feasibility and importance: results from the Expert Recommendations for Implementing Change (ERIC) study.

PubMed

Waltz, Thomas J; Powell, Byron J; Matthieu, Monica M; Damschroder, Laura J; Chinman, Matthew J; Smith, Jeffrey L; Proctor, Enola K; Kirchner, JoAnn E

2015-08-07

Poor terminological consistency for core concepts in implementation science has been widely noted as an obstacle to effective meta-analyses. This inconsistency is also a barrier for those seeking guidance from the research literature when developing and planning implementation initiatives. The Expert Recommendations for Implementing Change (ERIC) study aims to address one area of terminological inconsistency: discrete implementation strategies involving one process or action used to support a practice change. The present report is on the second stage of the ERIC project that focuses on providing initial validation of the compilation of 73 implementation strategies that were identified in the first phase. Purposive sampling was used to recruit a panel of experts in implementation science and clinical practice (N = 35). These key stakeholders used concept mapping sorting and rating activities to place the 73 implementation strategies into similar groups and to rate each strategy's relative importance and feasibility. Multidimensional scaling analysis provided a quantitative representation of the relationships among the strategies, all but one of which were found to be conceptually distinct from the others. Hierarchical cluster analysis supported organizing the 73 strategies into 9 categories. The ratings data reflect those strategies identified as the most important and feasible. This study provides initial validation of the implementation strategies within the ERIC compilation as being conceptually distinct. The categorization and strategy ratings of importance and feasibility may facilitate the search for, and selection of, strategies that are best suited for implementation efforts in a particular setting.

Lung cancer incidence trends in Uruguay 1990-2014: An age-period-cohort analysis.

PubMed

Alonso, Rafael; Piñeros, Marion; Laversanne, Mathieu; Musetti, Carina; Garau, Mariela; Barrios, Enrique; Bray, Freddie

2018-05-11

Uruguay, a country with one of the highest lung cancer rates worldwide, initiated a series of comprehensive anti-smoking measures in 2005. We assess the tobacco control policies in the context of cohort-driven lung cancer incidence trends over a 25-year period, providing baseline predictions to 2035. Using data from the National Cancer Registry of Uruguay, an age-period-cohort analysis of trends 1990-2014 was performed. The NORDPRED package was used to predict the annual number of new cases of lung cancer and incidence rates up to 2035. In men, age-standardised (world) rates declined from a peak of 165.6 in 1995 to 103.1 by 2014, translating to a 70% reduction in the risk of lung cancer in men born in 1970 relative to the early-1940s. In females, rates increased steadily from 18.3 in 1991 to 30.0 by 2014, with successive increases in risk among generations of women born 1940-1960. There is however evidence of a decline in observed rates in women born recently. Extrapolations of the trends indicate an 8% reduction in the mean number of new lung cancer cases in men by 2035, but a 69% increase in women. Despite observed and predicted reductions in lung cancer incidence in Uruguayan men, rates among women are set to continue to increase, with a large rise in the annual number of female lung cancer diagnoses expected before 2035. There are signals of a diminishing risk among recent generations of women born after 1960. The current analysis provides important baseline information in assessing the future impact of the recent tobacco control initiatives in Uruguay. Copyright © 2018 Elsevier Ltd. All rights reserved.

Titanium subhydride potassium perchlorate (TiH1.65/KClO4) burn rates from hybrid closed bomb-strand burner experiments.

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

Cooper, Marcia A.; Oliver, Michael S.

2012-08-01

A hybrid closed bomb-strand burner is used to measure the burning behavior of the titanium subhydride potassium perchlorate pyrotechnic with an equivalent hydrogen concentration of 1.65. This experimental facility allows for simultaneous measurement of the closed bomb pressure rise and pyrotechnic burn rate as detected by electrical break wires over a range of pressures. Strands were formed by pressing the pyrotechnic powders to bulk densities between 60% and 90% theoretical maximum density. The burn rate dependance on initial density and vessel pressure are measured. At all initial strand densities, the burn is observed to transition from conductive to convective burningmore » within the strand. The measured vessel pressure history is further analyzed following the closed bomb analysis methods developed for solid propellants.« less

The effect of the baby-friendly hospital initiative on long-term breast feeding.

PubMed

Duyan Camurdan, A; Ozkan, S; Yüksel, D; Pasli, F; Sahin, F; Beyazova, U

2007-08-01

The aim of this study was to evaluate the effects of 'baby-friendly hospital initiative' (BFHI) on breast feeding. In the four consecutive months after BFHI in Gazi University Hospital (November 2002-February 2003), breast feeding status until the second year of life in 297 babies, born in the same hospital was compared with the values of 258 babies born before BFHI (November 2001-February 2002). The exclusive breast feeding rate in the first 6 months was higher in the babies born after BFHI. Cox regression analysis revealed that BFHI increases the duration of breast feeding 1.5 times. At the end of the second year, cumulative rate of breast feeding was higher in the group after-BFHI (p=0.0036). The rate of breast feeding was increased by BFHI implementation.

Factors Affecting Seedling Survivorship of Blue Oak (Quercus douglasii H. & A.) in Central California

Treesearch

Frank W. Davis; Mark Borchert; L. E. Harvey; Joel C. Michaelsen

1991-01-01

Blue oak seedling mortality was studied in relation to vertebrate predators, initial acorn planting position, slope and aspect, and oak canopy cover at two sites in the Central Coast Ranges of California. Seedling survival rates (Psd) were related to treatment variables using logistic regression analysis. Analysis of 2842 seedlings for 3 years following establishment...

Clarifying Inconclusive Functional Analysis Results: Assessment and Treatment of Automatically Reinforced Aggression

PubMed Central

Saini, Valdeep; Greer, Brian D.; Fisher, Wayne W.

2016-01-01

We conducted a series of studies in which multiple strategies were used to clarify the inconclusive results of one boy’s functional analysis of aggression. Specifically, we (a) evaluated individual response topographies to determine the composition of aggregated response rates, (b) conducted a separate functional analysis of aggression after high rates of disruption masked the consequences maintaining aggression during the initial functional analysis, (c) modified the experimental design used during the functional analysis of aggression to improve discrimination and decrease interaction effects between conditions, and (d) evaluated a treatment matched to the reinforcer hypothesized to maintain aggression. An effective yet practical intervention for aggression was developed based on the results of these analyses and from data collected during the matched-treatment evaluation. PMID:25891269

Rates of homicide during the first episode of psychosis and after treatment: a systematic review and meta-analysis.

PubMed

Nielssen, Olav; Large, Matthew

2010-07-01

The observation that almost half of the homicides committed by people with a psychotic illness occur before initial treatment suggests an increased risk of homicide during the first episode of psychosis. The aim of this study was to estimate the rates of homicide during the first episode of psychosis and after treatment. A systematic search located 10 studies that reported details of all the homicide offenders with a psychotic illness within a known population during a specified period and reported the number of people who had received treatment prior to the offense. Meta-analysis of these studies showed that 38.5% (95% confidence interval [CI] = 31.1%-46.5%) of homicides occurred during the first episode of psychosis, prior to initial treatment. Homicides during first-episode psychosis occurred at a rate of 1.59 homicides per 1000 (95% CI = 1.06-2.40), equivalent to 1 in 629 presentations. The annual rate of homicide after treatment for psychosis was 0.11 homicides per 1000 patients (95% CI = 0.07-0.16), equivalent to 1 homicide in 9090 patients with schizophrenia per year. The rate ratio of homicide in the first episode of psychosis in these studies was 15.5 (95% CI = 11.0-21.7) times the annual rate of homicide after treatment for psychosis. Hence, the rate of homicide in the first episode of psychosis appears to be higher than previously recognized, whereas the annual rate of homicide by patients with schizophrenia after treatment is lower than previous estimates. Earlier treatment of first-episode psychosis might prevent some homicides.

Predictors of early breastfeeding initiation among mothers of children under 24 months of age in rural part of West Ethiopia.

PubMed

Hailemariam, Tsedeke Wolde; Adeba, Emiru; Sufa, Alem

2015-10-21

The World Health Organization recommends initiation of breastfeeding within the first hour after childbirth. In developing countries alone, early initiation of breastfeeding could save as many as 1.45 million lives each year by reducing deaths mainly due to diarrheal disorders and lower respiratory tract infections in children. The current study aimed to determine the rate and the predictors of breastfeeding initiation in East Wollega Zones of West Ethiopia. A community-based, cross-sectional study was conducted from April to May 2014 among 594 mothers who had children less than 24 months. Multi stage cluster sampling method was used to select the study population. Eligible mothers were invited to interview using pretested questionnaires to gather data regarding sociodemographics, health-related variables, breastfeeding initiation, and current breastfeeding practices. A multivariable logistic regression analysis was used to identify independent predictors of early initiation of breastfeeding after controlling for confounding variables. A sample of 593 mothers was included in the study. Breastfeeding was initiated by 83.1 % of mothers within the first hour of childbirth. Being a housewife (AOR (95 % CI) = 2.48 (1.54- 3.99)) and infant received colostrum (AOR (95 % CI) =2.22 (1.08-4.55)) were significant positive predictors for early breastfeeding initiation as revealed by logistic regression. The multivariable logistic regression analysis showed that the mothers who had no radio and/or TV in the household (AOR (95 % CI = 0.55 (0.35-0.88)), were not exposure to health information (AOR (95 % CI) = 0.44 (0.25-0.75)), and infants were provided with prelacteal feeds (AOR (95 % CI)=0.30 (0.14-0.65)) were less likely to initiate breastfeeding. The rate of timely initiation of breastfeeding was high. Breastfeeding promotion program is essential to encourage the practice of timely initiation of breastfeeding, and reduce the practice of providing prelacteal feeds within three days of life. Thus appropriate health information is vital to boost early initiation of breastfeeding.

Debris flow-induced topographic changes: effects of recurrent debris flow initiation.

PubMed

Chen, Chien-Yuan; Wang, Qun

2017-08-12

Chushui Creek in Shengmu Village, Nantou County, Taiwan, was analyzed for recurrent debris flow using numerical modeling and geographic information system (GIS) spatial analysis. The two-dimensional water flood and mudflow simulation program FLO-2D were used to simulate debris flow induced by rainfall during typhoon Herb in 1996 and Mindulle in 2004. Changes in topographic characteristics after the debris flows were simulated for the initiation of hydrological characteristics, magnitude, and affected area. Changes in topographic characteristics included those in elevation, slope, aspect, stream power index (SPI), topographic wetness index (TWI), and hypsometric curve integral (HI), all of which were analyzed using GIS spatial analysis. The results show that the SPI and peak discharge in the basin increased after a recurrence of debris flow. The TWI was higher in 2003 than in 2004 and indicated higher potential of landslide initiation when the slope of the basin was steeper. The HI revealed that the basin was in its mature stage and was shifting toward the old stage. Numerical simulation demonstrated that the parameters' mean depth, maximum depth, affected area, mean flow rate, maximum flow rate, and peak flow discharge were increased after recurrent debris flow, and peak discharge occurred quickly.

Persistence, switch rates, drug consumption and costs of biological treatment of rheumatoid arthritis: an observational study in Italy.

PubMed

Degli Esposti, Luca; Favalli, Ennio Giulio; Sangiorgi, Diego; Di Turi, Roberta; Farina, Giuseppina; Gambera, Marco; Ravasio, Roberto

2017-01-01

The aim of this analysis was to provide an estimate of drug utilization indicators (persistence, switch rate and drug consumption) on biologics and the corresponding costs (drugs, admissions and specialist care) incurred by the Italian National Health Service in the management of adult patients with rheumatoid arthritis (RA). We conducted an observational retrospective cohort analysis using the administrative databases of three local health units. We considered all patients aged ≥18 years with a diagnosis of RA and at least one biologic drug prescription between January 2010 and December 2012 (recruitment period). Persistence was defined as maintenance over the last 3 months of the follow-up period of the same biological therapy administered at the index date. A switch was defined as the presence of a biological therapy other than that administered at the index date during the last 3 months of the follow-up period. Hospital admissions (with a diagnosis of RA or other RA-related diagnoses), specialist outpatient services, instrumental diagnostics and pharmaceutical consumption were assessed. The drug utilization analysis took into account only biologics with at least 90 patients on treatment at baseline (adalimumab n=144, etanercept n=236 and infliximab n=94). In each year, etanercept showed better persistence with initial treatment than adalimumab or infliximab. Etanercept was characterized by the lowest number of patients increasing the initial drug consumption (2.6%) and by the highest number of patients reducing the initial drug consumption (10.5%). The mean cost of treatment for a patient persisting with the initial treatment was €12,388 (€14,182 for adalimumab, €12,103 for etanercept and €11,002 for infliximab). The treatment costs for patients switching from initial treatment during the first year of follow-up were higher than for patients who did not switch (€12,710 vs. €11,332). Persistence, switch rate and drug consumption seem to directly influence treatment costs. In subjects not persisting with initial treatment, other health care costs were approximately three times higher than for persistent patients. This difference could suggest a positive effect on the quality of life for persistent patients. Etanercept showed the highest persistence with treatment.

Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services

PubMed Central

Leal, Maria do Carmo; Esteves-Pereira, Ana Paula; Nakamura-Pereira, Marcos; Torres, Jacqueline Alves; Domingues, Rosa Maria Soares Madeira; Dias, Marcos Augusto Bastos; Moreira, Maria Elizabeth; Theme-Filha, Mariza; da Gama, Silvana Granado Nogueira

2016-01-01

Background A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk. Methods This is a sub-analysis of a national population-based survey of postpartum women entitled “Birth in Brazil”, performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services. Results Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s) and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8%) when compared to the ones receiving public services (rate of 2.4%), regardless of obstetric risk–adjusted OR of 2.3 (CI 1.5–3.6) for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1–2.3) for women of high obstetric risk. Conclusion The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care. PMID:27196102

A retrospective analysis of compact fluorescent lamp experience curves and their correlations to deployment programs

DOE PAGES

Smith, Sarah Josephine; Wei, Max; Sohn, Michael D.

2016-09-17

Experience curves are useful for understanding technology development and can aid in the design and analysis of market transformation programs. Here, we employ a novel approach to create experience curves, to examine both global and North American compact fluorescent lamp (CFL) data for the years 1990–2007. We move away from the prevailing method of fitting a single, constant, exponential curve to data and instead search for break points where changes in the learning rate may have occurred. Our analysis suggests a learning rate of approximately 21% for the period of 1990–1997, and 51% and 79% in global and North Americanmore » datasets, respectively, after 1998. We use price data for this analysis; therefore our learning rates encompass developments beyond typical “learning by doing”, including supply chain impacts such as market competition. We examine correlations between North American learning rates and the initiation of new programs, abrupt technological advances, and economic and political events, and find an increased learning rate associated with design advancements and federal standards programs. Our findings support the use of segmented experience curves for retrospective and prospective technology analysis, and may imply that investments in technology programs have contributed to an increase of the CFL learning rate.« less

A retrospective analysis of compact fluorescent lamp experience curves and their correlations to deployment programs

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

Smith, Sarah Josephine; Wei, Max; Sohn, Michael D.

Experience curves are useful for understanding technology development and can aid in the design and analysis of market transformation programs. Here, we employ a novel approach to create experience curves, to examine both global and North American compact fluorescent lamp (CFL) data for the years 1990–2007. We move away from the prevailing method of fitting a single, constant, exponential curve to data and instead search for break points where changes in the learning rate may have occurred. Our analysis suggests a learning rate of approximately 21% for the period of 1990–1997, and 51% and 79% in global and North Americanmore » datasets, respectively, after 1998. We use price data for this analysis; therefore our learning rates encompass developments beyond typical “learning by doing”, including supply chain impacts such as market competition. We examine correlations between North American learning rates and the initiation of new programs, abrupt technological advances, and economic and political events, and find an increased learning rate associated with design advancements and federal standards programs. Our findings support the use of segmented experience curves for retrospective and prospective technology analysis, and may imply that investments in technology programs have contributed to an increase of the CFL learning rate.« less

Breastfeeding rates in Hong Kong: a comparison of the 1987 and 1997 birth cohorts.

PubMed

Leung, Gabriel M; Ho, Lai-Ming; Lam, Tai-Hing

2002-09-01

Low breastfeeding rates are an issue of international public health concern. Anecdotal reports suggest very low breastfeeding rates in Asia, but no population-based studies have been conducted in the region. To determine the secular trend in breastfeeding practice in an Asian postindustrialized metropolitan community, we examined data from two population-based birth cohorts of Hong Kong infants in 1987 and 1997. Annual population rates of breastfeeding initiation and duration were estimated from the birth cohorts, considering the change in breastfeeding rates over 10 years with correction for sociodemographic and birth characteristics. Factors associated with breastfeeding practice were identified using multivariate logistic regression modeling in a pooled analysis of individual data of both cohorts. Overall, 26.8 percent of mothers initiated breastfeeding in 1987, and the rate increased to 33.5 percent in 1997. The rate would have been 27.4 percent in 1987 if the distributions of method of delivery, birthweight, birth order, maternal age, education, and employment status had been the same as in 1997. Only 7.6 percent of infants remained on the breast for more than 1 month in 1987 compared with 20.4 percent a decade later. Similarly, the rate for breastfeeding more than 3 months increased from 3.9 to 10.3 percent. Total breastfeeding duration was significantly longer in 1997 than 10 years earlier. This is the first systematic report of secular variations of breastfeeding rates in Asia. Hong Kong should set higher but realistic goals for breastfeeding that emphasize both initiation and maintenance. Given the wide latitude for improvement in terms of readily modifiable risk factors, such as smoking and cesarean section, these new goals should focus on improving rates in these targeted groups where breastfeeding rates are lowest.

Rates of breastfeeding initiation among newborns.

PubMed

Maimburg, Rikke Damkjær

2017-06-01

Rates of breastfeeding initiation in hospitals with a tertiary neonatal intensive care unit are limited. A follow-up study with prospectively collected data in a Danish university hospital with approximately 5000 annual births was conducted. Between 1 February 2015 and 30 June 2015, 1939 newborns were enrolled in the study. Rates of frequencies for initiation of breastfeeding were calculated. High initiations rates for breastfeeding were found among term-born infants. Newborns of multiparous women had the highest initiation rate of 91.7% and newborns delivered by cesarean section had the lowest initiation rate of 73.3%. Copyright © 2017 Elsevier B.V. All rights reserved.

Clinical and radiographic assessment of various predictors for healing outcome 1 year after periapical surgery.

PubMed

von Arx, Thomas; Jensen, Simon Storgård; Hänni, Stefan

2007-02-01

This clinical study prospectively evaluated the influence of various predictors on healing outcome 1 year after periapical surgery. The study cohort included 194 teeth in an equal number of patients. Three teeth were lost for the follow-up (1.5% drop-out rate). Clinical and radiographic measures were used to determine the healing outcome. For statistical analysis, results were dichotomized (healed versus nonhealed). The overall success rate was 83.8% (healed cases). The only individual predictors to prove significant for the outcome were pain at initial examination (p=0.030) and other clinical signs or symptoms at initial examination (p=0.042), meaning that such teeth had lower healing rates 1 year after periapical surgery compared with teeth without such signs or symptoms. Logistic regression revealed that pain at initial examination (odds ratio=2.59, confidence interval=1.2-5.6, p=0.04) was the only predictor reaching significance. Several predictors almost reached statistical significance: lesion size (p=0.06), retrofilling material (p=0.06), and postoperative healing course (p=0.06).

Clinical cure and survival in Gram-positive ventilator-associated pneumonia: retrospective analysis of two double-blind studies comparing linezolid with vancomycin.

PubMed

Kollef, Marin H; Rello, Jordi; Cammarata, Sue K; Croos-Dabrera, Rodney V; Wunderink, Richard G

2004-03-01

To assess the effect of baseline variables, including treatment, on clinical cure and survival rates in patients with Gram-positive, ventilator-associated pneumonia (VAP). Retrospective analysis of two randomized, double-blind studies. Multinational study with 134 sites. 544 patients with suspected Gram-positive VAP, including 264 with documented Gram-positive VAP and 91 with methicillin-resistant S. aureus (MRSA) VAP. Linezolid 600 mg or vancomycin 1 g every 12 h for 7-21 days, each with aztreonam. Clinical cure rates assessed 12-28 days after the end of therapy and excluding indeterminate or missing outcomes significantly favored linezolid in the Gram-positive and MRSA subsets. Logistic regression showed that linezolid was an independent predictor of clinical cure with odds ratios of 1.8 for all patients, 2.4 for Gram-positive VAP, and 20.0 for MRSA VAP. Kaplan-Meier survival rates favored linezolid in the MRSA subset. Logistic regression showed that linezolid was an independent predictor of survival with odds ratios of 1.6 for all patients, 2.6 for Gram-positive VAP, and 4.6 for MRSA VAP. Initial linezolid therapy was associated with significantly better clinical cure and survival rates than was initial vancomycin therapy in patients with MRSA VAP.

Dose-rate effect of ultrashort electron beam radiation on DNA damage and repair in vitro.

PubMed

Babayan, Nelly; Hovhannisyan, Galina; Grigoryan, Bagrat; Grigoryan, Ruzanna; Sarkisyan, Natalia; Tsakanova, Gohar; Haroutiunian, Samvel; Aroutiounian, Rouben

2017-11-01

Laser-generated electron beams are distinguished from conventional accelerated particles by ultrashort beam pulses in the femtoseconds to picoseconds duration range, and their application may elucidate primary radiobiological effects. The aim of the present study was to determine the dose-rate effect of laser-generated ultrashort pulses of 4 MeV electron beam radiation on DNA damage and repair in human cells. The dose rate was increased via changing the pulse repetition frequency, without increasing the electron energy. The human chronic myeloid leukemia K-562 cell line was used to estimate the DNA damage and repair after irradiation, via the comet assay. A distribution analysis of the DNA damage was performed. The same mean level of initial DNA damages was observed at low (3.6 Gy/min) and high (36 Gy/min) dose-rate irradiation. In the case of low-dose-rate irradiation, the detected DNA damages were completely repairable, whereas the high-dose-rate irradiation demonstrated a lower level of reparability. The distribution analysis of initial DNA damages after high-dose-rate irradiation revealed a shift towards higher amounts of damage and a broadening in distribution. Thus, increasing the dose rate via changing the pulse frequency of ultrafast electrons leads to an increase in the complexity of DNA damages, with a consequent decrease in their reparability. Since the application of an ultrashort pulsed electron beam permits us to describe the primary radiobiological effects, it can be assumed that the observed dose-rate effect on DNA damage/repair is mainly caused by primary lesions appearing at the moment of irradiation. © The Author 2017. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology.

Gas generation behavior of transuranic waste under disposal conditions

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

Fujisawa, Ryutaro; Kurashige, Tetsunari; Inagaki, Yusuke

1999-07-01

The generation of hydrogen-gas from metallic waste is an important issue for the safety analysis of geological disposal facilities for transuranic (TRU) radioactive waste in Japan. The objective of this study is to clarify the gas-generation behavior of stainless steel and carbon steel in non-oxidizing alkaline synthetic groundwater (pH 12.8 and 10.5) at 30 C simulating geological disposal environments. At pH 12.8, the observed gas-generation rate from stainless steel in the initial period of immersion was 1.0 x 10{sup 2} Nml/m{sup 2}/y and 1.0 x 10 Nml/m{sup 2}/y after 200 days (N represents the standard state of gas at 0more » C and 1 atm). At pH 10.5, gas generation was not observed for 60 days in the initial period. At 60 days, the gas-generation observed was 5.0 x 10 NMl/m{sup 2}/y. After 250 days, the gas-generation rate approaches zero. At pH 12.8, the observed gas generation rate of carbon steel in the initial period of immersion was 1.5 x 10{sup 2} Nml/m{sup 2}/y and the gas generation rate began to decrease after 200 days. After 300 days, it was 25 Nml/m{sup 2}/y. At pH 10.5, the gas generation rate in the initial period was 5.0 x 10{sup 2} Nml/m{sup 2}/y and was 1.0 x 10 Nml/m{sup 2}/y after 200 days.« less

Acute salicylate poisoning: risk factors for severe outcome.

PubMed

Shively, Rachel M; Hoffman, Robert S; Manini, Alex F

2017-03-01

Salicylate poisoning remains a significant public health threat with more than 20,000 exposures reported annually in the United States. We aimed to establish early predictors of severe in-hospital outcomes in Emergency Department patients presenting with acute salicylate poisoning. This was a secondary data analysis of adult salicylate overdoses from a prospective cohort study of acute drug overdoses at two urban university teaching hospitals from 2009 to 2013. Patients were included based on confirmed salicylate ingestion and enrolled consecutively. Demographics, clinical parameters, treatment and disposition were collected from the medical record. Severe outcome was defined as a composite occurrence of acidemia (pH <7.3 or bicarbonate <16 mEq/L), hemodialysis, and/or death. Out of 1997 overdoses screened, 48 patients met inclusion/exclusion criteria. Patient characteristics were 43.8% male, median age 32 (range 18-87), mean initial salicylate concentration 28.1 mg/dL (SD 26.6), and 20.8% classified as severe outcome. Univariate analysis indicated that age, respiratory rate, lactate, coma, and the presence of co-ingestions were significantly associated with severe outcome, while initial salicylate concentration alone had no association. However, when adjusted for salicylate concentration, only age (OR 1.13; 95% CI 1.02-1.26) and respiratory rate (OR 1.29; 95% CI 1.02-1.63) were independent predictors. Additionally, lactate showed excellent test characteristics to predict severe outcome, with an optimal cutpoint of 2.25 mmol/L (78% sensitivity, 67% specificity). In adult Emergency Department patients with acute salicylate poisoning, independent predictors of severe outcome were older age and increased respiratory rate, as well as initial serum lactate, while initial salicylate concentration alone was not predictive.

Air Defense Initiative Air-to-Air Engagement Analysis. Volume 2. Error Models and Simulation for Case I: Pre-Launch Coordination Without Post-Launch Updates

DTIC Science & Technology

1991-03-08

acceleration and angular rates (produced by roll, pitch. and yaw motions) experienced by the LP. 12 ___________________________________ Synetics Table 3 2...at time tlP,INIT. The corresponding n-frame to b-frame D(’NI is: Cb(t) = L.q(Y’LP,INIT). (A.30) 41). (’onipute angular rates: The angular rates with...respect to inertial space (p, q, and r) are computed from the angular rates with respect to the n-frame (P, Q, and R), which in turn are computed from

Predictors of pharmacological treatment outcomes with atomoxetine or methylphenidate in patients with attention-deficit/hyperactivity disorder from China, Egypt, Lebanon, Russian Federation, Taiwan, and United Arab Emirates.

PubMed

Treuer, T; Feng, Q; Desaiah, D; Altin, M; Wu, S; El-Shafei, A; Serebryakova, E; Gado, M; Faries, D

2014-09-01

The reduced availability of data from non-Western countries limits our ability to understand attention-deficit/hyperactivity disorder (ADHD) treatment outcomes, specifically, adherence and persistence of ADHD in children and adolescents. This analysis assessed predictors of treatment outcomes in a non-Western cohort of patients with ADHD treated with atomoxetine or methylphenidate. Data from a 12-month, prospective, observational study in outpatients aged 6-17 years treated with atomoxetine (N = 234) or methylphenidate (N = 221) were analysed post hoc to determine potential predictors of treatment outcomes. Participating countries included the Russian Federation, China, Taiwan, Egypt, United Arab Emirates and Lebanon. Factors associated with remission were analysed with stepwise multiple logistic regression and classification and regression trees (CART). Cox proportional hazards models with propensity score adjustment assessed differences in atomoxetine persistence among initial-dose cohorts. In patients treated with atomoxetine who had available dosing information (N = 134), Cox proportional hazards revealed lower (< 0.5 mg/kg) initial dose was significantly associated with shorter medication persistence (p < 0.01). multiple logistic regression analysis revealed greater rates of remission for atomoxetine-treated patients were associated with age (older), country (United Arab Emirates) and gender (female) (all p < 0.05). CART analysis confirmed older age and lack of specific phobias were associated with greater remission rates. For methylphenidate, greater baseline weight (highly correlated with the age factor found for atomoxetine) and prior atomoxetine use were associated with greater remission rates. These findings may help clinicians assess factors upon initiation of ADHD treatment to improve course prediction, proper dosing and treatment adherence and persistence. Observational study, therefore no registration. © 2014 John Wiley & Sons Ltd.

Progressively increasing fracture risk with advancing age after initial incident fragility fracture: the Tromsø study.

PubMed

Ahmed, Luai Awad; Center, Jacqueline R; Bjørnerem, Ashild; Bluic, Dana; Joakimsen, Ragnar M; Jørgensen, Lone; Meyer, Haakon E; Nguyen, Nguyen D; Nguyen, Tuan V; Omsland, Tone K; Størmer, Jan; Tell, Grethe S; van Geel, Tineke Acm; Eisman, John A; Emaus, Nina

2013-10-01

The risk of subsequent fracture is increased after initial fractures; however, proper understanding of its magnitude is lacking. This population-based study examines the subsequent fracture risk in women and men by age and type of initial incident fracture. All incident nonvertebral fractures between 1994 and 2009 were registered in 27,158 participants in the Tromsø Study, Norway. The analysis included 3108 subjects with an initial incident fracture after the age of 49 years. Subsequent fracture (n = 664) risk was expressed as rate ratios (RR) and absolute proportions irrespective of death. The rates of both initial and subsequent fractures increased with age, the latter with the steepest curve. Compared with initial incident fracture rate of 30.8 per 1000 in women and 12.9 per 1000 in men, the overall age-adjusted RR of subsequent fracture was 1.3 (95% CI, 1.2-1.5) in women, and 2.0 (95% CI, 1.6-2.4) in men. Although the RRs decreased with age, the absolute proportions of those with initial fracture who suffered a subsequent fracture increased with age; from 9% to 30% in women and from 10% to 26% in men, between the age groups 50-59 to 80+ years. The type of subsequent fracture varied by age from mostly minor fractures in the youngest to hip or other major fractures in the oldest age groups, irrespective of type and severity of initial fracture. In women and men, 45% and 38% of the subsequent hip or other major fractures, respectively, were preceded by initial minor fractures. The risk of subsequent fracture is high in all age groups. At older age, severe subsequent fracture types follow both clinically severe and minor initial incident fractures. Any fragility fracture in the elderly reflects the need for specific osteoporosis management to reduce further fracture risk. © 2013 American Society for Bone and Mineral Research.

Cost-effectiveness of apixaban versus low molecular weight heparin/vitamin k antagonist for the treatment of venous thromboembolism and the prevention of recurrences.

PubMed

Lanitis, Tereza; Leipold, Robert; Hamilton, Melissa; Rublee, Dale; Quon, Peter; Browne, Chantelle; Cohen, Alexander T

2017-01-23

Prior analyses beyond clinical trials are yet to evaluate the projected lifetime benefit of apixaban treatment compared to low-molecular-weight heparin (LMWH)/vitamin K antagonist (VKA) for treatment of venous thromboembolism (VTE) and prevention of recurrences. The objective of this study is to assess the cost-effectiveness of initial plus extended treatment with apixaban versus LMWH/VKA for either initial treatment only or initial plus extended treatment. A Markov cohort model was developed to evaluate the lifetime clinical and economic impact of treatment of VTE and prevention of recurrences with apixaban (starting at 10 mg BID for 1 week, then 5 mg BID for 6 months, then 2.5 mg BID for an additional 12 months) versus LMWH/VKA for 6 months and either no further treatment or extended treatment with VKA for an additional 12 months. Clinical event rates to inform the model were taken from the AMPLIFY and AMPLIFY-EXT trials and a network meta-analysis. Background mortality rates, costs, and utilities were obtained from published sources. The analysis was conducted from the perspective of the United Kingdom National Health Service. The evaluated outcomes included the number of events avoided in a 1000-patient cohort, total costs, life-years, quality-adjusted life-years (QALYs), and cost per QALY gained. Initial plus extended treatment with apixaban was superior to both treatment durations of LMWH/VKA in reducing the number of bleeding events, and was superior to initial LMWH/VKA for 6 months followed by no therapy, in reducing VTE recurrences. Apixaban treatment was cost-effective compared to 6-month treatment with LMWH/VKA at an incremental cost-effectiveness ratio (ICER) of £6692 per QALY. When initial LMWH/VKA was followed by further VKA therapy for an additional 12 months (i.e., total treatment duration of 18 months), apixaban was cost-effective at an ICER of £8528 per QALY gained. Sensitivity analysis suggested these findings were robust over a wide range of inputs and scenarios for the model. In the UK, initial plus extended treatment with apixaban for treatment of VTE and prevention of recurrences appears to be economical and a clinically effective alternative to LMWH/VKA, whether used for initial or initial plus extended treatment.

Tensile strength and failure mechanisms of tantalum at extreme strain rates

NASA Astrophysics Data System (ADS)

Hahn, Eric; Fensin, Saryu; Germann, Timothy; Meyers, Marc

Non-equilibrium molecular dynamics simulations are used to probe the tensile response of monocrystalline, bicrystalline, and nanocrystalline tantalum over six orders of magnitude of strain rate. Our analysis of the strain rate dependence of strength is extended to over nine orders of magnitude by bridging the present simulations to recent laser-driven shock experiments. Tensile strength shows a power-law dependence with strain rate over this wide range, with different relationships depending on the initial microstructure and active deformation mechanism. At high strain rates, multiple spall events occur independently and continue to occur until communication occurs by means of relaxation waves. Temperature plays a significant role in the reduction of spall strength as the initial shock required to achieve such large strain rates also contributes to temperature rise, through pressure-volume work as well as visco-plastic heating, which leads to softening and sometimes melting upon release. At ultra-high strain rates, those approaching or exceeding the atomic vibrational frequency, spall strength saturates at the ultimate cohesive strength of the material. UC Research Laboratories Grant (09-LR-06-118456-MEYM); Department of Energy NNSA/SSAP (DE-NA0002080); DOE ASCR Exascale Co-design Center for Materials in Extreme Environments.

Hepatitis B virus seroconversion rates among health sciences students in the southeastern United States.

PubMed

Bookstaver, P Brandon; Foster, Jenna L; Lu, Z Kevin; Mann, Joshua R; Ambrose, Chelsea; Grant, Amy; Burgess, Stephanie

2016-01-01

To investigate the hepatitis B virus (HBV) seroconversion rate among health sciences students. The study included pharmacy, doctor of nursing, and medical students over 18 years of age enrolled at the University of South Carolina between 2007 and 2011. The primary end point was HBV seroconversion rates among students at the initial reporting period. Seroconversion was defined as hepatitis B surface antibody (anti-HBs) level greater than or equal to 10 mIU/mL. Multivariate regression analysis was used to determine predictive factors of seroconversion. Of 777 records, data were available for 709 students. An 83.9% seroconversion rate was observed after a mean of 10 years between vaccine receipt and anti-HBs evaluation. Students with incomplete HBV vaccine series and longer time between initial series and evaluation were less likely to exhibit antibody response. These data highlight the importance of assessment and documentation of HBV vaccination series among health sciences students prior to direct patient care activities.

Plasma induced degradation of Indigo Carmine by bipolar pulsed dielectric barrier discharge(DBD) in the water-air mixture.

PubMed

Zhang, Ruo-Bing; Wu, Yan; Li, Guo-Feng; Wang, Ning-Hui; Li, Jie

2004-01-01

Degradation of the Indigo Carmine (IC) by the bipolar pulsed DBD in water-air mixture was studied. Effects of various parameters such as gas flow rate, solution conductivity, pulse repetitive rate and ect., on color removal efficiency of dying wastewater were investigated. Concentrations of gas phase o3 and aqueous phase H2O2 under various conditions were measured. Experimental results showed that air bubbling facilitates the breakdown of water and promotes generation of chemically active species. Color removal efficiency of IC solution can be greatly improved by the air aeration under various solution conductivities. Decolorization efficiency increases with the increase of the gas flow rate, and decreases with the increase of the initial solution conductivity. A higher pulse repetitive rate and a larger pulse capacitor C(p) are favorable for the decolorization process. Ozone and hydrogen peroxide formed decreases with the increase of initial solution conductivity. In addition, preliminary analysis of the decolorization mechanisms is given.

A computer program for cyclic plasticity and structural fatigue analysis

NASA Technical Reports Server (NTRS)

Kalev, I.

1980-01-01

A computerized tool for the analysis of time independent cyclic plasticity structural response, life to crack initiation prediction, and crack growth rate prediction for metallic materials is described. Three analytical items are combined: the finite element method with its associated numerical techniques for idealization of the structural component, cyclic plasticity models for idealization of the material behavior, and damage accumulation criteria for the fatigue failure.

Temporal Trends in Late Preterm and Early Term Birth Rates in 6 High-Income Countries in North America and Europe and Association With Clinician-Initiated Obstetric Interventions

PubMed Central

Richards, Jennifer L.; Kramer, Michael S.; Deb-Rinker, Paromita; Rouleau, Jocelyn; Mortensen, Laust; Gissler, Mika; Morken, Nils-Halvdan; Skjærven, Rolv; Cnattingius, Sven; Johansson, Stefan; Delnord, Marie; Dolan, Siobhan M.; Morisaki, Naho; Tough, Suzanne; Zeitlin, Jennifer; Kramer, Michael R.

2017-01-01

IMPORTANCE Clinicians have been urged to delay the use of obstetric interventions (eg, labor induction, cesarean delivery) until 39 weeks or later in the absence of maternal or fetal indications for intervention. OBJECTIVE To describe recent trends in late preterm and early term birth rates in 6 high-income countries and assess association with use of clinician-initiated obstetric interventions. DESIGN Retrospective analysis of singleton live births from 2006 to the latest available year (ranging from 2010 to 2015) in Canada, Denmark, Finland, Norway, Sweden, and the United States. EXPOSURES Use of clinician-initiated obstetric intervention (either labor induction or prelabor cesarean delivery) during delivery. MAIN OUTCOMES AND MEASURES Annual country-specific late preterm (34–36 weeks) and early term (37–38 weeks) birth rates. RESULTS The study population included 2 415 432 Canadian births in 2006–2014 (4.8% late preterm; 25.3% early term); 305 947 Danish births in 2006–2010 (3.6% late preterm; 18.8% early term); 571 937 Finnish births in 2006–2015 (3.3% late preterm; 16.8% early term); 468 954 Norwegian births in 2006–2013 (3.8% late preterm; 17.2% early term); 737 754 Swedish births in 2006–2012 (3.6% late preterm; 18.7% early term); and 25 788 558 US births in 2006–2014 (6.0% late preterm; 26.9% early term). Late preterm birth rates decreased in Norway (3.9% to 3.5%) and the United States (6.8% to 5.7%). Early term birth rates decreased in Norway (17.6% to 16.8%), Sweden (19.4% to 18.5%), and the United States (30.2% to 24.4%). In the United States, early term birth rates decreased from 33.0% in 2006 to 21.1% in 2014 among births with clinician-initiated obstetric intervention, and from 29.7% in 2006 to 27.1% in 2014 among births without clinician-initiated obstetric intervention. Rates of clinician-initiated obstetric intervention increased among late preterm births in Canada (28.0% to 37.9%), Denmark (22.2% to 25.0%), and Finland (25.1% to 38.5%), and among early term births in Denmark (38.4% to 43.8%) and Finland (29.8% to 40.1%). CONCLUSIONS AND RELEVANCE Between 2006 and 2014, late preterm and early term birth rates decreased in the United States, and an association was observed between early term birth rates and decreasing clinician-initiated obstetric interventions. Late preterm births also decreased in Norway, and early term births decreased in Norway and Sweden. Clinician-initiated obstetric interventions increased in some countries but no association was found with rates of late preterm or early term birth. PMID:27458946

Corticosteroids vs corticosteroids plus antiviral agents in the treatment of Bell palsy: a systematic review and meta-analysis.

PubMed

Goudakos, John K; Markou, Konstantinos D

2009-06-01

To review systematically and meta-analyze the results of all randomized controlled trials (RCTs) for the treatment of patients with Bell palsy with corticosteroids vs corticosteroids plus antiviral agents. A MEDLINE, EMBASE, Cochrane Library, and CENTRAL database search, followed by extensive hand-searching for the identification of relevant studies. No time and language limitations were applied. Prospective RCTs on the treatment of patients with Bell palsy. Odds ratios (ORs), 95% confidence intervals (CIs), and tests for heterogeneity were reported. Five studies were eventually identified and systematically reviewed. Meta-analysis was performed for 4 studies. Regarding the complete recovery rate of facial nerve paralysis 3 months after initiation of therapy, the current systematic review and meta-analysis suggests that the addition of an antiviral agent does not provide any benefit (OR, 1.03 [95% CI, 0.74-1.42]; P = .88). The same conclusion emerged at posterior (fourth, sixth, and ninth) months of assessment. Subgroup analysis, conducted on the basis of time point of therapy initiation, type of antiviral agent, and blindness of assessments did not change the results obtained. The occurrence rate of adverse effects attributable to therapy choice was not significantly different between patients receiving corticosteroids and those following combined treatment. The present systematic review and meta-analysis, based on the currently available evidence, suggests that the addition of an antiviral agent to corticosteroids for the treatment of Bell palsy is not associated with an increase in the complete recovery rate of the facial motor function.

Numerical Investigation of Desulfurization Kinetics in Gas-Stirred Ladles by a Quick Modeling Analysis Approach

NASA Astrophysics Data System (ADS)

Cao, Qing; Nastac, Laurentiu; Pitts-Baggett, April; Yu, Qiulin

2018-03-01

A quick modeling analysis approach for predicting the slag-steel reaction and desulfurization kinetics in argon gas-stirred ladles has been developed in this study. The model consists of two uncoupled components: (i) a computational fluid dynamics (CFD) model for predicting the fluid flow and the characteristics of slag-steel interface, and (ii) a multicomponent reaction kinetics model for calculating the desulfurization evolution. The steel-slag interfacial area and mass transfer coefficients predicted by the CFD simulation are used as the processing data for the reaction model. Since the desulfurization predictions are uncoupled from the CFD simulation, the computational time of this uncoupled predictive approach is decreased by at least 100 times for each case study when compared with the CFD-reaction kinetics fully coupled model. The uncoupled modeling approach was validated by comparing the evolution of steel and slag compositions with the experimentally measured data during ladle metallurgical furnace (LMF) processing at Nucor Steel Tuscaloosa, Inc. Then, the validated approach was applied to investigate the effects of the initial steel and slag compositions, as well as different types of additions during the refining process on the desulfurization efficiency. The results revealed that the sulfur distribution ratio and the desulfurization reaction can be promoted by making Al and CaO additions during the refining process. It was also shown that by increasing the initial Al content in liquid steel, both Al oxidation and desulfurization rates rapidly increase. In addition, it was found that the variation of the initial Si content in steel has no significant influence on the desulfurization rate. Lastly, if the initial CaO content in slag is increased or the initial Al2O3 content is decreased in the fluid-slag compositional range, the desulfurization rate can be improved significantly during the LMF process.

No Evidence of an Association Between Efavirenz Exposure and Suicidality Among HIV Patients Initiating Antiretroviral Therapy in a Retrospective Cohort Study of Real World Data.

PubMed

Nkhoma, Ella T; Coumbis, John; Farr, Amanda M; Johnston, Stephen S; Chu, Bong Chul; Rosenblatt, Lisa C; Seekins, Daniel; Villasis-Keever, Angelina

2016-01-01

Recently, published studies have reported conflicting results regarding the association between efavirenz exposure and the risk of suicidality among patients with human immunodeficiency virus. The objective of this analysis was to compare the rate of suicidality among patients initiating efavirenz-containing versus efavirenz-free antiretroviral (ARV) regimens.This retrospective cohort study used US administrative claims data for commercially and Medicaid-insured individuals for the years 2006 to 2013. ARV-naive patients aged ≥12 years initiating an efavirenz-containing or efavirenz-free ARV regimen with ≥6 months of continuous insurance enrollment prior to ARV initiation were selected. The primary outcome was suicidality, defined as the occurrence of any medical claim with a diagnosis code for suicidal ideation or an inpatient or emergency department medical claim for suicide attempt. Unadjusted incidence rates were calculated and propensity score-adjusted hazard ratios were estimated to account for differences in patient characteristics.There were 19,983 patients (efavirenz-containing, n = 11,187; efavirenz-free, n = 8796) in the commercial database and 5154 patients (efavirenz-containing, n = 2224; efavirenz-free, n = 2930) in the Medicaid database. Unadjusted incidence rates (95% confidence interval [CI]) of suicidality per 1000 person-years were: commercial, efavirenz-containing (3.3 [2.4-4.4]), efavirenz-free (4.0 [2.7-5.8]); Medicaid, efavirenz-containing (25.7 [18.8-34.4]), efavirenz-free (40.6 [31.9-50.9]). In propensity score-adjusted analyses, efavirenz use was not associated with suicidality: adjusted hazard ratio (95% CI) of suicidality compared with efavirenz-free regimen, commercial, 1.029 (0.636-1.665); Medicaid, 0.902 (0.617-1.319).This analysis found no conclusive evidence of an increased risk of suicidality among patients initiating an efavirenz-containing ARV regimen. However, channeling bias may exist even after adjusting for measured patient characteristics.

Numerical Investigation of Desulfurization Kinetics in Gas-Stirred Ladles by a Quick Modeling Analysis Approach

NASA Astrophysics Data System (ADS)

Cao, Qing; Nastac, Laurentiu; Pitts-Baggett, April; Yu, Qiulin

2018-06-01

A quick modeling analysis approach for predicting the slag-steel reaction and desulfurization kinetics in argon gas-stirred ladles has been developed in this study. The model consists of two uncoupled components: (i) a computational fluid dynamics (CFD) model for predicting the fluid flow and the characteristics of slag-steel interface, and (ii) a multicomponent reaction kinetics model for calculating the desulfurization evolution. The steel-slag interfacial area and mass transfer coefficients predicted by the CFD simulation are used as the processing data for the reaction model. Since the desulfurization predictions are uncoupled from the CFD simulation, the computational time of this uncoupled predictive approach is decreased by at least 100 times for each case study when compared with the CFD-reaction kinetics fully coupled model. The uncoupled modeling approach was validated by comparing the evolution of steel and slag compositions with the experimentally measured data during ladle metallurgical furnace (LMF) processing at Nucor Steel Tuscaloosa, Inc. Then, the validated approach was applied to investigate the effects of the initial steel and slag compositions, as well as different types of additions during the refining process on the desulfurization efficiency. The results revealed that the sulfur distribution ratio and the desulfurization reaction can be promoted by making Al and CaO additions during the refining process. It was also shown that by increasing the initial Al content in liquid steel, both Al oxidation and desulfurization rates rapidly increase. In addition, it was found that the variation of the initial Si content in steel has no significant influence on the desulfurization rate. Lastly, if the initial CaO content in slag is increased or the initial Al2O3 content is decreased in the fluid-slag compositional range, the desulfurization rate can be improved significantly during the LMF process.

Volatile release from self-assembly structured emulsions: effect of monoglyceride content, oil content, and oil type.

PubMed

Mao, Like; Roos, Yrjö H; Miao, Song

2013-02-20

Monoglycerides (MGs) can form self-assembled structures in emulsions, which can be used to control volatile release. In this study, initial headspace concentrations (C(initial)), maximum headspace concentrations (C(max)), release rates, and partition coefficients of propanol, diacetyl, hexanal, and limonene were determined in MG structured oil-in-water emulsions using dynamic and static headspace analyses. For all of the volatile compounds, C(initial) values above structured emulsions were significantly lower than those above unstructured emulsions and decreased with increasing MG contents (p < 0.05). However, volatiles had higher release rates in emulsions with higher MG contents. When oil content was reduced from 20 to 10%, C(initial) and C(max) increased for limonene and hexanal and decreased for propanol and diacetyl. When different oils were applied, both C(initial) and C(max) were significantly lower in medium-chain triglyceride emulsions than in soybean oil emulsions (p < 0.05). Static headspace analysis revealed that volatile compounds had significantly lower air-emulsion partition coefficients in the structured emulsions than in unstructured emulsions (p < 0.05). These results indicated that MG structured emulsions can be potentially used as delivery systems to modulate volatile release.

Effect of pH and lactose concentration on solvent production from whey permeate using Clostridium acetobutylicum

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

Ennis, B.M.; Maddox, I.S.

1987-02-20

A study was performed to optimize the production of solvents from whey permeate in batch fermentation using Clostridium acetobutylicum P262. Fermentations performed at relatively low pH values resulted in high solvent yields and productivities, but lactose utilization was incomplete. At higher pH values, lactose-utilization was improved but acid production dominated over solvent production. When operating at the higher pH values, an increase in the initial lactose concentration of the whey permeate resulted in lower rates of lactose utilization, and this was accompanied by increased solvent production and decreased acid production. Analysis of data from several experiments revealed a strong inversemore » relationship between solvent yield and lactose utilization rate. Thus, conditions which minimize the lactose utilization rate such as low culture pH values or high initial lactose concentrations, favor solventogenesis at the expense of acid production. 12 references.« less

Advanced bridge safety initiative : investigation of floor beam performance in three steel through-truss bridges - task 7.

DOT National Transportation Integrated Search

2014-08-01

The Advanced Structures and Composites Center at the University of Maine (UMaine) performed live load testing : and rating adjustment factor analysis for three truss bridges. The Maine Department of Transportation (DOT) : indicated that the floor bea...

Characterization of arterial traffic congestion through analysis of operational parameters (gap acceptance and lane changing).

DOT National Transportation Integrated Search

2010-05-01

This project monitored an urban arterial highway to characterize recurring congestion. There were two major initiatives in the project. The first one focused on observed variations in gap acceptance and lane changing in relation to traffic flow rates...

Dynamic evolutionary change in post-Paleozoic echinoids and the importance of scale when interpreting changes in rates of evolution.

PubMed

Hopkins, Melanie J; Smith, Andrew B

2015-03-24

How ecological and morphological diversity accrues over geological time has been much debated by paleobiologists. Evidence from the fossil record suggests that many clades reach maximal diversity early in their evolutionary history, followed by a decline in evolutionary rates as ecological space fills or due to internal constraints. Here, we apply recently developed methods for estimating rates of morphological evolution during the post-Paleozoic history of a major invertebrate clade, the Echinoidea. Contrary to expectation, rates of evolution were lowest during the initial phase of diversification following the Permo-Triassic mass extinction and increased over time. Furthermore, although several subclades show high initial rates and net decreases in rates of evolution, consistent with "early bursts" of morphological diversification, at more inclusive taxonomic levels, these bursts appear as episodic peaks. Peak rates coincided with major shifts in ecological morphology, primarily associated with innovations in feeding strategies. Despite having similar numbers of species in today's oceans, regular echinoids have accrued far less morphological diversity than irregular echinoids due to lower intrinsic rates of morphological evolution and less morphological innovation, the latter indicative of constrained or bounded evolution. These results indicate that rates of evolution are extremely heterogenous through time and their interpretation depends on the temporal and taxonomic scale of analysis.

Epidemiological Patterns of Initial and Subsequent Injuries in Collegiate Football Athletes.

PubMed

Williams, Jacob Z; Singichetti, Bhavna; Li, Hongmei; Xiang, Henry; Klingele, Kevin E; Yang, Jingzhen

2017-04-01

A body of epidemiological studies has examined football injuries and associated risk factors among collegiate athletes. However, few existing studies specifically analyzed injury risk in terms of initial or subsequent injuries. To determine athlete-exposures (AEs) and rates of initial and subsequent injury among collegiate football athletes. Descriptive epidemiological study. Injury and exposure data collected from collegiate football players from two Division I universities (2007-2011) were analyzed. Rate of initial injury was calculated as the number of initial injuries divided by the total number of AEs for initial injuries, while the rate for subsequent injury was calculated as the number of subsequent injuries divided by the total number of AEs for subsequent injury. Poisson regression was used to determine injury rate ratio (subsequent vs initial injury), with adjustment for other covariates. The total AEs during the study period were 67,564, resulting in an overall injury rate of 35.2 per 10,000 AEs. Rates for initial and subsequent injuries were 31.7 and 45.3 per 10,000 AEs, respectively, with a rate ratio (RR) of 1.4 for rate of subsequent injury vs rate of initial injury (95% CI, 1.1-1.9). Rate of injury appeared to increase with each successive injury. RR during games was 1.8 (95% CI, 1.1-3.0). The rate of subsequent injuries to the head, neck, and face was 10.9 per 10,000 AEs, nearly double the rate of initial injuries to the same sites (RR = 2.0; 95% CI, 1.1-3.5). For wide receivers, the rate of subsequent injuries was 2.2 times the rate of initial injuries (95% CI, 1.3-3.8), and for defensive linemen, the rate of subsequent injuries was 2.1 times the rate of initial injuries (95% CI, 1.1-3.9). The method used in this study allows for a more accurate determination of injury risk among football players who have already been injured at least once. Further research is warranted to better identify which specific factors contribute to this increased risk for subsequent injury.

The effects of land use change on soil infiltration capacity in China: A meta-analysis.

PubMed

Sun, Di; Yang, Hong; Guan, Dexin; Yang, Ming; Wu, Jiabing; Yuan, Fenghui; Jin, Changjie; Wang, Anzhi; Zhang, Yushu

2018-06-01

Land use changes are often considered to be the main factors influencing soil infiltration. But the difference of soil infiltration capacity for different land use type is less clear. In this paper, we conduct a meta-analysis of all 42 papers that could be found associated with the effects of land use changes on soil infiltration capacity. The results showed that soil initial and steady infiltration rates increased after land use changes from grassland to forest (+41.35%, /), shrubland to forest (+42.73%, /) and cropland to agroforestry (+70.28%, +84.17%). Soil infiltration rates declined after land use changes from grassland to cropland (/, -45.23%), shrubland to cropland (-64.24%, /) and forest to cropland (-53.58%, -42.15%). It was evident that soil infiltration rates were negatively related to soil bulk density and initial moisture and positively related to soil total porosity and organic matter content. In sum, establishing agroforestry ecosystem was beneficial to improve soil infiltration capacity compare to cropland and plantation, which has important implications for developing sustainable agriculture and forest from the viewpoint of soil and water conservation. Copyright © 2018 Elsevier B.V. All rights reserved.

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.

Fast repetition rate (FRR) flasher

DOEpatents

Kolber, Z.; Falkowski, P.

1997-02-11

A fast repetition rate (FRR) flasher is described suitable for high flash photolysis including kinetic chemical and biological analysis. The flasher includes a power supply, a discharge capacitor operably connected to be charged by the power supply, and a flash lamp for producing a series of flashes in response to discharge of the discharge capacitor. A triggering circuit operably connected to the flash lamp initially ionizes the flash lamp. A current switch is operably connected between the flash lamp and the discharge capacitor. The current switch has at least one insulated gate bipolar transistor for switching current that is operable to initiate a controllable discharge of the discharge capacitor through the flash lamp. Control means connected to the current switch for controlling the rate of discharge of the discharge capacitor thereby to effectively keep the flash lamp in an ionized state between successive discharges of the discharge capacitor. Advantageously, the control means is operable to discharge the discharge capacitor at a rate greater than 10,000 Hz and even up to a rate greater than about 250,000 Hz. 14 figs.

Moisture Risk in Unvented Attics Due to Air Leakage Paths

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

Prahl, D.; Shaffer, M.

2014-11-01

IBACOS completed an initial analysis of moisture damage potential in an unvented attic insulated with closed-cell spray polyurethane foam. To complete this analysis, the research team collected field data, used computational fluid dynamics to quantify the airflow rates through individual airflow (crack) paths, simulated hourly flow rates through the leakage paths with CONTAM software, correlated the CONTAM flow rates with indoor humidity ratios from Building Energy Optimization software, and used Wärme und Feuchte instationär Pro two-dimensional modeling to determine the moisture content of the building materials surrounding the cracks. Given the number of simplifying assumptions and numerical models associated withmore » this analysis, the results indicate that localized damage due to high moisture content of the roof sheathing is possible under very low airflow rates. Reducing the number of assumptions and approximations through field studies and laboratory experiments would be valuable to understand the real-world moisture damage potential in unvented attics.« less

Moisture Risk in Unvented Attics Due to Air Leakage Paths

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

Prahl, D.; Shaffer, M.

2014-11-01

IBACOS completed an initial analysis of moisture damage potential in an unvented attic insulated with closed-cell spray polyurethane foam. To complete this analysis, the research team collected field data, used computational fluid dynamics to quantify the airflow rates through individual airflow (crack) paths, simulated hourly flow rates through the leakage paths with CONTAM software, correlated the CONTAM flow rates with indoor humidity ratios from Building Energy Optimization software, and used Warme und Feuchte instationar Pro two-dimensional modeling to determine the moisture content of the building materials surrounding the cracks. Given the number of simplifying assumptions and numerical models associated withmore » this analysis, the results indicate that localized damage due to high moisture content of the roof sheathing is possible under very low airflow rates. Reducing the number of assumptions and approximations through field studies and laboratory experiments would be valuable to understand the real-world moisture damage potential in unvented attics.« less

Asymptotic Spreading Rate of Initially Compressible Jets-Experiment and Analysis

NASA Technical Reports Server (NTRS)

Zaman, K. B. M. Q.

1998-01-01

Experimental results for the spreading and centerline velocity decay rates for round, compressible jets, from a convergent and a convergent-divergent nozzle, are presented. The spreading rate is determined from the variation of streamwise mass flux obtained from Pitot probe surveys. Results for the far asymptotic region show that both spreading and centerline velocity decay rates, when nondimensionalized by parameters at the nozzle exit, decrease with increasing "jet Mach number" M(sub j). Dimensional analysis with the assumption of momentum conservation, together with compressible flow calculations for the conditions at the nozzle exit, predict this Mach number dependence well. The analysis also demonstrates that an increase in the "potential core length" of the jet occurring with increasing M(sub j), a commonly observed trend, is largely accounted for simply by the variations in the density and static pressure at the nozzle exit. The effect of decreasing mixing efficiency with increasing compressibility is inferred to contribute only partially to the latter trend.

Instabilities in a nonstationary model of self-gravitating disks. III. The phenomenon of lopsidedness and a comparison of perturbation modes

NASA Astrophysics Data System (ADS)

Mirtadjieva, K. T.; Nuritdinov, S. N.; Ruzibaev, J. K.; Khalid, Muhammad

2011-06-01

This is an examination of the gravitational instability of the major large-scale perturbation modes for a fixed value of the azimuthal wave number m = 1 in nonlinearly nonstationary disk models with isotropic and anisotropic velocity diagrams for the purpose of explaining the displacement of the nucleus away from the geometric center (lopsidedness) in spiral galaxies. Nonstationary analogs of the dispersion relations for these perturbation modes are obtained. Critical diagrams of the initial virial ratio are constructed from the rotation parameters for the models in each case. A comparative analysis is made of the instability growth rates for the major horizontal perturbation modes in terms of two models, and it is found that, on the average, the instability growth rate for the m = 1 mode with a radial wave number N = 3 almost always has a clear advantage relative to the other modes. An analysis of these results shows that if the initial total kinetic energy in an isotropic model is no more than 12.4% of the initial potential energy, then, regardless of the value of the rotation parameter Ω, an instability of the radial motions always occurs and causes the nucleus to shift away from the geometrical center. This instability is aperiodic when Ω = 0 and is oscillatory when Ω ≠ 0 . For the anisotropic model, this kind of structure involving the nucleus develops when the initial total kinetic energy in the model is no more than 30.6% of the initial potential energy.

Legionnaire's disease surveillance programme (initial survey analysis).

PubMed

O'Neill, K

1990-08-01

In Australia, approximately 150 cases of Legionnaire's Disease are reported annually. Untreated, the mortality rate is estimated at 20%. Australia's largest Legionnaire's Disease epidemic broke out in Wollongong (New South Wales) back in 1987, where some 45 cases required hospitalization and 10 of these died. Local Health Authorities have been advised to conduct initial surveys of their particular municipalities to locate all known water cooling towers and evaporative condensers to establish maintenance standards on such units to overcome possible future outbreaks of this disease with significant mortality.

A symptom self-rating scale for schizophrenia (4S): psychometric properties, reliability and validity.

PubMed

Lindström, Eva; Jedenius, Erik; Levander, Sten

2009-01-01

The objective of the study was to validate a self-administrated symptom rating scale for use in patients with schizophrenia spectrum disorders by item analysis, exploration of factor structure, and analyses of reliability and validity. Data on 151 patients, initially treated by risperidone, obtained within the framework of a naturalistic Phase IV longitudinal study, were analysed by comparing patient and clinician ratings of symptoms, side-effects and global indices of illness. The Symptom Self-rating Scale for Schizophrenia (4S) is psychometrically adequate (item analysis, internal consistency, factor structure). Side-effect ratings were reliable. Symptom ratings displayed consistent associations with clinicians' ratings of corresponding symptom dimensions, suggesting construct validity. Patients had most difficulties assessing negative symptom items. Patients were well able to assess their own symptoms and drug side-effects. The factor structure of symptom ratings differs between patients and clinicians as well as how they construe global indices of illness. Clinicians focus on psychotic, patients on affective symptoms. Use of symptom self-ratings is one way to improve communication and thereby strengthen the therapeutic alliance and increase treatment adherence.

Hypothesis testing for the validation of the kinetic spectrophotometric methods for the determination of lansoprazole in bulk and drug formulations via Fe(III) and Zn(II) chelates.

PubMed

Rahman, Nafisur; Kashif, Mohammad

2010-03-01

Point and interval hypothesis tests performed to validate two simple and economical, kinetic spectrophotometric methods for the assay of lansoprazole are described. The methods are based on the formation of chelate complex of the drug with Fe(III) and Zn(II). The reaction is followed spectrophotometrically by measuring the rate of change of absorbance of coloured chelates of the drug with Fe(III) and Zn(II) at 445 and 510 nm, respectively. The stoichiometric ratio of lansoprazole to Fe(III) and Zn(II) complexes were found to be 1:1 and 2:1, respectively. The initial-rate and fixed-time methods are adopted for determination of drug concentrations. The calibration graphs are linear in the range 50-200 µg ml⁻¹ (initial-rate method), 20-180 µg ml⁻¹ (fixed-time method) for lansoprazole-Fe(III) complex and 120-300 (initial-rate method), and 90-210 µg ml⁻¹ (fixed-time method) for lansoprazole-Zn(II) complex. The inter-day and intra-day precision data showed good accuracy and precision of the proposed procedure for analysis of lansoprazole. The point and interval hypothesis tests indicate that the proposed procedures are not biased. Copyright © 2010 John Wiley & Sons, Ltd.

Economic evaluation of single-tooth replacement: dental implant versus fixed partial denture.

PubMed

Kim, Younhee; Park, Joo-Yeon; Park, Sun-Young; Oh, Sung-Hee; Jung, YeaJi; Kim, Ji-Min; Yoo, Soo-Yeon; Kim, Seong-Kyun

2014-01-01

This study assessed the cost-effectiveness from a societal perspective of a dental implant compared with a three-unit tooth-supported fixed partial denture (FPD) for the replacement of a single tooth in 2010. A decision tree was developed to estimate cost-effectiveness over a 10-year period. The survival rates of single-tooth implants and FPDs were extracted from a meta-analysis of single-arm studies. Medical costs included initial treatment costs, maintenance costs, and costs to treat complications. Patient surveys were used to obtain the costs of the initial single-tooth implant or FPD. Maintenance costs and costs to treat complications were based on surveys of seven clinical experts at dental clinics or hospitals. Transportation costs were calculated based on the number of visits for implant or FPD treatment. Patient time costs were estimated using the number of visits and time required, hourly wage, and employment rate. Future costs were discounted by 5% to convert to present values. The results of a 10-year period model showed that a single dental implant cost US $261 (clinic) to $342 (hospital) more than an FPD and had an average survival rate that was 10.4% higher. The incremental cost-effectiveness ratio was $2,514 in a clinic and $3,290 in a hospital for a prosthesis in situ for 10 years. The sensitivity analysis showed that initial treatment costs and survival rate influenced the cost-effectiveness. If the cost of an implant were reduced to 80% of the current cost, the implant would become the dominant intervention. Although the level of evidence for effectiveness is low, and some aspects of single-tooth implants or FPDs, such as satisfaction, were not considered, this study will help patients requiring single-tooth replacement to choose the best treatment option.

Breast cancer screening in Italy: evaluating key performance indicators for time trends and activity volumes.

PubMed

Giordano, Livia; Castagno, Roberta; Giorgi, Daniela; Piccinelli, Cristiano; Ventura, Leonardo; Segnan, Nereo; Zappa, Marco

2015-01-01

Together with the National centre for screening monitoring (ONS), GISMa supports annual collection of data on national breast screening activities. Aggregated data on implementation and performance are gathered through a standardized form to calculate process and impact indicators. Analyzed data belong to 153 local programmes in the period 2006-2011 (2006-2012 for participation rate only). During the whole period, Italian crude participation rate exceeded GISMa's acceptable standard (50%), even though a higher participation in northern and central Italy compared to southern Italy and Islands was observed. Time trend analysis of diagnostic indicators confirmed in 2011 an adequate quality of breast screening performance, especially at subsequent screening. Recall rate at initial screening did not reach the acceptable standard (<7%) and rose slightly over the period. On the contrary, a good performance was achieved at subsequent screening. The same trend was followed by the overall detection rate and positive predictive value. They both showed a progressive reduction (from 6.2‰ in 2006 to 4.5‰ in 2011 for DR and from 8.0% in 2006 to 5.2% in 2011 for PPV, respectively) at initial screening and a good, stable trend at subsequent screening. Activity volume analysis shows that in programmes with greater activity (test/year ≥10,000) RR at both initial and subsequent screening has a better performance. This is also true for DR and PPV where programmes with high volumes of activity do better, especially when compared with those that interpret fewer than 5,000 mammograms per year. In spite of a few limits, these results are reassuring, and they reward the efforts made by screening professionals. It is therefore important to continue to monitor screening indicators and suggest, test, and evaluate new strategies for continuous improvement.

The association between cinacalcet use and missed in-center hemodialysis treatment rate.

PubMed

Brunelli, Steven M; Sibbel, Scott; Dluzniewski, Paul J; Cooper, Kerry; Bensink, Mark E; Bradbury, Brian D

2016-11-01

Missed in-center hemodialysis treatments (MHT) are a general indicator of health status in hemodialysis patients. This analysis was conducted to estimate the association between cinacalcet use and MHT rate. We studied patients receiving hemodialysis and prescription benefits services from a large dialysis organization. Incident cinacalcet users were propensity score matched to controls on 31 demographic, clinical, and laboratory variables. We applied inverse probability (IP) of censoring and crossover weights to account for informative censoring. Weighted negative binomial modeling was used to estimate MHT rates and pooled logistics models were used to estimate the association between cinacalcet use and MHT. Baseline demographic and clinical variables included serum calcium, phosphorus, parathyroid hormone, and vitamin D use, and were balanced between 15,474 new cinacalcet users and 15,474 matched controls. In an analysis based on intention-to-treat principles, 40.8% of cinacalcet users and 46.5% of nonusers were censored. MHT rate was 13% lower among cinacalcet initiators versus controls: IP of censoring weighted incidence rate ratio was 0.87 (95% confidence interval [CI]: 0.84-0.90 p < 0.001). In analyses based on as-treated principles, 72.8% and 61.5% of cinacalcet users and nonusers, respectively, crossed over or were censored. MHT rate was 15% lower among cinacalcet initiators versus controls: IP of censoring/crossover weighted incidence rate ratio was 0.85 (95%CI: 0.82-0.87 p < 0.001). After controlling for indication and differential censoring, cinacalcet treatment was associated with lower MHT rates, which may reflect better health status. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Rates of Homicide During the First Episode of Psychosis and After Treatment: A Systematic Review and Meta-analysis

PubMed Central

Nielssen, Olav; Large, Matthew

2010-01-01

The observation that almost half of the homicides committed by people with a psychotic illness occur before initial treatment suggests an increased risk of homicide during the first episode of psychosis. The aim of this study was to estimate the rates of homicide during the first episode of psychosis and after treatment. A systematic search located 10 studies that reported details of all the homicide offenders with a psychotic illness within a known population during a specified period and reported the number of people who had received treatment prior to the offense. Meta-analysis of these studies showed that 38.5% (95% confidence interval [CI] = 31.1%–46.5%) of homicides occurred during the first episode of psychosis, prior to initial treatment. Homicides during first-episode psychosis occurred at a rate of 1.59 homicides per 1000 (95% CI = 1.06–2.40), equivalent to 1 in 629 presentations. The annual rate of homicide after treatment for psychosis was 0.11 homicides per 1000 patients (95% CI = 0.07–0.16), equivalent to 1 homicide in 9090 patients with schizophrenia per year. The rate ratio of homicide in the first episode of psychosis in these studies was 15.5 (95% CI = 11.0–21.7) times the annual rate of homicide after treatment for psychosis. Hence, the rate of homicide in the first episode of psychosis appears to be higher than previously recognized, whereas the annual rate of homicide by patients with schizophrenia after treatment is lower than previous estimates. Earlier treatment of first-episode psychosis might prevent some homicides. PMID:18990713

Reliability analysis of structures under periodic proof tests in service

NASA Technical Reports Server (NTRS)

Yang, J.-N.

1976-01-01

A reliability analysis of structures subjected to random service loads and periodic proof tests treats gust loads and maneuver loads as random processes. Crack initiation, crack propagation, and strength degradation are treated as the fatigue process. The time to fatigue crack initiation and ultimate strength are random variables. Residual strength decreases during crack propagation, so that failure rate increases with time. When a structure fails under periodic proof testing, a new structure is built and proof-tested. The probability of structural failure in service is derived from treatment of all the random variables, strength degradations, service loads, proof tests, and the renewal of failed structures. Some numerical examples are worked out.

Finite-element nonlinear transient response computer programs PLATE 1 and CIVM-PLATE 1 for the analysis of panels subjected to impulse or impact loads

NASA Technical Reports Server (NTRS)

Spilker, R. L.; Witmer, E. A.; French, S. E.; Rodal, J. J. A.

1980-01-01

Two computer programs are described for predicting the transient large deflection elastic viscoplastic responses of thin single layer, initially flat unstiffened or integrally stiffened, Kirchhoff-Lov ductile metal panels. The PLATE 1 program pertains to structural responses produced by prescribed externally applied transient loading or prescribed initial velocity distributions. The collision imparted velocity method PLATE 1 program concerns structural responses produced by impact of an idealized nondeformable fragment. Finite elements are used to represent the structure in both programs. Strain hardening and strain rate effects of initially isotropic material are considered.

Reduction of radial-head subluxation in children by triage nurses in the emergency department: a cluster-randomized controlled trial

PubMed Central

Dixon, Andrew; Clarkin, Chantalle; Barrowman, Nick; Correll, Rhonda; Osmond, Martin H.; Plint, Amy C.

2014-01-01

Background: Radial-head subluxation is an easily identified and treated injury. We investigated whether triage nurses in the emergency department can safely reduce radial-head subluxation at rates that are not substantially lower than those of emergency department physicians. Methods: We performed an open, noninferiority, cluster-randomized control trial. Children aged 6 years and younger who presented to the emergency department with a presentation consistent with radial-head subluxation and who had sustained a known injury in the previous 12 hours were assigned to either nurse-initiated or physician-initiated treatment, depending on the day. The primary outcome was the proportion of children who had a successful reduction (return to normal arm usage). We used a noninferiority margin of 10%. Results: In total, 268 children were eligible for inclusion and 245 were included in the final analysis. Of the children assigned to receive physician-initiated care, 96.7% (117/121) had a successful reduction performed by a physician. Of the children assigned to receive nurse-treatment care, 84.7% (105/124) had a successful reduction performed by a nurse. The difference in the proportion of successful radial head subluxations between the groups was 12.0% (95% confidence interval [CI] 4.8% to 19.7%). Noninferiority of nurse-initiated radial head subluxation was not shown. Interpretation: In this trial, the rate of successful radial-head subluxation performed by nurses was inferior to the physician success rate. Although the success rate in the nurse-initiated care group did not meet the non-inferiority margin, nurses were able to reduce radial head subluxation for almost 85% of children who presented with probable radial-head subluxation. Trial registration: Clinical Trials.gov, no. NCT00993954. PMID:24664649

Temporal trends of time to antiretroviral treatment initiation, interruption and modification: examination of patients diagnosed with advanced HIV in Australia.

PubMed

Wright, Stephen T; Law, Matthew G; Cooper, David A; Keen, Phillip; McDonald, Ann; Middleton, Melanie; Woolley, Ian; Kelly, Mark; Petoumenos, Kathy

2015-01-01

HIV prevention strategies are moving towards reducing plasma HIV RNA viral load in all HIV-positive persons, including those undiagnosed, treatment naïve, on or off antiretroviral therapy. A proxy population for those undiagnosed are patients that present late to care with advanced HIV. The objectives of this analysis are to examine factors associated with patients presenting with advanced HIV, and establish rates of treatment interruption and modification after initiating ART. We deterministically linked records from the Australian HIV Observational Database to the Australian National HIV Registry to obtain information related to HIV diagnosis. Logistic regression was used to identify factors associated with advanced HIV diagnosis. We used survival methods to evaluate rates of ART initiation by diagnosis CD4 count strata and by calendar year of HIV diagnosis. Cox models were used to determine hazard of first ART treatment interruption (duration >30 days) and time to first major ART modification. Factors associated (p<0.05) with increased odds of advanced HIV diagnosis were sex, older age, heterosexual mode of HIV exposure, born overseas and rural-regional care setting. Earlier initiation of ART occurred at higher rates in later periods (2007-2012) in all diagnosis CD4 count groups. We found an 83% (69, 91%) reduction in the hazard of first treatment interruption comparing 2007-2012 versus 1996-2001 (p<0.001), and no difference in ART modification for patients diagnosed with advanced HIV. Recent HIV diagnoses are initiating therapy earlier in all diagnosis CD4 cell count groups, potentially lowering community viral load compared to earlier time periods. We found a marked reduction in the hazard of first treatment interruption, and found no difference in rates of major modification to ART by HIV presentation status in recent periods.

Helicobacter pylori eradication prior to initiation of long-term non-steroidal anti-inflammatory drug therapy in Chinese patients-a cost-effectiveness analysis.

PubMed

You, J H S; Lau, W; Lee, I Y C; Yung, M; Ching, J Y L; Chan, F K L; Lee, K K C

2006-04-01

Recent randomized clinical trials suggested that eradication of Helicobacter pylori prior to initiation of non-steroidal anti-inflammatory drug (NSAID) therapy would reduce the rate of peptic ulcer disease (PUD). To analyze the cost-effectiveness of H. pylori eradication prior to initiation of long-term NSAID therapy for prevention of NSAID-induced PUD in a cohort of Chinese patients at high risk for PUD. Clinical and economic data of 100 participants from a previously reported clinical trial conducted in Hong Kong were analyzed. Patients with a history of peptic ulcers were randomized to 1-week omeprazole 20 mg, amoxicillin 1 g and clarithromycin 500 mg twice daily (eradication group; n = 51) or 1-week omeprazole 20 mg twice daily (omeprazole group; n = 49) before initiation of diclofenac 100 mg daily for 6 months. The rates of PUD and healthcare utilization for routine follow-up as well as for management of symptomatic PUD of the 2 groups were retrieved from medical records. The rate of symptomatic ulcers in eradication group and omeprazole group were 3.9% and 18%, respectively. The mean direct medical cost of the eradication group was significantly lower than that of the omeprazole group by 30% (US dollar 797 (95% CI = 685 - 909) versus US dollar 1,128 (95% CI = 879 - 1,377)) (p = 0.018). The results were robust to variation of all the cost items. H. pylori eradication prior to initiation of NSAID therapy appeared to reduce the ulcer rate and mean direct medical cost when compared to no eradication for Chinese H. pylori-infected NSAID users at high risk for PUD.

Initial analysis of sperm DNA methylome in Holstein bulls

USDA-ARS?s Scientific Manuscript database

Aberrant DNA methylation patterns have been associated with abnormal semen parameters, idiopathic male infertility and early embryonic loss in mammals. Using Holstein bulls with high (Bull1) or low (Bull2) fertility rates, we created two representative sperm DNA methylomes at a single-base resolutio...

Investigating Student Communities with Network Analysis of Interactions in a Physics Learning Center

NASA Astrophysics Data System (ADS)

Brewe, Eric; Kramer, Laird; O'Brien, George

2009-11-01

We describe our initial efforts at implementing social network analysis to visualize and quantify student interactions in Florida International University's Physics Learning Center. Developing a sense of community among students is one of the three pillars of an overall reform effort to increase participation in physics, and the sciences more broadly, at FIU. Our implementation of a research and learning community, embedded within a course reform effort, has led to increased recruitment and retention of physics majors. Finn and Rock [1997] link the academic and social integration of students to increased rates of retention. To identify these interactions, we have initiated an investigation that utilizes social network analysis to identify primary community participants. Community interactions are then characterized through the network's density and connectivity, shedding light on learning communities and participation. Preliminary results, further research questions, and future directions utilizing social network analysis are presented.

Initial home health outcomes under prospective payment.

PubMed

Schlenker, Robert E; Powell, Martha C; Goodrich, Glenn K

2005-02-01

To assess initial changes in home health patient outcomes under Medicare's home health Prospective Payment System (PPS), implemented by the Centers for Medicare and Medicaid Services (CMS) in October 2000. Pre-PPS and early PPS data were obtained from CMS Outcome and Assessment Information Set (OASIS) and Medicare claims files. Regression analysis was applied to national random samples (n=164,810) to estimate pre-PPS/PPS outcome and visit-per-episode changes. Outcome episodes were constructed from OASIS data and linked with Medicare claims data on visits. Outcome changes (risk adjusted) were mixed and generally modest. Favorable changes included higher improvement rates under PPS for functioning and dyspnea, higher community discharge rates, and lower hospitalization and emergent care rates. Most stabilization (nonworsening) outcome rates also increased. However, improvement rates were lower under PPS for wounds, incontinence, and cognitive and emotional/behavioral outcomes. Total visits per episode (case-mix adjusted) declined 16.6 percent although therapy visits increased by 8.4 percent. The outcome and visit results suggest improved system efficiency under PPS (fewer visits, similar outcomes). However, declines in several improvement rates merit ongoing monitoring, as do subsequent (posthome health) hospitalization and emergent care use. Since only the early PPS period was examined, longer-term analyses are needed.

The occurrence of 'what', 'where', 'what house' and other repair initiations in the home environment of hearing-impaired individuals.

PubMed

Pajo, Kati

2013-01-01

Even though research has increasingly focused on the qualitative features of natural conversations, which have improved the communication therapy for hearing-impaired individuals (HI) and familiar partners (FP), very little is known about the interactions that occur outside clinical settings. This study investigated qualitatively how both HI and FP initiated repair due to misperceptions or to a difficulty in understanding during conversations conducted at home. The HI participant's multimodal production style was adopted in the present analysis, and the frequencies were calculated for the different types of verbal repair initiations. Participants with acquired hearing loss (43-69 years) and their familiar partners (24-67 years) were video recorded (total time approximately 9 h) in their homes. The data consisted of eight conversational dyads. The transcription and analysis utilized Conversation Analysis. A total of 209 (HI 164/FP 45) verbal repair initiations were identified. The five major types of initiations found in the data (used by both HI and FP) were: open repair initiation, targeting question word, question word with repetition, repetition, and candidate understanding. HI participants rarely explicitly verbalized their difficulty to hear, but the production style, which included a fast speech rate and 'trouble posture', indicated a sensitive routine that was visible particularly in clear misperceptions. Furthermore, the alerting action of overlapping turn taking with the FP participant's turn could be seen to reveal the depth of misperception. The individual differences between HI participants were found predominantly in the frequency of their repair initiations, but also in how they used the different types of repair initiation. Through a deeper qualitative analysis, conversational research can provide extended knowledge of the occurrence and style of ordinary repair initiations and highlight their relationship in certain conversational environments. A robust starting point in communication therapy is increasing the awareness of HI individuals' existing skills. © 2012 Royal College of Speech and Language Therapists.

New infrastructure for studies of transmutation and fast systems concepts

NASA Astrophysics Data System (ADS)

Panza, Fabio; Firpo, Gabriele; Lomonaco, Guglielmo; Osipenko, Mikhail; Ricco, Giovanni; Ripani, Marco; Saracco, Paolo; Viberti, Carlo Maria

2017-09-01

In this work we report initial studies on a low power Accelerator-Driven System as a possible experimental facility for the measurement of relevant integral nuclear quantities. In particular, we performed Monte Carlo simulations of minor actinides and fission products irradiation and estimated the fission rate within fission chambers in the reactor core and the reflector, in order to evaluate the transmutation rates and the measurement sensitivity. We also performed a photo-peak analysis of available experimental data from a research reactor, in order to estimate the expected sensitivity of this analysis method on the irradiation of samples in the ADS considered.

Eigenmode Analysis of Boundary Conditions for One-Dimensional Preconditioned Euler Equations

NASA Technical Reports Server (NTRS)

Darmofal, David L.

1998-01-01

An analysis of the effect of local preconditioning on boundary conditions for the subsonic, one-dimensional Euler equations is presented. Decay rates for the eigenmodes of the initial boundary value problem are determined for different boundary conditions. Riemann invariant boundary conditions based on the unpreconditioned Euler equations are shown to be reflective with preconditioning, and, at low Mach numbers, disturbances do not decay. Other boundary conditions are investigated which are non-reflective with preconditioning and numerical results are presented confirming the analysis.

20 CFR 227.2 - Initial supplemental annuity rate.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Initial supplemental annuity rate. 227.2... COMPUTING SUPPLEMENTAL ANNUITIES § 227.2 Initial supplemental annuity rate. The supplemental annuity rate... supplemental annuity rate is $43 for an employee with 30 or more years of service. ...

Attentional modulation of desensitization to odor.

PubMed

Fallon, Nicholas; Giesbrecht, Timo; Stancak, Andrej

2018-05-22

Subjective and behavioral responsiveness to odor diminishes during prolonged exposure. The precise mechanisms underlying olfactory desensitization are not fully understood, but previous studies indicate that the phenomenon may be modulated by central-cognitive processes. The present study investigated the effect of attention on perceived intensity during exposure to a pleasant odor. A within-subjects design was utilized with 19 participants attending 2 sessions. During each session, participants continuously rated their perceived intensity of a 10-minute exposure to a pleasant fragrance administered using an olfactometer. An auditory oddball task was implemented to manipulate the focus of attention in each session. Participants were instructed to either direct their attention toward the sounds, but still to rate odor, or to focus entirely on rating the odor. Analysis revealed three 50-second time windows with significantly lower mean intensity ratings during the distraction condition. Curve fitting of the data disclosed a linear function of desensitization in the focused attention condition compared with an exponential decay function during distraction condition, indicating an increased rate of initial desensitization when attention is distracted away from the odor. In the focused-attention condition, perceived intensity demonstrated a regular pattern of odor sensitivity occurring at approximately 1-2 minutes intervals following initial desensitization. Spectral analysis of low-frequency oscillations confirmed the presence of augmented spectral power in this frequency range during focused relative to distracted conditions. The findings demonstrate for the first time modulation of odor desensitization specifically by attentional factors, exemplifying the relevance of top-down control for ongoing perception of odor.

Recurrent urinary tract infections and complications after symptomatic versus antibiotic treatment: follow-up of a randomised controlled trial.

PubMed

Bleidorn, Jutta; Hummers-Pradier, Eva; Schmiemann, Guido; Wiese, Birgitt; Gágyor, Ildikó

2016-01-01

Uncomplicated urinary tract infections (UTI) are common in general practice, and are usually treated with antibiotics. Recurrent UTI often pose a serious problem for affected women. Little is known about recurrent UTI and complications when uncomplicated UTI are treated without antibiotics. With ICUTI (Immediate vs. conditional antibiotic use in uncomplicated UTI, funded by BMBF No. 01KG1105) we assessed whether initial symptomatic treatment with ibuprofen could be a treatment alternative for uncomplicated UTI. The presented analysis aims to assess the influence of initial (non-)antibiotic treatment on recurrent UTI rates and pyelonephritis after day 28 up to 6 months after trial participation. This study is a retrospective long-term follow-up analysis of ICUTI patients, surveyed telephonically six months after inclusion in the trial. Recurrent UTI, pyelonephritis or hospitalizations were documented. Statistical evaluation was performed by descriptive and multivariate analyses with SPSS 21. For the six months follow-up survey, 386 trial participants could be contacted (494 had been included in ICUTI initially, 446 had completed the trial). From day 28 until 6 months after inclusion in ICUTI, 84 recurrent UTI were reported by 80 patients. Univariate and multivariate analyses showed no effect of initial treatment group or antibiotic treatment on number of patients with recurrent UTI. Yet, both analyses showed that patients with a history of previous UTI had significantly more often recurrent UTI. Pyelonephritis occurred in two patients of the antibiotic group and in one patient in the non-antibiotic group. This follow-up analysis of a trial comparing antibiotic vs. symptomatic treatment for uncomplicated UTI showed that non-antibiotic treatment has no negative impact on recurrent UTI rates or pyelonephritis after day 28 and up to six months after initial treatment. Thus, a four week follow-up in UTI trials seems adequate.

Properties of some statistics for AR-ARCH model with application to technical analysis

NASA Astrophysics Data System (ADS)

Huang, Xudong; Liu, Wei

2009-03-01

In this paper, we investigate some popular technical analysis indexes for AR-ARCH model as real stock market. Under the given conditions, we show that the corresponding statistics are asymptotically stationary and the law of large numbers hold for frequencies of the stock prices falling out normal scope of these technical analysis indexes under AR-ARCH, and give the rate of convergence in the case of nonstationary initial values, which give a mathematical rationale for these methods of technical analysis in supervising the security trends.

Frontal sinus revision rate after nasal polyposis surgery including frontal recess clearance and middle turbinectomy: A long-term analysis.

PubMed

Benkhatar, Hakim; Khettab, Idir; Sultanik, Philippe; Laccourreye, Ollivier; Bonfils, Pierre

2018-08-01

To determine the frontal sinus revision rate after nasal polyposis (NP) surgery including frontal recess clearance (FRC) and middle turbinectomy (MT), to search for predictive factors and to analyse surgical management. Longitudinal analysis of 153 patients who consecutively underwent bilateral sphenoethmoidectomy with FRC and MT for NP with a minimum follow-up of 7 years. Decision of revision surgery was made in case of medically refractory chronic frontal sinusitis or frontal mucocele. Univariate and multivariate analysis incorporating clinical and radiological variables were performed. The frontal sinus revision rate was 6.5% (10/153). The mean time between the initial procedure and revision surgery was 3 years, 10 months. Osteitis around the frontal sinus outflow tract (FSOT) was associated with a higher risk of frontal sinus revision surgery (p=0.01). Asthma and aspirin intolerance did not increase the risk, as well as frontal sinus ostium diameter or residual frontoethmoid cells. Among revised patients, 60% required multiple procedures and 70% required frontal sinus ostium enlargement. Our long-term study reports that NP surgery including FRC and MT is associated with a low frontal sinus revision rate (6.5%). Patients developing osteitis around the FSOT have a higher risk of frontal sinus revision surgery. As mucosal damage can lead to osteitis, FSOT mucosa should be preserved during initial NP surgery. However, as multiple procedures are common among NP patients requiring frontal sinus revision, frontal sinus ostium enlargement should be considered during first revision in the hope of reducing the need of further revisions. Copyright © 2018 Elsevier B.V. All rights reserved.

Rate and Causes of Discharge against Medical Advice in Iranian Hospitals: A Systematic Review and Meta-Analysis

PubMed Central

MOHSENI, Mohammad; ALIKHANI, Mahtab; TOURANI, Sogand; AZAMI-AGHDASH, Saber; ROYANI, Sanaz; MORADI-JOO, Mohammad

2015-01-01

Background: Discharge against Medical Advice (DAMA) is a problem for hospitals which may result in increasing readmissions, morbidities, inabilities, deaths and health care costs. This study, aimed to investigate the rate and causes of DAMA in Iranian hospitals. Methods: A systematic review and meta-analysis study was conducted in 2014. Required data were collected through searching for key words included: “Discharge Against Medical Advice”, “Leaving against medical advice”, “causes*”, “hospital” and their Persian equivalents, over databases including PubMed, OVID, Google Scholar, Embase, Scopus, Magiran, scientific information database (SID). The reference lists of the articles, certain relevant journals and web sites in this field were also searched. Results: Out of 913 articles initially retrieved, finally 17 articles were incorporated into the study. There were 244858 individuals studied in the articles. Using a random effects model, the rate of DAMA in Iranian hospitals was estimated at 7.9% (6.3%–9.8%). While the highest rate of DAMA was associated with patients in departments of psychiatry (12%), the lowest rate was related to patients in departments of pediatrics (3.7). DAMA was in men more than women (P<0.05) Patient’s perception of feeling of wellbeing, financial problems, family problems, the lack of attention from physicians and nurses, inappropriate behavior with patients by hospital team and the lack of timely care were mentioned as main causes for DAMA. Conclusion: The rate of DAMA in Iranian hospitals is relatively high. Thus effective initiatives in this area are required. PMID:26576368

High-Throughput Characterization of Intrinsic Disorder in Proteins from the Protein Structure Initiative

PubMed Central

Johnson, Derrick E.; Xue, Bin; Sickmeier, Megan D.; Meng, Jingwei; Cortese, Marc S.; Oldfield, Christopher J.; Le Gall, Tanguy; Dunker, A. Keith; Uversky, Vladimir N.

2012-01-01

The identification of intrinsically disordered proteins (IDPs) among the targets that fail to form satisfactory crystal structures in the Protein Structure Initiative represent a key to reducing the costs and time for determining three-dimensional structures of proteins. To help in this endeavor, several Protein Structure Initiative Centers were asked to send samples of both crystallizable proteins and proteins that failed to crystallize. The abundance of intrinsic disorder in these proteins was evaluated via computational analysis using Predictors of Natural Disordered Regions (PONDR®) and the potential cleavage sites and corresponding fragments were determined. Then, the target proteins were analyzed for intrinsic disorder by their resistance to limited proteolysis. The rates of tryptic digestion of sample target proteins were compared to those of lysozyme/myoglobin, apo-myoglobin and α-casein as standards of ordered, partially disordered and completely disordered proteins, respectively. At the next stage, the protein samples were subjected to both far-UV and near-UV circular dichroism (CD) analysis. For most of the samples, a good agreement between CD data, predictions of disorder and the rates of limited tryptic digestion was established. Further experimentation is being performed on a smaller subset of these samples in order to obtain more detailed information on the ordered/disordered nature of the proteins. PMID:22651963

Computational Identification and Analysis of the Key Biosorbent Characteristics for the Biosorption Process of Reactive Black 5 onto Fungal Biomass

PubMed Central

Yang, Yu-Yi; Li, Ze-Li; Wang, Guan; Zhao, Xiao-Ping; Crowley, David E.; Zhao, Yu-Hua

2012-01-01

The performances of nine biosorbents derived from dead fungal biomass were investigated for their ability to remove Reactive Black 5 from aqueous solution. The biosorption data for removal of Reactive Black 5 were readily modeled using the Langmuir adsorption isotherm. Kinetic analysis based on both pseudo-second-order and Weber-Morris models indicated intraparticle diffusion was the rate limiting step for biosorption of Reactive Black 5 on to the biosorbents. Sorption capacities of the biosorbents were not correlated with the initial biosorption rates. Sensitivity analysis of the factors affecting biosorption examined by an artificial neural network model showed that pH was the most important parameter, explaining 22%, followed by nitrogen content of biosorbents (16%), initial dye concentration (15%) and carbon content of biosorbents (10%). The biosorption capacities were not proportional to surface areas of the sorbents, but were instead influenced by their chemical element composition. The main functional groups contributing to dye sorption were amine, carboxylic, and alcohol moieties. The data further suggest that differences in carbon and nitrogen contents of biosorbents may be used as a selection index for identifying effective biosorbents from dead fungal biomass. PMID:22442697

An initial-abstraction, constant-loss model for unit hydrograph modeling for applicable watersheds in Texas

USGS Publications Warehouse

Asquith, William H.; Roussel, Meghan C.

2007-01-01

Estimation of representative hydrographs from design storms, which are known as design hydrographs, provides for cost-effective, riskmitigated design of drainage structures such as bridges, culverts, roadways, and other infrastructure. During 2001?07, the U.S. Geological Survey (USGS), in cooperation with the Texas Department of Transportation, investigated runoff hydrographs, design storms, unit hydrographs,and watershed-loss models to enhance design hydrograph estimation in Texas. Design hydrographs ideally should mimic the general volume, peak, and shape of observed runoff hydrographs. Design hydrographs commonly are estimated in part by unit hydrographs. A unit hydrograph is defined as the runoff hydrograph that results from a unit pulse of excess rainfall uniformly distributed over the watershed at a constant rate for a specific duration. A time-distributed, watershed-loss model is required for modeling by unit hydrographs. This report develops a specific time-distributed, watershed-loss model known as an initial-abstraction, constant-loss model. For this watershed-loss model, a watershed is conceptualized to have the capacity to store or abstract an absolute depth of rainfall at and near the beginning of a storm. Depths of total rainfall less than this initial abstraction do not produce runoff. The watershed also is conceptualized to have the capacity to remove rainfall at a constant rate (loss) after the initial abstraction is satisfied. Additional rainfall inputs after the initial abstraction is satisfied contribute to runoff if the rainfall rate (intensity) is larger than the constant loss. The initial abstraction, constant-loss model thus is a two-parameter model. The initial-abstraction, constant-loss model is investigated through detailed computational and statistical analysis of observed rainfall and runoff data for 92 USGS streamflow-gaging stations (watersheds) in Texas with contributing drainage areas from 0.26 to 166 square miles. The analysis is limited to a previously described, watershed-specific, gamma distribution model of the unit hydrograph. In particular, the initial-abstraction, constant-loss model is tuned to the gamma distribution model of the unit hydrograph. A complex computational analysis of observed rainfall and runoff for the 92 watersheds was done to determine, by storm, optimal values of initial abstraction and constant loss. Optimal parameter values for a given storm were defined as those values that produced a modeled runoff hydrograph with volume equal to the observed runoff hydrograph and also minimized the residual sum of squares of the two hydrographs. Subsequently, the means of the optimal parameters were computed on a watershed-specific basis. These means for each watershed are considered the most representative, are tabulated, and are used in further statistical analyses. Statistical analyses of watershed-specific, initial abstraction and constant loss include documentation of the distribution of each parameter using the generalized lambda distribution. The analyses show that watershed development has substantial influence on initial abstraction and limited influence on constant loss. The means and medians of the 92 watershed-specific parameters are tabulated with respect to watershed development; although they have considerable uncertainty, these parameters can be used for parameter prediction for ungaged watersheds. The statistical analyses of watershed-specific, initial abstraction and constant loss also include development of predictive procedures for estimation of each parameter for ungaged watersheds. Both regression equations and regression trees for estimation of initial abstraction and constant loss are provided. The watershed characteristics included in the regression analyses are (1) main-channel length, (2) a binary factor representing watershed development, (3) a binary factor representing watersheds with an abundance of rocky and thin-soiled terrain, and (4) curve numb

Interest rate next-day variation prediction based on hybrid feedforward neural network, particle swarm optimization, and multiresolution techniques

NASA Astrophysics Data System (ADS)

Lahmiri, Salim

2016-02-01

Multiresolution analysis techniques including continuous wavelet transform, empirical mode decomposition, and variational mode decomposition are tested in the context of interest rate next-day variation prediction. In particular, multiresolution analysis techniques are used to decompose interest rate actual variation and feedforward neural network for training and prediction. Particle swarm optimization technique is adopted to optimize its initial weights. For comparison purpose, autoregressive moving average model, random walk process and the naive model are used as main reference models. In order to show the feasibility of the presented hybrid models that combine multiresolution analysis techniques and feedforward neural network optimized by particle swarm optimization, we used a set of six illustrative interest rates; including Moody's seasoned Aaa corporate bond yield, Moody's seasoned Baa corporate bond yield, 3-Month, 6-Month and 1-Year treasury bills, and effective federal fund rate. The forecasting results show that all multiresolution-based prediction systems outperform the conventional reference models on the criteria of mean absolute error, mean absolute deviation, and root mean-squared error. Therefore, it is advantageous to adopt hybrid multiresolution techniques and soft computing models to forecast interest rate daily variations as they provide good forecasting performance.

A cost-minimisation analysis comparing different antibiotic regimens used in treating all-cause bacterial pneumonia in Hong Kong.

PubMed

Lee, Kenneth K C; Wan, Matthew H S; Fan, Barry S K; Chau, Michelle W Y; Lee, Vivian W Y

2009-03-01

To find out the antibiotic treatment regimens with the lowest cost for all-cause bacterial pneumonia, a study to compare the costs of different antibiotic regimens in the treatment of patients diagnosed with all-cause bacterial pneumonia who required hospitalisation was carried out. This was a multicentre, retrospective study of patient medical records. The primary aim was to examine whether the initial choice of antibiotic had affected the total cost of treatment, while the secondary aim was to find out whether the initial choice of antibiotic had affected the initial treatment failure rates and death rates. A cost-minimisation analysis (CMA) from a public hospital perspective was employed. A total of 333 patient medical case notes were reviewed. The most commonly prescribed antibiotic regimen was amoxycillin-clavulanate (AC) followed by amoxycillin-clavulanate plus macrolide (ACM) and quinolone (Q). In the study population, no statistical significance could be detected between the mean cost of the three regimens. In the subgroup analysis of patients with a history of chronic obstructive pulmonary disease (COPD) and patients with a history of smoking, the Q regimen appeared to be the least expensive. In the study population, no significant difference could be identified between the mean cost of the three antibiotic regimens. In a special populations such as patients with a history of COPD and patients with a history of smoking, the Q regimen appeared to be superior. Further studies in these areas are needed.

Cost-minimization Analysis of the Management of Acute Achilles Tendon Rupture.

PubMed

Truntzer, Jeremy N; Triana, Brian; Harris, Alex H S; Baker, Laurence; Chou, Loretta; Kamal, Robin N

2017-06-01

Outcomes of nonsurgical management of acute Achilles tendon rupture have been demonstrated to be noninferior to those of surgical management. We performed a cost-minimization analysis of surgical and nonsurgical management of acute Achilles tendon rupture. We used a claims database to identify patients who underwent surgical (n = 1,979) and nonsurgical (n = 3,065) management of acute Achilles tendon rupture and compared overall costs of treatment (surgical procedure, follow-up care, physical therapy, and management of complications). Complication rates were also calculated. Patients were followed for 1 year after injury. Average treatment costs in the year after initial diagnosis were higher for patients who underwent initial surgical treatment than for patients who underwent nonsurgical treatment ($4,292 for surgical treatment versus $2,432 for nonsurgical treatment; P < 0.001). However, surgical treatment required fewer office visits (4.52 versus 10.98; P < 0.001) and less spending on physical therapy ($595 versus $928; P < 0.001). Rates of rerupture requiring subsequent treatment (2.1% versus 2.4%; P = 0.34) and additional costs ($2,950 versus $2,515; P = 0.34) were not significantly different regardless whether initial treatment was surgical or nonsurgical. In both cohorts, management of complications contributed to approximately 5% of the total cost. From the payer's perspective, the overall costs of nonsurgical management of acute Achilles tendon rupture were significantly lower than the overall costs of surgical management. III, Economic Decision Analysis.

Proton pump inhibitor step-down therapy for GERD: A multi-center study in Japan

PubMed Central

Tsuzuki, Takao; Okada, Hiroyuki; Kawahara, Yoshiro; Takenaka, Ryuta; Nasu, Junichiro; Ishioka, Hidehiko; Fujiwara, Akiko; Yoshinaga, Fumiya; Yamamoto, Kazuhide

2011-01-01

AIM: To investigate the predictors of success in step-down of proton pump inhibitor and to assess the quality of life (QOL). METHODS: Patients who had heartburn twice a week or more were treated with 20 mg omeprazole (OPZ) once daily for 8 wk as an initial therapy (study 1). Patients whose heartburn decreased to once a week or less at the end of the initial therapy were enrolled in study 2 and treated with 10 mg OPZ as maintenance therapy for an additional 6 mo (study 2). QOL was investigated using the gastrointestinal symptom rating scale (GSRS) before initial therapy, after both 4 and 8 wk of initial therapy, and at 1, 2, 3, and 6 mo after starting maintenance therapy. RESULTS: In study 1, 108 patients were analyzed. Their characteristics were as follows; median age: 63 (range: 20-88) years, sex: 46 women and 62 men. The success rate of the initial therapy was 76%. In the patients with successful initial therapy, abdominal pain, indigestion and reflux GSRS scores were improved. In study 2, 83 patients were analyzed. Seventy of 83 patients completed the study 2 protocol. In the per-protocol analysis, 80% of 70 patients were successful for step-down. On multivariate analysis of baseline demographic data and clinical information, no previous treatment for gastroesophageal reflux disease (GERD) [odds ratio (OR) 0.255, 95% CI: 0.06-0.98] and a lower indigestion score in GSRS at the beginning of step-down therapy (OR 0.214, 95% CI: 0.06-0.73) were found to be the predictors of successful step-down therapy. The improved GSRS scores by initial therapy were maintained through the step-down therapy. CONCLUSION: OPZ was effective for most GERD patients. However, those who have had previous treatment for GERD and experience dyspepsia before step-down require particular monitoring for relapse. PMID:21472108

Drying kinetic of industrial cassava flour: Experimental data in view.

PubMed

Odetunmibi, Oluwole A; Adejumo, Oluyemisi A; Oguntunde, Pelumi E; Okagbue, Hilary I; Adejumo, Adebowale O; Suleiman, Esivue A

2017-12-01

In this data article, laboratory experimental investigation results on drying kinetic properties: the drying temperature ( T ), drying air velocity ( V ) and dewatering time (Te), each of the factors has five levels, and the experiment was replicated three times and the output: drying rate and drying time obtained, were observed. The experiment was conducted at National Centre for Agricultural Mechanization (NCAM) for a period of eight months, in 2014. Analysis of variance was carried out using randomized complete block design with factorial experiment on each of the outputs: drying rate and drying times of the industrial cassava flour. A clear picture on each of these outputs was provided separately using tables and figures. It was observed that all the main factors as well as two and three ways interactions are significant at 5% level for both drying time and rate. This also implies that the rate of drying grated unfermented cassava mash, to produce industrial cassava flour, depend on the dewatering time (the initial moisture content), temperature of drying, velocity of drying air as well as the combinations of these factors altogether. It was also discovered that all the levels of each of these factors are significantly difference from one another. In summary, the time of drying is a function of the dewatering time which was responsible for the initial moisture content. The higher the initial moisture content the longer the time of drying, and the lower the initial moisture content, the lower the time of drying. Also, the higher the temperature of drying the shorter the time of drying and vice versa. Also, the air velocity effect on the drying process was significant. As velocity increases, rate of drying also increases and vice versa. Finally, it can be deduced that the drying kinetics are influenced by these processing factors.

Quantification of rapid environmental redox processes with quick-scanning x-ray absorption spectroscopy (Q-XAS)

PubMed Central

Ginder-Vogel, Matthew; Landrot, Gautier; Fischel, Jason S.; Sparks, Donald L.

2009-01-01

Quantification of the initial rates of environmental reactions at the mineral/water interface is a fundamental prerequisite to determining reaction mechanisms and contaminant transport modeling and predicting environmental risk. Until recently, experimental techniques with adequate time resolution and elemental sensitivity to measure initial rates of the wide variety of environmental reactions were quite limited. Techniques such as electron paramagnetic resonance and Fourier transform infrared spectroscopies suffer from limited elemental specificity and poor sensitivity to inorganic elements, respectively. Ex situ analysis of batch and stirred-flow systems provides high elemental sensitivity; however, their time resolution is inadequate to characterize rapid environmental reactions. Here we apply quick-scanning x-ray absorption spectroscopy (Q-XAS), at sub-second time-scales, to measure the initial oxidation rate of As(III) to As(V) by hydrous manganese(IV) oxide. Using Q-XAS, As(III) and As(V) concentrations were determined every 0.98 s in batch reactions. The initial apparent As(III) depletion rate constants (t < 30 s) measured with Q-XAS are nearly twice as large as rate constants measured with traditional analytical techniques. Our results demonstrate the importance of developing analytical techniques capable of analyzing environmental reactions on the same time scale as they occur. Given the high sensitivity, elemental specificity, and time resolution of Q-XAS, it has many potential applications. They could include measuring not only redox reactions but also dissolution/precipitation reactions, such as the formation and/or reductive dissolution of Fe(III) (hydr)oxides, solid-phase transformations (i.e., formation of layered-double hydroxide minerals), or almost any other reaction occurring in aqueous media that can be measured using x-ray absorption spectroscopy. PMID:19805269

The Effect of the Heat Flux on the Self-Ignition of Oriented Strand Board

NASA Astrophysics Data System (ADS)

Hirle, Siegfried; Balog, Karol

2017-06-01

This article deals with the initiation phase of flaming and smouldering burning of oriented strand board. The influence of heat flux on thermal degradation of OSB boards, time to ignition, heat release rate and mass loss rate using thermal analysis and vertical electrical radiation panel methods were studied. Significant information on the influence of the heat flux density and the thickness of the material on time to ignition was obtained.

Initiation and Modification of Reaction by Energy Addition: Kinetic and Transport Phenomena

DTIC Science & Technology

1990-10-01

ignition- delay time ranges from about 2 to 100 ps. The results of a computer- modeling calcu- lation of the chemical kinetics suggest that the...Page PROGRAM INFORMATION iii 1.0 RESEARCH OBJECTIVES 2.0 ANALYSIS 2 3.0 EXPERIMENT 7 REFERENCES 8 APPENDIX I. Evaluating a Simple Model for Laminar...Flame-Propagation I-1 Rates. I. Planar Geometry. APPENDIX II. Evaluating a Simple Model for Laminar-Flame-Propagation II-1 Rates. II. Spherical

Sex is not everything: the role of gender in early performance of a fundamental laparoscopic skill.

PubMed

Kolozsvari, Nicoleta O; Andalib, Amin; Kaneva, Pepa; Cao, Jiguo; Vassiliou, Melina C; Fried, Gerald M; Feldman, Liane S

2011-04-01

Existing literature on the acquisition of surgical skills suggests that women generally perform worse than men. This literature is limited by looking at an arbitrary number of trials and not adjusting for potential confounders. The objective of this study was to evaluate the impact of gender on the learning curve for a fundamental laparoscopic task. Thirty-two medical students performed the FLS peg transfer task and their scores were plotted to generate a learning curve. Nonlinear regression was used to estimate learning plateau and learning rate. Variables that may affect performance were assessed using a questionnaire. Innate visual-spatial abilities were evaluated using tests for spatial orientation, spatial scanning, and perceptual abilities. Score on first peg transfer attempt, learning plateau, and learning rate were compared for men and women using Student's t test. Innate abilities were correlated to simulator performance using Pearson's coefficient. Multivariate linear regression was used to investigate the effect of gender on early laparoscopic performance after adjusting for factors found significant on univariate analysis. Statistical significance was defined as P < 0.05. Nineteen men and 13 women participated in the study; 30 were right-handed, 12 reported high interest in surgery, and 26 had video game experience. There were no differences between men and women in initial peg transfer score, learning plateau, or learning rate. Initial peg transfer score and learning rate were higher in subjects who reported having a high interest in surgery (P = 0.02, P = 0.03). Initial score also correlated with perceptual ability score (P = 0.03). In multivariate analysis, only surgical interest remained a significant predictor of score on first peg transfer (P = 0.03) and learning rate (P = 0.02), while gender had no significant relationship to early performance. Gender did not affect the learning curve for a fundamental laparoscopic task, while interest in surgery and perceptual abilities did influence early performance.

Use of Neoadjuvant Chemotherapy Plus Molecular Targeted Therapy in Colorectal Liver Metastases: A Systematic Review and Meta-analysis.

PubMed

Sabanathan, Dhanusha; Eslick, Guy D; Shannon, Jenny

2016-12-01

Surgery remains the standard of care for patients with colorectal liver metastases (CLMs), with a 5-year survival rate approaching 35%. Perioperative chemotherapy confers a survival benefit in selected patients with CLMs. The use of molecular targeted therapy combined with neoadjuvant chemotherapy for CLMs, however, remains controversial. We reviewed the published data on combination neoadjuvant chemotherapy and molecular targeted therapy for resectable and initially unresectable CLMs. A literature search of the Medline and PubMed databases was conducted to identify studies of neoadjuvant chemotherapy plus molecular targeted therapy in the management of resectable or initially unresectable CLMs. We calculated the pooled proportion and 95% confidence intervals using a random effects model for the relationship of the combination neoadjuvant treatment on the overall response rate and performed a systematic review of all identified studies. The analysis was stratified according to the study design. The data from 11 studies of 908 patients who had undergone systemic chemotherapy plus targeted therapy for CLM were analyzed. The use of combination neoadjuvant therapy was associated with an overall response rate of 68% (95% confidence interval, 63%-73%), with significant heterogeneity observed in the studies (I 2  = 89.35; P < .001). Of the 11 studies, 4 used a combination that included oxaliplatin, 2 included irinotecan, and 5 included a combination of both. Also, 7 studies used cetuximab and 4 bevacizumab. The overall progression-free survival was estimated at 14.4 months. Current evidence suggests that neoadjuvant chemotherapy plus molecular targeted agents for CLM confers high overall response rates. Combination treatment might also increase the resectability rates in initially unresectable CLM. Further studies are needed to examine the survival outcomes, with a focus on the differential role of molecular targeted therapy in the neoadjuvant versus adjuvant setting. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

Trauma airway management in emergency departments: a multicentre, prospective, observational study in Japan.

PubMed

Nakao, Shunichiro; Kimura, Akio; Hagiwara, Yusuke; Hasegawa, Kohei

2015-02-04

Although successful airway management is essential for emergency trauma care, comprehensive studies are limited. We sought to characterise current trauma care practice of airway management in the emergency departments (EDs) in Japan. Analysis of data from a prospective, observational, multicentre registry-the Japanese Emergency Airway Network (JEAN) registry. 13 academic and community EDs from different geographic regions across Japan. 723 trauma patients who underwent emergency intubation from March 2010 through August 2012. ED characteristics, patient and operator demographics, methods of airway management, intubation success or failure at each attempt and adverse events. A total of 723 trauma patients who underwent emergency intubation were eligible for the analysis. Traumatic cardiac arrest comprised 32.6% (95% CI 29.3% to 36.1%) of patients. Rapid sequence intubation (RSI) was the initial method chosen in 23.9% (95% CI 21.0% to 27.2%) of all trauma patients and in 35.5% (95% CI 31.4% to 39.9%) of patients without cardiac arrest. Overall, intubation was successful in ≤3 attempts in 96% of patients (95% CI 94.3% to 97.2%). There was a wide variation in the initial methods of intubation; RSI as the initial method was performed in 0-50.9% of all trauma patients among 12 EDs. Similarly, there was a wide variation in success rates and adverse event rates across the EDs. Success rates varied between 35.5% and 90.5% at the first attempt, and 85.1% and 100% within three attempts across the 12 EDs. In this multicentre prospective study in Japan, we observed a high overall success rate in airway management during trauma care. However, the methods of intubation and success rates were highly variable among hospitals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Solutions of the chemical kinetic equations for initially inhomogeneous mixtures.

NASA Technical Reports Server (NTRS)

Hilst, G. R.

1973-01-01

Following the recent discussions by O'Brien (1971) and Donaldson and Hilst (1972) of the effects of inhomogeneous mixing and turbulent diffusion on simple chemical reaction rates, the present report provides a more extensive analysis of when inhomogeneous mixing has a significant effect on chemical reaction rates. The analysis is then extended to the development of an approximate chemical sub-model which provides much improved predictions of chemical reaction rates over a wide range of inhomogeneities and pathological distributions of the concentrations of the reacting chemical species. In particular, the development of an approximate representation of the third-order correlations of the joint concentration fluctuations permits closure of the chemical sub-model at the level of the second-order moments of these fluctuations and the mean concentrations.

Motivation Change in Therapeutic Community Residential Treatment

ERIC Educational Resources Information Center

Morgen, Keith; Kressel, David

2010-01-01

Latent growth curve analysis was used to assess motivation change across 3 time points for 120 therapeutic community residents. Models included the time-invariant predictor of readiness for treatment, which significantly predicted initial treatment motivation but not the rate of motivation change over time. (Contains 1 figure and 2 tables.)

Advanced bridge safety initiative : recommended practices for live load testing of existing flat-slab concrete bridges - task 5.

DOT National Transportation Integrated Search

2012-12-01

Current AASHTO provisions for load rating flat-slab concrete bridges use the equivalent strip : width method, which is regarded as overly conservative compared to more advanced analysis : methods and field live load testing. It has been shown that li...

Analysis of bluetooth and wi-fi technology to measure wait times of personal vehicles at Arizona-Mexico ports of entry : [executive summary].

DOT National Transportation Integrated Search

2015-11-01

The Arizona Department of Transportation (ADOT), Office of P3 Initiatives and International : Affairs selected Lee Engineering to analyze the penetration rate of Anonymous Re-Identification : (ARID) technology to measure wait time of U.S. and Mexico ...

Evaluating the risk of appendiceal perforation when using ultrasound as the initial diagnostic imaging modality in children with suspected appendicitis.

PubMed

Alerhand, Stephen; Meltzer, James; Tay, Ee Tein

2017-08-01

Ultrasound scan has gained attention for diagnosing appendicitis due to its avoidance of ionizing radiation. However, studies show that ultrasound scan carries inferior sensitivity to computed tomography scan. A non-diagnostic ultrasound scan could increase the time to diagnosis and appendicectomy, particularly if follow-up computed tomography scan is needed. Some studies suggest that delaying appendicectomy increases the risk of perforation. To investigate the risk of appendiceal perforation when using ultrasound scan as the initial diagnostic imaging modality in children with suspected appendicitis. We retrospectively reviewed 1411 charts of children ≤17 years old diagnosed with appendicitis at two urban academic medical centers. Patients who underwent ultrasound scan first were compared to those who underwent computed tomography scan first. In the sub-group analysis, patients who only received ultrasound scan were compared to those who received initial ultrasound scan followed by computed tomography scan. Main outcome measures were appendiceal perforation rate and time from triage to appendicectomy. In 720 children eligible for analysis, there was no significant difference in perforation rate between those who had initial ultrasound scan and those who had initial computed tomography scan (7.3% vs. 8.9%, p = 0.44), nor in those who had ultrasound scan only and those who had initial ultrasound scan followed by computed tomography scan (8.0% vs. 5.6%, p = 0.42). Those patients who had ultrasound scan first had a shorter triage-to-incision time than those who had computed tomography scan first (9.2 (IQR: 5.9, 14.0) vs. 10.2 (IQR: 7.3, 14.3) hours, p = 0.03), whereas those who had ultrasound scan followed by computed tomography scan took longer than those who had ultrasound scan only (7.8 (IQR: 5.3, 11.6) vs. 15.1 (IQR: 10.6, 20.6), p < 0.001). Children < 12 years old receiving ultrasound scan first had lower perforation rate (p = 0.01) and shorter triage-to-incision time (p = 0.003). Children with suspected appendicitis receiving ultrasound scan as the initial diagnostic imaging modality do not have increased risk of perforation compared to those receiving computed tomography scan first. We recommend that children <12 years of age receive ultrasound scan first.

Slow Crack Growth Analysis of Brittle Materials with Finite Thickness Subjected to Constant Stress-Rate Flexural Loading

NASA Technical Reports Server (NTRS)

Chio, S. R.; Gyekenyesi, J. P.

1999-01-01

A two-dimensional, numerical analysis of slow crack growth (SCG) was performed for brittle materials with finite thickness subjected to constant stress-rate ("dynamic fatigue") loading in flexure. The numerical solution showed that the conventional, simple, one-dimensional analytical solution can be used with a maximum error of about 5% in determining the SCG parameters of a brittle material with the conditions of a normalized thickness (a ratio of specimen thickness to initial crack size) T > 3.3 and of a SCG parameter n > 10. The change in crack shape from semicircular to elliptical configurations was significant particularly at both low stress rate and low T, attributed to predominant difference in stress intensity factor along the crack front. The numerical solution of SCG parameters was supported within the experimental range by the data obtained from constant stress-rate flexural testing for soda-lime glass microslides at ambient temperature.

A probabilistic fatigue analysis of multiple site damage

NASA Technical Reports Server (NTRS)

Rohrbaugh, S. M.; Ruff, D.; Hillberry, B. M.; Mccabe, G.; Grandt, A. F., Jr.

1994-01-01

The variability in initial crack size and fatigue crack growth is incorporated in a probabilistic model that is used to predict the fatigue lives for unstiffened aluminum alloy panels containing multiple site damage (MSD). The uncertainty of the damage in the MSD panel is represented by a distribution of fatigue crack lengths that are analytically derived from equivalent initial flaw sizes. The variability in fatigue crack growth rate is characterized by stochastic descriptions of crack growth parameters for a modified Paris crack growth law. A Monte-Carlo simulation explicitly describes the MSD panel by randomly selecting values from the stochastic variables and then grows the MSD cracks with a deterministic fatigue model until the panel fails. Different simulations investigate the influences of the fatigue variability on the distributions of remaining fatigue lives. Six cases that consider fixed and variable conditions of initial crack size and fatigue crack growth rate are examined. The crack size distribution exhibited a dominant effect on the remaining fatigue life distribution, and the variable crack growth rate exhibited a lesser effect on the distribution. In addition, the probabilistic model predicted that only a small percentage of the life remains after a lead crack develops in the MSD panel.

The assessment of mucosal surgical margins in head and neck cancer surgery with narrow band imaging.

PubMed

Šifrer, Robert; Urbančič, Jure; Strojan, Primož; Aničin, Aleksandar; Žargi, Miha

2017-07-01

The diagnostic gain of narrow band imaging in the definition of surgical margins in the treatment of head and neck cancer was evaluated. A prospective study, blinded to the pathologist, with historical comparison. The study group included 45 patients subjected to the intraoperative definition of margins by narrow band imaging. The control group included 55 patients who had undergone standard definition of margins. All patients underwent resection of the tumor and frozen section analysis of superficial margins. The rate of initial R 0 resection and the ratio of histologically negative margins for both groups were statistically compared. The rate of initial R 0 resection in the study group and in the control group was 88.9% and 70.9% (P = .047), and the ratio of histologically negative margins was 95.9% and 88.4% (P = .017), respectively. Narrow band imaging reveals a microscopic extension of the tumor that could be effectively used to better define superficial margins and to achieve a higher rate of initial R 0 resections. 4 Laryngoscope, 127:1577-1582, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Reaction Event Counting Statistics of Biopolymer Reaction Systems with Dynamic Heterogeneity.

PubMed

Lim, Yu Rim; Park, Seong Jun; Park, Bo Jung; Cao, Jianshu; Silbey, Robert J; Sung, Jaeyoung

2012-04-10

We investigate the reaction event counting statistics (RECS) of an elementary biopolymer reaction in which the rate coefficient is dependent on states of the biopolymer and the surrounding environment and discover a universal kinetic phase transition in the RECS of the reaction system with dynamic heterogeneity. From an exact analysis for a general model of elementary biopolymer reactions, we find that the variance in the number of reaction events is dependent on the square of the mean number of the reaction events when the size of measurement time is small on the relaxation time scale of rate coefficient fluctuations, which does not conform to renewal statistics. On the other hand, when the size of the measurement time interval is much greater than the relaxation time of rate coefficient fluctuations, the variance becomes linearly proportional to the mean reaction number in accordance with renewal statistics. Gillespie's stochastic simulation method is generalized for the reaction system with a rate coefficient fluctuation. The simulation results confirm the correctness of the analytic results for the time dependent mean and variance of the reaction event number distribution. On the basis of the obtained results, we propose a method of quantitative analysis for the reaction event counting statistics of reaction systems with rate coefficient fluctuations, which enables one to extract information about the magnitude and the relaxation times of the fluctuating reaction rate coefficient, without a bias that can be introduced by assuming a particular kinetic model of conformational dynamics and the conformation dependent reactivity. An exact relationship is established between a higher moment of the reaction event number distribution and the multitime correlation of the reaction rate for the reaction system with a nonequilibrium initial state distribution as well as for the system with the equilibrium initial state distribution.

Very high pressure liquid chromatography using fully porous particles: quantitative analysis of fast gradient separations without post-run times.

PubMed

Stankovich, Joseph J; Gritti, Fabrice; Stevenson, Paul G; Beaver, Lois Ann; Guiochon, Georges

2014-01-10

Using a column packed with fully porous particles, four methods for controlling the flow rates at which gradient elution runs are conducted in very high pressure liquid chromatography (VHPLC) were tested to determine whether reproducible thermal conditions could be achieved, such that subsequent analyses would proceed at nearly the same initial temperature. In VHPLC high flow rates are achieved, producing fast analyses but requiring high inlet pressures. The combination of high flow rates and high inlet pressures generates local heat, leading to temperature changes in the column. Usually in this case a post-run time is input into the analytical method to allow the return of the column temperature to its initial state. An alternative strategy involves operating the column without a post-run equilibration period and maintaining constant temperature variations for subsequent analysis after conducting one or a few separations to bring the column to a reproducible starting temperature. A liquid chromatography instrument equipped with a pressure controller was used to perform constant pressure and constant flow rate VHPLC separations. Six replicate gradient separations of a nine component mixture consisting of acetophenone, propiophenone, butyrophenone, valerophenone, hexanophenone, heptanophenone, octanophenone, benzophenone, and acetanilide dissolved in water/acetonitrile (65:35, v/v) were performed under various experimental conditions: constant flow rate, two sets of constant pressure, and constant pressure operation with a programmed flow rate. The relative standard deviations of the response factors for all the analytes are lower than 5% across the methods. Programming the flow rate to maintain a fairly constant pressure instead of using instrument controlled constant pressure improves the reproducibility of the retention times by a factor of 5, when plotting the chromatograms in time. Copyright © 2013 Elsevier B.V. All rights reserved.

Pharmacologic Conversion during Dofetilide Treatment for Persistent Atrial Fibrillation.

PubMed

Steinberg, Jonathan S; Shah, Yash; Szepietowska, Barbara

2017-06-01

Dofetilide is a pure I Kr blocker and is one of the few drugs specifically studied and approved in the United States for the management of persistent atrial fibrillation (AF). Dofetilide has been noted to have a high rate of pharmacologic conversion during initial dosing in prior smaller studies. The intent of the study was to examine the safety of an inpatient loading strategy, and the incidence and patterns of pharmacologic conversion by dofetilide during the treatment of persistent AF in a large consecutive cohort. This is a retrospective analysis of 308 consecutive patients with persistent AF electively admitted for inpatient dofetilide loading. The initiation dose of dofetilide was determined by the creatinine clearance. Overall, 88% (n = 271) successfully completed initiation of dofetilide and were discharged in sinus rhythm. The most common reason for failure to complete initiation of dofetilide loading was QTc prolongation in 24 patients (7.8%), and torsade de pointes occurred in three patients (1%). Pharmacologic conversion was observed in 56% (n = 151) after a median of two doses. The rate of pharmacologic conversion based on the final dose was 75%, 9%, and 0% for 500 mcg, 250 mcg, and 125 mcg, respectively (P < 0.05). Dofetilide is a well-tolerated antiarrhythmic drug with a low incidence of proarrhythmia and an especially high rate of pharmacologic conversion in patients with persistent AF. © 2017 Wiley Periodicals, Inc.

Refinement and initial validation of a multidimensional composite scale for use in assessing acute postoperative pain in cats.

PubMed

Brondani, Juliana Tabarelli; Luna, Stelio Pacca Loureiro; Padovani, Carlos Roberto

2011-02-01

To refine and test construct validity and reliability of a composite pain scale for use in assessing acute postoperative pain in cats undergoing ovariohysterectomy. 40 cats that underwent ovariohysterectomy in a previous study. In a previous randomized, double-blind, placebo-controlled study, a composite pain scale was developed to assess postoperative pain in cats that received a placebo or an analgesic (tramadol, vedaprofen, or tramadol-vedaprofen combination). In the present study, the scale was refined via item analysis (distribution frequency and occurrence), a nonparametric ANOVA, and item-to-total score correlation. Construct validity was assessed via factor analysis and known-groups discrimination, and reliability was measured by assessing internal consistency. Respiratory rate and respiratory pattern were rejected after item analysis. Factor analysis resulted in 5 dimensions (F1 [psychomotor change], posture, comfort, activity, mental status, and miscellaneous behaviors; F2 [protection of wound area], reaction to palpation of the surgical wound and palpation of the abdomen and flank; F3 [physiologic variables], systolic arterial blood pressure and appetite; F4 [vocal expression of pain], vocalization; and F5 [heart rate]). Internal consistency was excellent for the overall scale and for F1, F2, and F3; very good for F4; and unacceptable for F5. Except for heart rate, the identified factors and scale total score could be used to detect differences between the analgesic and placebo groups and differences among the analgesic treatments. Results provided initial evidence of construct validity and reliability of a multidimensional composite tool for use in assessing acute postoperative pain in cats undergoing ovariohysterectomy.

Main Clinical Outcomes of Feldspathic Porcelain and Glass-Ceramic Laminate Veneers: A Systematic Review and Meta-Analysis of Survival and Complication Rates.

PubMed

Morimoto, Susana; Albanesi, Rafael Borges; Sesma, Newton; Agra, Carlos Martins; Braga, Mariana Minatel

2016-01-01

The aim of this study was to perform a systematic review and meta-analysis based on clinical trials that evaluated the main outcomes of glass-ceramic and feldspathic porcelain laminate veneers. A systematic search was carried out in Cochrane and PubMed databases. From the selected studies, the survival rates for porcelain and glass-ceramic veneers were extracted, as were complication rates of clinical outcomes: debonding, fracture/chipping, secondary caries, endodontic problems, severe marginal discoloration, and influence of incisal coverage and enamel/dentin preparation. The Cochran Q test and the I(2) statistic were used to evaluate heterogeneity. Out of the 899 articles initially identified, 13 were included for analysis. Metaregression analysis showed that the types of ceramics and follow-up periods had no influence on failure rate. The estimated overall cumulative survival rate was 89% (95% CI: 84% to 94%) in a median follow-up period of 9 years. The estimated survival for glass-ceramic was 94% (95% CI: 87% to 100%), and for feldspathic porcelain veneers, 87% (95% CI: 82% to 93%). The meta-analysis showed rates for the following events: debonding: 2% (95% CI: 1% to 4%); fracture/chipping: 4% (95% CI: 3% to 6%); secondary caries: 1% (95% CI: 0% to 3%); severe marginal discoloration: 2% (95% CI: 1% to 10%); endodontic problems: 2% (95% CI: 1% to 3%); and incisal coverage odds ratio: 1.25 (95% CI: 0.33 to 4.73). It was not possible to perform meta-analysis of the influence of enamel/dentin preparation on failure rates. Glass-ceramic and porcelain laminate veneers have high survival rates. Fracture/ chipping was the most frequent complication, providing evidence that ceramic veneers are a safe treatment option that preserve tooth structure.

Dynamic evolutionary change in post-Paleozoic echinoids and the importance of scale when interpreting changes in rates of evolution

PubMed Central

Hopkins, Melanie J.; Smith, Andrew B.

2015-01-01

How ecological and morphological diversity accrues over geological time has been much debated by paleobiologists. Evidence from the fossil record suggests that many clades reach maximal diversity early in their evolutionary history, followed by a decline in evolutionary rates as ecological space fills or due to internal constraints. Here, we apply recently developed methods for estimating rates of morphological evolution during the post-Paleozoic history of a major invertebrate clade, the Echinoidea. Contrary to expectation, rates of evolution were lowest during the initial phase of diversification following the Permo-Triassic mass extinction and increased over time. Furthermore, although several subclades show high initial rates and net decreases in rates of evolution, consistent with “early bursts” of morphological diversification, at more inclusive taxonomic levels, these bursts appear as episodic peaks. Peak rates coincided with major shifts in ecological morphology, primarily associated with innovations in feeding strategies. Despite having similar numbers of species in today’s oceans, regular echinoids have accrued far less morphological diversity than irregular echinoids due to lower intrinsic rates of morphological evolution and less morphological innovation, the latter indicative of constrained or bounded evolution. These results indicate that rates of evolution are extremely heterogenous through time and their interpretation depends on the temporal and taxonomic scale of analysis. PMID:25713369

Association between adherence to an antimicrobial stewardship program and mortality among hospitalised cancer patients with febrile neutropaenia: a prospective cohort study

PubMed Central

2014-01-01

Background Initial management of chemotherapy-induced febrile neutropaenia (FN) comprises empirical therapy with a broad-spectrum antimicrobial. Currently, there is sufficient evidence to indicate which antibiotic regimen should be administered initially. However, no randomized trial has evaluated whether adherence to an antimicrobial stewardship program (ASP) results in lower rates of mortality in this setting. The present study sought to assess the association between adherence to an ASP and mortality among hospitalised cancer patients with FN. Methods We conducted a prospective cohort study in a single tertiary hospital from October 2009 to August 2011. All adult patients who were admitted to the haematology ward with cancer and FN were followed up for 28 days. ASP adherence to the initial antimicrobial prescription was determined. The mortality rates of patients who were treated with antibiotics according to the ASP protocol were compared with those of patients treated with other antibiotic regimens. The multivariate Cox proportional hazards model and propensity score were used to estimate 28-day mortality risk. Results A total of 307 FN episodes in 169 subjects were evaluated. The rate of adherence to the ASP was 53%. In a Cox regression analysis, adjusted for propensity scores and other potential confounding factors, ASP adherence was independently associated with lower mortality (hazard ratio, 0.36; 95% confidence interval, 0.14–0.92). Conclusions Antimicrobial selection is important for the initial management of patients with FN, and adherence to the ASP, which calls for the rational use of antibiotics, was associated with lower mortality rates in this setting. PMID:24884397

Association between adherence to an antimicrobial stewardship program and mortality among hospitalised cancer patients with febrile neutropaenia: a prospective cohort study.

PubMed

Rosa, Regis G; Goldani, Luciano Z; dos Santos, Rodrigo P

2014-05-23

Initial management of chemotherapy-induced febrile neutropaenia (FN) comprises empirical therapy with a broad-spectrum antimicrobial. Currently, there is sufficient evidence to indicate which antibiotic regimen should be administered initially. However, no randomized trial has evaluated whether adherence to an antimicrobial stewardship program (ASP) results in lower rates of mortality in this setting. The present study sought to assess the association between adherence to an ASP and mortality among hospitalised cancer patients with FN. We conducted a prospective cohort study in a single tertiary hospital from October 2009 to August 2011. All adult patients who were admitted to the haematology ward with cancer and FN were followed up for 28 days. ASP adherence to the initial antimicrobial prescription was determined. The mortality rates of patients who were treated with antibiotics according to the ASP protocol were compared with those of patients treated with other antibiotic regimens. The multivariate Cox proportional hazards model and propensity score were used to estimate 28-day mortality risk. A total of 307 FN episodes in 169 subjects were evaluated. The rate of adherence to the ASP was 53%. In a Cox regression analysis, adjusted for propensity scores and other potential confounding factors, ASP adherence was independently associated with lower mortality (hazard ratio, 0.36; 95% confidence interval, 0.14-0.92). Antimicrobial selection is important for the initial management of patients with FN, and adherence to the ASP, which calls for the rational use of antibiotics, was associated with lower mortality rates in this setting.

Establishment of the TREECS Platform: A Survey of Existing Tools, Portals, and Frameworks

DTIC Science & Technology

2009-12-01

advanced analysis tiers may require the user to download analysis components that will need to be run on his/her system. TREECS initially focuses on...location, water, economy, quality of life , and infrastructure (Jenicek and Goran 2005). Potential indicators for measuring regional resources within...County Quality of Life Sustainability QL1 Crime rate National Archive of Criminal Justice Data (NACJD) County QL2 Housing availability US Census

Variation in outpatient consultant physician fees in Australia by specialty and state and territory.

PubMed

Freed, Gary L; Allen, Amy R

2017-03-06

To determine the mean, median and 10th and 90th percentile levels of fees and out-of-pocket costs to the patient for an initial consultation with a consultant physician; to determine any differences in fees and bulk-billing rates between specialties and between states and territories. Analysis of 2015 Medicare claims data for an initial outpatient appointment with a consultant physician (Item 110) in 11 medical specialties representative of common adult non-surgical medical care (cardiology, endocrinology, gastroenterology, geriatric medicine, haematology, immunology/allergy, medical oncology, nephrology, neurology, respiratory medicine and rheumatology). Mean, median, 10th and 90th percentile levels for consultant physician fees and out-of-pocket costs, by medical specialty and state or territory; bulk-billing rate, by medical specialty and state/territory. Bulk-billing rates varied between specialties, with only haematology and medical oncology bulk-billing more than half of initial consultations. Bulk-billing rates also varied between states and territories, with rates in the Northern Territory (76%) nearly double those elsewhere. Most private consultations require a significant out-of-pocket payment by the patient, and these payments varied more than fivefold in some specialties. Without data on quality of care in private outpatient services, the rationale for the marked variations in fees within specialties is unknown. As insurers are prohibited from providing cover for the costs of outpatient care, the impact of out-of-pocket payments on access to private specialist care is unknown.

A meta-analysis of metronidazole and vancomycin for the treatment of Clostridium difficile infection, stratified by disease severity.

PubMed

Di, Xiuzhen; Bai, Nan; Zhang, Xin; Liu, Bin; Ni, Wentao; Wang, Jin; Wang, Kai; Liang, Beibei; Liu, Youning; Wang, Rui

2015-01-01

The aim of this meta-analysis was to compare the efficacy of metronidazole and vancomycin for the treatment of Clostridium difficile infection, especially to investigate which agent was superior for treating either mild or severe C. difficile infection. A meta-analysis of randomized controlled trials and cohort studies identified in Pubmed, Embase, and the Cochrane Library was conducted. Four randomized controlled trials and two cohort studies involving 1218 patients were included in this meta-analysis. Metronidazole was inferior to vancomycin for treating C. difficile infection in terms of both initial clinical cure rates (risk ratio, RR=0.91, 95% confidence interval, CI=0.84-0.98, p=0.02) and sustained cure rates (RR=0.88, 95% CI=0.82-0.96, p=0.003). For mild C. difficile infection, the efficacy of metronidazole and vancomycin resulted in similar clinical cure rates (RR=0.94, 95% CI=0.84-1.04, p=0.21) and sustained cure rates (RR=0.93, 95% CI=0.83-1.05, p=0.26). For severe C. difficile infection the efficacy of vancomycin was superior to metronidazole in terms of clinical cure rates (RR=0.81, 95% CI=0.69-0.95, p=0.009), whereas sustained cure rates were similar (RR=0.86, 95% CI=0.72-1.02, p=0.08). Regarding microbiological cure metronidazole therapy was as effective as vancomycin therapy (RR=0.88, 95% CI=0.64-1.21, p=0.43). Recurrence rates with metronidazole and vancomycin for both mild C. difficile infection (RR=0.95, 95% CI=0.56-1.60, p=0.85) and severe C. difficile infection (RR=1.27, 95% CI=0.85-1.91, p=0.25) were not different. Likewise, no difference in all-cause mortality was found as well (RR=0.87, 95% CI=0.56-1.35, p=0.53). In conclusion, vancomycin provides improved initial clinical and sustained cure rates in patients with C. difficile infection compared with metronidazole, especially in patients with severe C. difficile infection. In view of these data, vancomycin may be considered first line therapy for severe C. difficile infection. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

Comparative dynamic analysis of the full Grossman model.

PubMed

Ried, W

1998-08-01

The paper applies the method of comparative dynamic analysis to the full Grossman model. For a particular class of solutions, it derives the equations implicitly defining the complete trajectories of the endogenous variables. Relying on the concept of Frisch decision functions, the impact of any parametric change on an endogenous variable can be decomposed into a direct and an indirect effect. The focus of the paper is on marginal changes in the rate of health capital depreciation. It also analyses the impact of either initial financial wealth or the initial stock of health capital. While the direction of most effects remains ambiguous in the full model, the assumption of a zero consumption benefit of health is sufficient to obtain a definite for any direct or indirect effect.

Initial surgery for benign primary hyperparathyroidism: an analysis of 1,300 patients in a teaching hospital.

PubMed

Karakas, Elias; Schneider, Ralph; Rothmund, Matthias; Bartsch, Detlef K; Schlosser, Katja

2014-08-01

Success rates of initial surgery for primary hyperparathyroidism (pHPT) are greater than 95 % in specialized centers, mostly referring to single-surgeon experiences. The present study was performed to identify changes in clinical manifestations, diagnostic procedures, surgical strategies, and outcome of initial parathyroid interventions in a teaching hospital during the past 25 years with special regard to the surgical expertise. Clinical data of patients who underwent an initial neck exploration for benign pHPT between 1985 and 2010 at the University hospital Marburg were retrospectively evaluated. All data were analyzed particularly with regard to the implementation of additional pre- and intraoperative procedures and to the particular surgical strategy. In addition, operative results were furthermore analyzed with regard to the experience of the responsible surgeons. An initial neck exploration for benign pHPT was performed in 1,300 patients. Of these, 1,035 patients had a bilateral cervical exploration (BCE) and 265 patients had a focused, minimally invasive parathyroidectomy (MIP). Cure rates did not differ between focused surgeries and BCE (98.9 vs. 98.3%, p = 0.596) after a mean follow-up of 33.4 (± 44.3) months. Postoperative transient hypoparathyroidism was significantly lower in the MIP group (11 vs. 47%, p < 0.0001). The rate of permanent recurrent laryngeal nerve palsies (0.4 vs. 2%, p = 0.064) and nonsurgical complications (0 vs. 1.4%, p = 0.0875) tended to be lower in the MIP group. Success and complication rates of chief surgeons (n = 2), attending surgeons (n = 20), and residents (56 < 3 years, 30 > 3 years) were similar, despite a significantly shorter operating time in the chief surgeon group (p < 0.01). Despite the implementation of several diagnostic procedures and significant changes concerning the surgical strategy, high success rates of primary interventions for pHPT did not change over the past three decades. High success rates also can be achieved in a teaching hospital, provided that surgery is supervised by an experienced endocrine surgeon. MIP is the treatment of choice in patients with benign sporadic pHPT and positive preoperative localization studies.

Soiling of building envelope surfaces and its effect on solar reflectance. Part I: Analysis of roofing product databases

DOE PAGES

Sleiman, Mohamad; Ban-Weiss, George; Gilbert, Haley E.; ...

2011-12-01

The use of highly reflective “cool” roofing materials can decrease demand for air conditioning, mitigate the urban heat island effect, and potentially slow global warming. However, initially high roof solar reflectance can be degraded by natural soiling and weathering processes. We evaluated solar reflectance losses after three years of natural exposure reported in two separate databases: the Rated Products Directory of the US Cool Roof Rating Council (CRRC) and information reported by manufacturers to the US Environmental Protection Agency (EPA)’s ENERGY STAR® rating program. Many product ratings were culled because they were duplicative (within a database) or not measured. Amore » second, site-resolved version of the CRRC dataset was created by transcribing from paper records the site-specific measurements of aged solar reflectance in Florida, Arizona and Ohio. Products with high initial solar reflectance tended to lose reflectance, while those with very low initial solar reflectance tended to become more reflective as they aged. Within the site-resolved CRRC database, absolute solar reflectance losses for samples of medium-to-high initial solar reflectance were 2 - 3 times greater in Florida (hot and humid) than in Arizona (hot and dry); losses in Ohio (temperate but polluted) were intermediate. Disaggregating results by product type, factory-applied coating, field-applied coating, metal, modified bitumen, shingle, singleply membrane and tile, revealed that absolute solar reflectance losses were largest for fieldapplied coating, modified bitumen and single-ply membrane products, and smallest for factoryapplied coating and metal products.The 2008 Title 24 provisional aged solar reflectance formula overpredicts the measured aged solar reflectance of 0% to 30% of each product type in the culled public CRRC database. The rate of overprediction was greatest for field-applied coating and single-ply membrane products and least for factory-applied coating, shingle, and metal products. New product-specific formulas can be used to estimate provisional aged solar reflectance from initial solar reflectance pending measurement of aged solar reflectance. The appropriate value of soiling resistance varies by product type and is selected to attain some desired overprediction rate for the formula. The correlations for shingle products presented in this paper should not be used to predict aged solar reflectance or estimate provisional aged solar reflectance because the data set is too small and too limited in range of initial solar reflectance.« less

Boiling water jet outflow from a thin nozzle: spatial modeling

NASA Astrophysics Data System (ADS)

Bolotnova, R. Kh.; Korobchinskaya, V. A.

2017-09-01

This study presents dual-temperature two-phase model for liquid-vapor mixture with account for evaporation and inter-phase heat transfer (taken in single-velocity single-pressure approximation). Simulation was performed using the shock-capturing method and moving Lagrangian grids. Analysis was performed for simulated and experimental values of nucleation frequency (for refining the initial number and radius of microbubbles) which affect the evaporation rate. Validity of 2D and 1D simulation was examined through comparison with experimental data. The peculiarities of the water-steam formation at the initial stage of outflow through a thin nozzle were studied for different initial equilibrium states of water for the conditions close to chosen experimental conditions.

Improving substance abuse screening and intervention in a primary care clinic.

PubMed

Neushotz, Lori A; Fitzpatrick, Joyce J

2008-04-01

Despite recent efforts to educate primary care providers in the identification and management of patients presenting with substance abuse problems, many opportunities to identify and intervene with these patients are overlooked. This project was designed to identify factors that interfere with rates of screening and brief intervention (SBI) of substance abuse problems in a primary care clinic in a major academic medical center in New York City. Six informants representing the disciplines of medicine, nursing, and social work in the primary care clinic provided information regarding SBI. Analysis was focused on substantiation of the need for enhanced diffusion of knowledge related to screening for substance abuse problems to improve rates of SBI in primary care. Recommendations for improvement included continued promotion of SBI by influential role models and opinion leaders, improvement in primary care providers' perceptions of the perceived characteristics of SBI to improve rates of adoption, implementation of interdisciplinary educational initiatives toward the goal of improving rates of SBI in the primary care clinic, and initiation of translational research at the clinic supporting SBI in primary care.

Growth trajectories of mathematics achievement: Longitudinal tracking of student academic progress.

PubMed

Mok, Magdalena M C; McInerney, Dennis M; Zhu, Jinxin; Or, Anthony

2015-06-01

A number of methods to investigate growth have been reported in the literature, including hierarchical linear modelling (HLM), latent growth modelling (LGM), and multidimensional scaling applied to longitudinal profile analysis (LPAMS). This study aimed at modelling the mathematics growth of students over a span of 6 years from Grade 3 to Grade 9. The sample comprised secondary longitudinal data collected in three waves from n = 866 Hong Kong students when they were in Grade 3, Grade 6, and Grade 9. Mathematics achievement was measured thrice on a vertical scale linked with anchor items. Linear and nonlinear latent growth models were used to assess students' growth. Gender differences were also examined. A nonlinear latent growth curve with a decelerated rate had a good fit to the data. Initial achievement and growth rate were negatively correlated. No gender difference was found. Mathematics growth from Grade 6 to Grade 9 was slower than that from Grade 3 to Grade 6. Students with lower initial achievement improved at a faster rate than those who started at a higher level. Gender did not affect growth rate. © 2014 The British Psychological Society.

Role of HIV Infection Duration and CD4 Cell Level at Initiation of Combination Anti-Retroviral Therapy on Risk of Failure

PubMed Central

Lodi, Sara; Phillips, Andrew; Fidler, Sarah; Hawkins, David; Gilson, Richard; McLean, Ken; Fisher, Martin; Post, Frank; Johnson, Anne M.; Walker-Nthenda, Louise; Dunn, David; Porter, Kholoud

2013-01-01

Background The development of HIV drug resistance and subsequent virological failure are often cited as potential disadvantages of early cART initiation. However, their long-term probability is not known, and neither is the role of duration of infection at the time of initiation. Methods Patients enrolled in the UK Register of HIV seroconverters were followed-up from cART initiation to last HIV-RNA measurement. Through survival analysis we examined predictors of virologic failure (2HIV-RNA ≥400 c/l while on cART) including CD4 count and HIV duration at initiation. We also estimated the cumulative probabilities of failure and drug resistance (from the available HIV nucleotide sequences) for early initiators (cART within 12 months of seroconversion). Results Of 1075 starting cART at a median (IQR) CD4 count 272 (190,370) cells/mm3 and HIV duration 3 (1,6) years, virological failure occurred in 163 (15%). Higher CD4 count at initiation, but not HIV infection duration at cART initiation, was independently associated with lower risk of failure (p=0.033 and 0.592 respectively). Among 230 patients initiating cART early, 97 (42%) discontinued it after a median of 7 months; cumulative probabilities of resistance and failure by 8 years were 7% (95% CI 4,11) and 19% (13,25), respectively. Conclusion Although the rate of discontinuation of early cART in our cohort was high, the long-term rate of virological failure was low. Our data do not support early cART initiation being associated with increased risk of failure and drug resistance. PMID:24086588

Final Environmental Assessment Nellis Air Force Base School Initiative, Nellis Air Force Base, Clark County, Nevada

DTIC Science & Technology

2015-04-01

Analysis [BEA] 2012). The relatively high unemployment rate, as well as the predominance of the Accommodation and Food Services industry, a sector that...I for future mission-specific development. The intent is to lease base property to a private sector charter school company to design and construct...allow Nellis AFB to lease bas~ property to a private sector charter school company to develop, construct, and op~rate a new charter school centrally

National Readmission Patterns of Isolated Splenic Injuries Based on Initial Management Strategy.

PubMed

Rosenberg, Graeme M; Knowlton, Lisa; Rajasingh, Charlotte; Weng, Yingjie; Maggio, Paul M; Spain, David A; Staudenmayer, Kristan L

2017-12-01

Options for managing splenic injuries have evolved with a focus on nonoperative management. Long-term outcomes, such as readmissions and delayed splenectomy rate, are not well understood. To describe the natural history of isolated splenic injuries in the United States and determine whether patterns of readmission were influenced by management strategy. The Healthcare Cost and Utilization Project's Nationwide Readmission Database is an all-payer, all-ages, longitudinal administrative database that provides data on more than 35 million weighted US discharges yearly. The database was used to identify patients with isolated splenic injuries and the procedures that they received. Adult patients with isolated splenic injuries admitted from January 1 through June 30, 2013, and from January 1 through June 30, 2014, were included. Those who died during the index hospitalization or who had an additional nonsplenic injury with an Abbreviated Injury Score of 2 or greater were excluded. Univariate and mixed-effects logistic regression analysis controlling for center effect were used. Weighted numbers are reported. Initial management strategy at the time of index hospitalization, including nonprocedural management, angioembolization, and splenectomy. All-cause 6-month readmission rate. Secondary outcome was delayed splenectomy rate. A weighted sample of 3792 patients (2146 men [56.6%] and 1646 women [43.4%]; mean [SE] age, 48.5 [0.7] years) with 5155 admission events was included. During the index hospitalization, 825 (21.8%) underwent splenectomy, 293 (7.7%) underwent angioembolization, and 2673 (70.5%) had no procedure. The overall readmission rate was 21.1% (799 patients). Readmission rates did not differ based on initial management strategy (195 patients undergoing splenectomy [23.6%], 70 undergoing angioembolism [23.9%], and 534 undergoing no procedure [20%]; P = .33). Splenectomy was performed in 36 of 799 readmitted patients (4.5%) who did not have a splenectomy at their index hospitalization, leading to an overall delayed splenectomy rate of 1.2% (36 of 2967 patients). In mixed-effects logistic regression analysis controlling for patient, injury, clinical, and hospital characteristics, the choice of splenectomy (odds ratio, 0.93; 95% CI, 0.66-1.31) vs angioembolization (odds ratio, 1.19; 95% CI, 0.72-1.97) as initial management strategy was not associated with readmission. This national evaluation of the natural history of isolated splenic injuries from index admission through 6 months found that approximately 1 in 5 patients are readmitted within 6 months of discharge after an isolated splenic injury. However, the chance of readmission for splenectomy after initial nonoperative management was 1.2%. This finding suggests that the current management strategies used for isolated splenic injuries in the United States are well matched to patient need.

Role of glycogen availability in sarcoplasmic reticulum Ca2+ kinetics in human skeletal muscle

PubMed Central

Ørtenblad, Niels; Nielsen, Joachim; Saltin, Bengt; Holmberg, Hans-Christer

2011-01-01

Little is known about the precise mechanism that relates skeletal muscle glycogen to muscle fatigue. The aim of the present study was to examine the effect of glycogen on sarcoplasmic reticulum (SR) function in the arm and leg muscles of elite cross-country skiers (n= 10, 72 ± 2 ml kg−1 min−1) before, immediately after, and 4 h and 22 h after a fatiguing 1 h ski race. During the first 4 h recovery, skiers received either water or carbohydrate (CHO) and thereafter all received CHO-enriched food. Immediately after the race, arm glycogen was reduced to 31 ± 4% and SR Ca2+ release rate decreased to 85 ± 2% of initial levels. Glycogen noticeably recovered after 4 h recovery with CHO (59 ± 5% initial) and the SR Ca2+ release rate returned to pre-exercise levels. However, in the absence of CHO during the first 4 h recovery, glycogen and the SR Ca2+ release rate remained unchanged (29 ± 2% and 77 ± 8%, respectively), with both parameters becoming normal after the remaining 18 h recovery with CHO. Leg muscle glycogen decreased to a lesser extent (71 ± 10% initial), with no effects on the SR Ca2+ release rate. Interestingly, transmission electron microscopy (TEM) analysis revealed that the specific pool of intramyofibrillar glycogen, representing 10–15% of total glycogen, was highly significantly correlated with the SR Ca2+ release rate. These observations strongly indicate that low glycogen and especially intramyofibrillar glycogen, as suggested by TEM, modulate the SR Ca2+ release rate in highly trained subjects. Thus, low glycogen during exercise may contribute to fatigue by causing a decreased SR Ca2+ release rate. PMID:21135051

An Excel tool for deriving key photosynthetic parameters from combined gas exchange and chlorophyll fluorescence: theory and practice.

PubMed

Bellasio, Chandra; Beerling, David J; Griffiths, Howard

2016-06-01

Combined photosynthetic gas exchange and modulated fluorometres are widely used to evaluate physiological characteristics associated with phenotypic and genotypic variation, whether in response to genetic manipulation or resource limitation in natural vegetation or crops. After describing relatively simple experimental procedures, we present the theoretical background to the derivation of photosynthetic parameters, and provide a freely available Excel-based fitting tool (EFT) that will be of use to specialists and non-specialists alike. We use data acquired in concurrent variable fluorescence-gas exchange experiments, where A/Ci and light-response curves have been measured under ambient and low oxygen. From these data, the EFT derives light respiration, initial PSII (photosystem II) photochemical yield, initial quantum yield for CO2 fixation, fraction of incident light harvested by PSII, initial quantum yield for electron transport, electron transport rate, rate of photorespiration, stomatal limitation, Rubisco (ribulose 1·5-bisphosphate carboxylase/oxygenase) rate of carboxylation and oxygenation, Rubisco specificity factor, mesophyll conductance to CO2 diffusion, light and CO2 compensation point, Rubisco apparent Michaelis-Menten constant, and Rubisco CO2 -saturated carboxylation rate. As an example, a complete analysis of gas exchange data on tobacco plants is provided. We also discuss potential measurement problems and pitfalls, and suggest how such empirical data could subsequently be used to parameterize predictive photosynthetic models. © 2015 John Wiley & Sons Ltd.

Evaluation of Traditional and Contemporary Methods for Detecting Syphacia obvelata and Aspiculuris tetraptera in Laboratory Mice

PubMed Central

Gerwin, Philip M; Arbona, Rodolfo J Ricart; Riedel, Elyn R; Lepherd, Michelle L; Henderson, Ken S; Lipman, Neil S

2017-01-01

There is no consensus regarding the best practice for detecting murine pinworm infections. Initially, we evaluated 7 fecal concentration methods by using feces containing Aspiculuris tetraptera (AT) eggs (n = 20 samples per method). Sodium nitrate flotation, sodium nitrate centrifugation, Sheather sugar centrifugation, and zinc sulfate centrifugation detected eggs in 100% of samples; zinc sulfate flotation and water sedimentation detected eggs in 90%. All had better detection rates than Sheather sugar flotation (50%). To determine optimal detection methods, Swiss Webster mice were exposed to Syphacia obvelata (SO; n = 60) or AT (n = 60). We compared the following methods at days 0, 30, and 90, beginning 21 or 28 d after SO and AT exposure, respectively: fecal concentration (AT only), anal tape test (SO only), direct examination of intestinal contents (cecum and colon), Swiss roll histology (cecum and colon), and PCR analysis (pooled fur swab and feces). Detection rates for SO-exposed mice were: PCR analysis, 45%; Swiss roll histology, 30%; intestinal content exam, 27%; and tape test, 27%. The SO detection rate for PCR analysis was significantly greater than that for the tape test. Detection rates for AT-exposed mice were: intestinal content exam, 53%; PCR analysis, 33%; fecal flotation, 22%; and Swiss roll histology, 17%. The AT detection rate of PCR analysis combined with intestinal content examination was greater than for PCR analysis only and the AT detection rate of intestinal content examination was greater than for Swiss roll histology. Combining PCR analysis with intestinal content examination detected 100% of infected animals. No single test detected all positive animals. We recommend combining PCR analysis with intestinal content examination for optimal pinworm detection. PMID:28905712

Canadian experience with the pipeline embolization device for repair of unruptured intracranial aneurysms.

PubMed

O'Kelly, C J; Spears, J; Chow, M; Wong, J; Boulton, M; Weill, A; Willinsky, R A; Kelly, M; Marotta, T R

2013-02-01

Flow-diverting stents, such as the PED, have emerged as a novel means of treating complex intracranial aneurysms. This retrospective analysis of the initial Canadian experience provides insight into technical challenges, clinical and radiographic outcomes, and complication rates after the use of flow-diverting stents for unruptured aneurysms. Cases were compiled from 7 Canadian centers between July 2008 and December 2010. Each center prospectively tracked their initial experience; these data were retrospectively updated and pooled for analysis. During the defined study period, 97 cases of unruptured aneurysm were treated with the PED, with successful stent deployment in 94 cases. The overall complete or near-complete occlusion rate was 83%, with a median follow-up at 1.25 years (range 0.25-2.5 years). Progressive occlusion was witnessed over time, with complete or near-complete occlusion in 65% of aneurysms followed through 6 months, and 90% of aneurysms followed through 1 year. Multivariate analysis found previous aneurysm treatment and female sex predictive of persistent aneurysm filling. Most patients were stable or improved (88%), with the most favorable outcomes observed in patients with cavernous carotid aneurysms. The overall mortality rate was 6%. Postprocedural aneurysm hemorrhage occurred in 3 patients (3%), while ipsilateral distal territory hemorrhage was observed in 4 patients (3.4%). Flow-diverting stents represent an important tool in the treatment of complex intracranial aneurysms. The relative efficacy and morbidity of this treatment must be considered in the context of available alternate interventions.

Continuum mechanics analysis of fracture progression in the vitrified cryoprotective agent DP6

PubMed Central

Steif, Paul S.; Palastro, Matthew C.; Rabin, Yoed

2008-01-01

As part of an ongoing effort to study the continuum mechanics effects associated with cryopreservation, the current report focuses on the prediction of fracture formation in cryoprotective agents. Fractures had been previously observed in 1 mℓ samples of the cryoprotective agent cocktail DP6, contained in a standard 15 mℓ glass vial, and subjected to various cooling rates. These experimental observations were obtained by means of a cryomacroscope, which has been recently presented by the current research team. High and low cooling rates were found to produce very distinct patterns of cracking. The current study seeks to explain the observed patterns on the basis of stresses predicted from finite element analysis, which relies on a simple viscoelastic constitutive model and on estimates of the critical stress for cracking. The current study demonstrates that the stress which results in instantaneous fracture at low cooling rates is consistent with the stress to initiate fracture at high cooling rate. This consistency supports the credibility of the proposed constitutive model and analysis, and the unified criterion for fracturing, that is, a critical stress threshold. PMID:18412493

Initiation reactions in acetylene pyrolysis

DOE PAGES

Zador, Judit; Fellows, Madison D.; Miller, James A.

2017-05-10

In gas-phase combustion systems the interest in acetylene stems largely from its role in molecular weight growth processes. The consensus is that above 1500 K acetylene pyrolysis starts mainly with the homolytic fission of the C–H bond creating an ethynyl radical and an H atom. However, below ~1500 K this reaction is too slow to initiate the chain reaction. It has been hypothesized that instead of dissociation, self-reaction initiates this process. Nevertheless, rigorous theoretical or direct experimental evidence is lacking, to an extent that even the molecular mechanism is debated in the literature. In this work we use rigorous abmore » initio transition-state theory master equation methods to calculate pressure- and temperature-dependent rate coefficients for the association of two acetylene molecules and related reactions. We establish the role of vinylidene, the high-energy isomer of acetylene in this process, compare our results with available experimental data, and assess the competition between the first-order and second-order initiation steps. As a result, we also show the effect of the rapid isomerization among the participating wells and highlight the need for time-scale analysis when phenomenological rate coefficients are compared to observed time scales in certain experiments.« less

Electrical treeing behaviors in silicone rubber under an impulse voltage considering high temperature

NASA Astrophysics Data System (ADS)

Yunxiao, ZHANG; Yuanxiang, ZHOU; Ling, ZHANG; Zhen, LIN; Jie, LIU; Zhongliu, ZHOU

2018-05-01

In this paper, work was conducted to reveal electrical tree behaviors (initiation and propagation) of silicone rubber (SIR) under an impulse voltage with high temperature. Impulse frequencies ranging from 10 Hz to 1 kHz were applied and the temperature was controlled between 30 °C and 90 °C. Experimental results show that tree initiation voltage decreases with increasing pulse frequency, and the descending amplitude is different in different frequency bands. As the pulse frequency increases, more frequent partial discharges occur in the channel, increasing the tree growth rate and the final shape intensity. As for temperature, the initiation voltage decreases and the tree shape becomes denser as the temperature gets higher. Based on differential scanning calorimetry results, we believe that partial segment relaxation of SIR at high temperature leads to a decrease in the initiation voltage. However, the tree growth rate decreases with increasing temperature. Carbonization deposition in the channel under high temperature was observed under microscope and proven by Raman analysis. Different tree growth models considering tree channel characteristics are proposed. It is believed that increasing the conductivity in the tree channel restrains the partial discharge, holding back the tree growth at high temperature.

Initiation and propagation of mixed mode fractures in granite and sandstone

NASA Astrophysics Data System (ADS)

Rück, Marc; Rahner, Roman; Sone, Hiroki; Dresen, Georg

2017-10-01

We investigate mixed mode fracture initiation and propagation in experimentally deformed granite and sandstone. We performed a series of asymmetric loading tests to induce fractures in cylindrical specimens at confining pressures up to 20 MPa. Loading was controlled using acoustic emission (AE) feedback control, which allows studying quasi-static fracture propagation for several hours. Location of acoustic emissions reveals distinct differences in spatial-temporal fracture evolution between granite and sandstone samples. Before reaching peak stress in experiments performed on granite, axial fractures initiate first at the edge of the indenter and then propagate through the entire sample. Secondary inclined fractures develop during softening of the sample. In sandstone, inclined shear fractures nucleate at peak stress and propagate through the specimen. AE source type analysis shows complex fracturing in both materials with pore collapse contributing significantly to fracture growth in sandstone samples. We compare the experimental results with numerical models to analyze stress distribution and energy release rate per unit crack surface area in the samples at different stages during fracture growth. We thereby show that for both rock types the energy release rate increases approximately linearly during fracture propagation. The study illuminates how different material properties modify fracture initiation direction under similar loading conditions.

Breast-feeding initiation and exclusive breast-feeding in rural Vietnam.

PubMed

Duong, Dat V; Binns, Colin W; Lee, Andy H

2004-09-01

To investigate the initiation of breast-feeding and exclusive breast-feeding within the first week after delivery for women in rural Vietnam. An interviewer-administered survey was conducted on a sample of rural women who gave birth during August-October 2002. Quang Xuong District, Thanh Hoa Province of Vietnam. Four hundred and sixty-three women participated in the study, of whom 181 delivered at the district hospital (39.1%), 229 at a commune health centre (49.5%) and 53 at home attended by a traditional birth attendant (11.4%). Although the initiation and exclusive breast-feeding rates were relatively high at 98.3% and 83.6% respectively, the premature introduction of complementary food was a great concern. Logistic regression analysis showed that, together with socio-cultural determinants such as feeding preferences of the husband and maternal grandmother, feeding practices of friends, factors relating to delivery methods, delivery locations and health problems could influence the initiation rate and breast-feeding patterns. To promote breast-feeding practices of rural mothers, health education on breast-feeding should take into account local socio-cultural features in addition to improving the counselling skills of health workers.

Control of Growth Rate by Initial Substrate Concentration at Values Below Maximum Rate

PubMed Central

Gaudy, Anthony F.; Obayashi, Alan; Gaudy, Elizabeth T.

1971-01-01

The hyperbolic relationship between specific growth rate, μ, and substrate concentration, proposed by Monod and used since as the basis for the theory of steady-state growth in continuous-flow systems, was tested experimentally in batch cultures. Use of a Flavobacterium sp. exhibiting a high saturation constant for growth in glucose minimal medium allowed direct measurement of growth rate and substrate concentration throughout the growth cycle in medium containing a rate-limiting initial concentration of glucose. Specific growth rates were also measured for a wide range of initial glucose concentrations. A plot of specific growth rate versus initial substrate concentration was found to fit the hyperbolic equation. However, the instantaneous relationship between specific growth rate and substrate concentration during growth, which is stated by the equation, was not observed. Well defined exponential growth phases were developed at initial substrate concentrations below that required for support of the maximum exponential growth rate and a constant doubling time was maintained until 50% of the substrate had been used. It is suggested that the external substrate concentration initially present “sets” the specific growth rate by establishing a steady-state internal concentration of substrate, possibly through control of the number of permeation sites. PMID:5137579

Method of Real-Time Principal-Component Analysis

NASA Technical Reports Server (NTRS)

Duong, Tuan; Duong, Vu

2005-01-01

Dominant-element-based gradient descent and dynamic initial learning rate (DOGEDYN) is a method of sequential principal-component analysis (PCA) that is well suited for such applications as data compression and extraction of features from sets of data. In comparison with a prior method of gradient-descent-based sequential PCA, this method offers a greater rate of learning convergence. Like the prior method, DOGEDYN can be implemented in software. However, the main advantage of DOGEDYN over the prior method lies in the facts that it requires less computation and can be implemented in simpler hardware. It should be possible to implement DOGEDYN in compact, low-power, very-large-scale integrated (VLSI) circuitry that could process data in real time.

A Longitudinal Behavioral Genetic Analysis of Task Persistence

ERIC Educational Resources Information Center

Deater-Deckard, Kirby; Petrill, Stephen A.; Thompson, Lee A.; DeThorne, Laura S.

2006-01-01

Change in task persistence was assessed in two annual assessments using teachers', testers', and observers' ratings. Participants included 79 monozygotic and 116 same-sex dizygotic twin pairs who were in Kindergarten or 1st grade (4.3 to 7.9 years old) at the initial assessment. Task persistence was widely distributed and higher among older…

An Analysis of Initial Global Citizenship in a Liberal Arts College in Northeastern Pennsylvania

ERIC Educational Resources Information Center

Anthony, Dorothy; Miller, Patricia Bederman; Yarrish, Karen K.

2014-01-01

There are an increasing number of organizations conducting business in the global environment (Hill, 2011). Expatriate employees are frequently used and are critical for success in these assignments (Carpenter, Sanders, & Gregersen, 2000). Adjusting to a foreign culture is one reason for high failure rates of expatriates (Garonzik, Brockner…

Good Moments in Gestalt Therapy: A Descriptive Analysis of Two Perls Sessions.

ERIC Educational Resources Information Center

Boulet, Donald; And Others

1993-01-01

Analyzed two Gestalt therapy sessions conducted by Fritz Perls using category system for identifying in-session client behaviors valued by Gestalt therapists. Four judges independently rated 210 client statements. Found common pattern of therapeutic movement: initial phase dominated by building block good moments and second phase characterized by…

40 CFR 75.63 - Initial certification or recertification application.

Code of Federal Regulations, 2010 CFR

2010-07-01

... requirement of § 75.59(e), for DAHS (missing data and formula) verifications, no hardcopy submittal is... test data and results to the Administrator. (B) To the applicable EPA Regional Office and the... part) tests or any CEMS data analysis used to derive a fuel-and-unit-specific default NOX emission rate...

76 FR 67703 - Certain Steel Wheels From the People's Republic of China: Notice of Preliminary Determination of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-02

... scope of the investigation does not affect the Petitioners' assertion or our resulting analysis. \\39... (``Petition''), filed on March 30, 2011. The Department initiated this investigation on April 19, 2011.\\2\\ In... and producers may obtain separate rate status in non-market economy (``NME'') investigations. The...

The Association of Individual and Regional Socioeconomic Status on Initial Peritonitis and Outcomes in Peritoneal Dialysis Patients: A Propensity Score-Matched Cohort Study.

PubMed

Wang, Qin; Hu, Ke-Jie; Ren, Ye-Ping; Dong, Jie; Han, Qing-Feng; Zhu, Tong-Ying; Chen, Jiang-Hua; Zhao, Hui-Ping; Chen, Meng-Hua; Xu, Rong; Wang, Yue; Hao, Chuan-Ming; Zhang, Xiao-Hui; Wang, Mei; Tian, Na; Wang, Hai-Yan

2016-01-01

♦ Research indicates that the socioeconomic status (SES) of individuals and the area where they live are related to initial peritonitis and outcomes in peritoneal dialysis (PD). We conducted a retrospective, multi-center cohort study in China to examine these associations. ♦ Data on 2,171 PD patients were collected from 7 centers, including baseline demographic, socioeconomic, and laboratory data. We explored the potential risk factors for initial peritonitis and outcomes using univariate Cox regression and unadjusted binary logistic regression. Then, we used propensity score matching to balance statistically significant risk factors for initial peritonitis and outcomes, and Kaplan-Meier survival analysis to compare differences in peritonitis-free rates between different groups of participants after matching. ♦ A total of 563 (25.9%) initial episodes of peritonitis occurred during the study period. The Kaplan-Meier peritonitis-free rate curve showed high-income patients had a significantly lower risk than low-income patients (p = 0.007) after matching for age, hemoglobin, albumin, and regional SES and PD center. The risk of treatment failure was significantly lower in the high-income than the low-income group after matching for the organism causing peritonitis and PD center: odds ratio (OR) = 0.27 (0.09 - 0.80, p = 0.018). Regional SES and education were not associated with initial peritonitis and outcomes. ♦ Our study demonstrates low individual income is a risk factor for the initial onset of peritonitis and treatment failure after initial peritonitis. Copyright © 2016 International Society for Peritoneal Dialysis.

The initiation and growth of delaminations induced by matrix microcracks in laminated composites

NASA Technical Reports Server (NTRS)

Nairn, J. A.; Hu, S.

1992-01-01

A recent variational mechanics analysis of microcracking damage in cross-ply laminates of the form /(S)/90n/s, where (S) is any orthotropic sublaminate much stiffer than /90n/, has been extended to account for the presence of delaminations emanating from the tips of microcracks in the /90 2n/T sublaminate. The new two-dimensional stress analysis is used to calculate the total strain energy, effective modulus, and longitudinal thermal expansion coefficient for a laminate having microcracks and delaminations. These results are used to calculate the energy release rate for the initiation and growth of a delamination induced by a matrix microcrack. At low crack densities, /(S)/90n/s laminates are expected to fail by microcracking and to show little or no delamination. At some critical crack density, which is a function of laminate structure and material properties, the energy release rate for delamination exceeds that for microcracking and delamination is predicted to dominate over microcracking. A quasi-three-dimensional model is used to predict the propagation of arbitrarily shaped delamination fronts. All predictions agree with experimental observations.

Kinetic modeling predicts a stimulatory role for ribosome collisions at elongation stall sites in bacteria

PubMed Central

Ferrin, Michael A; Subramaniam, Arvind R

2017-01-01

Ribosome stalling on mRNAs can decrease protein expression. To decipher ribosome kinetics at stall sites, we induced ribosome stalling at specific codons by starving the bacterium Escherichia coli for the cognate amino acid. We measured protein synthesis rates from a reporter library of over 100 variants that encoded systematic perturbations of translation initiation rate, the number of stall sites, and the distance between stall sites. Our measurements are quantitatively inconsistent with two widely-used kinetic models for stalled ribosomes: ribosome traffic jams that block initiation, and abortive (premature) termination of stalled ribosomes. Rather, our measurements support a model in which collision with a trailing ribosome causes abortive termination of the stalled ribosome. In our computational analysis, ribosome collisions selectively stimulate abortive termination without fine-tuning of kinetic rate parameters at ribosome stall sites. We propose that ribosome collisions serve as a robust timer for translational quality control pathways to recognize stalled ribosomes. DOI: http://dx.doi.org/10.7554/eLife.23629.001 PMID:28498106

Community pharmacy owners' views of star ratings and performance measurement: In-depth interviews.

PubMed

Teeter, Benjamin S; Fox, Brent I; Garza, Kimberly B; Harris, Stanley G; Nau, David P; Owensby, Justin K; Westrick, Salisa C

2016-01-01

The star rating system implemented by Medicare has the potential to positively affect patient health and may have financial implications for community pharmacies. Learning from owners of community pharmacies with high performance on these quality measures may help us to identify and further understand factors contributing to their success. This study described high-performing community pharmacy owners' current awareness and knowledge of star ratings, attitudes toward star ratings and performance measurement, and initiatives being offered in pharmacies that aim to improve the quality of care. Qualitative interviews with owners of independent community pharmacies were conducted in Spring 2015. Fifteen community pharmacies with high performance on the star rating measures were invited to participate. Recruitment did not end until the saturation point had been reached. All interviews were transcribed verbatim. Interview data were analyzed with the use of ATLAS.ti by 2 coders trained in thematic analysis. Krippendorf's alpha was calculated to assess intercoder reliability. Ten high-performing pharmacy owners participated. Analysis identified 8 themes, which were organized into the following categories: 1) current awareness and knowledge (i.e., superficial or advanced knowledge); 2) attitudes toward star ratings (positive perceptions, skeptical of performance rewards, and lack a feeling of control); and 3) pharmacy initiatives (personal patient relationships, collaborative employee relationships, and use of technology). Intercoder reliability was good overall. Interviews with high-performing pharmacies suggested that awareness of the star rating measures, overall positive attitudes toward the star ratings, the relationships that pharmacy owners have with their patients and their employees, and the use of technology as a tool to enhance patient care may contribute to high performance on the star rating measures. Future research is needed to determine if and how these constructs are associated with pharmacy performance in a larger population. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

[Analysis of drug resistance to antituberculosis drugs of the first time retreated pulmonary tuberculosis patients in Shanghai].

PubMed

Fan, Yu-mei; Xiao, He-ping; Mei, Jian

2006-10-01

To investigate antituberculosis drug resistance among the first time retreated pulmonary tuberculosis patients in Shanghai, and therefore to provide evidence for establishing retreatment regimen. Analysis was conducted retrospectively on drug susceptibility tests to isoniazid, rifampin, streptomycin, ethambutol and para-aminosalicylates of the first time retreated pulmonary tuberculosis patients with a positive sputum culture in Shanghai Center for Disease Control from January 2002 to December 2004. The total drug resistance rate was 39.6%. The drug resistance rate in male and female patients was 38.5% and 44.4% respectively, the difference being not significant. The drug resistance rate in the young age group, the middle age group and the old age group were 50.0%, 41.6% and 34.6% respectively, the difference being not significant. The total drug resistance rates in the treatment failure group with standard initial chemotherapy and in the relapse group with standard regimen were both higher than in the relapse group with non-standard regimen (70.0%, 47.5%, 28.2%). So do the drug resistance rates of more than two drugs (70.0%, 18.3%, 6.4%). The multi-drug resistance rate of the failures with standard regimen was 70.0%, much higher than the relapses with standard regimen and the relapses with non-standard regimen. In relapses with non-standard initial therapy, the drug resistance rate of patients who received medications > or = 12 months was 55.0%, significantly higher than those treated for 1 - 5 months (13.0%). The drug resistance rate of patients who were treated with one to two drugs was lower than those treated with > or = 3 drugs, but no significant difference was observed (24.4% and 30.8%). Drug resistance rate varies in different types of the first time retreated pulmonary tuberculosis patients due to the history of drug use, which indicates that the current standard retreatment regimen is probably ineffective for some patients.

A Correlational Study of a Reading Comprehension Program and Attrition Rates of ESL Nursing Students in Texas.

PubMed

Donnell, Wendy M

The purpose of this study was to examine the associations between English as a second language (ESL), a reading comprehension program, and attrition rates of nursing students. Higher attrition rates of ESL nursing students are an assumption, seemingly based on anecdotal evidence. Data reflecting ESL student attrition should be measured and analyzed so that students can be identified prior to attrition. A secondary analysis of a large database of 27 initial licensure programs in Texas was completed. Data analysis identified that ESL students who used a reading comprehension program were almost twice as likely to be off track or out of the program as ESL students who did not use the program. Nurse educators need to evaluate student profile characteristics in a comprehensive way when determining risk of attrition.

Anastrozole is cost-effective vs tamoxifen as initial adjuvant therapy in early breast cancer: Canadian perspectives on the ATAC completed-treatment analysis.

PubMed

Rocchi, A; Verma, S

2006-09-01

To conduct an economic analysis comparing tamoxifen and anastrozole (Arimidex) in the adjuvant treatment of hormone receptor-positive (HR+), post-menopausal early breast cancer patients. An economic model examined typical patients (64 years of age, HR+, 64% node negative) from the Arimidex, tamoxifen alone, or in combination (ATAC) trial over a lifetime horizon. Rates of events were derived from ATAC trial results. Post-trial event rates were drawn from the literature for tamoxifen; event rates for anastrozole were modified by the relative risks observed in the ATAC trial. Resource utilization was drawn from Statistics Canada's Population Health Model for breast cancer, supplemented by an expert panel. A public health care system perspective, 2004 Canadian prices and a 5% discount rate were employed. Anastrozole-taking patients incurred additional hormonal treatment costs compared to tamoxifen-taking patients (incremental lifetime cost, 6,974 Canadian dollars per patient), partially offset by reduced downstream recurrences of breast cancer (1,143 Canadian dollars lifetime savings per patient) for a net incremental cost of 5,796 Canadian dollars per patient on anastrozole. The anastrozole-treated patients were projected to experience a 5.6% absolute risk reduction of first breast cancer recurrence and a 2.8% absolute risk reduction in breast cancer death. This corresponded to 30,000 Canadian dollars per life year gained and 28,000 Canadian dollars per quality-adjusted life year gained (95% confidence interval, 17,428 to 54,605 Canadian dollars). The results were affected by the duration and extent of anastrozole benefit under sensitivity analysis but remained cost-effective. Compared to tamoxifen, anastrozole therapy is effective and cost-effective as initial adjuvant therapy in post-menopausal, HR+ early breast cancer patients.

A comparison of prophylactic efficacy of tilmicosin and a new formulation of oxytetracycline in feedlot calves

PubMed Central

Schunicht, Oliver C.; Guichon, P. Timothy; Booker, Calvin W.; Jim, G. Kee; Wildman, Brian K.; Hill, Bruce W.; Ward, Tracy I.; Bauck, Stewart W.; Jacobsen, John A.

2002-01-01

Two replicated-pen field studies were performed under commercial feedlot conditions in western Canada to compare the administration of long-acting oxytetracycline at 30 mg/kg body weight (BW) versus tilmicosin at 10 mg/kg BW to feedlot calves upon arrival at the feedlot. Ten thousand nine hundred and eighty-nine, recently weaned, auction market derived, crossbred beef steer and bull calves were randomly allocated upon arrival at the feedlot to one of 2 experimental groups as follows: oxytetracycline, which received intramuscular long-acting oxytetracycline (300 mg/mL formulation) at a rate of 30 mg/kg BW; or tilmicosin, which received subcutaneous tilmicosin (300 mg/mL formulation) at a rate of 10 mg/kg BW. There were 20 pens in each experimental group. In Study 1 and in the combined analysis, the initial undifferentiated fever (UF) treatment rate was significantly (P < 0.05) higher in the oxytetracycline group as compared with the tilmicosin group. There were no significant (P ≥ 0.05) differences in first UF relapse, second UF relapse, third UF relapse, overall chronicity, overall rail, overall mortality, bovine respiratory disease (BRD) mortality, hemophilosis mortality, arthritis mortality, or miscellaneous mortality rates between the experimental groups in either study or in the combined analysis. In addition, there were no significant (P ≥ 0.05) differences in initial weight, final weight, weight gain, days on feed, daily dry matter intake, average daily gain, or the dry matter intake to gain ratio between the experimental groups in either study or in the combined analyses. In the economic analysis, there was a net economic advantage of $5.22 CDN per animal in the oxytetracycline group, due to a lower prophylactic cost, even though the UF therapeutic cost was higher. PMID:12001501

A comparison of prophylactic efficacy of tilmicosin and a new formulation of oxytetracycline in feedlot calves.

PubMed

Schunich, Oliver C; Guichon, P Timothy; Booker, Calvin W; Jim, G Kee; Wildman, Brian K; Hill, Bruce W; Ward, Tracy I; Bauck, Stewart W; Jacobsen, John A

2002-05-01

Two replicated-pen field studies were performed under commercial feedlot conditions in western Canada to compare the administration of long-acting oxytetracycline at 30 mg/kg body weight (BW) versus tilmicosin at 10 mg/kg BW to feedlot calves upon arrival at the feedlot. Ten thousand nine hundred and eighty-nine, recently weaned, auction market derived, crossbred beef steer and bull calves were randomly allocated upon arrival at the feedlot to one of 2 experimental groups as follows: oxytetracycline, which received intramuscular long-acting oxytetracycline (300 mg/mL formulation) at a rate of 30 mg/kg BW; or tilmicosin, which received subcutaneous tilmicosin (300 mg/mL formulation) at a rate of 10 mg/kg BW. There were 20 pens in each experimental group. In Study 1 and in the combined analysis, the initial undifferentiated fever (UF) treatment rate was significantly (P < 0.05) higher in the oxytetracycline group as compared with the tilmicosin group. There were no significant (P > or = 0.05) differences in first UF relapse, second UF relapse, third UF relapse, overall chronicity, overall rail, overall mortality, bovine respiratory disease (BRD) mortality, hemophilosis mortality, arthritis mortality, or miscellaneous mortality rates between the experimental groups in either study or in the combined analysis. In addition, there were no significant (P > or = 0.05) differences in initial weight, final weight, weight gain, days on feed, daily dry matter intake, average daily gain, or the dry matter intake to gain ratio between the experimental groups in either study or in the combined analyses. In the economic analysis, there was a net economic advantage of $5.22 CDN per animal in the oxytetracycline group, due to a lower prophylactic cost, even though the UF therapeutic cost was higher.

Early impact of a national multi-faceted road safety intervention program in Mexico: results of a time-series analysis.

PubMed

Chandran, Aruna; Pérez-Núñez, Ricardo; Bachani, Abdulgafoor M; Híjar, Martha; Salinas-Rodríguez, Aarón; Hyder, Adnan A

2014-01-01

In January 2008, a national multifaceted road safety intervention program (IMESEVI) funded by the Bloomberg Philanthropies was launched in Mexico. Two years later in 2010, IMESEVI was refocused as part of a 10-country international consortium demonstration project (IMESEVI/RS10). We evaluate the initial effects of each phase of the road safety intervention project on numbers of RT crashes, injuries and deaths in Mexico and in the two main target cities of Guadalajara-Zapopan and León. An interrupted time series analysis using autoregressive integrated moving average (ARIMA) modeling was performed using monthly data of rates of RT crashes and injuries (police data), as well as deaths (mortality system data) from 1999-2011 with dummy variables representing each intervention phase. In the period following the first intervention phase at the country level and in the city of León, the rate of RT crashes decreased significantly (p<0.05). Notably, following the second intervention phase although there was no reduction at the country level, there has been a decrease in the RT crash rate in both Guadalajara-Zapopan (p = 0.029) and in León (p = 0.029). There were no significant differences in the RT injury or death rates following either intervention phase in either city. These initial results suggest that a multi-faceted road safety intervention program appears to be effective in reducing road crashes in a middle-income country setting. Further analysis is needed to differentiate the effects of various interventions, and to determine what other economic and political factors might have affected this change.

Recruitment Methods and Show Rates to a Prostate Cancer Early Detection Program for High-Risk Men: A Comprehensive Analysis

PubMed Central

Giri, Veda N.; Coups, Elliot J.; Ruth, Karen; Goplerud, Julia; Raysor, Susan; Kim, Taylor Y.; Bagden, Loretta; Mastalski, Kathleen; Zakrzewski, Debra; Leimkuhler, Suzanne; Watkins-Bruner, Deborah

2009-01-01

Purpose Men with a family history (FH) of prostate cancer (PCA) and African American (AA) men are at higher risk for PCA. Recruitment and retention of these high-risk men into early detection programs has been challenging. We report a comprehensive analysis on recruitment methods, show rates, and participant factors from the Prostate Cancer Risk Assessment Program (PRAP), which is a prospective, longitudinal PCA screening study. Materials and Methods Men 35–69 years are eligible if they have a FH of PCA, are AA, or have a BRCA1/2 mutation. Recruitment methods were analyzed with respect to participant demographics and show to the first PRAP appointment using standard statistical methods Results Out of 707 men recruited, 64.9% showed to the initial PRAP appointment. More individuals were recruited via radio than from referral or other methods (χ2 = 298.13, p < .0001). Men recruited via radio were more likely to be AA (p<0.001), less educated (p=0.003), not married or partnered (p=0.007), and have no FH of PCA (p<0.001). Men recruited via referrals had higher incomes (p=0.007). Men recruited via referral were more likely to attend their initial PRAP visit than those recruited by radio or other methods (χ2 = 27.08, p < .0001). Conclusions This comprehensive analysis finds that radio leads to higher recruitment of AA men with lower socioeconomic status. However, these are the high-risk men that have lower show rates for PCA screening. Targeted motivational measures need to be studied to improve show rates for PCA risk assessment for these high-risk men. PMID:19758657

Early Impact of a National Multi-Faceted Road Safety Intervention Program in Mexico: Results of a Time-Series Analysis

PubMed Central

Chandran, Aruna; Pérez-Núñez, Ricardo; Bachani, Abdulgafoor M.; Híjar, Martha; Salinas-Rodríguez, Aarón; Hyder, Adnan A.

2014-01-01

Background In January 2008, a national multifaceted road safety intervention program (IMESEVI) funded by the Bloomberg Philanthropies was launched in Mexico. Two years later in 2010, IMESEVI was refocused as part of a 10-country international consortium demonstration project (IMESEVI/RS10). We evaluate the initial effects of each phase of the road safety intervention project on numbers of RT crashes, injuries and deaths in Mexico and in the two main target cities of Guadalajara-Zapopan and León. Methods An interrupted time series analysis using autoregressive integrated moving average (ARIMA) modeling was performed using monthly data of rates of RT crashes and injuries (police data), as well as deaths (mortality system data) from 1999–2011 with dummy variables representing each intervention phase. Results In the period following the first intervention phase at the country level and in the city of León, the rate of RT crashes decreased significantly (p<0.05). Notably, following the second intervention phase although there was no reduction at the country level, there has been a decrease in the RT crash rate in both Guadalajara-Zapopan (p = 0.029) and in León (p = 0.029). There were no significant differences in the RT injury or death rates following either intervention phase in either city. Conclusion These initial results suggest that a multi-faceted road safety intervention program appears to be effective in reducing road crashes in a middle-income country setting. Further analysis is needed to differentiate the effects of various interventions, and to determine what other economic and political factors might have affected this change. PMID:24498114

Shuttle bit rate synchronizer. [signal to noise ratios and error analysis

NASA Technical Reports Server (NTRS)

Huey, D. C.; Fultz, G. L.

1974-01-01

A shuttle bit rate synchronizer brassboard unit was designed, fabricated, and tested, which meets or exceeds the contractual specifications. The bit rate synchronizer operates at signal-to-noise ratios (in a bit rate bandwidth) down to -5 dB while exhibiting less than 0.6 dB bit error rate degradation. The mean acquisition time was measured to be less than 2 seconds. The synchronizer is designed around a digital data transition tracking loop whose phase and data detectors are integrate-and-dump filters matched to the Manchester encoded bits specified. It meets the reliability (no adjustments or tweaking) and versatility (multiple bit rates) of the shuttle S-band communication system through an implementation which is all digital after the initial stage of analog AGC and A/D conversion.

Neighborhood poverty rate and mortality in patients receiving critical care in the academic medical center setting.

PubMed

Zager, Sam; Mendu, Mallika L; Chang, Domingo; Bazick, Heidi S; Braun, Andrea B; Gibbons, Fiona K; Christopher, Kenneth B

2011-06-01

Poverty is associated with increased risk of chronic illness but its contribution to critical care outcome is not well defined. We performed a multicenter observational study of 38,917 patients, aged ≥ 18 years, who received critical care between 1997 and 2007. The patients were treated in two academic medical centers in Boston, Massachusetts. Data sources included 1990 US census and hospital administrative data. The exposure of interest was neighborhood poverty rate, categorized as < 5%, 5% to 10%, 10% to 20%, 20% to 40% and > 40%. Neighborhood poverty rate is the percentage of residents below the federal poverty line. Census tracts were used as the geographic units of analysis. Logistic regression examined death by days 30, 90, and 365 post-critical care initiation and in-hospital mortality. Adjusted ORs were estimated by multivariable logistic regression models. Sensitivity analysis was performed for 1-year postdischarge mortality among patients discharged to home. Following multivariable adjustment, neighborhood poverty rate was not associated with all-cause 30-day mortality: 5% to 10% OR, 1.05 (95% CI, 0.98-1.14; P = .2); 10% to 20% OR, 0.96 (95% CI, 0.87-1.06; P = .5); 20% to 40% OR, 1.08 (95% CI, 0.96-1.22; P = .2); > 40% OR, 1.20 (95% CI, 0.90-1.60; P = .2); referent in each is < 5%. Similar nonsignificant associations were noted at 90-day and 365-day mortality post-critical care initiation and in-hospital mortality. Among patients discharged to home, neighborhood poverty rate was not associated with 1-year-postdischarge mortality. Our study suggests that there is no relationship between the neighborhood poverty rate and mortality up to 1 year following critical care at academic medical centers.

Preconception Low-Dose Aspirin Restores Diminished Pregnancy and Live Birth Rates in Women With Low-Grade Inflammation: A Secondary Analysis of a Randomized Trial.

PubMed

Sjaarda, Lindsey A; Radin, Rose G; Silver, Robert M; Mitchell, Emily; Mumford, Sunni L; Wilcox, Brian; Galai, Noya; Perkins, Neil J; Wactawski-Wende, Jean; Stanford, Joseph B; Schisterman, Enrique F

2017-05-01

Inflammation is linked to causes of infertility. Low-dose aspirin (LDA) may improve reproductive success in women with chronic, low-grade inflammation. To investigate the effect of preconception-initiated LDA on pregnancy rate, pregnancy loss, live birth rate, and inflammation during pregnancy. Stratified secondary analysis of a multicenter, block-randomized, double-blind, placebo-controlled trial. Four US academic medical centers, 2007 to 2012. Healthy women aged 18 to 40 years (N = 1228) with one to two prior pregnancy losses actively attempting to conceive. Preconception-initiated, daily LDA (81 mg) or matching placebo taken up to six menstrual cycles attempting pregnancy and through 36 weeks' gestation in women who conceived. Confirmed pregnancy, live birth, and pregnancy loss were compared between LDA and placebo, stratified by tertile of preconception, preintervention serum high-sensitivity C-reactive protein (hsCRP) (low, <0.70 mg/L; middle, 0.70 to <1.95 mg/L; high, ≥1.95 mg/L). Live birth occurred in 55% of women overall. The lowest pregnancy and live birth rates occurred among the highest hsCRP tertile receiving placebo (44% live birth). LDA increased live birth among high-hsCRP women to 59% (relative risk, 1.35; 95% confidence interval, 1.08 to 1.67), similar to rates in the lower and mid-CRP tertiles. LDA did not affect clinical pregnancy or live birth in the low (live birth: 59% LDA, 54% placebo) or midlevel hsCRP tertiles (live birth: 59% LDA, 59% placebo). In women attempting conception with elevated hsCRP and prior pregnancy loss, LDA may increase clinical pregnancy and live birth rates compared with women without inflammation and reduce hsCRP elevation during pregnancy. Copyright © 2017 by the Endocrine Society

Maximum type 1 error rate inflation in multiarmed clinical trials with adaptive interim sample size modifications.

PubMed

Graf, Alexandra C; Bauer, Peter; Glimm, Ekkehard; Koenig, Franz

2014-07-01

Sample size modifications in the interim analyses of an adaptive design can inflate the type 1 error rate, if test statistics and critical boundaries are used in the final analysis as if no modification had been made. While this is already true for designs with an overall change of the sample size in a balanced treatment-control comparison, the inflation can be much larger if in addition a modification of allocation ratios is allowed as well. In this paper, we investigate adaptive designs with several treatment arms compared to a single common control group. Regarding modifications, we consider treatment arm selection as well as modifications of overall sample size and allocation ratios. The inflation is quantified for two approaches: a naive procedure that ignores not only all modifications, but also the multiplicity issue arising from the many-to-one comparison, and a Dunnett procedure that ignores modifications, but adjusts for the initially started multiple treatments. The maximum inflation of the type 1 error rate for such types of design can be calculated by searching for the "worst case" scenarios, that are sample size adaptation rules in the interim analysis that lead to the largest conditional type 1 error rate in any point of the sample space. To show the most extreme inflation, we initially assume unconstrained second stage sample size modifications leading to a large inflation of the type 1 error rate. Furthermore, we investigate the inflation when putting constraints on the second stage sample sizes. It turns out that, for example fixing the sample size of the control group, leads to designs controlling the type 1 error rate. © 2014 The Author. Biometrical Journal published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Factors affecting initial disability allowance rates for the Disability Insurance and Supplemental Security Income programs: the role of the demographic and diagnostic composition of applicants and local labor market conditions.

PubMed

Rupp, Kalman

2012-01-01

Various factors outside the control of decision makers may affect the rate at which disability applications are allowed or denied during the initial step of eligibility determination in the Social Security Disability Insurance (DI) and Supplemental Security Income (SSI) programs. In this article, using individual-level data on applications, I estimate the role of three important factors--the demographic characteristics of applicants, the diagnostic mix of applicants, and the local unemployment rate--in affecting the probability of an initial allowance and state allowance rates. I use a random sample of initial determinations from 1993 through 2008 and a fixed-effects multiple regression framework. The empirical results show that the demographic and diagnostic characteristics of applicants and the local unemployment rate substantially affect the initial allowance rate. An increase in the local unemployment rate tends to be associated with a decrease in the initial allowance rate. This negative relationship holds for adult DI and SSI applicants and for SSI childhood applicants.

Retention in Care of Adult HIV Patients Initiating Antiretroviral Therapy in Tigray, Ethiopia: A Prospective Observational Cohort Study

PubMed Central

Bucciardini, Raffaella; Fragola, Vincenzo; Abegaz, Teshome; Lucattini, Stefano; Halifom, Atakilt; Tadesse, Eskedar; Berhe, Micheal; Pugliese, Katherina; Binelli, Andrea; De Castro, Paola; Terlizzi, Roberta; Fucili, Luca; Di Gregorio, Massimiliano; Mirra, Marco; Olivieri, Erika; Teklu, Tsigemariam; Zegeye, Teame; Haile, Amanuel; Vella, Stefano; Abraham, Loko; Godefay, Hagos

2015-01-01

Introduction Although Ethiopia has been scaling up the antiretroviral therapy (ART) services, low retention in care of patients remains one of the main obstacles to treatment success. We report data on retention in care and its associated determinants in Tigray, Ethiopia. Methods We used data from the CASA project, a prospective observational and multi-site study of a cohort of HIV-infected patients who initiated ART for the first time in Tigray. Four participating health facilities (HFs) located in the South of Tigray were considered for this study. Patients were followed for one year after ART initiation. The main outcome measure was represented by the current retention in care, defined as the proportion of patients who were alive and receiving ART at the same HF one year after ART initiation. Patients who started ART between January 1, 2013 and December 31, 2013 were included in this analysis. Patients were followed for one year after ART initiation. The determinants of retention were analysed using univariate and multivariate Cox Proportional Hazards model with robust sandwich estimates to account for within HF correlation. Results The four participating HFs in Tigray were able to retain overall 85.1% of their patients after one year from starting ART. Loss to follow-up (5.5%) and transfers to other HF (6.6) were the main determinant of attrition. A multivariate analysis shows that the factors significantly associated with retention were the type of HF, gender and active TB. Alamata health center was the HF with the highest attrition rate (HR 2.99, 95% CI: 2.77–3.23). Active TB (HR 1.72, 95% CI: 1.23–2.41) and gender (HR 1.64, 95% CI: 1.10–2.56) were also significantly associated with attrition. Conclusions Although Ethiopia has significantly improved access to the ART program, achieving and maintaining a satisfactory long-term retention rate is a future goal. This is difficult because of different retention rates among HFs. Moreover specific interventions should be directed to people of different sex to improve retention in care in male population. PMID:26340271

Ineffectiveness of commercial weight-loss programs for achieving modest but meaningful weight loss: Systematic review and meta-analysis.

PubMed

McEvedy, Samantha M; Sullivan-Mort, Gillian; McLean, Siân A; Pascoe, Michaela C; Paxton, Susan J

2017-10-01

This study collates existing evidence regarding weight loss among overweight but otherwise healthy adults who use commercial weight-loss programs. Systematic search of 3 databases identified 11 randomized controlled trials and 14 observational studies of commercial meal-replacement, calorie-counting, or pre-packaged meal programs which met inclusion criteria. In meta-analysis using intention-to-treat data, 57 percent of individuals who commenced a commercial weight program lost less than 5 percent of their initial body weight. One in two (49%) studies reported attrition ≥30 percent. A second meta-analysis found that 37 percent of program completers lost less than 5 percent of initial body weight. We conclude that commercial weight-loss programs frequently fail to produce modest but clinically meaningful weight loss with high rates of attrition suggesting that many consumers find dietary changes required by these programs unsustainable.

Impact of Xpert MTB/RIF for TB diagnosis in a primary care clinic with high TB and HIV prevalence in South Africa: a pragmatic randomised trial.

PubMed

Cox, Helen S; Mbhele, Slindile; Mohess, Neisha; Whitelaw, Andrew; Muller, Odelia; Zemanay, Widaad; Little, Francesca; Azevedo, Virginia; Simpson, John; Boehme, Catharina C; Nicol, Mark P

2014-11-01

Xpert MTB/RIF is approved for use in tuberculosis (TB) and rifampicin-resistance diagnosis. However, data are limited on the impact of Xpert under routine conditions in settings with high TB burden. A pragmatic prospective cluster-randomised trial of Xpert for all individuals with presumptive (symptomatic) TB compared to the routine diagnostic algorithm of sputum microscopy and limited use of culture was conducted in a large TB/HIV primary care clinic. The primary outcome was the proportion of bacteriologically confirmed TB cases not initiating TB treatment by 3 mo after presentation. Secondary outcomes included time to TB treatment and mortality. Unblinded randomisation occurred on a weekly basis. Xpert and smear microscopy were performed on site. Analysis was both by intention to treat (ITT) and per protocol. Between 7 September 2010 and 28 October 2011, 1,985 participants were assigned to the Xpert (n = 982) and routine (n = 1,003) diagnostic algorithms (ITT analysis); 882 received Xpert and 1,063 routine (per protocol analysis). 13% (32/257) of individuals with bacteriologically confirmed TB (smear, culture, or Xpert) did not initiate treatment by 3 mo after presentation in the Xpert arm, compared to 25% (41/167) in the routine arm (ITT analysis, risk ratio 0.51, 95% CI 0.33-0.77, p = 0.0052). The yield of bacteriologically confirmed TB cases among patients with presumptive TB was 17% (167/1,003) with routine diagnosis and 26% (257/982) with Xpert diagnosis (ITT analysis, risk ratio 1.57, 95% CI 1.32-1.87, p<0.001). This difference in diagnosis rates resulted in a higher rate of treatment initiation in the Xpert arm: 23% (229/1,003) and 28% (277/982) in the routine and Xpert arms, respectively (ITT analysis, risk ratio 1.24, 95% CI 1.06-1.44, p = 0.013). Time to treatment initiation was improved overall (ITT analysis, hazard ratio 0.76, 95% CI 0.63-0.92, p = 0.005) and among HIV-infected participants (ITT analysis, hazard ratio 0.67, 95% CI 0.53-0.85, p = 0.001). There was no difference in 6-mo mortality with Xpert versus routine diagnosis. Study limitations included incorrect intervention allocation for a high proportion of participants and that the study was conducted in a single clinic. These data suggest that in this routine primary care setting, use of Xpert to diagnose TB increased the number of individuals with bacteriologically confirmed TB who were treated by 3 mo and reduced time to treatment initiation, particularly among HIV-infected participants. Pan African Clinical Trials Registry PACTR201010000255244. Please see later in the article for the Editors' Summary.

Effect of aeration rate, moisture content and composting period on availability of copper and lead during pig manure composting.

PubMed

Shen, Yujun; Zhao, Lixin; Meng, Haibo; Hou, Yueqing; Zhou, Haibin; Wang, Fei; Cheng, Hongsheng; Liu, Hongbin

2016-06-01

Pollution by heavy metals, such as copper and lead, has become a limiting factor for the land application of faecal manures, such as pig manure. This study was conducted to investigate the influence of composting process parameters, including aeration rate, moisture content and composting period, on the distribution of heavy metal species during composting, and to select an optimal parameter for copper and lead inactivation. Results showed that the distribution ratios of exchangeable fractions of copper and lead had a bigger decrease under conditions of aeration rate, 0.1 m(3) min(-1) m(-3), an initial moisture content of 65% and composting period of 50 days. Suboptimal composting process conditions could lead to increased availability of heavy metals. Statistical analysis indicated that the aeration rate was the main factor affecting copper and lead inactivation, while the effects of moisture content and composting period were not significant. The rates of reduction of copper-exchangeable fractions and lead-exchangeable fractions were positively correlated with increased pH. The optimal parameters for reducing heavy metal bioavailability during pig manure composting were aeration rate, 0.1 m(3) min(-1) m(-3), initial moisture content, 65%, and composting period, 20 days. © The Author(s) 2016.

Linear and non-linear regression analysis for the sorption kinetics of methylene blue onto activated carbon.

PubMed

Kumar, K Vasanth

2006-10-11

Batch kinetic experiments were carried out for the sorption of methylene blue onto activated carbon. The experimental kinetics were fitted to the pseudo first-order and pseudo second-order kinetics by linear and a non-linear method. The five different types of Ho pseudo second-order expression have been discussed. A comparison of linear least-squares method and a trial and error non-linear method of estimating the pseudo second-order rate kinetic parameters were examined. The sorption process was found to follow a both pseudo first-order kinetic and pseudo second-order kinetic model. Present investigation showed that it is inappropriate to use a type 1 and type pseudo second-order expressions as proposed by Ho and Blanachard et al. respectively for predicting the kinetic rate constants and the initial sorption rate for the studied system. Three correct possible alternate linear expressions (type 2 to type 4) to better predict the initial sorption rate and kinetic rate constants for the studied system (methylene blue/activated carbon) was proposed. Linear method was found to check only the hypothesis instead of verifying the kinetic model. Non-linear regression method was found to be the more appropriate method to determine the rate kinetic parameters.

Surgery versus physiotherapy for stress urinary incontinence.

PubMed

Labrie, Julien; Berghmans, Bary L C M; Fischer, Kathelijn; Milani, Alfredo L; van der Wijk, Ileana; Smalbraak, Dina J C; Vollebregt, Astrid; Schellart, René P; Graziosi, Giuseppe C M; van der Ploeg, J Marinus; Brouns, Joseph F G M; Tiersma, E Stella M; Groenendijk, Annette G; Scholten, Piet; Mol, Ben Willem; Blokhuis, Elisabeth E; Adriaanse, Albert H; Schram, Aaltje; Roovers, Jan-Paul W R; Lagro-Janssen, Antoine L M; van der Vaart, Carl H

2013-09-19

Physiotherapy involving pelvic-floor muscle training is advocated as first-line treatment for stress urinary incontinence; midurethral-sling surgery is generally recommended when physiotherapy is unsuccessful. Data are lacking from randomized trials comparing these two options as initial therapy. We performed a multicenter, randomized trial to compare physiotherapy and midurethral-sling surgery in women with stress urinary incontinence. Crossover between groups was allowed. The primary outcome was subjective improvement, measured by means of the Patient Global Impression of Improvement at 12 months. We randomly assigned 230 women to the surgery group and 230 women to the physiotherapy group. A total of 49.0% of women in the physiotherapy group and 11.2% of women in the surgery group crossed over to the alternative treatment. In an intention-to-treat analysis, subjective improvement was reported by 90.8% of women in the surgery group and 64.4% of women in the physiotherapy group (absolute difference, 26.4 percentage points; 95% confidence interval [CI], 18.1 to 34.5). The rates of subjective cure were 85.2% in the surgery group and 53.4% in the physiotherapy group (absolute difference, 31.8 percentage points; 95% CI, 22.6 to 40.3); rates of objective cure were 76.5% and 58.8%, respectively (absolute difference, 17.8 percentage points; 95% CI, 7.9 to 27.3). A post hoc per-protocol analysis showed that women who crossed over to the surgery group had outcomes similar to those of women initially assigned to surgery and that both these groups had outcomes superior to those of women who did not cross over to surgery. For women with stress urinary incontinence, initial midurethral-sling surgery, as compared with initial physiotherapy, results in higher rates of subjective improvement and subjective and objective cure at 1 year. (Funded by ZonMw, the Netherlands Organization for Health Research and Development; Dutch Trial Register number, NTR1248.).

Impact of Gram stain results on initial treatment selection in patients with ventilator-associated pneumonia: a retrospective analysis of two treatment algorithms.

PubMed

Yoshimura, Jumpei; Kinoshita, Takahiro; Yamakawa, Kazuma; Matsushima, Asako; Nakamoto, Naoki; Hamasaki, Toshimitsu; Fujimi, Satoshi

2017-06-19

Ventilator-associated pneumonia (VAP) is a common and serious problem in intensive care units (ICUs). Several studies have suggested that the Gram stain of endotracheal aspirates is a useful method for accurately diagnosing VAP. However, the usefulness of the Gram stain in predicting which microorganisms cause VAP has not been established. The purpose of this study was to evaluate whether a Gram stain of endotracheal aspirates could be used to determine appropriate initial antimicrobial therapy for VAP. Data on consecutive episodes of microbiologically confirmed VAP were collected from February 2013 to February 2016 in the ICU of a tertiary care hospital in Japan. We constructed two hypothetical empirical antimicrobial treatment algorithms for VAP: a guidelines-based algorithm (GLBA) based on the recommendations of the American Thoracic Society-Infectious Diseases Society of America (ATS-IDSA) guidelines and a Gram stain-based algorithm (GSBA) which limited the choice of initial antimicrobials according to the results of bedside Gram stains. The GLBA and the GSBA were retrospectively reviewed for each VAP episode. The initial coverage rates and the selection of broad-spectrum antimicrobial agents were compared between the two algorithms. During the study period, 219 suspected VAP episodes were observed and 131 episodes were assessed for analysis. Appropriate antimicrobial coverage rates were not significantly different between the two algorithms (GLBA 95.4% versus GSBA 92.4%; p = 0.134). The number of episodes for which antimethicillin-resistant Staphylococcus aureus agents were selected as an initial treatment was larger in the GLBA than in the GSBA (71.0% versus 31.3%; p < 0.001), as were the number of episodes for which antipseudomonal agents were recommended as an initial treatment (70.2% versus 51.9%; p < 0.001). Antimicrobial treatment based on Gram stain results may restrict the administration of broad-spectrum antimicrobial agents without increasing the risk of treatment failure. UMIN-CTR, UMIN000026457 . Registered 8 March 2017 (retrospectively registered).

The J-2X Fuel Turbopump - Turbine Nozzle Low Cycle Fatigue Acceptance Rationale

NASA Technical Reports Server (NTRS)

Hawkins, Lakiesha V.; Duke, Gregory C.; Newman, Wesley R.; Reynolds, David C.

2011-01-01

The J-2X Fuel Turbopump (FTP) turbine, which drives the pump that feeds hydrogen to the J-2X engine for main combustion, is based on the J-2S design developed in the early 1970 s. Updated materials and manufacturing processes have been incorporated to meet current requirements. This paper addresses an analytical concern that the J-2X Fuel Turbine Nozzle Low Cycle Fatigue (LCF) analysis did not meet safety factor requirements per program structural assessment criteria. High strains in the nozzle airfoil during engine transients were predicted to be caused by thermally induced stresses between the vane hub, vane shroud, and airfoil. The heritage J-2 nozzle was of a similar design and experienced cracks in the same area where analysis predicted cracks in the J-2X design. Redesign options that did not significantly impact the overall turbine configuration were unsuccessful. An approach using component tests and displacement controlled fracture mechanics analysis to evaluate LCF crack initiation and growth rate was developed. The results of this testing and analysis were used to define the level of inspection on development engine test units. The programmatic impact of developing crack initiation/growth rate/arrest data was significant for the J-2X program. Final Design Certification Review acceptance logic will ultimately be developed utilizing this test and analytical data.

Initiation and continuation of long-acting reversible contraception in the United States military healthcare system.

PubMed

Chiles, Daniel P; Roberts, Timothy A; Klein, David A

2016-09-01

Long-acting reversible contraception is more effective for pregnancy prevention than shorter-acting contraceptive methods and has the potential to reduce healthcare disparities and costs. However, long-acting reversible contraception is underused in the United States. One population of interest is beneficiaries of the United States military healthcare system who have access to universal healthcare, including no-cost, no-copay contraception with unlimited method switching, and comprise a large, actual use cohort. Efforts to increase long-acting reversible contraception initiation and continuation in this population may improve health outcomes and mitigate the profound consequences of unintended or mistimed pregnancy on readiness and cost to the military. We aimed to determine long-acting reversible contraception initiation and continuation rates among the diverse population with universal healthcare who are enrolled in the US military healthcare system. This study is a retrospective cohort of >1.7 million women, aged 14-40 years, who were enrolled in the US military healthcare system, TRICARE Prime, between October 2009 and September 2014. Individuals were assessed for long-acting reversible contraception initiation and continuation with the use of medical billing records. Method continuation and factors that were associated with early method discontinuation were evaluated with the Kaplan-Meier estimator and Cox proportional hazard models. During the study dates, 188,533 women initiated long-acting reversible contraception. Of these, 74.6% women selected intrauterine contraceptives. Method initiation rates remained relatively stable (41.7-50.1/1000 women/year) for intrauterine methods, although the rate for subdermal implants increased from 6.1-23.0/1000 women/year. In analysis of women who selected intrauterine contraceptives, 61.2% continued their method at 36 months, and 48.8% continued at 60 months. Among women who selected the implant, 32.0% continued their method at 36 months; however, 45.8% continued until 33 months (ie, 3 months before the currently recommended expiration date). Compared with intrauterine contraceptive users, implant users were more likely to discontinue their method during the 36 months after insertion (hazard ratio, 1.59; 95% confidence interval, 1.56-1.62; P < .001). Adolescents aged 14-19 years were the least likely age group to discontinue the implant before 36 months; women aged 35-40 years were the least likely to discontinue an intrauterine contraceptive before 60 months. In multivariable analysis that controlled for demographic factors and contraceptive type, early contraceptive method discontinuation was most likely among women aged 20-24 years, implant users, and women with method initiation in military clinics. In the US military healthcare system, TRICARE Prime, the initiation of long-acting reversible contraception is low but increasing, and continuation rates are high. This evidence supports long-acting reversible contraception as first-line recommendations for women of all ages who seek contraception. Published by Elsevier Inc.

Impact of a clinical trial initiative on clinical trial enrollment in a multidisciplinary prostate cancer clinic.

PubMed

Madsen, Lydia T; Kuban, Deborah A; Choi, Seungtaek; Davis, John W; Kim, Jeri; Lee, Andrew K; Domain, Delora; Levy, Larry; Pisters, Louis L; Pettaway, Curtis A; Ward, John F; Logothetis, Christopher; Hoffman, Karen E

2014-07-01

Clinical oncology trials are hampered by low accrual rates, with fewer than 5% of adult patients with cancer treated on study. Clinical trial enrollment was evaluated at The University of Texas MD Anderson Cancer Center's Multidisciplinary Prostate Cancer Clinic (MPCC) to assess whether a clinical trial initiative, introduced in 2006, impacted enrollment. The trial initiative included posting trial-specific information in clinic, educating patients about appropriate clinical trial options during the treatment recommendation discussion, and providing patients with trial-specific educational information. The investigators evaluated the frequency of clinical trial enrollment for men with newly diagnosed prostate cancer seen in the MPCC from 2004 to 2008. Logistic regression evaluated the impact of patient characteristics and the clinical trial initiative on trial enrollment. The median age of the 1370 men was 64 years; 32% had low-risk, 49% had intermediate-risk, and 19% had high-risk disease. Overall, 74% enrolled in at least one trial and 29% enrolled in more than one trial. Trial enrollment increased from 39% before the initiative (127/326) to 84% (880/1044) after the trial initiative. Patient enrollment increased in laboratory studies (from 25% to 80%), quality-of-life studies (from 10% to 26%), and studies evaluating investigational treatments and systemic agents (from 6% to 15%) after the trial initiative. In multivariate analysis, younger men (P<.001) and men seen after implementation of the clinical trial initiative (P<.001) were more likely to enroll in trials. Clinical trial enrollment in the MPCC was substantially higher than that seen nationally in adult patients with cancer, and enrollment rates increased after the introduction of a clinical trial initiative. Copyright © 2014 by the National Comprehensive Cancer Network.

The dynamic role of parental influences in preventing adolescent smoking initiation.

PubMed

Mahabee-Gittens, E Melinda; Xiao, Yang; Gordon, Judith S; Khoury, Jane C

2013-04-01

As adolescents grow, protective parental influences become less important and peer influences take precedence in adolescent's initiation of smoking. It is unknown how and when this occurs. We sought to: prospectively estimate incidence rates of smoking initiation from late childhood through mid-adolescence, identify important risk and protective parental influences on smoking initiation, and examine their dynamic nature in order to identify key ages. Longitudinal data from the National Survey of Parents and Youth of 8 nationally representative age cohorts (9-16 years) of never smokers in the U.S. were used (N=5705 dyads at baseline). Analysis involved a series of lagged logistic regression models using a cohort-sequential design. The mean sample cumulative incidence rates of tobacco use increased from 1.8% to 22.5% between the 9 and 16 years old age cohorts. Among risk factors, peer smoking was the most important across all ages; 11-15 year-olds who spent time with peers who smoked had 2 to 6.5 times higher odds of initiating smoking. Parent-youth connectedness significantly decreased the odds of smoking initiation by 14-37% in 11-14 year-olds; parental monitoring and punishment for smoking decreased the odds of smoking initiation risk by 36-59% in 10-15 year-olds, and by 15-28% in 12-14 year-olds, respectively. Parental influences are important in protecting against smoking initiation across adolescence. At the same time, association with peers who smoke is a very strong risk factor. Our findings provide empirical evidence to suggest that in order to prevent youth from initiating smoking, parents should be actively involved in their adolescents' lives and guard them against association with peers who smoke. Copyright © 2013 Elsevier Ltd. All rights reserved.

Influence of a counteradvertising media campaign on initiation of smoking: the Florida "truth" campaign.

PubMed Central

Sly, D F; Hopkins, R S; Trapido, E; Ray, S

2001-01-01

OBJECTIVES: The purpose of this study was to assess the short-term effects of television advertisements from the Florida "truth" campaign on rates of smoking initiation. METHODS: A follow-up survey of young people aged 12 to 17 years (n = 1820) interviewed during the first 6 months of the advertising campaign was conducted. Logistic regression analyses were used to estimate the independent effects of the campaign on smoking initiation while other factors were controlled for. RESULTS: Youths scoring at intermediate and high levels on a media effect index were less likely to initiate smoking than youths who could not confirm awareness of television advertisements. Adjusted odds ratios between the media index and measures of initiation were similar within categories of age, sex, susceptibility, and whether a parent smoked. CONCLUSIONS: Exposure to the "truth" media campaign lowered the risk of youth smoking initiation. However, the analysis did not demonstrate that all such media programs will be effective. PMID:11211631

Every antibiotic, every day: Maximizing the impact of prospective audit and feedback on total antibiotic use.

PubMed

Campbell, Tonya J; Decloe, Melissa; Gill, Suzanne; Ho, Grace; McCready, Janine; Powis, Jeff

2017-01-01

The success of antimicrobial stewardship is dependent on how often it is completed and which antimicrobials are targeted. We evaluated the impact of an antimicrobial stewardship program (ASP) in three non-ICU settings where all systemic antibiotics, regardless of spectrum, were targeted on the first weekday after initiation. Prospective audit and feedback (PAAF) was initiated on the surgical, respiratory, and medical wards of a community hospital on July 1, 2010, October 1, 2010, and April 1, 2012, respectively. We evaluated rates of total antibiotic use, measured in days on therapy (DOTs), among all patients admitted to the wards before and after PAAF initiation using an interrupted time series analysis. Changes in antibiotic costs, rates of C. difficile infection (CDI), mortality, readmission, and length of stay were evaluated using univariate analyses. Time series modelling demonstrated that total antibiotic use decreased (± standard error) by 100 ± 51 DOTs/1,000 patient-days on the surgical wards (p = 0.049), 100 ± 46 DOTs/1,000 patient-days on the respiratory ward (p = 0.029), and 91 ± 33 DOTs/1,000 patient-days on the medical wards (p = 0.006) immediately following PAAF initiation. Reductions in antibiotic use were sustained up to 50 months after intervention initiation, and were accompanied by decreases in antibiotic costs. There were no significant changes to patient outcomes on the surgical and respiratory wards following intervention initiation. On the medical wards, however, readmission increased from 4.6 to 5.6 per 1,000 patient-days (p = 0.043), while mortality decreased from 7.4 to 5.0 per 1,000 patient-days (p = 0.001). CDI rates showed a non-significant declining trend after PAAF initiation. ASPs can lead to cost-effective, sustained reductions in total antibiotic use when interventions are conducted early in the course of therapy and target all antibiotics. Shifting to such a model may help strengthen the effectiveness of ASPs in non-ICU settings.

Interbank lending, network structure and default risk contagion

NASA Astrophysics Data System (ADS)

Zhang, Minghui; He, Jianmin; Li, Shouwei

2018-03-01

This paper studies the default risk contagion in banking systems based on a dynamic network model with two different kinds of lenders' selecting mechanisms, namely, endogenous selecting (ES) and random selecting (RS). From sensitivity analysis, we find that higher risk premium, lower initial proportion of net assets, higher liquid assets threshold, larger size of liquidity shocks, higher proportion of the initial investments and higher Central Bank interest rates all lead to severer default risk contagion. Moreover, the autocorrelation of deposits and lenders' selecting probability have non-monotonic effects on the default risk contagion, and the effects differ under two mechanisms. Generally, the default risk contagion is much severer under RS mechanism than that of ES, because the multi-money-center structure generated by ES mechanism enables borrowers to borrow from more liquid banks with lower interest rates.

Initiation of air ionization by ultrashort laser pulses: evidence for a role of metastable-state air molecules

NASA Astrophysics Data System (ADS)

Bulgakov, A. V.; Mirza, I.; Bulgakova, N. M.; Zhukov, V. P.; Machulka, R.; Haderka, O.; Campbell, E. E. B.; Mocek, T.

2018-06-01

Transmission measurements for femtosecond laser pulses focused in air with spectral analysis of emission from the focal region have been carried out for various pulse energies and air pressures. The air breakdown threshold and pulse attenuation due to plasma absorption are evaluated and compared with calculations based on the multiphoton ionization model. The plasma absorption is found to depend on the pulse repetition rate and is considerably stronger at 1 kHz than at 1–10 Hz. This suggests that accumulation of metastable states of air molecules plays an important role in initiation of air breakdown, enhancing the ionization efficiency at high repetition rates. Possible channels of metastable-state-assisted air ionization and the role of the observed accumulation effect in laser material processing are discussed.

Thermodynamics and kinetics of the sulfation of porous calcium silicate

NASA Technical Reports Server (NTRS)

Miller, R. A.; Kohl, F. J.

1981-01-01

The sulfation of plasma sprayed calcium silicate in flowing SO2/air mixtures at 900 and 1000 C was investigated thermogravimetrically. Reaction products were analyzed using electron microprobe and X-ray diffraction analysis techniques, and results were compared with thermodynamic predictions. The percentage, by volume, of SO2 in air was varied between 0.036 and 10 percent. At 10 percent SO2 the weight gain curve displays a concave downward shoulder early in the sulfation process. An analytical model was developed which treats the initial process as one which decays exponentially with increasing time and the subsequent process as one which decays exponentially with increasing weight gain. At lower SO2 levels the initial rate is controlled by the reactant flow rate. At 1100 C and 0.036 percent SO2 there is no reaction, in agreement with thermodynamic predictions.

Line-Focused Optical Excitation of Parallel Acoustic Focused Sample Streams for High Volumetric and Analytical Rate Flow Cytometry.

PubMed

Kalb, Daniel M; Fencl, Frank A; Woods, Travis A; Swanson, August; Maestas, Gian C; Juárez, Jaime J; Edwards, Bruce S; Shreve, Andrew P; Graves, Steven W

2017-09-19

Flow cytometry provides highly sensitive multiparameter analysis of cells and particles but has been largely limited to the use of a single focused sample stream. This limits the analytical rate to ∼50K particles/s and the volumetric rate to ∼250 μL/min. Despite the analytical prowess of flow cytometry, there are applications where these rates are insufficient, such as rare cell analysis in high cellular backgrounds (e.g., circulating tumor cells and fetal cells in maternal blood), detection of cells/particles in large dilute samples (e.g., water quality, urine analysis), or high-throughput screening applications. Here we report a highly parallel acoustic flow cytometer that uses an acoustic standing wave to focus particles into 16 parallel analysis points across a 2.3 mm wide optical flow cell. A line-focused laser and wide-field collection optics are used to excite and collect the fluorescence emission of these parallel streams onto a high-speed camera for analysis. With this instrument format and fluorescent microsphere standards, we obtain analysis rates of 100K/s and flow rates of 10 mL/min, while maintaining optical performance comparable to that of a commercial flow cytometer. The results with our initial prototype instrument demonstrate that the integration of key parallelizable components, including the line-focused laser, particle focusing using multinode acoustic standing waves, and a spatially arrayed detector, can increase analytical and volumetric throughputs by orders of magnitude in a compact, simple, and cost-effective platform. Such instruments will be of great value to applications in need of high-throughput yet sensitive flow cytometry analysis.

Budget impact analysis of 8 hormonal contraceptive options.

PubMed

Crespi, Simone; Kerrigan, Matthew; Sood, Vipan

2013-07-01

To develop a model comparing costs of 8 hormonal contraceptives and determine whether acquisition costs for implants and intrauterine devices (IUDs) were offset by decreased pregnancy-related costs over a 3-year time horizon from a managed care perspective. A model was developed to assess the budget impact of branded or generic oral contraceptives (OCs), quarterly intramuscular depot medroxyprogesterone, etonogestrel/ethinyl estradiol vaginal ring, etonogestrel implant, levonorgestrel IUD, norelgestromin/ethinyl estradiol transdermal contraceptive, and ethinyl estradiol/levonorgestrel extended-cycle OC. Major variables included drug costs, typical use failure rates, discontinuation rates, and pregnancy costs. The base case assessed costs for 1000 women initiating each of the hormonal contraceptives. The etonogestrel implant and levonorgestrel IUD resulted in the fewest pregnancies, 63 and 85, respectively, and the least cost, $1.75 million and $2.0 million, respectively. In comparison, generic OC users accounted for a total of 243 pregnancies and $3.4 million in costs. At the end of year 1, costs for the etonogestrel implant ($800,471) and levonorgestrel IUD ($949,721) were already lower than those for generic OCs ($1,146,890). Sensitivity analysis showed that the cost of pregnancies, not product acquisition cost, was the primary cost driver. Higher initial acquisition costs for the etonogestrel implant and levonorgestrel IUD were offset within 1 year by lower contraceptive failure rates and consequent pregnancy costs. Thus, after accounting for typical use failure rates of contraceptive products, the etonogestrel implant and levonorgestrel IUD emerged as the least expensive hormonal contraceptives.

Stepwise kinetic equilibrium models of quantitative polymerase chain reaction.

PubMed

Cobbs, Gary

2012-08-16

Numerous models for use in interpreting quantitative PCR (qPCR) data are present in recent literature. The most commonly used models assume the amplification in qPCR is exponential and fit an exponential model with a constant rate of increase to a select part of the curve. Kinetic theory may be used to model the annealing phase and does not assume constant efficiency of amplification. Mechanistic models describing the annealing phase with kinetic theory offer the most potential for accurate interpretation of qPCR data. Even so, they have not been thoroughly investigated and are rarely used for interpretation of qPCR data. New results for kinetic modeling of qPCR are presented. Two models are presented in which the efficiency of amplification is based on equilibrium solutions for the annealing phase of the qPCR process. Model 1 assumes annealing of complementary targets strands and annealing of target and primers are both reversible reactions and reach a dynamic equilibrium. Model 2 assumes all annealing reactions are nonreversible and equilibrium is static. Both models include the effect of primer concentration during the annealing phase. Analytic formulae are given for the equilibrium values of all single and double stranded molecules at the end of the annealing step. The equilibrium values are then used in a stepwise method to describe the whole qPCR process. Rate constants of kinetic models are the same for solutions that are identical except for possibly having different initial target concentrations. Analysis of qPCR curves from such solutions are thus analyzed by simultaneous non-linear curve fitting with the same rate constant values applying to all curves and each curve having a unique value for initial target concentration. The models were fit to two data sets for which the true initial target concentrations are known. Both models give better fit to observed qPCR data than other kinetic models present in the literature. They also give better estimates of initial target concentration. Model 1 was found to be slightly more robust than model 2 giving better estimates of initial target concentration when estimation of parameters was done for qPCR curves with very different initial target concentration. Both models may be used to estimate the initial absolute concentration of target sequence when a standard curve is not available. It is argued that the kinetic approach to modeling and interpreting quantitative PCR data has the potential to give more precise estimates of the true initial target concentrations than other methods currently used for analysis of qPCR data. The two models presented here give a unified model of the qPCR process in that they explain the shape of the qPCR curve for a wide variety of initial target concentrations.

Breast-feeding intention, initiation and duration among Hong Kong Chinese women: a prospective longitudinal study.

PubMed

Wang, Wenru; Lau, Ying; Chow, Aloysius; Chan, Kin Sin

2014-06-01

to (1) estimate the breast-feeding intention, initiation and duration rate; (2) identify the reasons to initiate and wean breast feeding and (3) explore predictors of breast-feeding duration. a prospective longitudinal study antenatal clinics of five regional hospitals from four clusters in Hong Kong a population-based sample of 2098 women in the second trimester of pregnancy was recruited with a systematic sampling method. three different sets of self-administered questionnaires were used to measure the breast-feeding intention, initiation and duration, demographic, socio-economic, obstetric, complications of pregnancy and intrapartum variables at three time points. Reasons for initiating and weaning breast feeding, the formal and informal supportive resources of participants during breast feeding were collated at the third time points. the rates of artificial feeding and breast feeding were 41.1% and 58.9%, whereas breast-feeding intention and initiation rates were 85.3% and 67.0%, respectively. The breast-feeding duration rates were 11.1%, 10.3%, 10.7% and 26.7%, for the 'within <1 week', '1-3 weeks', '>3-6 weeks' and '>6 weeks' groups. The common reasons for initiating breast feeding were that breast feeding is beneficial for both the baby (89.8%) and mother (39.7%). Reasons for weaning breast feeding were insufficient breast milk (32.7%), tiredness and fatigue (39.7%) and return to work (29.6%). Partner, relatives and nurse midwives were important supportive resource during breast feeding. Ordinal logistic regression analysis identified five predictive factors of breast-feeding duration. Participants who were working part-time or were housewives (p=0.037), had monthly family income of

Uncertainty and sensitivity analysis of the basic reproduction number of diphtheria: a case study of a Rohingya refugee camp in Bangladesh, November–December 2017

PubMed Central

Matsuyama, Ryota; Lee, Hyojung; Yamaguchi, Takayuki; Tsuzuki, Shinya

2018-01-01

Background A Rohingya refugee camp in Cox’s Bazar, Bangladesh experienced a large-scale diphtheria epidemic in 2017. The background information of previously immune fraction among refugees cannot be explicitly estimated, and thus we conducted an uncertainty analysis of the basic reproduction number, R0. Methods A renewal process model was devised to estimate the R0 and ascertainment rate of cases, and loss of susceptible individuals was modeled as one minus the sum of initially immune fraction and the fraction naturally infected during the epidemic. To account for the uncertainty of initially immune fraction, we employed a Latin Hypercube sampling (LHS) method. Results R0 ranged from 4.7 to 14.8 with the median estimate at 7.2. R0 was positively correlated with ascertainment rates. Sensitivity analysis indicated that R0 would become smaller with greater variance of the generation time. Discussion Estimated R0 was broadly consistent with published estimate from endemic data, indicating that the vaccination coverage of 86% has to be satisfied to prevent the epidemic by means of mass vaccination. LHS was particularly useful in the setting of a refugee camp in which the background health status is poorly quantified. PMID:29629244

Uncertainty and sensitivity analysis of the basic reproduction number of diphtheria: a case study of a Rohingya refugee camp in Bangladesh, November-December 2017.

PubMed

Matsuyama, Ryota; Akhmetzhanov, Andrei R; Endo, Akira; Lee, Hyojung; Yamaguchi, Takayuki; Tsuzuki, Shinya; Nishiura, Hiroshi

2018-01-01

A Rohingya refugee camp in Cox's Bazar, Bangladesh experienced a large-scale diphtheria epidemic in 2017. The background information of previously immune fraction among refugees cannot be explicitly estimated, and thus we conducted an uncertainty analysis of the basic reproduction number, R 0 . A renewal process model was devised to estimate the R 0 and ascertainment rate of cases, and loss of susceptible individuals was modeled as one minus the sum of initially immune fraction and the fraction naturally infected during the epidemic. To account for the uncertainty of initially immune fraction, we employed a Latin Hypercube sampling (LHS) method. R 0 ranged from 4.7 to 14.8 with the median estimate at 7.2. R 0 was positively correlated with ascertainment rates. Sensitivity analysis indicated that R 0 would become smaller with greater variance of the generation time. Estimated R 0 was broadly consistent with published estimate from endemic data, indicating that the vaccination coverage of 86% has to be satisfied to prevent the epidemic by means of mass vaccination. LHS was particularly useful in the setting of a refugee camp in which the background health status is poorly quantified.

Suicide rates in European OECD nations converged during the period 1990-2010.

PubMed

Bremberg, Sven G

2017-05-01

The aim of this study was to investigate, with multiple regression analyses, the effect of selected characteristics on the rate of decrease of suicide rates in 21 OECD (Organisation for Economic Co-operation and Development) nations over the period 1990-2010, with initial levels of suicide rates taken into account. The rate of decrease seems mainly (83%) to be determined by the initial suicide rates in 1990. In nations with relatively high initial rates, the rates decreased faster. The suicide rates also converged. The study indicates that beta convergence alone explained most of the cross-national variations.

Multivariate analysis of prognostic factors for idiopathic sudden sensorineural hearing loss treated with adjuvant hyperbaric oxygen therapy.

PubMed

Xie, Shaobing; Qiang, Qingfen; Mei, Lingyun; He, Chufeng; Feng, Yong; Sun, Hong; Wu, Xuewen

2018-01-01

The objective of this study is to evaluate possible prognostic factors of idiopathic sudden sensorineural hearing loss (ISSNHL) treated with adjuvant hyperbaric oxygen therapy (HBOT) using univariate and multivariate analyses. From January 2008 to October 2016, records of 178 ISSNHL patients treated with auxiliary hyperbaric oxygen therapy were reviewed to assess hearing recovery and evaluate associated prognostic factors (gender, age, localization, initial hearing threshold, presence of tinnitus, vertigo, ear fullness, hypertension, diabetes, onset of HBOT, number of HBOT, and audiogram), by using univariate and multivariate analyses. The overall recovery rate was 37.1%, including complete recovery (19.7%) and partial recovery (17.4%). According to multivariate analysis, later onset of HBOT and higher initial hearing threshold were associated with a poor prognosis in ISSNHL patients treated with HBOT. HBOT is a safe and beneficial adjuvant therapy for ISSNHL patients. 20 sessions of HBOT is possibly enough to show its therapeutic effect. Earlier HBOT onset and lower initial hearing threshold is associated with favorable hearing recovery.

Longitudinal Analysis of Academic Burnout in Korean Middle School Students.

PubMed

Kim, Boyoung; Lee, Minyoung; Kim, Keunhwa; Choi, Hyunju; Lee, Sang Min

2015-10-01

The purpose of the study was to investigate the longitudinal relationships between the initial values and slopes of three dimensions of burnout syndrome (i.e. emotional exhaustion, cynicism and academic inefficacy). The study utilized four-wave longitudinal data from a total of 367 (81.6% response rate) middle school students in South Korea. Comprising a 6-month interval survey, the first survey was conducted in June 2010, the second in December 2010, the third in June 2011 and the fourth in December 2011. All participants were 13-year-olds at the first and second surveys, and 14-year-olds at the third and fourth surveys. The Maslach Burnout Inventory-Student Survey was used for each survey to assess the level of academic burnout. The longitudinal data were analysed using latent growth modelling. The results of the study indicated that high initial values (intercept) for emotional exhaustion were associated with a higher rate of increase (slope) in cynicism and academic inefficacy. On the other hand, high initial values for cynicism and academic inefficacy were associated with a lower rate of increase in the other dimensions. This longitudinal study should promote understanding of burned-out students and contribute to the literature by informing the design of prevention programmes for academic burnout. Copyright © 2014 John Wiley & Sons, Ltd.

Testing the limits of optimality: the effect of base rates in the Monty Hall dilemma.

PubMed

Herbranson, Walter T; Wang, Shanglun

2014-03-01

The Monty Hall dilemma is a probability puzzle in which a player tries to guess which of three doors conceals a desirable prize. After an initial selection, one of the nonchosen doors is opened, revealing that it is not a winner, and the player is given the choice of staying with the initial selection or switching to the other remaining door. Pigeons and humans were tested on two variants of the Monty Hall dilemma, in which one of the three doors had either a higher or a lower chance of containing the prize than did the other two options. The optimal strategy in both cases was to initially choose the lowest-probability door available and then switch away from it. Whereas pigeons learned to approximate the optimal strategy, humans failed to do so on both accounts: They did not show a preference for low-probability options, and they did not consistently switch. An analysis of performance over the course of training indicated that pigeons learned to perform a sequence of responses on each trial, and that sequence was one that yielded the highest possible rate of reinforcement. Humans, in contrast, continued to vary their responses throughout the experiment, possibly in search of a more complex strategy that would exceed the maximum possible win rate.

Strain energy release rate analysis of delamination in a tapered laminate subjected to tension load

NASA Technical Reports Server (NTRS)

Salpekar, S. A.; Raju, I. S.; Obrien, T. K.

1990-01-01

A tapered composite laminate subjected to tension load was analyzed using the finite-element method. The glass/epoxy laminate has a (+ or - 45)sub 3 group of plies dropped in three distinct steps, each 20 ply-thicknesses apart, thus forming a taper angle of 5.71 degrees. Steep gradients of interlaminar normal and shear stress on a potential delamination interface suggest the existence of stress singularities at the points of material and geometric discontinuities created by the internal plydrops. The delamination was assumed to initiate at the thin end of the taper on a -45/+45 interface and the delamination growth was simulated in both directions, i.e., along the taper and into the thin region. The strain-energy-release rate for a delamination growing into the thin laminate consisted predominantly of mode I (opening) component. For a delamination growing along the tapered region, the strain-energy-release rate was initially all mode I, but the proportion of mode I decreased with increase in delamination size until eventually total G was all mode II. The total G for both delamination tips increased with increase in delamination size, indicating that a delamination initiating at the end of the taper will grow unstably along the taper and into the thin laminate simultaneously.

Investigation of the operating conditions to morphology evolution of β-L-glutamic acid during seeded cooling crystallization

NASA Astrophysics Data System (ADS)

Zhang, Fangkun; Liu, Tao; Huo, Yan; Guan, Runduo; Wang, Xue Z.

2017-07-01

In this paper the effects of operating conditions including cooling rate, initial supersaturation, and seeding temperature were investigated on the morphology evolution of β-L-glutamic acid (β-LGA) during seeded cooling crystallization. Based on the results of in-situ image acquisition of the crystal morphology evolution during the crystallization process, it was found that the crystal products tend to be plate-like or short rod-like under a slow cooling rate, low initial supersaturation, and low seeding temperature. In the opposite, the operating conditions of a faster cooling rate, higher initial supersaturation, and higher seeding temperature tend to produce long rod-like or needle-like crystals, and meanwhile, the length and width of crystal products will be increased together with a wider crystal size distribution (CSD). The aspect ratio of crystals, defined by the crystal length over width measured from in-situ or sample images, was taken as a shape index to analyze the crystal morphologies. Based on comparative analysis of the experimental results, guidelines on these operating conditions were given for obtaining the desired crystal shapes, along with the strategies for obtaining a narrower CSD for better product quality. Experimental verifications were performed to illustrate the proposed guidelines on the operating conditions for seeded cooling crystallization of LGA solution.

Hydrolytic resolution of (R,S)-naproxen 2,2,2-trifluoroethyl thioester by Carica papaya lipase in water-saturated organic solvents.

PubMed

Ng, I-Son; Tsai, Shau-Wei

2005-01-05

For the first time, the Carica papaya lipase (CPL) stored in crude papain is explored as a potential enantioselective biocatalyst for obtaining chiral acids from their racemic thioesters. Hydrolytic resolution of (R,S)-naproxen 2,2,2-trifluoroethyl thioester in water-saturated organic solvents is employed as a model system for studying the effects of temperature and solvents on lipase activity and enantioselectivity. An optimal temperature of 60 degrees C, based on the initial rate of (S)-thioester and a high enantiomeric ratio (i.e., E-value defined as the ratio of initial rates for both substrates) of >100 at 45 degrees C in isooctane, is obtained. Kinetic analysis, considering product inhibition and enzyme deactivation, is also performed, showing agreement between the experimental and best-fit conversions for (S)-thioester. A comparison of the kinetic and thermodynamic behaviors of CPL and Candida rugosa lipase (CRL) in isooctane and cyclohexane indicates that both lipases are very similar in terms of thermodynamic parameters DeltaDeltaH and DeltaDeltaS, initial rate of (S)-substrate, and E-value when (R,S)-naproxen 2,2,2-trifluoroethyl thioester or ester is employed as substrate. (c) 2004 Wiley Periodicals, Inc.

Estimating division and death rates from CFSE data

NASA Astrophysics Data System (ADS)

de Boer, Rob J.; Perelson, Alan S.

2005-12-01

The division tracking dye, carboxyfluorescin diacetate succinimidyl ester (CFSE) is currently the most informative labeling technique for characterizing the division history of cells in the immune system. Gett and Hodgkin (Nat. Immunol. 1 (2000) 239-244) have proposed to normalize CFSE data by the 2-fold expansion that is associated with each division, and have argued that the mean of the normalized data increases linearly with time, t, with a slope reflecting the division rate p. We develop a number of mathematical models for the clonal expansion of quiescent cells after stimulation and show, within the context of these models, under which conditions this approach is valid. We compare three means of the distribution of cells over the CFSE profile at time t: the mean, [mu](t), the mean of the normalized distribution, [mu]2(t), and the mean of the normalized distribution excluding nondivided cells, .In the simplest models, which deal with homogeneous populations of cells with constant division and death rates, the normalized frequency distribution of the cells over the respective division numbers is a Poisson distribution with mean [mu]2(t)=pt, where p is the division rate. The fact that in the data these distributions seem Gaussian is therefore insufficient to establish that the times at which cells are recruited into the first division have a Gaussian variation because the Poisson distribution approaches the Gaussian distribution for large pt. Excluding nondivided cells complicates the data analysis because , and only approaches a slope p after an initial transient.In models where the first division of the quiescent cells takes longer than later divisions, all three means have an initial transient before they approach an asymptotic regime, which is the expected [mu](t)=2pt and . Such a transient markedly complicates the data analysis. After the same initial transients, the normalized cell numbers tend to decrease at a rate e-dt, where d is the death rate.Nonlinear parameter fitting of CFSE data obtained from Gett and Hodgkin to ordinary differential equation (ODE) models with first-order terms for cell proliferation and death gave poor fits to the data. The Smith-Martin model with an explicit time delay for the deterministic phase of the cell cycle performed much better. Nevertheless, the insights gained from analysis of the ODEs proved useful as we showed by generating virtual CFSE data with a simulation model, where cell cycle times were drawn from various distributions, and then computing the various mean division numbers.

CHAP-2 heat-transfer analysis of the Fort St. Vrain reactor core

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

Kotas, J.F.; Stroh, K.R.

1983-01-01

The Los Alamos National Laboratory is developing the Composite High-Temperature Gas-Cooled Reactor Analysis Program (CHAP) to provide advanced best-estimate predictions of postulated accidents in gas-cooled reactor plants. The CHAP-2 reactor-core model uses the finite-element method to initialize a two-dimensional temperature map of the Fort St. Vrain (FSV) core and its top and bottom reflectors. The code generates a finite-element mesh, initializes noding and boundary conditions, and solves the nonlinear Laplace heat equation using temperature-dependent thermal conductivities, variable coolant-channel-convection heat-transfer coefficients, and specified internal fuel and moderator heat-generation rates. This paper discusses this method and analyzes an FSV reactor-core accident thatmore » simulates a control-rod withdrawal at full power.« less

Effect of C/N ratio, aeration rate and moisture content on ammonia and greenhouse gas emission during the composting.

PubMed

Jiang, Tao; Schuchardt, Frank; Li, Guoxue; Guo, Rui; Zhao, Yuanqiu

2011-01-01

Gaseous emission (N2O, CH4 and NH3) from composting can be an important source of anthropogenic greenhouse gas and air pollution. A laboratory scale orthogonal experiment was conducted to estimate the effects of C/N ratio, aeration rate and initial moisture content on gaseous emission during the composting of pig faeces from Chinese Ganqinfen system. The results showed that about 23.9% to 45.6% of total organic carbon (TOC) was lost in the form of CO2 and 0.8% to 7.5% of TOC emitted as CH4. Most of the nitrogen was lost in the form of NH3, which account for 9.6% to 32.4% of initial nitrogen. N2O was also an important way of nitrogen losses and 1.5% to 7.3% of initial total nitrogen was lost as it. Statistic analysis showed that the aeration rate is the most important factor which could affect the NH3 (p = 0.0189), CH4 (p = 0.0113) and N2O (p = 0.0493) emissions significantly. Higher aeration rates reduce the CH4 emission but increase the NH3 and N2O losses. C/N ratio could affect the NH3 (p = 0.0442) and CH4 (p = 0.0246) emissions significantly, but not the N2O. Lower C/N ratio caused higher NH3 and CH4 emissions. The initial moisture content can not influence the gaseous emission significantly. Most treatments were matured after 37 days, except a trial with high moisture content and a low C/N ratio.

Maximum initial growth-rate of strong-shock-driven Richtmyer-Meshkov instability

NASA Astrophysics Data System (ADS)

Abarzhi, Snezhana I.; Bhowmich, Aklant K.; Dell, Zachary R.; Pandian, Arun; Stanic, Milos; Stellingwerf, Robert F.; Swisher, Nora C.

2017-10-01

We focus on classical problem of dependence on the initial conditions of the initial growth-rate of strong shocks driven Richtmyer-Meshkov instability (RMI) by developing a novel empirical model and by employing rigorous theories and Smoothed Particle Hydrodynamics (SPH) simulations to describe the simulations data with statistical confidence in a broad parameter regime. For given values of the shock strength, fluids' density ratio, and wavelength of the initial perturbation of the fluid interface, we find the maximum value of RMI initial growth-rate, the corresponding amplitude scale of the initial perturbation, and the maximum fraction of interfacial energy. This amplitude scale is independent of the shock strength and density ratio, and is characteristic quantity of RMI dynamics. We discover the exponential decay of the ratio of the initial and linear growth-rates of RMI with the initial perturbation amplitude that excellently agrees with available data. National Science Foundation, USA.

Maximum initial growth-rate of strong-shock-driven Richtmyer-Meshkov instability

NASA Astrophysics Data System (ADS)

Abarzhi, Snezhana I.; Bhowmich, Aklant K.; Dell, Zachary R.; Pandian, Arun; Stanic, Milos; Stellingwerf, Robert F.; Swisher, Nora C.

2017-11-01

We focus on classical problem of dependence on the initial conditions of the initial growth-rate of strong shocks driven Richtmyer-Meshkov instability (RMI) by developing a novel empirical model and by employing rigorous theories and Smoothed Particle Hydrodynamics (SPH) simulations to describe the simulations data with statistical confidence in a broad parameter regime. For given values of the shock strength, fluids' density ratio, and wavelength of the initial perturbation of the fluid interface, we find the maximum value of RMI initial growth-rate, the corresponding amplitude scale of the initial perturbation, and the maximum fraction of interfacial energy. This amplitude scale is independent of the shock strength and density ratio, and is characteristic quantity of RMI dynamics. We discover the exponential decay of the ratio of the initial and linear growth-rates of RMI with the initial perturbation amplitude that excellently agrees with available data. National Science Foundation, USA.

Targeting health visitor care: lessons from Starting Well.

PubMed

Wright, C M; Jeffrey, S K; Ross, M K; Wallis, L; Wood, R

2009-01-01

UK child health promotion guidelines expect health visitors to assess family needs before new babies are aged 4 months and offer targeted care on that basis thereafter. Data from an intensive family support programme were used to assess how accurately family needs can be predicted at this stage. A population based cohort of 1202 families with new babies receiving an intensive health visiting programme. Analysis of routinely recorded data. Starting Well project, Glasgow, UK. Health visitor rating of family needs. Families receiving high visiting rates or referred to social work services. Of 302 families rated high need, only 143 (47%) were identified by age 4 months. Visiting rates in the first year for those initially rated high need were nearly double those for the remainder, but around two thirds of those with high contact rates/referred to social work were not initially rated high need. Six family characteristics (no income, baby born preterm, multiple pregnancy, South Asian, prior social work/criminal justice involvement, either parent in care as a child) were identified as the commonest/strongest predictors of contact rates; 1003 (83%) families had one such characteristics and/or lived in a highly deprived area, including 228 (93%) of those with high contact rates and 157 (96%) of those referred to social work. Most families at risk will not be identified on an individual basis in the early weeks. Most families in deprived areas need continued input if the most vulnerable families are to be reliably identified.

High rate dry etching of InGaZnO by BCl3/O2 plasma

NASA Astrophysics Data System (ADS)

Park, Wanjae; Whang, Ki-Woong; Gwang Yoon, Young; Hwan Kim, Jeong; Rha, Sang-Ho; Seong Hwang, Cheol

2011-08-01

This paper reports the results of the high-rate dry etching of indium gallium zinc oxide (IGZO) at room temperature using BCl3/O2 plasma. We achieved an etch rate of 250 nm/min. We inferred from the x-ray photoelectron spectroscopy analysis that BOx or BOClx radicals generated from BCl3/O2 plasma cause the etching of the IGZO material. O2 initiates the etching of IGZO, and Ar removes nonvolatile byproducts from the surface during the etching process. Consequently, a smooth etched surface results when these gases are added to the etch gas.

Reirradiation of Large-Volume Recurrent Glioma With Pulsed Reduced-Dose-Rate Radiotherapy

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

Adkison, Jarrod B.; Tome, Wolfgang; Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI

2011-03-01

Purpose: Pulsed reduced-dose-rate radiotherapy (PRDR) is a reirradiation technique that reduces the effective dose rate and increases the treatment time, allowing sublethal damage repair during irradiation. Patients and Methods: A total of 103 patients with recurrent glioma underwent reirradiation using PRDR (86 considered to have Grade 4 at PRDR). PRDR was delivered using a series of 0.2-Gy pulses at 3-min intervals, creating an apparent dose rate of 0.0667 Gy/min to a median dose of 50 Gy (range, 20-60) delivered in 1.8-2.0-Gy fractions. The mean treatment volume was 403.5 {+-} 189.4 cm{sup 3} according to T{sub 2}-weighted magnetic resonance imaging andmore » a 2-cm margin. Results: For the initial or upgraded Grade 4 cohort (n = 86), the median interval from the first irradiation to PRDR was 14 months. Patients undergoing PRDR within 14 months of the first irradiation (n = 43) had a median survival of 21 weeks. Those treated {>=}14 months after radiotherapy had a median survival of 28 weeks (n = 43; p = 0.004 and HR = 1.82 with a 95% CI ranging from 1.25 to 3.10). These data compared favorably to historical data sets, because only 16% of the patients were treated at first relapse (with 46% treated at the second relapse, 32% at the third or fourth relapse, and 4% at the fourth or fifth relapse). The median survival since diagnosis and retreatment was 6.3 years and 11.4 months for low-grade, 4.1 years and 5.6 months for Grade 3, and 1.6 years and 5.1 months for Grade 4 tumors, respectively, according to the initial histologic findings. Multivariate analysis revealed age at the initial diagnosis, initial low-grade disease, and Karnofsky performance score of {>=}80 to be significant predictors of survival after initiation of PRDR. Conclusion: PRDR allowed for safe retreatment of larger volumes to high doses with palliative benefit.« less

A Human-Centered Platform for HIV Infection Reduction in New York: Development and Usage Analysis of the Ending the Epidemic (ETE) Dashboard.

PubMed

Joshi, Ashish; Amadi, Chioma; Katz, Benjamin; Kulkarni, Sarah; Nash, Denis

2017-12-11

Dashboards have been increasingly used in clinic-based interventions, such as clinical performance improvement and monitoring risk of hospital readmissions, and are now gaining traction in population-based interventions, especially in disease assessment. We describe the design, development, and usage analysis of a geovisualization dashboard, the Ending the Epidemic (ETE) Dashboard. The ETE dashboard is a tool developed to track New York's progress towards achieving the goal of its ETE Initiative, to reduce new HIV infections from 3000 per year to 750 per year by the end of 2020. The ETE dashboard was adapted from an existing human-centered geovisualization platform, SanaViz, an Internet-enabled, interactive app incorporating principles of human-centered design and cognitive fit theory to enhance visual exploration of population health data. Usage evaluation of the ETE geovisualization dashboard was conducted using Google Analytics over a 4-week period from March 19 to April 18, 2016. The aim was to monitor user activity and analyze traffic on the ETE dashboard using evidence-based metrics that can provide adequate feedback to enhance its utilization. Usage was characterized based on three metrics: (1) number of unique visits to each page, (2) average time on each page in seconds, and (3) page bounce rate (ie, percentage of visits where user left the site immediately after viewing just a single page). Further analysis was also conducted by cross-tabulating specific usage metrics. Of 860 sessions, 324 sessions were initiated by unique users (37.7%). The most common acquisition channels included direct source (353/860, 41.0%); followed by referral traffic (340/860, 39.5%) and organic search (134/860, 15.5%). Usage statistics indicate that for the 860 sessions initiated by both new and returning users, the average viewing time was 8 minutes, 51 seconds, and the bounce rate was 46%. These statistics reflect positive results given that prior literature estimates an average session duration of 10-20 seconds and a bounce rate of 40-60% for most websites. Key findings from our study showed that the highest bounce rates were seen for the "About" page of the ETE website (65%), which describes the ETE initiative. The lowest bounce rates were seen for the ETE blog page (17%), consistent with prior research on website usage metrics that indicate that blog pages are often the most frequently viewed pages on Web portals. Our findings reveal the potential of Google Analytics as a tool to enhance user traffic and performance of the ETE geovisualization platform by using feedback from regular monitoring of key parameters including page bounce rates and average time on page. It also identifies the need for a follow-up usability assessment of the system. ©Ashish Joshi, Chioma Amadi, Benjamin Katz, Sarah Kulkarni, Denis Nash. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 11.12.2017.

A Human-Centered Platform for HIV Infection Reduction in New York: Development and Usage Analysis of the Ending the Epidemic (ETE) Dashboard

PubMed Central

Amadi, Chioma; Katz, Benjamin; Kulkarni, Sarah; Nash, Denis

2017-01-01

Background Dashboards have been increasingly used in clinic-based interventions, such as clinical performance improvement and monitoring risk of hospital readmissions, and are now gaining traction in population-based interventions, especially in disease assessment. Objective We describe the design, development, and usage analysis of a geovisualization dashboard, the Ending the Epidemic (ETE) Dashboard. The ETE dashboard is a tool developed to track New York’s progress towards achieving the goal of its ETE Initiative, to reduce new HIV infections from 3000 per year to 750 per year by the end of 2020. Methods The ETE dashboard was adapted from an existing human-centered geovisualization platform, SanaViz, an Internet-enabled, interactive app incorporating principles of human-centered design and cognitive fit theory to enhance visual exploration of population health data. Usage evaluation of the ETE geovisualization dashboard was conducted using Google Analytics over a 4-week period from March 19 to April 18, 2016. The aim was to monitor user activity and analyze traffic on the ETE dashboard using evidence-based metrics that can provide adequate feedback to enhance its utilization. Usage was characterized based on three metrics: (1) number of unique visits to each page, (2) average time on each page in seconds, and (3) page bounce rate (ie, percentage of visits where user left the site immediately after viewing just a single page). Further analysis was also conducted by cross-tabulating specific usage metrics. Results Of 860 sessions, 324 sessions were initiated by unique users (37.7%). The most common acquisition channels included direct source (353/860, 41.0%); followed by referral traffic (340/860, 39.5%) and organic search (134/860, 15.5%). Usage statistics indicate that for the 860 sessions initiated by both new and returning users, the average viewing time was 8 minutes, 51 seconds, and the bounce rate was 46%. These statistics reflect positive results given that prior literature estimates an average session duration of 10-20 seconds and a bounce rate of 40-60% for most websites. Key findings from our study showed that the highest bounce rates were seen for the “About” page of the ETE website (65%), which describes the ETE initiative. The lowest bounce rates were seen for the ETE blog page (17%), consistent with prior research on website usage metrics that indicate that blog pages are often the most frequently viewed pages on Web portals. Conclusions Our findings reveal the potential of Google Analytics as a tool to enhance user traffic and performance of the ETE geovisualization platform by using feedback from regular monitoring of key parameters including page bounce rates and average time on page. It also identifies the need for a follow-up usability assessment of the system. PMID:29229592

Establishment of joint attention in dyads involving hearing mothers of deaf and hearing children, and its relation to adaptive social behavior.

PubMed

Nowakowski, Matilda E; Tasker, Susan L; Schmidt, Louis A

2009-01-01

Mounting evidence points to joint attention as a mediating variable in children's adaptive behavior development. Joint attention in interactions between hearing mothers and congenitally deaf (n = 27) and hearing (n = 29) children, ages 18-36 months, was examined. All deaf children had severe to profound hearing loss. Mother-child interactions were coded for maternally initiated and child-initiated success rates in establishing joint attention; mothers completed ratings of their children's adaptive behavior. Hearing mother-deaf child dyads had significantly lower maternally initiated success rates. No significant between-group differences on child-initiated success rates were shown. Maternal ratings of adaptive behavior were significantly lower for deaf children, and related positively and significantly to both child-initiated and maternally initiated success rates. The findings suggest that mother-child interactions that are low in successful establishment of joint attention might mediate the development of socioemotional problems evident in deaf children with hearing families.

Novel kinetic spectrophotometric method for estimation of certain biologically active phenolic sympathomimetic drugs in their bulk powders and different pharmaceutical formulations

NASA Astrophysics Data System (ADS)

Omar, Mahmoud A.; Badr El-Din, Khalid M.; Salem, Hesham; Abdelmageed, Osama H.

2018-03-01

A simple, selective and sensitive kinetic spectrophotometric method was described for estimation of four phenolic sympathomimetic drugs namely; terbutaline sulfate, fenoterol hydrobromide, isoxsuprine hydrochloride and etilefrine hydrochloride. This method is depended on the oxidation of the phenolic drugs with Folin-Ciocalteu reagent in presence of sodium carbonate. The rate of color development at 747-760 nm was measured spectrophotometrically. The experimental parameters controlling the color development were fully studied and optimized. The reaction mechanism for color development was proposed. The calibration graphs for both the initial rate and fixed time methods were constructed, where linear correlations were found in the general concentration ranges of 3.65 × 10- 6-2.19 × 10- 5 mol L- 1 and 2-24.0 μg mL- 1 with correlation coefficients in the following range 0.9992-0.9999, 0.9991-0.9998 respectively. The limits of detection and quantitation for the initial rate and fixed time methods were found to be in general concentration range 0.109-0.273, 0.363-0.910 and 0.210-0.483, 0.700-1.611 μg mL- 1 respectively. The developed method was validated according to ICH and USP 30 -NF 25 guidelines. The suggested method was successfully implemented to the estimation of these drugs in their commercial pharmaceutical formulations and the recovery percentages obtained were ranged from 97.63% ± 1.37 to 100.17% ± 0.95 and 97.29% ± 0.74 to 100.14 ± 0.81 for initial rate and fixed time methods respectively. The data obtained from the analysis of dosage forms were compared with those obtained by reported methods. Statistical analysis of these results indicated no significant variation in the accuracy and precision of both the proposed and reported methods.

A Logistic Regression Analysis of Student Experience Factors for the Enhancement of Developmental Post-Secondary Retention Initiatives

ERIC Educational Resources Information Center

Shenkle, Michael Thomas

2017-01-01

In response to stagnant undergraduate completion rates and growing demands for post-secondary accountability, institutions are actively pursuing effective, broadly applicable methods for promoting student success. One notable scarcity in existing research is found in the tailoring of broad academic interventions to better meet the specific needs…

77 FR 74224 - OSHA Data Initiative (ODI); Extension of the Office of Management and Budget's (OMB) Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-13

... Schmidt, Office of Statistical Analysis, Occupational Safety and Health Administration, U.S. Department of... 1904. These data will allow OSHA to calculate occupational injury and illness rates and to focus its... and dates of birth. Although all submissions are listed in the http://www.regulations.gov index, some...

The Effect of a State Department of Education Teacher Mentor Initiative on Science Achievement

ERIC Educational Resources Information Center

Pruitt, Stephen L.

2010-01-01

This study analyzed a state department of education's ability to have actual influence over the improvement of science achievement and proficiency by having direct relationships with science teachers in Georgia's lowest performing schools. The study employed a mixed ANOVA analysis of the mean scale scores and proficiency rates of the science…

Advanced bridge safety initiative : phase 2, task 2 - effects of curb and railing inclusion on rating factors of reinforced concrete flat slab bridges using finite element analysis.

DOT National Transportation Integrated Search

2017-03-01

The Maine Department of Transportation (Maine DOT) owns a number of existing reinforced concrete slab : bridges that utilize the standard Maine concrete bridge rail. At issue is the additional stiffening and strengthening : that the curb and this rai...

[Influence of Saccharomyces boulardii Sachets combined with bismuth quadruple therapy for initial Helicobacter pylori eradication].

PubMed

Zhu, X Y; Du, J; Wu, J; Zhao, L W; Meng, X; Liu, G F

2017-08-08

Objective: To evaluate the efficacy and safety of Saccharomyces boulardii Sachets combined with bismuth quadruple therapy for initial Helicobacter pylori ( H . pylori ) eradication. Methods: From March 2014 to March 2015, 240 participants from the third hospital of Hebei medical university with H . pylori infection were recruited and randomized into three groups: Quadruple therapy group received bismuth potassium citrate 220 mg bid + Rabeprazole 10 mg bid + amoxicillin 1 000 mg bid+ furazolidone 100 mg bid for 10 days. Short-term group and long-term group received the same quadruple therapy for 10 days as above, as well as Saccharomyces boulardii Sachets 500 mg bid for 14 days and 28 days, respectively. H . pylori eradication was confirmed by (13)C/(14)C-UBT at least 4 weeks after completion of therapy. And side effects were investigated during the therapy. Results: The H . pylori eradication rates in quadruple therapy, short-term and long-term group were 80%, 87.5% and 87.5% by ITT analysis ( P =0.321) and 92.8%, 94.6% and 95.9% by PP analysis ( P =0.717), respectively. The overall side effect rate and occurrence of diarrhea and abdominal distension were significantly lower in short-term or long-term group as compared with quadruple therapy group( P =0.007, 0.003, 0.004), but there was no significant difference between the two probiotics groups. Conclusions: Both short and long-term Saccharomyces boulardii Sachets reduced the overall side effect rate and occurrence of diarrhea or abdominal distension when combined with bismuth quadruple therapy for initial H . pylori eradication and no difference was observed in efficacy or safety between the two groups.

Emergency department information system implementation and process redesign result in rapid and sustained financial enhancement at a large academic center.

PubMed

Shapiro, Jason S; Baumlin, Kevin M; Chawla, Neal; Genes, Nicholas; Godbold, James; Ye, Fen; Richardson, Lynne D

2010-05-01

The objectives were to measure the financial impact of implementing a fully integrated emergency department information system (EDIS) and determine the length of time to "break even" on the initial investment. A before-and-after study design was performed using a framework of analysis consisting of four 15-month phases: 1) preimplementation, 2) peri-implementation, 3) postimplementation, and 4) sustained effects. Registration and financial data were reviewed. Costs and rates of professional and facility charges and receipts were calculated for the phases in question and compared against monthly averages for covariates such as volume, collections rates, acuity, age, admission rate, and insurance status with an autoregressive time series analysis using a segmented model. The break-even point was calculated by measuring cumulative monthly receipts for the last three study phases in excess of the average monthly receipts from the preimplementation phase, corrected for change in volume, and then plotting this against cumulative overall cost. Time to break even on the initial EDIS investment was less than 8 months. Total revenue enhancement at the end of the 5-year study period was $16,138,953 with an increase of 69.40% in charges and 70.06% in receipts. This corresponds to an increase in receipts per patient from $50 to $90 for professional services and $131 to $183 for facilities charges. Other than volume, there were no significant changes in trends for covariates between the preimplementation and sustained-effects periods. A comprehensive EDIS implementation with process redesign resulted in sustained increases in professional and facility revenues and a rapid initial break-even point. .

Have we left some behind? Trends in socio-economic inequalities in breastfeeding initiation: a population-based epidemiological surveillance study.

PubMed

Nickel, Nathan C; Martens, Patricia J; Chateau, Dan; Brownell, Marni D; Sarkar, Joykrishna; Goh, Chun Yan; Burland, Elaine; Taylor, Carole; Katz, Alan

2014-07-31

Breastfeeding is associated with improved health. Surveillance data show that breastfeeding initiation rates have increased; however, limited work has examined trends in socio-economic inequalities in initiation. The study's research question was whether socio-economic inequalities in breastfeeding initiation have changed over the past 20 years. This population-based study is a project within PATHS Equity for Children. Analyses used hospital discharge data for Manitoba mother-infant dyads with live births, 1988-2011 (n=316,027). Income quintiles were created, each with ~20% of dyads. Three-year, overall and by-quintile breastfeeding initiation rates were estimated for Manitoba and two hospitals. Age-adjusted rates were estimated for Manitoba. Rates were modelled using generalized linear models. Three measures, rate ratios (RRs), rate differences (RDs) and concentration indices, assessed inequality at each time point. We also compared concentration indices with Gini coefficients to assess breastfeeding inequality vis-à-vis income inequality. Trend analyses tested for changes over time. Manitoba and Hospital A initiation rates increased; Hospital B rates did not change. Significant inequalities existed in nearly every period, across all three measures: RRs, RDs and concentration indices. RRs and concentration indices suggested little to no change in inequality from 1988 to 2011. RDs for Manitoba (comparing initiation in the highest to lowest income quintiles) did not change significantly over time. RDs decreased for Hospital A, suggesting decreasing socio-economic inequalities in breastfeeding; RDs increased for Hospital B. Income inequality increased significantly in Manitoba during the study period. Overall breastfeeding initiation rates can improve while inequality persists or worsens.

Experiences of Racism and Breastfeeding Initiation and Duration Among First-Time Mothers of the Black Women's Health Study.

PubMed

Griswold, Michele K; Crawford, Sybil L; Perry, Donna J; Person, Sharina D; Rosenberg, Lynn; Cozier, Yvette C; Palmer, Julie R

2018-02-12

Breastfeeding rates are lower for black women in the USA compared with other groups. Breastfeeding and lactation are sensitive time points in the life course, centering breastfeeding as a health equity issue. In the USA, experiences of racism have been linked to poor health outcomes but racism relative to breastfeeding has not been extensively investigated. This study aims to investigate the association between experiences of racism, neighborhood segregation, and nativity with breastfeeding initiation and duration. This is a prospective secondary analysis of the Black Women's Health Study, based on data collected from 1995 through 2005. Daily and institutional (job, housing, police) racism, nativity, and neighborhood segregation in relation to breastfeeding were examined. Odds ratios and 95% confidence intervals were calculated using binomial logistic regression for the initiation outcomes (N = 2705) and multinomial logistic regression for the duration outcomes (N = 2172). Racism in the job setting was associated with lower odds of breastfeeding duration at 3-5 months. Racism with the police was associated with higher odds of breastfeeding initiation and duration at 3-5 and 6 months. Being born in the USA or having a parent born in the USA predicted lower odds of breastfeeding initiation and duration. Living in a segregated neighborhood (primarily black residents) as a child was associated with decreased breastfeeding initiation and duration relative to growing up in a predominantly white neighborhood. Experiences of institutionalized racism influenced breastfeeding initiation and duration. Structural-level interventions are critical to close the gap of racial inequity in breastfeeding rates in the USA.

Examples of data assimilation in mesoscale models

NASA Technical Reports Server (NTRS)

Carr, Fred; Zack, John; Schmidt, Jerry; Snook, John; Benjamin, Stan; Stauffer, David

1993-01-01

The keynote address was the problem of physical initialization of mesoscale models. The classic purpose of physical or diabatic initialization is to reduce or eliminate the spin-up error caused by the lack, at the initial time, of the fully developed vertical circulations required to support regions of large rainfall rates. However, even if a model has no spin-up problem, imposition of observed moisture and heating rate information during assimilation can improve quantitative precipitation forecasts, especially early in the forecast. The two key issues in physical initialization are the choice of assimilating technique and sources of hydrologic/hydrometeor data. Another example of data assimilation in mesoscale models was presented in a series of meso-beta scale model experiments with and 11 km version of the MASS model designed to investigate the sensitivity of convective initiation forced by thermally direct circulations resulting from differential surface heating to four dimensional assimilation of surface and radar data. The results of these simulations underscore the need to accurately initialize and simulate grid and sub-grid scale clouds in meso- beta scale models. The status of the application of the CSU-RAMS mesoscale model by the NOAA Forecast Systems Lab for producing real-time forecasts with 10-60 km mesh resolutions over (4000 km)(exp 2) domains for use by the aviation community was reported. Either MAPS or LAPS model data are used to initialize the RAMS model on a 12-h cycle. The use of MAPS (Mesoscale Analysis and Prediction System) model was discussed. Also discussed was the mesobeta-scale data assimilation using a triply-nested nonhydrostatic version of the MM5 model.

Examining parents' ratings of middle-school students' academic self-regulation using principal axis factoring analysis.

PubMed

Chen, Peggy P; Cleary, Timothy J; Lui, Angela M

2015-09-01

This study examined the reliability and validity of a parent rating scale, the Self-Regulation Strategy Inventory: Parent Rating Scale (SRSI-PRS), using a sample of 451 parents of sixth- and seventh-grade middle-school students. Principal axis factoring (PAF) analysis revealed a 3-factor structure for the 23-item SRSI-PRS: (a) Managing Behavior and Learning (α = .92), (b) Maladaptive Regulatory Behaviors (α = .76), and (c) Managing Environment (α = .84). The majority of the observed relations between these 3 subscales, and the SRSI-SR, student motivation beliefs, and student mathematics grades were statistically significant and in the small to medium range. After controlling for various student variables and motivation indices of parental involvement, 2 SRSI-PRS factors (Managing Behavior and Learning, Maladaptive Regulatory Behaviors) reliably predicted students' achievement in their mathematics course. This study provides initial support for the validity and reliability of the SRSI-PRS and underscores the advantages of obtaining parental ratings of students' SRL behaviors. (c) 2015 APA, all rights reserved).

[Measures to reduce costs for prescriptions in Vienna--preliminary analysis].

PubMed

Tönies, Hans

2009-01-01

To increase the rate of prescriptions for generic drugs in Vienna an information campaign was started in 2004 and quality circles for prescribing doctors were organized. Since the result of this initiative is not yet known publicly this report aims to present a preliminary analysis. The prescription statements kindly provided by the health insurance fund of Vienna could be analysed. Data from the Chamber of Viennese Physicians were used for compiling a report about the quality circles. A total of 17 quality circles with an average of 15 participants were formed; they met four times yearly. Participants were paid for their attendance. The rate of prescribed generic drugs in Vienna has continuously improved, with the major increase in the first year of the activities. In the year 2006 a rate of over 40% generic prescriptions was reached by 80% of general practitioners. This cooperation between the health insurance fund and doctors apparently resulted in both an increase in the rate of generic drugs prescribed and in a good acceptance among physicians.

Operation Pied Piper: a geographical reappraisal of the impact of wartime evacuation on scarlet fever and diphtheria rates in England and Wales, 1939-1945.

PubMed

Smallman-Raynor, M R; Cliff, A D

2015-10-01

This paper examines the geographical impact of the British Government's wartime evacuation scheme on notified rates of two common acute childhood diseases (scarlet fever and diphtheria) in the 1470 local government districts of England and Wales, 1939-1945. Drawing on the notifications of communicable diseases collated by the General Register Office (GRO), we establish pre-war (baseline) disease rates for the 1470 districts. For the war years, techniques of binary logistic regression analysis are used to assess the associations between (a) above-baseline ('raised') disease rates in evacuation, neutral and reception districts and (b) the major phases of the evacuation scheme. The analysis demonstrates that the evacuation was temporally associated with distinct national and regional effects on notified levels of disease activity. These effects were most pronounced in the early years of the dispersal (1939-1941) and corresponded with initial levels of evacuation-related population change at the regional and district scales.

Research on the water-entry attitude of a submersible aircraft.

PubMed

Xu, BaoWei; Li, YongLi; Feng, JinFu; Hu, JunHua; Qi, Duo; Yang, Jian

2016-01-01

The water entry of a submersible aircraft, which is transient, highly coupled, and nonlinear, is complicated. After analyzing the mechanics of this process, the change rate of every variable is considered. A dynamic model is build and employed to study vehicle attitude and overturn phenomenon during water entry. Experiments are carried out and a method to organize experiment data is proposed. The accuracy of the method is confirmed by comparing the results of simulation of dynamic model and experiment under the same condition. Based on the analysis of the experiment and simulation, the initial attack angle and angular velocity largely influence the water entry of vehicle. Simulations of water entry with different initial and angular velocities are completed, followed by an analysis, and the motion law of vehicle is obtained. To solve the problem of vehicle stability and control during water entry, an approach is proposed by which the vehicle sails with a zero attack angle after entering water by controlling the initial angular velocity. With the dynamic model and optimization research algorithm, calculation is performed, and the optimal initial angular velocity of water-entry is obtained. The outcome of simulations confirms that the effectiveness of the propose approach by which the initial water-entry angular velocity is controlled.

Pattern of spread and prognosis in lower limb-onset ALS

PubMed Central

TURNER, MARTIN R.; BROCKINGTON, ALICE; SCABER, JAKUB; HOLLINGER, HANNAH; MARSDEN, RACHAEL; SHAW, PAMELA J.; TALBOT, KEVIN

2011-01-01

Our objective was to establish the pattern of spread in lower limb-onset ALS (contra- versus ipsi-lateral) and its contribution to prognosis within a multivariate model. Pattern of spread was established in 109 sporadic ALS patients with lower limb-onset, prospectively recorded in Oxford and Sheffield tertiary clinics from 2001 to 2008. Survival analysis was by univariate Kaplan-Meier log-rank and multivariate Cox proportional hazards. Variables studied were time to next limb progression, site of next progression, age at symptom onset, gender, diagnostic latency and use of riluzole. Initial progression was either to the contralateral leg (76%) or ipsilateral arm (24%). Factors independently affecting survival were time to next limb progression, age at symptom onset, and diagnostic latency. Time to progression as a prognostic factor was independent of initial direction of spread. In a regression analysis of the deceased, overall survival from symptom onset approximated to two years plus the time interval for initial spread. In conclusion, rate of progression in lower limb-onset ALS is not influenced by whether initial spread is to the contralateral limb or ipsilateral arm. The time interval to this initial spread is a powerful factor in predicting overall survival, and could be used to facilitate decision-making and effective care planning. PMID:20001488

Magneto-Rayleigh-Taylor instability in solid media

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

Sun, Y. B.; School of Physical Science and Technology, Lanzhou University, Lanzhou 73000; University of Chinese Academy of Sciences, Beijing 100049

2014-07-15

A linear analysis of the magneto-Rayleigh-Taylor instability at the interface between a Newtonian fluid and an elastic-plastic solid is performed by considering a uniform magnetic B{sup →}, parallel to the interface, which has diffused into the fluid but not into the solid. It is found that the magnetic field attributes elastic properties to the viscous fluid which enhance the stability region by stabilizing all the perturbation wavelengths shorter than λ{sub 0}∝B{sup 2} for any initial perturbation amplitude. Longer wavelengths are stabilized by the mechanical properties of the solid provided that the initial perturbation wavelength is smaller than a threshold valuemore » determined by the yield strength and the shear modulus of the solid. Beyond this threshold, the amplitude grows initially with a growth rate reduced by the solid strength properties. However, such properties do not affect the asymptotic growth rate which is only determined by the magnetic field and the fluid viscosity. The described physical situation intends to resemble some of the features present in recent experiments involving the magnetic shockless acceleration of flyers plates.« less

[Removal of AOX and Chroma in Biologically Treated Effluent of Chemical Dyestuff Wastewater with Nanoscale Ni/Fe].

PubMed

Shu, Xiao-ming; Xu, Can-can; Liu, Rui; Zhao, Yuan; Chen, Lü-jun

2016-02-15

Nanoscale Ni/Fe was applied to biologically treated effluent of chemical dyestuff wastewater. The removal rates of absorbable organic halogens (AOX) and chroma were investigated at different Ni loadings (0-5%), initial wastewater pH (4.1-10.0), Ni/Fe dosage (1-5 g x L(-1)) and reaction time (0.5-96 h). The results showed that the removal rates of AOX and chroma firstly increased and then decreased with the increase of the Ni loading, while continuously increased with the decrease of the initial wastewater pH and the increase of Ni/Fe dosage. The optimal condition was Ni loading of 1%, initial wastewater pH of 4.1 and Ni/Fe dosage of 3 g x L(-1), under which 29.2% of AOX and 79.6% of chroma were removed after 24 h reaction, and 50.6% of AOX and 80.7% of chroma were removed after 96 h reaction. GC-MS analysis revealed that toxicants such as chlorinated anilines, p-nitroaniline, 4-methoxy-2-nitroaniline and halogenated hydrocarbons were efficiently removed.

Procurement of a more efficient railroad system

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

Detmold, P.J.

An analysis of how new technology penetrates the railroad system and who initiates the changes suggests ways for improving the procedures. The author identifies a six-step process in transport development which includes invention, innovation, information dissemination, and persuasion. He concludes that poor economic justification and the lack of capital explain the low rate of equipment replacement. The nature of the market and the need for standardized specification appear to influence procurement changes, but both suppliers and transport operators must be convinced of the need for change. The Advanced Train Control Systems Project illustrates how the initiation process works.

Mechanistic Study of Nickel-Catalyzed Ynal Reductive Cyclizations Through Kinetic Analysis

PubMed Central

Baxter, Ryan D.; Montgomery, John

2011-01-01

The mechanism of nickel-catalyzed, silane-mediated reductive cyclization of ynals has been evaluated. The cyclizations are first-order in [Ni] and [ynal] and zeroth-order in [silane]. These results, in combination with the lack of rapid silane consumption upon reaction initiation are inconsistent with mechanisms involving reaction initiation by oxidative addition of Ni(0) to the silane. Silane consumption occurs only when both the alkyne and aldehyde and are present. Mechanisms involving rate-determining oxidative cyclization to a metallacycle followed by rapid reaction with the silane are consistent with the data obtained. PMID:21438642

Resolving the Origin of Rabbit Hemorrhagic Disease Virus: Insights from an Investigation of the Viral Stocks Released in Australia

PubMed Central

Eden, John-Sebastian; Read, Andrew J.; Duckworth, Janine A.; Strive, Tanja

2015-01-01

To resolve the evolutionary history of rabbit hemorrhagic disease virus (RHDV), we performed a genomic analysis of the viral stocks imported and released as a biocontrol measure in Australia, as well as a global phylogenetic analysis. Importantly, conflicts were identified between the sequences determined here and those previously published that may have affected evolutionary rate estimates. By removing likely erroneous sequences, we show that RHDV emerged only shortly before its initial description in China. PMID:26378178

Development of the Expert System Domain Advisor and Analysis Tool

DTIC Science & Technology

1991-09-01

analysis. Typical of the current methods in use at this time is the " tarot metric". This method defines a decision rule whose output is whether to go...B - TAROT METRIC B. ::TTRODUCTION The system chart of ESEM, Figure 1, shows the following three risk-based decision points: i. At prolect initiation...34 decisions. B-I 201 PRELIMINARY T" B-I. Evaluais Factan for ES Deyelopsineg FACTORS POSSIBLE VALUE RATINGS TAROT metric (overall suitability) Poor, Fair

Preliminary Failure Modes and Effects Analysis of the US DCLL Test Blanket Module

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

Lee C. Cadwallader

2010-06-01

This report presents the results of a preliminary failure modes and effects analysis (FMEA) of a small tritium-breeding test blanket module design for the International Thermonuclear Experimental Reactor. The FMEA was quantified with “generic” component failure rate data, and the failure events are binned into postulated initiating event families and frequency categories for safety assessment. An appendix to this report contains repair time data to support an occupational radiation exposure assessment for test blanket module maintenance.

Preliminary Failure Modes and Effects Analysis of the US DCLL Test Blanket Module

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

Lee C. Cadwallader

2007-08-01

This report presents the results of a preliminary failure modes and effects analysis (FMEA) of a small tritium-breeding test blanket module design for the International Thermonuclear Experimental Reactor. The FMEA was quantified with “generic” component failure rate data, and the failure events are binned into postulated initiating event families and frequency categories for safety assessment. An appendix to this report contains repair time data to support an occupational radiation exposure assessment for test blanket module maintenance.

Flocking of the Motsch-Tadmor Model with a Cut-Off Interaction Function

NASA Astrophysics Data System (ADS)

Jin, Chunyin

2018-04-01

In this paper, we study the flocking behavior of the Motsch-Tadmor model with a cut-off interaction function. Our analysis shows that connectedness is important for flocking of this kind of model. Fortunately, we get a sufficient condition imposed only on the model parameters and initial data to guarantee the connectedness of the neighbor graph associated with the system. Then we present a theoretical analysis for flocking, and show that the system achieves consensus at an exponential rate.

Multi-factor Analysis of Pre-control Fracture Simulations about Projectile Material

NASA Astrophysics Data System (ADS)

Wan, Ren-Yi; Zhou, Wei

2016-05-01

The study of projectile material pre-control fracture is helpful to improve the projectile metal effective fragmentation and the material utilization rate. Fragments muzzle velocity and lethality can be affected by the different explosive charge and the way of initiation. The finite element software can simulate the process of projectile explosive rupture which has a pre-groove in the projectile shell surface and analysis of typical node velocity change with time, to provides a reference for the design and optimization of precontrol frag.

Analysis of Crystallization Kinetics

NASA Technical Reports Server (NTRS)

Kelton, Kenneth F.

1997-01-01

A realistic computer model for polymorphic crystallization (i.e., initial and final phases with identical compositions), which includes time-dependent nucleation and cluster-size-dependent growth rates, is developed and tested by fits to experimental data. Model calculations are used to assess the validity of two of the more common approaches for the analysis of crystallization data. The effects of particle size on transformation kinetics, important for the crystallization of many systems of limited dimension including thin films, fine powders, and nanoparticles, are examined.

Analysis and performance of paralleling circuits for modular inverter-converter systems

NASA Technical Reports Server (NTRS)

Birchenough, A. G.; Gourash, F.

1972-01-01

As part of a modular inverter-converter development program, control techniques were developed to provide load sharing among paralleled inverters or converters. An analysis of the requirements of paralleling circuits and a discussion of the circuits developed and their performance are included in this report. The current sharing was within 5.6 percent of rated-load current for the ac modules and 7.4 percent for the dc modules for an initial output voltage unbalance of 5 volts.

Comparison of salivary cortisol, heart rate, and oxygen saturation between early skin-to-skin contact with different initiation and duration times in healthy, full-term infants.

PubMed

Takahashi, Yuki; Tamakoshi, Koji; Matsushima, Miyoko; Kawabe, Tsutomu

2011-03-01

There are few studies that compare the physiological and biological efficacies between different early skin-to-skin contacts (SSC) post birth. To investigate physiologically and biochemically how early SSC with different initiation and duration time influence the stress post birth for full-term infants. Non-experimental study. Study I; Thirty-two infants who began SSC 5 min or less [birth SSC, mean initiation time (standard deviation): 1.6 (1.1) min] after birth and 36 infants who did so more than 5 min [very early SSC, 26.3 (5.0) min] in heart rate (HR) and oxygen saturation (SpO(2)) analysis. Study II; Eighteen infants who underwent SSC for 60 min or less [mean initiation time: 7.5 (12.2) min] and 61 infants who did so for more than 60 min [15.3 (12.5) min] in salivary cortisol analysis. HR and SpO(2) measured for 30 min post birth. Salivary cortisol concentration measured at 1 min, 60 min, and 120 min post birth. Birth SSC group reached HR stability of 120-160 bpm significantly faster than very early SSC group by Kaplan-Meier analysis (P=0.001 by log-rank test). As for SpO(2) stability of 92% and 96%, no significantly between-group difference was found. Salivary cortisol levels were significantly lower between 60 and 120 min after birth in SSC group, continuing for more than 60 min compared with SSC group for 60 min or less after adjustment for salivary cortisol level at 1 min besides the infant stress factors (P=0.046). Earlier SSC beginning within 5 min post birth and longer SSC continuing for more than 60 min within 120 min post birth are beneficial for stability of cardiopulmonary dynamics and the reduction of infant stress during the early period post birth. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Linear bubble plume model for hypolimnetic oxygenation: Full-scale validation and sensitivity analysis

NASA Astrophysics Data System (ADS)

Singleton, V. L.; Gantzer, P.; Little, J. C.

2007-02-01

An existing linear bubble plume model was improved, and data collected from a full-scale diffuser installed in Spring Hollow Reservoir, Virginia, were used to validate the model. The depth of maximum plume rise was simulated well for two of the three diffuser tests. Temperature predictions deviated from measured profiles near the maximum plume rise height, but predicted dissolved oxygen profiles compared very well with observations. A sensitivity analysis was performed. The gas flow rate had the greatest effect on predicted plume rise height and induced water flow rate, both of which were directly proportional to gas flow rate. Oxygen transfer within the hypolimnion was independent of all parameters except initial bubble radius and was inversely proportional for radii greater than approximately 1 mm. The results of this work suggest that plume dynamics and oxygen transfer can successfully be predicted for linear bubble plumes using the discrete-bubble approach.

Linear Stability of Binary Alloy Solidification for Unsteady Growth Rates

NASA Technical Reports Server (NTRS)

Mazuruk, K.; Volz, M. P.

2010-01-01

An extension of the Mullins and Sekerka (MS) linear stability analysis to the unsteady growth rate case is considered for dilute binary alloys. In particular, the stability of the planar interface during the initial solidification transient is studied in detail numerically. The rapid solidification case, when the system is traversing through the unstable region defined by the MS criterion, has also been treated. It has been observed that the onset of instability is quite accurately defined by the "quasi-stationary MS criterion", when the growth rate and other process parameters are taken as constants at a particular time of the growth process. A singular behavior of the governing equations for the perturbed quantities at the constitutional supercooling demarcation line has been observed. However, when the solidification process, during its transient, crosses this demarcation line, a planar interface is stable according to the linear analysis performed.

Use of histamine H2 receptor antagonists and outcomes in patients with heart failure: a nationwide population-based cohort study.

PubMed

Adelborg, Kasper; Sundbøll, Jens; Schmidt, Morten; Bøtker, Hans Erik; Weiss, Noel S; Pedersen, Lars; Sørensen, Henrik Toft

2018-01-01

Histamine H 2 receptor activation promotes cardiac fibrosis and apoptosis in mice. However, the potential effectiveness of histamine H 2 receptor antagonists (H2RAs) in humans with heart failure is largely unknown. We examined the association between H2RA initiation and all-cause mortality among patients with heart failure. Using Danish medical registries, we conducted a nationwide population-based active-comparator cohort study of new users of H2RAs and proton pump inhibitors (PPIs) after first-time hospitalization for heart failure during the period 1995-2014. Hazard ratios (HRs) for all-cause mortality and hospitalization due to worsening of heart failure, adjusting for age, sex, and time between heart failure diagnosis and initiation of PPI or H2RA therapy, index year, comorbidity, cardiac surgery, comedications, and socioeconomic status were computed based on Cox regression analysis. Our analysis included 42,902 PPI initiators (median age 78 years, 46% female) and 3,296 H2RA initiators (median age 76 years, 48% female). Mortality risk was lower among H2RA initiators than PPI initiators after 1 year (26% vs 31%) and 5 years (60% vs 66%). In multivariable analyses, the 1-year HR was 0.80 (95% CI, 0.74-0.86) and the 5-year HR was 0.85 (95% CI, 0.80-0.89). These findings were consistent after propensity score matching and for ischemic and nonischemic heart failure, as for sex and age groups. The rate of hospitalization due to worsening of heart failure was lower among H2RA initiators than PPI initiators. In patients with heart failure, H2RA initiation was associated with 15%-20% lower mortality than PPI initiation.

Handling of computational in vitro/in vivo correlation problems by Microsoft Excel: IV. Generalized matrix analysis of linear compartment systems.

PubMed

Langenbucher, Frieder

2005-01-01

A linear system comprising n compartments is completely defined by the rate constants between any of the compartments and the initial condition in which compartment(s) the drug is present at the beginning. The generalized solution is the time profiles of drug amount in each compartment, described by polyexponential equations. Based on standard matrix operations, an Excel worksheet computes the rate constants and the coefficients, finally the full time profiles for a specified range of time values.

Initial statistics from the Perth Automated Supernova Search

NASA Astrophysics Data System (ADS)

Williams, A. J.

1997-08-01

The Perth Automated Supernova Search uses the 61-cm PLAT (Perth Lowell Automated Telescope) at Perth Observatory, Western Australia. Since 1993 January 1, five confirmed supernovae have been found by the search. The analysis of the first three years of data is discussed, and preliminary results presented. We find a Type Ib/c rate of 0.43 +/- 0.43 SNu, and a Type IIP rate of 0.86 +/- 0.49 SNu, where SNu are 'supernova units'. These values are for a Hubble constant of 75 km per sec per Mpc.

Sex Differences in Application, Success, and Funding Rates for NIH Extramural Programs

PubMed Central

Pohlhaus, Jennifer Reineke; Jiang, Hong; Wagner, Robin M.; Schaffer, Walter T.; Pinn, Vivian W.

2011-01-01

Purpose The authors provide an analysis of sex differences in National Institutes of Health (NIH) award programs to inform potential initiatives for promoting diversity in the research workforce. Method In 2010, the authors retrieved data for NIH extramural grants in the electronic Research Administration Information for Management, Planning, and Coordination II database, and used statistical analysis to determine any sex differences in securing NIH funding, as well as subsequent success of researchers who had already received independent NIH support. Results Success and funding rates for men and women were not significantly different in most award programs. Furthermore, in programs where participation was lower for women than men, the disparity was primarily related to a lower percentage of women applicants compared to men, rather than decreased success rates or funding rates. However, for subsequent grants, both application and funding rates were generally higher for men than for women. Conclusions Cross-sectional analysis showed that women and men were generally equally successful at all career stages, but longitudinal analysis showed that men with previous experience as NIH grantees had higher application and funding rates than women at similar career points. On average, although women received larger R01 awards than men, men had more R01 awards than women at all points in their careers. Therefore, while greater participation of women in NIH programs is underway, further action will be required to eradicate remaining sex differences. PMID:21512358

Portfolio of prospective clinical trials including brachytherapy: an analysis of the ClinicalTrials.gov database.

PubMed

Cihoric, Nikola; Tsikkinis, Alexandros; Miguelez, Cristina Gutierrez; Strnad, Vratislav; Soldatovic, Ivan; Ghadjar, Pirus; Jeremic, Branislav; Dal Pra, Alan; Aebersold, Daniel M; Lössl, Kristina

2016-03-22

To evaluate the current status of prospective interventional clinical trials that includes brachytherapy (BT) procedures. The records of 175,538 (100 %) clinical trials registered at ClinicalTrials.gov were downloaded on September 2014 and a database was established. Trials using BT as an intervention were identified for further analyses. The selected trials were manually categorized according to indication(s), BT source, applied dose rate, primary sponsor type, location, protocol initiator and funding source. We analyzed trials across 8 available trial protocol elements registered within the database. In total 245 clinical trials were identified, 147 with BT as primary investigated treatment modality and 98 that included BT as an optional treatment component or as part of the standard treatment. Academic centers were the most frequent protocol initiators in trials where BT was the primary investigational treatment modality (p < 0.01). High dose rate (HDR) BT was the most frequently investigated type of BT dose rate (46.3 %) followed by low dose rate (LDR) (42.0 %). Prostate was the most frequently investigated tumor entity in trials with BT as the primary treatment modality (40.1 %) followed by breast cancer (17.0 %). BT was rarely the primary investigated treatment modality for cervical cancer (6.8 %). Most clinical trials using BT are predominantly in early phases, investigator-initiated and with low accrual numbers. Current investigational activities that include BT mainly focus on prostate and breast cancers. Important questions concerning the optimal usage of BT will not be answered in the near future.

49 CFR 236.503 - Automatic brake application; initiation when predetermined rate of speed exceeded.

Code of Federal Regulations, 2011 CFR

2011-10-01

... predetermined rate of speed exceeded. 236.503 Section 236.503 Transportation Other Regulations Relating to... § 236.503 Automatic brake application; initiation when predetermined rate of speed exceeded. An automatic train control system shall operate to initiate an automatic brake application when the speed of...

49 CFR 236.503 - Automatic brake application; initiation when predetermined rate of speed exceeded.

Code of Federal Regulations, 2010 CFR

2010-10-01

... predetermined rate of speed exceeded. 236.503 Section 236.503 Transportation Other Regulations Relating to... § 236.503 Automatic brake application; initiation when predetermined rate of speed exceeded. An automatic train control system shall operate to initiate an automatic brake application when the speed of...

Clinically relevant reductions in HbA1c without hypoglycaemia: results across four studies of saxagliptin.

PubMed

Karyekar, C S; Frederich, R; Ravichandran, S

2013-08-01

In four 24-week controlled studies, the antihyperglycaemic efficacy of saxagliptin was demonstrated in patients with type 2 diabetes mellitus as add-on therapy to glyburide, a thiazolidinedione, or metformin, and when used in initial combination with metformin vs. metformin monotherapy in drug-naive patients. Data from these studies were analysed to compare the proportions of patients who achieved specific reductions from baseline in glycated haemoglobin [HbA(1c); reductions of ≥ 0.5% and ≥ 0.7% in all studies (prespecified); reductions ≥ 1.0% in the add-on studies and ≥ 1.0% to ≥ 2.5% in the initial combination study (post hoc)] for saxagliptin vs. comparator at week 24. We report overall rates of glycaemic response defined by these reductions in HbA(1c) and rates of response without experiencing hypoglycaemia. Large glycaemic response rates were higher with saxagliptin 2.5 and 5 mg/day than with comparator (HbA(1c) ≥ 1.0%, 31.7-50.3% vs. 10.3-20.0%) as add-on therapy and higher with saxagliptin 5 mg/day as initial combination with metformin than with metformin monotherapy (HbA(1c) ≥ 2.0%, 68.3% vs. 49.8%) in drug-naive patients. Addition of saxagliptin was associated with a low incidence of hypoglycaemia; overall response rates and response rates excluding patients who experienced hypoglycaemia were similar. Analysis of several demographic and baseline clinical variables revealed no consistent correlations with response to saxagliptin. Whether receiving saxagliptin as an add-on therapy to glyburide, a thiazolidinedione, or metformin or in initial combination with metformin, a greater percentage of patients achieve clinically relevant large reductions in HbA(1c) vs. comparator, with a low incidence of hypoglycaemia. © 2013 Bristol-Myers Squibb Co. International Journal of Clinical Practice published by John Wiley & Sons Ltd.

Clinically relevant reductions in HbA1c without hypoglycaemia: results across four studies of saxagliptin

PubMed Central

Karyekar, C S; Frederich, R; Ravichandran, S

2013-01-01

BackgroundIn four 24-week controlled studies, the antihyperglycaemic efficacy of saxagliptin was demonstrated in patients with type 2 diabetes mellitus as add-on therapy to glyburide, a thiazolidinedione, or metformin, and when used in initial combination with metformin vs. metformin monotherapy in drug-naive patients. MethodsData from these studies were analysed to compare the proportions of patients who achieved specific reductions from baseline in glycated haemoglobin [HbA1c; reductions of ≥ 0.5% and ≥ 0.7% in all studies (prespecified); reductions ≥ 1.0% in the add-on studies and ≥ 1.0% to ≥ 2.5% in the initial combination study (post hoc)] for saxagliptin vs. comparator at week 24. We report overall rates of glycaemic response defined by these reductions in HbA1c and rates of response without experiencing hypoglycaemia. ResultsLarge glycaemic response rates were higher with saxagliptin 2.5 and 5 mg/day than with comparator (HbA1c ≥ 1.0%, 31.7–50.3% vs. 10.3–20.0%) as add-on therapy and higher with saxagliptin 5 mg/day as initial combination with metformin than with metformin monotherapy (HbA1c ≥ 2.0%, 68.3% vs. 49.8%) in drug-naive patients. Addition of saxagliptin was associated with a low incidence of hypoglycaemia; overall response rates and response rates excluding patients who experienced hypoglycaemia were similar. Analysis of several demographic and baseline clinical variables revealed no consistent correlations with response to saxagliptin. ConclusionsWhether receiving saxagliptin as an add-on therapy to glyburide, a thiazolidinedione, or metformin or in initial combination with metformin, a greater percentage of patients achieve clinically relevant large reductions in HbA1c vs. comparator, with a low incidence of hypoglycaemia. PMID:23795975

Mapping mental health service access: achieving equity through quality improvement.

PubMed

Green, Stuart A; Poots, Alan J; Marcano-Belisario, Jose; Samarasundera, Edgar; Green, John; Honeybourne, Emmi; Barnes, Ruth

2013-06-01

Improving access to psychological therapies (IAPTs) services deliver evidence-based care to people with depression and anxiety. A quality improvement (QI) initiative was undertaken by an IAPT service to improve referrals providing an opportunity to evaluate equitable access. QI methodologies were used by the clinical team to improve referrals to the service. The collection of geo-coded data allowed referrals to be mapped to small geographical areas according to deprivation. A total of 6078 patients were referred to the IAPT service during the period of analysis and mapped to 120 unique lower super output areas (LSOAs). The average weekly referral rate rose from 17 during the baseline phase to 43 during the QI implementation phase. Spatial analysis demonstrated all 15 of the high deprivation/low referral LSOAs were converted to high deprivation/high or medium referral LSOAs following the QI initiative. This work highlights the importance of QI in developing clinical services aligned to the needs of the population through the analysis of routine data matched to health needs. Mapping can be utilized to communicate complex information to inform the planning and organization of clinical service delivery and evaluate the progress and sustainability of QI initiatives.

Rapid intravenous rehydration of children with acute gastroenteritis and dehydration: a systematic review and meta-analysis.

PubMed

Iro, M A; Sell, T; Brown, N; Maitland, K

2018-02-09

The World Health Organization (WHO) recommends rapid intravenous rehydration, using fluid volumes of 70-100mls/kg over 3-6 h, with some of the initial volume given rapidly as initial fluid boluses to treat hypovolaemic shock for children with acute gastroenteritis (AGE) and severe dehydration. The evidence supporting the safety and efficacy of rapid versus slower rehydration remains uncertain. We conducted a systematic review of randomised controlled trials (RCTs) on 11th of May 2017 comparing different rates of intravenous fluid therapy in children with AGE and moderate or severe dehydration, using standard search terms. Two authors independently assessed trial quality and extracted data. Non-RCTs and non-English articles were excluded. The primary endpoint was mortality and secondary endpoints included adverse events (safety) and treatment efficacy. Of the 1390 studies initially identified, 18 were assessed for eligibility. Of these, 3 studies (n = 464) fulfilled a priori criteria for inclusion; most studied children with moderate dehydration and none were conducted in resource-poor settings. Volumes and rates of fluid replacement varied from 20 to 60 ml/kg given over 1-2 h (fast) versus 2-4 h (slow). There was substantial heterogeneity in methodology between the studies with only one adjudicated to be of high quality. There were no deaths in any study. Safety endpoints only identified oedema (n = 6) and dysnatraemia (n = 2). Pooled analysis showed no significant difference between the rapid and slow intravenous rehydration groups for the proportion of treatment failures (N = 468): pooled RR 1.30 (95% CI: 0.87, 1.93) and the readmission rates (N = 439): pooled RR 1.39 (95% CI: 0.68, 2.85). Despite wide implementation of WHO Plan C guideline for severe AGE, we found no clinical evaluation in resource-limited settings, and only limited evaluation of the rate and volume of rehydration in other parts of the world. Recent concerns over aggressive fluid expansion warrants further research to inform guidelines on rates of intravenous rehydration therapy for severe AGE.

Treatment of caries in relation to lesion severity: implications for minimum intervention dentistry.

PubMed

Brennan, D S; Balasubramanian, M; Spencer, A J

2015-01-01

To date there is little evidence of minimum intervention in relation to treatment patterns, particularly for initial carious lesions. The objective of this study was to investigate treatment provided to patients with a main diagnosis of coronal caries in relation to the severity of the caries lesion. A random sample of Australian dentists was surveyed by mailed questionnaires in 2009-2010 (response rate 67%). Data on services, patient characteristics and main diagnosis were collected from a service log. Models of service rates adjusted for age, sex, insurance status and reason for visit showed that compared to the reference category of gross caries lesions, there were higher rates [rate ratio, 95% CI] of restorative services for initial [1.63, 1.31-2.03] and cavitated [1.69, 1.39-2.05] lesions, higher rates of prophylaxis for initial [3.77, 2.09-6.79] and cavitated [3.88, 2.29-6.58] lesions, lower rates of endodontic services for initial [0.07, 0.02-0.30] and cavitated [0.11, 0.04-0.30] lesions, and lower rates of extraction for initial [0.15, 0.06-0.34] and cavitated [0.15, 0.07-0.31] lesions. Treatment of coronal caries was characterized by high rates of restorative services, but gross lesions had lower restorative rates and higher rates of endodontic and extraction services. There was little differentiation in treatment of coronal caries between initial and cavitated lesions, suggesting scope for increased management of initial carious lesions by the adoption of more minimum intervention approaches. Copyright © 2014 Elsevier Ltd. All rights reserved.

Deformation Behavior of a Coarse-Grained Mg-8Al-1.5Ca-0.2Sr Magnesium Alloy at Elevated Temperatures

NASA Astrophysics Data System (ADS)

Lou, Yan; Liu, Xiao

2018-02-01

The compression tests were carried out on a coarse-grained Mg-8Al-1.5Ca-0.2Sr magnesium alloy samples at temperatures from 300 to 450 °C and strain rates from 0.001 to 10 s-1. The flow stress curves were analyzed using the double-differentiation method, and double minima were detected on the flow curves. The first set of minima is shown to identify the critical strain for twinning, while the second set indicates the critical strain for the initiation of dynamic recrystallization (DRX). Twin variant selection was numerically identified by comprehensive analysis of the Schmid factors for different deformation modes and the accommodation strains imposed on neighboring grains. It was found that twinning is initiated before DRX. Dynamic recrystallization volume increases with strain rate at a given deformation temperature. At high strain rate, various twin variants are activated to accommodate deformation, leading to the formation of twin intersections and high DRX volume. Fully dynamic recrystallized structure can be obtained at both high and low strain rates due to the high mobility of the grain and twin boundaries at the temperature of 400 °C.

Prognostic value of heart rate turbulence for risk assessment in patients with unstable angina and non-ST elevation myocardial infarction

PubMed Central

Harris, Patricia RE; Stein, Phyllis K; Fung, Gordon L; Drew, Barbara J

2013-01-01

Background We sought to examine the prognostic value of heart rate turbulence derived from electrocardiographic recordings initiated in the emergency department for patients with non-ST elevation myocardial infarction (NSTEMI) or unstable angina. Methods Twenty-four-hour Holter recordings were started in patients with cardiac symptoms approximately 45 minutes after arrival in the emergency department. Patients subsequently diagnosed with NSTEMI or unstable angina who had recordings with ≥18 hours of sinus rhythm and sufficient data to compute Thrombolysis In Myocardial Infarction (TIMI) risk scores were chosen for analysis (n = 166). Endpoints were emergent re-entry to the cardiac emergency department and/or death at 30 days and one year. Results In Cox regression models, heart rate turbulence and TIMI risk scores together were significant predictors of 30-day (model chi square 13.200, P = 0.001, C-statistic 0.725) and one-year (model chi square 31.160, P < 0.001, C-statistic 0.695) endpoints, outperforming either measure alone. Conclusion Measurement of heart rate turbulence, initiated upon arrival at the emergency department, may provide additional incremental value in the risk assessment for patients with NSTEMI or unstable angina. PMID:23976860

Benzene degradation in a denitrifying biofilm reactor: activity and microbial community composition.

PubMed

van der Waals, Marcelle J; Atashgahi, Siavash; da Rocha, Ulisses Nunes; van der Zaan, Bas M; Smidt, Hauke; Gerritse, Jan

2017-06-01

Benzene is an aromatic compound and harmful for the environment. Biodegradation of benzene can reduce the toxicological risk after accidental or controlled release of this chemical in the environment. In this study, we further characterized an anaerobic continuous biofilm culture grown for more than 14 years on benzene with nitrate as electron acceptor. We determined steady state degradation rates, microbial community composition dynamics in the biofilm, and the initial anaerobic benzene degradation reactions. Benzene was degraded at a rate of 0.15 μmol/mg protein/day and a first-order rate constant of 3.04/day which was fourfold higher than rates reported previously. Bacteria belonging to the Peptococcaceae were found to play an important role in this anaerobic benzene-degrading biofilm culture, but also members of the Anaerolineaceae were predicted to be involved in benzene degradation or benzene metabolite degradation based on Illumina MiSeq analysis of 16S ribosomal RNA genes. Biomass retention in the reactor using a filtration finger resulted in reduction of benzene degradation capacity. Detection of the benzene carboxylase encoding gene, abcA, and benzoic acid in the culture vessel indicated that benzene degradation proceeds through an initial carboxylation step.

Process, cost, and clinical quality: the initial oral contraceptive visit.

PubMed

McMullen, Michael J; Woolford, Samuel W; Moore, Charles L; Berger, Barry M

2013-01-01

To demonstrate how the analysis of clinical process, cost, and outcomes can identify healthcare improvements that reduce cost without sacrificing quality, using the example of the initial visit associated with oral contraceptive pill use. Cross-sectional study using data collected by HealthMETRICS between 1996 and 2009. Using data collected from 106 sites in 24 states, the unintended pregnancy (UIP) rate, effectiveness of patient education, and unit visit cost were calculated. Staff type providing education and placement of education were recorded. Two-way analysis of variance models were created and tested for significance to identify differences between groups. Sites using nonclinical staff to provide education outside the exam were associated with lower cost, higher education scores, and a UIP rate no different from that of sites using clinical staff. Sites also providing patient education during the physical examination were associated with higher cost, lower education scores, and a UIP rate no lower than that of sites providing education outside of the exam. Through analyzing process, cost, and quality, lower-cost processes that did not reduce clinical quality were identified. This methodology is applicable to other clinical services for identifying low-cost processes that do not result in lower clinical quality. By using nonclinical staff educators to provide education outside of the physical examination, sites could save an average of 32% of the total cost of the visit.

Computational method for analysis of polyethylene biodegradation

NASA Astrophysics Data System (ADS)

Watanabe, Masaji; Kawai, Fusako; Shibata, Masaru; Yokoyama, Shigeo; Sudate, Yasuhiro

2003-12-01

In a previous study concerning the biodegradation of polyethylene, we proposed a mathematical model based on two primary factors: the direct consumption or absorption of small molecules and the successive weight loss of large molecules due to β-oxidation. Our model is an initial value problem consisting of a differential equation whose independent variable is time. Its unknown variable represents the total weight of all the polyethylene molecules that belong to a molecular-weight class specified by a parameter. In this paper, we describe a numerical technique to introduce experimental results into analysis of our model. We first establish its mathematical foundation in order to guarantee its validity, by showing that the initial value problem associated with the differential equation has a unique solution. Our computational technique is based on a linear system of differential equations derived from the original problem. We introduce some numerical results to illustrate our technique as a practical application of the linear approximation. In particular, we show how to solve the inverse problem to determine the consumption rate and the β-oxidation rate numerically, and illustrate our numerical technique by analyzing the GPC patterns of polyethylene wax obtained before and after 5 weeks cultivation of a fungus, Aspergillus sp. AK-3. A numerical simulation based on these degradation rates confirms that the primary factors of the polyethylene biodegradation posed in modeling are indeed appropriate.

Fatigue Analysis Before and After Shaker Exercise: Physiologic Tool for Exercise Design

PubMed Central

White, Kevin T.; Easterling, Caryn; Roberts, Niles; Shaker, Reza

2016-01-01

Recent studies suggest that the Shaker exercise induces fatigue in the upper esophageal sphincter (UES) opening muscles and sternocleidomastoid (SCM), with the SCMs fatiguing earliest. The aim of this study was to measure fatigue induced by the isometric portion of the Shaker exercise by measuring the rate of change in the median frequency (MF rate) of the power spectral density (PSD) function, which is interpreted as proportional to the rate of fatigue, from surface electromyography (EMG) of suprahyoid (SHM), infrahyoid (IHM), and SCM. EMG data compared fatigue-related changes from 20-, 40-, and 60-s isometric hold durations of the Shaker exercise. We found that fatigue-related changes were manifested during the 20-s hold. The findings confirm that the SCM fatigues initially and as fast as or faster than the SHM and IHM. In addition, upon completion of the exercise protocol, the SCM had a decreased MF rate, implying improved fatigue resistance, while the SHM and IHM showed increased MF rates, implying that these muscles increased their fatiguing effort. We conclude that the Shaker exercise initially leads to increased fatigue resistance of the SCM, after which the exercise loads the less fatigue-resistant SHM and IHM, potentiating the therapeutic effect of the Shaker exercise regimen with continued exercise performance. PMID:18369673

CO2 Urban Synthesis and Analysis ("CO2-USA") Network

NASA Astrophysics Data System (ADS)

Lin, J. C.; Hutyra, L.; Loughner, C.; Stein, A. F.; Lusk, K.; Mitchell, L.; Gately, C.; Wofsy, S. C.

2017-12-01

Emissions of carbon associated with cities comprise a large component of the anthropogenic source. A number of cities have announced plans to reduce greenhouse gas emissions, but the scientific knowledge to quantitatively track emissions and assess the efficacy of mitigation is lacking. As the global population increasingly resides in urban regions, scientific knowledge about how much, where, and why a particular city emits carbon becomes increasingly important. To address this gap, researchers have initiated studies of carbon emissions and cycling in several U.S. cities, making it timely to develop a collaborative network to exchange information on community standards and common measurements, facilitate data sharing, and create analysis frameworks and cross-city syntheses to catalyze a new generation of researchers and enable new collaborations tackling important objectives that are difficult to address in isolation. We describe initial results from an incipient network focusing initially on cities in the U.S. with low barriers of entry that entrains a cross-section of U.S. urban centers with varying characteristics: size, population density, vegetation, urban form, infrastructure, development rates, climate, and meteorological patterns. Results will be reported that emerge from an initial workshop covering data harmonization & integration, inventory comparison, stakeholder outreach, network design, inverse modeling, and collaboration.

Slow slip and self-similar asymptotics of rate-strengthening faults

NASA Astrophysics Data System (ADS)

Viesca, R. C.; Dublanchet, P.

2016-12-01

We examine how slow slip progresses on rate-strengthening faults. We consider that the source of rate-strengthening may be a linear or non-linear (power-law) viscous fault rheology, a logarithmic rate-dependence, or a Dieterich-Ruina dependence on slip rate and its history. We show the existence of self-similar asymptotic solutions for slip rate of the form V = t^alpha f(x/t^beta). The exponent beta is determined by the nature of the elastic interaction (for slip between elastic half-spaces in contact, beta = 1; and for layer sliding above a substrate, beta = 1/2). The similarity exponent alpha is determined by the type of initial or boundary conditions. Such conditions may be, for example, an imposed (i) boundary slip rate or (ii) a sudden change in stress on the fault. We consider in-plane or anti-plane slip for examples (i) and (ii) and present the asymptotic solutions thereof, which may be found numerically or in closed form. The self-similar behavior of scenario (i) is, for a step increase in stress, that of an initially elevated slip rate decaying in time while spreading in space; and of scenario (ii) is that an elevated slip rate propagating along the fault. Under scenario (i) we show that the disparate fault rheologies share a common closed-form similarity solution for the decay of slip rate following the initial stress change. For comparison, we compute numerical solutions to the evolution equation for slip rate (and state, when applicable) and find precise agreement with the above analysis. We illustrate how the above solutions provide robust, low-parameter models to test whether there is a frictional basis for spatio-temporal observations indicating the accumulation of post-seismic slip or the occurrence of slow slip event. Such observations include those derived from (a) geodetic observations [e.g., Hsu et al., Science 2006], or migration of (b) low-frequency earthquakes and tremor [e.g., Obara and Hirose, Tectonophys. 2006], and of (c) micro-seismicity [e.g., Bourouis and Bernard, Geophys. J. Int., 2007].

Getting the word out: neural correlates of enthusiastic message propagation.

PubMed

Falk, Emily B; O'Donnell, Matthew Brook; Lieberman, Matthew D

2012-01-01

What happens in the mind of a person who first hears a potentially exciting idea?We examined the neural precursors of spreading ideas with enthusiasm, and dissected enthusiasm into component processes that can be identified through automated linguistic analysis, gestalt human ratings of combined linguistic and non-verbal cues, and points of convergence/divergence between the two. We combined tools from natural language processing (NLP) with data gathered using fMRI to link the neurocognitive mechanisms that are set in motion during initial exposure to ideas and subsequent behaviors of these message communicators outside of the scanner. Participants' neural activity was recorded as they reviewed ideas for potential television show pilots. Participants' language from video-taped interviews collected post-scan was transcribed and given to an automated linguistic sentiment analysis (SA) classifier, which returned ratings for evaluative language (evaluative vs. descriptive) and valence (positive vs. negative). Separately, human coders rated the enthusiasm with which participants transmitted each idea. More positive sentiment ratings by the automated classifier were associated with activation in neural regions including medial prefrontal cortex; MPFC, precuneus/posterior cingulate cortex; PC/PCC, and medial temporal lobe; MTL. More evaluative, positive, descriptions were associated exclusively with neural activity in temporal-parietal junction (TPJ). Finally, human ratings indicative of more enthusiastic sentiment were associated with activation across these regions (MPFC, PC/PCC, DMPFC, TPJ, and MTL) as well as in ventral striatum (VS), inferior parietal lobule and premotor cortex. Taken together, these data demonstrate novel links between neural activity during initial idea encoding and the enthusiasm with which the ideas are subsequently delivered. This research lays the groundwork to use machine learning and neuroimaging data to study word of mouth communication and the spread of ideas in both traditional and new media environments.

Getting the word out: neural correlates of enthusiastic message propagation

PubMed Central

Falk, Emily B.; O'Donnell, Matthew Brook; Lieberman, Matthew D.

2012-01-01

What happens in the mind of a person who first hears a potentially exciting idea?We examined the neural precursors of spreading ideas with enthusiasm, and dissected enthusiasm into component processes that can be identified through automated linguistic analysis, gestalt human ratings of combined linguistic and non-verbal cues, and points of convergence/divergence between the two. We combined tools from natural language processing (NLP) with data gathered using fMRI to link the neurocognitive mechanisms that are set in motion during initial exposure to ideas and subsequent behaviors of these message communicators outside of the scanner. Participants' neural activity was recorded as they reviewed ideas for potential television show pilots. Participants' language from video-taped interviews collected post-scan was transcribed and given to an automated linguistic sentiment analysis (SA) classifier, which returned ratings for evaluative language (evaluative vs. descriptive) and valence (positive vs. negative). Separately, human coders rated the enthusiasm with which participants transmitted each idea. More positive sentiment ratings by the automated classifier were associated with activation in neural regions including medial prefrontal cortex; MPFC, precuneus/posterior cingulate cortex; PC/PCC, and medial temporal lobe; MTL. More evaluative, positive, descriptions were associated exclusively with neural activity in temporal-parietal junction (TPJ). Finally, human ratings indicative of more enthusiastic sentiment were associated with activation across these regions (MPFC, PC/PCC, DMPFC, TPJ, and MTL) as well as in ventral striatum (VS), inferior parietal lobule and premotor cortex. Taken together, these data demonstrate novel links between neural activity during initial idea encoding and the enthusiasm with which the ideas are subsequently delivered. This research lays the groundwork to use machine learning and neuroimaging data to study word of mouth communication and the spread of ideas in both traditional and new media environments. PMID:23189049

TiO2-V2O5 nanocomposites as alternative energy storage substances for photocatalysts.

PubMed

Ngaotrakanwiwat, Pailin; Meeyoo, Vissanu

2012-01-01

TiO2-V2O5 was prepared and evaluated as an energy storage material for photocatalysts with high capacity and initial charging rate. The compound was successfully obtained by sol-gel technique and effects of compound composition and calcination temperature on the energy storage ability were investigated. The synthesized compounds were characterized by means of X-ray powder diffraction (XRD), scanning electron microscopy equipped with energy-dispersive X-ray analysis (SEM-EDX) and transmission electron microscopy (TEM). The results reveals that the compound of Ti:V molar ratio equal to 1:0.11 calcined at 550 degrees C exhibited superior energy storage ability than parent substances and 1.7-times higher capacity and 2.3-times higher initial charging rate compared to WO3, indicating that the compound is a remarkable alternative to conventional energy storage substances.

Attachment, Development, and Mental Health in Abused and Neglected Preschool Children in Foster Care: A Meta-Analysis.

PubMed

Vasileva, Mira; Petermann, Franz

2016-09-22

A proper preparation for foster parents to care for abused and neglected children includes effective training and initial diagnostics in order to plan individual treatment. Hence, a basic knowledge about the main psychosocial and developmental problems associated with abuse and neglect and their prevalence in foster children is needed. For this purpose, a systematical literature review and a series of meta-analyses were conducted. A total of 25 studies reporting data on development (n = 4,033), mental health (n = 726), and attachment (n = 255) of foster children in preschool age met the inclusion criteria. The meta-analyses indicated prevalence rates of approximately 40% for developmental, mental health problems, and insecure attachment. Rates of disorganized attachment were estimated to 22%. These findings outline the necessity of an initial trauma-oriented diagnostics and trainings for foster parents that address foster children's development, mental health, and disorganized attachment. © The Author(s) 2016.

Single-Molecule Probing the Energy Landscape of Enzymatic Reaction and Non-Covalent Interactions

NASA Astrophysics Data System (ADS)

Lu, H. Peter; Hu, Dehong; Chen, Yu; Vorpagel, Erich R.

2002-03-01

We have applied single-molecule spectroscopy under physiological conditions to study the mechanisms and dynamics of T4 lysozyme enzymatic reactions, characterizing mode-specific protein conformational dynamics. Enzymatic reaction turnovers and the associated structure changes of individual protein molecules were observed simultaneously in real-time. The overall reaction rates were found to vary widely from molecule-to-molecule, and the initial non-specific binding of the enzyme to the substrate was seen to dominate this inhomogeneity. The reaction steps subsequent to the initial binding were found to have homogeneous rates. Molecular dynamics simulation has been applied to elucidate the mechanism and intermediate states of the single-molecule enzymatic reaction. Combining the analysis of single-molecule experimental trajectories, MD simulation trajectories, and statistical modeling, we have revealed the nature of multiple intermediate states involved in the active enzyme-substrate complex formation and the associated conformational change mechanism and dynamics.

Mechanism of growth of the Ge wetting layer upon exposure of Si(100)-2 x 1 to GeH4.

PubMed

Liu, Chie-Sheng; Chou, Li-Wei; Hong, Lu-Sheng; Jiang, Jyh-Chiang

2008-04-23

This paper describes the initial reaction kinetics of Ge deposition after exposure of Si(100)-2 x 1 to GeH4 in a UHV-CVD system. The rate of Ge growth, especially at the wetting layer stage, was investigated using in situ X-ray photoelectron spectroscopy to measure the Ge signal at the onset of deposition. A kinetic analysis of the initial growth of the Ge wetting layer at temperatures ranging from 698 to 823 K revealed an activation energy of 30.7 kcal/mol. Density functional theory calculations suggested that opening of the Si dimer--with a closely matching energy barrier of 29.7 kcal/mol, following hydrogen atom migration--was the rate controlling step for the incorporation of a GeH2 unit into the lattice to complete the growth of the Ge wetting layer after dissociative adsorption of GeH4.

Simultaneous effect of initial weight, initial crowding, temperature and O2 concentration on the nutritional use of food by rainbow trout (Oncorhynchus mykiss).

PubMed

Martinez, F J; Garcia, M P; Canteras, M; De Costa, J; Zamora, S

1992-01-01

The simultaneous effects of initial weight, initial crowding, temperature and O2 concentration on the following ratios: relative growth rate percent (RGRP), feed efficiency (FE), protein efficiency ratio (PER) and protein productive value (PPV) were studied in the rainbow trout. Multivariant equations were obtained for each of the mentioned indices. The joint effects of these factors were evidenced by means of a multiple correlation analysis. The influence of temperature and, to a lesser extent, of crowding, and O2 concentration on the nutritional use of food by the trout was demonstrated, their fundamental dependence on factors extrinsic to the animal being underlined. The non proportional changes in PER and PPV as temperature rises revealed that an increasing part of the ingested aminoacids were used for synthesis of fat, non for proteins edification.

Getting men in the room: perceptions of effective strategies to initiate men's involvement in gender-based violence prevention in a global sample.

PubMed

Casey, Erin A; Leek, Cliff; Tolman, Richard M; Allen, Christopher T; Carlson, Juliana M

2017-09-01

As engaging men in gender-based violence prevention efforts becomes an increasingly institutionalised component of gender equity work globally, clarity is needed about the strategies that best initiate male-identified individuals' involvement in these efforts. The purpose of this study was to examine the perceived relevance and effectiveness of men's engagement strategies from the perspective of men around the world who have organised or attended gender-based violence prevention events. Participants responded to an online survey (available in English, French and Spanish) and rated the effectiveness of 15 discrete engagement strategies derived from earlier qualitative work. Participants also provided suggestions regarding strategies in open-ended comments. Listed strategies cut across the social ecological spectrum and represented both venues in which to reach men, and the content of violence prevention messaging. Results suggest that all strategies, on average, were perceived as effective across regions of the world, with strategies that tailor messaging to topics of particular concern to men (such as fatherhood and healthy relationships) rated most highly. Open-ended comments also surfaced tensions, particularly related to the role of a gender analysis in initial men's engagement efforts. Findings suggest the promise of cross-regional adaptation and information sharing regarding successful approaches to initiating men's anti-violence involvement.

Impact of Introducing the Line Probe Assay on Time to Treatment Initiation of MDR-TB in Delhi, India

PubMed Central

Singla, Neeta; Satyanarayana, Srinath; Sachdeva, Kuldeep Singh; Van den Bergh, Rafael; Reid, Tony; Tayler-Smith, Katherine; Myneedu, V. P.; Ali, Engy; Enarson, Donald A.; Behera, Digamber; Sarin, Rohit

2014-01-01

Setting National Institute of Tuberculosis and Respiratory Diseases (erstwhile Lala Ram Sarup Institute) in Delhi, India. Objectives To evaluate before and after the introduction of the line Probe Assay (LPA) a) the overall time to MDR-TB diagnosis and treatment initiation; b) the step-by-step time lapse at each stage of patient management; and c) the lost to follow-up rates. Methods A retrospective cohort analysis was done using data on MDR-TB patients diagnosed during 2009–2012 under Revised National Tuberculosis Control Programme at the institute. Results Following the introduction of the LPA in 2011, the overall median time from identification of patients suspected for MDR-TB to the initiation of treatment was reduced from 157 days (IQR 127–200) to 38 days (IQR 30–79). This reduction was attributed mainly to a lower diagnosis time at the laboratory. Lost to follow-up rates were also significantly reduced after introduction of the LPA (12% versus 39% pre-PLA). Conclusion Introduction of the LPA was associated with a major reduction in the delay between identification of patients suspected for MDR-TB and initiation of treatment, attributed mainly to a reduction in diagnostic time in the laboratory. PMID:25058124

Bioincompatibility of dialyzer membranes may have a negative impact on outcome of acute renal failure, independent of the dose of dialysis delivered: a retrospective multicenter analysis.

PubMed

Schiffl, H; Lang, S M; Haider, M

1998-01-01

The mortality rate of critically ill patients with acute renal failure (ARF) has remained high. The impact of vigorous intermittent hemodialysis (IHD) on the outcome of ARF has not been validated. In this retrospective multicenter analysis, 154 patients with ARF were treated daily (intensive) or on alternate days (conventional) using complement and cell activating cuprophane (bioincompatible) or high-flux polysulfone dialyzer membranes with insignificant effects on circulating complement or cells (biocompatible). At initiation of IHD, all four groups were similar in patient characteristics and ARF factors. The use of synthetic membranes resulted in a reduced mortality rate (18% vs 45%; p < 0.001) and shorter duration of ARF (8 vs 15 sessions; p < 0.001). Daily IHD with cellulose based membranes tended to increase mortality rates compared with conventional cuprophane dialysis (37% vs 53%). Intensive IHD with polysulfone membranes resulted in a further decrease in overall mortality rates (15% vs 22%). This retrospective analysis shows that bioincompatibility of dialyzer membranes may be more important for the outcome of patients with ARF than the dose of dialysis. Its impact on outcome occurs independently of the dose of dialysis delivered.

Performance analysis of air-water quantum key distribution with an irregular sea surface

NASA Astrophysics Data System (ADS)

Xu, Hua-bin; Zhou, Yuan-yuan; Zhou, Xue-jun; Wang, Lian

2018-05-01

In the air-water quantum key distribution (QKD), the irregular sea surface has some influence on the photon polarization state. The wind is considered as the main factor causing the irregularity, so the model of irregular sea surface based on the wind speed is adopted. The relationships of the quantum bit error rate with the wind speed and the initial incident angle are simulated. Therefore, the maximum secure transmission depth of QKD is confirmed, and the limitation of the wind speed and the initial incident angle is determined. The simulation results show that when the wind speed and the initial incident angle increase, the performance of QKD will fall down. Under the intercept-resend attack condition, the maximum safe transmission depth of QKD is up to 105 m. To realize safe communications in the safe diving depth of submarines (100 m), the initial incident angle is requested to be not exceeding 26°, and with the initial incident angle increased, the limitation of wind speed is decreased.

Association Between Direct-to-Consumer Advertising and Testosterone Testing and Initiation in the United States, 2009-2013.

PubMed

Layton, J Bradley; Kim, Yoonsang; Alexander, G Caleb; Emery, Sherry L

2017-03-21

Testosterone initiation increased substantially in the United States from 2000 to 2013, especially among men without clear indications. Direct-to-consumer advertising (DTCA) also increased during this time. To investigate associations between televised DTCA and testosterone testing and initiation in the United States. Ecologic study conducted in designated market areas (DMAs) in the United States. Monthly testosterone advertising ratings were linked to DMA-level testosterone use data from 2009-2013 derived from commercial insurance claims. Associations between DTCA and testosterone testing, initiation, and initiation without recent baseline tests were estimated using Poisson generalized estimating equations. Monthly Nielsen ratings for testosterone DTCA in the 75 largest DMAs. (1) Rates of new serum testosterone testing; (2) rates of testosterone initiation (in-office injection, surgical implant, or pharmacy dispensing) for all testosterone products combined and for specific brands; and (3) rates of testosterone initiation without recent serum testosterone testing. Of 17 228 599 commercially insured men in the 75 DMAs, 1 007 990 (mean age, 49.6 [SD, 11.5] years) had new serum testosterone tests and 283 317 (mean age, 51.8 [SD, 11.3] years) initiated testosterone treatment. Advertising intensity varied by geographic region and time, with the highest intensity seen in the southeastern United States and with months ranging from no ad exposures to a mean of 13.6 exposures per household. Nonbranded advertisements were common prior to 2012, with branded advertisements becoming more common during and after 2012. Each household advertisement exposure was associated with a monthly increase in rates of new testosterone testing (rate ratio [RR], 1.006; 95% CI, 1.004-1.008), initiation (RR, 1.007; 95% CI, 1.004-1.010), and initiation without a recent test (RR, 1.008; 95% CI, 1.002-1.013). Mean absolute rate increases were 0.14 tests (95% CI, 0.09-0.19), 0.05 new initiations (95% CI, 0.03-0.08), and 0.02 initiations without a recent test (95% CI, 0.01-0.03) per 10 000 men for each monthly ad exposure over the entire period. Among US men residing in the 75 designated market areas, regional exposure to televised direct-to-consumer advertising was associated with greater testosterone testing, new initiation, and initiation without recent testing.

Risk factors for poor multidrug-resistant tuberculosis treatment outcomes in Kyiv Oblast, Ukraine.

PubMed

Aibana, Omowunmi; Bachmaha, Mariya; Krasiuk, Viatcheslav; Rybak, Natasha; Flanigan, Timothy P; Petrenko, Vasyl; Murray, Megan B

2017-02-07

Ukraine is among ten countries with the highest burden of multidrug- resistant TB (MDR-TB) worldwide. Treatment success rates for MDR-TB in Ukraine remain below global success rates as reported by the World Health Organization. Few studies have evaluated predictors of poor MDR-TB outcomes in Ukraine. We conducted a retrospective analysis of patients initiated on MDR-TB treatment in the Kyiv Oblast of Ukraine between January 01, 2012 and March 31st, 2015. We defined good treatment outcomes as cure or completion and categorized poor outcomes among those who died, failed treatment or defaulted. We used logistic regression analyses to identify baseline patient characteristics associated with poor MDR-TB treatment outcomes. Among 360 patients, 65 (18.1%) achieved treatment cure or completion while 131 (36.4%) died, 115 (31.9%) defaulted, and 37 (10.3%) failed treatment. In the multivariate analysis, the strongest baseline predictors of poor outcomes were HIV infection without anti-retroviral therapy (ART) initiation (aOR 10.07; 95% CI 1.20-84.45; p 0.03) and presence of extensively-drug resistant TB (aOR 9.19; 95% CI 1.17-72.06; p 0.03). HIV-positive patients initiated on ART were not at increased risk of poor outcomes (aOR 1.43; 95% CI 0.58-3.54; p 0.44). There was no statistically significant difference in risk of poor outcomes among patients who received baseline molecular testing with Gene Xpert compared to those who were not tested (aOR 1.31; 95% CI 0.63-2.73). Rigorous compliance with national guidelines recommending prompt initiation of ART among HIV/TB co-infected patients and use of drug susceptibility testing results to construct treatment regimens can have a major impact on improving MDR-TB treatment outcomes in Ukraine.

Impact of time of initiation of once-monthly paliperidone palmitate in hospitalized Asian patients with acute exacerbation of schizophrenia: a post hoc analysis from the PREVAIL study

PubMed Central

Li, Huafang; Li, Yan; Feng, Yu; Zhuo, Jianmin; Turkoz, Ibrahim; Mathews, Maju; Tan, Wilson

2018-01-01

Purpose To evaluate the differences in efficacy and safety outcomes in acute exacerbating schizophrenia patients between 2 subgroups (≤1 week and >1 week), differing in time interval from hospitalization to time of initiation of once-monthly paliperidone palmitate. Patients and methods PREVAIL was a multicenter, single-arm, open-label, prospective Phase IV study in hospitalized Asian patients (either sex, aged 18–65 years) diagnosed with schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition). Change from baseline to week 13 in primary (Positive and Negative Syndrome Scale [PANSS] total score), secondary endpoints (PANSS responder rate, PANSS subscale, PANSS Marder factor, Clinical Global Impression-Severity, and Personal and Social Performance scale scores, readiness for hospital discharge questionnaire) and safety were assessed in this post hoc analysis. Results Significant mean reduction from baseline to week 13 in the PANSS total score, 30% PANSS responder rates (P≤0.01), PANSS subscales (positive and general psychopathology; all P≤0.01), PANSS Marder factor (positive symptoms, uncontrolled hostility, and excitement and anxiety/depression; all P≤0.01), Personal and Social Performance scale scores (P≤0.05) and Clinical Global Impression-Severity categorical summary (P≤0.05) were significantly greater in the ≤1 week subgroup versus >1 week subgroup (P≤0.05). The readiness for hospital discharge questionnaire improved over time for the overall study population, but remained similar between subgroups at all-time points. Treatment-emergent adverse events were similar between the subgroups. Conclusion Early initiation of once-monthly paliperidone palmitate in hospitalized patients with acute exacerbation of schizophrenia led to greater improvements in psychotic symptoms with comparable safety than treatment initiation following 1 week of hospitalization. PMID:29731633

Impact of time of initiation of once-monthly paliperidone palmitate in hospitalized Asian patients with acute exacerbation of schizophrenia: a post hoc analysis from the PREVAIL study.

PubMed

Li, Huafang; Li, Yan; Feng, Yu; Zhuo, Jianmin; Turkoz, Ibrahim; Mathews, Maju; Tan, Wilson

2018-01-01

To evaluate the differences in efficacy and safety outcomes in acute exacerbating schizophrenia patients between 2 subgroups (≤1 week and >1 week), differing in time interval from hospitalization to time of initiation of once-monthly paliperidone palmitate. PREVAIL was a multicenter, single-arm, open-label, prospective Phase IV study in hospitalized Asian patients (either sex, aged 18-65 years) diagnosed with schizophrenia ( Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition). Change from baseline to week 13 in primary (Positive and Negative Syndrome Scale [PANSS] total score), secondary endpoints (PANSS responder rate, PANSS subscale, PANSS Marder factor, Clinical Global Impression-Severity, and Personal and Social Performance scale scores, readiness for hospital discharge questionnaire) and safety were assessed in this post hoc analysis. Significant mean reduction from baseline to week 13 in the PANSS total score, 30% PANSS responder rates ( P ≤0.01), PANSS subscales (positive and general psychopathology; all P ≤0.01), PANSS Marder factor (positive symptoms, uncontrolled hostility, and excitement and anxiety/depression; all P ≤0.01), Personal and Social Performance scale scores ( P ≤0.05) and Clinical Global Impression-Severity categorical summary ( P ≤0.05) were significantly greater in the ≤1 week subgroup versus >1 week subgroup ( P ≤0.05). The readiness for hospital discharge questionnaire improved over time for the overall study population, but remained similar between subgroups at all-time points. Treatment-emergent adverse events were similar between the subgroups. Early initiation of once-monthly paliperidone palmitate in hospitalized patients with acute exacerbation of schizophrenia led to greater improvements in psychotic symptoms with comparable safety than treatment initiation following 1 week of hospitalization.

Studies of the Wetting of Gaps in Weightlessness

NASA Astrophysics Data System (ADS)

Collicott, Steven H.; Chen, Yongkang

2010-10-01

The geometry of a thin sheet metal vane terminating near a wall in a surface tension propellant management device (PMD) is common in devices designed by various people. A research program into the capillary fluid physics of the common vane-wall gap began in 1998 with the arrival of the second author at the School of Aeronautics and Astronautics at Purdue University. Drop tower experiments, Surface Evolver computations, and analysis were combined to explore the details of the fluid behavior in the vane-wall gap geometry. Results of four vane-wall gap experiment topics: critical wetting, advance rates, sensitivity to vane orientation, and effect of imperfect initial conditions, are discussed here. This work led to a desire by Weislogel to incorporate this type of geometry into his "Capillary Fluids Experiment" (CFE) that operated flawlessly on the International Space Station in 2006 and 2007. It is found that the wetting of vane-wall gaps is predicted correctly through use of the critical wetting analysis of Concus and Finn. Furthermore, the dynamics of the wetting flows are found to have scaling of flow rates versus time similar to those known for capillary advances in solid corners. In some cases, a seemingly misaligned vane is found to have more rapid capillary advance than for the same vane and gap but with the vane normal to the tank wall. An initial drop tower study of sensitivity to imperfect initial conditions shows that a critical wetting flow is largely immune to small tilts in the initial test orientation but that larger errors can be seen in cases that lack critical wetting and in the measurements of the time history of the meniscus minimum point.

The increased cost of ventral hernia recurrence: a cost analysis.

PubMed

Davila, D G; Parikh, N; Frelich, M J; Goldblatt, M I

2016-12-01

Over 300,000 ventral hernia repairs (VHRs) are performed each year in the US. We sought to assess the economic burden related to ventral hernia recurrences with a focused comparison of those with the initial open versus laparoscopic surgery. The Premier Alliance database from 2009 to 2014 was utilized to obtain patient demographics and comorbid indices, including the Charlson comorbidity index (CCI). Total hospital cost and resource expenses during index laparoscopic and open VHRs and subsequent recurrent repairs were also obtained. The sample was separated into laparoscopic and open repair groups from the initial operation. Adjusted and propensity score matched cost outcome data were then compared amongst groups. One thousand and seventy-seven patients were used for the analysis with a recurrence rate of 3.78 %. For the combined sample, costs were significantly higher during recurrent hernia repair hospitalization ($21,726 versus $19,484, p < 0.0001). However, for index laparoscopic repairs, both the adjusted total hospital cost and department level costs were similar during the index and the recurrent visit. The costs and resource utilization did not go up due to recurrence, even though these patients had greater severity during the recurrent visit (CCI score 0.92 versus 1.06; p = 0.0092). Using a matched sample, the total hospital recurrence cost was higher for the initial open group compared to laparoscopic group ($14,520 versus $12,649; p = 0.0454). Based on our analysis, need for recurrent VHR adds substantially to total hospital costs and resource utilization. Following initial laparoscopic repair, however, the total cost of recurrent repair is not significantly increased, as it is following initial open repair. When comparing the initial laparoscopic repair versus open, the cost of recurrence was higher for the prior open repair group.

An instrumental case study examining the introduction and dissemination of the Baby Friendly Health Initiative in Australia: Participants' perspectives.

PubMed

Atchan, Marjorie; Davis, Deborah; Foureur, Maralyn

2018-06-01

Australia experiences high breastfeeding initiation but low duration rates. UNICEF introduced the global breastfeeding strategy, the Baby-Friendly Hospital Initiative, to Australia in 1992, transferring governance to the Australian College of Midwives (ACM) in 1995. In 2017 23% of facilities were registered as 'baby-friendly' accredited. To examine the introduction and dissemination of the Baby-friendly Hospital Initiative into the Australian national setting. An instrumental case study was conducted containing two components: analysis of historical documents pertaining to the Initiative and participant's interviews, reported here. A purposive sampling strategy identified 14 participants from UNICEF, ACM, maternity and community health services, the Australian government and volunteer organisations who took part in in-depth interviews. Thematic analysis explored participants' perceptions of factors influencing the uptake and future of the since renamed Baby Friendly Health Initiative (BFHI) and accreditation programme, BFHI Australia. Two broad categories, enablers and barriers, guided the interviews and analysis. Participants revealed a positive perception of the BFHI whilst identifying that its interpretation and expansion in Australia had been negatively influenced by intangible government support and suboptimal capacity building. BFHI's advocacy agenda competed with BFHI Australia's need for financial viability. Widespread stakeholder collaboration and tangible political endorsement was seen as a way to move the strategy forward. Dissemination of BFHI Australia is hampered by multi-level systems issues. Prioritisation, stakeholder collaboration and adequate resourcing of the BFHI is required to create a supportive and enabling environment for Australian women to determine and practice their preferred infant feeding method. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

A randomized controlled trial to compare the safety and effectiveness of doxycycline (200 mg daily) with oral prednisolone (0.5 mg kg(-1) daily) for initial treatment of bullous pemphigoid: a protocol for the Bullous Pemphigoid Steroids and Tetracyclines (BLISTER) Trial.

PubMed

Chalmers, J R; Wojnarowska, F; Kirtschig, G; Nunn, A J; Bratton, D J; Mason, J; Foster, K A; Whitham, D; Williams, H C

2015-07-01

Bullous pemphigoid (BP) is the most common autoimmune blistering disease in older people, and is associated with significant morbidity and mortality. Oral corticosteroids are usually effective but the side-effects are thought to contribute to the high morbidity and mortality rate. Treatment with oral tetracyclines may be effective but high-quality, randomized controlled trials (RCTs) are needed to confirm this. To compare the effectiveness and safety of two strategies for treating BP. This is a two-arm, parallel group, 52-week RCT comparing doxycycline with prednisolone for initial treatment of BP. Dose is fixed for the initial 6 weeks of treatment (doxycycline 200 mg daily; prednisolone 0.5 mg kg(-1) daily), after which it can be adjusted according to need. A total of 256 patients with BP will be recruited in the U.K. and Germany. The primary outcomes are: (i) effectiveness (assessor-blinded blister count at 6 weeks) and (ii) safety [proportion of patients experiencing ≥ grade 3 adverse events (i.e. severe, life: threatening or fatal) related to trial medication during the year of follow-up]. Primary effectiveness analysis will be an assessment of whether doxycycline can be considered noninferior to prednisolone after 6 weeks of treatment. Primary safety analysis is a superiority analysis at 12 months. Secondary outcomes include longer-term assessment of effectiveness, relapse rates, the proportion of patients experiencing any grade of adverse events related to treatment, quality of life and cost-effectiveness. The trial will provide good evidence for whether the strategy of starting BP treatment with doxycycline is a useful alternative to prednisolone. © 2015 British Association of Dermatologists.

Forgetting of Foreign-Language Skills: A Corpus-Based Analysis of Online Tutoring Software

ERIC Educational Resources Information Center

Ridgeway, Karl; Mozer, Michael C.; Bowles, Anita R.

2017-01-01

We explore the nature of forgetting in a corpus of 125,000 students learning Spanish using the Rosetta Stone® foreign-language instruction software across 48 lessons. Students are tested on a lesson after its initial study and are then retested after a variable time lag. We observe forgetting consistent with power function decay at a rate that…

Why Did Abolishing Fees Not Increase Public School Enrollment in Kenya? Africa Growth Initiative. Working Paper 4

ERIC Educational Resources Information Center

Bold, Tessa; Kimenyi, Mwangi S.; Mwabu, Germano; Sandefur, Justin

2013-01-01

A large empirical literature has shown that user fees significantly deter public service utilization in developing countries. While most of these results reflect partial equilibrium analysis, we find that the nationwide abolition of public school fees in Kenya in 2003 led to no increase in net public enrollment rates, but rather a dramatic shift…

Adaptation strategies to climate change in the Arctic: a global patchwork of reactive community-scale initiatives

NASA Astrophysics Data System (ADS)

Loboda, Tatiana V.

2014-11-01

Arctic regions have experienced and will continue to experience the greatest rates of warming compared to any other region of the world. The people living in the Arctic are considered among most vulnerable to the impacts of environmental change ranging from decline in natural resources to increasing mental health concerns (IPCC 2014 Climate Change 2014: Impacts, Adaptation and Vulnerability. Contribution of Working Group II to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change (Cambridge: Cambridge University Press)). A meta-analysis study by Ford et al (2014 Environ. Res. Lett. 9 104005) has assessed the volume, scope and geographic distribution of reported in the English language peer-reviewed literature initiatives for adaptation to climate change in the Arctic. Their analysis highlights the reactive nature of the adopted policies with a strong emphasis on local and community-level policies mostly targeting indigenous population in Canada and Alaska. The study raises concerns about the lack of monitoring and evaluation mechanism to track the success rate of the existing policies and the need for long-term strategic planning in adaption policies spanning international boundaries and including all groups of population.

Age at smoking initiation and self-rated health among second grade high school boys and girls in Scania, Sweden, a cross-sectional study.

PubMed

Hansen, Kristina; Lindström, Martin; Rosvall, Maria

2015-11-18

Smoking is usually initiated early in life and most adult regular smokers have started smoking before 18 years of age. A younger age at smoking initiation is associated with risk taking behaviours and worse health outcomes regarding psychological and somatic conditions, suggested to be caused by exposure during critical developmental periods. The present study aims to investigate self-rated health among second grade high school boys and girls related to age at smoking initiation (<14 years of age and ≥ 14 years of age) among current and former smokers, compared to never smokers. Data was derived from the Scania public health survey among children and adolescents in 2012. The study was cross-sectional with retrospective information about first time cigarette smoking experiences among 3245 boys and 3434 girls in second grade of high school. Self-rated health was assessed with the question "How do you rate your general health". Associations of age at smoking initiation, current smoking status and poor self-rated health were investigated with logistic regression models. Crude odds ratios of poor self-rated health were increased for all smoking groups compared to never smokers. Former smoking boys and currently smoking girls with early smoking initiation had the highest odds ratios of poor self-rated health, with odds ratios (OR) 2.4 (95 % confidence interval (CI): 1.5-3.7) and OR 2.9 (95 % CI: 2.3-3.6), respectively. After adjustments for sociodemographic factors, health-related behaviours, psychosocial factors, weight and functional disabilities, the results were attenuated, but remained statistically significant regarding former and current smoking boys with early smoking initiation, OR 2.0 (95 % CI: 1.1-3.7) and OR 1.7 (95 % CI: 1.1-2.4) and for current smoking girls with early and later smoking initiation, OR 2.1 (95 % CI: 1.5-2.8) and OR 1.5 (95 % CI: 1.1-2.0). Boys and girls in second grade of high school with early smoking initiation reported poorer self-rated health than later initiators and never smokers. Poorer self-rated health persisted also after smoking cessation among early initiating boys. Further studies are needed to understand the adverse health effects associated with timing of smoking initiation.

Membranectomy in Chronic Subdural Hematoma: Meta-Analysis.

PubMed

Sahyouni, Ronald; Mahboubi, Hossein; Tran, Peter; Roufail, John S; Chen, Jefferson W

2017-08-01

Initial management strategies of chronic subdural hematoma (cSDH) are controversial and range from bedside twist-drill or burr-hole drainage to craniotomy with membranectomy (CWM). We aim to 1) perform a meta-analysis of the available data on the outcomes of CWM for treatment of cSDH in published English-language literature and 2) evaluate collective outcomes of CWM with respect to morbidity, mortality, and recurrence rates. A search of English-language literature performed in PubMed, Ovid, and Cochrane databases using key words ("subdural hematoma" or "chronic subdural hematoma") and ("membrane" or "membranectomy") from inception to December 2016 was conducted. Studies reporting outcomes of CWM in cSDH were included. Mortality, morbidity, follow-up duration, and recurrence rate data were extracted and analyzed. Pooled estimates and confidence intervals (CIs) were calculated for all outcomes using a random-effects model. Of 301 articles found, 17 articles containing 5369 patients met our eligibility criteria. Mean follow-up duration ranged from 1-30.8 months. Collective mean mortality and morbidity rates were 3.7% and 6.9%, respectively (95% CI 2-5.4% and 2.1-11.6%; P < 0.001 and P = 0.004). The collective mean recurrence rate was 7.6% (95% CI: 5%-10.2%; P < 0.001). Clinical data on outcomes of CWM in cSDH are limited to single institutional analyses, with considerable variation in recurrence rates and follow-up time. The rates we reported are comparable with the 5% mortality and 3%-12% morbidity rates and lower than the 10%-21% recurrence rate in the literature for burr holes or craniotomy without membranectomy. This meta-analysis provides an in-depth analysis of available data and reviews reported outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

Initial fuel temperature effects on burning rate of pool fire.

PubMed

Chen, Bing; Lu, Shou-Xiang; Li, Chang-Hai; Kang, Quan-Sheng; Lecoustre, Vivien

2011-04-15

The influence of the initial fuel temperature on the burning behavior of n-heptane pool fire was experimentally studied at the State Key Laboratory of Fire Science (SKLFS) large test hall. Circular pool fires with diameters of 100mm, 141 mm, and 200 mm were considered with initial fuel temperatures ranging from 290 K to 363 K. Burning rate and temperature distributions in fuel and vessel wall were recorded during the combustion. The burning rate exhibited five typical stages: initial development, steady burning, transition, bulk boiling burning, and decay. The burning rate during the steady burning stage was observed to be relatively independent of the initial fuel temperature. In contrast, the burning rate of the bulk boiling burning stage increases with increased initial fuel temperature. It was also observed that increased initial fuel temperature decreases the duration of steady burning stage. When the initial temperature approaches the boiling point, the steady burning stage nearly disappears and the burning rate moves directly from the initial development stage to the transition stage. The fuel surface temperature increases to its boiling point at the steady burning stage, shortly after ignition, and the bulk liquid reaches boiling temperature at the bulk boiling burning stage. No distinguished cold zone is formed in the fuel bed. However, boiling zone is observed and the thickness increases to its maximum value when the bulk boiling phenomena occurs. Copyright © 2011 Elsevier B.V. All rights reserved.

Chronodiagnostic acquisition of recovery speed of heart rate under bathing stress.

PubMed

Ishijima, M; Togawa, T

1999-11-01

Cycling on an ergometer is one effective means of measuring cardiovascular function while applying stress on the heart. Bathing in a hot water bath applies a low stress to the heart. The electrocardiograms of a healthy adult male (aged 35 at the start of study) were recorded while taking a hot water bath with no electrode attached to the body over a period of 2 years (376 days over a 762 day period). The recovery speed following the initial overshoot of the heart rate (HR) was observed. The bathtub was designed for the automatic acquisition of ECG data. Immediately after immersion in the tub, the HR reached a peak within 20 s and then exponentially decreased toward the lowest rate in the 120 s of bathing. The initial recovery speed of the HR from the stress of bathing had a specific rhythm in the subject. Spectrum analysis of the speed series indicated that slow recovery speed appeared in cyclic periods of approximately 1 year, 42 days and 17 days. The methodology may provide a chronodiagnostic index of an exercise test for cardiovascular function.

Impact of Xpert MTB/RIF for TB Diagnosis in a Primary Care Clinic with High TB and HIV Prevalence in South Africa: A Pragmatic Randomised Trial

PubMed Central

Cox, Helen S.; Mbhele, Slindile; Mohess, Neisha; Whitelaw, Andrew; Muller, Odelia; Zemanay, Widaad; Little, Francesca; Azevedo, Virginia; Simpson, John; Boehme, Catharina C.; Nicol, Mark P.

2014-01-01

Background Xpert MTB/RIF is approved for use in tuberculosis (TB) and rifampicin-resistance diagnosis. However, data are limited on the impact of Xpert under routine conditions in settings with high TB burden. Methods and Findings A pragmatic prospective cluster-randomised trial of Xpert for all individuals with presumptive (symptomatic) TB compared to the routine diagnostic algorithm of sputum microscopy and limited use of culture was conducted in a large TB/HIV primary care clinic. The primary outcome was the proportion of bacteriologically confirmed TB cases not initiating TB treatment by 3 mo after presentation. Secondary outcomes included time to TB treatment and mortality. Unblinded randomisation occurred on a weekly basis. Xpert and smear microscopy were performed on site. Analysis was both by intention to treat (ITT) and per protocol. Between 7 September 2010 and 28 October 2011, 1,985 participants were assigned to the Xpert (n = 982) and routine (n = 1,003) diagnostic algorithms (ITT analysis); 882 received Xpert and 1,063 routine (per protocol analysis). 13% (32/257) of individuals with bacteriologically confirmed TB (smear, culture, or Xpert) did not initiate treatment by 3 mo after presentation in the Xpert arm, compared to 25% (41/167) in the routine arm (ITT analysis, risk ratio 0.51, 95% CI 0.33–0.77, p = 0.0052). The yield of bacteriologically confirmed TB cases among patients with presumptive TB was 17% (167/1,003) with routine diagnosis and 26% (257/982) with Xpert diagnosis (ITT analysis, risk ratio 1.57, 95% CI 1.32–1.87, p<0.001). This difference in diagnosis rates resulted in a higher rate of treatment initiation in the Xpert arm: 23% (229/1,003) and 28% (277/982) in the routine and Xpert arms, respectively (ITT analysis, risk ratio 1.24, 95% CI 1.06–1.44, p = 0.013). Time to treatment initiation was improved overall (ITT analysis, hazard ratio 0.76, 95% CI 0.63–0.92, p = 0.005) and among HIV-infected participants (ITT analysis, hazard ratio 0.67, 95% CI 0.53–0.85, p = 0.001). There was no difference in 6-mo mortality with Xpert versus routine diagnosis. Study limitations included incorrect intervention allocation for a high proportion of participants and that the study was conducted in a single clinic. Conclusions These data suggest that in this routine primary care setting, use of Xpert to diagnose TB increased the number of individuals with bacteriologically confirmed TB who were treated by 3 mo and reduced time to treatment initiation, particularly among HIV-infected participants. Trial registration Pan African Clinical Trials Registry PACTR201010000255244 Please see later in the article for the Editors' Summary PMID:25423041

THE EFFECT OF STEP RATE MANIPULATION ON FOOT STRIKE PATTERN OF LONG DISTANCE RUNNERS.

PubMed

Allen, Darrell J; Heisler, Hollie; Mooney, Jennifer; Kring, Richard

2016-02-01

Running gait retraining to change foot strike pattern in runners from a heel strike pattern to a non heel- strike pattern has been shown to reduce impact forces and may help to reduce running related injuries. Step rate manipulation above preferred is known to help decrease step length, foot inclination angle, and vertical mass excursion, but has not yet been evaluated as a method to change foot strike pattern. The purpose of this study was to investigate the effect of step rate manipulation on foot strike pattern in shod recreational runners who run with a heel strike pattern. A secondary purpose was to describe the effect of step rate manipulation at specific percentages above preferred on foot inclination angle at initial contact. Forty volunteer runners, who were self-reported heel strikers and had a weekly running mileage of at least 10 miles, were recruited. Runners were confirmed to be heel strikers during the warm up period on the treadmill. The subject's step rate was determined at their preferred running pace. A metronome was used to increase step rate above the preferred step rate by 5%, 10% and 15%. 2D video motion analysis was utilized to determine foot strike pattern and to measure foot inclination angle at initial contact for each step rate condition. There was a statistically significant change in foot strike pattern from a heel strike pattern to a mid-foot or forefoot strike pattern at both 10% and 15% step rates above preferred. Seven of the 40 subjects (17.5%) changed from a heel- strike pattern to a non- heel strike pattern at +10% and 12 of the 40 subjects (30%) changed to a non-heel strike pattern at +15%. Mean foot inclination angle at initial contact showed a statistically significant change (reduction) as step rate increased. Step rate manipulation of 10% or greater may be enough to change foot strike pattern from a heel strike to a mid-foot or forefoot strike pattern in a small percentage of recreational runners who run in traditional running shoes. If changing the foot strike pattern is the main goal, other gait re-training methods may be needed to make a change from a heel strike to a non-heel strike pattern. Step rate manipulation shows a progressive reduction of foot inclination angle at 5%, 10%, and 15% above preferred step rate which reduces the severity of the heel strike at initial contact. Step rate manipulation of at least +10% above preferred may be an effective running gait retraining method for clinicians to decrease the severity of heel strike and possibly assist a runner to change to a non-heel strike pattern. 3.

Changes in healthcare-associated Staphylococcus aureus bloodstream infections after the introduction of a national hand hygiene initiative.

PubMed

Barnett, Adrian G; Page, Katie; Campbell, Megan; Brain, David; Martin, Elizabeth; Rashleigh-Rolls, Rebecca; Halton, Kate; Hall, Lisa; Jimmieson, Nerina; White, Katherine; Paterson, David; Graves, Nicholas

2014-08-01

Interventions that prevent healthcare-associated infection should lead to fewer deaths and shorter hospital stays. Cleaning hands (with soap or alcohol) is an effective way to prevent the transmission of organisms, but rates of compliance with hand hygiene are sometimes disappointingly low. The National Hand Hygiene Initiative in Australia aimed to improve hand hygiene compliance among healthcare workers, with the goal of reducing rates of healthcare-associated infection. We examined whether the introduction of the National Hand Hygiene Initiative was associated with a change in infection rates. Monthly infection rates for healthcare-associated Staphylococcus aureus bloodstream infections were examined in 38 Australian hospitals across 6 states. We used Poisson regression and examined 12 possible patterns of change, with the best fitting pattern chosen using the Akaike information criterion. Monthly bed-days were included to control for increased hospital use over time. The National Hand Hygiene Initiative was associated with a reduction in infection rates in 4 of the 6 states studied. Two states showed an immediate reduction in rates of 17% and 28%, 2 states showed a linear decrease in rates of 8% and 11% per year, and 2 showed no change in infection rates. The intervention was associated with reduced infection rates in most states. The failure in 2 states may have been because those states already had effective initiatives before the national initiative's introduction or because infection rates were already low and could not be further reduced.

Lipid monitoring in patients with schizophrenia prescribed second-generation antipsychotics.

PubMed

Weissman, Ellen M; Zhu, Carolyn W; Schooler, Nina R; Goetz, Raymond R; Essock, Susan M

2006-09-01

Treatment with second-generation antipsychotic (SGA) medications has been linked with increased rates of the metabolic syndrome (i.e., dyslipidemia, obesity, and hyperglycemia). Several sets of published recommendations now provide clinicians with guidelines for monitoring metabolic parameters in individuals with schizophrenia treated with SGAs. However, few data are available regarding actual metabolic monitoring practices in this patient population. The objectives of the study were to determine baseline lipid monitoring rates for individuals with schizophrenia prescribed SGAs during the period prior to the publication of monitoring guidelines and to determine whether individuals with abnormal lipid levels received follow-up monitoring sooner than individuals with normal levels. Lipid monitoring rates for 408 individuals with schizophrenia who were prescribed SGAs from October 1999 to October 2003 were examined using administrative data from a Veterans Affairs facility. Survival analysis was used to examine time to follow-up lipid measurement and to compare time to follow-up measure for individuals with normal initial lipid levels versus those with elevated initial lipid levels. Eighty-five percent of individuals had at least 1 measurement for total cholesterol or triglycerides in a 4-year period. Abnormal initial measurements predicted significantly earlier follow-up monitoring (p < .005 for total cholesterol, p < .05 for triglycerides, p < .001 for low-density lipoprotein cholesterol). However, median time to follow-up measure was 304 days (approximately 10 months) for individuals with elevated total cholesterol levels, which is too long for optimal clinical follow-up. Program managers and clinicians should assess adequacy of monitoring and support quality improvement initiatives in this area.

Modeling of ultrasonic degradation of non-volatile organic compounds by Langmuir-type kinetics.

PubMed

Chiha, Mahdi; Merouani, Slimane; Hamdaoui, Oualid; Baup, Stéphane; Gondrexon, Nicolas; Pétrier, Christian

2010-06-01

Sonochemical degradation of phenol (Ph), 4-isopropylphenol (4-IPP) and Rhodamine B (RhB) in aqueous solutions was investigated for a large range of initial concentrations in order to analyze the reaction kinetics. The initial rates of substrate degradation and H(2)O(2) formation as a function of initial concentrations were determined. The obtained results show that the degradation rate increases with increasing initial substrate concentration up to a plateau and that the sonolytic destruction occurs mainly through reactions with hydroxyl radicals in the interfacial region of cavitation bubbles. The rate of H(2)O(2) formation decreases with increasing substrate concentration and reaches a minimum, followed by almost constant production rate for higher substrate concentrations. Sonolytic degradation data were analyzed by the models of Okitsu et al. [K. Okitsu, K. Iwasaki, Y. Yobiko, H. Bandow, R. Nishimura, Y. Maeda, Sonochemical degradation of azo dyes in aqueous solution: a new heterogeneous kinetics model taking into account the local concentration OH radicals and azo dyes, Ultrason. Sonochem. 12 (2005) 255-262.] and Seprone et al. [N. Serpone, R. Terzian, H. Hidaka, E. Pelizzetti, Ultrasonic induced dehalogenation and oxidation of 2-, 3-, and 4-chlorophenol in air-equilibrated aqueous media. Similarities with irradiated semiconductor particulates, J. Phys. Chem. 98 (1994) 2634-2640.] developed on the basis of a Langmuir-type mechanism. The five linearized forms of the Okitsu et al.'s equation as well as the non-linear curve fitting analysis method were discussed. Results show that it is not appropriate to use the coefficient of determination of the linear regression method for comparing the best-fitting. Among the five linear expressions of the Okitsu et al.'s kinetic model, form-2 expression very well represent the degradation data for Ph and 4-IPP. Non-linear curve fitting analysis method was found to be the more appropriate method to determine the model parameters. An excellent representation of the experimental results of sonolytic destruction of RhB was obtained using the Serpone et al.'s model. The Serpone et al.'s model gives a worse fit for the sonolytic degradation data of Ph and 4-IPP. These results indicate that Ph and 4-IPP undergo degradation predominantly at the bubble/solution interface, whereas RhB undergoes degradation at both bubble/solution interface and in the bulk solution. (c) 2010 Elsevier B.V. All rights reserved.

Laboratory study of nitrogen and phosphorus remineralization during the decomposition of coastal plankton and seston

NASA Astrophysics Data System (ADS)

Garber, Jonathan H.

1984-06-01

The decomposition of cultured marine phytoplankton ( Skeletonema costatum) and natural estuarine seston from Narragansett Bay, RI, was studied at two temperatures (8°C and 18°C) in bottles containing sterile bay-water (30‰) and in bay-water with micro-organisms small enough to pass through a glass fibre filter (nominally < 1μ). About 50% of the particulate organic nitrogen (PON) and particulate phosphorus (PP) was immediately released to the water in dissolved organic forms from both types of organic matter. Comparison of changes in the dissolved organic nitrogen (DON) fraction in the sterile and non-sterile systems indicated that nearly all of the DON initially released was subsequently remineralized. Ammonification proceeded only in non-sterile bay-water. 20-25% of the PP was converted to dissolved inorganic-P (DIP) fraction after only 7 h in both sterile and non-sterile bay-water. Following autolytic releases of DON, DOP and DIP the initial rates of N and P remineralization were temperature dependent: Q 10 values for PON and PP decay during first phase of microbially mediated decomposition ranged from 1·3 to 6·4. Rates of remineralization then slowed so that about equal amounts of nutrients were remineralized (45-50% of the N and 57-60% of the P in the phytoplankton and 60-63% of the N and 36-60% of the P in the natural seston) after 30 days storage at either temperature. During 30 days of decomposition in non-sterile seawater the N/P ratios in the dissolved inorganic fractions converged on the ratios of total-N/total-P initially present in the bottles. Kinetic analysis of the decay of total organic-N (TON) and total organic-P (TOP) in the non-sterile systems and analysis of similar sets found in the literature showed that the initial stages of the decomposition of N and P from planktonic POM in vitro could be modelled as the sequential decay, at first-order rates, of two particulate fractions. The first, more labile, fraction comprised about 60% of the particulate N and P. First-order rate constants (- k, base e) for decomposition during the 1st and 2nd phases were 0·02 to 0·2 day -1 and 0·003 to 0·02 day -1, respectively. The decay rates are far too slow to account for the 'rapid in situ recycling' of nutrients needed to support phytoplankton production when other means of nutrient resupply (by advection, fixation, rainfall, etc.) are very low.

18 CFR 154.202 - Filings to initiate a new rate schedule.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Filings to initiate a new rate schedule. 154.202 Section 154.202 Conservation of Power and Water Resources FEDERAL ENERGY... Procedures for Changing Tariffs § 154.202 Filings to initiate a new rate schedule. (a) When the filing is to...

18 CFR 154.202 - Filings to initiate a new rate schedule.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Filings to initiate a new rate schedule. 154.202 Section 154.202 Conservation of Power and Water Resources FEDERAL ENERGY... Procedures for Changing Tariffs § 154.202 Filings to initiate a new rate schedule. (a) When the filing is to...

18 CFR 154.202 - Filings to initiate a new rate schedule.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Filings to initiate a new rate schedule. 154.202 Section 154.202 Conservation of Power and Water Resources FEDERAL ENERGY... Procedures for Changing Tariffs § 154.202 Filings to initiate a new rate schedule. (a) When the filing is to...

18 CFR 154.202 - Filings to initiate a new rate schedule.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Filings to initiate a new rate schedule. 154.202 Section 154.202 Conservation of Power and Water Resources FEDERAL ENERGY... Procedures for Changing Tariffs § 154.202 Filings to initiate a new rate schedule. (a) When the filing is to...

18 CFR 154.202 - Filings to initiate a new rate schedule.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Filings to initiate a new rate schedule. 154.202 Section 154.202 Conservation of Power and Water Resources FEDERAL ENERGY... Procedures for Changing Tariffs § 154.202 Filings to initiate a new rate schedule. (a) When the filing is to...

38 CFR 4.88c - Ratings for inactive nonpulmonary tuberculosis initially entitled after August 19, 1968.

Code of Federal Regulations, 2010 CFR

2010-07-01

... nonpulmonary tuberculosis initially entitled after August 19, 1968. 4.88c Section 4.88c Pensions, Bonuses, and... tuberculosis initially entitled after August 19, 1968. Rating For 1 year after date of inactivity, following active tuberculosis 100 Thereafter: Rate residuals under the specific body system or systems affected...

38 CFR 4.88c - Ratings for inactive nonpulmonary tuberculosis initially entitled after August 19, 1968.

Code of Federal Regulations, 2013 CFR

2013-07-01

... nonpulmonary tuberculosis initially entitled after August 19, 1968. 4.88c Section 4.88c Pensions, Bonuses, and... tuberculosis initially entitled after August 19, 1968. Rating For 1 year after date of inactivity, following active tuberculosis 100 Thereafter: Rate residuals under the specific body system or systems affected...

38 CFR 4.88c - Ratings for inactive nonpulmonary tuberculosis initially entitled after August 19, 1968.

Code of Federal Regulations, 2011 CFR

2011-07-01

... nonpulmonary tuberculosis initially entitled after August 19, 1968. 4.88c Section 4.88c Pensions, Bonuses, and... tuberculosis initially entitled after August 19, 1968. Rating For 1 year after date of inactivity, following active tuberculosis 100 Thereafter: Rate residuals under the specific body system or systems affected...

38 CFR 4.88c - Ratings for inactive nonpulmonary tuberculosis initially entitled after August 19, 1968.

Code of Federal Regulations, 2014 CFR

2014-07-01

... nonpulmonary tuberculosis initially entitled after August 19, 1968. 4.88c Section 4.88c Pensions, Bonuses, and... tuberculosis initially entitled after August 19, 1968. Rating For 1 year after date of inactivity, following active tuberculosis 100 Thereafter: Rate residuals under the specific body system or systems affected...

38 CFR 4.88c - Ratings for inactive nonpulmonary tuberculosis initially entitled after August 19, 1968.

Code of Federal Regulations, 2012 CFR

2012-07-01

... nonpulmonary tuberculosis initially entitled after August 19, 1968. 4.88c Section 4.88c Pensions, Bonuses, and... tuberculosis initially entitled after August 19, 1968. Rating For 1 year after date of inactivity, following active tuberculosis 100 Thereafter: Rate residuals under the specific body system or systems affected...

47 CFR 76.930 - Initiation of review of basic cable service and equipment rates.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 4 2010-10-01 2010-10-01 false Initiation of review of basic cable service and...) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Cable Rate Regulation § 76.930 Initiation of review of basic cable service and equipment rates. A cable operator shall file its schedule of...

[Analysis of diagnosis and treatment of Alport syndrome].

PubMed

An, X G; Zhang, Y Q; Ding, J; Wang, F; Xiao, H J; Yao, Y

2016-09-01

To investigate the clinical characteristics and the status of diagnosis and treatment of patients with Alport syndrome in China. Patients with affirmative diagnosis of Alport syndrome from Department of Pedatrics, Peking University First Hospital in the past 20 years (1995-2015) were analyzed retrospectively. The clinical data including initial symptoms, visit reasons, age at onset of disease, family history, hereditary mode, methods of diagnosis, misdiagnosis and mistreatment were collected. A total of 398 patients with Alport syndrome were included in this study, 48.2% of patients had the onset of symptoms before age of 3 years. The rate of onset of symptoms and diagnosis before age of 17 years were 95.7%. The initial symptoms included gross hematuria (37.2%), microscopic hematuria and proteinuria (25.1%), microscopic hematuria (14.8%), edema of eyelid and lower limbs (10.3%), increased foam in urine (4.3%), etc.; 39.5% of patients had no symptoms of urinary tract. Only 14.0% of the patients were diagnosed as Alport syndrome for the first time, and 86.0% of the patients were misdiagnosed. Hormones and immunosuppressive agents were used in 19.0% of patients diagnosed as Alport syndrome, and in 43.0% of patients there was misdiagnosis. Skin biopsy and immunofluorescence of type Ⅳ collagen ɑ5 chain in epithelial basement membrane had a detection rate of 77.8%. Electron microscopy of glomerular basement membrane had a detection rate of 92.6%, and genetic testing 96.6%. The time interval of diagnosis was 18.2 months and was gradually shortened in recent years. Alport syndrome developed at a very young age. Hematuria was the most frequent initial symptom. There was a high rate of misdiagnosis and mistreatment for Alport syndrome. Genetic testing for Alport syndrome had advantages of high detection rate, genetic consultation and prenatal diagnosis.

Dental Homes for Children With Autism: A Longitudinal Analysis of Iowa Medicaid's I-Smile Program.

PubMed

Chi, Donald L; Momany, Elizabeth T; Mancl, Lloyd A; Lindgren, Scott D; Zinner, Samuel H; Steinman, Kyle J

2016-05-01

Medicaid-enrolled children with autism spectrum disorder (ASD) encounter significant barriers to dental care. Iowa's I-Smile Program was implemented in 2006 to improve dental use for all children in Medicaid. This study compared dental home and preventive dental utilization rates for Medicaid-enrolled children by ASD status and within three time periods (pre-implementation, initial implementation, maturation) and determined I-Smile's longitudinal influence on ASD-related dental use disparities. Data from 2002-2011 were analyzed for newly Medicaid-enrolled children aged 3-17 years (N=30,059); identified each child's ASD status; and assessed whether the child had a dental home or utilized preventive dental care. Log-linear regression models were used to generate rate ratios. Analyses were conducted in 2015. In 2003-2011, 9.8% of children with ASD had dental homes compared with 8% of children without ASD; 36.3% of children with ASD utilized preventive care compared to 45.7% of children without ASD. There were no significant differences in dental home rates by ASD status during pre-implementation, initial implementation, or maturation. There were no significant differences in preventive dental utilization by ASD status during pre-implementation or initial implementation, but children with ASD were significantly less likely to utilize preventive care during maturation (rate ratio=0.79, p<0.001). Longitudinal trends in dental home and preventive dental utilization rates were not significant (p=0.54 and p=0.71, respectively). Among newly Medicaid-enrolled children in Iowa's I-Smile Program, those with ASDs were not less likely than those without ASD to have dental homes but were significantly less likely to utilize preventive dental care. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Flow and fracture behavior of aluminum alloy 6082-T6 at different tensile strain rates and triaxialities.

PubMed

Chen, Xuanzhen; Peng, Yong; Peng, Shan; Yao, Song; Chen, Chao; Xu, Ping

2017-01-01

This study aims to investigate the flow and fracture behavior of aluminum alloy 6082-T6 (AA6082-T6) at different strain rates and triaxialities. Two groups of Charpy impact tests were carried out to further investigate its dynamic impact fracture property. A series of tensile tests and numerical simulations based on finite element analysis (FEA) were performed. Experimental data on smooth specimens under various strain rates ranging from 0.0001~3400 s-1 shows that AA6082-T6 is rather insensitive to strain rates in general. However, clear rate sensitivity was observed in the range of 0.001~1 s-1 while such a characteristic is counteracted by the adiabatic heating of specimens under high strain rates. A Johnson-Cook constitutive model was proposed based on tensile tests at different strain rates. In this study, the average stress triaxiality and equivalent plastic strain at facture obtained from numerical simulations were used for the calibration of J-C fracture model. Both of the J-C constitutive model and fracture model were employed in numerical simulations and the results was compared with experimental results. The calibrated J-C fracture model exhibits higher accuracy than the J-C fracture model obtained by the common method in predicting the fracture behavior of AA6082-T6. Finally, the Scanning Electron Microscope (SEM) of fractured specimens with different initial stress triaxialities were analyzed. The magnified fractographs indicate that high initial stress triaxiality likely results in dimple fracture.

Geography of primary mental health care through the Better Access initiative in South Australia 2006-2010.

PubMed

Carson, Dean; Bidargaddi, Niranjan; Schrader, Geoffrey; Allison, Stephen; Jones, Gabrielle Margaret; Bastiampillai, Tarun; Strobel, Jörg

2016-06-01

To examine how the rates of the use of particular face-to-face primary mental health care services changed in the first 4 years (2006-2010) of the Better Access initiative in both urban and rural regions of South Australia. Time-series analysis of the number of psychology session, psychiatry assessment and general practitioner care plan services recorded in Medicare Australia data. South Australia. Pre-existing data set of South Australian residents who accessed Medicare between 2006 and 2010 MAIN OBJECTIVE MEASURE: Number of services per 100 000 population (service rate). Psychology session service rates increased in all regions, but continued to follow a 'location gradient', being higher in areas closer to Adelaide and lower in areas more distant from Adelaide. Psychiatry assessment service rates increased in Adelaide but did not change in other regions. Rates in remote areas were subject to substantial variation over time. General practitioner care plan service rates increased in Adelaide and in the Riverland, but declined in the Murray Mallee region. Overall, service rates increased in Adelaide and nearby regions, but the results for rural and remote regions were mixed. Possible explanations for the geographical variability include population characteristics (such as socio-economic status), methods of service delivery (visiting practitioners, telepsych), the relative proportion of total health services provided by general practitioners versus other practitioners, or real variations in the need for primary mental health services. © 2015 National Rural Health Alliance Inc.

Delamination micromechanics analysis

NASA Technical Reports Server (NTRS)

Adams, D. F.; Mahishi, J. M.

1985-01-01

A three-dimensional finite element analysis was developed which includes elastoplastic, orthotropic material response, and fracture initiation and propagation. Energy absorption due to physical failure processes characteristic of the heterogeneous and anisotropic nature of composite materials is modeled. A local energy release rate in the presence of plasticity was defined and used as a criterion to predict the onset and growth of cracks in both micromechanics and macromechanics analyses. This crack growth simulation technique is based upon a virtual crack extension method. A three-dimensional finite element micromechanics model is used to study the effects of broken fibers, cracked matrix and fiber-matrix debond on the fracture toughness of the unidirectional composite. The energy release rates at the onset of unstable crack growth in the micromechanics analyses are used as critical energy release rates in the macromechanics analysis. This integrated micromechanical and macromechanical fracture criterion is shown to be very effective in predicting the onset and growth of cracks in general multilayered composite laminates by applying the criterion to a single-edge notched graphite/epoxy laminate subjected to implane tension normal to the notch.

Effectiveness of practices to reduce blood culture contamination: a Laboratory Medicine Best Practices systematic review and meta-analysis.

PubMed

Snyder, Susan R; Favoretto, Alessandra M; Baetz, Rich Ann; Derzon, James H; Madison, Bereneice M; Mass, Diana; Shaw, Colleen S; Layfield, Christopher D; Christenson, Robert H; Liebow, Edward B

2012-09-01

This article is a systematic review of the effectiveness of three practices for reducing blood culture contamination rates: venipuncture, phlebotomy teams, and prepackaged preparation/collection (prep) kits. The CDC-funded Laboratory Medicine Best Practices Initiative systematic review methods for quality improvement practices were used. Studies included as evidence were: 9 venipuncture (vs. versus intravenous catheter), 5 phlebotomy team; and 7 prep kit. All studies for venipuncture and phlebotomy teams favored these practices, with meta-analysis mean odds ratios for venipuncture of 2.69 and phlebotomy teams of 2.58. For prep kits 6 studies' effect sizes were not statistically significantly different from no effect (meta-analysis mean odds ratio 1.12). Venipuncture and the use of phlebotomy teams are effective practices for reducing blood culture contamination rates in diverse hospital settings and are recommended as evidence-based "best practices" with high overall strength of evidence and substantial effect size ratings. No recommendation is made for or against prep kits based on uncertain improvement. Copyright © 2012 The Canadian Society of Clinical Chemists. All rights reserved.

Evaluating the impact of the Baby-Friendly Hospital Initiative on breast-feeding rates: a multi-state analysis

PubMed Central

Hawkins, Summer Sherburne; Stern, Ariel Dora; Baum, Christopher F; Gillman, Matthew W

2014-01-01

Objective To evaluate the impact of the Baby-Friendly Hospital Initiative (BFHI) on breast-feeding initiation and duration overall and according to maternal education. Design Quasi-experimental study using data from five states (Alaska, Maine, Nebraska, Ohio, Washington) that participated in the Pregnancy Risk Assessment Monitoring System from 1999 to 2009. Using differences-in-differences models that included year and hospital fixed effects, we compared rates of breast-feeding initiation and duration (any and exclusive breast-feeding for ≥4 weeks) before and after BFHI accreditation between mothers who gave birth in hospitals that were accredited or became accredited and mothers from matched non-BFHI facilities. We stratified analyses into lower and higher education groups. Setting Thirteen BFHI hospitals and nineteen matched non-BFHI facilities across five states in the USA. Subjects Mothers (n 11723) who gave birth in BFHI hospitals and mothers (n 13604) from nineteen matched non-BFHI facilities. Results Although we did not find overall differences in breast-feeding initiation between birth facilities that received BFHI accreditation compared with non-Baby-Friendly facilities (adjusted coefficient = 0.024; 95 % CI −0.00, 0.51), breast-feeding initiation increased by 3.8 percentage points among mothers with lower education who delivered in Baby-Friendly facilities (P = 0.05), but not among mothers with higher education (adjusted coefficient = 0.002; 95 % CI −0.04, 0.05). BFHI accreditation also increased exclusive breast-feeding for ≥4 weeks by 4.5 percentage points (P=0.02) among mothers with lower education who delivered in BFHI facilities. Conclusions By increasing breast-feeding initiation and duration among mothers with lower education, the BFHI may reduce socio-economic disparities in breast-feeding. PMID:24625787

Evaluating the impact of the Baby-Friendly Hospital Initiative on breast-feeding rates: a multi-state analysis.

PubMed

Hawkins, Summer Sherburne; Stern, Ariel Dora; Baum, Christopher F; Gillman, Matthew W

2015-02-01

To evaluate the impact of the Baby-Friendly Hospital Initiative (BFHI) on breast-feeding initiation and duration overall and according to maternal education. Quasi-experimental study using data from five states (Alaska, Maine, Nebraska, Ohio, Washington) that participated in the Pregnancy Risk Assessment Monitoring System from 1999 to 2009. Using differences-in-differences models that included year and hospital fixed effects, we compared rates of breast-feeding initiation and duration (any and exclusive breast-feeding for ≥4 weeks) before and after BFHI accreditation between mothers who gave birth in hospitals that were accredited or became accredited and mothers from matched non-BFHI facilities. We stratified analyses into lower and higher education groups. Thirteen BFHI hospitals and nineteen matched non-BFHI facilities across five states in the USA. Mothers (n 11 723) who gave birth in BFHI hospitals and mothers (n 13 604) from nineteen matched non-BFHI facilities. Although we did not find overall differences in breast-feeding initiation between birth facilities that received BFHI accreditation compared with non-Baby-Friendly facilities (adjusted coefficient = 0·024; 95 % CI -0·00, 0·51), breast-feeding initiation increased by 3·8 percentage points among mothers with lower education who delivered in Baby-Friendly facilities (P = 0·05), but not among mothers with higher education (adjusted coefficient = 0·002; 95 % CI -0·04, 0·05). BFHI accreditation also increased exclusive breast-feeding for ≥4 weeks by 4·5 percentage points (P = 0·02) among mothers with lower education who delivered in BFHI facilities. By increasing breast-feeding initiation and duration among mothers with lower education, the BFHI may reduce socio-economic disparities in breast-feeding.

The solution of linear systems of equations with a structural analysis code on the NAS CRAY-2

NASA Technical Reports Server (NTRS)

Poole, Eugene L.; Overman, Andrea L.

1988-01-01

Two methods for solving linear systems of equations on the NAS Cray-2 are described. One is a direct method; the other is an iterative method. Both methods exploit the architecture of the Cray-2, particularly the vectorization, and are aimed at structural analysis applications. To demonstrate and evaluate the methods, they were installed in a finite element structural analysis code denoted the Computational Structural Mechanics (CSM) Testbed. A description of the techniques used to integrate the two solvers into the Testbed is given. Storage schemes, memory requirements, operation counts, and reformatting procedures are discussed. Finally, results from the new methods are compared with results from the initial Testbed sparse Choleski equation solver for three structural analysis problems. The new direct solvers described achieve the highest computational rates of the methods compared. The new iterative methods are not able to achieve as high computation rates as the vectorized direct solvers but are best for well conditioned problems which require fewer iterations to converge to the solution.

An automated assay for the assessment of cardiac arrest in fish embryo.

PubMed

Puybareau, Elodie; Genest, Diane; Barbeau, Emilie; Léonard, Marc; Talbot, Hugues

2017-02-01

Studies on fish embryo models are widely developed in research. They are used in several research fields including drug discovery or environmental toxicology. In this article, we propose an entirely automated assay to detect cardiac arrest in Medaka (Oryzias latipes) based on image analysis. We propose a multi-scale pipeline based on mathematical morphology. Starting from video sequences of entire wells in 24-well plates, we focus on the embryo, detect its heart, and ascertain whether or not the heart is beating based on intensity variation analysis. Our image analysis pipeline only uses commonly available operators. It has a low computational cost, allowing analysis at the same rate as acquisition. From an initial dataset of 3192 videos, 660 were discarded as unusable (20.7%), 655 of them correctly so (99.25%) and only 5 incorrectly so (0.75%). The 2532 remaining videos were used for our test. On these, 45 errors were made, leading to a success rate of 98.23%. Copyright © 2016 Elsevier Ltd. All rights reserved.

What proportion of people who try one cigarette become daily smokers? A meta analysis of representative surveys.

PubMed

Birge, Max; Duffy, Stephen; Miler, Joanna Astrid; Hajek, Peter

2017-11-04

The 'conversion rate' from initial experimentation to daily smoking is a potentially important metric of smoking behavior, but estimates of it based on current representative data are lacking. The Global Health Data Exchange was searched for representative surveys conducted in English speaking, developed countries after year 2000 that included questions about ever trying a cigarette and ever smoking daily. The initial search identified 2776 surveys that were further screened for language, location, year, sample size, survey structure and representativeness. 44 surveys that passed the screening process were accessed and their codebooks were examined to see whether the two questions of interest were included. Eight datasets allowed extraction or estimation of relevant information. Survey quality was assessed with regards to response rates, sampling methods and data collection procedures. PRISMA guidelines were followed, with explicit rules for approaching derived variables and skip patterns. Proportions were pooled using random effects meta-analysis. The eight surveys used representative samples of the general adult population. Response rates varied from 45% to 88%. Survey methods were on par with the best practice in this field. Altogether 216,314 respondents were included of whom 60.3% (95%CI 51.3-69.3) ever tried a cigarette. Among those, 68.9% (95% CI 60.9-76.9%) progressed to daily smoking. Over two thirds of people who try one cigarette become, at least temporarily, daily smokers. The finding provides strong support for the current efforts to reduce cigarette experimentation among adolescents. The transition from trying the first cigarette through occasional to daily smoking usually implies that a recreational activity is turning into a compulsive need that has to be satisfied virtually continuously. The 'conversion rate' from initial experimentation to daily smoking is thus a potentially important metric of smoking behavior, but estimates of it based on representative data are lacking. The present meta analysis addressed this gap. Currently, about two thirds of non-smokers experimenting with cigarettes progress to daily smoking. The finding supports strongly the current efforts to reduce cigarette experimentation among adolescents. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Degradation kinetics and mechanism of trace nitrobenzene by granular activated carbon enhanced microwave/hydrogen peroxide system.

PubMed

Tan, Dina; Zeng, Honghu; Liu, Jie; Yu, Xiaozhang; Liang, Yanpeng; Lu, Lanjing

2013-07-01

The kinetics of the degradation of trace nitrobenzene (NB) by a granular activated carbon (GAC) enhanced microwave (MW)/hydrogen peroxide (H202) system was studied. Effects of pH, NB initial concentration and tert-butyl alcohol on the removal efficiency were examined. It was found that the reaction rate fits well to first-order reaction kinetics in the MW/GAC/H202 process. Moreover, GAC greatly enhanced the degradation rate of NB in water. Under a given condition (MW power 300 W, H202 dosage 10 mg/L, pH 6.85 and temperature (60 +/- 5)degrees C), the degradation rate of NB was 0.05214 min-1when 4 g/L GAC was added. In general, alkaline pH was better for NB degradation; however, the optimum pH was 8.0 in the tested pH value range of 4.0-12.0. At H202 dosage of 10 mg/L and GAC dosage of 4 g/L, the removal of NB was decreased with increasing initial concentrations of NB, indicating that a low initial concentration was beneficial for the degradation of NB. These results indicated that the MW/GAC/H202 process was effective for trace NB degradation in water. Gas chromatography-mass spectrometry analysis indicated that a hydroxyl radical addition reaction and dehydrogenation reaction enhanced NB degradation.

Scaling laws for homogeneous turbulent shear flows in a rotating frame

NASA Technical Reports Server (NTRS)

Speziale, Charles G.; Mhuiris, Nessan Macgiolla

1988-01-01

The scaling properties of plane homogeneous turbulent shear flows in a rotating frame are examined mathematically by a direct analysis of the Navier-Stokes equations. It is proved that two such shear flows are dynamically similar if and only if their initial dimensionless energy spectrum E star (k star, 0), initial dimensionless shear rate SK sub 0/epsilon sub 0, initial Reynolds number K squared sub 0/nu epsilon sub 0, and the ration of the rotation rate to the shear rate omega/S are identical. Consequently, if universal equilibrium states exist, at high Reynolds numbers, they will only depend on the single parameter omega/S. The commonly assumed dependence of such equilibrium states on omega/S through the Richardson number Ri=-2(omega/S)(1-2 omega/S) is proven to be inconsistent with the full Navier-Stokes equations and to constitute no more than a weak approximation. To be more specific, Richardson number similarity is shown to only rigorously apply to certain low-order truncations of the Navier-Stokes equations (i.e., to certain second-order closure models) wherein closure is achieved at the second-moment level by assuming that the higher-order moments are a small perturbation of their isotropic states. The physical dependence of rotating turbulent shear flows on omega/S is discussed in detail along with the implications for turbulence modeling.

Trends and factors associated with early initiation of breastfeeding in Namibia: analysis of the Demographic and Health Surveys 2000-2013.

PubMed

Ndirangu, M N; Gatimu, S M; Mwinyi, H M; Kibiwott, D C

2018-05-16

Early initiation of breastfeeding (EIBF) lowers the risk for all-cause mortality in babies, including those with low birth weight. However, rates of neonatal mortality and delayed initiation of breastfeeding remain high in most low- and middle-income countries. This study aimed to assess the trends and factors associated with EIBF in Namibia from 2000 to 2013. An analysis of EIBF trends was conducted using data from three Namibia Demographic Health Surveys. The present sample included singleton children younger than 2-years from 2000 (n = 1655), 2006-2007 (n = 2152) and 2013 (n = 2062) surveys. Descriptive statistics were used to analyse respondents' demographic, socioeconomic and obstetric characteristics. Factors associated with EIBF were assessed using univariate analysis and further evaluated using multivariable logistic regression analysis. EIBF significantly decreased from 82.5% (confidence interval [CI]: 79.5-85.0) in 2000 to 74.9% (72.5-77.2) in 2013. Factors associated with EIBF in 2000 were urban residence (adjusted odds ratio 0.58, 95% CI: 0.36-0.93), poorer household wealth index (1.82, 1.05-3.17), lack of antenatal care (0.14, 0.03-0.81), small birth size (0.38, 0.24-0.63) and large birth size (0.51, 0.37-0.79). In 2013, factors associated with EIBF were maternal age of 15-19 years (2.28, 1.22-4.24), vaginal delivery (2.74, 1.90-3.93), married mothers (1.57, 1.16-2.14), delivery assistance from health professionals (3.67, 1.23-10.9) and birth order of fourth or above (1.52, 1.03-2.26). Namibia has experienced a declining trend in EIBF rates from 2000 to 2013. Factors associated with EIBF differed between 2000 and 2013. The present findings highlight the importance of continued commitment to addressing neonatal health challenges and strengthening implementation of interventions to increase EIBF in Namibia.

A Multi-scale Approach for CO2 Accounting and Risk Analysis in CO2 Enhanced Oil Recovery Sites

NASA Astrophysics Data System (ADS)

Dai, Z.; Viswanathan, H. S.; Middleton, R. S.; Pan, F.; Ampomah, W.; Yang, C.; Jia, W.; Lee, S. Y.; McPherson, B. J. O. L.; Grigg, R.; White, M. D.

2015-12-01

Using carbon dioxide in enhanced oil recovery (CO2-EOR) is a promising technology for emissions management because CO2-EOR can dramatically reduce carbon sequestration costs in the absence of greenhouse gas emissions policies that include incentives for carbon capture and storage. This study develops a multi-scale approach to perform CO2 accounting and risk analysis for understanding CO2 storage potential within an EOR environment at the Farnsworth Unit of the Anadarko Basin in northern Texas. A set of geostatistical-based Monte Carlo simulations of CO2-oil-water flow and transport in the Marrow formation are conducted for global sensitivity and statistical analysis of the major risk metrics: CO2 injection rate, CO2 first breakthrough time, CO2 production rate, cumulative net CO2 storage, cumulative oil and CH4 production, and water injection and production rates. A global sensitivity analysis indicates that reservoir permeability, porosity, and thickness are the major intrinsic reservoir parameters that control net CO2 injection/storage and oil/CH4 recovery rates. The well spacing (the distance between the injection and production wells) and the sequence of alternating CO2 and water injection are the major operational parameters for designing an effective five-spot CO2-EOR pattern. The response surface analysis shows that net CO2 injection rate increases with the increasing reservoir thickness, permeability, and porosity. The oil/CH4 production rates are positively correlated to reservoir permeability, porosity and thickness, but negatively correlated to the initial water saturation. The mean and confidence intervals are estimated for quantifying the uncertainty ranges of the risk metrics. The results from this study provide useful insights for understanding the CO2 storage potential and the corresponding risks of commercial-scale CO2-EOR fields.

[Short-term impact of changes in drinking-and-driving legislation in Guadalajara and Zapopan, Jalisco, Mexico].

PubMed

Gómez-García, Lourdes; Pérez-Núñez, Ricardo; Hidalgo-Solórzano, Elisa

2014-06-01

The municipalities of Guadalajara and Zapopan, Jalisco State, Mexico, have participated in efforts to reduce road traffic injuries. They have participated actively in the Mexican Road Safety Initiative since 2008. As a result, in September 2010 they passed laws to reduce the legal alcohol levels for driving motor vehicles. To assess the short-term impact of these measures on rates and severity of alcohol-related collisions and injuries, we conducted a secondary analysis of official databases on mortality, morbidity, and collisions. We performed a time-series analysis to assess the trend. Significant changes were observed in the monthly proportion of alcohol-related deaths and collision rates following these interventions. The article concludes with recommendations to improve the reform's enforcement and results.

DIFFERENTIATION OF AURANTII FRUCTUS IMMATURUS AND FRUCTUS PONICIRI TRIFOLIATAE IMMATURUS BY FLOW-INJECTION WITH ULTRAVIOLET SPECTROSCOPIC DETECTION AND PROTON NUCLEAR MAGNETIC RESONANCE USING PARTIAL LEAST-SQUARES DISCRIMINANT ANALYSIS.

PubMed

Zhang, Mengliang; Zhao, Yang; Harrington, Peter de B; Chen, Pei

2016-03-01

Two simple fingerprinting methods, flow-injection coupled to ultraviolet spectroscopy and proton nuclear magnetic resonance, were used for discriminating between Aurantii fructus immaturus and Fructus poniciri trifoliatae immaturus . Both methods were combined with partial least-squares discriminant analysis. In the flow-injection method, four data representations were evaluated: total ultraviolet absorbance chromatograms, averaged ultraviolet spectra, absorbance at 193, 205, 225, and 283 nm, and absorbance at 225 and 283 nm. Prediction rates of 100% were achieved for all data representations by partial least-squares discriminant analysis using leave-one-sample-out cross-validation. The prediction rate for the proton nuclear magnetic resonance data by partial least-squares discriminant analysis with leave-one-sample-out cross-validation was also 100%. A new validation set of data was collected by flow-injection with ultraviolet spectroscopic detection two weeks later and predicted by partial least-squares discriminant analysis models constructed by the initial data representations with no parameter changes. The classification rates were 95% with the total ultraviolet absorbance chromatograms datasets and 100% with the other three datasets. Flow-injection with ultraviolet detection and proton nuclear magnetic resonance are simple, high throughput, and low-cost methods for discrimination studies.

Effect of Initial Conditions on Reproducibility of Scientific Research

PubMed Central

Djulbegovic, Benjamin; Hozo, Iztok

2014-01-01

Background: It is estimated that about half of currently published research cannot be reproduced. Many reasons have been offered as explanations for failure to reproduce scientific research findings- from fraud to the issues related to design, conduct, analysis, or publishing scientific research. We also postulate a sensitive dependency on initial conditions by which small changes can result in the large differences in the research findings when attempted to be reproduced at later times. Methods: We employed a simple logistic regression equation to model the effect of covariates on the initial study findings. We then fed the input from the logistic equation into a logistic map function to model stability of the results in repeated experiments over time. We illustrate the approach by modeling effects of different factors on the choice of correct treatment. Results: We found that reproducibility of the study findings depended both on the initial values of all independent variables and the rate of change in the baseline conditions, the latter being more important. When the changes in the baseline conditions vary by about 3.5 to about 4 in between experiments, no research findings could be reproduced. However, when the rate of change between the experiments is ≤2.5 the results become highly predictable between the experiments. Conclusions: Many results cannot be reproduced because of the changes in the initial conditions between the experiments. Better control of the baseline conditions in-between the experiments may help improve reproducibility of scientific findings. PMID:25132705

Effect of initial conditions on reproducibility of scientific research.

PubMed

Djulbegovic, Benjamin; Hozo, Iztok

2014-06-01

It is estimated that about half of currently published research cannot be reproduced. Many reasons have been offered as explanations for failure to reproduce scientific research findings- from fraud to the issues related to design, conduct, analysis, or publishing scientific research. We also postulate a sensitive dependency on initial conditions by which small changes can result in the large differences in the research findings when attempted to be reproduced at later times. We employed a simple logistic regression equation to model the effect of covariates on the initial study findings. We then fed the input from the logistic equation into a logistic map function to model stability of the results in repeated experiments over time. We illustrate the approach by modeling effects of different factors on the choice of correct treatment. We found that reproducibility of the study findings depended both on the initial values of all independent variables and the rate of change in the baseline conditions, the latter being more important. When the changes in the baseline conditions vary by about 3.5 to about 4 in between experiments, no research findings could be reproduced. However, when the rate of change between the experiments is ≤2.5 the results become highly predictable between the experiments. Many results cannot be reproduced because of the changes in the initial conditions between the experiments. Better control of the baseline conditions in-between the experiments may help improve reproducibility of scientific findings.

Predicting extinction debt from community patterns.

PubMed

Kitzes, Justin; Harte, John

2015-08-01

A significant challenge in both measuring and predicting species extinction rates at global and local scales is the possibility of extinction debt, time-delayed extinctions that occur gradually following an initial impact. Here we examine how relative abundance distributions and spatial aggregation combine to influence the likely magnitude of future extinction debt following habitat loss or climate-driven range contraction. Our analysis is based on several fundamental premises regarding abundance distributions, most importantly that species abundances immediately following habitat loss are a sample from an initial relative abundance distribution and that the long-term, steady-state form of the species abundance distribution is a property of the biology of a community and not of area. Under these two hypotheses, the results show that communities following canonical lognormal and broken-stick abundance distributions are prone to exhibit extinction debt, especially when species exhibit low spatial aggregation. Conversely, communities following a logseries distribution with a constant Fisher's α parameter never demonstrate extinction debt and often show an "immigration credit," in which species richness rises in the long term following an initial decrease. An illustration of these findings in 25 biodiversity hotspots suggests a negligible immediate extinction rate for bird communities and eventual extinction debts of 30-50% of initial species richness, whereas plant communities are predicted to immediately lose 5-15% of species without subsequent extinction debt. These results shed light on the basic determinants of extinction debt and provide initial indications of the magnitude of likely debts in landscapes where few empirical data are available.

Reduced Disparities in Birth Rates Among Teens

MedlinePlus

... teen births rates. Top of Page Community-wide Initiatives As part of a coordinated national teen pregnancy ... Health and CDC partnered to fund community-wide initiatives in areas with high rates of teen births, ...

Surgery versus endoscopic cauterization in patients with third or fourth branchial pouch sinuses: A systematic review.

PubMed

Derks, Laura S M; Veenstra, Hidde J; Oomen, Karin P Q; Speleman, Lucienne; Stegeman, Inge

2016-01-01

To systematically review the current literature on treatment of third and fourth branchial pouch sinuses with endoscopic cauterization, including chemocauterization and electrocauterization, in comparison to surgical treatment. PubMed, Embase, and the Cochrane Library. We conducted a systematic search. Studies reporting original study data were included. After assessing the directness of evidence and risk of bias, studies with a low directness of evidence or a high risk of bias were excluded from analysis. Cumulative success rates after initial and recurrent treatments were calculated for both methods. A meta-analysis was conducted comparing the success rate of electrocauterization and surgery. A total of 2,263 articles were retrieved, of which seven retrospective and one prospective article were eligible for analysis. The cumulative success rate after primary treatment with cauterization ranged from 66.7% to 100%, and ranged from 77.8% to 100% after a second cauterization. The cumulative success rate after the first surgical treatment ranged from 50% to 100% and was 100% after the second surgical attempt. Meta-analysis on electrocauterization showed a nonsignificant risk ratio of 1.35 (95% confidence interval: 0.78-2.33). The effectiveness of cauterization in preventing recurrence seems to be comparable to surgical treatment. However, we suggest endoscopic cauterization as the treatment of choice for third and fourth branchial pouch sinuses because of the lower morbidity rate. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Retrospective North American CFL Experience Curve Analysis and Correlation to Deployment Programs

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

Smith, Sarah J.; Wei, Max; Sohn, Michael D.

Retrospective experience curves are a useful tool for understanding historic technology development, and can contribute to investment program analysis and future cost estimation efforts. This work documents our development of an analysis approach for deriving retrospective experience curves with a variable learning rate, and its application to develop an experience curve for compact fluorescent lamps for the global and North American markets over the years 1990-2007. Uncertainties and assumptions involved in interpreting data for our experience curve development are discussed, including the processing and transformation of empirical data, the selection of system boundaries, and the identification of historical changes inmore » the learning rate over the course of 15 years. In the results that follow, we find that that the learning rate has changed at least once from 1990-2007. We also explore if, and to what degree, public deployment programs may have contributed to an increased technology learning rate in North America. We observe correlations between the changes in the learning rate and the initiation of new policies, abrupt technological advances, including improvements to ballast technology, and economic and political events such as trade tariffs and electricity prices. Finally, we discuss how the findings of this work (1) support the use of segmented experience curves for retrospective and prospective analysis and (2) may imply that investments in technological research and development have contributed to a change in market adoption and penetration.« less

Breast feeding initiation rate across Western countries: does religion matter? An ecological study

PubMed Central

Cohen, Emmanuel; Kramer, Michael S

2016-01-01

Background Breast feeding initiation rates remain below 80% in some Western countries. Many individual-level determinants are known; however, less is known regarding cultural and societal determinants, such as religion, that could explain population-level variations. We examined the correlations of the proportions of Catholics and Protestants with the breast feeding initiation rates across and within Western countries. Methods Using publicly available data, we carried out an ecological study comparing the proportions of Catholics and Protestants with the rates of breast feeding initiation. We correlated data at the country level, and additionally explored within-country data in five Western countries: France (Departments), Ireland (counties), the UK (countries), Canada (provinces) and the USA (states). Our analyses accounted for human development index, gross domestic product and population density. Results We observed a negative correlation (r=−0.30) between the proportion of Catholics and the rate of breast feeding initiation in Western countries. This correlation was consistent when using within-country data in France (r=−0.27), Ireland (r=−0.23), the UK (r=−0.79) and Canada (r=−0.62). In the USA, the positive correlation (r=0.26) between a state's proportion of Catholics and its breast feeding initiation rate was confounded by race, education and socioeconomic status (SES). After controlling for education and SES, the state proportion of non-Hispanic white Catholics was negatively correlated (r=−0.29) with the rate of breast feeding initiation. Conclusions In this ecological study, we found consistent negative correlations between Catholicism and breast feeding initiation rates. Qualitative and quantitative studies at the individual level are needed to confirm and explain our findings. Our results suggest that women living in a country or region where Catholicism has historically dominated are less likely to initiate breast feeding, and that breast feeding promotion policies should be adapted to better fit populations' cultural and religious norms. PMID:28588983

Breast feeding initiation rate across Western countries: does religion matter? An ecological study.

PubMed

Bernard, Jonathan Y; Cohen, Emmanuel; Kramer, Michael S

2016-01-01

Breast feeding initiation rates remain below 80% in some Western countries. Many individual-level determinants are known; however, less is known regarding cultural and societal determinants, such as religion, that could explain population-level variations. We examined the correlations of the proportions of Catholics and Protestants with the breast feeding initiation rates across and within Western countries. Using publicly available data, we carried out an ecological study comparing the proportions of Catholics and Protestants with the rates of breast feeding initiation. We correlated data at the country level, and additionally explored within-country data in five Western countries: France (Departments), Ireland (counties), the UK (countries), Canada (provinces) and the USA (states). Our analyses accounted for human development index, gross domestic product and population density. We observed a negative correlation (r=-0.30) between the proportion of Catholics and the rate of breast feeding initiation in Western countries. This correlation was consistent when using within-country data in France (r=-0.27), Ireland (r=-0.23), the UK (r=-0.79) and Canada (r=-0.62). In the USA, the positive correlation (r=0.26) between a state's proportion of Catholics and its breast feeding initiation rate was confounded by race, education and socioeconomic status (SES). After controlling for education and SES, the state proportion of non-Hispanic white Catholics was negatively correlated (r=-0.29) with the rate of breast feeding initiation. In this ecological study, we found consistent negative correlations between Catholicism and breast feeding initiation rates. Qualitative and quantitative studies at the individual level are needed to confirm and explain our findings. Our results suggest that women living in a country or region where Catholicism has historically dominated are less likely to initiate breast feeding, and that breast feeding promotion policies should be adapted to better fit populations' cultural and religious norms.

Every antibiotic, every day: Maximizing the impact of prospective audit and feedback on total antibiotic use

PubMed Central

Decloe, Melissa; Gill, Suzanne; Ho, Grace; McCready, Janine; Powis, Jeff

2017-01-01

Background The success of antimicrobial stewardship is dependent on how often it is completed and which antimicrobials are targeted. We evaluated the impact of an antimicrobial stewardship program (ASP) in three non-ICU settings where all systemic antibiotics, regardless of spectrum, were targeted on the first weekday after initiation. Methods Prospective audit and feedback (PAAF) was initiated on the surgical, respiratory, and medical wards of a community hospital on July 1, 2010, October 1, 2010, and April 1, 2012, respectively. We evaluated rates of total antibiotic use, measured in days on therapy (DOTs), among all patients admitted to the wards before and after PAAF initiation using an interrupted time series analysis. Changes in antibiotic costs, rates of C. difficile infection (CDI), mortality, readmission, and length of stay were evaluated using univariate analyses. Results Time series modelling demonstrated that total antibiotic use decreased (± standard error) by 100 ± 51 DOTs/1,000 patient-days on the surgical wards (p = 0.049), 100 ± 46 DOTs/1,000 patient-days on the respiratory ward (p = 0.029), and 91 ± 33 DOTs/1,000 patient-days on the medical wards (p = 0.006) immediately following PAAF initiation. Reductions in antibiotic use were sustained up to 50 months after intervention initiation, and were accompanied by decreases in antibiotic costs. There were no significant changes to patient outcomes on the surgical and respiratory wards following intervention initiation. On the medical wards, however, readmission increased from 4.6 to 5.6 per 1,000 patient-days (p = 0.043), while mortality decreased from 7.4 to 5.0 per 1,000 patient-days (p = 0.001). CDI rates showed a non-significant declining trend after PAAF initiation. Conclusions ASPs can lead to cost-effective, sustained reductions in total antibiotic use when interventions are conducted early in the course of therapy and target all antibiotics. Shifting to such a model may help strengthen the effectiveness of ASPs in non-ICU settings. PMID:28562638

The workload book: Assessment of operator workload to engineering systems

NASA Technical Reports Server (NTRS)

Gopher, D.

1983-01-01

The structure and initial work performed toward the creation of a handbook for workload analysis directed at the operational community of engineers and human factors psychologists are described. The goal, when complete, will be to make accessible to such individuals the results of theoretically-based research that are of practical interest and utility in the analysis and prediction of operator workload in advanced and existing systems. In addition, the results of laboratory study focused on the development of a subjective rating technique for workload that is based on psychophysical scaling techniques are described.

Risk factors for Pseudomonas aeruginosa infections consequences of inappropriate initial antimicrobial therapy: a systematic literature review meta-analysis.

PubMed

Merchant, Sanjay; Proudfoot, Emma M; Quadri, Hafsa N; McElroy, Heather J; Wright, William R; Gupta, Ankur; Sarpong, Eric M

2018-02-15

Treating infections of Gram-negative pathogens, in particular Pseudomonas aeruginosa, is a challenge for clinicians in the Asia-Pacific region due to inherent and acquired resistance to antimicrobials. This systematic review and meta-analysis provides updated information of the risk factors for P. aeruginosa infections in Asia-Pacific, and consequences (e.g., mortality, costs) of initial inappropriate antimicrobial therapy (IIAT). EMBASE and MEDLINE databases were searched for Asia-Pacific studies reporting the consequences of IIAT versus initial appropriate antimicrobial therapy (IAAT) in Gram-negative infections, and risk factors for serious P. aeruginosa infections. A meta-analysis of unadjusted mortality was performed using random-effects model. Twenty-two studies reporting mortality and 13 reporting risk factors were identified. The meta-analysis demonstrated that mortality was significantly lower in patients receiving IAAT versus IIAT, with 67% reduction observed for 28- or 30-day all-cause mortality (OR 0.33; 95% CI 0.20, 0.55; P <0.001). Risk factors for serious P. aeruginosa infection include previous exposure to antimicrobials, mechanical ventilation, and previous hospitalization. The high rates of antimicrobial resistance in Asia-Pacific, as well as increased mortality associated with IIAT and the presence of risk factors for serious infection, highlight the importance of access to newer and appropriate antimicrobials. Copyright © 2018. Published by Elsevier Ltd.

Association Between Direct-to-Consumer Advertising and Testosterone Testing and Initiation in the United States, 2009–2013

PubMed Central

Layton, J. Bradley; Kim, Yoonsang; Alexander, G. Caleb; Emery, Sherry L.

2017-01-01

IMPORTANCE Testosterone initiation increased substantially in the United States from 2000 to 2013, especially among men without clear indications. Direct-to-consumer advertising (DTCA) also increased during this time. OBJECTIVE To investigate associations between televised DTCA and testosterone testing and initiation in the United States. DESIGN, SETTING, AND POPULATION Ecologic study conducted in designated market areas (DMAs) in the United States. Monthly testosterone advertising ratings were linked to DMA-level testosterone use data from 2009–2013 derived from commercial insurance claims. Associations between DTCA and testosterone testing, initiation, and initiation without recent baseline tests were estimated using Poisson generalized estimating equations. EXPOSURES Monthly Nielsen ratings for testosterone DTCA in the 75 largest DMAs. MAIN OUTCOMES AND MEASURES (1) Rates of new serum testosterone testing; (2) rates of testosterone initiation (in-office injection, surgical implant, or pharmacy dispensing) for all testosterone products combined and for specific brands; and (3) rates of testosterone initiation without recent serum testosterone testing. RESULTS Of 17 228 599 commercially insured men in the 75 DMAs, 1 007 990 (mean age, 49.6 [SD, 11.5] years) had new serum testosterone tests and 283 317 (mean age, 51.8 [SD, 11.3] years) initiated testosterone treatment. Advertising intensity varied by geographic region and time, with the highest intensity seen in the southeastern United States and with months ranging from no ad exposures to a mean of 13.6 exposures per household. Nonbranded advertisements were common prior to 2012, with branded advertisements becoming more common during and after 2012. Each household advertisement exposure was associated with a monthly increase in rates of new testosterone testing (rate ratio [RR], 1.006; 95% CI, 1.004–1.008), initiation (RR, 1.007; 95% CI, 1.004–1.010), and initiation without a recent test (RR, 1.008; 95% CI, 1.002–1.013). Mean absolute rate increases were 0.14 tests (95% CI, 0.09–0.19), 0.05 new initiations (95% CI, 0.03–0.08), and 0.02 initiations without a recent test (95% CI, 0.01–0.03) per 10 000 men for each monthly ad exposure over the entire period. CONCLUSIONS AND RELEVANCE Among US men residing in the 75 designated market areas, regional exposure to televised direct-to-consumer advertising was associated with greater testosterone testing, new initiation, and initiation without recent testing. PMID:28324090

Methodology and Results of Mathematical Modelling of Complex Technological Processes

NASA Astrophysics Data System (ADS)

Mokrova, Nataliya V.

2018-03-01

The methodology of system analysis allows us to draw a mathematical model of the complex technological process. The mathematical description of the plasma-chemical process was proposed. The importance the quenching rate and initial temperature decrease time was confirmed for producing the maximum amount of the target product. The results of numerical integration of the system of differential equations can be used to describe reagent concentrations, plasma jet rate and temperature in order to achieve optimal mode of hardening. Such models are applicable both for solving control problems and predicting future states of sophisticated technological systems.

Non-isothermal crystallization of poly(etheretherketone) aromatic polymer composite

NASA Technical Reports Server (NTRS)

Cebe, Peggy

1988-01-01

The nonisothermal crystallization kinetics of PEEK APC-2 and of 450G neat resin PEEK material were compared using a differential scanning calorimeter to monitor heat flow during crystallization; the effects of cooling rate on the crystallization temperature, the degree of crystallinity, and the conversion rate were investigated. A modified Avrami (1940) analysis was used to describe nonisothermal crystallization kinetics. It was found that, compared with the 450G neat resin PEEK, the nonisothermal crystallization of the PEEK APC-2 composite is characterized by higher initiation temperature, higher heat flow maximum temperature, and greater relative conversion by primary processes.

Droplet-based magnetically activated cell separation: analysis of separation efficiency based on the variation of flow-induced circulation in a pendent drop.

PubMed

Kim, Youngho; Lee, Sang Ho; Kim, Byungkyu

2009-12-01

Under the assumption that separation efficiencies are mainly affected by the velocity of flow-induced circulation due to buffer injection in a pendent drop, this paper describes an analysis of the separation efficiency of a droplet-based magnetically activated cell separation (DMACS) system. To investigate the velocity of the flow-induced circulation, we supposed that numerous flows in a pendent drop could be considered as a "theoretically normalized" flow (or conceptually normalized flow, CNF) based on the Cauchy-Goursat theorem. With the morphological characteristics (length and duration time) of a pendent drop depending on the initial volume, we obtained the velocities of the CNF. By measuring the separation efficiencies for different initial volumes and by analyzing the separation efficiency in terms of the velocity of the CNF, we found that the separation efficiencies (in the case of a low rate of buffer injection; 5 and 15 microl x min(-1)) are mainly affected by the velocity of the CNF. Moreover, we confirmed that the phenomenological features of a pendent drop cause a fluctuation of its separation efficiencies over a range of specific volumes (initial volumes ranging from 40 to 80 microl), because of the "sweeping-off" phenomenon, that is, positive cells gathered into the positive fraction are forced to move away from the magnetic side by flow-induced circulation due to buffer injection. In addition, from the variation of the duration time, that is, the interval between the beginning of injection of the buffer solution and the time at which a pendent drop detaches, it could also be confirmed that a shorter duration time leads to decrease of the number of positive cells in negative fraction regardless of the rate of buffer injection (5, 15, and 50 microl x min(-1)). Therefore, if a DMACS system is operated with a 15 microl x min(-1) buffer injection flow rate and an initial volume of 80 microl or more, we would have the best efficiency of separation in the negative fraction.

Grade of hypospadias is the only factor predicting for re-intervention after primary hypospadias repair: a multivariate analysis from a cohort of 474 patients.

PubMed

Spinoit, Anne-Françoise; Poelaert, Filip; Van Praet, Charles; Groen, Luitzen-Albert; Van Laecke, Erik; Hoebeke, Piet

2015-04-01

There is an ongoing quest on how to minimize complications in hypospadias surgery. There is however a lack of high-quality data on the following parameters that might influence the outcome of primary hypospadias repair: age at initial surgery, the type of suture material, the initial technique, and the type of hypospadias. The objective of this study was to identify independent predictors for re-intervention in primary hypospadias repair. We retrospectively analyzed our database of 474 children undergoing primary hypospadias surgery. Univariate and multivariate logistic regression was performed to identify variables associated with re-intervention. A p-value <0.05 was considered statistically significant and therefore considered as a prognostic factor for re-intervention. Distal penile hypospadias was reported in 77.2% (n = 366), midpenile in 11.4% (n = 54) and proximal in 11.4% (n = 54) of children. Initial repair was based on an incised plate technique in 39.9% (n = 189), meatal advancement in 36.0% (n = 171), an onlay flap in 17.3% (n = 82) and other or combined techniques in 5.3% (n = 25). In 114 patients (24.1%) re-intervention was required (n = 114) of which 54 re-interventions (47.4%) were performed within the first year post-surgery, 17 (14.9%) in the second year and 43 (37.7%) later than 2 years after initial surgery. The reason for the first re-intervention was fistula in 52 patients (46.4%), meatal stenosis in 32 (28.6%), cosmesis in 35 (31.3%) and other in 14 (12.5%). The median time for re-intervention was 14 months after surgery [range 0-114]. Significant predictors for re-intervention on univariate logistic regression (polyglactin suture material versus poliglecaprone, proximal hypospadias, lower age at operation and other than meatal advancement repair) were put in a multivariate logistic regression model. Of all significant variables, only proximal hypospadias remained an independent predictor for re-intervention (OR 3.27; p = 0.012). The grade of hypospadias remains according to our retrospective analysis the only objective independent predicting factor for re-intervention in hypospadias surgery. This finding is rather obvious for everyone operating hypospadias. Curiously midpenile hypospadias cases were doing slightly better than distal hypospadias in terms of re-intervention rates. Our study however has also some shortcomings. First of all, data was gathered retrospectively and follow-up time was ill-balanced for several variables. We tried to correct this by applying sensitivity analysis, but possible associations between some variables and re-intervention might still be obscured by this. Standard questionnaires to analyze surgical outcome were not available. Therefore, we focused our analysis on re-intervention rate as this is a hard and clinically relevant end point. This retrospective analysis of a large hypospadias database with long-term follow-up indicates that the long-lasting debate about factors influencing the reoperation rate in hypospadias surgery might be futile: in experienced hands, the only variable that independently predicts for re-intervention is the severity of hypospadias, the only factor we cannot modify. This retrospective multivariate analysis of a large hypospadias database with long-term follow-up suggests that the only significant independent predictive factor for re-intervention is proximal hypospadias. In our series, technique did not influence the re-intervention rate. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Implementation of a Cardiogenic Shock Team and Clinical Outcomes (INOVA-SHOCK Registry): Observational and Retrospective Study.

PubMed

Tehrani, Behnam; Truesdell, Alexander; Singh, Ramesh; Murphy, Charles; Saulino, Patricia

2018-06-28

The development and implementation of a Cardiogenic Shock initiative focused on increased disease awareness, early multidisciplinary team activation, rapid initiation of mechanical circulatory support, and hemodynamic-guided management and improvement of outcomes in cardiogenic shock. The objectives of this study are (1) to collect retrospective clinical outcomes for acute decompensated heart failure cardiogenic shock and acute myocardial infarction cardiogenic shock, and compare current versus historical survival rates and clinical outcomes; (2) to evaluate Inova Heart and Vascular Institute site specific outcomes before and after initiation of the Cardiogenic Shock team on January 1, 2017; (3) to compare outcomes related to early implementation of mechanical circulatory support and hemodynamic-guided management versus historical controls; (4) to assess survival to discharge rate in patients receiving intervention from the designated shock team and (5) create a clinical archive of Cardiogenic Shock patient characteristics for future analysis and the support of translational research studies. This is an observational, retrospective, single center study. Retrospective and prospective data will be collected in patients treated at the Inova Heart and Vascular Institute with documented cardiogenic shock as a result of acute decompensated heart failure or acute myocardial infarction. This registry will include data from patients prior to and after the initiation of the multidisciplinary Cardiogenic Shock team on January 1, 2017. Clinical outcomes associated with early multidisciplinary team intervention will be analyzed. In the study group, all patients evaluated for documented cardiogenic shock (acute decompensated heart failure cardiogenic shock, acute myocardial infarction cardiogenic shock) treated at the Inova Heart and Vascular Institute by the Cardiogenic Shock team will be included. An additional historical Inova Heart and Vascular Institute control group will be analyzed as a comparator. Means with standard deviations will be reported for outcomes. For categorical variables, frequencies and percentages will be presented. For continuous variables, the number of subjects, mean, standard deviation, minimum, 25th percentile, median, 75th percentile and maximum will be reported. Reported differences will include standard errors and 95% CI. Preliminary data analysis for the year 2017 has been completed. Compared to a baseline 2016 survival rate of 47.0%, from 2017 to 2018, CS survival rates were increased to 57.9% (58/110) and 81.3% (81/140), respectively (P=.01 for both). Study data will continue to be collected until December 31, 2018. The preliminary results of this study demonstrate that the INOVA SHOCK team approach to the treatment of Cardiogenic Shock with early team activation, rapid initiation of mechanical circulatory support, hemodynamic-guided management, and strict protocol adherence is associated with superior clinical outcomes: survival to discharge and overall survival when compared to 2015 and 2016 outcomes prior to Shock team initiation. What may limit the generalization of these results of this study to other populations are site specific; expertise of the team, strict algorithm adherence based on the INOVA SHOCK protocol, and staff commitment to timely team activation. Retrospective clinical outcomes (acute decompensated heart failure cardiogenic shock, acute myocardial infarction cardiogenic shock) demonstrated an increase in current survival rates when compared to pre-Cardiogenic Shock team initiation, rapid team activation and diagnosis and timely utilization of mechanical circulatory support. ClinicalTrials.gov NCT03378739; https://clinicaltrials.gov/ct2/show/NCT03378739 (Archived by WebCite at http://www.webcitation.org/701vstDGd). ©Behnam Tehrani, Alexander Truesdell, Ramesh Singh, Charles Murphy, Patricia Saulino. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 28.06.2018.

Association between the inception of a SAFE KIDS Coalition and changes in pediatric unintentional injury rates

PubMed Central

Tamburro, R; Shorr, R; Bush, A; Kritchevsky, S; Stidham, G; Helms, S

2002-01-01

Setting: Shelby County, Tennessee. Design: Retrospective observational analysis. Patients: County residents nine years of age or younger presenting to the children's medical center, its emergency department, or its outpatient clinics from 1990–97. Intervention: Implementation of a SAFE KIDS Coalition. Main outcome measures: Rates of unintentional injuries targeted by the SAFE KIDS Coalition that resulted in hospitalization or in death. Rates of motor vehicle occupant injuries that resulted in hospitalization or in death. Rates of non-targeted unintentional injuries, namely injuries secondary to animals and by exposure to toxic plants. Rates of severe injuries (defined as those targeted injuries that required hospitalization or resulted in death), and specifically, severe motor vehicle occupant injuries were compared before and after the inception of the coalition using Poisson regression analysis. Results: The relative risk of targeted severe injury rates decreased after implementation of the coalition even after controlling for changes in hospital admission rates. Specifically, severe motor vehicle occupant injury rates decreased 30% (relative risk 0.70; 95% confidence interval 0.54 to 0.89) after initiation of the coalition. Conclusions: The implementation of a SAFE KIDS Coalition was associated with a decrease in severe targeted injuries, most notably, severe motor vehicle occupant injuries. Although causality cannot be determined, these data suggest that the presence of a coalition may be associated with decreased severe unintentional injury rates. PMID:12226125

Results of Propellant Mixing Variable Study Using Precise Pressure-Based Burn Rate Calculations

NASA Technical Reports Server (NTRS)

Stefanski, Philip L.

2014-01-01

A designed experiment was conducted in which three mix processing variables (pre-curative addition mix temperature, pre-curative addition mixing time, and mixer speed) were varied to estimate their effects on within-mix propellant burn rate variability. The chosen discriminator for the experiment was the 2-inch diameter by 4-inch long (2x4) Center-Perforated (CP) ballistic evaluation motor. Motor nozzle throat diameters were sized to produce a common targeted chamber pressure. Initial data analysis did not show a statistically significant effect. Because propellant burn rate must be directly related to chamber pressure, a method was developed that showed statistically significant effects on chamber pressure (either maximum or average) by adjustments to the process settings. Burn rates were calculated from chamber pressures and these were then normalized to a common pressure for comparative purposes. The pressure-based method of burn rate determination showed significant reduction in error when compared to results obtained from the Brooks' modification of the propellant web-bisector burn rate determination method. Analysis of effects using burn rates calculated by the pressure-based method showed a significant correlation of within-mix burn rate dispersion to mixing duration and the quadratic of mixing duration. The findings were confirmed in a series of mixes that examined the effects of mixing time on burn rate variation, which yielded the same results.

Initiation of migration and movement rates of Atlantic salmon smolts in fresh water

USGS Publications Warehouse

Stich, Daniel S.; Kinnison, Michael T.; Kocik, John F.; Zydlewski, Joseph D.

2015-01-01

Timing of ocean entry is critical for marine survival of both hatchery and wild Atlantic salmon (Salmo salar) smolts. Management practices and barriers to migration such as dams may constrain timing of smolt migrations resulting in suboptimal performance at saltwater entry. We modeled influences of stocking location, smolt development, and environmental conditions on (i) initiation of migration by hatchery-reared smolts and (ii) movement rate of hatchery- and wild-reared Atlantic salmon smolts in the Penobscot River, Maine, USA, from 2005 through 2014 using acoustic telemetry data. We also compared movement rates in free-flowing reaches with rates in reaches with hydropower dams and head ponds. We compared movement rates before and after (1) removal of two mainstem dams and (2) construction of new powerhouses. Initiation of movement by hatchery fish was influenced by smolt development, stocking location, and environmental conditions. Smolts with the greatest gill Na+, K+-ATPase (NKA) activity initiated migration 24 h sooner than fish with the lowest gill NKA activity. Fish with the greatest cumulative thermal experience initiated migration 5 days earlier than those with lowest cumulative thermal experience. Smolts released furthest from the ocean initiated migration earlier than those released downstream, but movement rate increased by fivefold closer to the ocean, indicating behavioral trade-offs between initiation and movement rate. Dams had a strong effect on movement rate. Movement rate increased from 2.8 to 5.4 km·h−1 in reaches where dams were removed, but decreased from 2.1 to 0.1 km·h−1 in reaches where new powerhouses were constructed. Movement rate varied throughout the migratory period and was inversely related to temperature. Fish moved slower at extreme high or low discharge. Responses in fish movement rates to dam removal indicate the potential scope of recovery for these activities.

Oxygen consumption rate and mitochondrial density in human melanoma monolayer cultures and multicellular spheroids.

PubMed

Hystad, M E; Rofstad, E K

1994-05-15

Rate of oxygen consumption per cell has been shown in previous studies to decrease with increasing depth in the viable rim of multicellular spheroids initiated from rodent cells, human colon-carcinoma cells, and human glioma cells, due to progressive accumulation of quiescent cells during spheroid growth. The purpose of our work was to determine oxygen-consumption profiles in human melanoma spheroids. Monolayer cultures of 4 lines (BEX-c, COX-c, SAX-c, and WIX-c) and spheroid cultures of 2 lines (BEX-c and WIX-c) were subjected to investigation. Spheroids were initiated from monolayer cell cultures and grown in spinner flasks. Rate of oxygen consumption was measured with a Clarke-type electrode. Mitochondrial density was determined by stereological analysis of transmission electron micrographs. Thickness of viable rim and cell packing density were assessed by light microscopy of central spheroid sections. Cell-cycle distribution was determined by analysis of DNA histograms measured by flow cytometry. Cell volume was measured by an electronic particle counter. Rate of oxygen consumption per cell differed by a factor of approximately 1.8 between the 4 cell lines and was positively correlated to total volume of mitochondria per cell. Rate of oxygen consumption per cell and total volume of mitochondria per cell were equal for monolayer cell cultures, 600-microns spheroids and 1,200-microns spheroids of the same line. Mitochondrial density and location in the cell did not differ between cells at the spheroid surface, in the middle of the viable rim and adjacent to the central necrosis. Cell-cycle distribution, cell volume, and cell-packing density in the outer and inner halves of the viable rim were not significantly different. Consequently, the rate of oxygen consumption per cell in inner regions of the viable rim was probably equal to that at the spheroid surface, suggesting that oxygen diffusion distances may be shorter in some melanomas than in many other tumor types.

[Meta-analysis of the clinical significance of thyroidectomy combined with central neck dissection in differentiated thyroid carcinoma at the first treatment].

PubMed

Sun, Ronghao; Li, Chao; Fan, Jinchuan; Liu, Jifeng; Chen, Jianchao; Zhang, Bing

2014-02-01

To compare the differences in recurrence rates and surgical complications between thyroidectomy alone and thyroidectomy combined with central neck dissection as initial treatments to differentiated thyroid cancer and evaluate the clinic significance of central neck dissection for these patients. The literatures published in 1998-2013 were searched in Wanfang database, Chongqing VIP database, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Pubmed, Medline and Beijing Kangjian foreign medical journal full text service. According to the inclusion and deletion criteria, 30 articles were included. Of them 26 articles involved in complications, hypocalcemia and recurrent laryngeal nerve palsy as two major complications were involved in 26 articles and 24 articles respectively, and 26 articles involved in recurrence rate. RevMan5.0 software package was used to perform meta-analysis. Total complication rate in experimental group (plus central neck dissection) was 13.08% higher than that in control group (thyroidectomy only), the odds ratio (OR) [95% confidence interval (95%CI)] was 2.32[2.02, 2.67], Z value was 11.80, P < 0.01. Hypocalcemia in the experimental group was 11.80% higher than that in control group, OR value [95%CI] was 2.58[2.21, 3.02], Z was 11.98, P < 0.01. The rates of recurrent laryngeal nerve paralysis were low in both experimental group (5.26%) and control group(3.95%), and OR value [95%CI] was 1.22 [0.94, 1.58], Z was 1.48, P = 0.14. Recurrence rate in experimental group was 2.23% lower than that in control group, OR value [95%CI] was 0.78 [0.63,0.97], Z was 2.35, P = 0.03. Central compartment dissection as initial treatment to differentiated thyroid cancer may reduce the risk of recurrence, but increases the incidence of total complications and hypocalcemia, and has no significant effect on the rate of the recurrent laryngeal nerve paralysis.

Chloroquine transport in Plasmodium falciparum. 1. Influx and efflux kinetics for live trophozoite parasites using a novel fluorescent chloroquine probe.

PubMed

Cabrera, Mynthia; Natarajan, Jayakumar; Paguio, Michelle F; Wolf, Christian; Urbach, Jeffrey S; Roepe, Paul D

2009-10-13

Several models for how amino acid substitutions in the Plasmodium falciparum chloroquine resistance transporter (PfCRT) confer resistance to chloroquine (CQ) and other antimalarial drugs have been proposed. Distinguishing between these models requires detailed analysis of high-resolution CQ transport data that is unfortunately impossible to obtain with traditional radio-tracer methods. Thus, we have designed and synthesized fluorescent CQ analogues for drug transport studies. One probe places a NBD (6-(N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl)amino)hexanoic acid) group at the tertiary aliphatic N of CQ, via a flexible 6 C amide linker. This probe localizes to the malarial parasite digestive vacuole (DV) during initial perfusion under physiologic conditions and exhibits similar pharmacology relative to CQ, vs both CQ-sensitive (CQS) and CQ-resistant (CQR) parasites. Using live, synchronized intraerythrocytic parasites under continuous perfusion, we define NBD-CQ influx and efflux kinetics for CQS vs CQR parasites. Since this fluorescence approach provides data at much higher kinetic resolution relative to fast-filtration methods using (3)H-CQ, rate constants vs linear initial rates for CQ probe flux can be analyzed in detail. Importantly, we find that CQR parasites have a decreased rate constant for CQ influx into the DV and that this is due to mutation of PfCRT. Analysis of zero trans efflux for CQS and CQR parasites suggests that distinguishing between bound vs free pools of intra-DV drug probe is essential for proper kinetic analysis of efflux. The accompanying paper (DOI 10.1021/bi901035j ) further probes efflux kinetics for proteoliposomes containing purified, reconstituted PfCRT.

Executive functions and consumption of fruits/ vegetables and high saturated fat foods in young adults.

PubMed

Limbers, Christine A; Young, Danielle

2015-05-01

Executive functions play a critical role in regulating eating behaviors and have been shown to be associated with overeating which over time can result in overweight and obesity. There has been a paucity of research examining the associations among healthy dietary behaviors and executive functions utilizing behavioral rating scales of executive functioning. The objective of the present cross-sectional study was to evaluate the associations among fruit and vegetable consumption, intake of foods high in saturated fat, and executive functions using the Behavioral Rating Inventory of Executive Functioning-Adult Version. A total of 240 university students completed the Behavioral Rating Inventory of Executive Functioning-Adult Version, the 26-Item Eating Attitudes Test, and the Diet subscale of the Summary of Diabetes Self-Care Activities Questionnaire. Multiple linear regression analysis was conducted with two separate models in which fruit and vegetable consumption and saturated fat intake were the outcomes. Demographic variables, body mass index, and eating styles were controlled for in the analysis. Better initiation skills were associated with greater intake of fruits and vegetables in the last 7 days (standardized beta = -0.17; p < 0.05). Stronger inhibitory control was associated with less consumption of high fat foods in the last 7 days (standardized beta = 0.20; p < 0.05) in the multiple linear regression analysis. Executive functions that predict fruit and vegetable consumption are distinct from those that predict avoidance of foods high in saturated fat. Future research should investigate whether continued skill enhancement in initiation and inhibition following standard behavioral interventions improves long-term maintenance of weight loss. © The Author(s) 2015.

Awhina Revolution: A Bayesian Analysis of Undergraduate and Postgraduate Completion Rates from a Program for Maori and Pacific Success in STEM Disciplines

ERIC Educational Resources Information Center

Richardson, Ken; Clark, Zaramasina; Gaines, Michael; Kingi, Hautahi; Miller, Sonja; Pearson, Willie, Jr.; Richardson, Liz

2018-01-01

Maori and Pacific students generally do not attain the same levels of tertiary success as New Zealanders of European descent, particularly in science, technology, engineering, and mathematics (STEM) subjects. Te Ropu Awhina (Awhina), an equity initiative at Victoria University of Wellington in New Zealand between 1999 and 2015, aimed to produce…

Oppositional Defiant Disorder toward Adults and Oppositional Defiant Disorder toward Peers: Initial Evidence for Two Separate Constructs

ERIC Educational Resources Information Center

Taylor, Ted K.; Burns, G. Leonard; Rusby, Julie C.; Foster, E. Michael

2006-01-01

Confirmatory factor analysis of 25 items on the Child and Adolescent Disruptive Behavior Inventory (CADBI, Version 2.3; G. L. Burns, T. K. Taylor, & J. C. Rusby, 2001) was conducted on teacher ratings of 824 kindergarten children and replicated on 534 children. Model fit was improved when correcting for 2 method effects: (a) adjacent items and…

A Comparative Analysis of Factors Promoting Academic and Social Integration in First-Year Seminars at Three Regional Institutions in Texas

ERIC Educational Resources Information Center

Smith, Hollie

2012-01-01

Approximately half the students who enroll at an institution will complete a bachelor's degree within six years (Kuh, Cruce, Shoup, Kinzie, & Gonyea, 2008). The majority of the students who decide to leave their initial institution do so during their first year (Tinto, 1993). Tinto reported that the withdrawal rate is highest during the first…

The prediction of shallow landslide location and size using a multidimensional landslide analysis in a digital terrain model

Treesearch

W. E. Dietrich; J. McKean; D. Bellugi; T. Perron

2007-01-01

Shallow landslides on steep slopes often mobilize as debris flows. The size of the landslide controls the initial size of the debris flows, defines the sediment discharge to the channel network, affects rates and scales of landform development, and influences the relative hazard potential. Currently the common practice in digital terrain-based models is to set the...

Efficacies of different proton pump inhibitor-based 14-day bismuth-furazolidone quadruple regimens for the initial eradication of Helicobacter pylori in the southeast coastal region of China: an open-label, randomized clinical trial.

PubMed

Chen, Luyi; He, Jiamin; Wang, Lan; Ge, Qiwei; Chu, Hua; Chen, Yujia; Chen, Xiaoli; Long, Yanqin; Deng, Yanyong; He, Huiqin; Li, Aiqing; Chen, Shujie

2018-06-06

To evaluate potency and safety of 14-day bismuth-furazolidone quadruple regimens and to compare efficacies of five proton pump inhibitors (PPIs) for the initial eradication of Helicobacter pylori (H. pylori), 175 eligible patients were enrolled and randomly assigned to 14-day quadruple regimens consisting of bismuth (400 mg), amoxicillin (1 g), furazolidone (100 mg), and a PPI, twice a day. PPIs used were Group A (pantoprazole capsules, 40 mg), Group B (pantoprazole tablets, 40 mg), Group C (lansoprazole, 30 mg), Group D (esomeprazole, 20 mg), and Group E (rabeprazole, 10 mg). H. pylori status was reassessed by 13 C urea breath test on day 56 as the primary outcome. Gastrointestinal symptoms, parenteral side effects, compliance, and stool type were recorded simultaneously. The total eradication rates were 86.9% (152/175 [95% CI 80.9-91.5%]) and 95.6% (152/159 [91.1-98.2%]) by intention-to-treat (ITT) and per-protocol (PP) analysis. The efficacies of Group A, B, C, D, and E by ITT analysis were 91.4% (32/35 [76.9-98.2%]), 85.7% (30/35 [69.7-95.2%]), 88.6% (31/35 [73.3-96.8%]), 85.7% (30/35 [69.7-95.2%]), and 82.9% (29/35 [66.4-93.4%]) (p > 0.05). In the PP analysis, the efficacies were 97.0% (32/33), 93.8% (30/32), 93.9% (31/33), 100% (30/30), and 93.5% (29/31) (p > 0.05). Gastrointestinal symptoms and stool type were improved significantly (p < 0.05). Total side effects rate and poor compliance rate were 15.7% (25/159) and 5.0% (8/159). Fourteen-day bismuth-furazolidone quadruple regimens are of high potency and safety for the initial eradication of H. pylori. Efficacies of different PPIs and different dosages (9-32 mg omeprazole equivalents) showed no significant difference. The appropriate PPI can thus be chosen by clinicians.

Survival rate and prognostic factors of conventional osteosarcoma in Northern Thailand: A series from Chiang Mai University Hospital.

PubMed

Pruksakorn, Dumnoensun; Phanphaisarn, Areerak; Arpornchayanon, Olarn; Uttamo, Nantawat; Leerapun, Taninnit; Settakorn, Jongkolnee

2015-12-01

Osteosarcoma is a common and aggressive primary malignant bone tumor occurring in children and adolescents. It is one of the most aggressive human cancers and the most common cause of cancer-associated limb loss. As treatment in Thailand has produced a lower survival rate than in developed countries; therefore, this study identified survival rate and the poor prognostic factors of osteosarcoma in Northern Thailand. The retrospective cases of osteosarcoma, diagnosis between 1 January 1996 and 31 December 2013, were evaluated. Five and ten year overall survival rates were analyzed using time-to-event analysis. Potential prognostic factors were identified by multivariate regression analysis. There were 208 newly diagnosed osteosarcomas during that period, and 144 cases met the criteria for analysis. The majority of the osteosarcoma cases (78.5%) were aged 0-24 years. The overall 5- and 10-year survival rates were 37.9% and 33.6%, respectively. Presence of metastasis at initial examination, delayed and against treatment co-operation, and axial skeletal location were identified as independent prognostic factors for survival, with hazard ratios of 4.3, 2.5 and 3.8, and 3.1, respectively. This osteosarcoma cohort had a relatively poor overall survival rate. The prognostic factors identified would play a critical role in modifying survival rates of osteosarcoma patients; as rapid disease recognition, a better treatment counselling, as well as improving of chemotherapeutic regimens were found to be important in improving the overall survival rate in Thailand. Copyright © 2015 Elsevier Ltd. All rights reserved.

Serious Fall Injuries Before and After Initiation of Hemodialysis Among Older ESRD Patients in the United States: A Retrospective Cohort Study.

PubMed

Plantinga, Laura C; Patzer, Rachel E; Franch, Harold A; Bowling, C Barrett

2017-07-01

Because initiation of dialysis therapy often occurs in the setting of acute illness and may signal worsening health and functional decline, we examined whether rates of serious fall injuries among older hemodialysis patients differ before and after dialysis therapy initiation. Retrospective cohort study of claims data from the 2 years spanning dialysis therapy initiation among patients initiating dialysis therapy in 2010 to 2012. Claims from 81,653 Medicare end-stage renal disease beneficiaries aged 67 to 100 years. Post- versus pre-dialysis therapy initiation periods, defined as on or after versus before dialysis therapy initiation. Serious fall injuries were defined using diagnostic codes for falls in combination with fractures, brain injuries, or joint dislocation. Incidence rate ratios (overall and stratified) for post- versus pre-dialysis therapy initiation periods were estimated using generalized estimating equation models with a negative binomial link. Overall, 12,757 serious fall injuries occurred in the pre- and post-dialysis therapy initiation periods. Annual rates of serious fall injuries were 64.4 (95% CI, 62.7-66.2) and 107.8 (95% CI, 105.4-110.3) per 1,000 patient-years, respectively, in the pre- and post-dialysis therapy initiation periods (incidence rate ratio, 1.62; 95% CI, 1.56-1.67). Relative rates of serious fall injuries in the post- vs pre-dialysis initiation periods were of greater magnitude among patients who were younger (<75 years), had pre-end-stage renal disease nephrology care, had albumin levels > 3g/dL, were able to walk and transfer, did not need assistance with activities of daily living, and were not institutionalized compared with relative rates among their counterparts. Potential misclassification due to the use of claims data and survival bias among those initiating hemodialysis therapy. Among older Medicare beneficiaries receiving hemodialysis, serious fall injuries are common, the post-dialysis initiation period is a high-risk time for falls, and dialysis therapy initiation may be an important time to screen for fall risk factors and implement multifactorial fall prevention strategies. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Batch versus column modes for the adsorption of radioactive metal onto rice husk waste: conditions optimization through response surface methodology.

PubMed

Kausar, Abida; Bhatti, Haq Nawaz; Iqbal, Munawar; Ashraf, Aisha

2017-09-01

Batch and column adsorption modes were compared for the adsorption of U(VI) ions using rice husk waste biomass (RHWB). Response surface methodology was employed for the optimization of process variables, i.e., (pH (A), adsorbent dose (B), initial ion concentration (C)) in batch mode. The B, C and C 2 affected the U(VI) adsorption significantly in batch mode. The developed quadratic model was found to be validated on the basis of regression coefficient as well as analysis of variance. The predicted and actual values were found to be correlated well, with negligible residual value, and B, C and C 2 were significant terms. The column study was performed considering bed height, flow rate and initial metal ion concentration, and adsorption efficiency was evaluated through breakthrough curves and bed depth service time and Thomas models. Adsorption was found to be dependent on bed height and initial U(VI) ion concentration, and flow rate decreased the adsorption capacity. Thomas models fitted well to the U(VI) adsorption onto RHWB. Results revealed that RHWB has potential to remove U(VI) ions and batch adsorption was found to be efficient versus column mode.

Early regimes of water capillary flow in slit silica nanochannels.

PubMed

Oyarzua, Elton; Walther, Jens H; Mejía, Andrés; Zambrano, Harvey A

2015-06-14

Molecular dynamics simulations are conducted to investigate the initial stages of spontaneous imbibition of water in slit silica nanochannels surrounded by air. An analysis is performed for the effects of nanoscopic confinement, initial conditions of liquid uptake and air pressurization on the dynamics of capillary filling. The results indicate that the nanoscale imbibition process is divided into three main flow regimes: an initial regime where the capillary force is balanced only by the inertial drag and characterized by a constant velocity and a plug flow profile. In this regime, the meniscus formation process plays a central role in the imbibition rate. Thereafter, a transitional regime takes place, in which, the force balance has significant contributions from both inertia and viscous friction. Subsequently, a regime wherein viscous forces dominate the capillary force balance is attained. Flow velocity profiles identify the passage from an inviscid flow to a developing Poiseuille flow. Gas density profiles ahead of the capillary front indicate a transient accumulation of air on the advancing meniscus. Furthermore, slower capillary filling rates computed for higher air pressures reveal a significant retarding effect of the gas displaced by the advancing meniscus.

Maternal WIC participation improves breastfeeding rates: a statewide analysis of WIC participants.

PubMed

Metallinos-Katsaras, E; Brown, L; Colchamiro, R

2015-01-01

This study examined the association between length of exposure to Women, Infants, and Children (WIC) services and breastfeeding initiation/duration. All women with singleton live births, first certified into MA WIC prenatally or postpartum (2001-2009), with complete breastfeeding and covariate data (maternal race, age, education, smoking status, BMI, HH income and size, birth weight, whether full or preterm, and sex) were included (n = 122,506). Regressions models were used to examine timing of WIC entry (i.e., trimester of prenatal or postpartum) with: (1) breastfeeding initiation, (2) mean duration (3) and 3, 6 and 12 month durations. Among prenatal entrants, first (vs. third) trimester entry was associated with a higher likelihood of initiation for both primiparous, and multiparous mothers (10 and 32 % respectively; p < .01). Prenatal entrants breastfed 1.7 (primiparous), and 3.4 (multiparous) weeks longer than postpartum entrants (p < .0001). Among multiparous women, first trimester entry was associated a greater likelihood of breastfeeding for three (15 % greater), six (25 % greater) and twelve (33 % greater) months compared to third trimester entrants (p < .0001). Greater exposure to WIC services improves breastfeeding rates among a low income diverse population of women.

SIRT6 knockout cells resist apoptosis initiation but not progression: a computational method to evaluate the progression of apoptosis.

PubMed

Domanskyi, Sergii; Nicholatos, Justin W; Schilling, Joshua E; Privman, Vladimir; Libert, Sergiy

2017-11-01

Apoptosis is essential for numerous processes, such as development, resistance to infections, and suppression of tumorigenesis. Here, we investigate the influence of the nutrient sensing and longevity-assuring enzyme SIRT6 on the dynamics of apoptosis triggered by serum starvation. Specifically, we characterize the progression of apoptosis in wild type and SIRT6 deficient mouse embryonic fibroblasts using time-lapse flow cytometry and computational modelling based on rate-equations and cell distribution analysis. We find that SIRT6 deficient cells resist apoptosis by delaying its initiation. Interestingly, once apoptosis is initiated, the rate of its progression is higher in SIRT6 null cells compared to identically cultured wild type cells. However, SIRT6 null cells succumb to apoptosis more slowly, not only in response to nutrient deprivation but also in response to other stresses. Our data suggest that SIRT6 plays a role in several distinct steps of apoptosis. Overall, we demonstrate the utility of our computational model to describe stages of apoptosis progression and the integrity of the cellular membrane. Such measurements will be useful in a broad range of biological applications.

Blade loss transient dynamic analysis of turbomachinery

NASA Technical Reports Server (NTRS)

Stallone, M. J.; Gallardo, V.; Storace, A. F.; Bach, L. J.; Black, G.; Gaffney, E. F.

1982-01-01

This paper reports on work completed to develop an analytical method for predicting the transient non-linear response of a complete aircraft engine system due to the loss of a fan blade, and to validate the analysis by comparing the results against actual blade loss test data. The solution, which is based on the component element method, accounts for rotor-to-casing rubs, high damping and rapid deceleration rates associated with the blade loss event. A comparison of test results and predicted response show good agreement except for an initial overshoot spike not observed in test. The method is effective for analysis of large systems.

Parental Restriction of Movie Viewing Prospectively Predicts Adolescent Alcohol and Marijuana Initiation: Implications for Media Literacy Programs.

PubMed

Cox, Melissa J; Gabrielli, Joy; Janssen, Tim; Jackson, Kristina M

2018-05-02

Youth are heavy consumers of media, and exposure to mature media content is associated with initiation and progression of substance use. Parental restriction of such content has been shown to be an effective mechanism to reduce negative consequences attributed to exposure to mature media content. This study assessed the influence of parental restriction of movie watching across Motion Picture Association of America rating categories on subsequent alcohol and marijuana initiation at 1- and 2-year follow-up. Using data from a longitudinal study of adolescent substance use (N = 1023), we used logistic regression analyses to determine the odds of alcohol and marijuana initiation across movie rating categories, within R-rated restriction categories in particular, and based on changes in parental restriction of movies over time. All analyses controlled for important parental, personality, and behavioral correlates of adolescent substance use. Results suggest that restriction of R-rated movies is protective of both alcohol and marijuana initiation. Important differences among parental restriction of R-rated movie categories emerged such that being allowed to watch them with adult supervision was protective of substance use, while those who reported watching R-rated films despite parental restrictions were at heightened risk for alcohol initiation. Changes in parental movie restrictions were not predictive of substance use initiation over the subsequent year. Implications of these findings for media literacy program prevention strategies are discussed.

FOLFOXIRI Plus Bevacizumab as Conversion Therapy for Patients With Initially Unresectable Metastatic Colorectal Cancer: A Systematic Review and Pooled Analysis.

PubMed

Tomasello, Gianluca; Petrelli, Fausto; Ghidini, Michele; Russo, Alessandro; Passalacqua, Rodolfo; Barni, Sandro

2017-07-13

The combination of fluorouracil, oxaliplatin, and irinotecan plus bevacizumab (FOLFOXIRI-Bev) is an established and effective first-line chemotherapy regimen for metastatic colorectal cancer. However, resection rates of metastases and overall survival with this schedule have never been systematically evaluated in published studies including, but not limited to, the TRIBE (TRIplet plus BEvacizumab) trial. To assess the clinical efficacy of FOLFOXIRI-Bev, including outcomes and rates of surgical conversions. A systematic review was conducted in October 2016 in concordance with the PRISMA guidelines of PubMed, the Cochrane Central Register of Controlled Trials, SCOPUS, Web of Science, Google Scholar, CINAHL, Ovid, and EMBASE using the terms FOLFOXIRI and bevacizumab and (colorectal cancer). Clinical trials, retrospective case series, and prospective case series that used FOLFOXIRI-Bev for the treatment of initially unresectable metastatic colorectal cancer in humans were included. Individual case reports and retrospective case series with fewer than 10 patients were excluded. Data were extracted independently by 2 reviewers on a predesigned, standardized form. Ultimately, data were aggregated to obtain the pooled effect size of efficacy, according to the random-effects model and weighted for the number of patients included in each trial. Median overall survival and progression-free survival, overall response rates, and rates of R0 surgical conversions and overall surgical conversions. Eleven FOLFOXIRI-Bev studies published between 2010 and 2016 met the inclusion criteria and were pooled for analysis. The studies included 889 patients, with 877 patients clinically evaluable for overall response rates. The objective response rate to FOLFOXIRI-Bev was 69% (95% CI, 65%-72%; I2 = 25%). The rate of overall surgical conversions was 39.1% (95% CI, 26.9%-52.8%), and the rate of R0 surgical conversions was 28.1% (95% CI, 18.1%-40.8%). Median pooled overall survival was 30.2 months (95% CI, 26.5-33.7 months) in 6 trials with data available, and progression-free survival was 12.4 months (95% CI, 10.0-14.3 months) in 9 trials with data available. In meta-regression analysis, variables significantly associated with conversion surgery were disease limited to the liver and a higher median number of cycles (close to 12). For patients with surgically unresectable metastatic colorectal cancer, FOLFOXIRI-Bev is associated with a significant overall response rate. Such an effective regimen leads to a probability of surgical conversion of distant metastases approaching 40%, with more than one-fourth of patients having an R0 resection.

Reconstruction of disease transmission rates: Applications to measles, dengue, and influenza.

PubMed

Lange, Alexander

2016-07-07

Transmission rates are key in understanding the spread of infectious diseases. Using the framework of compartmental models, we introduce a simple method to reconstruct time series of transmission rates directly from incidence or disease-related mortality data. The reconstruction employs differential equations, which model the time evolution of infective stages and strains. Being sensitive to initial values, the method produces asymptotically correct solutions. The computations are fast, with time complexity being quadratic. We apply the reconstruction to data of measles (England and Wales, 1948-1967), dengue (Thailand, 1982-1999), and influenza (U.S., 1910-1927). The Measles example offers comparison with earlier work. Here we re-investigate reporting corrections, include and exclude demographic information. The dengue example deals with the failure of vector-control measures in reducing dengue hemorrhagic fever (DHF) in Thailand. Two competing mechanisms have been held responsible: strain interaction and demographic transitions. Our reconstruction reveals that both explanations are possible, showing that the increase in DHF cases is consistent with decreasing transmission rates resulting from reduced vector counts. The flu example focuses on the 1918/1919 pandemic, examining the transmission rate evolution for an invading strain. Our analysis indicates that the pandemic strain could have circulated in the population for many months before the pandemic was initiated by an event of highly increased transmission. Copyright © 2016 Elsevier Ltd. All rights reserved.

Kinetics of silicide formation over a wide range of heating rates spanning six orders of magnitude

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

Molina-Ruiz, Manel; Lopeandía, Aitor F.; Gonzalez-Silveira, Marta

Kinetic processes involving intermediate phase formation are often assumed to follow an Arrhenius temperature dependence. This behavior is usually inferred from limited data over narrow temperature intervals, where the exponential dependence is generally fully satisfied. However, direct evidence over wide temperature intervals is experimentally challenging and data are scarce. Here, we report a study of silicide formation between a 12 nm film of palladium and 15 nm of amorphous silicon in a wide range of heating rates, spanning six orders of magnitude, from 0.1 to 10{sup 5 }K/s, or equivalently more than 300 K of variation in reaction temperature. The calorimetric traces exhibit severalmore » distinct exothermic events related to interdiffusion, nucleation of Pd{sub 2}Si, crystallization of amorphous silicon, and vertical growth of Pd{sub 2}Si. Interestingly, the thickness of the initial nucleation layer depends on the heating rate revealing enhanced mass diffusion at the fastest heating rates during the initial stages of the reaction. In spite of this, the formation of the silicide strictly follows an Arrhenius temperature dependence over the whole temperature interval explored. A kinetic model is used to fit the calorimetric data over the complete heating rate range. Calorimetry is complemented by structural analysis through transmission electron microscopy and both standard and in-situ synchrotron X-ray diffraction.« less

Stability analysis of a pressure-solution surface

NASA Astrophysics Data System (ADS)

Gal, Doron; Nur, Amos; Aharonov, Einat

We present a linear stability analysis of a dissolution surface subjected to non-hydrostatic stress. A sinusoidal perturbation is imposed on an initially flat solid/fluid interface, and the consequent changes in elastic strain energy and surface energy are calculated. Our results demonstrate that if the far-field lateral stresses are either greater, or much smaller than the fluid pressure, the perturbed configuration has a lower strain energy than the initial one. For wavelengths greater than a critical wavelength this energy decrease may be large enough to offset the increased surface energy. Under these conditions, the perturbation grows unstably. If these conditions are not met, the surface becomes flat. The growth rate and wavelength of the maximally unstable mode depend on the mechanism of matter transport. We conclude that the instability discussed in this paper may account for the formation of stylolites and other pressure-solution phenomena, such as roughening of grain contacts.

LSENS, a general chemical kinetics and sensitivity analysis code for gas-phase reactions: User's guide

NASA Technical Reports Server (NTRS)

Radhakrishnan, Krishnan; Bittker, David A.

1993-01-01

A general chemical kinetics and sensitivity analysis code for complex, homogeneous, gas-phase reactions is described. The main features of the code, LSENS, are its flexibility, efficiency and convenience in treating many different chemical reaction models. The models include static system, steady, one-dimensional, inviscid flow, shock initiated reaction, and a perfectly stirred reactor. In addition, equilibrium computations can be performed for several assigned states. An implicit numerical integration method, which works efficiently for the extremes of very fast and very slow reaction, is used for solving the 'stiff' differential equation systems that arise in chemical kinetics. For static reactions, sensitivity coefficients of all dependent variables and their temporal derivatives with respect to the initial values of dependent variables and/or the rate coefficient parameters can be computed. This paper presents descriptions of the code and its usage, and includes several illustrative example problems.

The effect of physical parameterizations and initial data on the numerical prediction of the President's Day cyclone

NASA Technical Reports Server (NTRS)

Atlas, R.

1984-01-01

Results are presented from a series of forecast experiments which were conducted to assess the importance of large-scale dynamical processes, diabatic heating, and initial data to the prediction of the President's Day cyclone. The synoptic situation and NMC model forecasts for this case are summarized, and the analysis/forecast system and experiments are described. The GLAS Model forecast from the GLAS analysis at 0000 GMT 18 February is found to have correctly predicted intense coastal cyclogenesis and heavy precipitation. A forecast with surface heat and moisture fluxes eliminated failed to predict any cyclogenesis while a similar forecast with only the surface moisture flux excluded showed weak development. Diabatic heating resulting from oceanic fluxes significantly contributed to the generation of low-level cyclonic vorticity and the intensification and slow rate of movement of an upper level ridge over the western Atlantic.

Prediction of the containment of HIV infection by antiretroviral therapy - a variable structure control approach.

PubMed

Anelone, Anet J N; Spurgeon, Sarah K

2017-02-01

It is demonstrated that the reachability paradigm from variable structure control theory is a suitable framework to monitor and predict the progression of the human immunodeficiency virus (HIV) infection following initiation of antiretroviral therapy (ART). A manifold is selected which characterises the infection-free steady-state. A model of HIV infection together with an associated reachability analysis is used to formulate a dynamical condition for the containment of HIV infection on the manifold. This condition is tested using data from two different HIV clinical trials which contain measurements of the CD4+ T cell count and HIV load in the peripheral blood collected from HIV infected individuals for the six month period following initiation of ART. The biological rates of the model are estimated using the multi-point identification method and data points collected in the initial period of the trial. Using the parameter estimates and the numerical solutions of the model, the predictions of the reachability analysis are shown to be consistent with the clinical diagnosis at the conclusion of the trial. The methodology captures the dynamical characteristics of eventual successful, failed and marginal outcomes. The findings evidence that the reachability analysis is an appropriate tool to monitor and develop personalised antiretroviral treatment.

Reuse of acid coagulant-recovered drinking waterworks sludge residual to remove phosphorus from wastewater

NASA Astrophysics Data System (ADS)

Yang, Lan; Wei, Jie; Zhang, Yumei; Wang, Jianli; Wang, Dongtian

2014-06-01

Acid coagulant-recovered drinking waterworks sludge residual (DWSR) is a waste product from drinking waterworks sludge (DWS) treatment with acid for coagulant recovery. In this study, we evaluated DWSR as a potential phosphorus (P) removing material in wastewater treatment by conducting a series of batch and semi-continuous tests. Batch tests were carried out to study the effects of pH, initial concentration, and sludge dose on P removal. Batch test results showed that the P removal efficiency of DWSR was highly dependent on pH. Calcinated DWSR (C-DWSR) performed better in P removal than DWSR due to its higher pH. At an optimum initial pH value of 5-6 and a sludge dose of 10 g/L, the P removal rates of DWSR and DWS decreased from 99% and 93% to 84% and 14%, respectively, and the specific P uptake of DWSR and DWS increased from 0.19 and 0.19 mg P/g to 33.60 and 5.72 mg P/g, respectively, when the initial concentration was increased from 2 to 400 mg/L. The effective minimum sludge doses of DWSR and DWS were 0.5 g/L and 10 g/L, respectively, when the P removal rates of 90% were obtained at an initial concentration of 10 mg/L. Results from semi-continuous test indicated that P removal rates over 99% were quickly achieved for both synthetic and actual wastewater (lake water and domestic sewage). These rates could be maintained over a certain time under a certain operational conditions including sludge dose, feed flow, and initial concentration. The physicochemical properties analysis results showed that the contents of aluminum (Al) and iron (Fe) in DWSR were reduced by 50% and 70%, respectively, compared with DWS. The insoluble Al and Fe hydroxide in DWS converted into soluble Al and Fe in DWSR. Metal leaching test results revealed that little soluble Al and Fe remained in effluent when DWSR was used for P removal. We deduced that chemical precipitation might be the major action for P removal by DWSR and that adsorption played only a marginal role.

Process relevant screening of cellulolytic organisms for consolidated bioprocessing.

PubMed

Antonov, Elena; Schlembach, Ivan; Regestein, Lars; Rosenbaum, Miriam A; Büchs, Jochen

2017-01-01

Although the biocatalytic conversion of cellulosic biomass could replace fossil oil for the production of various compounds, it is often not economically viable due to the high costs of cellulolytic enzymes. One possibility to reduce costs is consolidated bioprocessing (CBP), integrating cellulase production, hydrolysis of cellulose, and the fermentation of the released sugars to the desired product into one process step. To establish such a process, the most suitable cellulase-producing organism has to be identified. Thereby, it is crucial to evaluate the candidates under target process conditions. In this work, the chosen model process was the conversion of cellulose to the platform chemical itaconic acid by a mixed culture of a cellulolytic fungus with Aspergillus terreus as itaconic acid producer. Various cellulase producers were analyzed by the introduced freeze assay that measures the initial carbon release rate, quantifying initial cellulase activity under target process conditions. Promising candidates were then characterized online by monitoring their respiration activity metabolizing cellulose to assess the growth and enzyme production dynamics. The screening of five different cellulase producers with the freeze assay identified Trichoderma   reesei and Penicillium   verruculosum as most promising. The measurement of the respiration activity revealed a retarded induction of cellulase production for P.   verruculosum but a similar cellulase production rate afterwards, compared to T.   reesei . The freeze assay measurement depicted that P.   verruculosum reaches the highest initial carbon release rate among all investigated cellulase producers. After a modification of the cultivation procedure, these results were confirmed by the respiration activity measurement. To compare both methods, a correlation between the measured respiration activity and the initial carbon release rate of the freeze assay was introduced. The analysis revealed that the different initial enzyme/cellulose ratios as well as a discrepancy in cellulose digestibility are the main differences between the two approaches. With two complementary methods to quantify cellulase activity and the dynamics of cellulase production for CBP applications, T.   reesei and P.   verruculosum were identified as compatible candidates for the chosen model process. The presented methods can easily be adapted to screen for suitable cellulose degrading organisms for various other applications.

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