40 CFR 63.2862 - What records must I keep?

Code of Federal Regulations, 2011 CFR

2011-07-01

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

40 CFR 63.2862 - What records must I keep?

Code of Federal Regulations, 2010 CFR

2010-07-01

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

Preventing Delays in First-Case Starts on the Neurosurgery Service: A Resident-Led Initiative at an Academic Institution.

PubMed

Han, Seunggu J; Rolston, John D; Zygourakis, Corinna C; Sun, Matthew Z; McDermott, Michael W; Lau, Catherine Y; Aghi, Manish K

2016-01-01

On-time starts for the first case of the day are critical to maintaining efficiency in operating rooms (ORs). We studied whether a resident-led initiative to ensure on-time site marking and documentation of surgical consent could lead to improved first-case start time. In a resident-led initiative at a large 600-bed academic hospital with 25 ORs, we aimed to complete site marking and surgical consents half an hour before the scheduled start time for all first-case neurosurgical patients. We monitored the occurrence of delayed first starts and the length of delay during our initiative, and compared these cases to neurosurgical cases 3 months before the implementation of the initiative and to first-start nonneurosurgical cases. In the year of the initiative, both site marking and surgical consents were completed 30 minutes before the case start in 97% of neurosurgical cases. The average delay across all first-case starts was reduced to 7.17 minutes (N = 1271), compared with 9.67 minutes before the intervention (N = 345). During the study period, non-neurosurgical cases were delayed on average 10.3 minutes (N = 3592). There was a significant difference in latencies between the study period and the period before the initiative (p < 0.001), and also between neurosurgical cases and nonneurosurgical cases (p < 0.001). There was no reduction in delay times seen on the non-neurosurgical services in the study period when compared to the case 3 months before. Considering its effect across 1271 cases, this initiative over 1 year resulted in a total reduction of 52 hours and 57 minutes in delays. Through a resident-led quality improvement program, neurosurgical trainees successfully reduced delays in first-case starts on a surgical service. Engaging physician trainees in quality improvement and enhancing OR efficiency can be successfully achieved and can have a significant clinical and financial effect. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

The Leader Ship Is Sinking: A Temporal Investigation of Narcissistic Leadership.

PubMed

Ong, Chin Wei; Roberts, Ross; Arthur, Calum A; Woodman, Tim; Akehurst, Sally

2016-04-01

Individuals higher in narcissism have leader emergent tendencies. The characteristics of their personality suggest, however, that their leadership qualities will decrease over time as a function of group acquaintance. We present data from two studies that provide the first empirical support for this theoretical position within a transformational leadership framework. In Study 1 (N = 112), we tested narcissistic leadership qualities in groups of unacquainted individuals over a 12-week period. In Study 2 (N = 152), we adopted the same protocol with groups of acquainted individuals. In Study 1, narcissism was positively associated with peer-rated leadership during initial group formation but not later. In Study 2, narcissism was not significantly associated with peer-rated leadership during initial group formation and was negatively associated with peer-rated leadership later. In Study 1, transformational leadership mediated the relationship between narcissism and leadership initially but not later on. In Study 2, transformational leadership failed to mediate the relationship between narcissism and leadership throughout the study. Despite enjoying a honeymoon period of leadership, the appeal and attractiveness of the narcissistic leader rapidly wane. This decline is explained in part by their changing transformational leadership qualities. © 2014 Wiley Periodicals, Inc.

Minimal Brain Dysfunction in Childhood: II. Late Outcome in Relation to Initial Presentation. III. Predictive Factors in Relation to Late Outcome.

ERIC Educational Resources Information Center

Milman, Doris H.

Two studies explore the late outcome of minimal brain dysfunction in 73 patients in relation to their initial presentation and predictive factors. Both studies followed the patients for a period of 10 to 20 years. Findings from the first study of initial presentation in relation to adult outcome showed that there was a strong positive correlation…

Dosing of selective serotonin reuptake inhibitors in children and adults before and after the FDA black-box warning

PubMed Central

Bushnell, Greta A; Stürmer, Til; Swanson, Sonja A; White, Alice; Azrael, Deborah; Pate, Virginia; Miller, Matthew

2016-01-01

Objective Prior research evaluated various effects of the antidepressant black-box warning on the risk of suicidality in children, but the dosing of antidepressants has not been considered. This study estimated, relative to the FDA warnings, whether the initial antidepressant dose prescribed decreased and the proportion augmenting dose on the second fill increased. Method The study utilized the LifeLink Health Plan Claims Database. The study cohort consisted of commercially insured children (5–17 years), young adults (18–24 years), and adults (25–64 years) initiating an SSRI (citalopram, fluoxetine, paroxetine, or sertraline) from 1/1/2000 to 12/31/2009. Dose-per-day was determined by days supply, strength, and quantity dispensed. Initiation on low dose, defined based on guidelines, and dose augmentations (dose increase >1mg/day) on the second prescription were considered across time periods related to the antidepressant warnings. Results Of 51,948 children who initiated an SSRI, 15% initiated on low dose in the period before the 2004 black-box warning and 31% in the period after the warning (a 16 percentage-point change); there was a smaller percentage-point change in young adults (6%) and adults (3%). The overall increase in dose augmentations in children and young adults was driven by the increase in patients initiating on a low dose. Conclusions As guidelines recommend children initiate antidepressant treatment on low dose, findings that an increased proportion of commercially insured children initiated an SSRI on low dose after the 2004 black-box warning suggest prescribing practices surrounding SSRI dosing improved in children following the warning but dosing practices still fall short of guidelines. PMID:26567938

Search for and Study of Nearly Periodic Orbits in the Plane Problem of Three Equal-Mass Bodies

NASA Astrophysics Data System (ADS)

Martynova, A. I.; Orlov, V. V.

2005-09-01

We analyze nearly periodic solutions in the plane problem of three equal-mass bodies by numerically simulating the dynamics of triple systems. We identify families of orbits in which all three points are on one straight line (syzygy) at the initial time. In this case, at fixed total energy of a triple system, the set of initial conditions is a bounded region in four-dimensional parameter space. We scan this region and identify sets of trajectories in which the coordinates and velocities of all bodies are close to their initial values at certain times (which are approximately multiples of the period). We classify the nearly periodic orbits by the structure of trajectory loops over one period. We have found the families of orbits generated by von Schubart’s stable periodic orbit revealed in the rectilinear three-body problem. We have also found families of hierarchical, nearly periodic trajectories with prograde and retrograde motions. In the orbits with prograde motions, the trajectory loops of two close bodies form looplike structures. The trajectories with retrograde motions are characterized by leafed structures. Orbits with central and axial symmetries are identified among the families found.

Student Initiatives in Urban Elementary Science Classrooms

ERIC Educational Resources Information Center

Lewis, Scott; Lee, Okhee; Santau, Alexandra; Cone, Neporcha

2010-01-01

Student initiatives play an important role in inquiry-based science with all students, including English language learning (ELL) students. This study examined initiatives that elementary students made as they participated in an intervention to promote science learning and English language development over a three-year period. In addition, the…

Adult emergency department patients with sickle cell pain crisis: results from a quality improvement learning collaborative model to improve analgesic management.

PubMed

Tanabe, Paula; Hafner, John W; Martinovich, Zoran; Artz, Nicole

2012-04-01

The aims of this study were to 1) estimate differences in pain management process and patient-reported outcomes, pre- and postimplementation of analgesic protocols for adults with sickle cell disease (SCD), and 2) examine the effects of site and visit frequency on changes in pain scores and time to analgesic. A multicenter, prospective, longitudinal study enrolled patients from three academic medical centers between October 2007 and September 2009. All ED patients 18 years or older with a chief complaint of a sickle cell pain episode were enrolled. Sites formed a SCD quality improvement (QI) team and implemented standard nurse-initiated emergency department (ED) analgesic protocols; outcomes were compared between study periods defined as pre- and postimplementation of protocols. Medical record review was conducted to measure time to administration of initial analgesic, opioids used, route of opioid administration, the change in pain scores from arrival to discharge (negative numbers reflect a decrease in pain scores), and the number of ED visits per individual patient during the study period at each site. On day 7 after the ED visit, a follow-up phone interview was conducted. Patients were queried about their ED pain management using a scale from 1 to 10 (1 = outstanding, 10 = worst). Descriptive statistics are used to report the results. Ordinary least-squares regression models were constructed to measure the effect of time period, site, and number of visits per patient on change in pain score. During the study period, 342 unique patients (57% female, mean ± SD age = 32 ± 11 years) were enrolled and had a total of 2,934 visits. There was no difference in time to administration of the initial analgesic between study periods. Overall, there was a significant decrease in pain scores from arrival to discharge between the pre- and postintervention study periods: the average difference in arrival to discharge pain scores (cm) was greater during the postimplementation period than during the preintervention period (-4.1 vs. -3.6, t = 2.6, p < 0.01). Site 1 had significant improvement between study periods (mean difference = -0.87, t = 2.63, p < 0.01; F = 14.3, p < 0.01). Patients with few ED visits (one to six annual visits, mean difference = -1.55, t = 2.1, p = 0.04) and those with frequent ED visits (7 to 19 annual visits, mean difference = -1.65, t = 3.52, p < 0.01) had a significant decrease in pain scores compared to patients with very frequent ED visits (>19 visits). There was an overall decrease in the use of morphine sulfate (MS) and increase in the use of hydromorphone (χ(2) = 105.67, p < 0.001) between study periods and a significant increase in the use of oral (PO) and subcutaneous (SC) routes, with a corresponding decrease in the intravenous (IV) route (χ(2) = 13.67, p < 0.001). There were no statistically significant differences in patient-reported satisfaction with the attempt to manage pain in the ED between study periods (p = 0.54). While the use of a learning collaborative and implementation of nurse-initiated analgesic protocols was not associated with improvement in time to administration of the initial analgesic, improvements in the decrease in the arrival to discharge pain score and increased use of hydromorphone and the SC route were noted in adults with SCD in the ED. © 2012 by the Society for Academic Emergency Medicine.

Temporal Order in Periodically Driven Spins in Star-Shaped Clusters

NASA Astrophysics Data System (ADS)

Pal, Soham; Nishad, Naveen; Mahesh, T. S.; Sreejith, G. J.

2018-05-01

We experimentally study the response of star-shaped clusters of initially unentangled N =4 , 10, and 37 nuclear spin-1 /2 moments to an inexact π -pulse sequence and show that an Ising coupling between the center and the satellite spins results in robust period-2 magnetization oscillations. The period is stable against bath effects, but the amplitude decays with a timescale that depends on the inexactness of the pulse. Simulations reveal a semiclassical picture in which the rigidity of the period is due to a randomizing effect of the Larmor precession under the magnetization of surrounding spins. The timescales with stable periodicity increase with net initial magnetization, even in the presence of perturbations, indicating a robust temporal ordered phase for large systems with finite magnetization per spin.

Hearing conservation in the primary aluminium industry.

PubMed

Donoghue, A M; Frisch, N; Dixon-Ernst, C; Chesson, B J; Cullen, M R

2016-04-01

Noise-induced hearing loss has been an intractable problem for heavy industry. To report our experience in reducing the incidence of age-corrected confirmed 10 dB hearing shifts (averaged over 2, 3 and 4 kHz) in employees in the primary aluminium industry in Australia over the period 2006-13. We analysed annual audiometric data to determine the number of permanent hearing shifts that occurred in employees in two bauxite mines, three alumina refineries and two aluminium smelters. Annual hearing shift rates were calculated based on the number of employees tested per year. Hearing conservation initiatives undertaken during the study period are described. An assessment of similar exposure group noise exposures was also undertaken to determine the magnitude of noise exposure reduction during the study period. Across all operations, hearing shift rates declined from 5.5% per year in 2006 to 1.3% per year in 2013 (P < 0.001). The decline in shift rates was greater in mines and refineries, where baseline shift rates were higher, than in smelter workers. Modest reductions in noise exposure occurred during the study period. We observed a substantial decline in hearing shift rates during the study period. We describe the hearing conservation initiatives that were collectively associated with this decline. We suspect these initiatives could be deployed relatively easily and at modest cost in other industries with noise-exposed employees. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine.

Persistence of initial conditions in continental scale air quality simulations

NASA Astrophysics Data System (ADS)

Hogrefe, Christian; Roselle, Shawn J.; Bash, Jesse O.

2017-07-01

This study investigates the effect of initial conditions (IC) for pollutant concentrations in the atmosphere and soil on simulated air quality for two continental-scale Community Multiscale Air Quality (CMAQ) model applications. One of these applications was performed for springtime and the second for summertime. Results show that a spin-up period of ten days commonly used in regional-scale applications may not be sufficient to reduce the effects of initial conditions to less than 1% of seasonally-averaged surface ozone concentrations everywhere while 20 days were found to be sufficient for the entire domain for the spring case and almost the entire domain for the summer case. For the summer case, differences were found to persist longer aloft due to circulation of air masses and even a spin-up period of 30 days was not sufficient to reduce the effects of ICs to less than 1% of seasonally-averaged layer 34 ozone concentrations over the southwestern portion of the modeling domain. Analysis of the effect of soil initial conditions for the CMAQ bidirectional NH3 exchange model shows that during springtime they can have an important effect on simulated inorganic aerosols concentrations for time periods of one month or longer. The effects are less pronounced during other seasons. The results, while specific to the modeling domain and time periods simulated here, suggest that modeling protocols need to be scrutinized for a given application and that it cannot be assumed that commonly-used spin-up periods are necessarily sufficient to reduce the effects of initial conditions on model results to an acceptable level. What constitutes an acceptable level of difference cannot be generalized and will depend on the particular application, time period and species of interest. Moreover, as the application of air quality models is being expanded to cover larger geographical domains and as these models are increasingly being coupled with other modeling systems to better represent air-surface-water exchanges, the effects of model initialization in such applications needs to be studied in future work.

Assessing the initial adaptability and impact of a mobile dictation and reporting system in the radiology department of an academic hospital

NASA Astrophysics Data System (ADS)

Gali, Raja L.; Dave, Jaydev K.

2017-03-01

Mobile Radiologist 360, rolled out as part of the voice dictation system upgrade from Nuance Powerscribe 5.0 to PS360 allows an attending radiologist to edit and sign-off a report assigned by a trainee or that has been started by the radiologist on a workstation. The purpose of this study was to evaluate the adoptability and impact of this application. Report turnaround time data was extracted from the RIS (GE-Centricity RIS-IC) for 60 days before- (period-1) and 60 days after- (period-2) the application implementation and then, for 60 days after end of period-2 (period-3). Adoptability of the application was evaluated using two metrics; first, the number of attending radiologists who signed-off reports using the application in periods 2 and 3, and second, the proportion of reports signed-off by the top five users of the mobile application using the application. Impact of the application was evaluated by comparing the time from initial dictation to final sign-off (time_PF) for the top five users of the mobile application to the time_PF by other five radiologists who did not use the application. 41% radiologists used the mobile application at least once during the study period; the proportion of cases signed-off using the mobile application ranged from 1% to 20%. ANOVA revealed no statistically significant effect of the mobile application system on time_PF (p=0.842). In conclusion, there was low initial adoptability and no impact of the mobile dictation and reporting system in reducing the time from initial dictation to final sign-off on a radiology report.

Groundwater quality data in 15 GAMA study units: results from the 2006–10 Initial sampling and the 2009–13 resampling of wells, California GAMA Priority Basin Project

USGS Publications Warehouse

Kent, Robert

2015-08-31

Most constituents that were detected in groundwater samples from the trend wells were found at concentrations less than drinking-water benchmarks. Two volatile organic compounds (VOCs)—tetrachloroethene and trichloroethene—were detected in samples from one or more wells at concentrations greater than their health-based benchmarks, and three VOCs—chloroform, tetrachloroethene, and trichloroethene—were detected in at least 10 percent of the trend-well samples from the initial sampling period and the later trend sampling period. No pesticides were detected at concentrations near or greater than their health-based benchmarks. Three pesticide constituents—atrazine, deethylatrazine, and simazine—were detected in more than 10 percent of the trend-well samples in both sampling periods. Perchlorate, a constituent of special interest, was detected at a concentration greater than its health-based benchmark in samples from one trend well in the initial sampling and trend sampling periods, and in an additional trend well sample only in the trend sampling period. Most detections of nutrients, major and minor ions, and trace elements in samples from trend wells were less than health-based benchmarks in both sampling periods. Exceptions included nitrate, fluoride, arsenic, boron, molybdenum, strontium, and uranium; these were all detected at concentrations greater than their health-based benchmarks in at least one well sample in both sampling periods. Lead and vanadium were detected above their health-based benchmarks in one sample each collected in the initial sampling period only. The isotopic ratios of oxygen and hydrogen in water and the activities of tritium and carbon-14 generally changed little between sampling periods.

Treatment Patterns and Associated Health Care Costs Before and After Treatment Initiation Among Pulmonary Arterial Hypertension Patients in the United States.

PubMed

Burger, Charles D; Ozbay, A Burak; Lazarus, Howard M; Riehle, Ellen; Montejano, Leslie B; Lenhart, Gregory; White, R James

2018-02-13

Despite multiple treatment options, the prognosis of pulmonary arterial hypertension (PAH) remains poor. PAH patients experience a high economic burden due to comorbidities, hospitalizations, and medication costs. Although combination therapy has been shown to reduce hospitalizations, the relationship between treatment, health care utilization, and costs remains unclear. To provide a characterization of health care utilization and costs in real-world settings by comparing periods before and after initiating PAH-specific treatment. This retrospective study identified PAH patients in the Truven Health MarketScan Commercial and Medicare Supplemental Databases between 2010 and 2014 who initiated treatment with endothelin receptor antagonists (ERAs), phosphodiesterase-5 inhibitors (PDE-5Is), or soluble guanylate cyclase (sGC) stimulators. The index date was the date of the first PAH pharmacy claim. We included patients with ≥ 2 medical claims with diagnoses for PAH (ICD-9-CM: 416.0, 416.8) or PAH-related conditions and continuous enrollment in medical and pharmacy benefits for the 6 months before and after the index date. Treatment patterns were assessed at the drug class level (ERAs, PDE-5Is, sGC stimulators, and prostacyclins) from outpatient pharmacy claims during the 6-month post-index period. All-cause and PAH-related utilization and costs were measured. McNemar's and paired t-tests were used to compare patients' health care resource utilization and costs in the 6-month pre- and posttreatment periods. A total of 3,908 patients met the selection criteria. The study sample was 63% female with a mean age of 63 ± 15 years. Only 5% of patients began initial combination therapy for PAH, defined as claims for ≥ 2 medication classes within the first 30 days of treatment. Treatment interruption (≥ 30-day gap in days supply) of any PAH-specific medication was observed in 38% of patients. Compared with the 6-month pre-index period, the proportion of patients in the 6-month post-index period with any inpatient admission decreased, 42% versus 30% (P < 0.001). In addition, PAH-related inpatient admissions decreased in the 6-month post-index period from 7% to 3% (P < 0.001). After treatment initiation, patients' nonpharmacy medical costs decreased from $48,200 (SD = $117,686) to $33,962 (SD = $90,294; P < 0.001), mainly attributable to reduced inpatient costs. However, total average medical costs including pharmacy costs remained comparable after treatment initiation (pre-index period = $51,455 vs. post-index period = $53,923; P = 0.213). This study found that while patients' PAH-related pharmacy costs increased after treatment initiation, the increase was offset by reduced inpatient utilization; therefore, total health care costs remained constant. While the majority of patients in this study were treated with monotherapy, the recently completed AMBITION study indicated that initial combination therapy with ambrisentan plus tadalafil reduced PAH-related hospitalizations compared with initial monotherapy with either of these agents. Future cost analyses of patients treated with combination therapy will be required to determine the economic effect of initial combination therapy. This study was sponsored and funded by Gilead Sciences. Ozbay is an employee of Gilead Sciences. At the time that this project and manuscript were developed, Lazarus was an employee of Gilead Sciences and may own stock/stock options. Riehle, Montejano, and Lenhart are employees of Truven Health Analytics, an IBM company, which received funding from Gilead Sciences to conduct this study. Burger and White do research with, and are paid consultants for, Gilead Sciences; they do not own equity and received no personal compensation for the work here. Burger also reports consultancy and advisory board work for Actelion Pharmaceuticals and grants from Gilead Sciences, Actelion Pharmaceuticals, Bayer, and United Therapeutics. Study concept and design were contributed by Ozbay, Riehle, and Montejano, along with the other authors. Riehle, Montejano, and Lenhart collected the data, and data interpretation was performed by Burger, Lazarus, and White, with assistance from the other authors. The manuscript was written by Riehle, Burger, Montejano, Osbay, and White and revised by Burger and White, along with Osbay, Lazarus, Riehle, and Montejano.

Learning at Air Navigation Services after Initial Training

ERIC Educational Resources Information Center

Teperi, Anna-Maria; Leppanen, Anneli

2010-01-01

Purpose: This study aims to find out the means used for individual, group and organizational learning at work at one air navigation service provider after the initial training period. The study also aims to find out what practices need to be improved to enhance learning at work. Design/methodology/approach: The data for the study were collected…

78 FR 65621 - Implementation of Title I/II Program Initiatives; Extension of Public Comment Period; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-01

... DEPARTMENT OF EDUCATION Implementation of Title I/II Program Initiatives; Extension of Public Comment Period; Correction AGENCY: Department of Education. ACTION: Correction notice. SUMMARY: On October... Title I/II Program Initiatives,'' Docket ID ED- 2013-ICCD-0090. The comment period for this information...

Postmenopausal hormone therapy and risk of stroke: A pooled analysis of data from population-based cohort studies

PubMed Central

Carrasquilla, Germán D.; Frumento, Paolo; Berglund, Anita; Borgfeldt, Christer; Bottai, Matteo; Chiavenna, Chiara; Eliasson, Mats; Engström, Gunnar; Hallmans, Göran; Jansson, Jan-Håkan; Nilsson, Peter M.; Pedersen, Nancy L.

2017-01-01

Background Recent research indicates a favourable influence of postmenopausal hormone therapy (HT) if initiated early, but not late, on subclinical atherosclerosis. However, the clinical relevance of timing of HT initiation for hard end points such as stroke remains to be determined. Further, no previous research has considered the timing of initiation of HT in relation to haemorrhagic stroke risk. The importance of the route of administration, type, active ingredient, and duration of HT for stroke risk is also unclear. We aimed to assess the association between HT and risk of stroke, considering the timing of initiation, route of administration, type, active ingredient, and duration of HT. Methods and findings Data on HT use reported by the participants in 5 population-based Swedish cohort studies, with baseline investigations performed during the period 1987–2002, were combined in this observational study. In total, 88,914 postmenopausal women who reported data on HT use and had no previous cardiovascular disease diagnosis were included. Incident events of stroke (ischaemic, haemorrhagic, or unspecified) and haemorrhagic stroke were identified from national population registers. Laplace regression was employed to assess crude and multivariable-adjusted associations between HT and stroke risk by estimating percentile differences (PDs) with 95% confidence intervals (CIs). The fifth and first PDs were calculated for stroke and haemorrhagic stroke, respectively. Crude models were adjusted for age at baseline only. The final adjusted models included age at baseline, level of education, smoking status, body mass index, level of physical activity, and age at menopause onset. Additional variables evaluated for potential confounding were type of menopause, parity, use of oral contraceptives, alcohol consumption, hypertension, dyslipidaemia, diabetes, family history of cardiovascular disease, and cohort. During a median follow-up of 14.3 years, 6,371 first-time stroke events were recorded; of these, 1,080 were haemorrhagic. Following multivariable adjustment, early initiation (<5 years since menopause onset) of HT was associated with a longer stroke-free period than never use (fifth PD, 1.00 years; 95% CI 0.42 to 1.57), but there was no significant extension to the time period free of haemorrhagic stroke (first PD, 1.52 years; 95% CI −0.32 to 3.37). When considering timing as a continuous variable, the stroke-free and the haemorrhagic stroke-free periods were maximal if HT was initiated approximately 0–5 years from the onset of menopause. If single conjugated equine oestrogen HT was used, late initiation of HT was associated with a shorter stroke-free (fifth PD, −4.41 years; 95% CI −7.14 to −1.68) and haemorrhagic stroke-free (first PD, −9.51 years; 95% CI −12.77 to −6.24) period than never use. Combined HT when initiated late was significantly associated with a shorter haemorrhagic stroke-free period (first PD, −1.97 years; 95% CI −3.81 to −0.13), but not with a shorter stroke-free period (fifth PD, −1.21 years; 95% CI −3.11 to 0.68) than never use. Given the observational nature of this study, the possibility of uncontrolled confounding cannot be excluded. Further, immortal time bias, also related to the observational design, cannot be ruled out. Conclusions When initiated early in relation to menopause onset, HT was not associated with increased risk of incident stroke, regardless of the route of administration, type of HT, active ingredient, and duration. Generally, these findings held also for haemorrhagic stroke. Our results suggest that the initiation of HT 0–5 years after menopause onset, as compared to never use, is associated with a decreased risk of stroke and haemorrhagic stroke. Late initiation was associated with elevated risks of stroke and haemorrhagic stroke when conjugated equine oestrogen was used as single therapy. Late initiation of combined HT was associated with haemorrhagic stroke risk. PMID:29149179

Relapse Prevention in Pediatric Patients with ADHD Treated with Atomoxetine: A Randomized, Double-Blind, Placebo-Controlled Study

ERIC Educational Resources Information Center

Michelson, David; Buitelaar, Jan K.; Danckaerts, Marina; Gillberg, Christopher; Spencer, Thomas J.; Zuddas, Alessandro; Faries, Douglas E.; Zhang, Shuyu; Biederman, Joseph

2004-01-01

Objective: Attention-deficit/hyperactivity disorder (ADHD) is typically treated over extended periods; however, few placebo-controlled, long-term studies of efficacy have been reported. Method: In a global multicenter study, children and adolescents who responded to an initial 12-week, open-label period of treatment with atomoxetine, a…

Characterization of Mineralocorticoid Receptor Antagonist Therapy Initiation in High-Risk Patients With Heart Failure.

PubMed

Cooper, Lauren B; Hammill, Bradley G; Peterson, Eric D; Pitt, Bertram; Maciejewski, Matthew L; Curtis, Lesley H; Hernandez, Adrian F

2017-01-01

Heart failure guidelines recommend routine monitoring of serum potassium, and renal function in patients treated with a mineralocorticoid receptor antagonist (MRA). How these recommendations are implemented in high-risk patients or according to setting of drug initiation is poorly characterized. We conducted a retrospective cohort study of Medicare beneficiaries linked to laboratory data in 10 states with prevalent heart failure as of July 1, 2011, and incident MRA use between May 1 and September 30, 2011. Outcomes included laboratory testing before MRA initiation and in the early (days 1-10) and extended (days 11-90) post-initiation periods, based on setting of drug initiation and the presence of renal insufficiency. Additional outcomes included abnormal laboratory results and adverse events proximate to MRA initiation. Of 10 443 Medicare beneficiaries with heart failure started on an MRA, 19.7% were initiated during a hospitalization. Appropriate follow-up laboratory testing across all time periods occurred in 25.2% of patients with inpatient initiation compared with 2.8% of patients begun as an outpatient. Patients with chronic kidney disease had higher rates of both hyperkalemia and acute kidney failure in the early (1.3% and 2.7%, respectively) and extended (5.6% and 9.8%, respectively) post-initiation periods compared with those without chronic kidney disease. Patients initiated on MRA therapy as an outpatient had extremely poor rates of guideline indicated follow-up laboratory monitoring after drug initiation. In particular, patients with chronic kidney disease are at high risk for adverse events after MRA initiation. Quality improvement initiatives focused on systems to improve appropriate laboratory monitoring are needed. © 2017 American Heart Association, Inc.

42 CFR 457.370 - Alignment with Exchange initial open enrollment period.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Alignment with Exchange initial open enrollment period. 457.370 Section 457.370 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... Alignment with Exchange initial open enrollment period. The terms of § 435.1205 apply equally to the State...

In-Patient Code Stroke: A Quality Improvement Strategy to Overcome Knowledge-to-Action Gaps in Response Time.

PubMed

Kassardjian, Charles D; Willems, Jacqueline D; Skrabka, Krystyna; Nisenbaum, Rosane; Barnaby, Judith; Kostyrko, Pawel; Selchen, Daniel; Saposnik, Gustavo

2017-08-01

Stroke is a relatively common and challenging condition in hospitalized patients. Previous studies have shown delays in recognition and assessment of inpatient strokes leading to poor outcomes. The goal of this quality improvement initiative was to evaluate an in-hospital code stroke algorithm and educational program aimed at reducing the response times for inpatient stroke. An inpatient code stroke algorithm was developed, and an educational intervention was implemented over 5 months. Data were recorded and compared between the 36-month period before and the 15-month period after the intervention was implemented. Outcome measures included time from last seen normal to initial assessment and from last seen normal to brain imaging. During the study period, there were 218 inpatient strokes (131 before the intervention and 87 after the intervention). Inpatient strokes were more common on cardiovascular wards (45% of cases) and occurred mainly during the perioperative period (60% of cases). After implementation of an inpatient code stroke intervention and educational initiative, there were consistent reductions in all timed outcome measures (median time to initial assessment fell from 600 [109-1460] to 160 [35-630] minutes and time to computed tomographic scan fell from 925 [213-1965] to 348.5 [128-1587] minutes). Our study reveals the efficacy of an inpatient code stroke algorithm and educational intervention directed at nurses and allied health personnel to optimize the prompt management of inpatient strokes. Prompt assessment may lead to faster stroke interventions, which are associated with better outcomes. © 2017 American Heart Association, Inc.

An assessment of prospects for international cooperation on the Space Exploration Initiative

NASA Technical Reports Server (NTRS)

Cline, Lynn F. H.; Rosendhal, Jeffrey D.

1991-01-01

This paper discusses the unique characteristics of the Space Exploration Initiative (SEI) which will have to be taken into account if the Initiative is to become an international one; the technical capabilities offered by prospective international partners; the political and economic prospects for proceeding with the Initiative both in the United States and elsewhere; and the advantages and disadvantages of various possible approaches to international cooperation on SEI. SEI preparatory activities are likely to extend over a several-year period. Such an extended preparatory period should provide the time needed for coordinating studies, for identifing interests and potential contributions, and for resolving the numerous planning, budgeting, organizational and political issues which will have to be dealt with if such a complex undertaking is to be successfully internationalized.

Health care resource utilization before and after perampanel initiation among patients with epilepsy in the United States.

PubMed

Faught, Edward; Laliberté, François; Wang, Zhixiao; Barghout, Victoria; Haider, Batool; Lejeune, Dominique; Germain, Guillaume; Choi, Jiyoon; Wagh, Aneesha; Duh, Mei Sheng

2017-10-01

The purpose of this study was to evaluate changes in health care resource utilization following the initiation of perampanel for the treatment of epilepsy in the United States. Health care claims from Symphony Health's Integrated Dataverse database between December 2012 and November 2015 were analyzed. Patients newly initiated on perampanel, having ≥1 epilepsy (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 345.xx, ICD-10-CM code G40.xxx) or nonfebrile convulsion (ICD-9-CM code 780.39, ICD-10-CM code R56.9) diagnosis, and having ≥6 months of baseline and observation periods were included. Patients <12 years old at perampanel initiation were excluded. Of the 2,508 perampanel patients included in the study, the mean [median] (±standard deviation [SD]) age was 35.8 [34] (±16.0) years and 56.2% were female. The mean [median] (±SD) observation duration was 459.8 [462] (±146.3) days in the postperampanel period. The postperampanel period was associated with significantly lower rates of all health care resource utilization outcomes than the pre-period. For the post- versus pre-period, perampanel users had 42.3 versus 53.8 overall hospitalizations per 100 person-years (rate ratio [RR] = 0.80, p < 0.001) and 1,240.2 versus 1,343.8 outpatient visits per 100 person-years (RR = 0.91, p < 0.001). Epilepsy-related hospitalizations and outpatient visits were 25.2 versus 33.6 per 100 person-years (RR = 0.76, p < 0.001) and 327.0 versus 389.0 per 100 person-years (RR = 0.84, p < 0.001), respectively. Additionally, a significantly lower rate of status epilepticus in the post-period (1.8 events per 100 person-years) was observed compared to the pre-period (4.4 events per 100 person-years; RR = 0.43, p < 0.001). The monthly time trend of hospitalizations showed an increasing trend leading up to the initiation of perampanel, after which the hospitalizations decreased steadily. Use of perampanel for the treatment of epilepsy was associated with significant reduction in all-cause and epilepsy-related health care resource utilization, including hospitalizations, especially for status epilepticus, and outpatient visits. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

Assessing medication adherence and healthcare utilization and cost patterns among hospital-discharged patients with schizoaffective disorder.

PubMed

Karve, Sudeep; Markowitz, Michael; Fu, Dong-Jing; Lindenmayer, Jean-Pierre; Wang, Chi-Chuan; Candrilli, Sean D; Alphs, Larry

2014-06-01

Hospital-discharged patients with schizoaffective disorder have a high risk of re-hospitalization. However, limited data exist evaluating critical post-discharge periods during which the risk of re-hospitalization is significant. Among hospital-discharged patients with schizoaffective disorder, we assessed pharmacotherapy adherence and healthcare utilization and costs during sequential 60-day clinical periods before schizoaffective disorder-related hospitalization and post-hospital discharge. From the MarketScan(®) Medicaid database (2004-2008), we identified patients (≥18 years) with a schizoaffective disorder-related inpatient admission. Study measures including medication adherence and healthcare utilization and costs were assessed during sequential preadmission and post-discharge periods. We conducted univariate and multivariable regression analyses to compare schizoaffective disorder-related and all-cause healthcare utilization and costs (in 2010 US dollars) between each adjacent 60-day post-discharge periods. No adjustment was made for multiplicity. We identified 1,193 hospital-discharged patients with a mean age of 41 years. The mean medication adherence rate was 46% during the 60-day period prior to index inpatient admission, which improved to 80% during the 60-day post-discharge period. Following hospital discharge, schizoaffective disorder-related healthcare costs were significantly greater during the initial 60-day period compared with the 61- to 120-day post-discharge period (mean US$2,370 vs US$1,765; p < 0.001), with rehospitalization (36%) and pharmacy (40%) accounting for over three-fourths of the initial 60-day period costs. Compared with the initial 60-day post-discharge period, both all-cause and schizoaffective disorder-related costs declined during the 61- to 120-day post-discharge period and remained stable for the remaining post-discharge periods (days 121-365). We observed considerably lower (46%) adherence during 60 days prior to the inpatient admission; in comparison, adherence for the overall 6-month period was 8% (54%) higher. Our study findings suggest that both short-term (e.g., 60 days) and long-term (e.g., 6-12 months) medication adherence likely are important characteristics to examine among patients with schizoaffective disorder and help provide a more holistic view of patients' adherence patterns. Furthermore, we observed a high rate of rehospitalization and greater healthcare costs during the initial 60-day period post-discharge among patients with schizoaffective disorder. Further research is required to better understand and manage transitional care after discharge (e.g., monitor adherence), which may help reduce the likelihood of rehospitalization and the associated downstream costs.

Revisiting convergence: A research note.

PubMed

Clark, Rob

2015-09-01

A number of recent studies show that income inequality is declining between countries. In this research note, I question the significance of this trend by examining the role of initial conditions in producing convergence. An important (but neglected) property of inequality dynamics is the tendency for extreme distributions to become more moderate. When income disparities are large, the subsequent trend is biased toward convergence. Conversely, when initial conditions approach parity, divergence becomes the more likely long-term outcome. I apply this principle to trends in GDP PC across 127 countries during the 1980-2010 period. Using counterfactual analysis, I manipulate the initial level of inequality in GDP PC while holding constant each country's observed growth rate during the sample period. I find that the growth dynamics of GDP PC produce either convergence or divergence based simply on the initial distribution of income. The point of transition occurs at a moderate level of inequality, whether using population weights (Gini=.365) or not (Gini=.377). I conclude that the recent convergence observed in GDP PC is primarily a function of large income gaps between countries and would not have materialized at more moderate levels of initial inequality. By contrast, an examination of the pre-1950 period reveals divergent growth patterns that are not sensitive to initial conditions. Copyright © 2015 Elsevier Inc. All rights reserved.

Shock initiation of nitromethane

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

Yoo, C.S.; Holmes, N.C.

1993-12-31

The shock initiation processes of nitromethane have been examined by using a fast time-resolved emission spectroscopy at a two-stage gas gun. a broad, but strong emission has been observed in a spectral range between 350 and 700 nm from shocked nitromethane above 9 GPa. The temporal profile suggests that shocked nitromethane detonates through three characteristic periods, namely an induction period, a hock initiation period, and a thermal explosion period. This paper discusses temporal and chemical characteristics of these periods and present the temperature of the shock-detonating nitromethane at pressures between 9 and 15 GPa.

The Dynamics of Initiative in Communication Networks.

PubMed

Mollgaard, Anders; Mathiesen, Joachim

2016-01-01

Human social interaction is often intermittent. Two acquainted persons can have extended periods without social interaction punctuated by periods of repeated interaction. In this case, the repeated interaction can be characterized by a seed initiative by either of the persons and a number of follow-up interactions. The tendency to initiate social interaction plays an important role in the formation of social networks and is in general not symmetric between persons. In this paper, we study the dynamics of initiative by analysing and modeling a detailed call and text message network sampled from a group of 700 individuals. We show that in an average relationship between two individuals, one part is almost twice as likely to initiate communication compared to the other part. The asymmetry has social consequences and ultimately might lead to the discontinuation of a relationship. We explain the observed asymmetry by a positive feedback mechanism where individuals already taking initiative are more likely to take initiative in the future. In general, people with many initiatives receive attention from a broader spectrum of friends than people with few initiatives. Lastly, we compare the likelihood of taking initiative with the basic personality traits of the five factor model.

Impact of dialysis practice patterns on outcomes in acute kidney injury in Intensive Care Unit.

PubMed

Annigeri, Rajeev A; Nandeesh, Venkatappa; Karuniya, Ramanathan; Rajalakshmi, Sasikumar; Venkataraman, Ramesh; Ramakrishnan, Nagarajan

2016-01-01

Recent advances in dialysis therapy have made an impact on the clinical practice of renal replacement therapy (RRT) in acute kidney injury (AKI) in Intensive Care Unit (ICU). We studied the impact of RRT practice changes on outcomes in AKI in ICU over a period of 8 years. AKI patients requiring RRT in ICU referred to a nephrologist during two different periods (period-1: Between May 2004 and May 2007, n = 69; period-2: Between August 2008 and May 2011, n = 93) were studied. The major changes in the dialysis practice during the period-2, compared to period-1 were introduction of prolonged intermittent RRT (PIRRT), early dialysis for metabolic acidosis, early initiation of RRT for anuria and positive fluid balance and use of bicarbonate-based fluids for continuous RRT (CRRT) instead of lactate buffer. The primary study outcome was 28-day hospital mortality. The mean age was 53.8 ± 16.1 years and 72.6% were male. Introduction of PIRRT resulted in 37% reduction in utilization of CRRT during period-2 (from 85.5% to 53.7%). The overall mortality was high (68%) but was significantly reduced during period-2 compared to period-1 (59% vs. 79.7%, P = 0.006). Metabolic acidosis but not the mode of RRT, was the significant factor which influenced mortality. Adaption of PIRRT resulted in 37% reduction of utilization of CRRT. The mortality rate was significantly reduced during the period of adaption of PIRRT, possibly due to early initiation of RRT in the latter period for indications such as anuria and metabolic acidosis.

Safety of fentanyl initiation according to past opioid exposure among patients newly prescribed fentanyl patches

PubMed Central

Friesen, Kevin J.; Woelk, Cornelius; Bugden, Shawn

2016-01-01

Background: Although a convenient opioid delivery system, transdermal fentanyl patches have caused several deaths and resulted in safety warnings reminding prescribers that fentanyl patches should be prescribed only for patients who have adequate prior exposure to opioids. We conducted a longitudinal analysis of the safety of fentanyl initiation by examining past opioid exposure among patients newly prescribed fentanyl patches. Methods: We identified all patients in the province of Manitoba who were newly prescribed fentanyl patches between Apr. 1, 2001, and Mar. 31, 2013. We converted all prior opioid use to oral morphine equivalents and determined the average daily dose in the 7–30 days before initial fentanyl patch use. Fentanyl initiation was considered unsafe if the patient’s pre-fentanyl opioid exposure was below the recommended level. Results: We identified 11 063 patients who began using fentanyl patches during the study period. Overall, fentanyl initiation was deemed unsafe in 74.1% of cases because the patient’s prior opioid exposure was inadequate. Women and patients 65 years of age and older were more likely than men and younger patients, respectively, to have inadequate prior opioid exposure (p < 0.001 for each comparison). The proportion of patients who had unsafe prescriptions for fentanyl patches decreased significantly over the study period, from 87.0% in 2001 to 50.0% in 2012 (p < 0.001). Interpretation: The safety of fentanyl initiation improved over the study period, but still half of fentanyl patch prescriptions were written for patients with inadequate prior opioid exposure. Review of prior opioid exposure may be a simple but important way to improve the safe use of fentanyl patches. PMID:27044480

Genital HSV Shedding among Kenyan Women Initiating Antiretroviral Therapy

PubMed Central

Manguro, Griffins O.; Masese, Linnet N.; Deya, Ruth W.; Magaret, Amalia; Wald, Anna; McClelland, R. Scott; Graham, Susan M.

2016-01-01

Objectives Genital ulcer disease (GUD) prevalence increases in the first month of antiretroviral treatment (ART), followed by a return to baseline prevalence by month 3. Since most GUD is caused by herpes simplex virus type 2 (HSV-2), we hypothesized that genital HSV detection would follow a similar pattern after treatment initiation. Methods We conducted a prospective cohort study of 122 HSV-2 and HIV-1 co-infected women with advanced HIV disease who initiated ART and were followed closely with collection of genital swab specimens for the first three months of treatment. Results At baseline, the HSV detection rate was 32%, without significant increase in genital HSV detection noted during the first month or the third month of ART. HIV-1 shedding declined during this period; no association was also noted between HSV and HIV-1 shedding during this period. Conclusion Because other studies have reported increased HSV detection in women initiating ART and we have previously reported an increase in GUD during early ART, it may be prudent to counsel HIV-1 infected women initiating ART that HSV shedding in the genital tract may continue after ART initiation. PMID:27683204

How a Historically Black College University (HBCU) Established a Sustainable Online Learning Program in Partnership with Quality Matters™

ERIC Educational Resources Information Center

Harkness, S. Suzan J.

2015-01-01

This case study describes an initiative approach to establishing online learning at a medium-size historically black college university. The study reveals the collaborative efforts between university administration and faculty, Quality Matters™, and Blackboard. The strategic initiative spanned a period of five academic years (2010-2014) during…

Structure resonances due to space charge in periodic focusing channels

NASA Astrophysics Data System (ADS)

Li, Chao; Jameson, R. A.

2018-02-01

The Vlasov-Poisson model is one of the most effective methods to study the space charge dominated beam evolution self-consistently in a periodic focusing channel. Since the approach to get the solution with this model is not trivial, previous studies are limited in degenerated conditions, either in smoothed channel (constant focusing) [I. Hofmann, Phys. Rev. E 57, 4713 (1998)] or in alternating gradient focusing channel with equal initial beam emittance condition in the degrees of freedom [I. Hofmann et al., Part. Accel. 13, 145 (1983); Chao Li et al., THOBA02, IPAC2016]. To establish a basis, we intentionally limit this article to the study of the pure transverse periodic focusing lattice with arbitrary initial beam condition, and the same lattice structure in both degrees of freedom, but with possibility of different focusing strengths. This will show the extension of the existing work. The full Hamiltonian is invoked for a pure transverse focusing lattice in various initial beam conditions, revealing different mode structure and additional modes beyond those of the degenerated cases. Application of the extended method to realistic lattices (including longitudinal accelerating elements) and further details will then reveal many new insights, and will be presented in later work.

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.

Cadmium removal by Lemna minor and Spirodela polyrhiza.

PubMed

Chaudhuri, Devaleena; Majumder, Arunabha; Misra, Amal K; Bandyopadhyay, Kaushik

2014-01-01

The present study investigates the ability of two genus of duckweed (Lemna minor and Spirodela polyrhiza) to phytoremediate cadmium from aqueous solution. Duckweed was exposed to six different cadmium concentrations, such as, 0.5,1.0,1.5, 2.0, 2.5, and 3.0 mg/L and the experiment was continued for 22 days. Water samples were collected periodically for estimation of residual cadmium content in aqueous solution. At the end of treatment period plant samples were collected and accumulated cadmium content was measured. Cadmium toxicity was observed through relative growth factor and changes in chlorophyll content Experimental results showed that Lemna minor and Spirodela polyrhiza were capable of removing 42-78% and 52-75% cadmium from media depending upon initial cadmium concentrations. Cadmium was removed following pseudo second order kinetic model Maximum cadmium accumulation in Lemna minor was 4734.56 mg/kg at 2 mg/L initial cadmium concentration and 7711.00 mg/kg in Spirodela polyrhiza at 3 mg/L initial cadmium concentration at the end of treatment period. Conversely in both cases maximum bioconcentration factor obtained at lowest initial cadmium concentrations, i.e., 0.5 mg/L, were 3295.61 and 4752.00 for Lemna minor and Spirodela polyrhiza respectively. The present study revealed that both Lemna minor and Spirodela polyrhiza was potential cadmium accumulator.

Short-term Risk of Serious Fall Injuries in Older Adults Initiating and Intensifying Treatment with Antihypertensive Medication

PubMed Central

Shimbo, Daichi; Bowling, C. Barrett; Levitan, Emily B.; Deng, Luqin; Sim, John J.; Huang, Lei; Reynolds, Kristi; Muntner, Paul

2016-01-01

Background Antihypertensive medication use has been associated with an increased risk of falls in some but not all studies. Few data are available on the short-term risk of falls following antihypertensive medication initiation and intensification. Methods and Results We examined the association between initiating and intensifying antihypertensive medication and serious fall injuries in a case-crossover study of 90,127 Medicare beneficiaries who were ≥65 years old and had a serious fall injury between July 1, 2007 and December 31, 2012, based on emergency department and inpatient claims. Antihypertensive medication initiation was defined by a prescription fill with no fills in the prior year. Intensification was defined by the addition of a new antihypertensive class, and, separately, titration by the addition of a new class or increase in dosage of a current class. Exposures were ascertained for the 15 days before the fall (case period) and six 15-day earlier periods (control periods). Overall, 272, 1508, and 3113 Medicare beneficiaries initiated, added a new class of antihypertensive medication or titrated therapy, respectively, within 15 days of their serious fall injury. The odds for a serious fall injury was increased during the 15 days following antihypertensive medication initiation [odds ratio, OR, 1.36 (95% CI 1.19, 1.55)], adding a new class [OR 1.16 (95% CI 1.10, 1.23)], and titration [OR 1.13 (95% CI 1.08, 1.18)]. These associations were attenuated beyond 15 days. Conclusions Antihypertensive medication initiation and intensification was associated with a short-term, but not long-term, increased risk of serious fall injuries among older adults. PMID:27166208

Short-Term Risk of Serious Fall Injuries in Older Adults Initiating and Intensifying Treatment With Antihypertensive Medication.

PubMed

Shimbo, Daichi; Barrett Bowling, C; Levitan, Emily B; Deng, Luqin; Sim, John J; Huang, Lei; Reynolds, Kristi; Muntner, Paul

2016-05-01

Antihypertensive medication use has been associated with an increased risk of falls in some but not all studies. Few data are available on the short-term risk of falls after antihypertensive medication initiation and intensification. We examined the association between initiating and intensifying antihypertensive medication and serious fall injuries in a case-crossover study of 90 127 Medicare beneficiaries who were ≥65 years old and had a serious fall injury between July 1, 2007, and December 31, 2012, based on emergency department and inpatient claims. Antihypertensive medication initiation was defined by a prescription fill with no fills in the previous year. Intensification was defined by the addition of a new antihypertensive class, and separately, titration by the addition of a new class or increase in dosage of a current class. Exposures were ascertained for the 15 days before the fall (case period) and six 15-day earlier periods (control periods). Overall, 272, 1508, and 3113 Medicare beneficiaries initiated, added a new class of antihypertensive medication or titrated therapy within 15 days of their serious fall injury. The odds for a serious fall injury was increased during the 15 days after antihypertensive medication initiation (odds ratio, 1.36 [95% confidence interval, 1.19-1.55]), adding a new class (odds ratio, 1.16 [95% confidence interval, 1.10-1.23]), and titration [odds ratio, 1.13 [95% confidence interval, 1.08-1.18]). These associations were attenuated beyond 15 days. Antihypertensive medication initiation and intensification was associated with a short-term, but not long-term, increased risk of serious fall injuries among older adults. © 2016 American Heart Association, Inc.

An Early View of Real-World Patient Response to Sacubitril/Valsartan: A Retrospective Study of Patients with Heart Failure with Reduced Ejection Fraction.

PubMed

Antol, Dana Drzayich; Casebeer, Adrianne Waldman; DeClue, Richard W; Stemkowski, Stephen; Russo, Patricia A

2018-06-01

Sacubitril/valsartan has been established as an effective treatment for heart failure (HF) with reduced ejection fraction based on clinical trial data; however, little is known about its use or impact in real-world practice. This study included data from medical and pharmacy claims and medical records review for patients (n = 200) who initiated sacubitril/valsartan between August 2015 and March 2016 preceding issuance of American College of Cardiology (ACC)/American Heart Association (AHA)/Heart Failure Society of America (HFSA) focused update on new pharmacological therapy for HF (May 2016), which included recommendations for sacubitril/valsartan. A within-subject analysis compared symptoms and healthcare resource utilization before and after treatment initiation. Patients treated with sacubitril/valsartan had multiple comorbidities, and nearly all had previous treatment for HF. Most patients initiated sacubitril/valsartan at the lowest dose of 24/26 mg twice a day (BID), which remained unchanged during the observation period for half of the patients. During the first 6 weeks of treatment, few patients discontinued sacubitril/valsartan treatment (5.5%), and only 17% achieved the target dose of 97/103 mg BID after 4 months of treatment. The proportion of patients with ≥ 1 all-cause inpatient stay decreased significantly between the pre-initiation period (27.5%) and the post-initiation period (17.0%), P = 0.009. Fatigue was noted in 51.8% of patients pre-initiation and 39.5% post-initiation, P = 0.027. Shortness of breath was documented for 66.7% of patients pre-initiation and 51.8% post-initiation, P = 0.008. The findings of this real-world investigation suggest sacubitril/valsartan is associated with symptom improvements and a reduction in hospitalizations within 4 months of treatment for patients with HF and reduced ejection fraction. Novartis Pharmaceuticals Corporation.

Entrainment to periodic initiation and transition rates in a computational model for gene translation.

PubMed

Margaliot, Michael; Sontag, Eduardo D; Tuller, Tamir

2014-01-01

Periodic oscillations play an important role in many biomedical systems. Proper functioning of biological systems that respond to periodic signals requires the ability to synchronize with the periodic excitation. For example, the sleep/wake cycle is a manifestation of an internal timing system that synchronizes to the solar day. In the terminology of systems theory, the biological system must entrain or phase-lock to the periodic excitation. Entrainment is also important in synthetic biology. For example, connecting several artificial biological systems that entrain to a common clock may lead to a well-functioning modular system. The cell-cycle is a periodic program that regulates DNA synthesis and cell division. Recent biological studies suggest that cell-cycle related genes entrain to this periodic program at the gene translation level, leading to periodically-varying protein levels of these genes. The ribosome flow model (RFM) is a deterministic model obtained via a mean-field approximation of a stochastic model from statistical physics that has been used to model numerous processes including ribosome flow along the mRNA. Here we analyze the RFM under the assumption that the initiation and/or transition rates vary periodically with a common period T. We show that the ribosome distribution profile in the RFM entrains to this periodic excitation. In particular, the protein synthesis pattern converges to a unique periodic solution with period T. To the best of our knowledge, this is the first proof of entrainment in a mathematical model for translation that encapsulates aspects such as initiation and termination rates, ribosomal movement and interactions, and non-homogeneous elongation speeds along the mRNA. Our results support the conjecture that periodic oscillations in tRNA levels and other factors related to the translation process can induce periodic oscillations in protein levels, and may suggest a new approach for re-engineering genetic systems to obtain a desired, periodic, protein synthesis rate.

A combination SMS and transportation reimbursement intervention to improve HIV care following abnormal CD4 test results in rural Uganda: a prospective observational cohort study.

PubMed

Siedner, Mark J; Santorino, Data; Lankowski, Alexander J; Kanyesigye, Michael; Bwana, Mwebesa B; Haberer, Jessica E; Bangsberg, David R

2015-07-06

Up to 50 % of HIV-infected persons in sub-Saharan Africa are lost from care between HIV diagnosis and antiretroviral therapy (ART) initiation. Structural barriers, including cost of transportation to clinic and poor communication systems, are major contributors. We conducted a prospective, pragmatic, before-and-after clinical trial to evaluate a combination mobile health and transportation reimbursement intervention to improve care at a publicly operated HIV clinic in Uganda. Patients undergoing CD4 count testing were enrolled, and clinicians selected a result threshold that would prompt early return for ART initiation or further care. Participants enrolled in the pre-intervention period (January - August 2012) served as a control group. Participants in the intervention period (September 2012 - November 2013) were randomized to receive daily short message service (SMS) messages for up to seven days in one of three formats: 1) messages reporting an abnormal result directly, 2) personal identification number-protected messages reporting an abnormal result, or 3) messages reading "ABCDEFG" to confidentially convey an abnormal result. Participants returning within seven days of their first message received transportation reimbursements (about $6USD). Our primary outcomes of interest were time to return to clinic and time to ART initiation. There were 45 participants in the pre-intervention period and 138 participants in the intervention period (46, 49, and 43 in the direct, PIN, and coded groups, respectively) with low CD4 count results. Median time to clinic return was 33 days (IQR 11-49) in the pre-intervention period and 6 days (IQR 3-16) in the intervention period (P < 0.001); and median time to ART initiation was 47 days (IQR 11-75) versus 12 days (IQR 5-19), (P < 0.001). In multivariable models, participants in the intervention period had earlier return to clinic (AHR 2.32, 95 %CI 1.53 to 3.51) and earlier time to ART initiation (AHR 2.27, 95 %CI 1.38 to 3.72). All three randomized message formats improved time to return to clinic and time to ART initiation (P < 0.01 for all comparisons versus the pre-intervention period). A combination of an SMS laboratory result communication system and transportation reimbursements significantly decreased time to clinic return and time to ART initiation after abnormal CD4 test results. Clinicaltrials.gov NCT01579214 , approved 13 April 2012.

Movement initiation-locked activity of the anterior putamen predicts future movement instability in periodic bimanual movement.

PubMed

Aramaki, Yu; Haruno, Masahiko; Osu, Rieko; Sadato, Norihiro

2011-07-06

In periodic bimanual movements, anti-phase-coordinated patterns often change into in-phase patterns suddenly and involuntarily. Because behavior in the initial period of a sequence of cycles often does not show any obvious errors, it is difficult to predict subsequent movement errors in the later period of the cyclical sequence. Here, we evaluated performance in the later period of the cyclical sequence of bimanual periodic movements using human brain activity measured with functional magnetic resonance imaging as well as using initial movement features. Eighteen subjects performed a 30 s bimanual finger-tapping task. We calculated differences in initiation-locked transient brain activity between antiphase and in-phase tapping conditions. Correlation analysis revealed that the difference in the anterior putamen activity during antiphase compared within-phase tapping conditions was strongly correlated with future instability as measured by the mean absolute deviation of the left-hand intertap interval during antiphase movements relative to in-phase movements (r = 0.81). Among the initial movement features we measured, only the number of taps to establish the antiphase movement pattern exhibited a significant correlation. However, the correlation efficient of 0.60 was not high enough to predict the characteristics of subsequent movement. There was no significant correlation between putamen activity and initial movement features. It is likely that initiating unskilled difficult movements requires increased anterior putamen activity, and this activity increase may facilitate the initiation of movement via the basal ganglia-thalamocortical circuit. Our results suggest that initiation-locked transient activity of the anterior putamen can be used to predict future motor performance.

Exploring the initial steps of the testing process: frequency and nature of pre-preanalytic errors.

PubMed

Carraro, Paolo; Zago, Tatiana; Plebani, Mario

2012-03-01

Few data are available on the nature of errors in the so-called pre-preanalytic phase, the initial steps of the testing process. We therefore sought to evaluate pre-preanalytic errors using a study design that enabled us to observe the initial procedures performed in the ward, from the physician's test request to the delivery of specimens in the clinical laboratory. After a 1-week direct observational phase designed to identify the operating procedures followed in 3 clinical wards, we recorded all nonconformities and errors occurring over a 6-month period. Overall, the study considered 8547 test requests, for which 15 917 blood sample tubes were collected and 52 982 tests undertaken. No significant differences in error rates were found between the observational phase and the overall study period, but underfilling of coagulation tubes was found to occur more frequently in the direct observational phase (P = 0.043). In the overall study period, the frequency of errors was found to be particularly high regarding order transmission [29 916 parts per million (ppm)] and hemolysed samples (2537 ppm). The frequency of patient misidentification was 352 ppm, and the most frequent nonconformities were test requests recorded in the diary without the patient's name and failure to check the patient's identity at the time of blood draw. The data collected in our study confirm the relative frequency of pre-preanalytic errors and underline the need to consensually prepare and adopt effective standard operating procedures in the initial steps of laboratory testing and to monitor compliance with these procedures over time.

Impact of dialysis practice patterns on outcomes in acute kidney injury in Intensive Care Unit

PubMed Central

Annigeri, Rajeev A.; Nandeesh, Venkatappa; Karuniya, Ramanathan; Rajalakshmi, Sasikumar; Venkataraman, Ramesh; Ramakrishnan, Nagarajan

2016-01-01

Aim: Recent advances in dialysis therapy have made an impact on the clinical practice of renal replacement therapy (RRT) in acute kidney injury (AKI) in Intensive Care Unit (ICU). We studied the impact of RRT practice changes on outcomes in AKI in ICU over a period of 8 years. Subjects and Methods: AKI patients requiring RRT in ICU referred to a nephrologist during two different periods (period-1: Between May 2004 and May 2007, n = 69; period-2: Between August 2008 and May 2011, n = 93) were studied. The major changes in the dialysis practice during the period-2, compared to period-1 were introduction of prolonged intermittent RRT (PIRRT), early dialysis for metabolic acidosis, early initiation of RRT for anuria and positive fluid balance and use of bicarbonate-based fluids for continuous RRT (CRRT) instead of lactate buffer. The primary study outcome was 28-day hospital mortality. Results: The mean age was 53.8 ± 16.1 years and 72.6% were male. Introduction of PIRRT resulted in 37% reduction in utilization of CRRT during period-2 (from 85.5% to 53.7%). The overall mortality was high (68%) but was significantly reduced during period-2 compared to period-1 (59% vs. 79.7%, P = 0.006). Metabolic acidosis but not the mode of RRT, was the significant factor which influenced mortality. Conclusions: Adaption of PIRRT resulted in 37% reduction of utilization of CRRT. The mortality rate was significantly reduced during the period of adaption of PIRRT, possibly due to early initiation of RRT in the latter period for indications such as anuria and metabolic acidosis. PMID:26955212

Alcohol Behaviors and Deviant Behaviors among Adolescents in a Rural State.

ERIC Educational Resources Information Center

Nagy, Stephen; Dunn, Michael S.

1999-01-01

Study provides a descriptive profile of alcohol consumption patterns of adolescents in a southern state from four time periods over the past decade. Also examines the relationship between alcohol initiation and binge drinking behaviors and sexual initiation, pregnancy, multiple sex partners, and violence. Regression analyses showed very modest…

75 FR 76447 - Notice of Intent to Prepare a Draft Environmental Impact Statement (EIS), Initiate the Public...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-08

... Draft Environmental Impact Statement (EIS), Initiate the Public Scoping Period and Host Public Scoping Meetings for the Great Lakes and Mississippi River Interbasin Study (``GLMRIS''); Correction, Clarification... international commerce, travel and local practices, ANS have been introduced throughout the Mississippi River...

Sleep Quantity and Quality of Ontario Wildland Firefighters Across a Low-Hazard Fire Season

PubMed Central

McGillis, Zachary; Dorman, Sandra C.; Robertson, Ayden; Larivière, Michel; Leduc, Caleb; Eger, Tammy; Oddson, Bruce E.; Larivière, Céline

2017-01-01

Objective: The aim of the study was to assess the sleep quality, quantity, and fatigue levels of Canadian wildland firefighters while on deployment. Methods: Objective and subjective sleep and fatigue measures were collected using actigraphy and questionnaires during non-fire (Base) and fire (Initial Attack and Project) deployments. Results: Suboptimal sleep quality and quantity were more frequently observed during high-intensity, Initial Attack fire deployments. Suboptimal sleep was also exhibited during non-fire (Base) work periods, which increases the risk of prefire deployment sleep debt. Self-reported, morning fatigue scores were low-to-moderate and highest for Initial Attack fire deployments. Conclusions: The study highlights the incidence of suboptimal sleep patterns in wildland firefighters during non-fire and fire suppression work periods. These results have implications for the health and safety practices of firefighters given the link between sleep and fatigue, in a characteristically hazardous occupation. PMID:29216017

Physicochemical characteristics and microbial community evolution of biofilms during the start-up period in a moving bed biofilm reactor.

PubMed

Zhu, Yan; Zhang, Yan; Ren, Hong-Qiang; Geng, Jin-Ju; Xu, Ke; Huang, Hui; Ding, Li-Li

2015-03-01

This study aimed to investigate biofilm properties evolution coupled with different ages during the start-up period in a moving bed biofilm reactor system. Physicochemical characteristics including adhesion force, extracellular polymeric substances (EPS), morphology as well as volatile solid and microbial community were studied. Results showed that the formation and development of biofilms exhibited four stages, including (I) initial attachment and young biofilm formation, (II) biofilms accumulation, (III) biofilm sloughing and updating, and (IV) biofilm maturation. During the whole start-up period, adhesion force was positively and significantly correlated with the contents of EPS, especially the content of polysaccharide. In addition, increased adhesion force and EPS were beneficial for biofilm retention. Gram-negative bacteria mainly including Sphaerotilus, Zoogloea and Haliscomenobacter were predominant in the initial stage. Actinobacteria was beneficial to resist sloughing. Furthermore, filamentous bacteria were dominant in maturation biofilm. Copyright © 2015 Elsevier Ltd. All rights reserved.

Microscopic and macroscopic instabilities in finitely strained porous elastomers

NASA Astrophysics Data System (ADS)

Michel, J. C.; Lopez-Pamies, O.; Ponte Castañeda, P.; Triantafyllidis, N.

2007-05-01

The present work is an in-depth study of the connections between microstructural instabilities and their macroscopic manifestations—as captured through the effective properties—in finitely strained porous elastomers. The powerful second-order homogenization (SOH) technique initially developed for random media, is used for the first time here to study the onset of failure in periodic porous elastomers and the results are compared to more accurate finite element method (FEM) calculations. The influence of different microgeometries (random and periodic), initial porosity, matrix constitutive law and macroscopic load orientation on the microscopic buckling (for periodic microgeometries) and macroscopic loss of ellipticity (for all microgeometries) is investigated in detail. In addition to the above-described stability-based onset-of-failure mechanisms, constraints on the principal solution are also addressed, thus giving a complete picture of the different possible failure mechanisms present in finitely strained porous elastomers.

Shock initiation of nitromethane

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

Yoo, C.S.; Holmes, N.C.

1994-07-10

The shock initiation processes of nitromethane have been examined by using a fast time-resolved emission spectroscopy at a two-stage gas gun. A broad, but strong emission has been observed in a spectral range between 350 nm and 700 nm from the shocked nitromethane above 9 GPa. The temporal profile suggests that the shocked nitromethane detonates through three characteristic periods, namely an induction period, a shock initiation period, and a thermal explosion period. In this paper we will discuss the temporal and chemical characteristics of these periods and present the temperature of the shock-detonating nitromethane at pressures between 9 and 15more » GPa. [copyright]American Institute of Physics« less

Tuning the Ignition Performance of a Microchip Initiator by Integrating Various Al/MoO3 Reactive Multilayer Films on a Semiconductor Bridge.

PubMed

Xu, Jianbing; Tai, Yu; Ru, Chengbo; Dai, Ji; Ye, Yinghua; Shen, Ruiqi; Zhu, Peng

2017-02-15

Reactive multilayer films (RMFs) can be integrated into semiconducting electronic structures with the use of microelectromechanical systems (MEMS) technology and represent potential applications in the advancement of microscale energy-demanding systems. In this study, aluminum/molybdenum trioxide (Al/MoO 3 )-based RMFs with different modulation periods were integrated on a semiconductor bridge (SCB) using a combination of an image reversal lift-off process and magnetron sputtering technology. This produced an energetic semiconductor bridge (ESCB)-chip initiator with controlled ignition performance. The effects of the Al/MoO 3 RMFs with different modulation periods on ignition properties of the ESCB initiator were then systematically investigated in terms of flame duration, maximum flame area, and the reaction ratio of the RMFs. These microchip initiators achieved flame durations of 60-600 μs, maximum flame areas of 2.85-17.61 mm 2 , and reaction ratios of ∼14-100% (discharged with 47 μF/30 V) by simply changing the modulation periods of the Al/MoO 3 RMFs. This behavior was also consistent with a one-dimensional diffusion reaction model. The microchip initiator exhibited a high level of integration and proved to have tuned ignition performance, which can potentially be used in civilian and military applications.

Period Ratio Distribution of Near-Resonant Planets Indicates Planetesimal Scattering

NASA Astrophysics Data System (ADS)

Chatterjee, Sourav; Krantzler, Seth O.; Ford, Eric B.

2016-10-01

An intriguing trend among it Kepler's multi-planet systems is an overabundance of planet pairs with period ratios just wide of mean motion resonances (MMR) and a dearth of systems just narrow of them. In a recently published paper Chatterjee & Ford (2015; henceforth CF15) has proposed that gas-disk migration traps planets in a MMR. After gas dispersal, orbits of these trapped planets are altered through interaction with a residual planetesimal disk. They found that for massive enough disks planet-planetesimal disk interactions can break resonances and naturally create moderate to large positive offsets from the initial period ratio for large ranges of planetesimal disk and planet properties. Divergence from resonance only happens if the mass of planetesimals that interact with the planets is at least a few percent of the total planet mass. This threshold, above which resonances are broken and the offset from resonances can grow, naturally explains why the asymmetric large offsets were not seen in more massive planet pairs found via past radial velocity surveys. In this article we will highlight some of the key findings of CF15. In addition, we report preliminary results from an extension of this study, that investigates the effects of planet-planetesimal disk interactions on initially non-resonant planet pairs. We find that planetesimal scattering typically increases period ratios of non-resonant planets. If the initial period ratios are below and in proximity of a resonance, under certain conditions, this increment in period ratios can create a deficit of systems with period ratios just below the exact integer corresponding to the MMR and an excess just above. From an initially uniform distribution of period ratios just below a 2:1 MMR, planetesimal interactions can create an asymmetric distribution across this MMR similar to what is observed for the kepler planet pairs.

Size-guided multi-seed heuristic method for geometry optimization of clusters: Application to benzene clusters.

PubMed

Takeuchi, Hiroshi

2018-05-08

Since searching for the global minimum on the potential energy surface of a cluster is very difficult, many geometry optimization methods have been proposed, in which initial geometries are randomly generated and subsequently improved with different algorithms. In this study, a size-guided multi-seed heuristic method is developed and applied to benzene clusters. It produces initial configurations of the cluster with n molecules from the lowest-energy configurations of the cluster with n - 1 molecules (seeds). The initial geometries are further optimized with the geometrical perturbations previously used for molecular clusters. These steps are repeated until the size n satisfies a predefined one. The method locates putative global minima of benzene clusters with up to 65 molecules. The performance of the method is discussed using the computational cost, rates to locate the global minima, and energies of initial geometries. © 2018 Wiley Periodicals, Inc. © 2018 Wiley Periodicals, Inc.

A statistical study of decaying kink oscillations detected using SDO/AIA

NASA Astrophysics Data System (ADS)

Goddard, C. R.; Nisticò, G.; Nakariakov, V. M.; Zimovets, I. V.

2016-01-01

Context. Despite intensive studies of kink oscillations of coronal loops in the last decade, a large-scale statistically significant investigation of the oscillation parameters has not been made using data from the Solar Dynamics Observatory (SDO). Aims: We carry out a statistical study of kink oscillations using extreme ultraviolet imaging data from a previously compiled catalogue. Methods: We analysed 58 kink oscillation events observed by the Atmospheric Imaging Assembly (AIA) on board SDO during its first four years of operation (2010-2014). Parameters of the oscillations, including the initial apparent amplitude, period, length of the oscillating loop, and damping are studied for 120 individual loop oscillations. Results: Analysis of the initial loop displacement and oscillation amplitude leads to the conclusion that the initial loop displacement prescribes the initial amplitude of oscillation in general. The period is found to scale with the loop length, and a linear fit of the data cloud gives a kink speed of Ck = (1330 ± 50) km s-1. The main body of the data corresponds to kink speeds in the range Ck = (800-3300) km s-1. Measurements of 52 exponential damping times were made, and it was noted that at least 21 of the damping profiles may be better approximated by a combination of non-exponential and exponential profiles rather than a purely exponential damping envelope. There are nine additional cases where the profile appears to be purely non-exponential and no damping time was measured. A scaling of the exponential damping time with the period is found, following the previously established linear scaling between these two parameters.

Thirteen Week Oral Toxicity Study of WR238605 with a Thirteen Week Recovery Period in Rats. Volume 3 of 3

DTIC Science & Technology

1993-06-18

Page 1 REVISED PAGE A u STUDY Mfr CBM, INITIAL (77 DATE-y-Hl^. 5.0 7.0 Contract No.: DAMD17-92-C-2C01 Task Order No.: UIC-5B Study No.: 098 ® i...Report. The results will not be Page 6 REVISED PAGE /?. STUDY Mfr 2M INITIAL: (jLL i OATF- \\yjuftl.’ I I 1’ II II II II II II II...necessary) recovery animals. . Page 7 REVISED PAGE A,. INITIALIZE cninvwyO^g DATE: ><-/*’ fr ?. i u JU ft Contract No. Task Order No. Study No

Space transfer concepts and analysis for exploration missions

NASA Technical Reports Server (NTRS)

1991-01-01

A broad scoped and systematic study was made of space transfer concepts for human Lunar and Mars missions. Relevant space transportation studies were initiated to lead to further detailed activities in the following study period.

Nonspecific abdominal pain is a safe diagnosis.

PubMed

Pennel, David John Laurie; Goergen, Nina; Driver, Chris P

2014-11-01

The aim of this study is to assess if a clinical diagnosis of nonspecific abdominal pain (NSAP) is safe and if patients with this initial diagnosis are likely to require further investigation or surgical intervention. 3323 patients admitted with NSAP from July 1990 to September 2012 utilizing a prospective database of all surgical admissions were included. Readmission over the period of the study and specifically within 30 days of their initial presentation was identified together with any invasive investigation or surgical intervention. 319 children (9.6%) were subsequently readmitted with abdominal pain at some point during the study period. Of these, 78 (2.3%) were readmitted within 30 days. 118 (3.5%) children subsequently had an operation or invasive investigation some point following their initial admission. Of these 33 (0.6%) had the procedure within 3 months of the initial admission. 13 patients had an appendicectomy within 3 months of the initial presentation. Of these histology confirmed appendicitis in 8 patients. This gives an overall incidence of "missed" appendicitis of 0.2 % (8/3323). This study confirms that a clinical diagnosis of nonspecific abdominal pain (NSAP) is safe in a pediatric population and the risk of "missing" appendicitis is only 0.2%. Patients and/or parents can be confidently reassured that the risk of missing organic pathology is very low. Copyright © 2014 Elsevier Inc. All rights reserved.

The solution of Cauchy's problem for the Toda lattice with limit periodic initial data

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

Khanmamedov, A Kh

Cauchy's problem for Toda lattices with initial data equal to the sum of a periodic and a rapidly decreasing sequence is solved with the use of the inverse scattering method. A method allowing one to find a limit periodic solution of the Toda lattice from a known periodic solution is described. The existence and uniqueness of a limit periodic solution is proved. Bibliography: 17 titles.

The Effect of Age in the Alteration in Fluid Balance of Rats in Response to Centrifugation

NASA Technical Reports Server (NTRS)

Fuller, Charles A.

2000-01-01

With an increase in gravity load induced by centrifugation or upon return to Earth following spaceflight, there is a period of adjustment in fluid balance in rats. With centrifugation there is a reduced fluid intake with maintenance of the rate of urine excretion. Following spaceflight there is an increase in urine output and maintenance of fluid intake. The initial period of acclimation to hypergravity is associated with a net loss of fluids. In the present study in response to centrifugation at 2.0 G this period of acclimation is present in mature rats for a longer period of time, about 24 hours. Following this initial response a period of over compensation has previously been reported. In the present study this was not observed. The net effect of these alterations in water intake and output in response to centrifugation for 14 days was slight increase in the percent total body water, with effective compensation seen in both young and mature rats. Older rats have been shown to have a reduced relative thirst and compensatory renal function in response to hypohydration, hyperosmolality and pharmacological stimuli. Responsiveness to these stimuli are delayed and/or attenuated in older animals. Similar findings were noted in the present study in the initial response to centrifugation. The older animal had a delayed return of fluid intake to control levels. The delay of one day did not appear to effect long-term fluid homeostasis, as there was difference in the response of percent total body water at the end of 14 days of centrifugation with both age groups having a slight but significant increase. This increase has been attributed to the increase in lean body mass induced by centrifugation.

Prospective cohort studies of newly marketed medications: using covariate data to inform the design of large-scale studies.

PubMed

Franklin, Jessica M; Rassen, Jeremy A; Bartels, Dorothee B; Schneeweiss, Sebastian

2014-01-01

Nonrandomized safety and effectiveness studies are often initiated immediately after the approval of a new medication, but patients prescribed the new medication during this period may be substantially different from those receiving an existing comparator treatment. Restricting the study to comparable patients after data have been collected is inefficient in prospective studies with primary collection of outcomes. We discuss design and methods for evaluating covariate data to assess the comparability of treatment groups, identify patient subgroups that are not comparable, and decide when to transition to a large-scale comparative study. We demonstrate methods in an example study comparing Cox-2 inhibitors during their postmarketing period (1999-2005) with nonselective nonsteroidal anti-inflammatory drugs (NSAIDs). Graphical checks of propensity score distributions in each treatment group showed substantial problems with overlap in the initial cohorts. In the first half of 1999, >40% of patients were in the region of nonoverlap on the propensity score, and across the study period this fraction never dropped below 10% (the a priori decision threshold for transitioning to the large-scale study). After restricting to patients with no prior NSAID use, <1% of patients were in the region of nonoverlap, indicating that a large-scale study could be initiated in this subgroup and few patients would need to be trimmed from analysis. A sequential study design that uses pilot data to evaluate treatment selection can guide the efficient design of large-scale outcome studies with primary data collection by focusing on comparable patients.

Fractional conductance oscillations in quantum rings: wave packet picture of transport in a few-electron system.

PubMed

Chwiej, T; Szafran, B

2013-04-17

We study electron transfer across a two-terminal quantum ring using a time-dependent description of the scattering process. For the considered scattering event the quantum ring is initially charged with one or two electrons, with another electron incident to the ring from the input channel. We study the electron transfer probability (T) as a function of the external magnetic field. We determine the periodicity of T for a varied number of electrons confined within the ring. For that purpose we develop a method to describe the wave packet dynamics for a few electrons participating in the scattering process, taking into full account the electron-electron correlations. We find that electron transfer across the quantum ring initially charged by a single electron acquires a distinct periodicity of half of the magnetic flux quantum (Φ0/2), corresponding to the formation of a transient two-electron state inside the ring. In the case of a three-electron scattering problem with two electrons initially occupying the ring, a period of Φ0/3 for T is formed in the limit of thin channels. The effect of disorder present in the confinement potential of the ring is also discussed.

Screening for Homelessness in the Veterans Health Administration: Monitoring Housing Stability through Repeat Screening.

PubMed

Byrne, Thomas; Fargo, Jamison D; Montgomery, Ann Elizabeth; Roberts, Christopher B; Culhane, Dennis P; Kane, Vincent

2015-01-01

This study examined veterans' responses to the Veterans Health Administration's (VHA's) universal screen for homelessness and risk of homelessness during the first 12 months of implementation. We calculated the baseline annual frequency of homelessness and risk of homelessness among all veterans who completed an initial screen during the study period. We measured changes in housing status among veterans who initially screened positive and then completed a follow-up screen, assessed factors associated with such changes, and identified distinct risk profiles of veterans who completed a follow-up screen. More than 4 million veterans completed an initial screen; 1.8% (n=77,621) screened positive for homelessness or risk of homelessness. Of those who initially screened positive for either homelessness or risk of homelessness and who completed a second screen during the study period, 85.0% (n=15,060) resolved their housing instability prior to their second screen. Age, sex, race, VHA eligibility, and screening location were all associated with changes in housing stability. We identified four distinct risk profiles for veterans with ongoing housing instability. To address homelessness among veterans, efforts should include increased and targeted engagement of veterans experiencing persistent housing instability.

Follow-Up Study of Reading Achievement in Learning Disabled Children.

ERIC Educational Resources Information Center

Gottesman, Ruth L.

Forty-three learning disabled children referred initially between ages 7 and 14 years to a medical outpatient clinic for developmentally disabled children were evaluated and followed for a period of 5 to 7 years after which their level of academic achievement was reassessed. Initial evaluation included pediatric, neurological and developmental…

Desert tortoise (Gopherus agassizii) survival at two eastern Mojave Desert sites: Death by short-term drought?

USGS Publications Warehouse

Longshore, Kathleen M.; Jaeger, Jef R.; Sappington, J. Mark

2003-01-01

Survival of adult Desert Tortoises (Gopherus agassizii) appears related to site-specific variation in precipitation and productivity of annual plants. We studied adult tortoise survival rates at two closely situated, but physiographically different, sites in the eastern Mojave Desert over a nine-year period (spring 1992 to spring 2001). Survival rates were initially derived from population surveys conducted over a three-year period and by radio-telemetry monitoring over a seven-year period beginning in 1994. After a period of initial stability, survival rates on the two sites diverged over the study period, and seven-year survival rates estimated from radio-telemetry monitoring were 0.900 and 0.269, respectively. A die-off in 1996 on the latter site appears to have been triggered by a period of drought, which began in the summer of 1995, coupled with a failure of annual vegetation production in 1996. Depressed survival rates on this site were associated with drought conditions during three of four years. Although the decline had the appearance of an epizootic, there were no clinical signs of disease. Relatively short-term drought, combined with little or no annual biomass, appears to have caused severe reductions in tortoise survival. If periods of drought-induced low survival are common over relatively small areas, then source-sink population dynamics may be an important factor determining tortoise population densities.

42 CFR 435.1205 - Alignment with exchange initial open enrollment period.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Alignment with exchange initial open enrollment... exchange initial open enrollment period. (a) Definitions. For purposes of this section— Eligibility based... 435.119, 435.218 and 435.603. (b) Medicaid agency responsibilities to achieve coordinated open...

Periodicity computation of generalized mathematical biology problems involving delay differential equations.

PubMed

Jasim Mohammed, M; Ibrahim, Rabha W; Ahmad, M Z

2017-03-01

In this paper, we consider a low initial population model. Our aim is to study the periodicity computation of this model by using neutral differential equations, which are recognized in various studies including biology. We generalize the neutral Rayleigh equation for the third-order by exploiting the model of fractional calculus, in particular the Riemann-Liouville differential operator. We establish the existence and uniqueness of a periodic computational outcome. The technique depends on the continuation theorem of the coincidence degree theory. Besides, an example is presented to demonstrate the finding.

Resonance transition periodic orbits in the circular restricted three-body problem

NASA Astrophysics Data System (ADS)

Lei, Hanlun; Xu, Bo

2018-04-01

This work studies a special type of cislunar periodic orbits in the circular restricted three-body problem called resonance transition periodic orbits, which switch between different resonances and revolve about the secondary with multiple loops during one period. In the practical computation, families of multiple periodic orbits are identified first, and then the invariant manifolds emanating from the unstable multiple periodic orbits are taken to generate resonant homoclinic connections, which are used to determine the initial guesses for computing the desired periodic orbits by means of multiple-shooting scheme. The obtained periodic orbits have potential applications for the missions requiring long-term continuous observation of the secondary and tour missions in a multi-body environment.

Analysis of patients' narratives posted on social media websites on benfluorex's (Mediator® ) withdrawal in France.

PubMed

Abou Taam, M; Rossard, C; Cantaloube, L; Bouscaren, N; Roche, G; Pochard, L; Montastruc, F; Herxheimer, A; Montastruc, J L; Bagheri, H

2014-02-01

Websites and discussion lists on health issues are among the most popular resources on the Web. Use experience reported on social media websites may provide useful information on drugs and their adverse reactions (ADRs). Clear communication on the benefit/harm balance of drugs is important to inform proper use of drugs. Some data have shown that communication (advisories or warnings) is difficult. This study aimed to explore the Internet as a source of data on patients' perception of risk associated with benfluorex and the impact of wider media coverage. Three French websites were selected: Doctissimo, Atoute.org considered the best-known and visited website in France for health questions and Vivelesrondes (Long live the Tubbies) for overweight people. Three periods were chosen: (1) before November 2009 (i.e. before benfluorex withdrawal), (2) between November 2009 and November 2010 (when the risk of valvulopathy with benfluorex appeared in social media) and (3) after November 2010. Two hundred twenty initial postings were analysed. These lead to 660 secondary postings which were analysed separately. In period 1, 114 initial postings were analysed, mostly concerning efficacy of the drug (72%). In period 2, 42 initial postings were analysed involving mainly ADRs or warnings (73%). In period 3, 64 initial postings were analysed; most frequent expressing anger directed at the healthcare system (58%) and anxiety about cardiovascular ADRs (30%). Online consumer postings showed that there were drastic changes in consumers' perceptions following media coverage. This study suggests that analysis of website data can inform on drug ADRs. Social media are important for communicating information on drug ADRs and for assessing consumer behaviour and their risk perception. © 2013 John Wiley & Sons Ltd.

Effects of sales promotion on smoking among U.S. ninth graders.

PubMed

Redmond, W H

1999-03-01

The purpose of this study was to examine the association between tobacco marketing efforts and daily cigarette smoking by adolescents. This was a longitudinal study of uptake of smoking on a daily basis with smoking data from the Monitoring the Future project. Diffusion modeling was used to generate expected rates of daily smoking initiation, which were compared with actual rates. Study data were from a national survey, administered annually from 1978 through 1995. Between 4,416 and 6,099 high school seniors participated per year, for a total of 94,652. The main outcome measure was a deviation score based on expected rates from diffusion modeling vs actual rates of initiation of daily use of cigarettes by ninth graders. Annual data on cigarette marketing expenditures were reported by the Federal Trade Commission. The deviation scores of expected vs actual rates of smoking initiation for ninth graders were correlated with annual changes in marketing expenditures. The correlation between sales promotion expenditures and the deviation score in daily smoking initiation was large (r = 0. 769) and statistically significant (P = 0.009) in the 1983-1992 period. Correlations between sales promotion and smoking initiation were not statistically significant in 1978-1982. Correlations between advertising expenditures and smoking initiation were not significant in either period. In years of high promotional expenditures, the rate of daily smoking initiation among ninth graders was higher than expected from diffusion model predictions. Large promotional pushes by cigarette marketers in the 1980s and 1990s appear to be linked with increased levels of daily smoking initiation among ninth graders. Copyright 1999 American Health Foundation and Academic Press.

Energy in the Environment - Initiatives 2004-08

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

Paul Jehn

Under the Energy and Environment Initiative, the GWPC/GWPRF will expand the oil and gas electronic commerce initiatives used to enhance the Risk Based Data Management System (RBDMS) and the Cost Effective Regulatory Approach (CERA). The GWPC/GWPRF has identified the following priorities for work efforts during the time period that will act as the base from which selections for each work period will be proposed. Work tasks will be presented for each reporting period by the GWPC from areas selected from the general list of priorities.

Estrogen Plus Progestin Therapy and Breast Cancer in Recently Postmenopausal Women

PubMed Central

Prentice, Ross L.; Chlebowski, Rowan T.; Stefanick, Marcia L.; Manson, JoAnn E.; Pettinger, Mary; Hendrix, Susan L.; Hubbell, F. Allan; Kooperberg, Charles; Kuller, Lewis H.; Lane, Dorothy S.; McTiernan, Anne; O’Sullivan, Mary Jo; Rossouw, Jacques E.; Anderson, Garnet L.

2009-01-01

The Women’s Health Initiative trial found a modestly increased risk of invasive breast cancer with daily 0.625-mg conjugated equine estrogens plus 2.5-mg medroxyprogesterone acetate, with most evidence among women who had previously received postmenopausal hormone therapy. In comparison, observational studies mostly report a larger risk increase. To explain these patterns, the authors examined the effects of this regimen in relation to both prior hormone therapy and time from menopause to first use of postmenopausal hormone therapy (“gap time”) in the Women’s Health Initiative trial and in a corresponding subset of the Women’s Health Initiative observational study. Postmenopausal women with a uterus enrolled at 40 US clinical centers during 1993–1998. The authors found that hazard ratios agreed between the two cohorts at a specified gap time and time from hormone therapy initiation. Combined trial and observational study data support an adverse effect on breast cancer risk. Women who initiate use soon after menopause, and continue for many years, appear to be at particularly high risk. For example, for a woman who starts soon after menopause and adheres to this regimen, estimated hazard ratios are 1.64 (95% confidence interval: 1.00, 2.68) over a 5-year period of use and 2.19 (95% confidence interval: 1.56, 3.08) over a 10-year period of use. PMID:18372396

Student-Initiated Attention to Form in Wiki-Based Collaborative Writing

ERIC Educational Resources Information Center

Kessler, Greg

2009-01-01

This study reports on student initiated attention to form within the collaborative construction of a wiki among pre-service Non-Native Speaker (NNS) English teachers. Forty NNS pre-service teachers from a large Mexican university were observed over a period of a sixteen week semester in an online content-based course aimed at improving their…

Hydroxyurea effectiveness in children and adolescents with sickle cell anemia: A large retrospective, population-based cohort.

PubMed

Quarmyne, Maa-Ohui; Dong, Wei; Theodore, Rodney; Anand, Sonia; Barry, Vaughn; Adisa, Olufolake; Buchanan, Iris D; Bost, James; Brown, Robert C; Joiner, Clinton H; Lane, Peter A

2017-01-01

The clinical efficacy of hydroxyurea in patients with sickle cell anemia (SCA) has been well established. However, data about its clinical effectiveness in practice is limited. We evaluated the clinical effectiveness of hydroxyurea in a large pediatric population using a retrospective cohort, pre-post treatment study design to control for disease severity selection bias. The cohort included children with SCA (SS, Sβ 0 thalassemia) who received care at Children's Healthcare of Atlanta (CHOA) and who initiated hydroxyurea in 2009-2011. Children on chronic transfusions, or children with inadequate follow up data and/or children who had taken hydroxyurea in the 3 years prior were excluded. For each patient healthcare utilization, laboratory values, and clinical outcomes for the 2-year period prior to hydroxyurea initiation were compared to those 2 years after initiation. Of 211 children with SCA who initiated hydroxyurea in 2009-2011, 134 met eligibility criteria. After initiation of hydroxyurea, rates of hospitalizations, pain encounters, and emergency department visits were reduced by 47% (<0.0001), 36% (P = 0.0001) and 43% (P < 0.0001), respectively. Average hemoglobin levels increased by 0.7 g/dl (P < 0.0001). Hydroxyurea effectiveness was similar across gender, insurance types and age, although there was a slightly greater reduction in hospitalizations in younger children. Am. J. Hematol. 92:77-81, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

A Randomized Effectiveness Trial of a Systems-Level Approach to Stepped Care for War-Related PTSD

DTIC Science & Technology

2016-05-01

period rather than storing the hard copies at their respective posts was approved. Also, an amendment changing the study Initiating PI from COL...care is the de facto mental health system; in Collaborative Medicine Case Studies : Evidence in Prac- tice. Edited by Kessler R, Stafford D. New York...Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT During the 6.5 year study period, investigators developed the STEPS UP

The incidence and impact of recurrent workplace injury and disease: a cohort study of WorkSafe Victoria, Australia compensation claims

PubMed Central

Ruseckaite, Rasa; Collie, Alex

2013-01-01

Objective To determine the incidence and impact of recurrent workplace injury and disease over the period 1995–2008. Design Population-based cohort study using data from the state workers’ compensation system database. Setting State of Victoria, Australia. Participants A total of 448 868 workers with an accepted workers’ compensation claim between 1 January 1995 and 31 December 2008 were included into this study. Of them, 135 349 had at least one subsequent claim accepted for a recurrent injury or disease during this period. Main outcome measures Incidence of initial and recurrent injury and disease claims and time lost from work for initial and recurrent injury and disease. Results Over the study period, 448 868 workers lodged 972 281 claims for discrete occurrences of work-related injury or disease. 53.4% of these claims were for recurrent injury or disease. On average, the rates of initial claims dropped by 5.6%, 95% CI (−5.8% to −5.7%) per annum, while the rates of recurrent injuries decreased by 4.1%, 95% CI (−4.2% to −0.4%). In total, workplace injury and disease resulted in 188 978 years of loss in full-time work, with 104 556 of them being for the recurrent injury. Conclusions Recurrent work-related injury and disease is associated with a substantial social and economic impact. There is an opportunity to reduce the social, health and economic burden of workplace injury by enacting secondary prevention programmes targeted at workers who have incurred an initial occupational injury or disease. PMID:23457329

Smoking Initiation and the Iron Law of Demand *

PubMed Central

Lillard, Dean R.; Molloy, Eamon; Sfekas, Andrew

2012-01-01

We show, with three longitudinal datasets, that cigarette taxes and prices affect smoking initiation decisions. Previous longitudinal studies have found somewhat mixed results, but generally have not found initiation to be sensitive to increases in price or tax. We show that the lack of statistical significance in previous studies may be at least partially attributed to a lack of policy variation in the time periods studied, truncated behavioral windows, or mis-assignment of price and tax rates in retrospective data (which occurs when one has no information about respondents’ prior state or region of residence in retrospective data). We show how each factor may affect the estimation of initiation models. Our findings suggest several problems that are applicable to initiation behavior generally, particularly those for which individuals’ responses to policy changes may be noisy or small in magnitude. PMID:23220458

Subharmonic Solutions of Order One-Third

ERIC Educational Resources Information Center

Fay, Temple H.

2005-01-01

Finding a periodic solution to a nonlinear ordinary differential equation is in general a difficult task. Only in a very few cases can direct methods be applied to an equation to find initial values leading to a solution of the corresponding initial value problem that is periodic. Oscillatory periodic solutions have such practical importance that…

34 CFR 303.343 - IFSP Team meeting and periodic review.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 2 2012-07-01 2012-07-01 false IFSP Team meeting and periodic review. 303.343 Section... Service Plans Individualized Family Service Plan (ifsp) § 303.343 IFSP Team meeting and periodic review. (a) Initial and annual IFSP Team meeting. (1) Each initial meeting and each annual IFSP Team meeting...

34 CFR 303.343 - IFSP Team meeting and periodic review.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 2 2013-07-01 2013-07-01 false IFSP Team meeting and periodic review. 303.343 Section... Service Plans Individualized Family Service Plan (ifsp) § 303.343 IFSP Team meeting and periodic review. (a) Initial and annual IFSP Team meeting. (1) Each initial meeting and each annual IFSP Team meeting...

34 CFR 303.343 - IFSP Team meeting and periodic review.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 34 Education 2 2014-07-01 2013-07-01 true IFSP Team meeting and periodic review. 303.343 Section... Service Plans Individualized Family Service Plan (ifsp) § 303.343 IFSP Team meeting and periodic review. (a) Initial and annual IFSP Team meeting. (1) Each initial meeting and each annual IFSP Team meeting...

40 CFR 35.688 - Award limitations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... protection program or agrees to establish an approvable program within four years of the initial award. (b... within the four-year period after initial award. After the four-year period expires, the Regional...

Global behavior of a vibro-impact system with asymmetric clearances

NASA Astrophysics Data System (ADS)

Li, Guofang; Ding, Wangcai

2018-06-01

A simple dynamic model of a vibro-impact system subjected to harmonic excitation with two asymmetric clearances is considered. The Semi-Analytical Method for getting periodic solutions of the vibro-impact system is proposed. Diversity and evolution of the fundamental periodic impact motions are analyzed. The formation mechanism of the complete chatting-impact periodic motion with sticking motion by the influence of gazing bifurcation is analyzed. The transitional law of periodic motions in the periodical inclusions area is presented. The coexistence of periodic motions and the extreme sensitivity of the initial value within the high frequency region are studied. The global distribution of the periodic and chaos motions of the system is obtained by the state-parameter space co-simulation method which very few have considered before. The distribution of the attractor and the corresponding attracting domain corresponding to different periodic motions are also studied.

Treatment patterns in disease-modifying therapy for patients with multiple sclerosis in the United States.

PubMed

Bonafede, Machaon M; Johnson, Barbara H; Wenten, Madé; Watson, Crystal

2013-10-01

Patients with multiple sclerosis (MS) whose disease activity is inadequately controlled with a platform therapy (interferon beta or glatiramer acetate [GA]) may switch to another platform therapy or escalate therapy to natalizumab or fingolimod, which were approved in the US in 2006 and 2010, respectively. The objective of this study was to describe treatment patterns in patients with multiple sclerosis (MS) in the United States who were followed for 2 years after initiating a disease-modifying therapy (DMT). A retrospective observational cohort study was conducted to examine treatment patterns of initial DMT use (on initial therapy for 2 years with and without gaps of ≥ 60 days, medication switching, and discontinuation) among patients with MS who initiated a platform therapy (interferon-β or glatiramer acetate) or natalizumab between January 1, 2007, and September 30, 2009; the first DMT claim was the index. Eligible patients were identified in the MarketScan Commercial and Medicare Supplemental databases based on continuous enrollment for 6 months before (preindex period) and 24 months after their index date, with a diagnosis of MS and no claim for a previous DMT in the 6-month preindex period. Demographics at index and clinical characteristics during the preindex period were also analyzed. A total of 6181 MS patients were included, with 5735 (92.8%) starting on platform therapy. Natalizumab initiators were more likely to stay on index therapy (32.3% vs 16.9%, P < 0.001) and have fewer treatment gaps of ≥ 60 days (44.8% vs 55.3%, P < 0.001) compared with platform initiators. In addition, natalizumab initiators were less likely to switch treatment (13.9% vs 19.1%, P = 0.007) and took longer to switch (400.9 days vs 330.7 days, P < 0.001) compared with platform initiators. Nearly 79% of platform initiators who switched went to another platform therapy. Approximately two thirds of patients who switched to a third DMT (n = 130) switched to another platform therapy. A total of 9% of natalizumab and platform initiators discontinued DMT within the 2 years. Most MS patients initiating DMT started on platform therapy. Natalizumab initiators tended to stay on index therapy, have fewer treatment gaps, and switch less than platform initiators in the 2 years after treatment initiation. Switching between platform therapies is common despite evidence that MS patients on platform therapy may benefit from switching to natalizumab. © 2013 Elsevier HS Journals, Inc. All rights reserved.

[Current Status and Future Perspectives of SCRUM-Japan].

PubMed

Ohtsu, Atsushi; Goto, Koichi; Yoshino, Takayuki; Okamoto, Wataru; Tsuchihara, Katsuya

2017-08-01

SCRUM-Japan was launched as a nation-wide genome screening consortium for recruiting patients to 35 sponsor-/investigator- initiated registration trials in collaboration with 15 pharmaceutical companies and 240 hospitals. During the first period between February 2015 and March 2017, a total of 4,805 patients have been enrolled. Genomic profiling of each cancer were analyzed and newdrug applications of label expansion are in preparation based on the results of several registration studies including investigator-initiated trial of vandetanib for RET fusion gene positive non-small cell lung cancer. In addition, on-time clinical-genome data sharing with industries and academic institutions and prospective cohort registry for new drug evaluation as a historical control data have already initiated, which will facilitate new agent development in Japan. In the second period started from April 2017, new studies using cutting-edge liquid biopsy and immune-genome panel for precision medi- cine will start soon. These efforts are attempted towards a leading group for innovative clinical/translations researches in the world.

Interplanetary field and plasma during initial phase of geomagnetic storms

NASA Technical Reports Server (NTRS)

Patel, V. L.; Wiskerchen, M. J.

1975-01-01

A study has been conducted of a large number of geomagnetic storms occurring during the period from 1966 to 1970. Questions of data selection are discussed and the large-scale interplanetary magnetic field during the initial phase is examined. Small-scale interplanetary fields during the initial phase are also considered, taking into account important features of small-scale variations in the interplanetary field and plasma for three storms. Details concerning 23 geomagnetic storms and the interplanetary magnetic field are presented in a table. A study of the initial phase of these storms indicates that in most of these events, the solar-ecliptic Z component of the interplanetary magnetic field turns southward when the main phase decrease begins.

Impact of folic acid fortification on global DNA methylation and one-carbon biomarkers in the Women's Health Initiative Observational Study cohort.

PubMed

Bae, Sajin; Ulrich, Cornelia M; Bailey, Lynn B; Malysheva, Olga; Brown, Elissa C; Maneval, David R; Neuhouser, Marian L; Cheng, Ting-Yuan David; Miller, Joshua W; Zheng, Yingye; Xiao, Liren; Hou, Lifang; Song, Xiaoling; Buck, Katharina; Beresford, Shirley A A; Caudill, Marie A

2014-03-01

DNA methylation is an epigenetic mechanism that regulates gene expression and can be modified by one-carbon nutrients. The objective of this study was to investigate the impact of folic acid (FA) fortification of the US food supply on leukocyte global DNA methylation and the relationship between DNA methylation, red blood cell (RBC) folate, and other one-carbon biomarkers among postmenopausal women enrolled in the Women's Health Initiative Observational Study. We selected 408 women from the highest and lowest tertiles of RBC folate distribution matching on age and timing of the baseline blood draw, which spanned the pre- (1994-1995), peri- (1996-1997), or post-fortification (1998) periods. Global DNA methylation was assessed by liquid chromatography-tandem mass spectrometry and expressed as a percentage of total cytosine. We observed an interaction (P = 0.02) between fortification period and RBC folate in relation to DNA methylation. Women with higher (vs. lower) RBC folate had higher mean DNA methylation (5.12 vs. 4.99%; P = 0.05) in the pre-fortification period, but lower (4.95 vs. 5.16%; P = 0.03) DNA methylation in the post-fortification period. We also observed significant correlations between one-carbon biomarkers and DNA methylation in the pre-fortification period, but not in the peri- or post-fortification period. The correlation between plasma homocysteine and DNA methylation was reversed from an inverse relationship during the pre-fortification period to a positive relationship during the post-fortification period. Our data suggest that (1) during FA fortification, higher RBC folate status is associated with a reduction in leukocyte global DNA methylation among postmenopausal women and; (2) the relationship between one-carbon biomarkers and global DNA methylation is dependent on folate availability.

Fluid Overload and Fluid Removal in Pediatric Patients on Extracorporeal Membrane Oxygenation Requiring Continuous Renal Replacement Therapy

PubMed Central

Selewski, David T; Cornell, Timothy T; Blatt, Neal B; Han, Yong Y; Mottes, Theresa; Kommareddi, Mallika; Gaies, Michael G; Annich, Gail M; Kershaw, David B; Shanley, Thomas P; Heung, Michael

2012-01-01

Objective In pediatric patients fluid overload (FO) at continuous renal replacement (CRRT) initiation is associated with increased mortality. The aim of this study was to characterize the association between fluid overload at CRRT initiation, fluid removal during CRRT, the kinetics of fluid removal and mortality in a large pediatric population receiving CRRT while on extracorporeal membrane oxygenation (ECMO). Design Retrospective chart review. Setting Tertiary children’s hospital Patients ECMO patients requiring CRRT from July 2006 to September 2010 Interventions None Measurements and Main Results Overall ICU survival was 34% for 53 patients that were initiated on CRRT while on ECMO during the study period. Median FO at CRRT initiation was significantly lower in survivors compared to non-survivors (24.5 vs. 38%, p=0.006). Median FO at CRRT discontinuation was significantly lower in survivors compared to non-survivors (7.1 vs. 17.5%, p=0.035). After adjusting for percent FO at CRRT initiation, age and severity of illness, the change in FO at CRRT discontinuation was not significantly associated with mortality (p=0.212). Models investigating the rates of fluid removal in different periods, age, severity of illness and fluid overload at CRRT initiation found that fluid overload at CRRT initiation was the most consistent predictor of survival. Conclusions Our data demonstrates an association between FO at CRRT initiation and mortality in pediatric patients receiving ECMO. The degree of FO at CRRT discontinuation is also associated with mortality, but appears to reflect the effect of FO at initiation. Furthermore, correction of FO to ≤ 10% was not associated with improved survival. These results suggest that intervening prior to the development of significant FO may be more clinically effective than attempting fluid removal after significant fluid overload has developed. Our findings suggest a role for earlier initiation of CRRT in this population, and warrant further clinical studies. PMID:22743776

Persistence of initial conditions in continental scale air quality ...

EPA Pesticide Factsheets

This study investigates the effect of initial conditions (IC) for pollutant concentrations in the atmosphere and soil on simulated air quality for two continental-scale Community Multiscale Air Quality (CMAQ) model applications. One of these applications was performed for springtime and the second for summertime. Results show that a spin-up period of ten days commonly used in regional-scale applications may not be sufficient to reduce the effects of initial conditions to less than 1% of seasonally-averaged surface ozone concentrations everywhere while 20 days were found to be sufficient for the entire domain for the spring case and almost the entire domain for the summer case. For the summer case, differences were found to persist longer aloft due to circulation of air masses and even a spin-up period of 30 days was not sufficient to reduce the effects of ICs to less than 1% of seasonally-averaged layer 34 ozone concentrations over the southwestern portion of the modeling domain. Analysis of the effect of soil initial conditions for the CMAQ bidirectional NH3 exchange model shows that during springtime they can have an important effect on simulated inorganic aerosols concentrations for time periods of one month or longer. The effects are less pronounced during other seasons. The results, while specific to the modeling domain and time periods simulated here, suggest that modeling protocols need to be scrutinized for a given application and that it cannot be assum

Oseltamivir use and severe abnormal behavior in Japanese children and adolescents with influenza: Is a self-controlled case series study applicable?

PubMed

Fukushima, Wakaba; Ozasa, Kotaro; Okumura, Akihisa; Mori, Masaaki; Hosoya, Mitsuaki; Nakano, Takashi; Tanabe, Takuya; Yamaguchi, Naoto; Suzuki, Hiroshi; Mori, Mitsuru; Hatayama, Hideaki; Ochiai, Hirotaka; Kondo, Kyoko; Ito, Kazuya; Ohfuji, Satoko; Nakamura, Yosikazu; Hirota, Yoshio

2017-08-24

Since the 1990s, self-controlled designs including self-controlled case series (SCCS) studies have been occasionally used in post-marketing evaluation of drug or vaccine safety. An SCCS study was tentatively applied to evaluate the relationship between oseltamivir use and abnormal behavior Type A (serious abnormal behavior potentially leading to an accident or harm to another person) in influenza patients. From the original prospective cohort study with approximately 10,000 Japanese children and adolescents with influenza (aged <18years), 28 subjects (mean age: 7.3years) who developed abnormal behavior Type A after the first visit to the collaborating hospitals/clinics were analyzed. We hypothesized four combination patterns of the effect period (i.e., the period that effect of oseltamivir on occurrence of abnormal behavior Type A is likely) and the control period. Mantel-Haenszel rate ratio (M-H RR) and its 95% confidence interval (CI) were calculated as the relative risk estimate. Among 28 subjects in the SCCS study, 24 subjects (86%) were administered oseltamivir and 4 subjects (14%) were not. Abnormal behavior Type A was more likely to occur in the effect period than the control period in every pattern (M-H RR: 1.90-29.1). We observed the highest estimate when the effect period was set between the initial intake of oseltamivir and T max (M-H RR: 29.1, 95% CI: 4.21-201). Abnormal behavior Type A was more likely to develop up to approximately 30 times during the period between the initial intake of oseltamivir and T max . However, this period overlapped with the early period of influenza where high fever was observed. Since useful approaches to control the influence of the natural disease course of influenza were not available in this study, we could not deny the possibility that abnormal behavior was induced by influenza itself. The SCCS study was not an optimal method to evaluate the relationship between oseltamivir use and abnormal behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

Chen, W.; Kan, A.T.; Fu, G.

Neutral organic contaminants commonly reside on the solid portion of soils and sediments. The extent of desorption from these solids determines the fate, reactivity, and toxicity. Numerous researchers have observed that, after an initial exposure of a few days, desorption takes place in two phases, namely, an initial rapid release followed by a long-term resistant phase. Resistant desorption has been highly unpredictable. In this research, the adsorption and desorption of chlorobenzenes, hexachlorobutadiene, and naphthalene have been studied using historically and freshly contaminated bayou sediments from Lake Charles, Louisiana, USA. After an initial release period, both laboratory-spiked and historically contaminated sedimentsmore » from Lake Charles, Louisiana, USA. After an initial release period, both laboratory-spiked and historically contaminated sediments exhibit similar desorption profiles. The simulations compare favorably with previous in situ measurements. All desorption results, both laboratory and field, could reasonably be interpreted using a single irreversible isotherm. Consequences of these results in terms of sediment quality criteria (SQC) are also discussed. Finally, an index of fractional irreversible adsorption is proposed and tested.« less

Patterns of drug use from adolescence to young adulthood: I. Periods of risk for initiation, continued use, and discontinuation.

PubMed Central

Kandel, D B; Logan, J A

1984-01-01

Patterns of initiation, continued use, and decline in drug use are described on the basis of detailed drug histories in a longitudinal cohort representative of former New York State adolescents. In this cohort, the period of major risk for initiation to cigarettes, alcohol, and marijuana, is completed for the most part by age 20, and to illicit drugs other than cocaine by age 21. Those who have not experimented with any of these substances by that age are unlikely to do so thereafter. Initiation into prescribed psychoactive drugs occurs at a later age than for the licit and illicit drugs and continues through the age period covered by the survey. A potential maturational trend in marijuana use in this cohort is apparent with a decline beginning approximately at age 22.5 for most usage patterns. The periods of highest marijuana and alcohol usage decline beginning at ages 20-21 and contrast sharply with cigarettes which exhibit climbing rates of highest use through the end of the surveillance period (age 25). Overall patterns are similar for men and women, with men initiating all drugs at higher rates than women, except for prescribed psychoactives . PMID:6611092

System and method for generating attitude determinations using GPS

NASA Technical Reports Server (NTRS)

Cohen, Clark E. (Inventor)

1996-01-01

A GPS attitude receiver for determining the attitude of a moving vehicle in conjunction with a first, a second, a third, and a fourth antenna mounted to the moving vehicle. Each of the antennas receives a plurality of GPS signals that each include a carrier component. For each of the carrier components of the received GPS signals there is an integer ambiguity associated with the first and fourth antennas, an integer ambiguity associated with second and fourth antennas, and an integer ambiguity associated with the third and fourth antennas. The GPS attitude receiver measures phase values for the carrier components of the GPS signals received from each of the antennas at a plurality of measurement epochs during an initialization period and at a measurement epoch after the initialization period. In response to the phase values measured at the measurement epochs during the initialization period, the GPS attitude receiver computes integer ambiguity resolution values representing resolution of the integer ambiguities. Then, in response to the computed integer ambiguity resolution values and the phase value measured at the measurement epoch after the initialization period, it computes values defining the attitude of the moving vehicle at the measurement epoch after the initialization period.

41 CFR 109-27.102-52 - Implementation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... initial feasibility study for the implementation of systems contracting shall perform such a study for selected commodity groups. The study may be accomplished over a period of time, until all commodity groups have been considered. The study should address functional requirements, activity levels of commodity...

Menstrual pattern, sexual behaviors, and contraceptive use among postpartum women in Nairobi urban slums.

PubMed

Ndugwa, Robert P; Cleland, John; Madise, Nyovani J; Fotso, Jean-Christophe; Zulu, Eliya M

2011-06-01

Postpartum months provide a challenging period for poor women. This study examined patterns of menstrual resumption, sexual behaviors and contraceptive use among urban poor postpartum women. Women were eligible for this study if they had a birth after the period September 2006 and were residents of two Nairobi slums of Korogocho and Viwandani. The two communities are under continuous demographic surveillance. A monthly calendar type questionnaire was administered retrospectively to cover the period since birth to the interview date and data on sexual behavior, menstrual resumption, breastfeeding patterns, and contraception were collected. The results show that sexual resumption occurs earlier than menses and postpartum contraceptive use. Out of all postpartum months where women were exposed to the risk of another pregnancy, about 28% were months where no contraceptive method was used. Menstrual resumption acts as a trigger for initiating contraceptive use with a peak of contraceptive initiation occurring shortly after the first month when menses are reported. There was no variation in contraceptive method choice between women who initiate use before and after menstrual resumption. Overall, poor postpartum women in marginalized areas such as slums experience an appreciable risk of unintended pregnancy. Postnatal visits and other subsequent health system contacts provide opportunities for reaching postpartum women with a need for family planning services.

42 CFR 422.62 - Election of coverage under an MA plan.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 3 2013-10-01 2013-10-01 false Election of coverage under an MA plan. 422.62... Enrollment § 422.62 Election of coverage under an MA plan. (a) General: Coverage election periods—(1) Initial coverage election period for MA. The initial coverage election period is the period during which a newly MA...

42 CFR 422.62 - Election of coverage under an MA plan.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Election of coverage under an MA plan. 422.62... § 422.62 Election of coverage under an MA plan. (a) General: Coverage election periods—(1) Initial coverage election period for MA. The initial coverage election period is the period during which a newly MA...

42 CFR 422.62 - Election of coverage under an MA plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 3 2011-10-01 2011-10-01 false Election of coverage under an MA plan. 422.62... § 422.62 Election of coverage under an MA plan. (a) General: Coverage election periods—(1) Initial coverage election period for MA. The initial coverage election period is the period during which a newly MA...

42 CFR 422.62 - Election of coverage under an MA plan.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 3 2014-10-01 2014-10-01 false Election of coverage under an MA plan. 422.62... Enrollment § 422.62 Election of coverage under an MA plan. (a) General: Coverage election periods—(1) Initial coverage election period for MA. The initial coverage election period is the period during which a newly MA...

42 CFR 422.62 - Election of coverage under an MA plan.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false Election of coverage under an MA plan. 422.62... Enrollment § 422.62 Election of coverage under an MA plan. (a) General: Coverage election periods—(1) Initial coverage election period for MA. The initial coverage election period is the period during which a newly MA...

The initial repair response of articular cartilage after mechanically induced damage.

PubMed

van Haaften, Eline E; Ito, Keita; van Donkelaar, Corrinus C

2017-06-01

The regenerative potential of articular cartilage (AC) defects is limited and depends on defect size, biomechanical conditions, and age. Early events after overloading might be predictive for cartilage degeneration in the long term. Therefore, the present aim is to investigate the temporal response of cartilage to overloading at cell, matrix, and tissue level during the first period after mechanical overloading. In the present study, the effect of high loading (∼8 MPa) at a high rate (∼14 MPa/s) at day 0 during a 9 day period on collagen damage, gene expression, cell death, and biochemical composition in AC was investigated. A model system was developed which enabled culturing osteochondral explants after loading. Proteoglycan content was repeatedly monitored over time using μCT, whereas other evaluations required destructive measurements. Changes in matrix related gene expressions indicated a degenerative response during the first 6 h after loading. After 24 h, this was restored and data suggested an initial repair response. Cell death and microscopic damage increased after 24 h following loading. These degradative changes were not restored within the 9 day culture period, and were accompanied by a slight loss of proteoglycans at the articular surface that extended into the middle zones. The combined findings indicate that high magnitude loading of articular cartilage at a high rate induces an initial damage that later initiates a healing response that can probably not be retained due to loss of cell viability. Consequently, the matrix cannot be restored in the short term. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1265-1273, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Safety and efficacy of pirfenidone in idiopathic pulmonary fibrosis in clinical practice.

PubMed

Okuda, Ryo; Hagiwara, Eri; Baba, Tomohisa; Kitamura, Hideya; Kato, Terufumi; Ogura, Takashi

2013-09-01

Previous pirfenidone trials have only involved patients with mild-to-moderate idiopathic pulmonary fibrosis (IPF). The aim of this study was to investigate the safety and efficacy of pirfenidone in patients with mild-to-severe IPF in clinical practice. The clinical records of 76 patients who were diagnosed with IPF and received pirfenidone were reviewed. The most frequent adverse event was anorexia, although the grade of anorexia in most patients was mild. Dose reduction of pirfenidone improved anorexia in 84% affected patients, which resulted in a high medication compliance rate. The mean forced vital capacity (FVC) at the initiation of pirfenidone therapy in this study was approximately 10% lower than that in previous clinical trials. The mean change in FVC during the 6-month period prior to the therapy initiation was -188 mL, which improved to -19 mL during the 6-month period after therapy. Significant attenuation in percentage predicted diffusion capacity of the lung for carbon monoxide decline was also achieved after pirfenidone therapy initiation. The efficacy of pirfenidone in attenuating the degree of FVC decline was higher in the group with FVC decline of ≥150 mL during the 6-month period prior to therapy initiation. The levels of serum markers, such as KL-6 and SP-D, were also lowered by the therapy. These results showed that pirfenidone was well-tolerated and had beneficial effects in patients with mild-to-severe and/or progressive IPF. The degree of disease progression prior to the initiation of pirfenidone therapy had an impact on the response to the therapy. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

PubMed Central

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

2017-01-01

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

Study of process variables associated with manufacturing hermetically-sealed nickel-cadmium cells

NASA Technical Reports Server (NTRS)

Miller, L.

1972-01-01

The effort and results of a program to determine and study the critical process variables associated with the manufacture of aerospace, hermetically-sealed, nickel-cadmium cells are reported. During the period, the impregnation/polarization process variable study was brought to a close with the completion of a series of related experiments. The results of the experiments are summarized. During this period, a general characterization of cell separator materials was initiated. The major conclusions resulting from the characterization of materials are included.

Characterizing Design Cognition of High School Students: Initial Analyses Comparing Those with and without Pre-Engineering Experiences

ERIC Educational Resources Information Center

Wells, John; Lammi, Matthew; Gero, John; Grubbs, Michael E.; Paretti, Marie; Williams, Christopher

2016-01-01

Reported in this article are initial results from of a longitudinal study to characterize the design cognition and cognitive design styles of high school students with and without pre-engineering course experience over a 2-year period, and to compare them with undergraduate engineering students. The research followed a verbal protocol analysis…

Small Island States Green Energy Initiative. Final report

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

Khattak, Nasir

1999-10-15

This report covers the activities carried out during a one year period from 7/15/99 to 7/15/00 as part of the Small Islands Green Energy Initiative. The three activities were: 1) Energy Ministerial conference in the Caribbean; 2) Training session on renewable energy for utility engineers; and 3) Case studies compilation on renewable energy in the Caribbean.

Cyclic AMP system in muscle tissue during prolonged hypokinesia

NASA Technical Reports Server (NTRS)

Antipenko, Y. A.; Bubeyev, Y. A.; Korovkin, B. F.; Mikhaleva, N. P.

1980-01-01

Components of the cyclic Adenosine-cyclic-35-monophosphate (AMP) system in the muscle tissue of white rats were studied during 70-75 days of hypokinesia, created by placing the animals in small booths which restricted their movements, and during the readaptation period. In the initial period, cyclic AMP levels and the activities of phosphodiesterase and adenylate cyclase in muscle tissue were increased. The values for these indices were roughly equal for controls and experimental animals during the adaptation period, but on the 70th day of the experiment cAMP levels dropped, phosphodiesterase activity increased, and the stimulative effect of epinephrine on the activity of adenylate cyclase decreased. The indices under study normalized during the readaptation period.

The effects of a flexible visual acuity-driven ranibizumab treatment regimen in age-related macular degeneration: outcomes of a drug and disease model.

PubMed

Holz, Frank G; Korobelnik, Jean-François; Lanzetta, Paolo; Mitchell, Paul; Schmidt-Erfurth, Ursula; Wolf, Sebastian; Markabi, Sabri; Schmidli, Heinz; Weichselberger, Andreas

2010-01-01

Differences in treatment responses to ranibizumab injections observed within trials involving monthly (MARINA and ANCHOR studies) and quarterly (PIER study) treatment suggest that an individualized treatment regimen may be effective in neovascular age-related macular degeneration. In the present study, a drug and disease model was used to evaluate the impact of an individualized, flexible treatment regimen on disease progression. For visual acuity (VA), a model was developed on the 12-month data from ANCHOR, MARINA, and PIER. Data from untreated patients were used to model patient-specific disease progression in terms of VA loss. Data from treated patients from the period after the three initial injections were used to model the effect of predicted ranibizumab vitreous concentration on VA loss. The model was checked by comparing simulations of VA outcomes after monthly and quarterly injections during this period with trial data. A flexible VA-guided regimen (after the three initial injections) in which treatment is initiated by loss of >5 letters from best previously observed VA scores was simulated. Simulated monthly and quarterly VA-guided regimens showed good agreement with trial data. Simulation of VA-driven individualized treatment suggests that this regimen, on average, sustains the initial gains in VA seen in clinical trials at month 3. The model predicted that, on average, to maintain initial VA gains, an estimated 5.1 ranibizumab injections are needed during the 9 months after the three initial monthly injections, which amounts to a total of 8.1 injections during the first year. A flexible, individualized VA-guided regimen after the three initial injections may sustain vision improvement with ranibizumab and could improve cost-effectiveness and convenience and reduce drug administration-associated risks.

The mechanism of Fe(2+)-initiated lipid peroxidation in liposomes: the dual function of ferrous ions, the roles of the pre-existing lipid peroxides and the lipid peroxyl radical.

PubMed Central

Tang, L; Zhang, Y; Qian, Z; Shen, X

2000-01-01

The mechanism of Fe(2+)-initiated lipid peroxidation in a liposomal system was studied. It was found that a second addition of ferrous ions within the latent period lengthened the time lag before lipid peroxidation started. The apparent time lag depended on the total dose of Fe(2+) whenever the second dose of Fe(2+) was added, which indicates that Fe(2+) has a dual function: to initiate lipid peroxidation on one hand and suppress the species responsible for the initiation of the peroxidation on the other. When the pre-existing lipid peroxides (LOOH) were removed by incorporating triphenylphosphine into liposomes, Fe(2+) could no longer initiate lipid peroxidation and the acceleration of Fe(2+) oxidation by the liposomes disappeared. However, when extra LOOH were introduced into liposomes, both enhancement of the lipid peroxidation and shortening of the latent period were observed. When the scavenger of lipid peroxyl radicals (LOO(.)), N,N'-diphenyl-p-phenylene-diamine, was incorporated into liposomes, neither initiation of the lipid peroxidation nor acceleration of the Fe(2+) oxidation could be detected. The results may suggest that both the pre-existing LOOH and LOO(.) are necessary for the initiation of lipid peroxidation. The latter comes initially from the decomposition of the pre-existing LOOH by Fe(2+) and can be scavenged by its reaction with Fe(2+). Only when Fe(2+) is oxidized to such a degree that LOO(.) is no longer effectively suppressed does lipid peroxidation start. It seems that by taking the reactions of Fe(2+) with LOOH and LOO(.) into account, the basic chemistry in lipid peroxidation can explain fairly well the controversial phenomena observed in Fe(2+)-initiated lipid peroxidation, such as the existence of a latent period, the critical ratio of Fe(2+) to lipid and the required oxidation of Fe(2+). PMID:11062055

Patterns of Spanish Emigration to the New World (1493-1580). Special Studies No. 34.

ERIC Educational Resources Information Center

Boyd-Bowman, Peter

The four periods discussed in this publication cover the patterns of Spanish emigration to the New World, mainly on the regional level and in terms of percentages. The effects of this emigration on the various Spanish American dialects are discussed. In the initial period (1493-1519), the largest single group, in every year and on all major…

Long-Term Major Clinical Outcomes in Patients With Long Chain Fatty Acid Oxidation Disorders Before and After Transition to Triheptanoin Treatment—A Retrospective Chart Review

PubMed Central

Vockley, Jerry; Marsden, Deborah; McCracken, Elizabeth; DeWard, Stephanie; Barone, Amanda; Hsu, Kristen; Kakkis, Emil

2015-01-01

Background Long chain fatty acid oxidation disorders (LC-FAOD) are caused by defects in the metabolic pathway that converts stored long-chain fatty acids into energy, leading to a deficiency in mitochondrial energy production during times of physiologic stress and fasting. Severe and potentially life threatening clinical manifestations include rhabdomyolysis, hypoglycemia, hypotonia/weakness, cardiomyopathy and sudden death. We present the largest cohort of patients to date treated with triheptanoin, a specialized medium odd chain (C7) triglyceride, as a novel energy source for the treatment of LC-FAOD. Methods This was a retrospective, comprehensive medical record review study of data from 20 of a total 24 patients with LC-FAOD who were treated for up to 12.5 years with triheptanoin, as part of a compassionate use protocol. Clinical outcomes including hospitalization event rates, number of hospitalization days/year, and abnormal laboratory values were determined for the total period of the study before and after triheptanoin treatment, as well as for specified periods before and after initiation of triheptanoin treatment. Other events of interest were documented including rhabdomyolysis, hypoglycemia, and cardiomyopathy. Results LC-FAOD in these 20 subjects was associated with 320 hospitalizations from birth to the end date of study. The mean hospitalization days/year decreased significantly by 67% during the period after triheptanoin initiation (n=15; 5.76 vs 17.55 vs; P=0.0242) and a trend toward a 35% lower hospitalization event rate was observed in the period after triheptanoin initiation compared with the before-treatment period (n=16 subjects >6 months of age; 1.26 vs 1.94; P=0.1126). The hypoglycemia event rate per year in 9 subjects with hypoglycemia problems declined significantly by 96% (0.04 vs 0.92; P=0.0091) and related hospitalization days/year were also significantly reduced (n=9; 0.18 vs 8.42; P=0.0257). The rhabdomyolysis hospital event rate in 11 affected subjects was similar before and after treatment but the number of hospitalization days/year trended lower in the period after triheptanoin initiation (n=9; 2.36 vs 5.94; P=0.1224) and peak CK levels trended toward a 68% decrease from 85,855 to 27,597 units in 7 subjects with reported peak CK values before and after treatment (P=0.1279). Triheptanoin was generally well tolerated. Gastrointestinal symptoms were the most commonly reported side effects. Conclusions This retrospective study represents the largest analysis reported to date of treatment of LC-FAOD with triheptanoin. The data suggest that triheptanoin improves the course of disease by decreasing the incidence and duration of major clinical manifestations and should be the focus of prospective investigations. Significant heterogeneity in the routine clinical care provided to subjects during the periods studied and the natural variation of clinical course of LC-FAODs with time emphasize the need additioanl study of the use of triheptanoin. PMID:26116311

Labour room Continuous Positive Airway Pressure (LR CPAP) in preterm neonates <34 weeks: An Indian experience.

PubMed

Desai, Saumil Ashvinkumar; Tule, Pankaj; Nanavati, Ruchi Nimish

2017-01-01

Early continuous positive airway pressure (CPAP) has proven to be beneficial in reducing ventilator dependence and subsequent chronic lung disease in neonates suffering from Respiratory distress syndrome (RDS). However, the efficacy of initiating labour room (LR) CPAP has not been determined prospectively in resource limited settings like India. Hence the objective of the present study was to study the efficacy of LR CPAP in preterm neonates with RDS in resource limited Indian settings. This was a prospective observational study including preterm neonates (26-34 weeks with RDS) carried out over a period of 6 months (January to June 2016) when the CPAP was initiated in LR. The outcome was compared with a similar population during the corresponding period of the previous year when CPAP was initiated in NICU. The historical controls were retrieved from case records and matched for gestational age and birth weight with the study population. There was 36% absolute risk reduction in the need for surfactant and 56% for mechanical ventilation in the LR CPAP group respectively. LR CPAP reduces the need for mechanical ventilation and surfactant in preterm neonates with RDS in resource limited settings.

Attention-deficit/hyperactivity disorder Under Treatment Outcomes Research (AUTOR): a European observational study in pediatric subjects.

PubMed

Haynes, Virginia; Lopez-Romero, Pedro; Anand, Ernie

2015-12-01

The ADHD Under Treatment Observational Research (AUTOR) study was a European prospective, observational study that assessed factors associated with changes in ADHD severity, estimated change from baseline in quality of life (QoL), and characterized changes in ADHD symptoms over a 2-year period as a function of baseline treatment. The primary objective was to identify factors associated with worsening in ADHD severity during a 2-year follow-up period for subjects aged 6-17 years, who were receiving the same pharmacotherapy for 3-8 months before enrollment and had a Clinical Global Impression (CGI)-ADHD-Severity score of mild/lower and a CGI-ADHD-Improvement score of improved/very much improved. Multivariate logistic regression examined the association of factors with worsening in ADHD. Mixed-model repeated measures regression analyzed QoL in terms of change from baseline in CHIP-CE PRF scores. There were 704 subjects analyzed. Variables associated with worsening ADHD severity were parental occupation, poorer school outcomes, and use of psychoeducation; baseline treatment was not significant. Among the secondary objectives, initial use of atomoxetine (vs. stimulants) was associated with a significant improvement on the CHIP-CE PRF total score, with an adjusted treatment difference of -6.0 (95 % CI -7.9, -4.1) at 24 months. Additionally, the odds of stability (CGI-ADHD-S ≤ 3 over the 2-year period) were significantly lower for subjects initially responding to stimulants compared with atomoxetine (OR 0.5; 95 % CI 0.3, 0.8). ADHD symptom worsening was associated with initial use of psychoeducation, parental occupation, and poorer school outcomes. Response to initial treatment with atomoxetine was associated with improved QoL over 2 years.

Evidence from stellar rotation of enhanced disc dispersal. I. The case of the triple visual system BD-21 1074 in the β Pictoris association

NASA Astrophysics Data System (ADS)

Messina, S.; Monard, B.; Biazzo, K.; Melo, C. H. F.; Frasca, A.

2014-10-01

Context. The early stage of stellar evolution is characterized by a magnetic coupling between a star and its accretion disc, known as a star-disc locking mechanism. The disc-locking prevents the star to spin its rotation up, and its timescale depends on the disc lifetime, which should not be longer than about 10 Myr. Some mechanisms can significantly shorten this lifetime, allowing a few stars to start spinning up much earlier than other stars and increasing the observed rotation period dispersion among coeval stars. Aims: In the present study, we aim to investigate how the properties of the circumstellar environment can shorten the disc lifetime, more specifically the presence of a close stellar companion. Methods: We have identified a few multiple stellar systems, composed of stars with similar masses, which belong to associations with a known age. Since all parameters that are responsible for the rotational evolution, with the exception of environment properties and initial stellar rotation, are similar for all components, we expect that significant differences among the rotation periods can only arise from differences in the disc lifetimes. A photometric timeseries allowed us to measure the rotation periods of each component, while high-resolution spectra provided us with the fundamental parameters, v sin i and chromospheric line fluxes. Results: In the present study, we have collected timeseries photometry of BD-21 1074, a member of the 21 Myr old β Pictoris association, and measured the rotation periods of its brightest components A and B. They differ significantly, and the component B, which has a closer companion C, rotates faster than the more distant and isolated component A. It also displays a slightly higher chromospheric activity level. Conclusions: Since components A and B have similar mass, age, and initial chemical composition, we can ascribe the rotation period difference to either different initial rotation periods or different disc-locking phases arising from the presence of the close companion C. In the specific case of BD-21 1074, the second scenario seems to be more favored. However, a statistically meaningful sample is yet needed to be able to infer which scenario is more likely. In our hypothesis of different disc-locking phase, any planet orbiting this star, if found by future investigations, is likely formed very rapidly owing to a gravitational instability mechanism, rather than core accretion. Only a large difference of initial rotation periods alone could account for the observed period difference, leaving comparable disc lifetimes.

Study of periodic motions of a satellite with a magnetic damper

NASA Technical Reports Server (NTRS)

Sadov, Y. A.; Teterin, A. D.

1979-01-01

The motion of a satellite with a magnetic damper in the plane of a circular polar orbit is studied. The asymptotics of periodic solutions are constructed for a satellite close to axisymmetric and the radius of convergence is evaluated for the power series obtained. In a broad range of values of parameters, a periodic solution is obtained by numerical integration of equations of motion of the satellite. The asymptotics of a bifurcated curve obtained (the curve on which origin of a pair of periodic solutions occurs) in the space of the parameters agrees well with the results of numerical computation with all physical values of these parameters. A breakdown is made of the space of the initial data of phase variables in the field of effect of different types of periodic motion.

Efficacy of preventive spinal manipulation for chronic low-back pain and related disabilities: a preliminary study.

PubMed

Descarreaux, Martin; Blouin, Jean-Sébastien; Drolet, Marc; Papadimitriou, Stanislas; Teasdale, Normand

2004-10-01

To document the potential role of maintenance chiropractic spinal manipulation to reduce overall pain and disability levels associated with chronic low-back conditions after an initial phase of intensive chiropractic treatments. Thirty patients with chronic nonspecific low-back pain were separated into 2 groups. The first group received 12 treatments in an intensive 1-month period but received no treatment in a subsequent 9-month period. For this group, a 4-week period preceding the initial phase of treatment was used as a control period to examine the sole effect of time on pain and disability levels. The second group received 12 treatments in an intensive 1-month period and also received maintenance spinal manipulation every 3 weeks for a 9-month follow-up period. Pain and disability levels were evaluated with a visual analog scale and a modified Oswestry questionnaire, respectively. The 1-month control period did not modify the pain and disability levels. For both groups, the pain and disability levels decreased after the intensive phase of treatments. Both groups maintained their pain scores at levels similar to the postintensive treatments throughout the follow-up period. For the disability scores, however, only the group that was given spinal manipulations during the follow-up period maintained their postintensive treatment scores. The disability scores of the other group went back to their pretreatment levels. Intensive spinal manipulation is effective for the treatment of chronic low back pain. This experiment suggests that maintenance spinal manipulations after intensive manipulative care may be beneficial to patients to maintain subjective postintensive treatment disability levels. Future studies, however, are needed to confirm the finding in a larger group of patients with chronic low-back pain.

Occupational correlates of smoking among urban transit operators: a prospective study.

PubMed

Cunradi, Carol B; Lipton, Rob; Banerjee, Aniruddha

2007-12-20

Workers in blue-collar and service occupations smoke at higher rates than workers in white-collar and professional occupations. Occupational stress may explain some of the occupational class differences in smoking and quitting behavior. The purpose of this study is to investigate the contribution of occupational factors to smoking behavior over a ten year period among a multiethnic cohort of urban transit operators, while accounting for demographic factors and alcohol. The sample consists of 654 San Francisco Municipal Railway (MUNI) transit operators who participated in two occupational health studies and biennial medical examinations during 1983-85 and 1993-95. Workers who had initiated, increased, or maintained their smoking over the ten year period were compared to workers who remained non-smokers. Occupational factors included self-rated frequency of job problems (e.g., difficulties with equipment, passengers, traffic), job burnout (i.e., the emotional exhaustion subscale of the Maslach Burnout Inventory), time needed to unwind after work, and years employed as a transit operator. A series of logistic regression models were developed to estimate the contribution of occupational factors to smoking behavior over time. Approximately 35% of the workers increased, initiated, or maintained their smoking over the ten-year period. Frequency of job problems was significantly associated with likelihood of smoking increase, initiation, or maintenance (OR = 1.30; 95% CI 1.09, 1.55). Black operators were significantly more likely to have smoked over the ten-year period compared to operators in other racial/ethnic groups. Understanding the role of work-related stress vis-à-vis smoking behavior is of critical importance for crafting workplace smoking prevention and cessation interventions that are applicable to blue-collar work settings, and for developing policies that mitigate occupational stress.

Results of Casting in Severe Curves in Infantile Scoliosis.

PubMed

Stasikelis, Peter J; Carpenter, Ashley M

2018-04-01

Previous work has demonstrated best results for casting in infantile scoliosis when the curves are small and the child begins casting under 2 years of age. This study examines if casting can delay the need for growth friendly instrumentation in severe curves (50 to 106 degrees) and how the comorbidities of syrinx or genetic syndromes affected outcomes. All children undergoing casting for scoliosis at a single institution over an 8-year period were examined. Inclusion criteria included initial curve at first casting of ≥50 degrees, age ≤3 years at the start of casting, and a minimum follow-up of 3 years. Of 148 children undergoing casting during this period, 44 met our inclusion criteria. All children underwent magnetic resonance imaging. Ten children with a syrinx were identified. Ten children had known genetic syndromes (2 who also had a syrinx). The 26 children without these comorbidities were considered idiopathic. Curve magnitude ranged from 50 to 106 degrees. Nine of the 26 (35%) children in the children with idiopathic curves demonstrated resolution of their curves, while only 3 of the remaining 18 (17%) did. Of the children that did not have resolution of their curves, 14 were maintained over the entire follow-up period to within 15 degrees of their initial curve and 13 were improved 15 degrees or more. Only 5 children had an increase of 15 degrees or more over the follow-up period and 4 of these have undergone growth friendly instrumentation after a mean delay from initial cast of 71 months (range, 18 to 100 mo). This study demonstrates that even in severe curves, casting was effective in delaying instrumentation in all cases, and led to curve resolution of the curves in 12 of 44 children. Level III-case control study.

Early insights into the characteristics and evolution of clinical parameters in a cohort of patients prescribed sacubitril/valsartan in Germany.

PubMed

Wachter, Rolf; Viriato, Daniel; Klebs, Sven; Grunow, Stefanie S; Schindler, Matthias; Engelhard, Johanna; Proenca, Catia C; Calado, Frederico; Schlienger, Raymond; Dworak, Markus; Balas, Bogdan; Bruce Wirta, Sara

2018-04-01

This study aimed to provide early insights into sacubitril/valsartan (sac/val) prescription patterns and the demographic and clinical characteristics of patients prescribed sac/val in primary care and cardiology settings in Germany. The study used electronic medical records from the German IMS® Disease Analyzer database. Patients with ≥1 prescription for sac/val during 1 January-31 December 2016 (n = 1643) were identified and followed up for ≤12 months from first prescription. Patients with ≥1 heart failure (HF) diagnosis during the study period, ≥1 additional HF diagnosis in the full history of the database, and ≥1 prescription for an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker and a β-blocker during the study period, without a prescription for sac/val (n = 25,264), were included as a reference cohort. Changes in clinical parameters in the 12 months before and after sac/val initiation were investigated and compared with those from the PARADIGM-HF study. The characteristics of patients prescribed sac/val more closely resembled those of patients enrolled in PARADIGM-HF (e.g. younger age, higher proportion of men than women, lower systolic blood pressure) than patients in the reference cohort. Most patients were initiated on the lowest dose of sac/val irrespective of clinical setting. Significant decreases (p < 0.001) in NT-proBNP and glycated haemoglobin levels were observed following sac/val initiation. Patients prescribed sac/val had similar baseline demographics and clinical characteristics to those from PARADIGM-HF, and most patients were initiated on the lowest dose. Changes in clinical parameters before and after initiation mirrored findings from the PARADIGM-HF study.

Alcohol Use Initiation is Associated with Changes in Personality Trait Trajectories from Early Adolescence to Young Adulthood

PubMed Central

Blonigen, Daniel M.; Durbin, C. Emily; Hicks, Brian M.; Johnson, Wendy; McGue, Matt; Iacono, William G.

2015-01-01

Background Recent work has demonstrated the codevelopment of personality traits and alcohol use characteristics from early adolescence to young adulthood. Few studies, however, have tested whether alcohol use initiation impacts trajectories of personality over this time period. We examined the effect of alcohol use initiation on personality development from early adolescence to young adulthood. Methods Participants were male (nmen = 2,350) and female (nwomen = 2,618) twins and adoptees from 3 community-based longitudinal studies conducted at the Minnesota Center for Twin and Family Research. Data on personality traits of Positive Emotionality (PEM; Well-being), Negative Emotionality (NEM; Stress Reaction, Alienation, and Aggression), and Constraint (CON; Control and Harm Avoidance)—assessed via the Multidimensional Personality Questionnaire (MPQ)—and age of first drink were collected for up to 4 waves spanning ages 10 to 32. Results Alcohol use initiation was associated with significant decreases in levels of Well-being and CON traits, most notably Control; and significant increases in levels of all NEM traits, particularly Aggression. In general, the effects of alcohol use initiation on personality traits were moderated by gender and enhanced among those with earlier age of first drink. Conclusions From early adolescence to young adulthood, alcohol use initiation predicts deviations from normative patterns of personality maturation. Such findings offer a potential mechanism underlying the codevelopment of personality traits and alcohol use characteristics during this formative period of development. PMID:26419887

Alcohol use initiation is associated with changes in personality trait trajectories from early adolescence to young adulthood.

PubMed

Blonigen, Daniel M; Durbin, C Emily; Hicks, Brian M; Johnson, Wendy; McGue, Matt; Iacono, William G

2015-11-01

Recent work has demonstrated the codevelopment of personality traits and alcohol use characteristics from early adolescence to young adulthood. Few studies, however, have tested whether alcohol use initiation impacts trajectories of personality over this time period. We examined the effect of alcohol use initiation on personality development from early adolescence to young adulthood. Participants were male (nmen = 2,350) and female (nwomen = 2,618) twins and adoptees from 3 community-based longitudinal studies conducted at the Minnesota Center for Twin and Family Research. Data on personality traits of Positive Emotionality (PEM; Well-being), Negative Emotionality (NEM; Stress Reaction, Alienation, and Aggression), and Constraint (CON; Control and Harm Avoidance)-assessed via the Multidimensional Personality Questionnaire (MPQ)-and age of first drink were collected for up to 4 waves spanning ages 10 to 32. Alcohol use initiation was associated with significant decreases in levels of Well-being and CON traits, most notably Control; and significant increases in levels of all NEM traits, particularly Aggression. In general, the effects of alcohol use initiation on personality traits were moderated by gender and enhanced among those with earlier age of first drink. From early adolescence to young adulthood, alcohol use initiation predicts deviations from normative patterns of personality maturation. Such findings offer a potential mechanism underlying the codevelopment of personality traits and alcohol use characteristics during this formative period of development. Copyright © 2015 by the Research Society on Alcoholism.

Effects of novelty on behavior in the adolescent and adult rat.

PubMed

Stansfield, Kirstie H; Kirstein, Cheryl L

2006-01-01

Adolescence is a time of high-risk behavior and increased exploration. This developmental period is marked by a greater probability of initiating drug use and is associated with an increased risk to develop addiction and dependency in adulthood. Human adolescents are predisposed towards an increased likelihood of risk taking behaviors (Zuckerman, 1986), including drug use or initiation. The purpose of the study was to examine differences in developmental risk taking behaviors. Adolescent and adult animals were exposed to a novel stimulus in a familiar environment to assess impulsive behaviors, novelty preference, and exploratory behaviors. Adolescent animals had greater novelty-induced locomotor activity, greater novelty preference, and showed higher approach and exploratory behaviors compared to adult animals. These data support the notion that adolescents may be predisposed toward sensation seeking and consequently, are more likely to engage in risk-taking behaviors, such as drug use initiation. Copyright 2005 Wiley Periodicals, Inc.

Circadian Activity Rhythms and Voluntary Ethanol Intake in Male and Female Ethanol-Preferring Rats: Effects of Long-Term Ethanol Access

PubMed Central

Rosenwasser, Alan M.; McCulley, Walter D.; Fecteau, Matthew

2014-01-01

Chronic alcohol (ethanol) intake alters fundamental properties of the circadian clock. While previous studies have reported significant alterations in free-running circadian period during chronic ethanol access, these effects are typically subtle and appear to require high levels of intake. In the present study we examined the effects of long-term voluntary ethanol intake on ethanol consumption and free-running circadian period in male and female, selectively bred ethanol-preferring P and HAD2 rats. In light of previous reports that intermittent access can result in escalated ethanol intake, an initial 2-week water-only baseline was followed by either continuous or intermittent ethanol access (i.e., alternating 15-day epochs of ethanol access and ethanol deprivation) in separate groups of rats. Thus, animals were exposed to either 135 days of continuous ethanol access or to five 15-day access periods alternating with four 15-day periods of ethanol deprivation. Animals were maintained individually in running-wheel cages under continuous darkness throughout the experiment to allow monitoring of free-running activity and drinking rhythms, and 10% (v/v) ethanol and plain water were available continuously via separate drinking tubes during ethanol access. While there were no initial sex differences in ethanol drinking, ethanol preference increased progressively in male P and HAD2 rats under both continuous and intermittent-access conditions, and eventually exceeded that seen in females. Free-running period shortened during the initial ethanol-access epoch in all groups, but the persistence of this effect showed complex dependence on sex, breeding line, and ethanol-access schedule. Finally, while females of both breeding lines displayed higher levels of locomotor activity than males, there was little evidence for modulation of activity level by ethanol access. These results are consistent with previous findings that chronic ethanol intake alters free-running circadian period, and show further that the development of chronobiological tolerance to ethanol may vary by sex and genotype. PMID:25281289

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.

Unpredictable convection in a small box: Molecular-dynamics experiments

NASA Astrophysics Data System (ADS)

Rapaport, D. C.

1992-08-01

The Rayleigh-Bénard problem has been studied using discrete-particle simulation of a two-dimensional fluid in a square box. The presence of temporal periodicity in the convective roll structure was observed, but, more significantly, different simulation runs under identical conditions but with initial states that differed in ways that are seemingly irrelevant at the macroscopic level exhibited very different forms of pattern evolution. The final state always consisted of a horizontally adjacent pair of rolls, but not all initial states evolved to produce well-established periodic behavior, despite the fact that very long runs were undertaken. Results for both hard- and soft-disk fluids are described; the simulations included systems with over 105 particles.

Addressing Diversity and Inclusion in the Early Years in Conflict-Affected Societies: A Case Study of the Media Initiative for Children--Northern Ireland

ERIC Educational Resources Information Center

Connolly, Paul; Fitzpatrick, Siobhan; Gallagher, Tony; Harris, Paul

2006-01-01

This article reports on the development and systematic evaluation of an innovative early years programme aimed at encouraging young children to respect differences within a deeply divided society that is emerging out of a prolonged period of violent conflict. The programme, the Media Initiative for Children--Northern Ireland, has been the product…

High-resolution simulation of deep pencil beam surveys - analysis of quasi-periodicity

NASA Astrophysics Data System (ADS)

Weiss, A. G.; Buchert, T.

1993-07-01

We carry out pencil beam constructions in a high-resolution simulation of the large-scale structure of galaxies. The initial density fluctuations are taken to have a truncated power spectrum. All the models have {OMEGA} = 1. As an example we present the results for the case of "Hot-Dark-Matter" (HDM) initial conditions with scale-free n = 1 power index on large scales as a representative of models with sufficient large-scale power. We use an analytic approximation for particle trajectories of a self-gravitating dust continuum and apply a local dynamical biasing of volume elements to identify luminous matter in the model. Using this method, we are able to resolve formally a simulation box of 1200h^-1^ Mpc (e.g. for HDM initial conditions) down to the scale of galactic halos using 2160^3^ particles. We consider this as the minimal resolution necessary for a sensible simulation of deep pencil beam data. Pencil beam probes are taken for a given epoch using the parameters of observed beams. In particular, our analysis concentrates on the detection of a quasi-periodicity in the beam probes using several different methods. The resulting beam ensembles are analyzed statistically using number distributions, pair-count histograms, unnormalized pair-counts, power spectrum analysis and trial-period folding. Periodicities are classified according to their significance level in the power spectrum of the beams. The simulation is designed for application to parameter studies which prepare future observational projects. We find that a large percentage of the beams show quasi- periodicities with periods which cluster at a certain length scale. The periods found range between one and eight times the cutoff length in the initial fluctuation spectrum. At significance levels similar to those of the data of Broadhurst et al. (1990), we find about 15% of the pencil beams to show periodicities, about 30% of which are around the mean separation of rich clusters, while the distribution of scales reaches values of more than 200h^-1^ Mpc. The detection of periodicities larger than the typical void size must not be due to missing of "walls" (like the so called "Great Wall" seen in the CfA catalogue of galaxies), but can be due to different clustering properties of galaxies along the beams.

Buprenorphine transdermal system utilization.

PubMed

Wallace, Laura; Kadakia, Aditi

2017-01-01

To evaluate utilization patterns in patients initiating buprenorphine transdermal system (BTDS), CIII, and estimate the proportion decreasing their total opioid dose over time. This retrospective cohort study used data from the Truven Health Analytics MarketScan® Commercial Claims and Encounters Database from 1 January 2011 through 31 December 2015. Eligible individuals were adults aged 18-64 years newly dispensed BTDS (index prescription) who had at least six months of insurance coverage prior to (baseline period) and following (study period) the index prescription. Back and neck pain was the most common pain condition in the study population (n = 31,533) and 88% were dispensed opioids in the baseline period. Nearly half (48%) received BTDS in a strength of 10 mcg/hour as their index prescription. Most (80%) patients prescribed BTDS had concomitant prescriptions for other opioids, chiefly immediate-release (IR) opioids (77%). During the baseline period, median opioid dose among patients prescribed opioids was 50 morphine-equivalent doses (MED), with 33% of patients using nonsteroidal anti-inflammatory drugs and 44% adjuvant analgesics. During the study period, BTDS use lasted a median 30 days and mean 100 days. Median dose of BTDS remained largely constant, and median dose of all opioids during continuous use of BTDS was 65.6 units MED. However, 24% of patients reduced total units MED from the baseline period (median mean dose, 74.5 units MED) until the end of the study period (42.8). Most patients initiating treatment with BTDS had a history of treatment with IR opioids. Though the average change in total opioid daily dose after patients were prescribed BTDS was modest, an important subpopulation of approximately one-quarter of patients were able to markedly reduce their total units MED compared with prior opioid therapy. BTDS should be investigated as an option to help patients step down from higher opioid doses.

The prevalence and determinants of breast-feeding initiation and duration in a sample of women in Ireland.

PubMed

Tarrant, Roslyn C; Younger, Katherine M; Sheridan-Pereira, Margaret; White, Martin J; Kearney, John M

2010-06-01

To assess breast-feeding initiation and prevalence from birth to 6 months in a sample of mothers in Dublin, and to determine the factors associated with breast-feeding initiation and 'any' breast-feeding at 6 weeks in a sample of Irish-national mothers. This prospective cross-sectional study involved the recruitment of women during the antenatal period, with subsequent follow-up of mothers who delivered healthy, term singleton infants, at 6 weeks and 6 months postpartum. Participants were recruited from antenatal clinics in the Coombe Women and Infants University Hospital, Dublin. In all, 401 Irish-national and forty-nine non-Irish-national mothers met the criteria for inclusion in the present study. Breast-feeding initiation rates of the Irish-national and non-Irish-nationals were 47% and 79.6%, respectively. Factors that were significantly (P = 0.000) associated with both breast-feeding initiation and 'any' breast-feeding at 6 weeks included mothers who were >or=35 years, educated to third level, reported positive postnatal encouragement to breast-feed from their partners and had a positive antenatal intention to breast-feed. The maternal negative perception that breast-feeding is an embarrassing way to feed an infant was demonstrated as a major barrier to initiation. Breast-feeding initiation and prevalence rates of the Irish-national population remain low and lag considerably behind national and international targets. Inclusion of the partner in breast-feeding promotional initiatives during the antenatal period may be crucial to increase breast-feeding rates in Ireland. Public health campaigns that focus on increasing the social acceptability of breast-feeding may prove effective in addressing this cultural barrier.

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

A Study of Time Constraints Related to Facilities Acquisition in Support of New Weapons Systems Initial Beddowns.

DTIC Science & Technology

1981-09-01

under SPO direction in one of three ways: 1) design definition paper studies, 2) hard- ware prototyping, or 3) some combination of both (17:2...initial tooling and production is accom- plished to bring the system production to the planned peak rate . The second period is concerned with follow-on...pro- duction after the peak rate is achieved (3:5-1). Sometime during this phase, program management 20 responsibility transfer (PMRT) is also

Laryngeal cancer in the United States: changes in demographics, patterns of care, and survival.

PubMed

Hoffman, Henry T; Porter, Kimberly; Karnell, Lucy H; Cooper, Jay S; Weber, Randall S; Langer, Corey J; Ang, Kie-Kian; Gay, Greer; Stewart, Andrew; Robinson, Robert A

2006-09-01

Survival has decreased among patients with laryngeal cancer during the past 2 decades in the United States. During this same period, there has been an increase in the nonsurgical treatment of laryngeal cancer. The objectives of this study were to identify trends in the demographics, management, and outcome of laryngeal cancer in the United States and to analyze factors contributing to the decreased survival. The authors conducted a retrospective, longitudinal study of laryngeal cancer cases. Review of the National Cancer Data Base (NCDB) revealed 158,426 cases of laryngeal squamous cell carcinoma (excluding verrucous carcinoma) diagnosed between the years 1985 and 2001. Analysis of these case records addressed demographics, management, and survival for cases grouped according to stage, site, and specific TNM classifications. This review of data from the NCDB analysis confirms the previously identified trend toward decreasing survival among patients with laryngeal cancer from the mid-1980s to mid-1990s. Patterns of initial management across this same period indicated an increase in the use of chemoradiation with a decrease in the use of surgery despite an increase in the use of endoscopic resection. The most notable decline in the 5-year relative survival between the 1985 to 1990 period and the 1994 to 1996 period occurred among advanced-stage glottic cancer, early-stage supraglottic cancers, and supraglottic cancers classified as T3N0M0. Initial treatment of T3N0M0 laryngeal cancer (all sites) in the 1994 to 1996 period resulted in poor 5-year relative survival for those receiving either chemoradiation (59.2%) or irradiation alone (42.7%) when compared with that of patients after surgery with irradiation (65.2%) and surgery alone (63.3%). In contrast, identical 5-year relative survival (65.6%) rates were observed during this same period for the subset of T3N0M0 glottic cancers initially treated with either chemoradiation or surgery with irradiation. The decreased survival recorded for patients with laryngeal cancer in the mid-1990s may be related to changes in patterns of management. Future studies are warranted to further evaluate these associations.

Incidence of Narcolepsy in Germany.

PubMed

Oberle, Doris; Drechsel-Bäuerle, Ursula; Schmidtmann, Irene; Mayer, Geert; Keller-Stanislawski, Brigitte

2015-10-01

Following the 2009 pandemic, reports of an association between an AS03 adjuvanted H1N1 pandemic influenza vaccine and narcolepsy were published. Besides determining background incidence rates for narcolepsy in Germany this study aimed at investigating whether there was a change in incidence rates of narcolepsy between the pre-pandemic, pandemic, and the post-pandemic period on the population level. Retrospective epidemiological study on the incidence of narcolepsy with additional capture-recapture analysis. German sleep centers. Eligible were patients with an initial diagnosis of narcolepsy (ICD10 Code G47.4) within the period from January 1, 2007 to December 31, 2011. None; observational study. A total of 342 sleep centers were invited to participate in the study. Adequate and suitable data were provided by 233 sleep centers (68.1%). A total of 1,198 patients with an initial diagnosis of narcolepsy within the observed period were included, of whom 106 (8.8%) were children and adolescents under the age of 18 years and 1,092 (91.2%) were adults. In children and adolescents, the age-standardized adjusted incidence rate significantly increased from 0.14/100,000 person-years in the pre-pandemic period to 0.50/100,000 person-years in the post-pandemic period (incidence density ratio, IDR 3.57; 95% CI 1.94-7.00). In adults, no significant change was detectable. This increase started in spring 2009. For the years 2007-2011, valid estimates for the incidence of narcolepsy in Germany were provided. In individuals under 18, the incidence rates continuously increased from spring 2009. © 2015 Associated Professional Sleep Societies, LLC.

Pit initiation on nitinol in simulated physiological solutions.

PubMed

Pound, Bruce G

2018-05-01

Inclusions appear to play a crucial role in the initiation of pitting on nitinol, but the reason remains unclear. Furthermore, it has not been established whether the type of inclusion is a central factor. In this study, potentiodynamic polarization together with scanning electron microscopy and energy dispersive X-ray spectroscopy were used to provide more insight into the initiation of pits on electropolished nitinol wire. Corrosion was limited to a single primary pit on each of the few wire samples that exhibited breakdown. The pit contained numerous Ti 2 NiO x inclusions, but secondary pits that developed within the primary pit provided evidence that these inclusions were the sites of pit initiation. Although several theories have been proposed to account for pit initiation at inclusions in mechanically polished and electropolished nitinol, titanium depletion in the adjacent alloy matrix appears to provide the most viable explanation. The key factor appears to be the size of the inclusion and therefore the extent of titanium depletion in the alloy matrix. The type of inclusion evidently plays a secondary role at most. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1605-1610, 2018. © 2017 Wiley Periodicals, Inc.

The Impacts of State Health Reform Initiatives on Adults in New York and Massachusetts

PubMed Central

Long, Sharon K; Stockley, Karen

2011-01-01

Objective To analyze the effects of health reform efforts in two large states—New York and Massachusetts. Data Sources/Study Setting National Health Interview Survey (NHIS) data from 1999 to 2008. Study Design We take advantage of the “natural experiments” that occurred in New York and Massachusetts to compare health insurance coverage and health care access and use for adults before and after the implementation of the health policy changes. To control for underlying trends not related to the reform initiatives, we subtract changes in the outcomes over the same time period for comparison groups of adults who were not affected by the policy changes using a differences-in-differences framework. The analyses are conducted using multiple comparison groups and different time periods as a check on the robustness of the findings. Data Collection/Extraction Methods Nonelderly adults ages 19–64 in the NHIS. Principal Findings We find evidence of the success of the initiatives in New York and Massachusetts at expanding insurance coverage, with the greatest gains reported by the initiative that was broadest in scope—the Massachusetts push toward universal coverage. There is no evidence of improvements in access to care in New York, reflecting the small gains in coverage under that state's reform effort and the narrow focus of the initiative. In contrast, there were significant gains in access to care in Massachusetts, where the impact on insurance coverage was greater and a more comprehensive set of reforms were implemented to improve access to a full array of health care services. The estimated gains in coverage and access to care reported here for Massachusetts were achieved in the early period under health reform, before the state's reform initiative was fully implemented. Conclusions Comprehensive reform initiatives are more successful at addressing gaps in coverage and access to care than are narrower efforts, highlighting the potential gains under national health reform. Tracking the implications of national health reform will be challenging, as sample sizes and content in existing national surveys are not currently sufficient for in-depth evaluations of the impacts of reform within many states. PMID:21091471

The Incorporation and Initialization of Cloud Water/ice in AN Operational Forecast Model

NASA Astrophysics Data System (ADS)

Zhao, Qingyun

Quantitative precipitation forecasts have been one of the weakest aspects of numerical weather prediction models. Theoretical studies show that the errors in precipitation calculation can arise from three sources: errors in the large-scale forecasts of primary variables, errors in the crude treatment of condensation/evaporation and precipitation processes, and errors in the model initial conditions. A new precipitation parameterization scheme has been developed to investigate the forecast value of improved precipitation physics via the introduction of cloud water and cloud ice into a numerical prediction model. The main feature of this scheme is the explicit calculation of cloud water and cloud ice in both the convective and stratiform precipitation parameterization. This scheme has been applied to the eta model at the National Meteorological Center. Four extensive tests have been performed. The statistical results showed a significant improvement in the model precipitation forecasts. Diagnostic studies suggest that the inclusion of cloud ice is important in transferring water vapor to precipitation and in the enhancement of latent heat release; the latter subsequently affects the vertical motion field significantly. Since three-dimensional cloud data is absent from the analysis/assimilation system for most numerical models, a method has been proposed to incorporate observed precipitation and nephanalysis data into the data assimilation system to obtain the initial cloud field for the eta model. In this scheme, the initial moisture and vertical motion fields are also improved at the same time as cloud initialization. The physical initialization is performed in a dynamical initialization framework that uses the Newtonian dynamical relaxation method to nudge the model's wind and mass fields toward analyses during a 12-hour data assimilation period. Results from a case study showed that a realistic cloud field was produced by this method at the end of the data assimilation period. Precipitation forecasts have been significantly improved as a result of the improved initial cloud, moisture and vertical motion fields.

Transient chaos in the Lorenz-type map with periodic forcing.

PubMed

Maslennikov, Oleg V; Nekorkin, Vladimir I; Kurths, Jürgen

2018-03-01

We consider a case study of perturbing a system with a boundary crisis of a chaotic attractor by periodic forcing. In the static case, the system exhibits persistent chaos below the critical value of the control parameter but transient chaos above the critical value. We discuss what happens to the system and particularly to the transient chaotic dynamics if the control parameter periodically oscillates. We find a non-exponential decaying behavior of the survival probability function, study the impact of the forcing frequency and amplitude on the escape rate, analyze the phase-space image of the observed dynamics, and investigate the influence of initial conditions.

Transient chaos in the Lorenz-type map with periodic forcing

NASA Astrophysics Data System (ADS)

Maslennikov, Oleg V.; Nekorkin, Vladimir I.; Kurths, Jürgen

2018-03-01

We consider a case study of perturbing a system with a boundary crisis of a chaotic attractor by periodic forcing. In the static case, the system exhibits persistent chaos below the critical value of the control parameter but transient chaos above the critical value. We discuss what happens to the system and particularly to the transient chaotic dynamics if the control parameter periodically oscillates. We find a non-exponential decaying behavior of the survival probability function, study the impact of the forcing frequency and amplitude on the escape rate, analyze the phase-space image of the observed dynamics, and investigate the influence of initial conditions.

Plain radiologic findings and chronological changes of incipient phase osteosarcoma overlooked by primary physicians.

PubMed

Song, Won Seok; Jeon, Dae-Geun; Cho, Wan Hyeong; Kong, Chang-Bae; Cho, Sang Hyun; Lee, Jung Wook; Lee, Soo-Yong

2014-06-01

We assessed the plain radiographic characteristics of 10 cases of osteosarcomas during the initial painful period that had been overlooked by a primary physician. In addition, we evaluated chronologic changes in radiographic findings from initial symptomatic period to the time of accurate diagnosis. The clinical records were reviewed for clinical parameters including age, sex, location, presenting symptoms, initial diagnosis, duration from initial symptoms to definite diagnosis, and initial and follow-up plain radiographic findings of the lesion. Initial clinical diagnoses included a sprain in 6, growing pain in 2, stress fracture in 1, and infection in 1 patient. Initial plain radiographic findings were trabecular destruction (100%), cortical disruption (60%), periosteal reaction (60%), and soft tissue mass (10%). Intramedullary matrix changes were osteosclerosis in 6 and osteolysis in 4 patients. On progression, 4 cases with minimal sclerosis changed to osteoblastic lesion in 3 patients and osteolytic lesion in 1. Four cases with faint osteolytic foci transformed into osteolytic lesion in 3 and mixed pattern in 1. Notable plain radiologic findings of incipient-stage osteosarcoma include trabecular disruption along with faint osteosclerosis or osteolysis. In symptomatic patients with trabecular destruction, additional imaging study including magnetic resonance imaging should be performed to exclude osteosarcoma in the incipient phase, even without radiologic findings suggesting malignant tumor, such as cortical destruction or periosteal reaction.

Real-world effectiveness of osteoporosis therapies for fracture reduction in post-menopausal women.

PubMed

Yusuf, Akeem A; Cummings, Steven R; Watts, Nelson B; Feudjo, Maurille Tepie; Sprafka, J Michael; Zhou, Jincheng; Guo, Haifeng; Balasubramanian, Akhila; Cooper, Cyrus

2018-03-21

Studies examining real-world effectiveness of osteoporosis therapies are beset by limitations due to confounding by indication. By evaluating longitudinal changes in fracture incidence, we demonstrated that osteoporosis therapies are effective in reducing fracture risk in real-world practice settings. Osteoporosis therapies have been shown to reduce incidence of vertebral and non-vertebral fractures in placebo-controlled randomized clinical trials. However, information on the real-world effectiveness of these therapies is limited. We examined fracture risk reduction in older, post-menopausal women treated with osteoporosis therapies. Using Medicare claims, we identified 1,278,296 women age ≥ 65 years treated with zoledronic acid, oral bisphosphonates, denosumab, teriparatide, or raloxifene. Fracture incidence rates before and after treatment initiation were described to understand patients' fracture risk profile, and fracture reduction effectiveness of each therapy was evaluated as a longitudinal change in incidence rates. Fracture incidence rates increased during the period leading up to treatment initiation and were highest in the 3-month period most proximal to treatment initiation. Fracture incidence rates following treatment initiation were significantly lower than before treatment initiation. Compared with the 12-month pre-index period, there were reductions in clinical vertebral fractures for denosumab (45%; 95% confidence interval [CI] 39-51%), zoledronic acid (50%; 95% CI 47-52%), oral bisphosphonates (24%; 95% CI 22-26%), and teriparatide (72%; 95% CI 69-75%) during the subsequent 12 months. Relative to the first 3 months after initiation, clinical vertebral fractures were reduced for denosumab (51%; 95% CI 42-59%), zoledronic acid (25%; 95% CI 17-32%), oral bisphosphonates (23%; 95% CI 20-26%), and teriparatide (64%; 95% CI 58-69%) during the subsequent 12 months. In summary, reductions in fracture incidence over time were observed in cohorts of patients treated with osteoporosis therapies.

Risk Analysis of Pneumonitis in Taxane Therapy After Chemoradiotherapy for Patients With Metastatic or Recurrent Esophageal Cancer.

PubMed

Kishida, Yoshihiro; Tsushima, Takahiro; Endo, Masahiro; Hamauchi, Satoshi; Todaka, Akiko; Yokota, Tomoya; Machida, Nozomu; Yamazaki, Kentaro; Fukutomi, Akira; Onozawa, Yusuke; Yasui, Hirofumi

2018-01-01

Taxane chemotherapy for esophageal cancer causes pneumonitis, not only by itself but also by radiation recall. This study aimed to clarify the risk of pneumonitis in patients with esophageal cancer who receive taxane therapy after chemoradiotherapy. The data of 129 patients with metastatic or recurrent esophageal cancer who initiated taxane therapy between September 2002 and June 2013 were retrospectively analyzed. Patient selection criteria were as follows: performance status ≤2, preserved organ functions, previous chemoradiotherapy with a radiation dose of ≥50 Gy, grade 0 or 1 pneumonitis at taxane initiation, and no concomitant malignancy. Logistic regression analysis was performed to identify risk factors for pneumonitis. Patient characteristics were as follows: males/females, 116/13; median age, 63 years (range, 44 to 80 y); performance status of 0/1/2, 61/60/8; smoking history, 112 (88%); location of the primary tumor Ce/Ut/Mt/Lt/Ae 12/30/66/20/1; median radiation dose, 60 Gy; history of radiation pneumonitis, 39 (30%); history of other pulmonary disease, 4 (3%); and median duration between the last radiation therapy (RT) exposure and taxane initiation, 6.1 months (range, 1.0 to 71 mo). During the median observation period of 7.8 months from taxane initiation, the incidence of grade 2 and 3 pneumonitis was observed in 7 (5.4%) and 3 (2.3%) patients, respectively. No patient died of pneumonitis. The only independent risk factor for pneumonitis was a ≤4-month period between the last RT exposure and taxane initiation (P=0.03). A short period between the last RT exposure and taxane initiation is an independent risk factor for pneumonitis development.

Investigating the effective range of vacuum ultraviolet-mediated breakdown in high-power microwave metamaterials

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

Liu, Chien-Hao, E-mail: cliu82@wisc.edu; Neher, Joel D., E-mail: jdneher@wisc.edu; Booske, John H., E-mail: booske@engr.wisc.edu

2014-10-14

Metamaterials and periodic structures operating under high-power excitations are susceptible to breakdown. It was recently demonstrated that a localized breakdown created in a given region of a periodic structure can facilitate breakdown in other regions of the structure where the intensity of the incident electromagnetic fields may not be high enough to cause breakdown under normal circumstances. It was also demonstrated that this phenomenon is due to the generation of vacuum ultraviolet radiation at the location of the initial discharge, which propagates to the neighboring regions (e.g., other unit cells in a periodic structure) and facilitates the generation of amore » discharge at a lower incident power level. In this paper, we present the results of an experimental study conducted to determine the effective range of this physical phenomenon for periodic structures that operate in air and in pure nitrogen gas at atmospheric pressure levels. It is demonstrated that when breakdown is induced in a periodic structure using a high-power pulse with a frequency of 9.382 GHz, duration of 0.8 μs, and peak power level of 25 kW, this phenomenon is highly likely to happen in radii of approximately 16–17 mm from the location of the initial discharge under these test conditions. The results of this study are significant in designing metamaterials and periodic structures for high-power microwave applications as they suggest that a localized discharge created in such a periodic structure with a periodicity less than 16–17 mm can spread over a large surface and result in a distributed discharge.« less

Chloroplast Osmotic Adjustment and Water Stress Effects on Photosynthesis 1

PubMed Central

Gupta, Ashima Sen; Berkowitz, Gerald A.

1988-01-01

Previous studies have suggested that chloroplast stromal volume reduction may mediate the inhibition of photosynthesis under water stress. In this study, the effects of spinach (Spinacia oleracea, var `Winter Bloomsdale') plant water deficits on chloroplast photosynthetic capacity, solute concentrations in chloroplasts, and chloroplast volume were studied. In situ (gas exchange) and in vitro measurements indicated that chloroplast photosynthetic capacity was maintained during initial leaf water potential (Ψw) and relative water content (RWC) decline. During the latter part of the stress period, photosynthesis dropped precipitously. Chloroplast stromal volume apparently remained constant during the initial period of decline in RWC, but as leaf Ψw reached −1.2 megapascals, stromal volume began to decline. The apparent maintenance of stromal volume over the initial RWC decline during a stress cycle suggested that chloroplasts are capable of osmotic adjustment in response to leaf water deficits. This hypothesis was confirmed by measuring chloroplast solute levels, which increased during stress. The results of these experiments suggest that stromal volume reduction in situ may be associated with loss of photosynthetic capacity and that one mechanism of photosynthetic acclimation to low Ψw may involve stromal volume maintenance. PMID:16666266

Thought suppression across time: Change in frequency and duration of thought recurrence.

PubMed

Lambert, Ann E; Hu, Yueqin; Magee, Joshua C; Beadel, Jessica R; Teachman, Bethany A

2014-01-01

Some studies have found that trying to suppress thoughts increases their long-term recurrence, a phenomenon associated with psychopathology, particularly obsessive-compulsive disorder. However, effect sizes in thought suppression studies have often been small and inconsistent. The present study sought to improve thought suppression conceptualization and measurement by examining two distinct dimensions of thought recurrence - frequency and duration of a thought's return - and how they evolve over time. After a thought focus period, 100 adults were assigned to either suppress or monitor the recurrence of an unpleasant thought for 4 min. Then, during a second four-minute period, all participants were asked to monitor the thought's recurrence. Hierarchical linear modeling indicated that thought frequency declined across time and the rate of decline slowed as time went on. Initially, the extent of thought duration remained short and stable for those asked to suppress, and increased linearly over time for those asked to monitor. Later, this pattern reversed. Duration increased linearly for those initially asked to suppress but was short and stable for those who initially monitored. Accounting for change over time and means of measuring recurrence (frequency vs. duration) may help elucidate past mixed findings, and improve thought suppression research methodology.

Complex transitions between spike, burst or chaos synchronization states in coupled neurons with coexisting bursting patterns

NASA Astrophysics Data System (ADS)

Gu, Hua-Guang; Chen, Sheng-Gen; Li, Yu-Ye

2015-05-01

We investigated the synchronization dynamics of a coupled neuronal system composed of two identical Chay model neurons. The Chay model showed coexisting period-1 and period-2 bursting patterns as a parameter and initial values are varied. We simulated multiple periodic and chaotic bursting patterns with non-(NS), burst phase (BS), spike phase (SS), complete (CS), and lag synchronization states. When the coexisting behavior is near period-2 bursting, the transitions of synchronization states of the coupled system follows very complex transitions that begins with transitions between BS and SS, moves to transitions between CS and SS, and to CS. Most initial values lead to the CS state of period-2 bursting while only a few lead to the CS state of period-1 bursting. When the coexisting behavior is near period-1 bursting, the transitions begin with NS, move to transitions between SS and BS, to transitions between SS and CS, and then to CS. Most initial values lead to the CS state of period-1 bursting but a few lead to the CS state of period-2 bursting. The BS was identified as chaos synchronization. The patterns for NS and transitions between BS and SS are insensitive to initial values. The patterns for transitions between CS and SS and the CS state are sensitive to them. The number of spikes per burst of non-CS bursting increases with increasing coupling strength. These results not only reveal the initial value- and parameter-dependent synchronization transitions of coupled systems with coexisting behaviors, but also facilitate interpretation of various bursting patterns and synchronization transitions generated in the nervous system with weak coupling strength. Project supported by the National Natural Science Foundation of China (Grant Nos. 11372224 and 11402039) and the Fundamental Research Funds for Central Universities designated to Tongji University (Grant No. 1330219127).

A possible formation channel for blue hook stars in globular cluster - II. Effects of metallicity, mass ratio, tidal enhancement efficiency and helium abundance

NASA Astrophysics Data System (ADS)

Lei, Zhenxin; Zhao, Gang; Zeng, Aihua; Shen, Lihua; Lan, Zhongjian; Jiang, Dengkai; Han, Zhanwen

2016-12-01

Employing tidally enhanced stellar wind, we studied in binaries the effects of metallicity, mass ratio of primary to secondary, tidal enhancement efficiency and helium abundance on the formation of blue hook (BHk) stars in globular clusters (GCs). A total of 28 sets of binary models combined with different input parameters are studied. For each set of binary model, we presented a range of initial orbital periods that is needed to produce BHk stars in binaries. All the binary models could produce BHk stars within different range of initial orbital periods. We also compared our results with the observation in the Teff-logg diagram of GC NGC 2808 and ω Cen. Most of the BHk stars in these two GCs locate well in the region predicted by our theoretical models, especially when C/N-enhanced model atmospheres are considered. We found that mass ratio of primary to secondary and tidal enhancement efficiency have little effects on the formation of BHk stars in binaries, while metallicity and helium abundance would play important roles, especially for helium abundance. Specifically, with helium abundance increasing in binary models, the space range of initial orbital periods needed to produce BHk stars becomes obviously wider, regardless of other input parameters adopted. Our results were discussed with recent observations and other theoretical models.

THE ROLE OF SELF-MONITORING IN THE MAINTENANCE OF WEIGHT LOSS SUCCESS

PubMed Central

Minski, Samantha A.; Perri, Michael G.

2016-01-01

Introduction Self-monitoring has been shown to be a crucial part of initial weight loss success in behavioral interventions. However, little is known about the impact of self-monitoring during the period following initial treatment. Methods The current study examined the role of self-monitoring on weight loss during an initial 6-month intervention period (Phase1) and a 12-month extended care period (Phase 2) in a group of 167 obese women (M±SD: BMI = 37.0±5.1 kg/m2, age = 59.9±6.2 years) enrolled in a behavioral weight loss program. Results Cluster analysis identified three groups of participants with low, moderate, and high rates of weight loss success during Phase 1 and Phase 2. A one-way ANOVA revealed no significant differences in self-monitoring frequency between groups during Phase 1 (p = .645), but significant differences between all three groups during Phase 2 (p = .001). High success participants completed the most self-monitoring records, followed by the moderate group. The low success group completed the least number of records. Furthermore, self-monitoring during Phase 2 significantly mediated the relationship between extended-care session attendance and percent weight change during that time (95% CI [−.004, −.001], p < .001). Conclusion These results highlight the importance of continuing self-monitoring after the initial phase of treatment to maintain lost weight. PMID:26974582

Collecting mortality data to drive real-time improvement in suicide prevention.

PubMed

Ahmedani, Brian K; Coffey, Justin; Coffey, C Edward

2013-11-01

To evaluate the use of government mortality records compared with internally collected data to drive quality improvement in suicide prevention programs using suicide mortality data from the Perfect Depression Care initiative. Perfect Depression Care (PDC) is a quality improvement suicide prevention initiative within the Behavioral Health Services (BHS) division of the Henry Ford Health System. Eligible subjects were all patients who received services from BHS, were members of the health maintenance organization, and had a medical group physician during the 11-year study period. Mortality data were collected internally and from government-collected death records, and were linked to treatment utilization data from the medical record. The mean suicide rate was 96.6 per 100,000 during the 2-year baseline period (1999- 2000) and declined to 19.1 per 100,000 during the initiative (2002-2009) using both sources of data combined. We observed a similar statistically significant (P <.001) reduction in the suicide death rate using both the internal and government data sources. There were no significant differences between the 2 sources of data in the mean suicide rates for the baseline and intervention periods (P >.05). The data sources did differ in the capture of unique suicide deaths. Internally collected data were an effective measure of suicide deaths in the PDC initiative. A combination of internal and government-collected records may be most effective for future suicide prevention programs.

77 FR 65555 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-29

... the initial data collection for select restaurant facility types, followed by the initial data... period data collection survey measurement) period Restaurants Full Service 2013 2016 2019 Restaurants. Fast Food Restaurants. Institutional Foodservice........ Hospitals 2014 2017 2020 Nursing Homes...

Retrospective Analysis of Dose Titration and Serum Testosterone Level Assessments in Patients Treated With Topical Testosterone.

PubMed

Muram, David; Kaltenboeck, Anna; Boytsov, Natalie; Hayes-Larson, Eleanor; Ivanova, Jasmina; Birnbaum, Howard G; Swindle, Ralph

2015-11-01

Patterns of care following topical testosterone agent (TTA) initiation are poorly understood. This study aimed to characterize care following TTA initiation and compare results between patients with and without a serum testosterone (T) assay within 30 days before and including TTA initiation. Adult men (N=4,146) initiating TTAs from January 1, 2011, to March 31, 2012, were identified from a commercially insured database. Patients were included if they initiated at recommended starting dose (RSD) and had ≥12 and ≥6 months of continuous eligibility preinitiation (baseline) and postinitiation (study period), respectively. Patients were stratified by preinitiation T assay. Maintenance dose attainment month was determined using unadjusted generalized estimating equations regression to compare dose relative to RSD month by month. Outcomes included maintenance dose attainment month, time to stopping of index TTA refills or a claim for nonindex testosterone replacement therapy (TRT), and proportion of patients with study period T assay or diagnosis of hypogonadism (HG) or another low testosterone condition, and were compared using chi-square and Wilcoxon rank-sum tests for categorical and continuous variables, respectively. Maintenance dose was attained in Month 4 postinitiation, at 115.2% of RSD. Approximately 46% of patients had a preinitiation T assay; these men were more likely to receive a diagnosis of HG or another low testosterone condition, to have a follow-up T assay, to continue treatment by filling a nonindex TRT, and less likely to stop refilling treatment with their index TTA. Differences in care following TTA initiation suggest that preinitiation T assays (i.e., guideline-based care) may be helpful in ensuring treatment benefits. © The Author(s) 2014.

Trends in initiation of direct oral anticoagulant therapies for atrial fibrillation in a national population-based cross-sectional study in the French health insurance databases

PubMed Central

Huiart, Laetitia; Ferdynus, Cyril; Renoux, Christel; Beaugrand, Amélie; Lafarge, Sophie; Bruneau, Léa; Suissa, Samy; Maillard, Olivier; Ranouil, Xavier

2018-01-01

Objective Unlike several other national health agencies, French health authorities recommended that the newer direct oral anticoagulant (DOAC) agents only be prescribed as second choice for the treatment of newly diagnosed non-valvular atrial fibrillation (NVAF), with vitamin K antagonists (VKA) remaining the first choice. We investigated the patterns of use of DOACs versus VKA in the treatment of NVAF in France over the first 5 years of DOAC availability. We also identified the changes in patient characteristics of those who initiated DOAC treatment over this time period. Methods Based on the French National Health Administrative Database, we constituted a population-based cohort of all patients who were newly treated for NVAF between January 2011 and December 2015. Trends in drug use were described as the percentage of patients initiating each drug at the time of treatment initiation. A multivariate analysis using logistic regression model was performed to identify independent sociodemographic and clinical predictors of initial anticoagulant choice. Results The cohort comprised 814 446 patients who had received a new anticoagulant treatment for NVAF. The proportion of patients using DOACs as initial anticoagulant therapy reached 54% 3 months after the Health Ministry approved the reimbursement of dabigatran for NVAF, and 61% by the end of 2015, versus VKA use. In the multivariate analysis, we found that DOAC initiators were younger and healthier overall than VKA initiators, and this tendency was reinforced over the 2011–2014 period. DOACs were more frequently prescribed by cardiologists in 2012 and after (adjusted OR in 2012: 2.47; 95% CI 2.40 to 2.54). Conclusion Despite recommendations from health authorities, DOACs have been rapidly and massively adopted as initial therapy for NVAF in France. Observational studies should account for the fact that patients selected to initiate DOAC treatment are healthier overall, as failure to do so may bias the risk–benefit assessment of DOACs. PMID:29602837

[Comparison of the botanic morphology and blooming characteristics of four cultivars of rose].

PubMed

Wang, Kang-cai; Tang, Xiao-qing; Sheng, Min-li; Xu, Xiao-lan; Fang, Zhen

2004-05-01

To establish identifying method for further development and utilization by studying botanic morphology and blooming characteristics of four varieties of roses in Jiangsu province. Flower-bud and flower-form were observed by dissection and plant modality and blooming process were investigated. The flower form and plant modality was obviously different among the 4 varieties of roses. The process of differentiation of flower-bud could be divided into five stages: the transformation of nutritive growth cone, the occurrence and development of sepal, formation of petal primordium, formation of pistil and stamen. The blooming process was made up of flower-bud period, display-petal period, initiating blooming period, blooming period, withering period and corresponding biological marks.

Memory consolidation in aging and MCI after 1 week

PubMed Central

Walsh, Christine M; Wilkins, Sarah; Bettcher, Brianne Magouirk; Butler, Christopher R; Miller, Bruce L; Kramer, Joel H

2014-01-01

Objective To assess consolidation in amnestic mild cognitive (aMCI) impairment, controlling for differences in initial learning and using a protracted delay period for recall. Methods Fifteen individuals with MCI were compared to fifteen healthy older adult controls on a story learning task. Subjects were trained to criteria to equalize initial learning across subjects. Recall was tested at both the 30-minute typically used delay and a 1-week delay used to target consolidation. Results Using repeated measures ANOVAs adjusted for age, we found group × time point interactions across the entire task between the final trial and 30-minute delay, and again between the 30-minute and 1-week delay periods, with MCI having greater declines in recall as compared to controls. Significant group main effects were also found, with MCI recalling less than controls. Conclusion Consolidation was impaired in aMCI as compared to controls. Our findings indicate that MCI-related performance typically measured at 30 minutes underestimates MCI-associated memory deficits. This is the first study to isolate consolidation by controlling for initial learning differences and using a protracted delay period to target consolidation in an MCI sample. PMID:24219610

Synchronization transition of a coupled system composed of neurons with coexisting behaviors near a Hopf bifurcation

NASA Astrophysics Data System (ADS)

Jia, Bing

2014-05-01

The coexistence of a resting condition and period-1 firing near a subcritical Hopf bifurcation point, lying between the monostable resting condition and period-1 firing, is often observed in neurons of the central nervous systems. Near such a bifurcation point in the Morris—Lecar (ML) model, the attraction domain of the resting condition decreases while that of the coexisting period-1 firing increases as the bifurcation parameter value increases. With the increase of the coupling strength, and parameter and initial value dependent synchronization transition processes from non-synchronization to compete synchronization are simulated in two coupled ML neurons with coexisting behaviors: one neuron chosen as the resting condition and the other the coexisting period-1 firing. The complete synchronization is either a resting condition or period-1 firing dependent on the initial values of period-1 firing when the bifurcation parameter value is small or middle and is period-1 firing when the parameter value is large. As the bifurcation parameter value increases, the probability of the initial values of a period-1 firing neuron that lead to complete synchronization of period-1 firing increases, while that leading to complete synchronization of the resting condition decreases. It shows that the attraction domain of a coexisting behavior is larger, the probability of initial values leading to complete synchronization of this behavior is higher. The bifurcations of the coupled system are investigated and discussed. The results reveal the complex dynamics of synchronization behaviors of the coupled system composed of neurons with the coexisting resting condition and period-1 firing, and are helpful to further identify the dynamics of the spatiotemporal behaviors of the central nervous system.

Initial study and verification of a distributed fiber optic corrosion monitoring system for transportation structures.

DOT National Transportation Integrated Search

2012-07-01

For this study, a novel optical fiber sensing system was developed and tested for the monitoring of corrosion in : transportation systems. The optical fiber sensing system consists of a reference long period fiber gratings (LPFG) sensor : for corrosi...

Japan's Colonial Policies--From National Assimilation to the Kominka Movement: A Comparative Study of Primary Education in Taiwan and Korea (1937-1945)

ERIC Educational Resources Information Center

Peng, Huan-Sheng; Chu, Jo-Ying

2017-01-01

The eight-year-long period from Japan's initiation of the Second Sino-Japanese War in 1937 to its unconditional surrender in 1945 forced Japan to invest its national economy and industrial and scientific technologies in the war. In addition, in the name of the Greater East Asia Co-Prosperity Sphere, Japan initiated its assimilation and Kominka…

Reduction of central line-associated bloodstream infections in a pediatric hematology/oncology population.

PubMed

Wilson, Matthew Z; Deeter, Deana; Rafferty, Colleen; Comito, Melanie M; Hollenbeak, Christopher S

2014-01-01

This study reports the results of an initiative to reduce central line-associated bloodstream infections (CLABSIs) among pediatric hematology/oncology patients, a population at increased risk for CLABSI. The study design was a pre-post comparison of a series of specific interventions over 40 months. Logistic regression was used to determine if the risk of developing CLABSI decreased in the postintervention period, after controlling for covariates. The overall CLABSI rate fell from 9 infections per 1000 line days at the beginning of the study to zero in a cohort of 291 patients encompassing 2107 admissions. Admissions during the intervention period had an 86% reduction in odds of developing a CLABSI, controlling for other factors. At the study team's institution, an initiative that standardized blood culturing techniques, lab draw times, line care techniques, and provided physician and nurse education was able to eliminate CLABSI among pediatric hematology/oncology patients. © 2013 by the American College of Medical Quality.

Impact of initiation of asenapine on patterns of utilization and cost of healthcare resources associated with the treatment of bipolar I disorder.

PubMed

Chitnis, Abhishek; Wang, Rosa; Sun, Shawn X; Dixit, Shailja; Tawah, Alie; Boulanger, Luke

2015-01-01

To assess the impact of initiation of asenapine on "real-world" levels of utilization and cost of healthcare services for the treatment of bipolar I disorder (BPD) in the US. Using two large US healthcare claims databases that collectively included commercially insured patients aged < 65 years and Medicare enrollees, this study identified all adults (≥ 18 years) with evidence of BPD who began therapy with asenapine between 2009-2012. The date of the earliest claim for asenapine during this period was deemed the 'index date', and patients without continuous enrollment for the 6-month periods before and after this date were excluded ('pre-index' and 'post-index', respectively). Healthcare claims with a BPD diagnosis, plus psychiatric medications and the costs thereof (2012 dollars) were deemed 'BPD-related'. Differences in BPD-related utilization and cost of healthcare services were compared between the pre- and post-index periods. A total of 1403 patients met all selection criteria; the mean age was 42.8 years and 70.6% were women. Relative to pre-index, significant decreases were noted in post-index use of BPD-related healthcare services, most notably admissions (from 24.0% to 12.3% during the post-index period) and emergency department visits (from 4.6% to 2.6%) (both p < 0.05). While pharmacy costs increased, mean total post-index BPD-related healthcare costs were $979 lower than pre-index ($5002 vs $5981; p < 0.05), primarily due to the decrease in BPD-related admissions. Relative to the 6-month period beforehand, levels of utilization of BPD-related healthcare services and costs decreased during the 6-month period immediately following initiation of asenapine therapy.

Factors associated with the initiation of disease-modifying antirheumatic drugs in newly diagnosed rheumatoid arthritis: a retrospective claims database study.

PubMed

Bonafede, Machaon M K; Fox, Kathleen M; Johnson, Barbara H; Watson, Crystal; Gandra, Shravanthi R

2012-02-01

The objectives of this study were to quantify the proportion of US patients with newly diagnosed rheumatoid arthritis (RA) in whom disease-modifying antirheumatic drug (DMARD) therapy was initiated within 12 months following diagnosis, to determine mean time to initiation, to compare the characteristics of initiators versus noninitiators, and to identify factors associated with noninitiation. A retrospective study was conducted using claims from the databases of commercial managed care and Medicare supplemental managed care to identify patients with claims containing codes for RA dated January 1, 2004, through September 30, 2008. The percentage of patients with RA and a prescription for a DMARD within 12 months after the index date (initiators) was evaluated. The characteristics of DMARD initiators and noninitiators during the preindex period were compared, including demographic and clinical characteristics, health care resource utilization, and cost variables. The probability of DMARD initiation was determined using survival analysis. Multivariate analysis was performed to estimate mean time from diagnosis to DMARD initiation based on demographic and clinical variables. Of 26,911 patients with newly diagnosed RA identified in the database searches, 63% had been prescribed a DMARD within 12 months after diagnosis. DMARD initiators were significantly more likely to have had a rheumatologist visit and rheumatoid factor testing and were more likely to have received a corticosteroid and/or an NSAID (all, P < 0.001). DMARD initiators had significantly lower total costs ($10,534 vs $12,725, respectively) and pharmacy drug costs ($2438 vs $2822) over the preindex period compared with noninitiators (both, P < 0.001). Independent factors associated with a greater likelihood of DMARD initiation included a rheumatologist visit, rheumatoid factor testing, NSAID use, and corticosteroid use. Age ≥85 years and the presence of comorbidities were associated with a significantly lower likelihood of DMARD initiation. Among managed care enrollees in the present analysis, 37% of patients newly diagnosed with RA were not being treated with DMARDs in the first 12 months after diagnosis. Time to DMARD initiation plateaued after 90 days, suggesting that if a patient was not prescribed a DMARD soon after RA diagnosis, he or she was not likely to receive one. Copyright © 2012 Elsevier HS Journals, Inc. All rights reserved.

Modeling Learning and Memory Using Verbal Learning Tests: Results From ACTIVE

PubMed Central

Gross, Alden L.

2013-01-01

Objective. To investigate the influence of memory training on initial recall and learning. Method. The Advanced Cognitive Training for Independent and Vital Elderly study of community-dwelling adults older than age 65 (n = 1,401). We decomposed trial-level recall in the Auditory Verbal Learning Test (AVLT) and Hopkins Verbal Learning Test (HVLT) into initial recall and learning across trials using latent growth models. Results. Trial-level increases in words recalled in the AVLT and HVLT at each follow-up visit followed an approximately logarithmic shape. Over the 5-year study period, memory training was associated with slower decline in Trial 1 AVLT recall (Cohen’s d = 0.35, p = .03) and steep pre- and posttraining acceleration in learning (d = 1.56, p < .001). Findings were replicated using the HVLT (decline in initial recall, d = 0.60, p = .01; pre- and posttraining acceleration in learning, d = 3.10, p < .001). Because of the immediate training boost, the memory-trained group had a higher level of recall than the control group through the end of the 5-year study period despite faster decline in learning. Discussion. This study contributes to the understanding of the mechanisms by which training benefits memory and expands current knowledge by reporting long-term changes in initial recall and learning, as measured from growth models and by characterization of the impact of memory training on these components. Results reveal that memory training delays the worsening of memory span and boosts learning. PMID:22929389

Chronic Hepatitis C Treatment with Daclatasvir Plus Asunaprevir Does Not Lead to a Decreased Quality of Life.

PubMed

Kawakubo, Megumi; Eguchi, Yuichiro; Okada, Michiaki; Iwane, Shinji; Oeda, Satoshi; Otsuka, Taiga; Nakashita, Syunya; Araki, Norimasa; Koga, Akemi

2018-03-09

Objective The aim of this study was to determine if direct-acting antiviral (DAA) treatment with daclatasvir (DCV) plus asunaprevir (ASV) for 24 weeks influenced the health-related quality of life (HRQOL) at 12 and 24 weeks after treatment initiation (end of treatment [EOT]). Methods This was a prospective, longitudinal study comparing the HRQOL of patients receiving DAA treatment at 12 weeks after treatment initiation and EOT with the HRQOL at baseline. We used a Japanese-validated version of the 8-item Short Form Health Survey (SF-8) to assess the HRQOL of patients. This score can be compared to the Japanese normative sample scores of SF-8. Wilcoxon signed-rank tests were used to compare the HRQOL before treatment, 12 weeks after treatment initiation, and at EOT. Patients We enrolled patients who received 24-week combination therapy using DCV and ASV for HCV at Saga University Hospital between November 2014 and July 2015. Those who discontinued treatment due to relapse or adverse reactions during the treatment period were excluded from the study. Results There were no significant changes in any of the SF-8 subscales, Physical component scores (PCS) or mental component scores (MCS) during the treatment period for both males and females. Conclusion Our study makes a significant contribution to the literature because 24-week DAA treatment with DCV plus ASV did not decrease the HRQOL at 12 or 24 weeks after treatment initiation.

Modeling learning and memory using verbal learning tests: results from ACTIVE.

PubMed

Gross, Alden L; Rebok, George W; Brandt, Jason; Tommet, Doug; Marsiske, Michael; Jones, Richard N

2013-03-01

To investigate the influence of memory training on initial recall and learning. The Advanced Cognitive Training for Independent and Vital Elderly study of community-dwelling adults older than age 65 (n = 1,401). We decomposed trial-level recall in the Auditory Verbal Learning Test (AVLT) and Hopkins Verbal Learning Test (HVLT) into initial recall and learning across trials using latent growth models. Trial-level increases in words recalled in the AVLT and HVLT at each follow-up visit followed an approximately logarithmic shape. Over the 5-year study period, memory training was associated with slower decline in Trial 1 AVLT recall (Cohen's d = 0.35, p = .03) and steep pre- and posttraining acceleration in learning (d = 1.56, p < .001). Findings were replicated using the HVLT (decline in initial recall, d = 0.60, p = .01; pre- and posttraining acceleration in learning, d = 3.10, p < .001). Because of the immediate training boost, the memory-trained group had a higher level of recall than the control group through the end of the 5-year study period despite faster decline in learning. This study contributes to the understanding of the mechanisms by which training benefits memory and expands current knowledge by reporting long-term changes in initial recall and learning, as measured from growth models and by characterization of the impact of memory training on these components. Results reveal that memory training delays the worsening of memory span and boosts learning.

40 CFR 90.318 - Oxides of nitrogen analyzer calibration.

Code of Federal Regulations, 2010 CFR

2010-07-01

... chemiluminescent oxides of nitrogen analyzer as described in this section. (b) Initial and Periodic Interference... and periodic calibration. Prior to its initial use and monthly thereafter, or within one month prior... following table). Example calibration points (%) Acceptable for calibration? 20, 30, 40, 50, 60, 70 No...

40 CFR 91.318 - Oxides of nitrogen analyzer calibration.

Code of Federal Regulations, 2011 CFR

2011-07-01

... nitrogen analyzer as described in this section. (b) Initial and periodic interference. Prior to its... is required. (c) Initial and periodic calibration. Prior to its introduction into service, and... 80 percent of the 10 to 90 percent range (64 percent) is required (see following table). Example...

40 CFR 91.318 - Oxides of nitrogen analyzer calibration.

Code of Federal Regulations, 2013 CFR

2013-07-01

... nitrogen analyzer as described in this section. (b) Initial and periodic interference. Prior to its... is required. (c) Initial and periodic calibration. Prior to its introduction into service, and... 80 percent of the 10 to 90 percent range (64 percent) is required (see following table). Example...

40 CFR 90.318 - Oxides of nitrogen analyzer calibration.

Code of Federal Regulations, 2011 CFR

2011-07-01

... chemiluminescent oxides of nitrogen analyzer as described in this section. (b) Initial and Periodic Interference... and periodic calibration. Prior to its initial use and monthly thereafter, or within one month prior... following table). Example calibration points (%) Acceptable for calibration? 20, 30, 40, 50, 60, 70 No...

40 CFR 91.318 - Oxides of nitrogen analyzer calibration.

Code of Federal Regulations, 2010 CFR

2010-07-01

... nitrogen analyzer as described in this section. (b) Initial and periodic interference. Prior to its... is required. (c) Initial and periodic calibration. Prior to its introduction into service, and... 80 percent of the 10 to 90 percent range (64 percent) is required (see following table). Example...

40 CFR 90.318 - Oxides of nitrogen analyzer calibration.

Code of Federal Regulations, 2013 CFR

2013-07-01

... chemiluminescent oxides of nitrogen analyzer as described in this section. (b) Initial and Periodic Interference... and periodic calibration. Prior to its initial use and monthly thereafter, or within one month prior... following table). Example calibration points (%) Acceptable for calibration? 20, 30, 40, 50, 60, 70 No...

Experimental Study of Tip Vortex Flow from a Periodically Pitched Airfoil Section

NASA Technical Reports Server (NTRS)

Zaman, Khairul; Fagan, Amy; Mankbadi, Mina

2016-01-01

An experimental investigation of tip vortex flow from a NACA0012 airfoil, pitched periodically at various frequencies, is conducted in a low-speed wind tunnel. Initially, data for stationary airfoil held fixed at various angles-of-attack are gathered. Flow visualization pictures as well as detailed cross-sectional properties areobtained at various streamwise locations using hot-wire anemometry. Data include mean velocity, streamwise vorticity as well as various turbulent stresses. Preliminary data are also acquired for periodically pitched airfoil. These results are briefly presented in this extended abstract.

Stabilizing the long-time behavior of the forced Navier-Stokes and damped Euler systems by large mean flow

NASA Astrophysics Data System (ADS)

Cyranka, Jacek; Mucha, Piotr B.; Titi, Edriss S.; Zgliczyński, Piotr

2018-04-01

The paper studies the issue of stability of solutions to the forced Navier-Stokes and damped Euler systems in periodic boxes. It is shown that for large, but fixed, Grashoff (Reynolds) number the turbulent behavior of all Leray-Hopf weak solutions of the three-dimensional Navier-Stokes equations, in periodic box, is suppressed, when viewed in the right frame of reference, by large enough average flow of the initial data; a phenomenon that is similar in spirit to the Landau damping. Specifically, we consider an initial data which have large enough spatial average, then by means of the Galilean transformation, and thanks to the periodic boundary conditions, the large time independent forcing term changes into a highly oscillatory force; which then allows us to employ some averaging principles to establish our result. Moreover, we also show that under the action of fast oscillatory-in-time external forces all two-dimensional regular solutions of the Navier-Stokes and the damped Euler equations converge to a unique time-periodic solution.

Chloromethane to olefins over H-SAPO-34: Probing the hydrocarbon pool mechanism

DOE PAGES

Fickel, Dustin W.; Sabnis, Kaiwalya D.; Li, Luanyi; ...

2016-09-09

In this paper, by means of in situ FTIR and ex situ 13C NMR studies, the initial periods of the chloromethane-to-olefins (CTO) reaction over SAPO-34 were probed in order to investigate the activation period of the reaction and to elucidate the formation of the catalyst active site. A methylated benzene species has been observed to form during the initial activation period of the reaction, and a direct positive correlation was constructed between the formation of this species and the catalytic activity. The data thus indicate that these methylated benzene species contribute to the formation of active sites within SAPO-34 formore » the CTO reaction. This is the first known report identifying a direct semi-quantitative correlation between the catalyst activity and growth of a methylated benzene active species, during the activation period of the chloromethane to olefins reaction. Finally, the findings here in correspond well to those reported for the methanol to olefins reaction, suggesting that a similar ‘hydrocarbon pool’ mechanism may be responsible for the formation of light olefins in CTO chemistry as well.« less

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

Fickel, Dustin W.; Sabnis, Kaiwalya D.; Li, Luanyi

In this paper, by means of in situ FTIR and ex situ 13C NMR studies, the initial periods of the chloromethane-to-olefins (CTO) reaction over SAPO-34 were probed in order to investigate the activation period of the reaction and to elucidate the formation of the catalyst active site. A methylated benzene species has been observed to form during the initial activation period of the reaction, and a direct positive correlation was constructed between the formation of this species and the catalytic activity. The data thus indicate that these methylated benzene species contribute to the formation of active sites within SAPO-34 formore » the CTO reaction. This is the first known report identifying a direct semi-quantitative correlation between the catalyst activity and growth of a methylated benzene active species, during the activation period of the chloromethane to olefins reaction. Finally, the findings here in correspond well to those reported for the methanol to olefins reaction, suggesting that a similar ‘hydrocarbon pool’ mechanism may be responsible for the formation of light olefins in CTO chemistry as well.« less

The Impact of Soil Moisture Initialization On Seasonal Precipitation Forecasts

NASA Technical Reports Server (NTRS)

Koster, R. D.; Suarez, M. J.; Tyahla, L.; Houser, Paul (Technical Monitor)

2002-01-01

Some studies suggest that the proper initialization of soil moisture in a forecasting model may contribute significantly to the accurate prediction of seasonal precipitation, especially over mid-latitude continents. In order for the initialization to have any impact at all, however, two conditions must be satisfied: (1) the initial soil moisture anomaly must be "remembered" into the forecasted season, and (2) the atmosphere must respond in a predictable way to the soil moisture anomaly. In our previous studies, we identified the key land surface and atmospheric properties needed to satisfy each condition. Here, we tie these studies together with an analysis of an ensemble of seasonal forecasts. Initial soil moisture conditions for the forecasts are established by forcing the land surface model with realistic precipitation prior to the start of the forecast period. As expected, the impacts on forecasted precipitation (relative to an ensemble of runs that do not utilize soil moisture information) tend to be localized over the small fraction of the earth with all of the required land and atmosphere properties.

41 CFR 302-11.23 - When must I request to have my initial time period extended?

Code of Federal Regulations, 2010 CFR

2010-07-01

... have my initial time period extended? 302-11.23 Section 302-11.23 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE TRANSACTION ALLOWANCES 11-ALLOWANCES FOR EXPENSES INCURRED IN CONNECTION WITH RESIDENCE TRANSACTIONS General Rules Time Limitations...

41 CFR 302-11.23 - When must I request to have my initial time period extended?

Code of Federal Regulations, 2014 CFR

2014-07-01

... have my initial time period extended? 302-11.23 Section 302-11.23 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE TRANSACTION ALLOWANCES 11-ALLOWANCES FOR EXPENSES INCURRED IN CONNECTION WITH RESIDENCE TRANSACTIONS General Rules Time Limitations...

41 CFR 302-11.23 - When must I request to have my initial time period extended?

Code of Federal Regulations, 2013 CFR

2013-07-01

... have my initial time period extended? 302-11.23 Section 302-11.23 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE TRANSACTION ALLOWANCES 11-ALLOWANCES FOR EXPENSES INCURRED IN CONNECTION WITH RESIDENCE TRANSACTIONS General Rules Time Limitations...

41 CFR 302-11.23 - When must I request to have my initial time period extended?

Code of Federal Regulations, 2011 CFR

2011-07-01

... have my initial time period extended? 302-11.23 Section 302-11.23 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE TRANSACTION ALLOWANCES 11-ALLOWANCES FOR EXPENSES INCURRED IN CONNECTION WITH RESIDENCE TRANSACTIONS General Rules Time Limitations...

41 CFR 302-11.23 - When must I request to have my initial time period extended?

Code of Federal Regulations, 2012 CFR

2012-07-01

... have my initial time period extended? 302-11.23 Section 302-11.23 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE TRANSACTION ALLOWANCES 11-ALLOWANCES FOR EXPENSES INCURRED IN CONNECTION WITH RESIDENCE TRANSACTIONS General Rules Time Limitations...

40 CFR 63.2860 - What notifications must I submit and when?

Code of Federal Regulations, 2013 CFR

2013-07-01

.... (2) The notification of actual startup date must also include whether you have elected to operate under an initial startup period subject to § 63.2850(c)(2) and provide an estimate and justification for the anticipated duration of the initial startup period. (c) Significant modification notifications...

40 CFR 63.2860 - What notifications must I submit and when?

Code of Federal Regulations, 2014 CFR

2014-07-01

.... (2) The notification of actual startup date must also include whether you have elected to operate under an initial startup period subject to § 63.2850(c)(2) and provide an estimate and justification for the anticipated duration of the initial startup period. (c) Significant modification notifications...

40 CFR 63.2860 - What notifications must I submit and when?

Code of Federal Regulations, 2012 CFR

2012-07-01

.... (2) The notification of actual startup date must also include whether you have elected to operate under an initial startup period subject to § 63.2850(c)(2) and provide an estimate and justification for the anticipated duration of the initial startup period. (c) Significant modification notifications...

Field studies of pine, spruce and aspen periodically subjected to sulfur gas emissions

Treesearch

A. H. Legge; R. G. Amundson; D. R. Jaques; R. B. Walker

1976-01-01

Field studies of photosynthesis in Pinus contorta/Pinus banksiana (lodgepole pine/jack pine) hybrids, Picea glauca (white spruce) and Populus tremuloides (aspen) subjected to SO2 and H2S from a nearby natural gas processing plant were initiated near Whitecourt,...

Angiotensin II inhibits ADH-stimulated cAMP: role on O2- and transport-related oxygen consumption in the loop of Henle.

PubMed

Silva, G B; Juncos, L I; Baigorria, S T; Garcia, N H

2013-01-01

Dehydration and acute reductions of blood pressure increases ADH and Ang II levels. These hormones increase transport along the distal nephron. In the thick ascending limb (TAL) ADH increases transport via cAMP, while Ang II acts via superoxide (O2-). However, the mechanism of interaction of these hormones in this segment remains unclear. The aim of this study was to explore ADH/Ang II interactions on TAL transport. For this, we measured the effects of ADH/Ang II, added sequentially to TAL suspensions from Wistar rats, on oxygen consumption (QO2) -as a transport index-, cAMP and O2-. Basal QO2 was 112+-5 nmol O2/min/mg protein. Addition of ADH (1nM) increased QO2 by 227 percent. In the presence of ADH, Ang II (1nM) elicited a QO2 transient response. During an initial 3.1+-0.7 minutes after adding Ang II, QO2 decreased 58 percent (p less than 0.03 initial vs. ADH) and then rose by 188 percent (p less than 0.03 late vs initial Ang II). We found that Losartan blocked the initial effects of Ang II and the latter blocked ADH and forskolin-stimulated cAMP. The NOS inhibitor L-NAME or the AT2 receptor antagonist PD123319 showed no effect on transported related oxygen consumption. Then, we assessed the late period after adding Ang II. The O2- scavenger tempol blocked the late Ang II effects on QO2, while Ang II increased O2- production during this period. We conclude that 1) Ang II has a transient effect on ADH-stimulated transport; 2) this effect is mediated by AT1 receptors; 3) the initial period is mediated by decreased cAMP and 4) the late period is mediated by O2-.

An Initial Study of the Greenhouse Whitefly Trialeurodes vaporariorum Westwood

ERIC Educational Resources Information Center

Hitchon, A.

1975-01-01

Describes the life cycle and control of the greenhouse whitefly. Explains the culture of the whitefly for school use and presents a list of laboratory exercises that can be done in a double period. (GS)

Vermicomposting of a lignocellulosic waste from olive oil industry: a pilot scale study.

PubMed

Benítez, E; Sainz, H; Melgar, R; Nogales, R

2002-04-01

The vermicomposting with Eisenia andrei of dry olive cake, a lignocellulosic waste produced during the extraction of olive oil, either alone or mixed with municipal biosolids, was studied in a nine-month pilot scale experiment. Number and biomass of earthworms and enzyme activities were periodically monitored and relevant properties of the final products were determined. In the assayed substrates, the total biomass of earthworms increased at the end of the experimental period between 9 and 12-fold respectively in comparison with the earthworm biomass initially inoculated. The increase in hydrolytic enzymes and overall microbial activity during the vermicomposting process indicated the biodegradation of the olive cake and resulted in the disappearance of the initial phytotoxicity of the substrate. However, the recalcitrant lignocellulosic nature of the dry olive cake prevented suitable humification during the vermicomposting process. For this reason, in addition to organic amendments, other management procedures should be considered.

A Laboratory Assessment of Factors That Affect Bacterial Adhesion to Contact Lenses

PubMed Central

Dutta, Debarun; Willcox, Mark DP

2013-01-01

Adhesion of pathogenic microbes, particularly bacteria, to contact lenses is implicated in contact lens related microbial adverse events. Various in vitro conditions such as type of bacteria, the size of initial inoculum, contact lens material, nutritional content of media, and incubation period can influence bacterial adhesion to contact lenses and the current study investigated the effect of these conditions on bacterial adhesion to contact lenses. There was no significant difference in numbers of bacteria that adhered to hydrogel etafilcon A or silicone hydrogel senofilcon A contact lenses. Pseudomonas aeruginosa adhered in higher numbers compared to Staphylococcus aureus. Within a genera/species, adhesion of different bacterial strains did not differ appreciably. The size of initial inoculum, nutritional content of media, and incubation period played significant roles in bacterial adhesion to lenses. A set of in vitro assay conditions to help standardize adhesion between studies have been recommended. PMID:24833224

Maintenance of long-term adaptation of synaptic transmission requires axonal transport following induction in an identified crayfish motoneuron.

PubMed

Nguyen, P V; Atwood, H L

1992-03-01

Motoneurons can adapt to altered levels of electrical activity by effecting semi-permanent changes in their neuromuscular synaptic physiology. In the present study, we tested the hypothesis that maintenance of activity-dependent long-term adaptation of synaptic transmission in a crayfish abdominal extensor motoneuron (phasic axon 3) required axonal transport following induction. Intact crayfish were chronically wired for periodic in vivo stimulation of axon 3. Periodic unilateral stimulation for 3-5 consecutive days (2 h/day) induced long-term adaptation (LTA) of neuromuscular synaptic transmission in axon 3. Initial EPSP amplitudes (measured at 0.1 Hz) were significantly reduced to approximately 40% of contralateral control amplitudes over a 7-day poststimulation period. Additionally, synaptic depression during 5 Hz test stimulation of axon 3 was significantly less in chronically stimulated neurons: excitatory postsynaptic potential (EPSP) amplitudes measured after 20 min of 5 Hz test stimulation (final EPSPs) were significantly larger in conditioned neurons than in unstimulated controls. The depression of initial EPSP amplitudes persisted for 7 days postinduction, while the increased synaptic stamina persisted for 4 days but was absent at 7 days postinduction. Axotomy of axon 3 following induction of LTA had no effect on long-term maintenance of the activity-induced reduction in initial EPSP amplitudes. Initial EPSP amplitudes in conditioned, axotomized neurons were still reduced to 42% of control amplitudes over the 7-day postinduction period. In contrast, postinduction axotomy of axon 3 elicited an accelerated decay of the enhanced synaptic stamina. Following axotomy, final EPSP amplitudes were significantly larger in conditioned neurons for only 1 day poststimulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Real-world comparison of major bleeding risk among non-valvular atrial fibrillation patients initiated on apixaban, dabigatran, rivaroxaban, or warfarin. A propensity score matched analysis.

PubMed

Lip, Gregory Y H; Keshishian, Allison; Kamble, Shital; Pan, Xianying; Mardekian, Jack; Horblyuk, Ruslan; Hamilton, Melissa

2016-10-28

In addition to warfarin, there are four non-vitamin K antagonist oral anticoagulants (NOACs) available for stroke prevention in non valvular atrial fibrillation (NVAF). There are limited data on the comparative risks of major bleeding among newly anticoagulated NVAF patients who initiate warfarin, apixaban, dabigatran, or rivaroxaban, when used in 'real world' clinical practice. The study used the Truven MarketScan ® Commercial & Medicare supplemental US claims database. NVAF patients aged ≥18 years newly prescribed an oral anticoagulant 01JAN2013-31DEC2014, with a ≥1-year baseline period, were included (study period: 01JAN2012-31DEC2014). Major bleeding was defined as bleeding requiring hospitalisation. Propensity score matching (PSM) was used to balance age, sex, region, baseline comorbidities, and comedications. Cox proportional hazards models were used to estimate the PSM hazard ratio (HR) of major bleeding. Among 45,361 newly anticoagulated NVAF patients, 15,461 (34.1 %) initiated warfarin, 7,438 (16.4 %) initiated apixaban, 17,801 (39.2 %) initiated rivaroxaban, and 4,661 (10.3 %) initiated dabigatran. Compared to matched warfarin initiators, apixaban (HR: 0.53; 95 % CI: 0.39-0.71) and dabigatran (HR: 0.69; 95 % CI: 0.50-0.96) initiators had a significantly lower risk of major bleeding. Patients initiating rivaroxaban (HR: 0.98; 95 % CI: 0.83-1.17) had a non-significant difference in major bleeding risk compared to matched warfarin patients. When comparisons were made between NOACs, matched rivaroxaban patients had a significantly higher risk of major bleeding (HR: 1.82; 95 % CI: 1.36-2.43) compared to apixaban patients. The differences for apixaban-dabigatran and dabigatran-rivaroxaban matched cohorts were not statistically significant. Among newly anticoagulated NVAF patients in the real-world setting, apixaban and dabigatran initiation was associated with significantly lower risk of major bleeding compared to warfarin initiation. When compared to apixaban, rivaroxaban initiation was associated with significantly higher risk of major bleeding.

Motivating Study Groups across the Disciplines in Secondary Schools

ERIC Educational Resources Information Center

Styslinger, Mary E.; Clary, Deidre M.; Oglan, Victoria A.

2015-01-01

This article introduces Project RAISSE: Reading Assistance Initiative for Secondary School Educators and shares the findings of a study into those factors found to motivate study group participants at two rural high schools in the southern USA. The research team collected qualitative data over a two-year period, including interviews, artifacts,…

The Bureaucratising of Lesson Study: A Javanese Case

ERIC Educational Resources Information Center

Kusanagi, Kanako N.

2014-01-01

Lesson study developed organically in Japan over a period of 140 years, whereas in Indonesia, lesson study was introduced as a top-down initiative. This research explores beyond general cultural differences by illustrating how the daily concerns of teachers and their social interactions differ in Japan and in the case of an Indonesian school, the…

Changes in Healthcare Utilization After Etanercept Initiation in Patients with Rheumatoid Arthritis: A Retrospective Claims Analysis.

PubMed

Accortt, Neil A; Schenfeld, Jennifer; Chang, Eunice; Papoyan, Elya; Broder, Michael S

2017-09-01

Effective treatment for rheumatoid arthritis (RA) may lead to lower overall and RA-related healthcare utilization. We evaluated healthcare utilization before and after initiation of the tumor necrosis factor inhibitor etanercept in patients with moderate to severe RA. This retrospective cohort study used data from the MarketScan ® claims database. Data from adult patients with RA newly exposed to etanercept between January 1, 2010 and December 31, 2013 were analyzed. Patients had at least one inpatient or outpatient claim for RA and at least one claim for etanercept (first claim was index date). Etanercept compliance was determined on the basis of proportion of days covered (PDC). Primary outcome was change in overall and RA-related healthcare utilization in the year before and year after etanercept initiation. McNemar's test and paired t test, respectively, were used to determine statistical significance for dichotomous and continuous variables. Data from 6737 patients were analyzed; mean age was 49.8 years and 77.3% were female. Overall outpatient services, office visits, outpatient hospital services, laboratory visits, and emergency department visits were significantly lower in the post-index period compared to pre-index. RA-related pharmacotherapy use (oral corticosteroids, opioid analgesics, nonsteroidal anti-inflammatory drugs, and nonbiologic disease-modifying antirheumatic drugs) was significantly lower in the post-index period compared to pre-index. Rates of RA-related total joint arthroplasty, joint reconstructions, and soft tissue procedures were similar in pre-index and post-index periods. High etanercept compliance (PDC ≥80%) was associated with significantly lower rates of RA-related outpatient services, office visits, diagnostic imaging studies, and joint reconstructions compared with noncompliance. Overall healthcare utilization decreased after etanercept initiation. Patients who were most compliant with etanercept had significantly lower utilization than less compliant patients. Amgen, Inc.

Acute-onset chronic inflammatory demyelinating polyneuropathy: An electrodiagnostic study.

PubMed

Anadani, Mohammad; Katirji, Bashar

2015-11-01

Acute-onset chronic inflammatory demyelinating polyneuropathy (A-CIDP) is an increasingly recognized CIDP subtype. Differentiating A-CIDP from Guillain-Barré syndrome (GBS) is challenging but important, because there are different treatment outcomes. We report 3 patients with A-CIDP who were initially diagnosed with severe GBS but were later confirmed to have CIDP based on their clinical course and electrodiagnostic (EDx) studies. We also report on the long-term treatment of these patients and review the literature on EDx studies in this syndrome. Three patients were initially diagnosed with GBS and responded to treatment. However, all 3 had arrest in improvement or deterioration during their rehabilitation phases. EDx studies showed prominent demyelinating changes many months after the initial presentation. All responded very well to immunotherapy. Although several features may suggest the diagnosis of A-CIDP at initial presentation, close follow-up of GBS patients during the recovery phase is also needed for accurate diagnosis. EDx studies may distinguish patients with A-CIDP from GBS patients. © 2015 Wiley Periodicals, Inc.

Pattern and predictors of the initiation of biologic agents for the treatment of rheumatoid arthritis in the United States: an analysis using a large observational data bank.

PubMed

DeWitt, Esi Morgan; Lin, Li; Glick, Henry A; Anstrom, Kevin J; Schulman, Kevin A; Reed, Shelby D

2009-08-01

The aim of this study was to identify factors associated with the initiation of biologic agents for the treatment of rheumatoid arthritis (RA) in a large US observational cohort. Semiannual patient-reported data in the ARAMIS (Arthritis, Rheumatism and Aging Medical Information System) data bank from January 1998 to January 2006 were analyzed retrospectively using pooled logistic regression (with adjustment for center-level and temporal effects) to identify patient-, disease-, and treatment-related characteristics associated with the initiation of biologics for the treatment of RA. The analysis included 1545 patients from 7 US centers. By 2006, 41.4% of 679 patients remaining in the sample had received biologics. Initiation of biologics was significantly associated with greater disability in the previous 6-month period (per 1-unit increase in Health Assessment Questionnaire score: odds ratio [OR] = 1.45; 95% CI, 1.22-1.72; P < 0.01) and treatment in the previous period with steroids (OR = 2.24; 95% CI, 1.76-2.85; P < 0.01) or nonbiologic disease-modifying antirheumatic drugs (OR = 2.43; 95% CI, 1.71-3.46; P < 0.01). Two sociodemographic factors were significant predictors of decreased use of biologics: older age (per 10 years: OR = 0.74; 95% CI, 0.660.82; P < 0.01) and lower annual income (per $10,000 reduction: OR = 0.95; 95% CI, 0.91-1.00; P = 0.04). There were no significant differences with respect to sex, race, employment status, comorbidity, previous NSAID use, or treatment center. Disease- and treatment-related factors were significant predictors of the initiation of biologics for RA. Independent of these factors, however, biologics were less often used in patients who were older and those with lower incomes. Use of biologics increased steadily over the period studied.

Updating histological data on crown initiation and crown completion ages in southern Africans.

PubMed

Reid, Donald J; Guatelli-Steinberg, Debbie

2017-04-01

To update histological data on crown initiation and completion ages in southern Africans. To evaluate implications of these data for studies that: (a) rely on these data to time linear enamel hypoplasias (LEHs), or, (b) use these data for comparison to fossil hominins. Initiation ages were calculated on 67 histological sections from southern Africans, with sample sizes ranging from one to 11 per tooth type. Crown completion ages for southern Africans were calculated in two ways. First, actual derived initiation ages were added to crown formation times for each histological section to obtain direct information on the crown completion ages of individuals. Second, average initiation ages from this study were added to average crown formation times of southern Africans from the Reid and coworkers previous studies that were based on larger samples. For earlier-initiating tooth types (all anterior teeth and first molars), there is little difference in ages of initiation and crown completion between this and previous studies. Differences increase as a function of initiation age, such that the greatest differences between this and previous studies for both initiation and crown completion ages are for the second and third molars. This study documents variation in initiation ages, particularly for later-initiating tooth types. It upholds the use of previously published histological aging charts for LEHs on anterior teeth. However, this study finds that ages of crown initiation and completion in second and third molars for this southern African sample are earlier than previously estimated. These earlier ages reduce differences between modern humans and fossil hominins for these developmental events in second and third molars. © 2017 Wiley Periodicals, Inc.

Association between prescription cost sharing and adherence to initial combination antiretroviral therapy in commercially insured antiretroviral-naïve patients with HIV.

PubMed

Johnston, Stephen S; Juday, Timothy; Seekins, Daniel; Espindle, Derek; Chu, Bong-Chul

2012-03-01

In treatment of human immunodeficiency virus (HIV), high levels of adherence to combination antiretroviral therapy (cART) are required to prevent failure of virologic suppression, development of drug resistance, and permanent loss of therapeutic options. No published research has assessed the association between cART prescription cost sharing and adherence to cART. To analyze the association between cART prescription cost sharing and adherence to initial cART in commercially insured antiretroviral (ARV)-naïve patients with HIV. This retrospective observational cohort study used 2002-2008 data from a large U.S. claims database of more than 56 million commercially insured individuals. Study subjects were patients aged 18 years or older who initiated cART during the period January 1, 2003, to December 31, 2007, had no ARV claims during the 6-month period prior to the initiation date, and had at least 1 ICD-9-CM diagnosis code for HIV infection (042, 795.71, V08) from 12 months before to 12 months after cART initiation. A minimum 12-month period of continuous enrollment after cART initiation was used to construct a patient-quarter repeated measures panel dataset in which each quarter of data that a patient contributed represented an observation. The evaluation period extended from cART initiation until the occurrence of 1 of the following events: addition of an ARV that was not part of the initial cART regimen, 30-day gap in possession of an ARV within the initiated cART regimen, hospitalization of 30 or more days, loss to follow-up due to study end (December 31, 2008), or disenrollment. The study's outcome was quarterly adherence to cART, defined as the number of days within the quarter that a patient possessed all components of the initial cART regimen. Each patient's cART cost-sharing amount was calculated per 30-day supply of the entire cART regimen. Adherence was dichotomized for analysis at the clinically meaningful thresholds of 95% and 78%. The dichotomized adherence outcomes were separately modeled using population-averaged generalized estimating equations (GEEs) with time-varying and time-constant covariates and an exchangeable working correlation structure. Independent variables included cost-sharing amount; sequential quarter number after cART initiation; interaction between cost-sharing amount and sequential quarter number (to capture any changes in the association of cost sharing with adherence that may occur over time after initiation of cART); and patient demographic, clinical, and insurance characteristics. For each sequential quarter after cART initiation, the GEE models were used to generate average predicted probabilities of adherence reaching each threshold (95% and 78%) at cost-sharing levels of $25, $75, and $144, which represented the 25th, 75th, and 90th percentiles of the cost-sharing distribution, respectively. The study sample included 19,199 patient-quarters and 3,731 patients: mean age 41.1 years; 83.2% male; mean (SD) duration of post-index period 5.1 (4.2) quarters; mean (SD) daily cART pill count 3.2 (2.2); mean (median) cost sharing per 30-day supply of the entire cART regimen $67 ($40). In the unadjusted analyses of patient-quarters, mean adherence ranged from 97.2% for cost-sharing levels within the 0-20th percentiles (from $0 to $20 per 30-day cART supply) to 94.0% for cost-sharing levels exceeding the 80th percentile (from $84 to $3,832 per 30-day cART supply). In the adjusted analyses for the second quarter (25th percentile of follow-up duration, n = 3,117 cases still under observation) at the cost-sharing levels of $25, $75, and $144, the predicted probabilities of at least 95% adherence were 0.782, 0.770, and 0.752, respectively, and the predicted probabilities of at least 78% adherence were 0.936, 0.931, and 0.924, respectively. The differences in the predicted probabilities of adherence grew over time. By the seventh quarter (the 75th percentile of follow-up duration, n = 1,096 cases still under observation), the predicted probabilities were 0.773, 0.746, and 0.707 for 95% adherence and 0.933, 0.922, and 0.904 for 78% adherence at cost-sharing levels of $25, $75, and $144, respectively. Increasing cART prescription cost sharing was associated with modestly decreased probability of maintaining clinically meaningful levels of cART adherence.

Peritonitis in peritoneal dialysis patients in Uruguay.

PubMed

Gadola, Liliana; Orihuela, Lucía; Pérez, Daniel; Gómez, Teresa; Solá, Laura; Chifflet, Liliana; Mautone, Mariela; Torres, Eugenia; Rodriguez, Grisel

2008-01-01

Uruguay is a South American country (3241003 inhabitants) where renal replacement treatment is universally available. The aim of this study was to analyze the incidence and outcome of peritonitis, and the causative organisms and their sensitivity, in order to recommend an empiric initial antibiotic treatment. A retrospective descriptive study of all peritonitis during the period 2004-2005 was performed (144 peritonitis, 44% due to gram-positive bacteria). We conclude that the high prevalence of methicillin-resistant coagulase-negative staphylococci justifies the use of vancomycin in the national empiric initial antibiotic protocols.

THE ARMOUR DUST FUELED REACTOR (ADFR). Quarterly Progress Report No. 1 for the Period February 21, 1958 to May 21, 1958

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

Loewe, W.E.; Krucoff, D.

1958-10-31

Work has begun on the ADFR, a reactor using a new fuel form -- fissionable dust carried in an inent gas. Temperatures in the range 2,000 to 3,000 deg F appear feasible in an all-ceramic system. Experimental study of the fuel form was initiated, and a loop to circulate the fuel dust was constructed. Initial operation is encouraging. Theoretical studies were carried on in the areas of reactor physics, heat transfer, and safety. (auth)

Prospective 15-year study of neuromuscular function in a cohort of patients with prior poliomyelitis.

PubMed

Daube, Jasper R; Sorenson, Eric J; Windebank, Anthony J

2009-01-01

Poliomyelitis is a monophasic illness affecting lower motor neurons and individuals may describe new problems years after the initial weakness. We have studied 38 people with the post-polio syndrome over a 15-year period assessing a number of neuromuscular measures, including motor unit number estimation (MUNE). Twenty-five individuals reported progressive weakness but there was no objective change in MUNE and other measures. There was an association with reported weakness and initial deficits. There was a slow decline in MUNE values over time in both groups.

Predictors of breast feeding self-efficacy in the immediate postpartum period: A cross-sectional study.

PubMed

Yang, Xiao; Gao, Ling-Ling; Ip, Wan-Yim; Sally Chan, Wai Chi

2016-10-01

to examine breast feeding self-efficacy and identify its predictors among mainland Chinese mothers in the early postpartum period. a cross-sectional descriptive questionnaire survey was conducted in a regional teaching hospital with childbirth rate over 3000 per year at Guangzhou, China from April 1 to July 14, 2014. a total of 571 Chinese mothers who were within 72-96hours post partum were recruited consecutively to the study. data were collected by the Chinese version of the Breastfeeding Self-efficacy Scale-Short Form (BSES-SF), the Network Support for Breastfeeding Scale (NSBS) and a socio-demographic data sheet. a total of 640 eligible women was approached and 571 mothers completed the study with the response rate of 89%. Mothers reported moderate level of breast feeding self-efficacy in the immediate postpartum period. The best-fit regression analysis revealed six variables that explained 43.9% of the variance in breast feeding self-efficacy in the immediate postpartum period. They were intention of breast feeding, support from husband, support from nurses/midwives, attending antenatal breast feeding classes, time from childbirth to initiate breast feeding and previous breast feeding experience. this study found six predictors of breast feeding self-efficacy in the immediate postpartum period. In order to increase maternal breast feeding self-efficacy level, a more women-centred approach is recommended. Mothers and fathers should be facilitated to attend antenatal classes on breast feeding. New mother' husband could be encouraged in supporting breast feeding. Nurses and midwives could encourage new mothers to initiate breast feeding as soon as possible. Further work to promote early mother-infant contact post birth, such as via skin to skin contact should also be facilitated where possible. Copyright © 2016 Elsevier Ltd. All rights reserved.

A cross-sectional study of hormone treatment and hippocampal volume in postmenopausal women: Evidence for a limited window of opportunity

PubMed Central

Erickson, Kirk I.; Voss, Michelle W.; Prakash, Ruchika S.; Chaddock, Laura; Kramer, Arthur F.

2010-01-01

The influence of hormone treatment on brain and cognition in postmenopausal women has been a controversial topic. Contradictory patterns of results have prompted speculation that a critical period, or a limited window of opportunity, exists for hormone treatment to protect against cognitive and neural decline in older women. Consistent with this hypothesis, studies in both humans and rodents indicate that the latency between the time of menopause and the initiation of hormone treatment is an important factor in determining whether hormone treatment will prevent or exacerbate cognitive impairment. In this cross-sectional study of 102 postmenopausal women, we examined whether hippocampal, amygdala, or caudate nucleus volumes and spatial memory performance were related to the interval between menopause and the initiation of hormone treatment. Consistent with a critical period hypothesis, we found that shorter intervals between menopause and the initiation of hormone treatment, as determined by self-report, were associated with larger hippocampal volumes compared with longer intervals between menopause and treatment initiation. Initiation of hormone treatment at the time of menopause was also associated with larger hippocampal volumes when compared to peers who had never used hormone treatment. Furthermore, these effects were independent from potentially confounding factors such as age, years of education, the duration of hormone treatment, current or past use of hormone therapy, the type of therapy, and the age at menopause. Larger hippocampal volumes in women who initiated hormone treatment at the time of menopause failed to translate to improved spatial memory performance. There was no relationship between the timing of hormone initiation, spatial memory performance, and amygdala or caudate nucleus volume. Our results provide support for the idea that there is a limited window of opportunity at the time of menopause for hormone treatment to influence hippocampal volume, yet the degree to which these effects translate to improved memory performance is uncertain. PMID:20063947

A Regional Model Study of Synoptic Features Over West Africa

NASA Technical Reports Server (NTRS)

Druyan, Leonard M.; Fulakeza, Matthew; Lonergan, Patrick; Saloum, Mahaman; Hansen, James E. (Technical Monitor)

2001-01-01

Synoptic weather features over West Africa were studied in simulations by the regional simulation model (RM) at the NASA/Goddard Institute for Space Studies. These pioneering simulations represent the beginning of an effort to adapt regional models for weather and climate prediction over West Africa. The RM uses a cartesian grid with 50 km horizontal resolution and fifteen vertical levels. An ensemble of four simulations was forced with lateral boundary conditions from ECMWF global analyses for the period 8-22 August 1988. The simulated mid-tropospheric circulation includes the skillful development and movement of several African wave disturbances. Wavelet analysis of mid-tropospheric winds detected a dominant periodicity of about 4 days and a secondary periodicity of 5-8 days. Spatial distributions of RM precipitation and precipitation time series were validated against daily rain gauge measurements and ISCCP satellite infrared cloud imagery. The time-space distribution of simulated precipitation was made more realistic by combining the ECMWR initial conditions with a 24-hr spin-up of the moisture field and also by damping high frequency gravity waves by dynamic initialization. Model precipitation "forecasts" over the Central Sahel were correlated with observations for about three days, but reinitializing with observed data on day 5 resulted in a dramatic improvement in the precipitation validation over the remaining 9 days. Results imply that information via the lateral boundary conditions is not always sufficient to minimize departures between simulated and actual precipitation patterns for more than several days. In addition, there was some evidence that the new initialization may increase the simulations' sensitivity to the quality of lateral boundary conditions.

Comparative "Glocal" Perspectives on European Teacher Education

ERIC Educational Resources Information Center

Caena, Francesca

2014-01-01

This article reports the findings of a PhD study, which offers comparative perspectives on teacher education in a period of reforms, inquiring into stakeholders' perceptions in English, French, Italian and Spanish contexts as case studies. The interaction of needs and constraints in European initial teacher education within higher education…

Thirteen Week Oral Toxicity Study of WR238605 with a Thirteen Week Recovery Period in Dogs. Volume 3

DTIC Science & Technology

1993-06-11

dogs will have been vaccinated against canine distemper , infectious canine hepatitis, leptospirosis, parainfluenza, parvo, oral papilloma, and...documented on the Clinical Veterinarian Log by the veterinarian prior to study initiation. Food: Purina Certified Canine Diet No. 5007 (Ralston

Multi-model assessment of the impact of soil moisture initialization on mid-latitude summer predictability

NASA Astrophysics Data System (ADS)

Ardilouze, Constantin; Batté, L.; Bunzel, F.; Decremer, D.; Déqué, M.; Doblas-Reyes, F. J.; Douville, H.; Fereday, D.; Guemas, V.; MacLachlan, C.; Müller, W.; Prodhomme, C.

2017-12-01

Land surface initial conditions have been recognized as a potential source of predictability in sub-seasonal to seasonal forecast systems, at least for near-surface air temperature prediction over the mid-latitude continents. Yet, few studies have systematically explored such an influence over a sufficient hindcast period and in a multi-model framework to produce a robust quantitative assessment. Here, a dedicated set of twin experiments has been carried out with boreal summer retrospective forecasts over the 1992-2010 period performed by five different global coupled ocean-atmosphere models. The impact of a realistic versus climatological soil moisture initialization is assessed in two regions with high potential previously identified as hotspots of land-atmosphere coupling, namely the North American Great Plains and South-Eastern Europe. Over the latter region, temperature predictions show a significant improvement, especially over the Balkans. Forecast systems better simulate the warmest summers if they follow pronounced dry initial anomalies. It is hypothesized that models manage to capture a positive feedback between high temperature and low soil moisture content prone to dominate over other processes during the warmest summers in this region. Over the Great Plains, however, improving the soil moisture initialization does not lead to any robust gain of forecast quality for near-surface temperature. It is suggested that models biases prevent the forecast systems from making the most of the improved initial conditions.

The "sticking period" in a maximum bench press.

PubMed

van den Tillaar, Roland; Ettema, Gertjan

2010-03-01

The purpose of this study was to examine muscle activity and three-dimensional kinematics in the ascending phase of a successful one-repetition maximum attempt in bench press for 12 recreational weight-training athletes, with special attention to the sticking period. The sticking period was defined as the first period of deceleration of the upward movement (i.e. from the highest barbell velocity until the first local lowest barbell velocity). All participants showed a sticking period during the upward movement that started about 0.2 s after the initial upward movement, and lasted about 0.9 s. Electromyography revealed that the muscle activity of the prime movers changed significantly from the pre-sticking to the sticking and post-sticking periods. A possible mechanism for the existence of the sticking period is the diminishing potentiation of the contractile elements during the upward movement together with the limited activity of the pectoral and deltoid muscles during this period.

The Impact of the One to One Laptop Initiative on High School Students' Academic Performance in Algebra I and English I--A Meta-Analytic Approach

ERIC Educational Resources Information Center

Dennis, Quincita

2014-01-01

This study examined the effectiveness of using laptops to teach and deliver instruction to students. The meta-analytic approach was employed to compare the means of End-of Course Test scores from North Carolina one-to-one high schools during the traditional teaching period and the laptop teaching period in order to determine if there are…

Incompressible limit of the degenerate quantum compressible Navier-Stokes equations with general initial data

NASA Astrophysics Data System (ADS)

Kwon, Young-Sam; Li, Fucai

2018-03-01

In this paper we study the incompressible limit of the degenerate quantum compressible Navier-Stokes equations in a periodic domain T3 and the whole space R3 with general initial data. In the periodic case, by applying the refined relative entropy method and carrying out the detailed analysis on the oscillations of velocity, we prove rigorously that the gradient part of the weak solutions (velocity) of the degenerate quantum compressible Navier-Stokes equations converge to the strong solution of the incompressible Navier-Stokes equations. Our results improve considerably the ones obtained by Yang, Ju and Yang [25] where only the well-prepared initial data case is considered. While for the whole space case, thanks to the Strichartz's estimates of linear wave equations, we can obtain the convergence of the weak solutions of the degenerate quantum compressible Navier-Stokes equations to the strong solution of the incompressible Navier-Stokes/Euler equations with a linear damping term. Moreover, the convergence rates are also given.

Milestones in the Success of Nursing as an Emerging Discipline.

ERIC Educational Resources Information Center

Schultz, Phyllis R.

1990-01-01

Six periods in the evolution of nursing are described: the early period (1860-1900); focus on practice, service, and specialization (1900-49); initiation of research (1950-59); research expansion and theory initiation (1960-79); the integration of practice, research, and theory (1980-89); and the near future (1990-2000). Nursing administration is…

More flowers or new cladodes? Environmental correlates and biological consequences of sexual reproduction in a Sonoran Desert prickly pear cactus, Opuntia engelmannii

USGS Publications Warehouse

Bowers, Janice E.

1996-01-01

Should a platyopuntia expend all aerolar meristems in flower production, now new cladodes could be produced, and further reproductive effort and vegetative growth would cease. To investigate the trade-off between flower and cladode production, the numbers of flowers, fruits, and cladodes were monitored for 4 years on 30 Opuntia engelmannii Salm-Dyek, plants on Tumamoc Hill, Tucson, Arizona. Plant size controlled the number of flowers initiated each spring. The proportion of flowers that developed (i.e., did not abort) was perhaps determined by December-February rainfall in the months before bloom, with more being developed in the wettest years. Models based on different ratios of initiated cladodes to initiated flowers demonstrated that continued high investment in flowers and fruits would eventually terminate reproduction altogether; therefore periods of high sexual reproduction should alternate with periods of high vegetative growth. In the first 3 years of this study, the ratio of new cladodes to initiated flowers was low, showing a high investment in sexual reproduction. As suggested by the model, the population recouped this investment in the fourth year, when the number of new cladodes was nearly 3 times the 1992-1994 mean, and the number of initiated flowers was only 73% of the 3-year mean.

Nearest pattern interaction and global pattern formation

NASA Astrophysics Data System (ADS)

Jeong, Seong-Ok; Moon, Hie-Tae; Ko, Tae-Wook

2000-12-01

We studied the effect of nearest pattern interaction on a global pattern formation in a two-dimensional space, where patterns are to grow initially from a noise in the presence of a periodic supply of energy. Although our approach is general, we found that this study is relevant in particular to the pattern formation on a periodically vibrated granular layer, as it gives a unified perspective of the experimentally observed pattern dynamics such as oscillon and stripe formations, skew-varicose and crossroll instabilities, and also a kink formation and decoration.

Eating behaviors and weight over time in a prospective study: the Healthy Twin Study.

PubMed

Song, Yun-Mi; Lee, Kayoung; Sung, Joohon

2014-01-01

We examined the relationships of combined initial restrained and external/emotional eating with initial BMI and change in weight and these subscales over time. BMI and the Dutch Eating Behavior Questionnaire were twicemeasured in 1361 Korean twins and families (482 men, 879 women) over a period of 2.7±0.9 years. Subjects were classified by combination of initial sex-specific restrained and external (or emotional) eating tertiles. Linear mixed models were performed after adjusting for confounders at baseline (household, sibling relations, sex, age, education level, smoking, alcohol use, energy intake, physical activity, and medical history). In adjusted models, initial BMI increased with increasing tertiles of initial restrained eating across initial external/emotional eating tertiles. Weight was less likely to increase over time with increasing tertiles of initial restrained eating in the lowest external eating tertile and middle tertile of emotional eating at baseline. Subscale scores decreased over time with increasing tertiles of corresponding subscales at baseline. These findings suggest that high dietary restraint and external/emotional eating may indicate concurrent high BMI and attenuated weight gain and decreases in corresponding subscales over time.

Patterns of Treatment Utilization and Methamphetamine Use during First Ten Years after Methamphetamine Initiation

PubMed Central

Brecht, Mary-Lynn; Lovinger, Katherine; Herbeck, Diane M.; Urada, Darren

2013-01-01

The study examined joint trajectories of methamphetamine (MA) use and substance abuse treatment utilization and identified differences among pattern groups for a sample of 348 treated for MA use. Results from group-based trajectory modeling showed that treatment utilization during the first 10 years after initiation of MA use could be categorized into three distinctive patterns: about half the MA users have a pattern of low treatment utilization; one-fourth follow a quicker-to-treatment trajectory with higher probability of treatment during the first 5 years of MA use and less treatment in the next 5 years; and one-fourth have a slower-to-treatment trajectory with more treatment during the second half of the 10-year period. Four MA use patterns were identified: consistently low use, moderate, and high use, as well as a decreasing use pattern. Periods of greater likelihood of treatment participation were associated with periods of decreasing or lower frequency of MA use. PMID:23313146

Sensitivity of soil moisture initialization for decadal predictions under different regional climatic conditions in Europe

NASA Astrophysics Data System (ADS)

Khodayar, S.; Sehlinger, A.; Feldmann, H.; Kottmeier, C.

2015-12-01

The impact of soil initialization is investigated through perturbation simulations with the regional climate model COSMO-CLM. The focus of the investigation is to assess the sensitivity of simulated extreme periods, dry and wet, to soil moisture initialization in different climatic regions over Europe and to establish the necessary spin up time within the framework of decadal predictions for these regions. Sensitivity experiments consisted of a reference simulation from 1968 to 1999 and 5 simulations from 1972 to 1983. The Effective Drought Index (EDI) is used to select and quantify drought status in the reference run to establish the simulation time period for the sensitivity experiments. Different soil initialization procedures are investigated. The sensitivity of the decadal predictions to soil moisture initial conditions is investigated through the analysis of water cycle components' (WCC) variability. In an episodic time scale the local effects of soil moisture on the boundary-layer and the propagated effects on the large-scale dynamics are analysed. The results show: (a) COSMO-CLM reproduces the observed features of the drought index. (b) Soil moisture initialization exerts a relevant impact on WCC, e.g., precipitation distribution and intensity. (c) Regional characteristics strongly impact the response of the WCC. Precipitation and evapotranspiration deviations are larger for humid regions. (d) The initial soil conditions (wet/dry), the regional characteristics (humid/dry) and the annual period (wet/dry) play a key role in the time that soil needs to restore quasi-equilibrium and the impact on the atmospheric conditions. Humid areas, and for all regions, a humid initialization, exhibit shorter spin up times, also soil reacts more sensitive when initialised during dry periods. (e) The initial soil perturbation may markedly modify atmospheric pressure field, wind circulation systems and atmospheric water vapour distribution affecting atmospheric stability conditions, thus modifying precipitation intensity and distribution even several years after the initialization.

A short 2 week dose titration regimen reduces the severity of flu-like symptoms with initial interferon gamma-1b treatment.

PubMed

Devane, John G; Martin, Mary L; Matson, Mark A

2014-06-01

Flu-like symptoms (FLS) are commonly experienced by patients receiving interferon gamma-1b which may cause discontinuation or disruption of dosing during initial therapy or on re-initiation following a break in therapy. In contrast to Type I interferons, the impact of dose-titration on FLS has not been reported and is not a practice described or included in the approved prescribing information for interferon gamma-1b.The objective of this study was to assess the effect of a 2 week titration regimen on the severity of FLS during the initial 3 weeks of therapy with three times weekly subcutaneous injections of interferon gamma-1b. Healthy men and women were randomized into a double-blind, two-period, crossover study. Each study period was 3 weeks in duration and there was a minimum 15 day washout between treatment periods. Two treatment regimens were compared: No Titration dosing (full 50 mcg/m(2) subcutaneously [s.c.] three times weekly for 3 weeks) and Titration (15 mcg/m(2) s.c. three times weekly during week 1, 30 mcg/m(2) s.c. three times weekly during week 2 followed by the full dose of 50 mcg/m(2) s.c. three times weekly during week 3). Subjects remained in the clinic for at least 12 hours following each injection. FLS was based on a composite score for fever, chills, tiredness and muscle aches assessed at baseline and 4, 8 and 12 hours following each injection. Acetaminophen was allowed at the discretion of the PI. The primary endpoint was the change from baseline in FLS severity at 8 hours averaged over the 3 weeks of treatment. Additional endpoints included FLS at 4 and 12 hours, individual flu-like symptoms, rates of discontinuation, incidence of FLS and acetaminophen use. NCT 01929382. Of the 40 subjects randomized, there were 15 (37.5%) discontinuations. Titration resulted in a significant reduction in FLS severity at 8 hours (p = 0.023) averaged over the 3 week treatment period. The difference in 3 week FLS severity reflects differences during week 1 treatment, indicating an early peak in FLS severity during the No Titration treatment and subsequent development of tolerance. In contrast, titration results in near baseline severity scores throughout the treatment period. Similar trends were seen for 4 and 12 hour FLS severity scores. Of the individual FLS, difference in fever severity was most marked. Safety profiles for both regimens were consistent with the approved prescribing information for interferon gamma-1b. Study limitations included the use of healthy subjects rather than disease subjects, the lack of a validated assessment tool for evaluating FLS and the relatively high discontinuation rate. A short 2 week, dose-titration regimen reduces FLS severity following interferon gamma-1b treatment initiation in normal subjects.

Prevention of urinary tract infections by antibiotic cycling in spinal cord injury patients and low emergence of multidrug resistant bacteria.

PubMed

Poirier, C; Dinh, A; Salomon, J; Grall, N; Andremont, A; Bernard, L

2016-09-01

Urinary tract infections (UTIs) are a major recurrent problem for spinal cord injury (SCI) patients. Repeated antibiotic treatments contribute to the emergence of multidrug-resistant bacteria (MDRB). We evaluated the use of weekly oral cycling antibiotics (WOCA) in the prevention of UTIs over a mean follow-up period of 53 months (median follow-up period: 57 months) and analyzed the risk of MDRB emergence. We conducted a cross-sectional study of adult SCI patients with neurogenic bladder who were receiving the WOCA regimen. We included 50 patients, mainly men (60%), with a mean age of 51±13.5 years. Overall, 66% of patients had been paraplegic or tetraplegic for 19.4±14.3 years; 92% underwent intermittent catheterization; and 36% had no postvoid residual. The number of febrile and non-febrile UTIs significantly reduced after WOCA initiation (9.45 non-febrile UTIs before WOCA initiation vs. 1.57 after; 2.25 febrile UTIs before WOCA initiation vs. 0.18 after; P=0.0001). Only one adverse event was reported during the follow-up period. The number of MDRB-colonized patients decreased from 9/50 to 4/50 during the follow-up period. WOCA is an effective and safe strategy to prevent UTIs in SCI patients with neurogenic bladder. WOCA does not lead to the emergence of MDRB resistance and even seems to reduce MDRB carriage. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Vlasov dynamics of periodically driven systems

NASA Astrophysics Data System (ADS)

Banerjee, Soumyadip; Shah, Kushal

2018-04-01

Analytical solutions of the Vlasov equation for periodically driven systems are of importance in several areas of plasma physics and dynamical systems and are usually approximated using ponderomotive theory. In this paper, we derive the plasma distribution function predicted by ponderomotive theory using Hamiltonian averaging theory and compare it with solutions obtained by the method of characteristics. Our results show that though ponderomotive theory is relatively much easier to use, its predictions are very restrictive and are likely to be very different from the actual distribution function of the system. We also analyse all possible initial conditions which lead to periodic solutions of the Vlasov equation for periodically driven systems and conjecture that the irreducible polynomial corresponding to the initial condition must only have squares of the spatial and momentum coordinate. The resulting distribution function for other initial conditions is aperiodic and can lead to complex relaxation processes within the plasma.

ESA situational awareness of space weather

NASA Astrophysics Data System (ADS)

Luntama, Juha-Pekka; Glover, Alexi; Keil, Ralf; Kraft, Stefan; Lupi, Adriano

2016-07-01

ESA SSA Period 2 started at the beginning of 2013 and will last until the end of 2016. For the Space Weather Segment, transition to Period 2 introduced an increasing amount of development of new space weather service capability in addition to networking existing European assets. This transition was started already towards the end of SSA Period 1 with the initiation of the SSA Space Weather Segment architecture definition studies and activities enhancing existing space weather assets. The objective of Period 2 has been to initiate SWE space segment developments in the form of hosted payload missions and further expand the federated service network. A strong focus has been placed on demonstration and testing of European capabilities in the range of SWE service domains with a view to establishing core products which can form the basis of SWE service provision during SSA Period 3. This focus has been particularly addressed in the SSA Expert Service Centre (ESC) Definition and Development activity that was started in September 2015. This presentation will cover the current status of the SSA SWE Segment and the achievements during SSA Programme Periods 1 and 2. Particular attention is given to the federated approach that allow building the end user services on the best European expertise. The presentation will also outline the plans for the Space Weather capability development in the framework of the ESA SSA Programme in 2017-2020.

Circadian activity rhythms and voluntary ethanol intake in male and female ethanol-preferring rats: effects of long-term ethanol access.

PubMed

Rosenwasser, Alan M; McCulley, Walter D; Fecteau, Matthew

2014-11-01

Chronic alcohol (ethanol) intake alters fundamental properties of the circadian clock. While previous studies have reported significant alterations in free-running circadian period during chronic ethanol access, these effects are typically subtle and appear to require high levels of intake. In the present study we examined the effects of long-term voluntary ethanol intake on ethanol consumption and free-running circadian period in male and female, selectively bred ethanol-preferring P and HAD2 rats. In light of previous reports that intermittent access can result in escalated ethanol intake, an initial 2-week water-only baseline was followed by either continuous or intermittent ethanol access (i.e., alternating 15-day epochs of ethanol access and ethanol deprivation) in separate groups of rats. Thus, animals were exposed to either 135 days of continuous ethanol access or to five 15-day access periods alternating with four 15-day periods of ethanol deprivation. Animals were maintained individually in running-wheel cages under continuous darkness throughout the experiment to allow monitoring of free-running activity and drinking rhythms, and 10% (v/v) ethanol and plain water were available continuously via separate drinking tubes during ethanol access. While there were no initial sex differences in ethanol drinking, ethanol preference increased progressively in male P and HAD2 rats under both continuous and intermittent-access conditions, and eventually exceeded that seen in females. Free-running period shortened during the initial ethanol-access epoch in all groups, but the persistence of this effect showed complex dependence on sex, breeding line, and ethanol-access schedule. Finally, while females of both breeding lines displayed higher levels of locomotor activity than males, there was little evidence for modulation of activity level by ethanol access. These results are consistent with previous findings that chronic ethanol intake alters free-running circadian period, and show further that the development of chronobiological tolerance to ethanol may vary by sex and genotype. Copyright © 2014 Elsevier Inc. All rights reserved.

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.

Effects of rinsing with arginine bicarbonate and urea solutions on initial enamel lesions in situ.

PubMed

Yu, Y; Wang, X; Ge, C; Wang, B; Cheng, C; Gan, Y-H

2017-04-01

The aim of this study was to investigate the effects of rinsing with arginine or urea solution on initial enamel lesions in situ. Fourteen subjects who wore mandibular removable partial dentures embedded with bovine enamel blocks with artificial enamel lesions were included. The experiment included four 4-week rinsing periods with a 10-day washout period between each rinsing period. In each rinsing period, the subjects rinsed after meal or snack using water, or 2% arginine bicarbonate, or 1% urea, or 0.05% NaF solution, five times daily. The mineralization changes of the enamel lesions were assessed using quantitative light-induced fluorescence. All groups except the water group showed a statistically significant decrease in the fluorescence loss after treatment, compared with their respective baseline. Although both the arginine group and urea group showed more decrease in fluorescence loss than that of the water group, the decrease was not statistically significantly different from that of the water group. The decrease in fluorescence loss of the NaF group was statistically significant than that of the water group, arginine group, and urea group. Rinsing with arginine or urea solution offers limited remineralizing benefit to enamel lesions over a period of 4-week time. © 2016 The Authors. Oral Diseases Published by John Wiley & Sons Ltd.

Self-Assembly of Parallel Atomic Wires and Periodic Clusters of Silicon on a Vicinal Si(111) Surface

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

Sekiguchi, Takeharu; Yoshida, Shunji; Itoh, Kohei M.

2005-09-02

Silicon self-assembly at step edges in the initial stage of homoepitaxial growth on a vicinal Si(111) surface is studied by scanning tunneling microscopy. The resulting atomic structures change dramatically from a parallel array of 0.7 nm wide wires to one-dimensionally aligned periodic clusters of diameter {approx}2 nm and periodicity 2.7 nm in the very narrow range of growth temperatures between 400 and 300 deg. C. These nanostructures are expected to play important roles in future developments of silicon quantum computers. Mechanisms leading to such distinct structures are discussed.

Longitudinal survey of the distribution of various serotypes of Streptococcus mutans in infants.

PubMed

Masuda, N; Tsutsumi, N; Sobue, S; Hamada, S

1979-10-01

The establishment of various serotypes of Streptococcus mutans was studied serologically in plaque samples collected from label surfaces of upper primary incisors of 22 infants (starting age, 5 to 13 months) over a period fo 30 months. Clinical examinations were also performed. No clear-cut association between the initiation of dental caries and previous detection of S. mutans was noted. However, all 12 of the infants with caries had S. mutans isolated at some time during the course of this study. The most common serotype isolated at the initial establishment of S. mutans on the tooth surfaces was serotype c, whereas types d, e, and g became established in a few cases. During the test period, changes in the distribution of serotypes of S. mutans were observed in some cases. The initiation of carious lesions could be found in a few cases even when S. mutans comprised about 1% or less of the total streptococcal count of the specimen from the tooth surfaces. Serotype d/g strains tended to develop carious lesions on smooth surfaces, although serotype c was isolated from almost all individuals who developed caries.

Constructed wetlands may lower inorganic nutrient inputs but enhance DOC loadings into a drinking water reservoir in North Wales.

PubMed

Scholz, C; Jones, T G; West, M; Ehbair, A M S; Dunn, C; Freeman, C

2016-09-01

The objective of this study was to monitor a newly constructed wetland (CW) in north Wales, UK, to assess whether it contributes to an improvement in water quality (nutrient removal) of a nearby drinking water reservoir. Inflow and outflow of the Free Water Surface (FWS) CW were monitored on a weekly basis and over a period of 6 months. Physicochemical parameters including pH, conductivity and dissolved oxygen (DO) were measured, as well as nutrients and dissolved organic and inorganic carbon (DOC, DIC) concentration. The CW was seen to contribute to water quality improvement; results show that nutrient removal took place within weeks after construction. It was found that 72 % of initial nitrate (N03 (-)), 53 % of initial phosphate (PO4 (3-)) and 35 % of initial biological oxygen demand (BOD) were removed, calculated as a total over the whole sampling period. From our study, it can be concluded that while inorganic nutrients do decline in CWs, the DOC outputs increases. This may suggest that CWs represent a source for DOC. To assess the carbon in- and output a C budget was calculated.

Turbulent solutions of the equations of fluid motion

NASA Technical Reports Server (NTRS)

Deissler, R. G.

1984-01-01

Some turbulent solutions of the unaveraged Navier-Stokes equations (equations of fluid motion) are reviewed. Those equations are solved numerically in order to study the nonlinear physics of incompressible turbulent flow. Initial three-dimensional cosine velocity fluctuations and periodic boundary conditions are used in most of the work considered. The three components of the mean-square velocity fluctuations are initially equal for the conditions chosen. The resulting solutions show characteristics of turbulence such as the linear and nonlinear excitation of small-scale fluctuations. For the stronger fluctuations, the initially nonrandom flow develops into an apparently random turbulence. Thus randomness or turbulence can arise as a consequence of the structure of the Navier-Stokes equations. The cases considered include turbulence which is statistically homogeneous or inhomogeneous and isotropic or anisotropic. A mean shear is present in some cases. A statistically steady-state turbulence is obtained by using a spatially periodic body force. Various turbulence processes, including the transfer of energy between eddy sizes and between directional components, and the production, dissipation, and spatial diffusion of turbulence, are considered. It is concluded that the physical processes occurring in turbulence can be profitably studied numerically.

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

NASA Technical Reports Server (NTRS)

Fraietta, Michael F.; Bond, Victor R.

1993-01-01

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

"What did you say?" Using review of tape-recorded interactions to increase social acknowledgments by trainees in a community-based vocational program.

PubMed

Grossi, T A; Kimball, J W; Heward, W L

1994-01-01

Dana and Rick, two adults with developmental disabilities enrolled in a restaurant training program, had poor prospects for long-term employment because of inappropriate social behavior. They often made no response, mumbled inaudibly, or made a negative remark when spoken to by their supervisors or other employees. Each trainee's Individual Vocational Plan (IVP) included goals of prompt and polite acknowledgement of coworker initiations. Previous efforts to improve Dana and Rick's acknowledging behavior had been unsuccessful. Throughout the study, each trainee's responses to 20 verbal initiations by coworkers (i.e., requests, questions, corrective feedback, praise, and social comments) were recorded during each of two observation periods per workshift. Throughout one of the observation periods during the intervention phases, the trainees carried in their work aprons a small, audio cassette recorder that recorded their interactions with coworkers. The primary intervention consisted of a preworkshift meeting in which the trainee and experimenter reviewed five randomly selected interactions recorded during the previous day's shift. The review included self-evaluation, praise, corrective feedback, and role-play. A multiple baseline across subjects design showed each trainee acknowledged a greater number of coworker initiations as a function of the intervention. Each trainee also acknowledged more coworker initiations during the second observation period when the tape recorder was never worn. In a subsequent intervention phase, Dana reviewed her tape-recorded interactions prior to randomly selected shifts. Rick's acknowledgments increased to a socially valid level when the review procedure was supplemented with graphic feedback. Both trainees continued to acknowledge their coworkers' initiations at levels equal to nondisabled restaurant employees when they no longer wore the tape recorder during a final phase and during follow-up observations 4 to 8 weeks later.

Medical Services at an International Summer Camp Event Under Hot and Humid Conditions: Experiences From the 23rd World Scout Jamboree, Japan.

PubMed

Watanabe, Takemasa; Mizutani, Keiji; Iwai, Toshiyasu; Nakashima, Hiroshi

2018-06-01

The 23rd World Scout Jamboree (WSJ) was a 10-day summer camp held in Japan in 2015 under hot and humid conditions. The attendees comprised 33,628 people from 155 countries and territories. The aim of this study was to examine the provision of medical services under such conditions and to identify preventive factors for major diseases among long-term campers. Data were obtained from WSJ medical center records and examined to clarify the effects of age, sex, and period on visit frequencies and rates. Medical records from 3215 patients were examined. Daytime temperatures were 31.5±3.2°C and relative humidity was 61±13% (mean±SD). The initial visit rates among scouts and adults were 72.2 and 77.2 per 1000 persons, respectively. No significant age difference was observed in the initial visit rate; however, it was significantly higher among female patients than male patients. Significant differences were also seen in the adjusted odds ratios by age, sex, and period for disease distributions of initial visit frequencies. In addition, a higher initial visit frequency for heat strain-related diseases was seen among the scouts. Initial visit frequencies for heatstroke and/or dehydration increased just after opening day and persisted until closing day. Our findings suggest the importance of taking effective countermeasures against heat strain, fatigue, and unsanitary conditions at the WSJ. Medical services staff should take attendees' age, sex, and period into consideration to prevent heat strain-related diseases during such camps under hot and humid conditions. Copyright © 2018 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

No Risk of Myocardial Infarction Associated With Initial Antiretroviral Treatment Containing Abacavir: Short and Long-Term Results from ACTG A5001/ALLRT

PubMed Central

Benson, Constance A.; Zheng, Yu; Koletar, Susan L.; Collier, Ann C.; Lok, Judith J.; Smurzynski, Marlene; Bosch, Ronald J.; Bastow, Barbara; Schouten, Jeffrey T.

2011-01-01

Background. Observational and retrospective clinical trial cohorts have reported conflicting results for the association of abacavir use with risk of myocardial infarction (MI), possibly related to issues that may bias estimation of treatment effects, such as time-varying confounders, informative dropout, and cohort loss due to competing events. Methods. We analyzed data from 5056 individuals initiating randomized antiretroviral treatment (ART) in AIDS Clinical Trials Group studies; 1704 started abacavir therapy. An intent-to-treat analysis adjusted for pretreatment covariates and weighting for informative censoring was used to estimate the hazard ratio (HR) of MIs after initiation of a regimen with or without abacavir. Results. Through 6 years after ART initiation, 36 MI events were observed in 17,404 person-years of follow-up. No evidence of an increased hazard of MI in subjects using abacavir versus no abacavir was seen (over a 1-year period: P = .50; HR, 0.7 [95% confidence interval {CI}, 0.2-2.4]); over a 6-year period: P = .24; HR, 0.6 [95% CI, 0.3-1.4]); these results were robust over as-treated and sensitivity analyses. Although the risk of MI decreased over time, there was no evidence to suggest a time-dependent abacavir effect. Classic cardiovascular disease (CVD) risk factors were the strongest predictors of MI. Conclusion. We find no evidence to suggest that initial ART containing abacavir increases MI risk over short-term and long-term periods in this population with relatively low MI risk. Traditional CVD risk factors should be the main focus in assessing CVD risk in individuals with human immunodeficiency virus infection. PMID:21427402

No risk of myocardial infarction associated with initial antiretroviral treatment containing abacavir: short and long-term results from ACTG A5001/ALLRT.

PubMed

Ribaudo, Heather J; Benson, Constance A; Zheng, Yu; Koletar, Susan L; Collier, Ann C; Lok, Judith J; Smurzynski, Marlene; Bosch, Ronald J; Bastow, Barbara; Schouten, Jeffrey T

2011-04-01

Observational and retrospective clinical trial cohorts have reported conflicting results for the association of abacavir use with risk of myocardial infarction (MI), possibly related to issues that may bias estimation of treatment effects, such as time-varying confounders, informative dropout, and cohort loss due to competing events. We analyzed data from 5056 individuals initiating randomized antiretroviral treatment (ART) in AIDS Clinical Trials Group studies; 1704 started abacavir therapy. An intent-to-treat analysis adjusted for pretreatment covariates and weighting for informative censoring was used to estimate the hazard ratio (HR) of MIs after initiation of a regimen with or without abacavir. Through 6 years after ART initiation, 36 MI events were observed in 17,404 person-years of follow-up. No evidence of an increased hazard of MI in subjects using abacavir versus no abacavir was seen (over a 1-year period: P=.50; HR, 0.7 [95% confidence interval {CI}, 0.2-2.4]); over a 6-year period: P=.24; HR, 0.6 [95% CI, 0.3-1.4]); these results were robust over as-treated and sensitivity analyses. Although the risk of MI decreased over time, there was no evidence to suggest a time-dependent abacavir effect. Classic cardiovascular disease (CVD) risk factors were the strongest predictors of MI. We find no evidence to suggest that initial ART containing abacavir increases MI risk over short-term and long-term periods in this population with relatively low MI risk. Traditional CVD risk factors should be the main focus in assessing CVD risk in individuals with human immunodeficiency virus infection. © The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.

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

PubMed

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

2017-12-01

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

The Impact of TRMM on Mesoscale Model Simulation of Super Typhoon Paka

NASA Technical Reports Server (NTRS)

Tao, W.-K.; Jia, Y.; Halverson, J.; Hou, A.; Olson, W.; Rodgers, E.; Simpson, J.

1999-01-01

Tropical cyclone Paka formed during the first week of December 1997 and underwent three periods of rapid intensification over the following two weeks. During one of these periods, which initiated early on December 10, Paka's Dvorak-measured windspeed increased from 23 to 60 m/s over a 48-hr period. On December 18, during the last rapid deepening episode, Paka became a supertyphoon with a maximum wind speed of about 80 m/s. In this study, the Penn State/NCAR Mesoscale Model (MM5) with improved physics (i.e., cloud microphysics, radiation, land-soil-vegetation-surface processes, and TOGA COARE flux scheme) and a multiple level nesting technique (135, 45 and 15 km horizontal resolution) will be used to simulate supertyphoon Paka. We performed two runs initialized with Goddard Earth Observing System (GEOS) data sets. The first GEOS data set does not incorporate either TRMM (tropical rainfall measuring mission satellite) or SSM/I (sensor microwave imager) observed rainfall fields into the GEOS's assimilation system while the second one does. Preliminary results show that the MM5 simulated surface pressure deepened by more than 25 mb (45 km resolution domain) in the run initialized with the GEOS data set incorporating TRMM and SSM/I derived rainfall, compared to the one initialized without. However, the track and precipitation patterns are quite similar between the runs. In our presentation, we will show the impact of TRMM rainfall upon the MM5 simulation of Paka at various horizontal resolutions. We will also examine the physical processes associated with initial explosive development by comparing MM5 simulated rainfall and latent heat release. In addition, budget (vorticity, PV, momentum and heat) calculations and sensitivity tests will be performed to examine the upper-tropospheric and SST mechanisms responsible for the explosive development of Paka.

Approximate solution of space and time fractional higher order phase field equation

NASA Astrophysics Data System (ADS)

Shamseldeen, S.

2018-03-01

This paper is concerned with a class of space and time fractional partial differential equation (STFDE) with Riesz derivative in space and Caputo in time. The proposed STFDE is considered as a generalization of a sixth-order partial phase field equation. We describe the application of the optimal homotopy analysis method (OHAM) to obtain an approximate solution for the suggested fractional initial value problem. An averaged-squared residual error function is defined and used to determine the optimal convergence control parameter. Two numerical examples are studied, considering periodic and non-periodic initial conditions, to justify the efficiency and the accuracy of the adopted iterative approach. The dependence of the solution on the order of the fractional derivative in space and time and model parameters is investigated.

Volume nanograting formation in laser-silica interaction as a result of the 1D plasma-resonance ionization instability

NASA Astrophysics Data System (ADS)

Gildenburg, V. B.; Pavlichenko, I. A.

2016-08-01

The initial stage of the small-scale ionization-induced instability developing inside the fused silica volume exposed to the femtosecond laser pulse is studied as a possible initial cause of the self-organized nanograting formation. We have calculated the spatial spectra of the instability with the electron-hole diffusion taken into account for the first time and have found that it results in the formation of some hybrid (diffusion-wave) 1D structure with the spatial period determined as the geometrical mean of the laser wavelength and characteristic diffusion length of the process considered. Near the threshold of the instability, this period occurs to be approximately equal to the laser half-wavelength in the silica, close to the one experimentally observed.

Tests Enhance the Transfer of Learning

ERIC Educational Resources Information Center

Rohrer, Doug; Taylor, Kelli; Sholar, Brandon

2010-01-01

Numerous learning studies have shown that if the period of time devoted to studying information (e.g., casa-house) includes at least 1 test (casa-?), performance on a final test is improved--a finding known as the "testing effect". In most of these studies, however, the final test is identical to the initial test. If the final test…

Examination of wireless technology to improve nurse communication, response time to bed alarms, and patient safety.

PubMed

Guarascio-Howard, Linda

2011-01-01

A medical-surgical unit in a southwestern United States hospital examined the results of adding wireless communication technology to assist nurses in identifying patient bed status changes and enhancing team communication. Following the addition of wireless communication, response time to patient calls and the number of nurse-initiated communications were compared to pre-wireless calls and response time sampling period. In the baseline study, nurse-initiated communications and response time to patient calls were investigated for a team nursing model (Guarascio-Howard & Malloch, 2007). At this time, technology consisted of a nurse call system and telephones located at each decentralized nurse station and health unit coordinator (HUC) station. For this follow-up study, a wireless device was given to nurses and their team members following training on device use and privacy issues. Four registered nurses (RNs) were shadowed for 8 hours (32 hours total) before and after the introduction of the wireless devices. Data were collected regarding patient room visits, number of patient calls, bed status calls, response time to calls, and the initiator of the communication episodes. Follow-up study response time to calls significantly decreased (t-test p = .03). RNs and licensed practical nurses responded to bed status calls in less than 1 minute-62% of the 37 calls. Communication results indicated a significant shift (One Proportion Z Test) in RN-initiated communications, suggesting an enhanced ability to communicate with team members and to assist in monitoring patient status. Patient falls trended downward, although not significantly (p > .05), for a 6-month period of wireless technology use compared to the same period the previous year. The addition of a wireless device has advantages in team nursing, namely increasing communication with staff members and decreasing response time to patient and bed status calls. Limitations of the study included a change in caregiver team members and issues regarding wireless device and locator badge compliance. Administrative issues that arose during this field study included bed and cable maintenance, device battery charging, and the training of new and floating team members.

Asthma in pregnancy: association between the Asthma Control Test and the Global Initiative for Asthma classification and comparisons with spirometry.

PubMed

de Araujo, Georgia Véras; Leite, Débora F B; Rizzo, José A; Sarinho, Emanuel S C

2016-08-01

The aim of this study was to identify a possible association between the assessment of clinical asthma control using the Asthma Control Test (ACT) and the Global Initiative for Asthma (GINA) classification and to perform comparisons with values of spirometry. Through this cross-sectional study, 103 pregnant women with asthma were assessed in the period from October 2010 to October 2013 in the asthma pregnancy clinic at the Clinical Hospital of the Federal University of Pernambuco. Questionnaires concerning the level of asthma control were administered using the Global Initiative for Asthma classification, the Asthma Control Test validated for asthmatic expectant mothers and spirometry; all three methods of assessing asthma control were performed during the same visit between the twenty-first and twenty-seventh weeks of pregnancy. There was a significant association between clinical asthma control assessment using the Asthma Control Test and the Global Initiative for Asthma classification (p<0.001). There were also significant associations between the results of the subjective instruments of asthma (the GINA classification and the ACT) and evidence of lung function by spirometry. This study shows that both the Global Initiative for Asthma classification and the Asthma Control Test can be used for asthmatic expectant mothers to assess the clinical control of asthma, especially at the end of the second trimester, which is assumed to be the period of worsening asthma exacerbations during pregnancy. We highlight the importance of the Asthma Control Test as a subjective instrument with easy application, easy interpretation and good reproducibility that does not require spirometry to assess the level of asthma control and can be used in the primary care of asthmatic expectant mothers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The structure of non-hierarchical triple system stability regions

NASA Astrophysics Data System (ADS)

Martynova, A. I.; Orlov, V. V.; Rubinov, A. V.

2009-08-01

A detailed study of the two-dimensional initial conditions region section in the planar three-body problem is performed. The initial conditions for the three well-known stable periodic orbits (the Schubart’s orbit, the Broucke’s orbit and the eight-like orbit) belong to this section. Continuous stability regions (for the fixed integration interval) generated by these periodic orbits are found. Zones of the quick stability violation are outlined. The analysis of some concrete trajectories coming from various stability regions is performed. In particular, trajectories possessing varying number of “eights” formed by moving triple system components are discovered. Orbits with librations are also found. The new periodic orbit originated from the zone siding with the Schubart’s orbit region is discovered. This orbit has reversibility points (each of the outer bodies possess a reversibility point) and two points of close double approach of the central body to each of the outer bodies. The influence of the numerical integration accuracy on the results is studied. The stability regions structure is preserved during calculations with different values of the precision parameter, numerical integration methods and regularization algorithms of the equations of motion.

Time dependency of the prediction skill for the North Atlantic subpolar gyre in initialized decadal hindcasts with MPI-ESM

NASA Astrophysics Data System (ADS)

Brune, Sebastian; Düsterhus, Andre; Pohlmann, Holger; Müller, Wolfgang; Baehr, Johanna

2017-04-01

We analyze the time dependency of decadal hindcast skill in the North Atlantic subpolar gyre within the time period 1961-2013. We compare anomaly correlation coefficients and interquartile ranges of total upper ocean heat content and sea surface temperature for three differently initialized sets of hindcast simulations with the global coupled model MPI-ESM. All initializations use weakly coupled assimilation with the same full-field nudging in the atmospheric component and different assimilation techniques for oceanic temperature and salinity: (1) ensemble Kalman filter assimilating EN4 and HadISST observations, (2) nudging of anomalies to ORAS4 reanalysis, (3) nudging of full values to ORAS4 reanalysis. We find that hindcast skill depends strongly on the evaluation time period, with higher hindcast skill during strong multiyear trends and lower hindcast skill in the absence of such trends. While there may only be small differences between the prediction systems in the analysis focusing on the entire hindcast period, these differences between the hindcast systems are much more pronounced when investigating any 20-year subperiod within the entire hindcast period. For the ensemble Kalman filter high skill in the assimilation experiment is generally linked to high skill in the initialized hindcasts. Such direct link does not seem to exist in the hindcasts initialized by either nudged system. In the ensemble Kalman filter initialized hindcasts, we find significant hindcast skill for up to 5 to 8 lead years, except for the 1970s. In the nudged system initialized hindcasts, hindcast skill is consistently diminished in lead years 2 and 3 with lowest skill in the 1970s as well. Overall, we find that a model-consistent assimilation technique can improve hindcast skill. Further, the evaluation of 20 year subperiods within the full hindcast period provides essential insights to judge the success of both the assimilation and the subsequent hindcast skill.

Comparing methods for assessing the effectiveness of subnational REDD+ initiatives

NASA Astrophysics Data System (ADS)

Bos, Astrid B.; Duchelle, Amy E.; Angelsen, Arild; Avitabile, Valerio; De Sy, Veronique; Herold, Martin; Joseph, Shijo; de Sassi, Claudio; Sills, Erin O.; Sunderlin, William D.; Wunder, Sven

2017-07-01

The central role of forests in climate change mitigation, as recognized in the Paris agreement, makes it increasingly important to develop and test methods for monitoring and evaluating the carbon effectiveness of REDD+. Over the last decade, hundreds of subnational REDD+ initiatives have emerged, presenting an opportunity to pilot and compare different approaches to quantifying impacts on carbon emissions. This study (1) develops a Before-After-Control-Intervention (BACI) method to assess the effectiveness of these REDD+ initiatives; (2) compares the results at the meso (initiative) and micro (village) scales; and (3) compares BACI with the simpler Before-After (BA) results. Our study covers 23 subnational REDD+ initiatives in Brazil, Peru, Cameroon, Tanzania, Indonesia and Vietnam. As a proxy for deforestation, we use annual tree cover loss. We aggregate data into two periods (before and after the start of each initiative). Analysis using control areas (‘control-intervention’) suggests better REDD+ performance, although the effect is more pronounced at the micro than at the meso level. Yet, BACI requires more data than BA, and is subject to possible bias in the before period. Selection of proper control areas is vital, but at either scale is not straightforward. Low absolute deforestation numbers and peak years influence both our BA and BACI results. In principle, BACI is superior, with its potential to effectively control for confounding factors. We conclude that the more local the scale of performance assessment, the more relevant is the use of the BACI approach. For various reasons, we find overall minimal impact of REDD+ in reducing deforestation on the ground thus far. Incorporating results from micro and meso level monitoring into national reporting systems is important, since overall REDD+ impact depends on land use decisions on the ground.

Vitamin A Deprivation Affects the Progression of the Spermatogenic Wave and Initial Formation of the Blood-testis Barrier, Resulting in Irreversible Testicular Degeneration in Mice

PubMed Central

CHIHARA, Masataka; OTSUKA, Saori; ICHII, Osamu; KON, Yasuhiro

2013-01-01

Abstract The blood testis-barrier (BTB) is essential for maintaining homeostasis in the seminiferous epithelium. Although many studies have reported that vitamin A (VA) is required for the maintenance of spermatogenesis, the relationships between the BTB, spermatogenesis and VA have not been elucidated. In this study, we analyzed BTB assembly and spermatogenesis in the testes of mice fed the VA-deficient (VAD) diet from the prepubertal period to adulthood. During the prepubertal period, no changes were observed in the initiation and progression of the first spermatogenic wave in mice fed the VAD diet. However, the numbers of preleptotene/leptotene spermatocytes derived from the second spermatogenic wave onwards were decreased, and initial BTB formation was also delayed, as evidenced by the decreased expression of mRNAs encoding BTB components and VA signaling molecules. From 60 days postpartum, mice fed the VAD diet exhibited apoptosis of germ cells, arrest of meiosis, disruption of the BTB, and dramatically decreased testis size. Furthermore, vacuolization and calcification were observed in the seminiferous epithelium of adult mice fed the VAD diet. Re-initiation of spermatogenesis by VA replenishment in adult mice fed the VAD diet rescued BTB assembly after when the second spermatogenic wave initiated from the arrested spermatogonia reached the preleptotene/leptotene spermatocytes. These results suggested that BTB integrity was regulated by VA metabolism with meiotic progression and that the impermeable BTB was required for persistent spermatogenesis rather than meiotic initiation. In conclusion, consumption of the VAD diet led to critical defects in spermatogenesis progression and altered the dynamics of BTB assembly. PMID:23934320

20 CFR 663.530 - Is there a time limit on the period of initial eligibility for training providers?

Code of Federal Regulations, 2010 CFR

2010-04-01

... initial eligibility for training providers? 663.530 Section 663.530 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Eligible Training Providers § 663.530 Is there a time limit on the period of...

20 CFR 663.530 - Is there a time limit on the period of initial eligibility for training providers?

Code of Federal Regulations, 2011 CFR

2011-04-01

... initial eligibility for training providers? 663.530 Section 663.530 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Eligible Training Providers § 663.530 Is there a time limit on the period of...

42 CFR 409.63 - Reduction of inpatient psychiatric benefit days available in the initial benefit period.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Reduction of inpatient psychiatric benefit days available in the initial benefit period. 409.63 Section 409.63 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Scope of...

Cellular Analogs of Operant Behavior.

DTIC Science & Technology

1992-07-31

confirmed at the behavioral level in parallel studies of hippocampal and intravenous self-administration. The results are consistent with the hypothesis...research is to elucidate the cellular reinforcement mechanisms underlying goal-directed or operant behavior. The specific aim here was to study the... studies and behavioral operant conditioning studies . Most of the research reported was initiated and completed in the present project period. Also

Survival period after tube feeding in bedridden older patients.

PubMed

Kosaka, Yoichi; Nakagawa-Satoh, Takuma; Ohrui, Takashi; Fujii, Masahiko; Arai, Hiroyuki; Sasaki, Hidetada

2012-04-01

We prospectively studied survival periods after tube feeding. Participants were 163 bedridden older patients suffering from dysphagia. A wide range of survival periods after tube feeding were observed within half a year without tube feeding after being bedridden. After this initial period, survival periods after tube feeding were limited to approximately half a year. Survival periods after tube feeding were positively proportional to the length of time patients were free from pneumonia after tube feeding. After tube feeding, patients died from pneumonia within half a year, and the frequency of pneumonia was 3.1 ± 2.7 times (mean ± SD) before death. Survival periods after tube feeding for less than 1 year were primarily determined by being bedridden for more than half a year without tube feeding and once pneumonia occurred; patients who were tube fed did not survive for more than half a year. © 2012 Japan Geriatrics Society.

Experiments with metallic and ceramic porous media

NASA Technical Reports Server (NTRS)

Frederking, T. H. K.; Abbassi, P.; Khandhar, P. K.; Luna, Jack

1988-01-01

Work in the area of mechano-caloric phenomena was initiated during 1988 with startup in the Summer 1988 period. The ideal system utilizing He-II super-phenomena is modeled readily, within the frame of thermodynamics energetics, using the concept of an ideal superleak. The real system however uses porous media of non-ideal pore-grain ingredients. The early phase of experimental and related modeling studies is outlined for the time period from Summer 1988 to the end of 1988.

[Metabolic study of the initial period of fasting in the king penguin chick].

PubMed

Cherel, Y; Le Maho, Y

1985-01-01

There is an 80% decrease in the specific daily change in body mass (dm/m dt) during the first 5-6 days of fasting in king penguin chicks, which characterizes period I of fasting. Parallel decreases in plasma alanine and uric acid concentrations suggest an important reduction in protein degradation. Plasma concentration of beta-hydroxybutyrate and glucose are high, respectively 1.3 and 12.5 mmol X 1(-1), and do not change significantly.

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

Vlies, C. H. van der, E-mail: c.h.vandervlies@amc.uva.nl; Hoekstra, J.; Ponsen, K. J.

Introduction: Nonoperative management (NOM) has become the treatment of choice for hemodynamically stable patients with blunt splenic injury. Results of outcome after NOM are predominantly based on large-volume studies from level 1 trauma centers in the United States. This study was designed to assess the results of NOM in a relatively low-volume Dutch level 1 trauma center. Methods: An analysis of a prospective trauma registry was performed for a 6-year period before (period 1) and after the introduction and implementation of splenic artery embolization (SAE) (period 2). Primary outcome was the failure rate of initial treatment. Results: A total ofmore » 151 patients were reviewed. An increased use of SAE and a reduction of splenic operations during the second period was observed. Compared with period 1, the failure rate after observation in period 2 decreased from 25% to 10%. The failure rate after SAE in period 2 was 18%. The splenic salvage rate (SSR) after observation increased from 79% in the first period to 100% in the second period. During the second period, all patients with failure after observation were successfully treated with SAE. The SSR after SAE in periods 1 and 2 was respectively 100% and 86%. Conclusions: SAE of patients with blunt splenic injuries is associated with a reduction in splenic operations. The failure and splenic salvage rates in this current study were comparable with the results from large-volume studies of level 1 trauma centers. Nonoperative management also is feasible in a relatively low-volume level 1 trauma center outside the United States.« less

On the Diurnal Periodicity of Representative Earthquakes in Greece: Comparison of Data from Different Observation Systems

NASA Astrophysics Data System (ADS)

Desherevskii, A. V.; Sidorin, A. Ya.

2017-12-01

Due to the initiation of the Hellenic Unified Seismic Network (HUSN) in late 2007, the quality of observation significantly improved by 2011. For example, the representative magnitude level considerably has decreased and the number of annually recorded events has increased. The new observational system highly expanded the possibilities for studying regularities in seismicity. In view of this, the authors revisited their studies of the diurnal periodicity of representative earthquakes in Greece that was revealed earlier in the earthquake catalog before 2011. We use 18 samples of earthquakes of different magnitudes taken from the catalog of Greek earthquakes from 2011 to June 2016 to derive a series of the number of earthquakes for each of them and calculate its average diurnal course. To increase the reliability of the results, we compared the data for two regions. With a high degree of statistical significance, we have obtained that no diurnal periodicity can be found for strongly representative earthquakes. This finding differs from the estimates obtained earlier from an analysis of the catalog of earthquakes at the same area for 1995-2004 and 2005-2010, i.e., before the initiation of the Hellenic Unified Seismic Network. The new results are consistent with the hypothesis of noise discrimination (observational selection) explaining the cause of the diurnal variation of earthquakes with different sensitivity of the seismic network in daytime and nighttime periods.

Early infant diet and ERP Correlates of Speech Stimuli Discrimination in 9 month old infants

USDA-ARS?s Scientific Manuscript database

Processing and discrimination of speech stimuli were examined during the initial period of weaning in infants enrolled in a longitudinal study of infant diet and development (the Beginnings Study). Event-related potential measures (ERP; 128 sites) were used to compare the processing of speech stimul...

Government Workers Adding Societal Value: The Ohio Workforce Development Program

ERIC Educational Resources Information Center

Guerra, Ingrid; Bernardez, Mariano; Jones, Michael; Zidan, Suhail

2005-01-01

This case study illustrates the application of Mega--adding measurable value for all stakeholders including society--as the central and ultimate focus for needs assessment. In this case, two needs assessment studies were conducted within a five-year period (1999-2003) with the State of Ohio's Workforce Development (WD) program. An initial needs…

Final Report of NATO/SPS Pilot Study on Clean Products and Processes (Phase I and II)

EPA Science Inventory

Early in 1998 the NATO Committee for Challenges to Modern Society (SPS) (Science for Peace and Security) approved the Pilot Study on Clean Products and Processes for an initial period of five years. The pilot was to provide a forum for member country representatives to discuss t...

Lecithotrophic behaviour in zoea and megalopa larvae of the ghost shrimp Lepidophthalmus siriboia Felder and Rodrigues, 1993 (Decapoda: Callianassidae).

PubMed

Abrunhosa, Fernando A; Simith, Darlan J B; Palmeira, Carlos A M; Arruda, Danielle C B

2008-12-01

Food supply is considered critical for a successful culturing of decapod larvae. However, some species may present yolk reserve sufficient to complete their larval development without external food supply (known as lecithotrophic larval development). In the present study, two experiments were carried out in order to verify whether the callianassid Lepidophthalmus siriboia have lecithotrophic behaviour or, if they need external food for their larval development: Experiment 1, larvae submitted to an initial feeding period and Experiment 2, larvae submitted to an initial starvation period. High survival rate was observed in both experiments, in which only 2 megalopae and 1 zoea III died. These results strongly suggest that larvae of L. siriboia are lecithotrophic as they have sufficiently large yolk reserve to complete their larval development, while the megalopa stage shows facultative lecithotrophy. The larval periods of each stage of the treatments were quite similar and, despite some significant differences in some larval periods, these can be related probably to larval rearing conditions, abiotic factors or, individual variability of larval health, as well as stress caused to the ovigerous females during embryogenesis.

Existence and numerical simulation of periodic traveling wave solutions to the Casimir equation for the Ito system

NASA Astrophysics Data System (ADS)

Abbasbandy, S.; Van Gorder, R. A.; Hajiketabi, M.; Mesrizadeh, M.

2015-10-01

We consider traveling wave solutions to the Casimir equation for the Ito system (a two-field extension of the KdV equation). These traveling waves are governed by a nonlinear initial value problem with an interesting nonlinearity (which actually amplifies in magnitude as the size of the solution becomes small). The nonlinear problem is parameterized by two initial constant values, and we demonstrate that the existence of solutions is strongly tied to these parameter values. For our interests, we are concerned with positive, bounded, periodic wave solutions. We are able to classify parameter regimes which admit such solutions in full generality, thereby obtaining a nice existence result. Using the existence result, we are then able to numerically simulate the positive, bounded, periodic solutions. We elect to employ a group preserving scheme in order to numerically study these solutions, and an outline of this approach is provided. The numerical simulations serve to illustrate the properties of these solutions predicted analytically through the existence result. Physically, these results demonstrate the existence of a type of space-periodic structure in the Casimir equation for the Ito model, which propagates as a traveling wave.

42 CFR 409.60 - Benefit periods.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Benefit periods. 409.60 Section 409.60 Public... HOSPITAL INSURANCE BENEFITS Scope of Hospital Insurance Benefits § 409.60 Benefit periods. (a) When benefit periods begin. The initial benefit period begins on the day the beneficiary receives inpatient hospital...

42 CFR 409.60 - Benefit periods.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Benefit periods. 409.60 Section 409.60 Public... HOSPITAL INSURANCE BENEFITS Scope of Hospital Insurance Benefits § 409.60 Benefit periods. (a) When benefit periods begin. The initial benefit period begins on the day the beneficiary receives inpatient hospital...

42 CFR 409.60 - Benefit periods.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Benefit periods. 409.60 Section 409.60 Public... HOSPITAL INSURANCE BENEFITS Scope of Hospital Insurance Benefits § 409.60 Benefit periods. (a) When benefit periods begin. The initial benefit period begins on the day the beneficiary receives inpatient hospital...

42 CFR 409.60 - Benefit periods.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Benefit periods. 409.60 Section 409.60 Public... HOSPITAL INSURANCE BENEFITS Scope of Hospital Insurance Benefits § 409.60 Benefit periods. (a) When benefit periods begin. The initial benefit period begins on the day the beneficiary receives inpatient hospital...

42 CFR 409.60 - Benefit periods.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Benefit periods. 409.60 Section 409.60 Public... HOSPITAL INSURANCE BENEFITS Scope of Hospital Insurance Benefits § 409.60 Benefit periods. (a) When benefit periods begin. The initial benefit period begins on the day the beneficiary receives inpatient hospital...

Are Vulnerability Disclosure Deadlines Justified?

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

Miles McQueen; Jason L. Wright; Lawrence Wellman

2011-09-01

Vulnerability research organizations Rapid7, Google Security team, and Zero Day Initiative recently imposed grace periods for public disclosure of vulnerabilities. The grace periods ranged from 45 to 182 days, after which disclosure might occur with or without an effective mitigation from the affected software vendor. At this time there is indirect evidence that the shorter grace periods of 45 and 60 days may not be practical. However, there is strong evidence that the recently announced Zero Day Initiative grace period of 182 days yields benefit in speeding up the patch creation process, and may be practical for many software products.more » Unfortunately, there is also evidence that the 182 day grace period results in more vulnerability announcements without an available patch.« less

The National Perinatal Depression Initiative: An evaluation of access to general practitioners, psychologists and psychiatrists through the Medicare Benefits Schedule.

PubMed

Chambers, Georgina M; Randall, Sean; Hoang, Van Phuong; Sullivan, Elizabeth A; Highet, Nicole; Croft, Maxine; Mihalopoulos, Cathrine; Morgan, Vera A; Reilly, Nicole; Austin, Marie-Paule

2016-03-01

To evaluate the impact of the National Perinatal Depression Initiative on access to Medicare services for women at risk of perinatal mental illness. Retrospective cohort study using difference-in-difference analytical methods to quantify the impact of the National Perinatal Depression Initiative policies on Medicare Benefits Schedule mental health usage by Australian women giving birth between 2006 and 2010. A random sample of women of reproductive age enrolled in Medicare who had not given birth where used as controls. The main outcome measures were the proportions of women giving birth each month who accessed a Medicare Benefits Schedule mental health items during the perinatal period (pregnancy through to the end of the first postnatal year) before and after the introduction of the National Perinatal Depression Initiative. The proportion of women giving birth who accessed at least one mental health item during the perinatal period increased from 88 to 141 per 1000 between 2007 and 2010. The difference-in-difference analysis showed that while there was an overall increase in Medicare Benefits Schedule mental health item access as a result of the National Perinatal Depression Initiative, this did not reach statistical significance. However, the National Perinatal Depression Initiative was found to significantly increase access in subpopulations of women, particularly those aged under 25 and over 34 years living in major cities. In the 2 years following its introduction, the National Perinatal Depression Initiative was found to have increased access to Medicare funded mental health services in particular groups of women. However, an overall increase across all groups did not reach statistical significance. Further studies are needed to assess the impact of the National Perinatal Depression Initiative on women during childbearing years, including access to tertiary care, the cost-effectiveness of the initiative, and mental health outcomes. It is recommended that new mental health policy initiatives incorporate a planned strategic approach to evaluation, which includes sufficient follow-up to assess the impact of public health strategies. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Physical explanation of the periodic table.

PubMed

Ostrovsky, V N

2003-05-01

The Periodic Table of the elements, the most important generalization in chemistry, is often considered as a representative special case in the study of the relation between chemistry and physics. Its quantum interpretation was initiated, but not completed, by Niels Bohr. In this paper, post-Bohr conceptual developments are discussed from historical and epistemological points of view. The difference between high-precision numerical calculations for individual atoms and the theory of the periodic system as a whole is emphasized. Periodic laws met in Nature are not restricted to the chemical Periodic Table. A comparative study of these laws makes it possible to single out essential features that define the particular pattern of periodicity. It is shown that the periodic system of neutral ground state atoms now has a firm nonempirical quantum-theoretical basis. Alternative approaches, based on group theory and other mathematical schemes, are briefly discussed. It is argued that, while quantum theory is capable of fully accurate calculations for relatively simple atoms or molecular objects, the complexity of polyatomic molecules and chemical reactions guarantees the flourishing of chemistry as a separate scientific discipline.

Physiologic effects of rhythmical massage: a prospective exploratory cohort study.

PubMed

Wälchli, Chantal; Saltzwedel, Georg; Krüerke, Daniel; Kaufmann, Christoph; Schnorr, Bettina; Rist, Lukas; Eberhard, Jutta; Decker, Michael; Simões-Wüst, Ana Paula

2014-06-01

This study was performed to characterize the physiologic effects of rhythmical massage (RM), an anthroposophic therapy whose effectiveness is supported by empirical observations and a prospective observational study. Patients referred to RM at the Paracelsus Hospital Richterswil for any indication were continuously enrolled. They received an average of 10 RM sessions, which included not only the massage but also therapeutic rest in the supine position immediately thereafter. Effects of RM on surface temperature and on heart rate variability (HRV) were determined with infrared imaging (IRI) and electrocardiography (ECG), respectively. IRI of the patients' dorsal region was performed without clothes, in standing position, at the start and at the end of two waiting periods before and after RM. ECG was performed from the beginning of the first waiting period until the end of the second one. Results on IRI from 9 and ECG from 11 patients could be analyzed. RM led to an immediate increase in dorsal temperature. Furthermore, comparison of the IRI images for consecutive RM sessions showed a tendency toward improved warmth distribution as a progressive therapy effect. Analysis of the EGC results recorded during the waiting periods-in the sitting position--showed a significant increase of HRV after RM, as detected by the standard deviation of the beat-to-beat periods and a relative increase of low-frequency power. During the course of the RM sessions, the change in HRV during the therapeutic rest period depended on the initial value: Low initial values were enhanced, whereas high ones were reduced. RM led to an immediate increase in the patient's dorsal surface temperature, as well as increased HRV and sympathetic stimulation. In the long term, RM resulted in a progressive improvement of warmth distribution and regulation of the resting HRV.

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

PubMed

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

2008-01-01

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

Observation and numerical simulation of a convective initiation during COHMEX

NASA Technical Reports Server (NTRS)

Song, J. Aaron; Kaplan, Michael L.

1991-01-01

Under a synoptically undisturbed condition, a dual-peak convective lifecycle was observed with the COoperative Huntsville Meteorological EXperiment (COHMEX) observational network over a 24-hour period. The lifecycle included a multicell storm, which lasted about 6 hours, produced a peak rainrate exceeding 100 mm/hr, and initiated a downstream mesoscale convective system. The 24-hour accumulated rainfall of this event was the largest during the entire COHMEX. The downstream mesoscale convective system, unfortunately, was difficult to investigate quantitatively due to the lack of mesoscale observations. The dataset collected near the time of the multicell storm evolution, including its initiation, was one of the best datasets of COHMEX. In this study, the initiation of this multicell storm is chosen as the target of the numerical simulations.

Neoseiulus californicus (Acari: Phytoseiidae) as a potential control agent of Tetranychus urticae (Acari: Tetranychidae): effect of pest/predator ratio on pest abundance on strawberry.

PubMed

Greco, Nancy M; Sánchez, Norma E; Liljesthröm, Gerardo G

2005-01-01

Neoseiulus californicus (McGregor) is a promising agent for successful Tetranychus urticae Koch control through conservation techniques, in strawberry crops in La Plata (Buenos Aires, Argentina). In prey-predator interaction, initial relative densities have an important effect on system dynamics. The economic threshold level (ETL) used for this pest in the present study was 50 active mites per leaflet. In our laboratory experiments, initial T. urticae to N. californicus ratio had a significant effect on the population abundance of T. urticae at a 7-day period. When pest/predator ratio was 5/1 (at initial pest densities from 5 to 15 females/leaflet) the final number of active T. urticae/leaflet was significantly lower than the ETL, while at 20 females/leaflet this number did not differ from the ETL. At 7.5/1 ratio, the final number of active T. urticae/leaflet, at initial pest densities from 5 to 15 females/leaflet, reached the ETL without surpassing it. At 10/1 and 15/1 ratios, pest densities exceeded the ETL only at 15 initial T. urticae/leaflet. Most greenhouse and field observations were consistent with the predictions of a graphical model based on experimental results. This predator was very effective in limiting pest densities at a 7-day period and within the range of pest-predator ratios and absolute densities used in this study. Conservation of N. californicus promoting favorable pest/predator ratios may result in early control of T. urticae.

Antiretroviral therapy, labor productivity, and sex: a longitudinal cohort study of tea pluckers in Kenya.

PubMed

Larson, Bruce A; Fox, Matthew P; Bii, Margaret; Rosen, Sydney; Rohr, Julia; Shaffer, Douglas; Sawe, Fredrick; Wasunna, Monique; Simon, Jonathon L

2013-01-02

To estimate the impact of antiretroviral therapy (ART) on labor productivity and income using detailed employment data from two large tea plantations in western Kenya for HIV-infected tea pluckers who initiated ART. Longitudinal study using primary data on key employment outcomes for a group of HIV-infected workers receiving antiretroviral therapy (ART) and workers in the general workforce. We used nearest-neighbor matching methods to estimate the impacts of HIV/AIDS and ART among 237 HIV-positive pluckers on ART (index group) over a 4-year period (2 years pre-ART and post-ART) on 4 monthly employment outcomes - days plucking tea, total kilograms (kgs) harvested, total days working, and total labor income. Outcomes for the index group were compared with those for a matched reference group from the general workforce. We observed a rapid deterioration in all four outcomes for HIV-infected individuals in the period before ART initiation and then a rapid improvement after treatment initiation. By 18-24 months after treatment initiation, the index group harvested 8% (men) and 19% (women) less tea than reference individuals. The index group earned 6% (men) and 9% (women) less income from labor than reference individuals. Women's income would have dropped further if they had not been able to offset their decline in tea plucking by spending more time on nonplucking assignments. HIV-infected workers experienced long-term income reductions before and after initiating ART. The implications of such long-term impacts in low-income countries have not been adequately addressed.

Risk for incident diabetes mellitus following initiation of second-generation antipsychotics among Medicaid-enrolled youths.

PubMed

Rubin, David M; Kreider, Amanda R; Matone, Meredith; Huang, Yuan-Shung; Feudtner, Chris; Ross, Michelle E; Localio, A Russell

2015-04-01

Second-generation antipsychotics (SGAs) have increasingly been prescribed to Medicaid-enrolled children, either singly or in a medication combination. Although metabolic adverse effects have been linked to SGA use in youths, estimating the risk for type 2 diabetes mellitus, a rarer outcome, has been challenging. To determine whether SGA initiation was associated with an increased risk for incident type 2 diabetes mellitus. Secondary analyses examined the risk associated with multiple-drug regimens, including stimulants and antidepressants, as well as individual SGAs. Retrospective national cohort study of Medicaid-enrolled youths between January 2003 and December 2007. In this observational study using national Medicaid Analytic eXtract data files, initiators and noninitiators of SGAs were identified in each month. Included in this study were US youths aged 10 to 18 years with a mental health diagnosis and enrolled in a Medicaid fee-for-service arrangement during the study. Those with chronic steroid exposure, a diagnosis of diabetes mellitus, or SGA use during a 1-year look-back period were ineligible. The mean follow-up time for all participants was 17.2 months. Youths were followed up until diagnosis of diabetes mellitus or end of follow-up owing to censoring caused by the transition into a Medicaid managed care arrangement or Medicaid ineligibility (the end of available data). Propensity weights were developed to balance observed demographic and clinical characteristics between exposure groups. Discrete failure time models were fitted using weighted logistic regression to estimate the risk for incident diabetes mellitus between initiators and noninitiators. A filled SGA prescription. Incident type 2 diabetes mellitus identified through visit and pharmacy claims during the observation period. Among 107,551 SGA initiators and 1,221,434 noninitiators, the risk for incident diabetes mellitus was increased among initiators (odds ratio [OR], 1.51; 95% CI, 1.35-1.69; P < .001). Compared with youths initiating only SGAs, the risk was higher among SGA initiators who used antidepressants concomitantly at the time of SGA initiation (OR, 1.54; 95% CI, 1.17-2.03; P = .002) but was not significantly different for SGA initiators who were concomitantly using stimulants. As compared with a reference group of risperidone initiators, the risk was higher among those initiating ziprasidone (OR, 1.61; 95% CI, 0.99-2.64; P = .06) and aripiprazole (OR, 1.58; 95% CI, 1.21-2.07; P = .001) but not quetiapine fumarate or olanzapine. The risk for incident type 2 diabetes mellitus was increased among youths initiating SGAs and was highest in those concomitantly using antidepressants. Compared with risperidone, newer antipsychotics were not associated with decreased risk.

Lactobacillus gasseri SBT2055 reduces postprandial and fasting serum non-esterified fatty acid levels in Japanese hypertriacylglycerolemic subjects.

PubMed

Ogawa, Akihiro; Kadooka, Yukio; Kato, Ken; Shirouchi, Bungo; Sato, Masao

2014-02-19

Lactobacillus gasseri SBT2055 (LG2055) inhibits dietary fat absorption in rats and exerts preventive effects on abdominal adiposity in rats and humans. The present study aimed to evaluate the effects of LG2055 on postprandial serum lipid responses in Japanese subjects with hypertriacylglycerolemia after the intake of oral fat-loading test (OFLT) meals. We conducted a single-blind, placebo-controlled, within-subject, repeated-measure intervention trial. Twenty subjects initially ingested the fermented milk (FM) without LG2055 for 4 weeks (control FM period), followed by a 4-week washout period, and then consumed FM containing LG2055 for 4 weeks (active FM period). The subjects were asked to consume FM at 200 g/day. At the end of each 4-week period, an 8-h OFLT was conducted. Blood samples were collected at fasting and every hour for 8 h after OFLT meal intake. Thereafter, postprandial serum non-esterified fatty acid (NEFA) and triacylglycerol (TAG) levels and fasting blood parameters were measured. The OFLT showed that the postprandial serum NEFA levels from 120 to 480 min and the postprandial serum TAG level at 120 min in the active FM period were significantly (P < 0.05) lower than those in the control FM period. The fasting serum NEFA level in the active FM period significantly (P < 0.001) decreased at week 4 from the initial period compared with the control FM period. The consumption of probiotic LG2055 reduced postprandial and fasting serum NEFA levels, suggesting its possible contribution to the reduction of the risk for obesity and type 2 diabetes mellitus. UMIN000011605.

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

PubMed Central

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

2009-01-01

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

Temporal evolutions and stationary waves for dissipative Benjamin-Ono equation

NASA Astrophysics Data System (ADS)

Feng, Bao-Feng; Kawahara, Takuji

2000-05-01

Initial value problems as well as stationary solitary and periodic waves are investigated for dissipative Benjamin-Ono (DBO) equation. Multi-hump stationary waves and their structures are identified numerically and the stability regions of stationary periodic waves are also examined numerically. These results elucidate a close relation between irregular behaviours in the initial value problem and the multiplicity of stationary waves.

The influence of environmental forcing on biodiversity and extinction in a resource competition model

NASA Astrophysics Data System (ADS)

Vakulenko, Sergey A.; Sudakov, Ivan; Mander, Luke

2018-03-01

In this paper, we study a model of many species that compete, directly or indirectly, for a pool of common resources under the influence of periodic, stochastic, and/or chaotic environmental forcing. Using numerical simulations, we find the number and sequence of species going extinct when the community is initially packed with a large number of species of random initial densities. Thereby, any species with a density below a given threshold is regarded to be extinct.

The Impact of Microwave-Derived Surface Soil Moisture on Watershed Hydrological Modeling

NASA Technical Reports Server (NTRS)

ONeill, P. E.; Hsu, A. Y.; Jackson, T. J.; Wood, E. F.; Zion, M.

1997-01-01

The usefulness of incorporating microwave-derived soil moisture information in a semi-distributed hydrological model was demonstrated for the Washita '92 experiment in the Little Washita River watershed in Oklahoma. Initializing the hydrological model with surface soil moisture fields from the ESTAR airborne L-band microwave radiometer on a single wet day at the start of the study period produced more accurate model predictions of soil moisture than a standard hydrological initialization with streamflow data over an eight-day soil moisture drydown.

The influence of environmental forcing on biodiversity and extinction in a resource competition model.

PubMed

Vakulenko, Sergey A; Sudakov, Ivan; Mander, Luke

2018-03-01

In this paper, we study a model of many species that compete, directly or indirectly, for a pool of common resources under the influence of periodic, stochastic, and/or chaotic environmental forcing. Using numerical simulations, we find the number and sequence of species going extinct when the community is initially packed with a large number of species of random initial densities. Thereby, any species with a density below a given threshold is regarded to be extinct.

Work situation and sickness absence in the initial period after breast cancer surgery.

PubMed

Petersson, Lena-Marie; Wennman-Larsen, Agneta; Nilsson, Marie; Olsson, Mariann; Alexanderson, Kristina

2011-02-01

Breast cancer is the most common cancer diagnosis in women, many of whom are of working age, and the five-year survival rate in Sweden is approaching 90%. Accordingly, aspects of working life and sickness absence are of increasing importance for breast cancer survivors and may have a long-term impact on health and quality of life of these women. The aim was to elucidate the work situation and sickness absence during the initial period after breast cancer surgery and to explore factors associated with sickness absence. This is a cross-sectional questionnaire study 4-6 weeks after breast cancer surgery of women aged 20-63 years, and living in Stockholm. A consecutive sample of 933 women were invited and 756 (81%) accepted to participate. Logistic regression analyses were computed to estimate crude and adjusted odds ratios for associations between sick leave and other variables. Most women (86%) were employed (including self-employed) at diagnosis, and 91% of those worked ≥75% of full-time. At time of survey, 56% were on sick leave, the majority for full-time. Low self-rated health, poorer health than before diagnosis, having a strenuous work posture, and younger age were associated with sick leave during the initial period after breast cancer surgery in both univariate and multivariate analyses. The results of this study is not fully consistent compared to previous studies in this field, often performed in later phases after breast cancer surgery or after other cancer diagnoses. Therefore our results indicate that knowledge is needed during all phases of the breast cancer trajectory to determine factors of importance regarding sick leave and their impact throughout the disease trajectory.

Full-Thickness Macular Hole Formation in the Postoperative Period After Initial Vitrectomy for Rhegmatogenous Retinal Detachment.

PubMed

Takashina, Hirotsugu; Watanabe, Akira; Tsuneoka, Hiroshi

2017-01-01

To evaluate full-thickness macular hole (MH) formation in the postoperative period after initial vitrectomy for rhegmatogenous retinal detachment (rRD). We retrospectively reviewed the medical records of 4 consecutive eyes that required additional vitrectomy for full-thickness MH between April 2013 and March 2016 after undergoing an initial vitrectomy for rRD. Epiretinal membrane (ERM) was identified by preoperative optical coherence tomography or intraoperative dye staining in each case. Photocoagulation of retinal breaks prior to initial vitrectomy was performed in Cases 1, 2, and 3 (4-16 days), with yttrium-aluminum-garnet capsulotomy after cataract extraction also performed prior to the retinal break formation in Case 3. At the initial vitrectomy, there was a superior retinal break which crossed the equator in Case 2, and an intentional hole was created in Cases 1 and 4. The mean interval from the initial vitrectomy until MH formation was 27.5 ± 15.8 months. As with Case 2, the intervals in Cases 1 and 4, in which an intentional hole was created, were clearly shorter than in those in Case 3. Finally, MH closure was achieved after an additional vitrectomy (removal of the internal limiting membrane with ERM and gas tamponade) and best-corrected visual acuity improved in each case. ERM was identified in the cases examined in our study. The presence of an intentional hole might shorten the interval of MH formation after vitrectomy for rRD.

Impact of high resolution land surface initialization in Indian summer monsoon simulation using a regional climate model

NASA Astrophysics Data System (ADS)

Unnikrishnan, C. K.; Rajeevan, M.; Rao, S. Vijaya Bhaskara

2016-06-01

The direct impact of high resolution land surface initialization on the forecast bias in a regional climate model in recent years over Indian summer monsoon region is investigated. Two sets of regional climate model simulations are performed, one with a coarse resolution land surface initial conditions and second one used a high resolution land surface data for initial condition. The results show that all monsoon years respond differently to the high resolution land surface initialization. The drought monsoon year 2009 and extended break periods were more sensitive to the high resolution land surface initialization. These results suggest that the drought monsoon year predictions can be improved with high resolution land surface initialization. Result also shows that there are differences in the response to the land surface initialization within the monsoon season. Case studies of heat wave and a monsoon depression simulation show that, the model biases were also improved with high resolution land surface initialization. These results show the need for a better land surface initialization strategy in high resolution regional models for monsoon forecasting.

Archaeological application of airborne LiDAR to examine social changes in the Ceibal region of the Maya lowlands.

PubMed

Inomata, Takeshi; Triadan, Daniela; Pinzón, Flory; Burham, Melissa; Ranchos, José Luis; Aoyama, Kazuo; Haraguchi, Tsuyoshi

2018-01-01

Although the application of LiDAR has made significant contributions to archaeology, LiDAR only provides a synchronic view of the current topography. An important challenge for researchers is to extract diachronic information over typically extensive LiDAR-surveyed areas in an efficient manner. By applying an architectural chronology obtained from intensive excavations at the site center and by complementing it with surface collection and test excavations in peripheral zones, we analyze LiDAR data over an area of 470 km2 to trace social changes through time in the Ceibal region, Guatemala, of the Maya lowlands. We refine estimates of structure counts and populations by applying commission and omission error rates calculated from the results of ground-truthing. Although the results of our study need to be tested and refined with additional research in the future, they provide an initial understanding of social processes over a wide area. Ceibal appears to have served as the only ceremonial complex in the region during the transition to sedentism at the beginning of the Middle Preclassic period (c. 1000 BC). As a more sedentary way of life was accepted during the late part of the Middle Preclassic period and the initial Late Preclassic period (600-300 BC), more ceremonial assemblages were constructed outside the Ceibal center, possibly symbolizing the local groups' claim to surrounding agricultural lands. From the middle Late Preclassic to the initial Early Classic period (300 BC-AD 300), a significant number of pyramidal complexes were probably built. Their high concentration in the Ceibal center probably reflects increasing political centralization. After a demographic decline during the rest of the Early Classic period, the population in the Ceibal region reached the highest level during the Late and Terminal Classic periods, when dynastic rule was well established (AD 600-950).

Archaeological application of airborne LiDAR to examine social changes in the Ceibal region of the Maya lowlands

PubMed Central

Triadan, Daniela; Pinzón, Flory; Burham, Melissa; Ranchos, José Luis; Aoyama, Kazuo; Haraguchi, Tsuyoshi

2018-01-01

Although the application of LiDAR has made significant contributions to archaeology, LiDAR only provides a synchronic view of the current topography. An important challenge for researchers is to extract diachronic information over typically extensive LiDAR-surveyed areas in an efficient manner. By applying an architectural chronology obtained from intensive excavations at the site center and by complementing it with surface collection and test excavations in peripheral zones, we analyze LiDAR data over an area of 470 km2 to trace social changes through time in the Ceibal region, Guatemala, of the Maya lowlands. We refine estimates of structure counts and populations by applying commission and omission error rates calculated from the results of ground-truthing. Although the results of our study need to be tested and refined with additional research in the future, they provide an initial understanding of social processes over a wide area. Ceibal appears to have served as the only ceremonial complex in the region during the transition to sedentism at the beginning of the Middle Preclassic period (c. 1000 BC). As a more sedentary way of life was accepted during the late part of the Middle Preclassic period and the initial Late Preclassic period (600–300 BC), more ceremonial assemblages were constructed outside the Ceibal center, possibly symbolizing the local groups’ claim to surrounding agricultural lands. From the middle Late Preclassic to the initial Early Classic period (300 BC-AD 300), a significant number of pyramidal complexes were probably built. Their high concentration in the Ceibal center probably reflects increasing political centralization. After a demographic decline during the rest of the Early Classic period, the population in the Ceibal region reached the highest level during the Late and Terminal Classic periods, when dynastic rule was well established (AD 600–950). PMID:29466384

Sequential cohort design applying propensity score matching to analyze the comparative effectiveness of atorvastatin and simvastatin in preventing cardiovascular events.

PubMed

Helin-Salmivaara, Arja; Lavikainen, Piia; Aarnio, Emma; Huupponen, Risto; Korhonen, Maarit Jaana

2014-01-01

Sequential cohort design (SCD) applying matching for propensity scores (PS) in accrual periods has been proposed to mitigate bias caused by channeling when calendar time is a proxy for strong confounders. We studied the channeling of patients according to atorvastatin and simvastatin initiation in Finland, starting from the market introduction of atorvastatin in 1998, and explored the SCD PS approach to analyzing the comparative effectiveness of atorvastatin versus simvastatin in the prevention of cardiovascular events (CVE). Initiators of atorvastatin or simvastatin use in the 45-75-year age range in 1998-2006 were characterized by their propensity of receiving atorvastatin over simvastatin, as estimated for 17 six-month periods. Atorvastatin (10 mg) and simvastatin (20 mg) initiators were matched 1∶1 on the PS, as estimated for the whole cohort and within each period. Cox regression models were fitted conventionally, and also for the PS matched cohort and the periodically PS matched cohort, to estimate the hazard ratios (HR) for CVEs. Atorvastatin (10 mg) was associated with a 11%-12% lower incidence of CVE in comparison with simvastatin (20 mg). The HR estimates were the same for a conventional Cox model (0.88, 95% confidence interval 0.85-0.91), for the analysis in which the PS was used to match across all periods and the Cox model was adjusted for strong confounders (0.89, 0.85-0.92), and for the analysis in which PS matching was applied within sequential periods (0.88, 0.84-0.92). The HR from a traditional PS matched analysis was 0.80 (0.77-0.83). The SCD PS approach produced effect estimates similar to those obtained in matching for PS within the whole cohort and adjusting the outcome model for strong confounders, but at the cost of efficiency. A traditional PS matched analysis without further adjustment in the outcome model produced estimates further away from unity.

A self-controlled case series to assess the effectiveness of beta blockers for heart failure in reducing hospitalisations in the elderly.

PubMed

Ramsay, Emmae N; Roughead, Elizabeth E; Ewald, Ben; Pratt, Nicole L; Ryan, Philip

2011-07-18

To determine the suitability of using the self-controlled case series design to assess improvements in health outcomes using the effectiveness of beta blockers for heart failure in reducing hospitalisations as the example. The Australian Government Department of Veterans' Affairs administrative claims database was used to undertake a self-controlled case-series in elderly patients aged 65 years or over to compare the risk of a heart failure hospitalisation during periods of being exposed and unexposed to a beta blocker. Two studies, the first using a one year period and the second using a four year period were undertaken to determine if the estimates varied due to changes in severity of heart failure over time. In the one year period, 3,450 patients and in the four year period, 12, 682 patients had at least one hospitalisation for heart failure. The one year period showed a non-significant decrease in hospitalisations for heart failure 4-8 months after starting beta-blockers, (RR, 0.76; 95% CI (0.57-1.02)) and a significant decrease in the 8-12 months post-initiation of a beta blocker for heart failure (RR, 0.62; 95% CI (0.39, 0.99)). For the four year study there was an increased risk of hospitalisation less than eight months post-initiation and significant but smaller decrease in the 8-12 month window (RR, 0.90; 95% CI (0.82, 0.98)). The results of the one year observation period are similar to those observed in randomised clinical trials indicating that the self-controlled case-series method can be successfully applied to assess health outcomes. However, the result appears sensitive to the study periods used and further research to understand the appropriate applications of this method in pharmacoepidemiology is still required. The results also illustrate the benefits of extending beta blocker utilisation to the older age group of heart failure patients in which their use is common but the evidence is sparse.

PLATINO, a nine-year follow-up study of COPD in the city of São Paulo, Brazil: the problem of underdiagnosis*

PubMed Central

Moreira, Graciane Laender; Manzano, Beatriz Martins; Gazzotti, Mariana Rodrigues; Nascimento, Oliver Augusto; Perez-Padilla, Rogelio; Menezes, Ana Maria Baptista; Jardim, José Roberto

2014-01-01

OBJECTIVE: To determine the underdiagnosis rate in new COPD cases at the end of a nine-year follow-up period-in the study designated "Projeto Latino-Americano de Investigação em Obstrução Pulmonar" (PLATINO, Latin-American Pulmonary Obstruction Investigation Project)-and compare that with the underdiagnosis rate during the initial phase of the study, as well as to identify the clinical features exhibited by the subjects who were not diagnosed until the end of the follow-up phase. METHODS: The study population comprised the 1,000 residents of the city of São Paulo, Brazil, who took part in the PLATINO study. Of those, 613 participated in the follow-up phase, during which the subjects were assessed with the same instruments and equipment employed in the initial phase of the study. We used the chi-square test or the independent sample t-test to analyze the underdiagnosis rate and to identify the characteristics of the subjects who were not diagnosed until the end of the follow-up phase. RESULTS: The underdiagnosis rate for new COPD cases at the end of the nine-year follow-up period was 70.0%. The underdiagnosis rate during the follow-up phase was 17.5% lower than that reported for the initial phase of the study. The subjects who were not diagnosed until the end of the follow-up phase presented with fewer respiratory symptoms, better pulmonary function, and less severe disease than did those previously diagnosed with COPD. CONCLUSIONS: The underdiagnosis rate for new COPD cases was lower in the follow-up phase of the study than in the initial phase. The subjects who were not diagnosed until the end of the follow-up phase of the PLATINO study presented with the same clinical profile as did those who were not diagnosed in the initial phase. These findings underscore the need for spirometry in order to confirm the diagnosis of COPD and provide early intervention. PMID:24626267

Advanced space system concepts and their orbital support needs (1980 - 2000). Volume 3: Detailed data. Part 1: Catalog of initiatives, functional options, and future environments and goals. [for the U.S. space program

NASA Technical Reports Server (NTRS)

Bekey, I.; Mayer, H. L.; Wolfe, M. G.

1976-01-01

The following areas were discussed in relation to a study of the commonality of space vehicle applications to future national needs: (1) index of initiatives (civilian observation, communication, support), brief illustrated description of each initiative, time periods (from 1980 to 2000+) for implementation of these initiatives; (2) data bank of functional system options, presented in the form of data sheets, one for each of the major functions, with the system option for near-term, midterm, and far-term space projects applicable to each subcategory of functions to be fulfilled; (3) table relating initiatives and desired goals (public service and humanistic, materialistic, scientific and intellectual); and (4) data on size, weight and cost estimations.

Peer Assisted Study Sessions and Student Performance: The Role of Academic Engagement, Student Identity, and Statistics Self-Efficacy

ERIC Educational Resources Information Center

Spedding, Jason; Hawkes, Amy J.; Burgess, Matthew

2017-01-01

The initial year of university is often a sensitive period for new students. Commencing students may lack the necessary skills and resources to adapt to unfamiliar learning environments. One intervention demonstrating academic benefits is Peer Assisted Study Sessions (PASS). PASS is a structured peer led study group where students collectively…

Temperature distribution of a hot water storage tank in a simulated solar heating and cooling system

NASA Technical Reports Server (NTRS)

Namkoong, D.

1976-01-01

A 2,300-liter hot water storage tank was studied under conditions simulating a solar heating and cooling system. The initial condition of the tank, ranging from 37 C at the bottom to 94 C at the top, represented a condition midway through the start-up period of the system. During the five-day test period, the water in the tank gradually rose in temperature but in a manner that diminished its temperature stratification. Stratification was found not to be an important factor in the operation of the particular solar system studied.

Improved survival in HIV treatment programs in Asia

PubMed Central

De La Mata, Nicole L; Kumarasamy, Nagalingeswaran; Khol, Vohith; Ng, Oon Tek; Van Nguyen, Kinh; Merati, Tuti Parwati; Pham, Thuy Thanh; Lee, Man Po; Durier, Nicolas; Law, Matthew

2016-01-01

Background Antiretroviral treatment (ART) for HIV-positive patients has expanded rapidly in Asia over the last ten years. Our study aimed to describe the time trends and risk factors for overall survival in patients receiving first-line ART in Asia. Methods We included HIV-positive adult patients who initiated ART between 2003–2013 (n=16 546), from seven sites across six Asia-Pacific countries. Patient follow-up was to May 2014. We compared survival for each country and overall by time period of ART initiation using Kaplan-Meier curves. Factors associated with mortality were assessed using Cox regression, stratified by site. We also summarized first-line ART regimens, CD4 count at ART initiation, and CD4 and HIV viral load testing frequencies. Results There were 880 deaths observed over 54 532 person-years of follow-up, a crude rate of 1.61 (1.51, 1.72) per 100 person-years. Survival significantly improved in more recent years of ART initiation. The survival probabilities at 4 years follow-up for those initiating ART in 2003–05 was 92.1%, 2006–09 was 94.3% and 2010–2013 was 94.5% (p<0.001). Factors associated with higher mortality risk included initiating ART in earlier time periods, older age, male sex, injecting drug use as HIV exposure and lower pre-ART CD4 count. Concurrent with improved survival was increased tenofovir use, ART initiation at higher CD4 counts, and greater monitoring of CD4 and HIV viral load. Conclusions Our results suggest that HIV-positive patients from Asia have improved survival in more recent years of ART initiation. This is likely a consequence of improvements in treatment and, patient management and monitoring over time. PMID:26961354

Changes in Rumen Microbial Community Composition during Adaption to an In Vitro System and the Impact of Different Forages

PubMed Central

Lengowski, Melanie B.; Zuber, Karin H. R.; Witzig, Maren; Möhring, Jens; Boguhn, Jeannette; Rodehutscord, Markus

2016-01-01

This study examined ruminal microbial community composition alterations during initial adaption to and following incubation in a rumen simulation system (Rusitec) using grass or corn silage as substrates. Samples were collected from fermenter liquids at 0, 2, 4, 12, 24, and 48 h and from feed residues at 0, 24, and 48 h after initiation of incubation (period 1) and on day 13 (period 2). Microbial DNA was extracted and real-time qPCR was used to quantify differences in the abundance of protozoa, methanogens, total bacteria, Fibrobacter succinogenes, Ruminococcus albus, Ruminobacter amylophilus, Prevotella bryantii, Selenomonas ruminantium, and Clostridium aminophilum. We found that forage source and sampling time significantly influenced the ruminal microbial community. The gene copy numbers of most microbial species (except C. aminophilum) decreased in period 1; however, adaption continued through period 2 for several species. The addition of fresh substrate in period 2 led to increasing copy numbers of all microbial species during the first 2–4 h in the fermenter liquid except protozoa, which showed a postprandial decrease. Corn silage enhanced the growth of R. amylophilus and F. succinogenes, and grass silage enhanced R. albus, P. bryantii, and C. aminophilum. No effect of forage source was detected on total bacteria, protozoa, S. ruminantium, or methanogens or on total gas production, although grass silage enhanced methane production. This study showed that the Rusitec provides a stable system after an adaption phase that should last longer than 48 h, and that the forage source influenced several microbial species. PMID:26928330

Impact of an Antimicrobial Stewardship Program on Antibiotic Use at a Nonfreestanding Children's Hospital.

PubMed

Turner, R Brigg; Valcarlos, Elena; Loeffler, Ann M; Gilbert, Michael; Chan, Dominic

2017-09-01

Pediatric stewardship programs have been successful at reducing unnecessary antibiotic use. Data from nonfreestanding children's hospitals are currently limited. This study is an analysis of antibiotic use after implementation of an antimicrobial stewardship program at a community nonfreestanding children's hospital. In April 2013, an antimicrobial stewardship program that consisted of physician-group engagement and pharmacist prospective auditing and feedback was initiated. We compared antibiotic use in the preintervention period (April 2012 to March 2013) with that in the postintervention period (April 2013 to March 2015) in all units except the neonatal intensive care unit and the emergency department. In addition, drug-acquisition costs, antibiotic-specific use, death, length of stay, and case-mix index were examined. Antibiotic use decreased by 16.8% (95% confidence interval, 18.0% to -9.2%; P < .001) in the postintervention period. Vancomycin use decreased by 38% (P = .001), whereas antipseudomonal β-lactam use was unaltered. Drug-acquisition cost savings were estimated to be $67 000/year over the 2-year postintervention period. Lengths of stay and mortality rates were unchanged in the postintervention period after adjusting for case-mix index. Implementation of a simple stewardship initiative with limited resources at a community nonfreestanding children's hospital effectively reduced antibiotic use without an overt negative impact on overall clinical outcomes. The results of this study suggest that nonfreestanding children's hospitals can achieve substantial reductions in antibiotic use despite limited resources. © The Author 2016. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Mutations in the Circadian Gene period Alter Behavioral and Biochemical Responses to Ethanol in Drosophila

PubMed Central

Liao, Jennifer; Seggio, Joseph A.; Ahmad, S. Tariq

2016-01-01

Clock genes, such as period, which maintain an organism’s circadian rhythm, can have profound effects on metabolic activity, including ethanol metabolism. In turn, ethanol exposure has been shown in Drosophila and mammals to cause disruptions of the circadian rhythm. Previous studies from our labs have shown that larval ethanol exposure disrupted the free-running period and period expression of Drosophila. In addition, a recent study has shown that arrhythmic flies show no tolerance to ethanol exposure. As such, Drosophila period mutants, which have either a shorter than wild-type free-running period (perS) or a longer one (perL), may also exhibit altered responses to ethanol due to their intrinsic circadian differences. In this study, we tested the initial sensitivity and tolerance of ethanol exposure on Canton-S, perS, and perL, and then measured their Alcohol Dehydrogenase (ADH) and body ethanol levels. We showed that perL flies had slower sedation rate, longer recovery from ethanol sedation, and generated higher tolerance for sedation upon repeated ethanol exposure compared to Canton-S wild-type flies. Furthermore, perL flies had lower ADH activity and had a slower ethanol clearance compared to wild-type flies. The findings of this study suggest that period mutations influence ethanol induced behavior and ethanol metabolism in Drosophila and that flies with longer circadian periods are more sensitive to ethanol exposure. PMID:26802726

Increased Medicaid Financing and Equalization of African Americans' and Whites' Outpatient and Emergency Treatment Expenditures.

PubMed

Snowden, Lonnie R; Wallace, Neal; Cordell, Kate; Graaf, Genevieve

2016-09-01

We investigated whether a new funding opportunity to finance mental health treatment, provided to autonomous county-level mental health systems without customary cost sharing requirements, equalized African American and White children's outpatient and emergency treatment expenditure inequalities. Using Whites as a benchmark, we considered expenditure patterns favoring Whites over African Americans ("disparities") and favoring African Americans over Whites ("reverse disparities"). Settlement-mandated Early Periodic Screening Diagnosis and Treatment (EPSDT) expenditure increases began in the third quarter of 1995. We analyzed Medi-Cal paid claims for mental health services delivered to youth (under 18 years of age) over 64 quarters for a study period covering July 1, 1991 through June 30, 2007 in controlled cross-sectional (systems), longitudinal (quarters) analyses. Settlement-mandated increases in EPSDT treatment funding was associated with relatively greater African American vs. White expenditures for outpatient care when systems initially spent more on Whites. When systems initially spent more on African Americans, relative increases were greater for Whites for outpatient and emergency services. With new funding that requires no matching funds from the county, county mental health systems did reduce outpatient treatment expenditure inequalities. This was found to be true in counties that initially favored African Americans and in counties that initially favored Whites. Adopting a systems level perspective and taking account of initial conditions and trends can be critical for understanding inequalities.

A Study of Overhead Rate Behavior at a US Air Force Base in the Context of A-76 Competitions.

DTIC Science & Technology

1999-07-28

was included separately to portray time as an important independent variable. 12 Defense Reform Initiative Report (DoD 1997a), p. 29 . 13 Defense...a threshold of savings that is at least 10 percent of direct personnel costs or $10 million over the performance period. 29 OMB established this...been performing the activity prior to the competition and, 29 The length of the contract is generally considered to be the performance period. Depending

Evolution of orbits of the Apollo group asteroids over 11550 years.

NASA Astrophysics Data System (ADS)

Zausaev, A. F.; Pushkarev, A. N.

The Everhart method is used to study the evolution of the orbits of 20 asteroids of the Apollo group over the time period from 9300 B.C. to 2250 A.D. Minimum distances of the asteroids to the major planets over the evolution process are calculated. The stability of resonances with Venus and Earth over the 9300 B.C.to 2250 A.D. time period is shown. Theoretical coordinates of radiants for the initial and final integration times are presented.

History of the Army Ground Forces. Study Number 11. Training in the Ground Army 1942-1945

DTIC Science & Technology

1948-01-01

beingmodified by the Replace- ment and School Commnd to relax controls and to nake it tactically realistic, -beqam& a prototype for the combat-in-cities exercise...of fillers would nake possible initiation of training soon after activation day), the unit period from 13 to 11 weeks, and the ooabine& period from i...Final Major Revision of the AGF Training Program, 7 June 193 Before 193, an previously noted, Arm Ground Forces had Teen oceeled by the limited use

Adult emergency department patients with sickle cell pain crisis: a learning collaborative model to improve analgesic management.

PubMed

Tanabe, Paula; Artz, Nicole; Mark Courtney, D; Martinovich, Zoran; Weiss, Kevin B; Zvirbulis, Elena; Hafner, John W

2010-04-01

The objectives were to report the baseline (prior to quality improvement interventions) patient and visit characteristics and analgesic management practices for each site participating in an emergency department (ED) sickle cell learning collaborative. A prospective, multisite longitudinal cohort study in the context of a learning-collaborative model was performed in three midwestern EDs. Each site formed a multidisciplinary team charged with improving analgesic management for patients with sickle cell disease (SCD). Each team developed a nurse-initiated analgesic protocol for SCD patients (implemented after a baseline data collection period of 3.5 months at one site and 10 months at the other two sites). All sites prospectively enrolled adults with an acute pain crisis and SCD. All medical records for patients meeting study criteria were reviewed. Demographic, health services, and analgesic management data were abstracted, including ED visit frequency data, ED disposition, arrival and discharge pain score, and name and route of initial analgesic administered. Ten interviews per quarter per site were conducted with patients within 14 days of their ED discharge, and subjects were queried about the highest level of pain acceptable at discharge. The primary outcome variable was the time to initial analgesic administration. Variable data were described as means and standard deviations (SDs) or medians and interquartile ranges (IQR) for nonnormal data. A total of 155 patients met study criteria (median age = 32 years, IQR = 24-40 years) with a total of 701 ED visits. Eighty-six interviews were conducted. Most patients (71.6%) had between one and three visits to the ED during the study period. However, after removing Site 3 from the analysis because of the short data enrollment period (3.5 months), which influenced the mean number of visits for the entire cohort, 52% of patients had between one and three ED visits over 10 months, 21% had four to nine visits, and 27% had between 10 and 67 visits. Fifty-nine percent of patients were discharged home. The median time to initial analgesic for the cohort was 74 minutes (IQR = 48-135 minutes). Differences between choice of analgesic agent and route selected were evident between sites. For the cohort, 680 initial analgesic doses were given (morphine sulfate, 42%; hydromorphone, 46%; meperidine, 4%; morphine sulfate and ibuprofen or ketorolac, 7%) using the following routes: oral (2%), intravenous (67%), subcutaneous (3%), and intramuscular (28%). Patients reported a significantly lower targeted discharge pain score (mean +/- SD = 4.19 +/- 1.18) compared to the actual documented discharge pain score within 45 minutes of discharge (mean +/- SD = 5.77 +/- 2.45; mean difference = 1.58, 95% confidence interval = .723 to 2.44, n = 43). While half of the patients had one to three ED visits during the study period, many patients had more frequent visits. Delays to receiving an initial analgesic were common, and post-ED interviews reveal that sickle cell pain patients are discharged from the ED with higher pain scores than what they perceive as desirable.

How cigarette design can affect youth initiation into smoking: Camel cigarettes 1983-93

PubMed Central

Wayne, G; Connolly, G

2002-01-01

Objective: To determine changes in the design of Camel cigarettes in the period surrounding the "Smooth Character" advertising campaign and to assess the impact of these changes on youth smoking. Data sources: Internal documents made available through the document website maintained by RJ Reynolds, manufacturer of Camel cigarettes. Study selection: Electronic searches using keywords to identify relevant data. Data extraction: A web based index search of documents targeting "smoothness" or "harshness" and "younger adult smokers" ("YAS") or "first usual brand younger adult smokers" ("FUBYAS") in the 10 year period surrounding the introduction of the "Smooth Character" campaign was used to identify Camel related product design research projects. A snowball methodology was used: initial documents were identified by focusing on key words, codes, researchers, committees, meetings, and gaps in overall chronology; a second set of documents was culled from these initial documents, and so on. Data synthesis: Product design research led to the introduction of redesigned Camel cigarettes targeted to younger adult males coinciding with the "Smooth Character" campaign. Further refinements in Camel cigarettes during the following five year period continued to emphasise the smoothness of the cigarette, utilising additives and blends which reduced throat irritation but increased or retained nicotine impact. Conclusions: Industry competition for market share among younger adult smokers may have contributed to the reversal of a decline in youth smoking rates during the late 1980s through development of products which were more appealing to youth smokers and which aided in initiation by reducing harshness and irritation. PMID:11893812

Trends in surgical management and pre-operative urodynamics in female medicare beneficiaries with mixed incontinence.

PubMed

Chughtai, Bilal; Hauser, Nicholas; Anger, Jennifer; Asfaw, Tirsit; Laor, Leanna; Mao, Jialin; Lee, Richard; Te, Alexis; Kaplan, Steven; Sedrakyan, Art

2017-02-01

We sought to examine the surgical trends and utilization of treatment for mixed urinary incontinence among female Medicare beneficiaries. Data was obtained from a 5% national random sample of outpatient and carrier claims from 2000 to 2011. Included were female patients 65 and older, diagnosed with mixed urinary incontinence, who underwent surgical treatment identified by Current Procedural Terminology, Fourth Edition (CPT-4) codes. Urodynamics (UDS) before initial and secondary procedure were also identified using CPT-4 codes. Procedural trends and utilization of UDS were analyzed. Utilization of UDS increased during the study period, from 38.4% to 74.0% prior to initial surgical intervention, and from 28.6% to 62.5% preceding re-intervention. Sling surgery (63.0%) and injectable bulking agents (28.0%) were the most common surgical treatments adopted, followed by sacral nerve stimulation (SNS) (4.8%) and Burch (4.0%) procedures. Re-intervention was performed in 4.0% of patients initially treated with sling procedures and 21.3% of patients treated with bulking agents, the majority of whom (51.7% and 76.3%, respectively) underwent injection of a bulking agent. Risk of re-intervention was not different among those who did or did not receive urodynamic tests prior to the initial procedure (8.5% vs. 9.3%) CONCLUSIONS: Sling and bulk agents are the most common treatment for MUI. Preoperative urodynamic testing was not related to risk of re-intervention following surgery for mixed urinary incontinence in this cohort. Neurourol. Urodynam. 36:422-425, 2017. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Culturing Conceptions: From First Principles

ERIC Educational Resources Information Center

Roth, Wolff-Michael; Lee, Yew Jin; Hwang, SungWon

2008-01-01

Over the past three decades, science educators have accumulated a vast amount of information on conceptions--variously defined as beliefs, ontologies, cognitive structures, mental models, or frameworks--that generally (at least initially) have been derived from interviews about certain topics. During the same time period, cultural studies has…

PESTICIDE ORCHARD ECOSYSTEM MODEL (POEM): A USER'S GUIDE

EPA Science Inventory

A mathematical model was developed to predict the transport and effects of a pesticide in an orchard ecosystem. The environmental behavior of azinphosmethyl was studied over a two-year period in a Michigan apple orchard. Data were gathered for the model on initial distribution wi...

The Temporal Course of Anxiety Sensitivity in Outpatients with Anxiety and Mood Disorders: Relationships with Behavioral Inhibition and Depression

PubMed Central

Rosellini, Anthony J.; Fairholme, Christopher P.; Brown, Timothy A.

2011-01-01

The present study evaluated the temporal course of three dimensions of anxiety sensitivity (AS; concerns over physical symptoms, mental incapacitation, and social embarrassment) and their relationships with behavioral inhibition (BI) and depression (DEP) in 606 outpatients with anxiety and mood disorders. A semi-structured interview and self-report questionnaires were administered on three occasions over a two-year period. All three constructs decreased over the study period and AS temporally functioned more similar to DEP than BI. Cross-sectional and temporal correlations supported the discriminant validity of AS from BI. As expected, initial levels of BI predicted less improvement in all AS dimensions. In contrast, higher initial levels of mental incapacitation AS were associated with greater improvement in DEP. Our results are discussed in regard to the measurement of AS in clinical samples, conceptualizations of AS as a lower-order vulnerability, and prognostic implications of directional paths between BI and AS and AS and DEP. PMID:21377316

Long-Term Depressive Symptoms and Acculturative Stress Issues Among Immigrants From the Former Soviet Union.

PubMed

Baker, Cathy J

2016-09-01

Previous studies regarding depressive symptoms and acculturative stress among immigrants have been limited to the initial period after immigration. The relationships between depressive symptoms, acculturation, and acculturative stress among immigrants from the former Soviet Union were examined in this descriptive study. Eighty immigrants from the former Soviet Union who had immigrated within the past 20 years were recruited in various community locations. Participants (N = 80), including recent and longer residing immigrants, reported elevated depressive symptoms and acculturative stress. Acculturative stress predicted depressive symptoms, controlling for dominant culture (American) immersion. However, length of time in the United States was not associated with depressive symptoms, ethnic culture immersion, or acculturative stress. Our results suggest that elevated depressive symptoms are related to acculturative stress but are not confined to the initial adjustment period. Steps to decrease acculturative stress might help decrease depressive symptoms in immigrants regardless of the number of years lived in the United States. © The Author(s) 2016.

New Directions: Ozone-initiated reaction products indoors may be more harmful than ozone itself

NASA Astrophysics Data System (ADS)

Weschler, Charles J.

2004-10-01

Epidemiological studies have found associations between ozone concentrations measured at outdoor monitoring stations and certain adverse health outcomes. As a recent example, Gent et al. (2003, Journal of the American Medical Association 290, 1859-1867) have observed an association between ozone levels and respiratory symptoms as well as the use of maintenance medication by 271 asthmatic children living in Connecticut and the Springfield area of Massachusetts. In another example, Gilliland et al. (2001, Epidemiology 12, 43-54) detected an association between short-term increases in ozone levels and increased absences among 4th grade students from 12 southern California communities during the period from January to June 1996. Although children may spend a significant amount of time outdoors, especially during periods when ozone levels are elevated, they spend a much larger fraction of their time indoors. I hypothesize that exposure to the products of ozone-initiated indoor chemistry is more directly responsible for the health effects observed in the cited epidemiological studies than is exposure to outdoor ozone itself.

The oxidation of aluminum at high temperature studied by Thermogravimetric Analysis and Differential Scanning Calorimetry.

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

Coker, Eric Nicholas

2013-10-01

The oxidation in air of high-purity Al foil was studied as a function of temperature using Thermogravimetric Analysis with Differential Scanning Calorimetry (TGA/DSC). The rate and/or extent of oxidation was found to be a non-linear function of the temperature. Between 650 and 750 ÀC very little oxidation took place; at 850 ÀC oxidation occurred after an induction period, while at 950 ÀC oxidation occurred without an induction period. At oxidation temperatures between 1050 and 1150 ÀC rapid passivation of the surface of the aluminum foil occurred, while at 1250 ÀC and above, an initial rapid mass increase was observed, followedmore » by a more gradual increase in mass. The initial rapid increase was accompanied by a significant exotherm. Cross-sections of oxidized specimens were characterized by scanning electron microscopy (SEM); the observed alumina skin thicknesses correlated qualitatively with the observed mass increases.« less

Scalar collapse in AdS with an OpenCL open source code

NASA Astrophysics Data System (ADS)

Liebling, Steven L.; Khanna, Gaurav

2017-10-01

We study the spherically symmetric collapse of a scalar field in anti-de Sitter spacetime using a newly constructed, open-source code which parallelizes over heterogeneous architectures using the open standard OpenCL. An open question for this scenario concerns how to tell, a priori, whether some form of initial data will be stable or will instead develop under the turbulent instability into a black hole in the limit of vanishing amplitude. Previous work suggested the existence of islands of stability around quasi-periodic solutions, and we use this new code to examine the stability properties of approximately quasi-periodic solutions which balance energy transfer to higher modes with energy transfer to lower modes. The evolutions provide some evidence, though not conclusively, for stability of initial data sufficiently close to quasiperiodic solutions.

Volume nanograting formation in laser-silica interaction as a result of the 1D plasma-resonance ionization instability

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

Gildenburg, V. B., E-mail: gil@appl.sci-nnov.ru; Pavlichenko, I. A.; Institute of Applied Physics, Russian Academy of Sciences, Nizhny Novgorod 603950

2016-08-15

The initial stage of the small-scale ionization-induced instability developing inside the fused silica volume exposed to the femtosecond laser pulse is studied as a possible initial cause of the self-organized nanograting formation. We have calculated the spatial spectra of the instability with the electron-hole diffusion taken into account for the first time and have found that it results in the formation of some hybrid (diffusion-wave) 1D structure with the spatial period determined as the geometrical mean of the laser wavelength and characteristic diffusion length of the process considered. Near the threshold of the instability, this period occurs to be approximatelymore » equal to the laser half-wavelength in the silica, close to the one experimentally observed.« less

78 FR 29139 - Medicare Program; Bundled Payments for Care Improvement Model 1 Open Period

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-17

... initiative. DATES: Model 1 of the Bundled Payments for Care Improvement Deadline: Interested organizations... initiative. For additional information on this initiative go to the CMS Center for Medicare and Medicaid Innovation Web site at http://innovation.cms.gov/initiatives/BPCI-Model-1/index.html . SUPPLEMENTARY...

Influence of indoor and outdoor activities on progression of myopia during puberty.

PubMed

Öner, Veysi; Bulut, Asker; Oruç, Yavuz; Özgür, Gökhan

2016-02-01

The purpose of this study was to investigate whether time spent on indoor and outdoor activities or the other possible risk factors including age, gender, parental history, and initial refraction was associated with progression of myopia, during puberty. Fifty eyes of 50 myopic children aged 9-14 years were enrolled in the study. The parents were interviewed to determine the amounts of time in hours per day spent on reading and writing, using computer, watching TV, and outdoor activities (i.e., sports, games, or being outdoor with no activities) on an average day. The annual myopia progression rate (diopters per year) was calculated for each subject and was used in the statistical analyses. The mean initial age of the subjects was 10.9 ± 1.5 (ranging from 9 to 14) years. The mean follow-up period was 33.3 ± 10.3 (ranging from 17 to 55) months. There was a significant increase in the mean myopia value of the subjects after follow-up period (p < 0.001). The mean daily time spent on reading and writing and initial refraction value were independently associated with annual myopic progression rate. On the other hand, age, gender, parental myopia, and the mean daily times spent on computer use, watching TV, and outdoor activities had no correlations with annual myopia progression rate. The present study showed that myopia progression was associated with time spent on reading and writing and initial refraction value, during puberty. However, myopia progression was not associated with parental myopia, age, gender, and daily times spent on using computer, watching TV, and outdoor activities.

Characterization of pain, disability, and psychological burden in Marfan syndrome.

PubMed

Speed, Traci J; Mathur, Vani A; Hand, Matthew; Christensen, Bryt; Sponseller, Paul D; Williams, Kayode A; Campbell, Claudia M

2017-02-01

The clinical manifestations of Marfan syndrome frequently cause pain. This study aimed to characterize pain in a cohort of adults with Marfan syndrome and investigate demographic, physical, and psychological factors associated with pain and pain-related disability. Two hundred and forty-five participants (73% female, 89% non-Hispanic white, 90% North American) completed an online questionnaire assessing clinical features of Marfan syndrome, pain severity, pain-related disability, physical and mental health, depressive symptoms, pain catastrophizing, and insomnia. Eighty-nine percent of respondents reported having pain with 28% of individuals reporting pain as a presenting symptom of Marfan syndrome. Almost half of individuals reported that pain has spread from its initial site. Participants in our study reported poor physical and mental health functioning, moderate pain-related disability, and mild levels of depressive symptoms, sleep disturbances, and pain catastrophizing. Those who identified pain as an initial symptom of Marfan syndrome and those who reported that pain had spread from its initial site reported greater psychological burden compared with those without pain as an initial symptom or pain spreading. Physical health is the largest predictor of pain severity and pain-related disability. While pain catastrophizing and worse mental health functioning are significant correlates of pain severity and pain-related disability, respectively. Pain is a significant and persistent problem in Marfan syndrome and is associated with profound disability and psychological burden. Further studies are indicated to better characterize the directionality of pain, pain-related disability, and psychological burden in Marfan syndrome. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Projections of annual rainfall and surface temperature from CMIP5 models over the BIMSTEC countries

NASA Astrophysics Data System (ADS)

Pattnayak, K. C.; Kar, S. C.; Dalal, Mamta; Pattnayak, R. K.

2017-05-01

Bay of Bengal Initiative for Multi-Sectoral Technical and Economic Cooperation (BIMSTEC) comprising Bangladesh, Bhutan, India, Myanmar, Nepal, Sri Lanka and Thailand brings together 21% of the world population. Thus the impact of climate change in this region is a major concern for all. To study the climate change, fifth phase of Climate Model Inter-comparison Project (CMIP5) models have been used to project the climate for the 21st century under the Representative Concentration Pathways (RCPs) 4.5 and 8.5 over the BIMSTEC countries for the period 1901 to 2100 (initial 105 years are historical period and the later 95 years are projected period). Climate change in the projected period has been examined with respect to the historical period. In order to validate the models, the mean annual rainfall has been compared with observations from multiple sources and temperature has been compared with the data from Climatic Research Unit (CRU) during the historical period. Comparison reveals that ensemble mean of the models is able to represent the observed spatial distribution of rainfall and temperature over the BIMSTEC countries. Therefore, data from these models may be used to study the future changes in the 21st century. Four out of six models show that the rainfall over India, Thailand and Myanmar has decreasing trend and Bangladesh, Bhutan, Nepal and Sri Lanka show an increasing trend in both the RCP scenarios. In case of temperature, all the models show an increasing trend over all the BIMSTEC countries in both the scenarios, however, the rate of increase is relatively less over Sri Lanka than the other countries. The rate of increase/decrease in rainfall and temperature are relatively more in RCP8.5 than RCP4.5 over all these countries. Inter-model comparison show that there are uncertainties within the CMIP5 model projections. More similar studies are required to be done for better understanding the model uncertainties in climate projections over this region.

[Effect of antecedent dry period on water quality of urban storm runoff pollution].

PubMed

Bian, Bo

2009-12-01

Identified the main factor influencing urban rainfall-runoff pollution provides a scientific basis for urban rainfall-runoff pollution control and management. Therefore, starting in May 2006, a study was conducted to characterize water quality from representative land uses types in Zhenjiang to analyse the effect of antecedent dry period on stormwater runoff quality. The results show that the beginning of rainfall, with the increase of antecedent dry periods, the percentages of less than 40 microm is increased, the correlation of the water quality parameters (TN, TP, Zn, Pb, Cu, TSS and COD) and antecedent dry period shows a significant positive correlation, dissolved pollutants in the initial period surface runoff is increased. These findings show that facilitating the recognition of antecedent dry periods is the main factor influencing the change in concentration and partitioning of pollutants to provide the scientific basis for non-point source pollution control and management.

Dynamics of femtosecond laser-induced periodic surface structures on silicon by high spatial and temporal resolution imaging

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

Jia, X., E-mail: jiaxin@sdju.edu.cn; Department of Mathematics and Physics, Shanghai Dianji University, Shanghai 201306; Jia, T. Q., E-mail: tqjia@phy.ecnu.edu.cn

2014-04-14

The formation dynamics of periodic ripples induced by femtosecond laser pulses (pulse duration τ = 50 fs and central wavelength λ = 800 nm) are studied by a collinear pump-probe imaging technique with a temporal resolution of 1 ps and a spatial resolution of 440 nm. The ripples with periods close to the laser wavelength begin to appear upon irradiation of two pump pulses at surface defects produced by the prior one. The rudiments of periodic ripples emerge in the initial tens of picoseconds after fs laser irradiation, and the ripple positions keep unmoved until the formation processes complete mainly in a temporal span of 1500 ps. Themore » results suggest that the periodic deposition of laser energy during the interaction between femtosecond laser pulses and sample surface plays a dominant role in the formation of periodic ripples.« less

Changes in sick-leave diagnoses over eleven years in a cohort of young adults initially sick-listed due to low back, neck, or shoulder diagnoses.

PubMed

Festin, Karin; Alexanderson, Kristina

2009-05-01

To study future general and diagnoses-specific sickness absence and disability pension among young adults who were initially on long-term sick-leave due to back, neck, or shoulder diagnoses. Eleven-year prospective cohort study. All 213 adults in a Swedish municipality who, in 1985, were in the age range 25-34 years and had begun a spell of sick-leave lasting > or = 28 days with low back, neck, or shoulder diagnoses. For the time-period 1985-96, data regarding the dates and diagnoses for all periods of sick-leave, and the dates of disability pension, emigration, and death were obtained. Numbers of days of sick-leave and disability pension were analysed separately for each of the 11 years in relation to the number of days at risk for such benefits. The cohort members were on sick-leave or disability pension for 25% of all days at risk during the 11 years of follow-up. A large difference in the number of sick-leave days between the 22% of subjects who were later granted disability pension and the others was already apparent during the first 2 years. During the entire period, up to 21% of the sick-leave days for women and 24% for men entailed psychiatric diagnoses. This cohort of young adults, initially off sick for 4 weeks due to back, neck, or shoulder diagnoses, also had a high level of sickness absence in the subsequent 11 years with other diagnoses.

Hydrodynamic interaction of two particles in confined linear shear flow at finite Reynolds number

NASA Astrophysics Data System (ADS)

Yan, Yiguang; Morris, Jeffrey F.; Koplik, Joel

2007-11-01

We discuss the hydrodynamic interactions of two solid bodies placed in linear shear flow between parallel plane walls in a periodic geometry at finite Reynolds number. The computations are based on the lattice Boltzmann method for particulate flow, validated here by comparison to previous results for a single particle. Most of our results pertain to cylinders in two dimensions but some examples are given for spheres in three dimensions. Either one mobile and one fixed particle or else two mobile particles are studied. The motion of a mobile particle is qualitatively similar in both cases at early times, exhibiting either trajectory reversal or bypass, depending upon the initial vector separation of the pair. At longer times, if a mobile particle does not approach a periodic image of the second, its trajectory tends to a stable limit point on the symmetry axis. The effect of interactions with periodic images is to produce nonconstant asymptotic long-time trajectories. For one free particle interacting with a fixed second particle within the unit cell, the free particle may either move to a fixed point or take up a limit cycle. Pairs of mobile particles starting from symmetric initial conditions are shown to asymptotically reach either fixed points, or mirror image limit cycles within the unit cell, or to bypass one another (and periodic images) indefinitely on a streamwise periodic trajectory. The limit cycle possibility requires finite Reynolds number and arises as a consequence of streamwise periodicity when the system length is sufficiently short.

Time-periodic solutions of the Benjamin-Ono equation

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

Ambrose , D.M.; Wilkening, Jon

2008-04-01

We present a spectrally accurate numerical method for finding non-trivial time-periodic solutions of non-linear partial differential equations. The method is based on minimizing a functional (of the initial condition and the period) that is positive unless the solution is periodic, in which case it is zero. We solve an adjoint PDE to compute the gradient of this functional with respect to the initial condition. We include additional terms in the functional to specify the free parameters, which, in the case of the Benjamin-Ono equation, are the mean, a spatial phase, a temporal phase and the real part of one ofmore » the Fourier modes at t = 0. We use our method to study global paths of non-trivial time-periodic solutions connecting stationary and traveling waves of the Benjamin-Ono equation. As a starting guess for each path, we compute periodic solutions of the linearized problem by solving an infinite dimensional eigenvalue problem in closed form. We then use our numerical method to continue these solutions beyond the realm of linear theory until another traveling wave is reached (or until the solution blows up). By experimentation with data fitting, we identify the analytical form of the solutions on the path connecting the one-hump stationary solution to the two-hump traveling wave. We then derive exact formulas for these solutions by explicitly solving the system of ODE's governing the evolution of solitons using the ansatz suggested by the numerical simulations.« less

Physical Activity Breaks and Student Learning: A Teacher-Research Project

ERIC Educational Resources Information Center

Camahalan, Faye Marsha G.; Ipock, Amanda R.

2015-01-01

This study is a teacher initiated action research. The purpose is to improve student learning in math using physical activity breaks during classroom lessons. The study was conducted by tracking the results of ten 5th grade students for a period of one week. Using anecdotal notes, students showed improvement on attentiveness during class…

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR PERFORMANCE OF COMPUTER SOFTWARE: VERIFICATION AND VALIDATION (IIT-A-2.0)

EPA Science Inventory

The purpose of this SOP is to define the procedures for the initial and periodic verification and validation of computer programs. The programs are used during the Arizona NHEXAS project and Border study at the Illinois Institute of Technology (IIT) site. Keywords: computers; s...

Beginning Teachers and Diversity--Why the Need for Extended Critical Professional Support

ERIC Educational Resources Information Center

Dharan, Vijaya M.

2015-01-01

This article draws from a qualitative study of seven beginning teachers' perceptions of diversity over a period of 6-18 months. The study found that while initial teacher training had broadened their understanding of diversity and its implication for teaching, it was established pedagogical practices in their schools that influenced the novices'…

Indicators of Faculty and Staff Perceptions of Campus Safety: A Case Study

ERIC Educational Resources Information Center

Woolfolk, Willie A.

2013-01-01

The study addressed the problem of a critical increase in campus crime between 1999 and 2009, a period during which overall crime in the United States declined. Further the research explored the perceptions of campus safety among faculty and staff at an institution where campus safety initiatives are nationally ranked as exemplary and incidents of…

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR PERFORMANCE OF COMPUTER SOFTWARE: VERIFICATION AND VALIDATION (UA-D-2.0)

EPA Science Inventory

The purpose of this SOP is to define the procedures used for the initial and periodic verification and validation of computer programs used during the Arizona NHEXAS project and the "Border" study. Keywords: Computers; Software; QA/QC.

The National Human Exposure Assessment Sur...

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

ERIC Educational Resources Information Center

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

2007-01-01

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

Initial results from a cryogenic proton irradiation of a p-channel CCD

NASA Astrophysics Data System (ADS)

Gow, J. P. D.; Wood, D.; Burt, D.; Hall, D. J.; Dryer, B.; Holland, A. D.; Murray, N. J.

2015-08-01

The displacement damage hardness that can be achieved using p-channel charge coupled devices (CCD) was originally demonstrated in 1997 and since then a number of other studies have demonstrated an improved tolerance to radiationinduced CTI when compared to n-channel CCDs. A number of recent studies have also shown that the temperature history of the device after the irradiation impacts the performance of the detector, linked to the mobility of defects at different temperatures. This study describes the initial results from an e2v technologies p-channel CCD204 irradiated at 153 K with a 10 MeV equivalent proton fluences of 1.24×109 and 1.24×1011 protons.cm-2. The number of defects identified using trap pumping, dark current and cosmetic quality immediately after irradiation and over a period of 150 hours after the irradiation with the device held at 153 K and then after different periods of time at room temperature are described. The device also exhibited a flatband voltage shift of around 30 mV per krad, determined by the reduction in full well capacity.

Factors associated with hookah use initiation among adolescents.

PubMed

Reveles, Caroline C; Segri, Neuber J; Botelho, Clovis

2013-01-01

to determine the prevalence and to analyze factors associated with hookah use initiation among adolescents. This was a cross-sectional study, in which questionnaires were collected from 495 students attending public and private schools of the urban area of the city of Várzea Grande, in the state of Mato Grosso, Brazil. Data were analyzed through descriptive, bivariate, and multiple Poisson regression analyses. A total of 19.7% students had tried a hookah. The use of hookah was associated with the final period of adolescence [PR=6.54 (2.79, 15.32)]; enrollment in private schools [PR=2.23 (1.73, 2.88)]; and presence of work activities [PR=1.80 (1.17, 2.78)]. The proportion of adolescents that had tried a hookah was high. The influence of age, work activities, and class period on smoking initiation using the hookah was observed. Preventive measures encompassing all forms of tobacco smoking should be targeted at adolescents in the school environment, aiming at tobacco use control. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

The role of different sampling methods in improving biological activity prediction using deep belief network.

PubMed

Ghasemi, Fahimeh; Fassihi, Afshin; Pérez-Sánchez, Horacio; Mehri Dehnavi, Alireza

2017-02-05

Thousands of molecules and descriptors are available for a medicinal chemist thanks to the technological advancements in different branches of chemistry. This fact as well as the correlation between them has raised new problems in quantitative structure activity relationship studies. Proper parameter initialization in statistical modeling has merged as another challenge in recent years. Random selection of parameters leads to poor performance of deep neural network (DNN). In this research, deep belief network (DBN) was applied to initialize DNNs. DBN is composed of some stacks of restricted Boltzmann machine, an energy-based method that requires computing log likelihood gradient for all samples. Three different sampling approaches were suggested to solve this gradient. In this respect, the impact of DBN was applied based on the different sampling approaches mentioned above to initialize the DNN architecture in predicting biological activity of all fifteen Kaggle targets that contain more than 70k molecules. The same as other fields of processing research, the outputs of these models demonstrated significant superiority to that of DNN with random parameters. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

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

PubMed

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

2016-05-01

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

Depression Symptom Trajectories and Associated Risk Factors among Adolescents in Chile

PubMed Central

Stapinski, Lexine A.; Montgomery, Alan A.; Heron, Jon; Jerrim, John; Vignoles, Anna; Araya, Ricardo

2013-01-01

Adolescence is a key period for studying the development of depression, with studies in Europe and North America showing a pattern of elevated risk that begins in early adolescence and continues to increase as adolescents age. Few studies have examined the course of adolescent depression and associated risk factors in low and middle-income countries. This longitudinal cohort study examined depression symptom trajectories and risk factors in a sample of socio-economically disadvantaged adolescents in Chile (n = 2,508). Data were collected over an 18-month period as part of a clinical trial for secondary students aged 12 to 18 (median age 14). Clinical levels of depression were prevalent in this sample at baseline (35% for girls and 28% for boys); yet latent growth models of symptom trajectories revealed a pattern of decreasing symptoms over time. There was evidence of an anxiety-depression developmental pathway for girls, with elevated anxiety levels initially predicting poorer depression outcomes later on. Poor problem-solving skills were associated with initial depression levels but did not predict the course of depressive symptoms. Critically, the declining symptom trajectories raise important methodological issues regarding the effects of repeated assessment in longitudinal studies. PMID:24147131

Depression symptom trajectories and associated risk factors among adolescents in Chile.

PubMed

Stapinski, Lexine A; Montgomery, Alan A; Heron, Jon; Jerrim, John; Vignoles, Anna; Araya, Ricardo

2013-01-01

Adolescence is a key period for studying the development of depression, with studies in Europe and North America showing a pattern of elevated risk that begins in early adolescence and continues to increase as adolescents age. Few studies have examined the course of adolescent depression and associated risk factors in low and middle-income countries. This longitudinal cohort study examined depression symptom trajectories and risk factors in a sample of socio-economically disadvantaged adolescents in Chile (n = 2,508). Data were collected over an 18-month period as part of a clinical trial for secondary students aged 12 to 18 (median age 14). Clinical levels of depression were prevalent in this sample at baseline (35% for girls and 28% for boys); yet latent growth models of symptom trajectories revealed a pattern of decreasing symptoms over time. There was evidence of an anxiety-depression developmental pathway for girls, with elevated anxiety levels initially predicting poorer depression outcomes later on. Poor problem-solving skills were associated with initial depression levels but did not predict the course of depressive symptoms. Critically, the declining symptom trajectories raise important methodological issues regarding the effects of repeated assessment in longitudinal studies.

Pre-adolescent Receptivity to Tobacco Marketing and Its Relationship to Acquiring Friends Who Smoke and Cigarette Smoking Initiation.

PubMed

Strong, David R; Messer, Karen; Hartman, Sheri J; Nodora, Jesse; Vera, Lisa; White, Martha M; Leas, Eric; Pharris-Ciurej, Nikolas; Borek, Nicolette; Pierce, John P

2017-10-01

This study extends research on receptivity to tobacco marketing over a key developmental period for cigarette smoking experimentation. The purpose of this study was to understand the effect of receptivity to tobacco marketing and exposure to friends who smoke on smoking experimentation. Participants were 10 to 13 years old who had never tried cigarettes (n = 878), interviewed six times at 8-month intervals. At baseline, 25% percent of the 10 and 11 years old in the sample of never smokers were receptive to tobacco marketing, while less than 5% had friends who smoked. Having a friend who smoked at study baseline and acquiring such friends for the first time during the study were the strongest predictors of smoking experimentation. Initial receptivity to tobacco marketing increased the risk of smoking experimentation independently of having friends who smoke at baseline or acquiring friends who smoke throughout the study period. The high level of receptivity observed even among 10 and 11 years old and its robust relationship with cigarette smoking experimentation independent of the significant risk associated with having friends who smoke suggests that successful prevention of receptivity may require intervention at an early age.

Minor Actinides-Loaded FBR Core Concept Suitable for the Introductory Period in Japan

NASA Astrophysics Data System (ADS)

Fujimura, Koji; Sasahira, Akira; Yamashita, Junichi; Fukasawa, Tetsuo; Hoshino, Kuniyoshi

According to the Japan's Framework for Nuclear Energy Policy(1), a basic scenario for fast breeder reactors (FBRs) is that they will be introduced on a commercial basis starting around 2050 replacing light water reactors (LWRs). During the FBR introduction period, the Pu from LWR spent fuel is used for FBR startup. Howerver, the FBR core loaded with this Pu has a larger burnup reactivity due to its larger isotopic content of Pu-241 than a core loaded with Pu from an FBR multi-recycling core. The increased burnup reactivity may reduce the cycle length of an FBR. We investigated, an FBR transitional core concept to confront the issues of the FBR introductory period in Japan. Core specifications are based on the compact-type sodium-cooled mixed oxide (MOX)-fueled core designed from the Japanese FBR cycle feasibility studies, because lower Pu inventory should be better for the FBR introductory period in view of its flexibility for the required reprocessing amount of LWR spent fuel to start up FBRs. The reference specifications were selected as follows. Output of 1500MWe and average discharge fuel burnup of about 150GWd/t. Minor Actinides (MAs) recovered from LWR spent fuels which provide Pu to startup FBRs are loaded to the initial loading fuels and exchanged fuels during few cycles until equilibrium. We made the MA content of the initial loading fuel four kinds like 0%, 3%, 4%, 5%. The average of the initial loading fuel is assumed to be 3%, and that of the exchange fuel is set as 5%. This 5% maximum of the MA content is based on the irradiation results of the experimental fast reactor Joyo. We evaluated the core performances including burnup characteristics and the reactivity coefficient and confirmed that transitional core from initial loading until equilibrium cycle with loaded Pu from LWR spent fuel performs similary to an FBR multi-recycling core.

Penetrating cardiac injuries: A 36-year perspective at an urban, Level I trauma center.

PubMed

Morse, Bryan C; Mina, Michael J; Carr, Jacquelyn S; Jhunjhunwala, Rashi; Dente, Christopher J; Zink, John U; Nicholas, Jeffrey M; Wyrzykowski, Amy D; Salomone, Jeffrey P; Vercruysse, Gary A; Rozycki, Grace S; Feliciano, David V

2016-10-01

This study evaluates patterns of injuries and outcomes from penetrating cardiac injuries (PCIs) at Grady Memorial Hospital, an urban, Level I trauma center in Atlanta, Georgia, over 36 years. Patients sustaining PCIs were identified from the Trauma Registry of the American College of Surgeons and the Emory Department of Surgery database; data of patients who died prior to any therapy were excluded. Demographics and outcomes were compared over three time intervals: Period 1 (1975-1985; n = 113), Period 2 (1986-1996; n = 79), and Period 3 (2000-2010; n = 79). Two hundred seventy-one patients (86% were male; mean age, 33 years; initial base deficit = -11.3 mEq/L) sustained cardiac stab (SW, 60%) or gunshot wounds (GSW, 40%). Emergency department thoracotomy was performed in 67 (25%) of 271 patients. Overall mortality increased in the modern era (Period 1, 27%, vs. Period 2, 22%, vs. Period 3, 42%; p = 0.03) along with GSW mechanisms (Period 1, 32%, vs. Period 2, 33%, vs. Period 3, 57%; p = 0.001), GSW mortality (Period 1, 36%, vs. Period 2, 42%, vs. Period 3, 56%; p = 0.04), and multichamber injuries (Period 1, 12%, vs. Period 2, 10%, vs. Period 3, 34%; p< 0.001). In Period 3, GSWs (n = 45) resulted in multichamber injuries in 28 patients (62%) and multicavity injuries in 19 patients (42%). Surgeon-performed ultrasound accurately identified pericardial blood in 55 of 55 patients in Period 3. Increased frequency of GSWs in the past decade is associated with increased overall mortality, multichamber injuries, and multicavity injuries. Ultrasound is sensitive for detection of PCI. Therapeutic study, level IV; epidemioligc study, level III.

A clinical investigation of force delivery systems for orthodontic space closure.

PubMed

Nightingale, C; Jones, S P

2003-09-01

To investigate the force retention, and rates of space closure achieved by elastomeric chain and nickel titanium coil springs. Randomized clinical trial. Eastman Dental Hospital, London and Queen Mary's University Hospital, Roehampton, 1998-2000. Twenty-two orthodontic patients, wearing the pre-adjusted edgewise appliance undergoing space closure in opposing quadrants, using sliding mechanics on 0.019 x 0.025-inch posted stainless steel archwires. Medium-spaced elastomeric chain [Durachain, OrthoCare (UK) Ltd., Bradford, UK] and 9-mm nickel titanium coil springs [OrthoCare (UK) Ltd.] were placed in opposing quadrants for 15 patients. Elastomeric chain only was used in a further seven patients. The initial forces on placement and residual forces at the subsequent visit were measured with a dial push-pull gauge [Orthocare (UK) Ltd]. Study models of eight patients were taken before and after space closure, from which measurements were made to establish mean space closure. The forces were measured in grammes and space closure in millimetres. Fifty-nine per cent (31/53) of the elastomeric sample maintained at least 50 per cent of the initial force over a time period of 1-15 weeks. No sample lost all its force, and the mean loss was 47 per cent (range: 0-76 per cent). Nickel titanium coil springs lost force rapidly over 6 weeks, following that force levels plateaued. Forty-six per cent (12/26) maintained at least 50 per cent of their initial force over a time period of 1-22 weeks, and mean force loss was 48 per cent (range: 12-68 per cent). The rate of mean weekly space closure for elastomeric chain was 0.21 mm and for nickel titanium coil springs 0.26 mm. There was no relationship between the initial force applied and rate of space closure. None of the sample failed during the study period giving a 100 per cent response rate. In clinical use, the force retention of elastomeric chain was better than previously concluded. High initial forces resulted in high force decay. Nickel titanium coil springs and elastomeric chain closed spaces at a similar rate.

Can focused trauma education initiatives reduce mortality or improve resource utilization in a low-resource setting?

PubMed

Petroze, Robin T; Byiringiro, Jean Claude; Ntakiyiruta, Georges; Briggs, Susan M; Deckelbaum, Dan L; Razek, Tarek; Riviello, Robert; Kyamanywa, Patrick; Reid, Jennifer; Sawyer, Robert G; Calland, J Forrest

2015-04-01

Over 90% of injury deaths occur in low-income countries. Evaluating the impact of focused trauma courses in these settings is challenging. We hypothesized that implementation of a focused trauma education initiative in a low-income country would result in measurable differences in injury-related outcomes and resource utilization. Two 3-day trauma education courses were conducted in the Rwandan capital over a one-month period (October-November, 2011). An ATLS provider demonstration course was delivered to 24 faculty surgeons and 15 Rwandan trauma nurse auditors, and a Canadian Network for International Surgery Trauma Team Training (TTT) course was delivered to 25 faculty, residents, and nurses. Trauma registry data over the 6 months prior to the courses were compared to the 6 months afterward with emergency department (ED) mortality as the primary endpoint. Secondary endpoints included radiology utilization and early procedural interventions. Univariate analyses were conducted using χ(2) and Fisher's exact test. A total of 798 and 575 patients were prospectively studied during the pre-intervention and post-intervention periods, respectively. Overall mortality of injured patients decreased after education implementation from 8.8 to 6.3%, but was not statistically significant (p = 0.09). Patients with an initial Glasgow Coma Score (GCS) of 3-8 had the highest injury-related mortality, which significantly decreased from 58.5% (n = 55) to 37.1% (n = 23), (p = 0.009, OR 0.42, 95% CI 0.22-0.81). There was no statistical difference in the rates of early intubation, cervical collar use, imaging studies, or transfusion in the overall cohort or the head injury subset. When further stratified by GCS, patients with an initial GCS of 3-5 in the post-intervention period had higher utilization of head CT scans and chest X-rays. The mortality of severely injured patients decreased after initiation of focused trauma education courses, but no significant increase in resource utilization was observed. The explanation may be complex and multi-factorial. Long-term multidisciplinary efforts that pair training with changes in resources and mentorship may be needed to produce broad and lasting changes in the overall care system.

42 CFR 408.8 - Grace period and termination date.

Code of Federal Regulations, 2010 CFR

2010-10-01

... MEDICARE PROGRAM PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE General Provisions § 408.8 Grace period and termination date. (a) Grace period. (1) For all initial premium payments (monthly or quarterly), and subsequent monthly or quarterly payments, the grace period ends with the last day of the third month after...

Exploring methods for comparing the real-world effectiveness of treatments for osteoporosis: adjusted direct comparisons versus using patients as their own control.

PubMed

Karlsson, Linda; Mesterton, Johan; Tepie, Maurille Feudjo; Intorcia, Michele; Overbeek, Jetty; Ström, Oskar

2017-09-21

Using Swedish and Dutch registry data for women initiating bisphosphonates, we evaluated two methods of comparing the real-world effectiveness of osteoporosis treatments that attempt to adjust for differences in patient baseline characteristics. Each method has advantages and disadvantages; both are potential complements to clinical trial analyses. We evaluated methods of comparing the real-world effectiveness of osteoporosis treatments that attempt to adjust for both observed and unobserved confounding. Swedish and Dutch registry data for women initiating zoledronate or oral bisphosphonates (OBPs; alendronate/risedronate) were used; the primary outcome was fracture. In adjusted direct comparisons (ADCs), regression and matching techniques were used to account for baseline differences in known risk factors for fracture (e.g., age, previous fracture, comorbidities). In an own-control analysis (OCA), for each treatment, fracture incidence in the first 90 days following treatment initiation (the baseline risk period) was compared with fracture incidence in the 1-year period starting 91 days after treatment initiation (the treatment exposure period). In total, 1196 and 149 women initiating zoledronate and 14,764 and 25,058 initiating OBPs were eligible in the Swedish and Dutch registries, respectively. Owing to the small Dutch zoledronate sample, only the Swedish data were used to compare fracture incidences between treatment groups. ADCs showed a numerically higher fracture incidence in the zoledronate than in the OBPs group (hazard ratio 1.09-1.21; not statistically significant, p > 0.05). For both treatment groups, OCA showed a higher fracture incidence in the baseline risk period than in the treatment exposure period, indicating a treatment effect. OCA showed a similar or greater effect in the zoledronate group compared with the OBPs group. ADC and OCA each possesses advantages and disadvantages. Combining both methods may provide an estimate of real-world treatment efficacy that could potentially complement clinical trial findings.

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.

The Sleep Disorder in Anti-lgLON5 Disease.

PubMed

Gaig, Carles; Iranzo, Alex; Santamaria, Joan; Graus, Francesc

2018-05-23

To review the clinical and polysomnographic features of the sleep disorder occurring in the recently described anti-IgLON5 disease. The hallmark of the disease is the presence of antibodies against IgLON5, a neural cell adhesion molecule of unknown function. The disease presents a robust HLA association, and the neuropathological examination shows a novel neuronal tauopathy with predominant hypothalamic and brainstem involvement. Most patients (> 80%) present sleep-related vocalizations with movements and behaviors and sleep-disordered breathing. Polysomnographic studies show (1) a complex NREM sleep parasomnia at sleep initiation characterized by undifferentiated NREM or poorly structured N2 sleep with sleep-talking or mumbling, and simple or finalistic movements followed by normal periods of N3 or N2 NREM sleep, (2) REM sleep behavior disorder (RBD), and (3) obstructive sleep apnea with stridor. The last two features appear mainly in periods where NREM sleep normalizes. Identification of the anti-IgLON5 sleep disorder is important to suspect the disease. The combination of abnormal NREM sleep initiation, followed by normal periods of NREM sleep and RBD, represents a novel parasomnia.

Evaluating the Legacy of Community Health Initiatives. A Conceptual Framework and Example from the California Wellness Foundation's Health Improvement Initiative

ERIC Educational Resources Information Center

Beery, William L.; Senter, Sandra; Cheadle, Allen; Greenwald, Howard P.; Pearson, David; Brousseau, Ruth; Nelson, Gary D.

2005-01-01

Community health initiatives typically involve time-limited funding from foundation or government grants to support their initial activities. But if there are to be lasting improvements in health outcomes, initiative activities must be sustained over a relatively long period of time. Despite the importance of sustaining work begun under health…

Cone-Beam Computed Tomography Evaluation of Horizontal and Vertical Dimensional Changes in Buccal Peri-Implant Alveolar Bone and Soft Tissue: A 1-Year Prospective Clinical Study.

PubMed

Kaminaka, Akihiro; Nakano, Tamaki; Ono, Shinji; Kato, Tokinori; Yatani, Hirofumi

2015-10-01

This study evaluated changes in the horizontal and vertical dimensions of the buccal alveolar bone and soft tissue over a 1-year period following implant prosthesis. Thirty-three participants with no history of guided bone regeneration or soft tissue augmentation underwent dental implant placement with different types of connections. The dimensions of the buccal alveolar bone and soft tissue were evaluated immediately and at 1 year after prosthesis from reconstructions of cross-sectional cone-beam computed tomography images. The vertical and horizontal loss of buccal bone and soft tissue around implants with conical connections were lower than around those with external or internal connections. Statistically significant negative correlations were observed between initial horizontal bone thickness and changes in vertical bone and soft tissue height (p < .05), and between initial horizontal soft tissue thickness and the change in vertical soft tissue height (p < .05). Implants with a conical connection preserve peri-implant alveolar bone and soft tissue more effectively than other connection types. Furthermore, the initial buccal alveolar bone and soft tissue thickness around the implant platform may influence their vertical dimensional changes at 1 year after implant prosthesis. © 2014 Wiley Periodicals, Inc.

Hospital participation in Meaningful Use and racial disparities in readmissions.

PubMed

Unruh, Mark Aaron; Jung, Hye Young; Kaushal, Rainu; Vest, Joshua R

2018-01-01

To measure the impact of hospital participation in Meaningful Use (MU) on disparities in 30-day readmissions associated with race. A retrospective cohort study that compared the likelihood of 30-day readmission for Medicare beneficiaries discharged from hospitals participating in Stage 1 of MU with the likelihood of readmission for beneficiaries concurrently discharged from hospitals that were not participating in the initiative. Inpatient claims for 2,414,205 Medicare beneficiaries from Florida, New York, and Washington State were used as the primary data source. The study period (2009-2013) included at least 2 years of baseline data prior to each hospital initiating participation in MU. Estimates were derived with linear regression models that included hospital and time fixed effects. By including both hospital and time fixed effects, estimates were based on discharges from the same hospital in the same time period. MU participation among hospitals was not associated with a statistically significant change in readmissions for the broader Medicare population (percentage points [PP], 0.6; 95% CI, -0.2 to 1.4), but hospitals' participation in the initiative was associated with a lower likelihood of readmission for African American beneficiaries (PP, -0.9; 95% CI, -1.5 to -0.4). Hospital participation in MU reduced disparities in 30-day readmissions for African American Medicare beneficiaries.

NASA industry education initiative. Education programs report, 1991

NASA Technical Reports Server (NTRS)

1991-01-01

Findings from the initial inventory of education programs show that support for the NASA-Industry Education Initiative (NIEI) appears to be strong among the organizations surveyed. In addition, the range, depth and historical baselines of NIEI education programs are encouraging. It is also apparent that there is a significant level of cooperation between NIEI members and other organizations. Heavily focused towards science, engineering, mathematics and technology achievement, NIEI activities appear to be aligned with national education goals. Three criticisms are revealed: (1) the majority of programs are targeted fairly late in the education cycle; (2) the number of initiatives geared towards adult literacy and adult skills-enhancement appears to be relatively low; (3) the majority of NIEI activities involve traditional education-assistance programs, but the number of critical assessment and systematic reform initiatives is low. Four Working Group recommendations resulted from this activity: (1) NIEI Working Group operations should continue for an indefinite period, with participation open to other like-minded private-sector organization; (2) the report should be periodically updated; (3) an analysis of ongoing education programs should be conducted; (4) American corporations should continue to support education and evaluate in-house programs periodically.

Involvement of Thalamus in Initiation of Epileptic Seizures Induced by Pilocarpine in Mice

PubMed Central

Li, Yong-Hua; Li, Jia-Jia; Lu, Qin-Chi; Gong, Hai-Qing; Liang, Pei-Ji

2014-01-01

Studies have suggested that thalamus is involved in temporal lobe epilepsy, but the role of thalamus is still unclear. We obtained local filed potentials (LFPs) and single-unit activities from CA1 of hippocampus and parafascicular nucleus of thalamus during the development of epileptic seizures induced by pilocarpine in mice. Two measures, redundancy and directionality index, were used to analyze the electrophysiological characters of neuronal activities and the information flow between thalamus and hippocampus. We found that LFPs became more regular during the seizure in both hippocampus and thalamus, and in some cases LFPs showed a transient disorder at seizure onset. The variation tendency of the peak values of cross-correlation function between neurons matched the variation tendency of the redundancy of LFPs. The information tended to flow from thalamus to hippocampus during seizure initiation period no matter what the information flow direction was before the seizure. In some cases the information flow was symmetrically bidirectional, but none was found in which the information flowed from hippocampus to thalamus during the seizure initiation period. In addition, inactivation of thalamus by tetrodotoxin (TTX) resulted in a suppression of seizures. These results suggest that thalamus may play an important role in the initiation of epileptic seizures. PMID:24778885

Sexual behavior of Pecari tajacu (Cetartiodactyla: Tayassuidae) during periovulatory and early gestation periods.

PubMed

da Silva, Suleima do Socorro Bastos; Le Pendu, Yvonnick; Ohashi, Otavio Mitio; Oba, Eunice; de Albuquerque, Natália Inagaki; Garcia, Alexandre Rossetto; Mayor, Pedro; de Araujo Guimarães, Diva Anelie

2016-10-01

The goal of this study was to describe the sexual behavior in female and male collared peccary. Twenty females and twelve males were monitored in familiar and non-familiar units for two 60 days periods. During both phases, we recorded 2747 sexual interactions initiated by 20 different females toward males and 4461 sexual interactions initiated by 12 males toward females. The frequency of sexual interactions initiated per female significantly increased from proestrus to estrus, and they were significantly more frequently courted. Females initiated olfactory inspections 15.42 times more and were mounted 22.6 times more during estrus than during proestrus. Nulliparous and primiparous females copulated only when exposed to non-parental males. After estrus, the frequency of sexual interactions received by females sharply decreased. One mating event was recorded during the first gestation week and 31 mountings were observed after the second week. In conclusion, the behavioral monitoring is a useful procedure for the recognition of estrus. Our results suggest that ovulation may be associated with the end of the estrus, which will support future work in assisted reproduction in this species. To promote good handling practices, females of reproductive age should be removed from their family unit of origin. Copyright © 2016 Elsevier B.V. All rights reserved.

Steady states and outbreaks of two-phase nonlinear age-structured model of population dynamics with discrete time delay.

PubMed

Akimenko, Vitalii; Anguelov, Roumen

2017-12-01

In this paper we study the nonlinear age-structured model of a polycyclic two-phase population dynamics including delayed effect of population density growth on the mortality. Both phases are modelled as a system of initial boundary values problem for semi-linear transport equation with delay and initial problem for nonlinear delay ODE. The obtained system is studied both theoretically and numerically. Three different regimes of population dynamics for asymptotically stable states of autonomous systems are obtained in numerical experiments for the different initial values of population density. The quasi-periodical travelling wave solutions are studied numerically for the autonomous system with the different values of time delays and for the system with oscillating death rate and birth modulus. In both cases it is observed three types of travelling wave solutions: harmonic oscillations, pulse sequence and single pulse.

A mathematical basis for plant patterning derived from physico-chemical phenomena.

PubMed

Beleyur, Thejasvi; Abdul Kareem, Valiya Kadavu; Shaji, Anil; Prasad, Kalika

2013-04-01

The position of leaves and flowers along the stem axis generates a specific pattern, known as phyllotaxis. A growing body of evidence emerging from recent computational modeling and experimental studies suggests that regulators controlling phyllotaxis are chemical, e.g. the plant growth hormone auxin and its dynamic accumulation pattern by polar auxin transport, and physical, e.g. mechanical properties of the cell. Here we present comprehensive views on how chemical and physical properties of cells regulate the pattern of leaf initiation. We further compare different computational modeling studies to understand their scope in reproducing the observed patterns. Despite a plethora of experimental studies on phyllotaxis, understanding of molecular mechanisms of pattern initiation in plants remains fragmentary. Live imaging of growth dynamics and physicochemical properties at the shoot apex of mutants displaying stable changes from one pattern to another should provide mechanistic insights into organ initiation patterns. Copyright © 2013 WILEY Periodicals, Inc.

Levels-of-growing-stock cooperative study in Douglas-fir: report no. 17—The Skykomish Study, 1961–93; The Clemons study, 1963–94.

Treesearch

James E. King; David D. Marshall; John F. Bell

2002-01-01

Stand treatments were completed as prescribed with an initial calibration cut and five thinnings resulting in eight new regimes for management of Douglas-fir (Pseudotsuga menziesii (Mirb.) Franco). Measurements were continued for an additional 14 years to observe stability and yields of stands in a postthinning holding period. Detailed descriptions...

Socialization to School: A Study of Low-Income and Minority Children in an Early Childhood Setting. Occasional Paper.

ERIC Educational Resources Information Center

Schwartz, Audrey James

This study is a description of the initial socialization of low-income children, aged 3 to 6 years, who were recruited by a middle- and upper-income elementary college-laboratory school. Data for this study were obtained through observations of 11 recruited children and their classmates during a 4-year period. These observations were supplemented…

Wavelet evolutionary network for complex-constrained portfolio rebalancing

NASA Astrophysics Data System (ADS)

Suganya, N. C.; Vijayalakshmi Pai, G. A.

2012-07-01

Portfolio rebalancing problem deals with resetting the proportion of different assets in a portfolio with respect to changing market conditions. The constraints included in the portfolio rebalancing problem are basic, cardinality, bounding, class and proportional transaction cost. In this study, a new heuristic algorithm named wavelet evolutionary network (WEN) is proposed for the solution of complex-constrained portfolio rebalancing problem. Initially, the empirical covariance matrix, one of the key inputs to the problem, is estimated using the wavelet shrinkage denoising technique to obtain better optimal portfolios. Secondly, the complex cardinality constraint is eliminated using k-means cluster analysis. Finally, WEN strategy with logical procedures is employed to find the initial proportion of investment in portfolio of assets and also rebalance them after certain period. Experimental studies of WEN are undertaken on Bombay Stock Exchange, India (BSE200 index, period: July 2001-July 2006) and Tokyo Stock Exchange, Japan (Nikkei225 index, period: March 2002-March 2007) data sets. The result obtained using WEN is compared with the only existing counterpart named Hopfield evolutionary network (HEN) strategy and also verifies that WEN performs better than HEN. In addition, different performance metrics and data envelopment analysis are carried out to prove the robustness and efficiency of WEN over HEN strategy.

The path dependence of district manager decision-space in Ghana

PubMed Central

Kwamie, Aku; van Dijk, Han; Ansah, Evelyn K; Agyepong, Irene Akua

2016-01-01

The district health system in Ghana today is characterized by high resource-uncertainty and narrow decision-space. This article builds a theory-driven historical case study to describe the influence of path-dependent administrative, fiscal and political decentralization processes on development of the district health system and district manager decision-space. Methods included a non-exhaustive literature review of democratic governance in Ghana, and key informant interviews with high-level health system officials integral to the development of the district health system. Through our analysis we identified four periods of district health system progression: (1) development of the district health system (1970–85); (2) Strengthening District Health Systems Initiative (1986–93); (3) health sector reform planning and creation of the Ghana Health Service (1994–96) and (4) health sector reform implementation (1997–2007). It was observed that district manager decision-space steadily widened during periods (1) and (2), due to increases in managerial profile, and concerted efforts at managerial capacity strengthening. Periods (3) and (4) saw initial augmentation of district health system financing, further widening managerial decision-space. However, the latter half of period 4 witnessed district manager decision-space contraction. Formalization of Ghana Health Service structures influenced by self-reinforcing tendencies towards centralized decision-making, national and donor shifts in health sector financing, and changes in key policy actors all worked to the detriment of the district health system, reversing early gains from bottom-up development of the district health system. Policy feedback mechanisms have been influenced by historical and contemporary sequencing of local government and health sector decentralization. An initial act of administrative decentralization, followed by incomplete political and fiscal decentralization has ensured that the balance of power has remained at national level, with strong vertical accountabilities and dependence of the district on national level. This study demonstrates that the rhetoric of decentralization does not always mirror actual implementation, nor always result in empowered local actors. PMID:26318537

Predictors of initiation and persistence of recurrent binge eating and inappropriate weight compensatory behaviors in college men.

PubMed

Dakanalis, Antonios; Clerici, Massimo; Caslini, Manuela; Gaudio, Santino; Serino, Silvia; Riva, Giuseppe; Carrà, Giuseppe

2016-06-01

The transition to college is considered as a risk period for the development of behavioral symptoms of eating disorders (BSEDs) and some evidence suggests that, amongst men, these symptoms occurring on a regular basis remain relatively stable over the college period. Nevertheless, little is known about factors associated with persistent engagement in and initiation of recurrent (or regular) binge eating and inappropriate weight compensatory behaviors in this population. The objective of this report was to address these research gaps. Data were examined from 2,555 male first-year college students who completed an assessment of potential vulnerability factors and BSEDs at the beginning of the autumn semester (baseline) and nine months later (end of the spring semester; follow-up). Elevated negative affectivity, body dissatisfaction, self-objectification, and lower self-esteem at baseline were predictive of persistent engagement in regular binge eating and four compensatory behaviors (self-induced vomiting, laxative/diuretic abuse, fasting, exercise) at follow-up, as well as initiation of all these behaviors occurring regularly (i.e., at least weekly for 3 months). Self-objectification (thinking and monitoring the body's outward appearance from a third-person perspective) emerged as the largest contributor of both the initiation and persistence of all behavioral symptoms. Data emphasize that the same psychological factors underlie initiation and persistence of recurrent BSEDs and should shape the focus of future interventions for college men. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:581-590). © 2016 Wiley Periodicals, Inc.

High speed transition prediction

NASA Technical Reports Server (NTRS)

Gasperas, Gediminis

1993-01-01

The main objective of this work period was to develop, maintain and exercise state-of-the-art methods for transition prediction in supersonic flow fields. Basic state and stability codes, acquired during the last work period, were exercised and applied to calculate the properties of various flowfields. The development of a code for the prediction of transition location using a currently novel method (the PSE or Parabolized Stability Equation method), initiated during the last work period and continued during the present work period, was cancelled at mid-year for budgetary reasons. Other activities during this period included the presentation of a paper at the APS meeting in Tallahassee, Florida entitled 'Stability of Two-Dimensional Compressible Boundary Layers', as well as the initiation of a paper co-authored with H. Reed of the Arizona State University entitled 'Stability of Boundary Layers'.

Shuttle-tethered satellite system definition study extension

NASA Technical Reports Server (NTRS)

1980-01-01

A system requirements definition and configuration study (Phase B) of the Tethered Satellite System (TSS) was conducted during the period 14 November 1977 to 27 February 1979. Subsequently a study extension was conducted during the period 13 June 1979 to 30 June 1980, for the purpose of refining the requirements identified during the main phase of the study, and studying in some detail the implications of accommodating various types of scientific experiments on the initial verification flight mission. An executive overview is given of the Tethered Satellite System definition developed during the study. The results of specific study tasks undertaken in the extension phase of the study are reported. Feasibility of the Tethered Satellite System has been established with reasonable confidence and the groundwork laid for proceeding with hardware design for the verification mission.

Comparison of adherence and persistence among adults with type 2 diabetes mellitus initiating saxagliptin or linagliptin.

PubMed

Farr, Amanda M; Sheehan, John J; Davis, Brian M; Smith, David M

2016-01-01

Adherence and persistence to antidiabetes medications are important to control blood glucose levels among individuals with type 2 diabetes mellitus (T2D). The objective of this study was to compare adherence and persistence over a 12-month period between patients initiating saxagliptin and patients initiating linagliptin, two dipeptidyl peptidase-4 inhibitors. This retrospective cohort study was conducted in MarketScan(®) Commercial and Medicare Supplemental claims databases. Patients with T2D initiating saxagliptin or linagliptin between January 1, 2009, and June 30, 2013, were selected. Patients were required to be at least 18 years old and have 12 months of continuous enrollment prior to and following initiation. Adherence and persistence to initiated medication were measured over the 12 months after initiation using outpatient pharmacy claims. Patients were considered adherent if the proportion of days covered was ≥0.80. Patients were considered nonpersistent (or to have discontinued) if there was a gap of >60 days without initiated medication on hand. Multivariable logistic regression and multivariable Cox proportional hazard models were fit to compare adherence and persistence, respectively, between the two cohorts. There were 21,599 saxagliptin initiators (mean age 55 years; 53% male) and 5,786 linagliptin initiators (mean age 57 years; 54% male) included in the study sample. Over the 12-month follow-up, 46% of saxagliptin initiators and 42% of linagliptin initiators were considered adherent and 47% of saxagliptin initiators and 51% of linagliptin initiators discontinued their initiated medication. After controlling for patient characteristics, saxagliptin initiation was associated with significantly greater odds of being adherent (adjusted odds ratio =1.212, 95% CI 1.140-1.289) and significantly lower hazards of discontinuation (adjusted hazard ratio =0.887, 95% CI 0.850-0.926) compared with linagliptin initiation. Compared with patients with T2D who initiated linagliptin, patients with T2D who initiated saxagliptin had significantly better adherence and persistence.

Pilot-in-the-Loop CFD Method Development

DTIC Science & Technology

2017-04-20

the methods on the NAVAIR Manned Flight Simulator. Activities this period During this report period, we implemented the CRAFT CFD code on the...Penn State VLRCROE Flight simulator and performed the first Pilot-in-the-Loop PILCFD tests at Penn State using the COCOA5 clusters. The initial tests...integration of the flight simulator and Penn State computing infrastructure. Initial tests showed slower performance than real-time (3x slower than real

Biochemical basis of synergism between pathogenic fungus Metarhizium anisopliae and insecticide chlorantraniliprole in Locusta migratoria (Meyen)

PubMed Central

Jia, Miao; Cao, Guangchun; Li, Yibo; Tu, Xiongbing; Wang, Guangjun; Nong, Xiangqun; Whitman, Douglas W.; Zhang, Zehua

2016-01-01

We challenged Locusta migratoria (Meyen) grasshoppers with simultaneous doses of both the insecticide chlorantraniliprole and the fungal pathogen, Metarhizium anisopliae. Our results showed synergistic and antagonistic effects on host mortality and enzyme activities. To elucidate the biochemical mechanisms that underlie detoxification and pathogen-immune responses in insects, we monitored the activities of 10 enzymes. After administration of insecticide and fungus, activities of glutathione-S-transferase (GST), general esterases (ESTs) and phenol oxidase (PO) decreased in the insect during the initial time period, whereas those of aryl acylamidase (AA) and chitinase (CHI) increased during the initial period and that of acetylcholinesterase (AChE) increased during a later time period. Activities of superoxide dismutase (SOD), catalase (CAT) and peroxidase (POD) decreased at a later time period post treatment. Interestingly, treatment with chlorantraniliprole and M. anisopliae relieved the convulsions that normally accompany M. anisopliae infection. We speculate that locust mortality increased as a result of synergism via a mechanism related to Ca2+ disruption in the host. Our study illuminates the biochemical mechanisms involved in insect immunity to xenobiotics and pathogens as well as the mechanisms by which these factors disrupt host homeostasis and induce death. We expect this knowledge to lead to more effective pest control. PMID:27328936

Communications with Mars During Periods of Solar Conjunction: Initial Study Results

NASA Astrophysics Data System (ADS)

Morabito, D.; Hastrup, R.

2001-07-01

During the initial phase of the human exploration of Mars, a reliable communications link to and from Earth will be required. The direct link can easily be maintained during most of the 780-day Earth-Mars synodic period. However, during periods in which the direct Earth-Mars link encounters increased intervening charged particles during superior solar conjunctions of Mars, the resultant effects are expected to corrupt the data signals to varying degrees. The purpose of this article is to explore possible strategies, provide recommendations, and identify options for communicating over this link during periods of solar conjunctions. A significant improvement in telemetry data return can be realized by using the higher frequency 32 GHz (Ka-band), which is less susceptible to solar effects. During the era of the onset of probable human exploration of Mars, six superior conjunctions were identified from 2015 to 2026. For five of these six conjunctions, where the signal source is not occulted by the disk of the Sun, continuous communications with Mars should be achievable. Only during the superior conjunction of 2023 is the signal source at Mars expected to lie behind the disk of the Sun for about one day and within two solar radii (0. 5 deg) for about three days.

15 CFR 904.271 - Initial decision.

Code of Federal Regulations, 2011 CFR

2011-01-01

... OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE GENERAL REGULATIONS CIVIL PROCEDURES Hearing and Appeal Procedures Decision § 904.271 Initial decision. (a) After expiration of the period...

15 CFR 904.271 - Initial decision.

Code of Federal Regulations, 2010 CFR

2010-01-01

... OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE GENERAL REGULATIONS CIVIL PROCEDURES Hearing and Appeal Procedures Decision § 904.271 Initial decision. (a) After expiration of the period...

Baclofen and naltrexone effects on alcohol self-administration: Comparison of treatment initiated during abstinence or ongoing alcohol access in baboons.

PubMed

Holtyn, August F; Kaminski, Barbara J; Weerts, Elise M

2017-10-01

Baclofen, a GABA B receptor agonist, is under investigation as a pharmacotherapy for alcohol use disorder. Treatment with a pharmacotherapeutic can be initiated during alcohol abstinence or active drinking, which may influence treatment outcomes. This study examined whether baclofen treatment initiated and maintained during alcohol abstinence would reduce alcohol seeking and self-administration upon return to alcohol access, and whether effects differed from treatment initiated and maintained during ongoing alcohol access. Naltrexone was tested under similar conditions for comparison. Five baboons self-administered alcohol under a three-component chained schedule of reinforcement that modeled periods of anticipation (Component 1), seeking (Component 2), and consumption (Component 3). Alcohol was only available in Component 3. In Experiment 1, baclofen (0.1-1.8mg/kg) or naltrexone (1.0-5.6mg/kg) was administered daily beginning on the first day of a 5-day abstinence period and treatment was continued for 5days of alcohol access. In Experiment 2, selected doses of both drugs were administered during ongoing alcohol access. When treatment was initiated during alcohol abstinence, baclofen and naltrexone did not significantly reduce total alcohol intake (g/kg) or alcohol seeking. In comparison, when treatment was initiated during ongoing alcohol access, both baclofen (1.8mg/kg) and naltrexone (3.2 and 5.6mg/kg) significantly reduced total alcohol intake (g/kg). Naltrexone (5.6mg/kg), but not baclofen, significantly reduced alcohol seeking. Initiation of baclofen treatment (or other alcohol use disorder treatments) during abstinence or active drinking may be an important factor in influencing efficacy and appropriate dose selection. Copyright © 2017 Elsevier B.V. All rights reserved.

The effect of increased mobility on morbidity in the neurointensive care unit.

PubMed

Titsworth, W Lee; Hester, Jeannette; Correia, Tom; Reed, Richard; Guin, Peggy; Archibald, Lennox; Layon, A Joseph; Mocco, J

2012-06-01

The detrimental effects of immobility on intensive care unit (ICU) patients are well established. Limited studies involving medical ICUs have demonstrated the safety and benefit of mobility protocols. Currently no study has investigated the role of increased mobility in the neurointensive care unit population. This study was a single-institution prospective intervention trial to investigate the effectiveness of increased mobility among neurointensive care unit patients. All patients admitted to the neurointensive care unit of a tertiary care center over a 16-month period (April 2010 through July 2011) were evaluated. The study consisted of a 10-month (8025 patient days) preintervention observation period followed by a 6-month (4455 patient days) postintervention period. The intervention was a comprehensive mobility initiative utilizing the Progressive Upright Mobility Protocol (PUMP) Plus. Implementation of the PUMP Plus increased mobility among neurointensive care unit patients by 300% (p < 0.0001). Initiation of this protocol also correlated with a reduction in neurointensive care unit length of stay (LOS; p < 0.004), hospital LOS (p < 0.004), hospital-acquired infections (p < 0.05), and ventilator-associated pneumonias (p < 0.001), and decreased the number of patient days in restraints (p < 0.05). Additionally, increased mobility did not lead to increases in adverse events as measured by falls or inadvertent line disconnections. Among neurointensive care unit patients, increased mobility can be achieved quickly and safely with associated reductions in LOS and hospital-acquired infections using the PUMP Plus program.

Cooperation for Quality Services in a Period of Declining Resources. Institute Report.

ERIC Educational Resources Information Center

Scholl, Geraldine T., Ed.

The document contains edited versions of sessions from the 1981 Special Study Institute, the fourth in a series designed initially for state education consultants for the visually handicapped. Objectives of the 1981 Institute are listed--to establish coordination, communication, and cooperation among teacher trainers; to develop interagency…

The Development of Causal Structure without a Language Model

ERIC Educational Resources Information Center

Rissman, Lilia; Goldin-Meadow, Susan

2017-01-01

Across a diverse range of languages, children proceed through similar stages in their production of causal language: their initial verbs lack internal causal structure, followed by a period during which they produce causative overgeneralizations, indicating knowledge of a productive causative rule. We asked in this study whether a child not…

The Tides of Talent.

ERIC Educational Resources Information Center

Taylor, Craig R.

2003-01-01

Results of recent studies on why people leave or stay with an employer identified organizational, job, and leadership issues. Factors included job satisfaction, organizational climate, salary and benefits, loyalty, and anxiety about the economy and job market. Research showed three periods of highest risk of turnover: after the initial 30-60 days,…

Theory into Practice: KSU PDS Model

ERIC Educational Resources Information Center

Yahnke, Sally J.; Shroyer, M. Gail

2014-01-01

The 1983 publication of "A Nation at Risk: The Imperative for Educational Reform" (National Commission of Excellence in Education) "initiated the longest sustained period of attention to public education in the nation's history and ignited a new wave of interest in teacher preparation" (NRC, Committee on the Study of Teacher…

Sustainbility and Undergraduate Management Curricula: Changes over a 5-Year Period

ERIC Educational Resources Information Center

Fisher, Josie; Bonn, Ingrid

2017-01-01

Global initiatives and a rapidly expanding academic literature identify the responsibility that universities have to incorporate sustainability education into their curricula. This study had two aims: first, to investigate the extent to which Australian undergraduate management curricula explicitly identified a focus on sustainability and, second,…

Technological Discontinuities and Dominant Designs: A Cyclical Model of Technological Change.

ERIC Educational Resources Information Center

Anderson, Philip; Tushman, Michael L.

1990-01-01

Based on longitudinal studies of the cement, glass, and minicomputer industries, this article proposes a technological change model in which a technological breakthrough, or discontinuity, initiates an era of intense technical variation and selection, culminating in a single dominant design and followed by a period of incremental technical…

Module for phosphorus separation and recycling from liquid manures

USDA-ARS?s Scientific Manuscript database

A method has been developed to extract and concentrate soluble phosphates from livestock wastewater. The research was conducted over a 10-year period and went from initial bench studies and discovery, to pilot module development, to full-scale demonstrations of the phosphorus (P) module in swine fa...

Assessing Self-Control Training in Children with Attention Deficit Hyperactivity Disorder

ERIC Educational Resources Information Center

Bloh, Christopher

2009-01-01

This study examined the use of a progressive delay procedure with and without a concurrent activity to teach self-control to children with attention deficit hyperactivity disorder. Three participants were initially required to wait progressively longer periods of time for access to preferred edible reinforcers. After demonstrating this…

Initial and sustained participation in an internet-delivered long-term worksite health promotion program on physical activity and nutrition.

PubMed

Robroek, Suzan J W; Lindeboom, Dennis E M; Burdorf, Alex

2012-03-05

Determinants of participation in health promotion programs are largely unknown. To evaluate and implement interventions, information is needed regarding their reach as well as regarding the characteristics of program users and non-users. In this study, individual, lifestyle, and health indicators were investigated in relation to initial, and sustained participation in an Internet-delivered physical activity and healthy nutrition program in the workplace setting. In addition, determinants of program website use were studied. Determinants of participation were investigated in a longitudinal study among employees from six workplaces participating in a two-year cluster randomized controlled trial. The employees were invited by email to participate. At baseline, all participants visited a website to fill out the questionnaire on lifestyle, work, and health factors. Subsequently, a physical health check was offered, followed by face-to-face advice. Throughout the study period, all participants had access to a website with information on lifestyle and health, and to fully automated personalized feedback on the questionnaire results. Only participants in the intervention received monthly email messages to promote website visits during the first year and had access to additional Web-based tools (self-monitors, a food frequency questionnaire assessing saturated fat intake, and the possibility to ask questions) to support behavior change. Website use was monitored by website statistics measuring access. Logistic regression analyses were conducted to identify characteristics of employees who participated in the program and used the website. Complete baseline data were available for 924 employees (intervention: n=456, reference: n=468). Lifestyle and health factors were not associated with initial participation. Employees aged 30 years and older were more likely to start using the program and to sustain their participation. Workers with a low intention to increase their physical activity level were less likely to participate (Odds Ratio (OR)=0.60, 95% Confidence interval (95%CI), 0.43-0.85) but more likely to sustain participation throughout the study period (ORs ranging from 1.40 to 2.06). Furthermore, it was found that smokers were less likely to sustain their participation in the first and second year (OR=0.54, 95%CI 0.35-0.82) and to visit the website (OR=0.72, 95%CI 0.54-0.96). Website use was highest in the periods immediately after the baseline (73%) and follow-up questionnaires (71% and 87%). Employees in the intervention were more likely to visit the website in the period they received monthly emails (OR=5.88, 95%CI 3.75-9.20) but less likely to visit the website in the subsequent period (OR=0.62, 95%CI 0.45-0.85). Modest initial participation and high attrition in program use were found. Workers with a low intention to change their behavior were less likely to participate, but once enrolled they were more likely to sustain their participation. Lifestyle and health indicators were not related to initial participation, but those with an unhealthy lifestyle were less likely to sustain. This might influence program effectiveness. Regular email messages prompted website use, but the use of important Web-based tools was modest. There is a need for more appealing techniques to enhance retention and to keep those individuals who need it most attracted to the program. ISRCTN52854353; http://www.controlled-trials.com/ISRCTN52854353.

When Teachers Give Up: Teacher Burnout, Teacher Turnover and Their Impact on Children.

ERIC Educational Resources Information Center

Dworkin, Anthony Gary

A large-scale sociological study of teacher burnout in the public schools is summarized. Data presented in the study consist of: a sample of 3,500 teachers in Houston, whose attitudes were monitored in 1977; exit interviews of every teacher in the initial sample who subsequently quit teaching over a 5-year period; achievement and attendance…

Insects affecting establishment of northern red oak seedlings in central Pennsylvania

Treesearch

J. Galford; L.R. Auchmoody; H.C. Smith; R.S. Walters

1991-01-01

Studies to evaluate the impact of insects on the establishment of advance oak regeneration in Pennsylvania were initiated in 1989. The populations and species of insects feeding on germinating acorns and new seedlings, their activity periods, and the damage caused by these insects were studied in relation to overstory-density (40, 60, and 100 percent relative density)...

Green fescue rangelands: changes over time in the Wallowa Mountains.

Treesearch

Charles G. Johnson

2003-01-01

This publication documents over 90 years of plant succession on green fescue grasslands in the subalpine ecological zone of the Wallowa Mountains in northeast Oregon. It also ties together the work of four scientists over a 60-year period. Arthur Sampson initiated his study of deteriorated rangeland in 1907. Elbert H. Reid began his studies of overgrazing in 1938. Both...

Directing Curriculum through Standards: A Content Analysis of the 2010 Texas State Social Studies Standards

ERIC Educational Resources Information Center

Smith, Norman

2012-01-01

In 2010 the Texas Education Agency adopted newly rewritten curriculum standards for the state's social studies courses K-12. The period leading up to the adoption of the standards proved contentious as the new standards moved out of the writing committees and into the public realm. The issues brought forth from initial readings of the standards…

Exploring Support for the Extracurriculum in a Time of Fiscal Constraint and Standards-Based Reform: A Case Study of One Pennsylvania School District

ERIC Educational Resources Information Center

Murphy, Mark Patrick

2012-01-01

Although much has been researched and written about the value of extracurricular programs in U.S. public schools, few studies have addressed the combined effect that school reform initiatives, including myriad standardized tests, accountability measures, and massive financial crisis which have become more commonplace during periods of economic…

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR PERFORMANCE OF COMPUTER SOFTWARE: VERIFICATION AND VALIDATION (UA-D-2.0)

EPA Science Inventory

The purpose of this SOP is to define the procedures used for the initial and periodic verification and validation of computer programs used during the Arizona NHEXAS project and the Border study. Keywords: Computers; Software; QA/QC.

The U.S.-Mexico Border Program is sponsored ...

Influence of Mentoring on African American and Hispanic Males in High School

ERIC Educational Resources Information Center

Smith, Jacqueline A.

2016-01-01

The mixed method research study was designed to evaluate the effects on a mentoring initiative on 40 African American and Hispanic males in an urban high school. The study took place over a three-month period in a traditional public school with 2,000 students. Data collection methods used included individual interview with student mentees, surveys…

47 CFR 22.947 - Five year build-out period.

Code of Federal Regulations, 2011 CFR

2011-10-01

... MOBILE SERVICES Cellular Radiotelephone Service § 22.947 Five year build-out period. Except for systems...-out period, the licensee of the first cellular system on each channel block in each market may enter...-out period begins on the date the initial authorization for the first cellular system is granted, and...

45 CFR 155.725 - Enrollment periods under SHOP.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Enrollment periods under SHOP. 155.725 Section 155... Functions: Small Business Health Options Program (SHOP) § 155.725 Enrollment periods under SHOP. (a) General requirements. The SHOP must— (1) Adhere to the start of the initial open enrollment period set forth in § 155...

45 CFR 155.725 - Enrollment periods under SHOP.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Enrollment periods under SHOP. 155.725 Section 155... Functions: Small Business Health Options Program (SHOP) § 155.725 Enrollment periods under SHOP. (a) General requirements. The SHOP must— (1) Adhere to the start of the initial open enrollment period set forth in § 155...

Experimental model of biofilm implant-related osteomyelitis to test combination biomaterials using biofilms as initial inocula.

PubMed

Williams, Dustin L; Haymond, Bryan S; Woodbury, Kassie L; Beck, J Peter; Moore, David E; Epperson, R Tyler; Bloebaum, Roy D

2012-07-01

Currently, the majority of animal models that are used to study biofilm-related infections use planktonic bacterial cells as initial inocula to produce positive signals of infection in biomaterials studies. However, the use of planktonic cells has potentially led to inconsistent results in infection outcomes. In this study, well-established biofilms of methicillin-resistant Staphylococcus aureus were grown and used as initial inocula in an animal model of a Type IIIB open fracture. The goal of the work was to establish, for the first time, a repeatable model of biofilm implant-related osteomyelitis, wherein biofilms were used as initial inocula to test combination biomaterials. Results showed that 100% of animals that were treated with biofilms developed osteomyelitis, whereas 0% of animals not treated with biofilm developed infection. The development of this experimental model may lead to an important shift in biofilm and biomaterials research by showing that when biofilms are used as initial inocula, they may provide additional insights into how biofilm-related infections in the clinic develop and how they can be treated with combination biomaterials to eradicate and/or prevent biofilm formation. Copyright © 2012 Wiley Periodicals, Inc.

DEVELOPMENT OF AN INSPECTION PLATFORM AND A SUITE OF SENSORS FOR ASSESSING CORROSION AND MECHANICAL DAMAGE ON UNPIGGABLE TRANSMISSION MAINS

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

George C. Vradis

2003-05-01

The present report summarizes the accomplishments of the project during its second three-month period (from January 2003 through March 2003). The project was initiated with delay in February 2003 due to contractual issues that emerged between the NGA and Foster-Miller, Inc. The two organizations are working diligently to maintain the program's pace so that it is completed in time. The efforts of the project focused during this period in the assessment of the tether technology that is intended to be used as the means of communication between robot and operator. Preliminary results indicate that tether is a viable option undermore » certain pipeline operating conditions but not all. The exact range of operating conditions that are viable for tether use are being determined as the study progresses. Work was also initiated regarding the design of the robotic platform.« less

Assessment of the Gaussian Covariance Approximation over an Earth-Asteroid Encounter Period

NASA Technical Reports Server (NTRS)

Mattern, Daniel

2017-01-01

In assessing the risk an asteroid may pose to the Earth, the asteroids state is often predicted for many years, often decades. Only by accounting for the asteroids initial state uncertainty can a measure of the risk be calculated. With the asteroids state uncertainty growing as a function of the initial velocity uncertainty, orbit velocity at the last state update, and the time from the last update to the epoch of interest, the asteroids position uncertainties can grow to many times the size of the Earth when propagated to the encounter risk corridor. This paper examines the merits of propagating the asteroids state covariance as an analytical matrix. The results of this study help to bound the efficacy of applying different metrics for assessing the risk an asteroid poses to the Earth. Additionally, this work identifies a criterion for when different covariance propagation methods are needed to continue predictions after an Earth-encounter period.

Rydberg wave packets in static electric fields initiated with far infrared pulses

NASA Astrophysics Data System (ADS)

Robicheaux, F.; Lankhuijzen, G. M.; Rella, C.; Noordam, L. D.

1998-05-01

We perform experimental and theoretical studies of transitions from bound atomic Rydberg Stark states in a static electric field to autoionizing states. The transitions are induced by a broadband, tunable free electron laser pulse (1-5 ps width). The systematics of the wave packet properties are investigated when the initial state is the lowest energy state or highest energy state of the n-manifold. We show that the recently proposed electron gun is realized for Rb giving an AC electron current with a 20 ps period.

Herd-level factors associated with the presence of bovine viral diarrhoea virus in herds participating in the voluntary phase of the Irish national eradication programme.

PubMed

Graham, D A; Clegg, T A; Lynch, M; More, S J

2013-10-01

A risk factor study was conducted to identify variables associated with initial positive or inconclusive results for bovine viral diarrhoea virus (BVDV) in ear punch samples collected from calves between 1st January and 15th July 2012 (the study period) as part of the voluntary phase of the Irish national BVD eradication programme based on testing of ear tag tissue samples from calves born in participating herds. Univariable analysis indicated significant associations with the following factors: herd type; the number of cows in the herd; the number of calves born in the study period; the number of calves tested in the study period; the number of cattle purchased in 2011, between 2009 and 2011 and between 2007 and 2011; the number of tested calves whose dams had been purchased within 9 months of their calving date; and the percentage of calf mortality within 28 days of birth. The percentage of the cows in each herd that was homebred, location (province) the number of separate land parcels used by each herd, the presence of an associated sheep enterprise and the purchase of cattle through marts were not found to be significant. An initial logistic regression model was developed to model the probability of a herd having one or more BVD virus-positive or inconclusive calves. When vaccination status was initially excluded, province, log of the numbers of cows in the herd, the number of cows purchased between 2009 and 2011, the number of tested calves whose dams had been purchased within 9 months of their calving date and calf mortality were significant. When vaccination status was included, using a subset of the data based on farmers responding to a survey on vaccination status, it was retained as a significant variable along with the same variables already listed, showing a significant 2-way interaction with the log of the number of cows. There was not a significant association between an initial positive or inconclusive result and the length of time for which herds had been vaccinating. The study provides a series of key communication messages relating to both the delivery of, and benefits from, the national eradication programme. Copyright © 2013 Elsevier B.V. All rights reserved.

Predicting the Initial Lapse Using a Mobile Health Application after Alcohol Detoxification

ERIC Educational Resources Information Center

Chih, Ming-Yuan

2013-01-01

The prediction and prevention of the initial lapse--which is defined as the first lapse after a period of abstinence--is important because the initial lapse often leads to subsequent lapses (within the same lapse episode) or relapse. The prediction of the initial lapse may allow preemptive intervention to be possible. This dissertation reports on…

Smoking initiation among youth: The role of cigarette excise taxes and prices by race/ethnicity and gender

PubMed Central

Nonnemaker, James M.; Farrelly, Matthew

2011-01-01

Existing evidence for the role of cigarette excise taxes and prices as significant determinants of youth smoking initiation is mixed. A few studies have considered the possibility that the impact of cigarette taxes and prices might differ by gender or race/ethnicity. In this paper, we address the role of cigarette taxes and prices on youth smoking initiation using the National Longitudinal Survey of Youth 1997 cohort and discrete-time survival methods. We present results overall and by gender, race/ethnicity, and gender by race/ethnicity. We examine initiation over the age range during which youth are most at risk of initiation and over a period in which substantial changes have occurred in tax and price. The result for cigarette excise taxes is small and mixed across alternative specifications, with the effect strongest for black youth. Cigarette prices are more consistently a significant determinant of youth smoking initiation, especially for black youth. PMID:21477875

Smoking initiation among youth: the role of cigarette excise taxes and prices by race/ethnicity and gender.

PubMed

Nonnemaker, James M; Farrelly, Matthew C

2011-05-01

Existing evidence for the role of cigarette excise taxes and prices as significant determinants of youth smoking initiation is mixed. A few studies have considered the possibility that the impact of cigarette taxes and prices might differ by gender or race/ethnicity. In this paper, we address the role of cigarette taxes and prices on youth smoking initiation using the National Longitudinal Survey of Youth 1997 cohort and discrete-time survival methods. We present results overall and by gender, race/ethnicity, and gender by race/ethnicity. We examine initiation over the age range during which youth are most at risk of initiation and over a period in which substantial changes have occurred in tax and price. The result for cigarette excise taxes is small and mixed across alternative specifications, with the effect strongest for black youth. Cigarette prices are more consistently a significant determinant of youth smoking initiation, especially for black youth. Copyright © 2011 Elsevier B.V. All rights reserved.

Differential tumor biology effects of double-initiation in a mouse skin chemical carcinogenesis model comparing wild type versus protein kinase Cepsilon overexpression mice.

PubMed

Li, Yafan; Wheeler, Deric L; Ananthaswamy, Honnavara N; Verma, Ajit K; Oberley, Terry D

2007-12-01

Our previous studies showed that protein kinase Cepsilon (PKCepsilon) verexpression in mouse skin resulted in metastatic squamous cell carcinoma (SCC) elicited by single 7,12-dimethylbenz(a)anthracene (DMBA)-initiation and 12-O-tetradecanoylphorbol-13-acetate (TPA)-promotion in the absence of preceding papilloma formation as is typically observed in wild type mice. The present study demonstrates that double-DMBA initiation modulates tumor incidence, multiplicity, and latency period in both wild type and PKCepsilon overexpression transgenic (PKCepsilon-Tg) mice. After 17 weeks (wks) of tumor promotion, a reduction in papilloma multiplicity was observed in double- versus single-DMBA initiated wild type mice. Papilloma multiplicity was inversely correlated with cell death indices of interfollicular keratinocytes, indicating decreased papilloma formation was caused by increased cell death and suggesting the origin of papillomas is in interfollicular epidermis. Double-initiated PKCepsilon-Tg mice had accelerated carcinoma formation and cancer incidence in comparison to single-initiated PKCepsilon-Tg mice. Morphologic analysis of mouse skin following double initiation and tumor promotion showed a similar if not identical series of events to those previously observed following single initiation and tumor promotion: putative preneoplastic cells were observed arising from hyperplastic hair follicles (HFs) with subsequent cancer cell infiltration into the dermis. Single-initiated PKCepsilon-Tg mice exhibited increased mitosis in epidermal cells of HFs during tumor promotion.

The effects of a muscle resistance program on the functional capacity, knee extensor muscle strength and plasma levels of IL-6 and TNF-alpha in pre-frail elderly women: a randomized crossover clinical trial--a study protocol.

PubMed

Lustosa, Lygia P; Coelho, Fernanda M; Silva, Juscelio P; Pereira, Daniele S; Parentoni, Adriana N; Dias, João M D; Dias, Rosangela C; Pereira, Leani S M

2010-07-28

With the increase in the elderly population, a growing number of chronic degenerative diseases and a greater dependency on caregivers have been observed. Elderly persons in states of frailty remain more susceptible to significant health complications. There is evidence of an inverse relationship between plasma levels of inflammatory mediators and levels of functionality and muscle strength, suggesting that muscle-strengthening measures can aid in inflammatory conditions. The purpose of this study will be verified the effect of a muscle-strengthening program with load during a ten-week period in pre-frail elderly women with attention to the following outcomes: (1) plasma levels of interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha), (2) functional capacity and (3) knee extensor muscle strength. The study design is a randomized crossover clinical trial evaluating 26 elderly women (regardless of their race and/or social condition) who are community residents, older than 65, and classified as pre-frail according to the criteria previously described by Fried et al. (2004). All subjects will be assessed using the Timed up and go and 10-Meter Walk Test functional tests. The plasma levels of IL-6 and TNF-alpha will be assessed by ELISA (enzyme-linked immunosorbent assay) with high sensitivity kits (QuantikineHS, R&D Systems Minneapolis, MN, U.S.). Knee extensor muscle strength will be assessed using the Byodex System 3 Pro(R) isokinetic dynamometer at angular speeds of 60 and 180 degrees/s. The intervention will consist of strengthening exercises of the lower extremities at 50 to 70% of 1RM (maximal resistance) three times per week for ten weeks. The volunteers will be randomized into two groups: group E, the intervention group, and group C, the control group that did not initiate any new activities during the initial study period (ten weeks). After the initial period, group C will begin the intervention and group E will maintain everyday activities without exercising. At the end of the total study period, all volunteers will be reassessed. To demonstrate and discuss possible influences of load-bearing exercises on the modification of plasma levels of IL-6 and TNF-alpha and in the functional performance of pre-frail elderly women. ISRCTN62824599.

Associated factors for treatment delay in pulmonary tuberculosis in HIV-infected individuals: a nested case-control study.

PubMed

Coimbra, Isabella; Maruza, Magda; Militão-Albuquerque, Maria de Fátima Pessoa; Moura, Líbia Vilela; Diniz, George Tadeu Nunes; Miranda-Filho, Demócrito de Barros; Lacerda, Heloísa Ramos; Rodrigues, Laura Cunha; Ximenes, Ricardo Arraes de Alencar

2012-09-07

The delay in initiating treatment for tuberculosis (TB) in HIV-infected individuals may lead to the development of a more severe form of the disease, with higher rates of morbidity, mortality and transmissibility. The aim of the present study was to estimate the time interval between the onset of symptoms and initiating treatment for TB in HIV-infected individuals, and to identify the factors associated to this delay. A nested case-control study was undertaken within a cohort of HIV-infected individuals, attended at two HIV referral centers, in the state of Pernambuco, Brazil. Delay in initiating treatment for TB was defined as the period of time, in days, which was greater than the median value between the onset of cough and initiating treatment for TB. The study analyzed biological, clinical, socioeconomic, and lifestyle factors as well as those related to HIV and TB infection, potentially associated to delay. The odds ratios were estimated with the respective confidence intervals and p-values. From a cohort of 2365 HIV-infected adults, 274 presented pulmonary TB and of these, 242 participated in the study. Patients were already attending 2 health services at the time they developed a cough (period range: 1 - 552 days), with a median value of 41 days. Factors associated to delay were: systemic symptoms asthenia, chest pain, use of illicit drugs and sputum smear-negative. The present study indirectly showed the difficulty of diagnosing TB in HIV-infected individuals and indicated the need for a better assessment of asthenia and chest pain as factors that may be present in co-infected patients. It is also necessary to discuss the role played by negative sputum smear results in diagnosing TB/HIV co-infection as well as the need to assess the best approach for drug users with TB/HIV.

Impact of an electronic sepsis initiative on antibiotic use and health care facility-onset Clostridium difficile infection rates.

PubMed

Hiensch, Robert; Poeran, Jashvant; Saunders-Hao, Patricia; Adams, Victoria; Powell, Charles A; Glasser, Allison; Mazumdar, Madhu; Patel, Gopi

2017-10-01

Although integrated, electronic sepsis screening and treatment protocols are thought to improve patient outcomes, less is known about their unintended consequences. We aimed to determine if the introduction of a sepsis initiative coincided with increases in broad-spectrum antibiotic use and health care facility-onset (HCFO) Clostridium difficile infection (CDI) rates. We used interrupted time series data from a large, tertiary, urban academic medical center including all adult inpatients on 4 medicine wards (June 2011-July 2014). The main exposure was implementation of the sepsis screening program; the main outcomes were the use of broad-spectrum antibiotics (including 3 that were part of an order set designed for the sepsis initiative) and HCFO CDI rates. Segmented regression analyses compared outcomes in 3 time segments: before (11 months), during (14 months), and after (12 months) implementation of a sepsis initiative. Antibiotic use and HFCO CDI rates increased during the period of implementation and the period after implementation compared with baseline; these increases were highest in the period after implementation (level change, 50.4 days of therapy per 1,000 patient days for overall antibiotic use and 10.8 HCFO CDIs per 10,000 patient days; P < .05). Remarkably, the main drivers of overall antibiotic use were not those included in the sepsis order set. The implementation of an electronic sepsis screening and treatment protocol coincided with increased broad-spectrum antibiotic use and HCFO CDIs. Because these protocols are increasingly used, further study of their unintended consequences is warranted. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

An analysis of nitrification during the aerobic digestion of secondary sludges.

PubMed

Bhargava, D S; Datar, M T

1989-01-01

Investigations were undertaken to study the occurrence and progress of nitrification during aerobic digestion of activated sludge in a wide range of initial concentrations of total solids (1000 to 80 000 mg litre(-1), initial pH range of 4.5 to 10.4 and digestion temperature range of 5 degrees to 60 degrees C. Batch aerobic digestion studies on activated sludge grown on wastewater (enriched with organic solids from human excretal material) indicate that almost complete elimination of the 'biodegradable' matter of the activated sludge was one of the essential prerequisites to initiate nitrification. Favourable ranges of temperature and pH for nitrification were observed to be 25 degrees to 30 degrees C and 6.0 to 8.3, respectively. With all favourable conditions, a minimum period of about 2 days was necessary for population build-up of genera Nitrosomonas and Nitrobacter, and to initiate nitrification. Nitrate formation invariably lagged behind nitrite formation, but under certain conditions both phases of nitrification were observed to progress hand in hand.

R-rated Movie Viewing, Growth in Sensation Seeking and Alcohol Initiation: Reciprocal and Moderation Effects

PubMed Central

Stoolmiller, Mike; Gerrard, Meg; Worth, Keilah A.; Gibbons, Frederick X.

2010-01-01

The current study employed parallel process and discrete time hazard regressions to examine the interplay among exposure to R-rated movies, sensation seeking, and initiation of alcohol use in a national U.S. sample (N=6255) of adolescents, ages 10–14, who were followed over four waves spanning 2 years. There was a short-term reciprocal relation between watching R-rated movies and sensation seeking, but over the 2-year observation period, exposure to R-rated movies was associated with increases in sensation seeking and not vice versa. Sensation seeking also moderated the effect of watching R-rated movies on initiation of alcohol consumption such that exposure was associated with greater increases in initiation of alcohol use among low sensation than among high sensation seeking adolescents. The study provides empirical evidence of an environmental media effect on sensation seeking, and important new information about the relations among sensation seeking, media exposure, and adolescent alcohol use. PMID:19655251

R-rated movie viewing, growth in sensation seeking and alcohol initiation: reciprocal and moderation effects.

PubMed

Stoolmiller, Mike; Gerrard, Meg; Sargent, James D; Worth, Keilah A; Gibbons, Frederick X

2010-03-01

The current study employed parallel process and discrete time hazard regressions to examine the interplay among exposure to R-rated movies, sensation seeking, and initiation of alcohol use in a national U.S. sample (N = 6255) of adolescents, ages 10-14, who were followed over four waves spanning 2 years. There was a short-term reciprocal relation between watching R-rated movies and sensation seeking, but over the 2-year observation period, exposure to R-rated movies was associated with increases in sensation seeking and not vice versa. Sensation seeking also moderated the effect of watching R-rated movies on initiation of alcohol consumption such that exposure was associated with greater increases in initiation of alcohol use among low sensation than among high sensation seeking adolescents. The study provides empirical evidence of an environmental media effect on sensation seeking, and important new information about the relations among sensation seeking, media exposure, and adolescent alcohol use.

Effect of voluntary physical activity initiated at age 7 months on skeletal hindlimb and cardiac muscle function in mdx mice of both genders.

PubMed

Ferry, Arnaud; Benchaouir, Rachid; Joanne, Pierre; Peat, Rachel A; Mougenot, Nathalie; Agbulut, Onnik; Butler-Browne, Gillian

2015-11-01

The effects of voluntary activity initiated in adult mdx (C57BL/10ScSc-DMD(mdx) /J) mice on skeletal and cardiac muscle function have not been studied extensively. We studied the effects of 3 months of voluntary wheel running initiated at age 7 months on hindlimb muscle weakness, increased susceptibility to muscle contraction-induced injury, and left ventricular function in mdx mice. We found that voluntary wheel running did not worsen the deficit in force-generating capacity and the force drop after lengthening contractions in either mdx mouse gender. It increased the absolute maximal force of skeletal muscle in female mdx mice. Moreover, it did not affect left ventricular function, structural heart dimensions, cardiac gene expression of inflammation, fibrosis, or remodeling markers. These results indicate that voluntary activity initiated at age 7 months had no detrimental effects on skeletal or cardiac muscles in either mdx mouse gender. © 2015 Wiley Periodicals, Inc.

A Re-examination of the Lightcurves for Seven Hungaria Asteroids

NASA Astrophysics Data System (ADS)

Warner, Brian D.; Stephens, Robert, D.; Harris, Alan W.; Pravec, Petr

2009-10-01

During the course of a study of long period asteroids (f < 1/d) within the Hungaria asteroid population, the lightcurves for seven asteroids were re-examined using updated software and techniques. Several were found to have significantly different periods from those previously reported by two of the authors (Warner and Stephens). The most significant change was 2074 Shoemaker, which was initially reported to have a period of 57 h but now appears to be a binary asteroid with a primary period of 2.5328 ± 0.0004 h and a possible orbital period of 55.52 ± 0.01 h. The other asteroids that were re-examined were 1919 Clemence, 3043 San Diego, 3353 Jarvis, 4142 Dersu-Uzala, (20232) 1997 YK, and (101549) 1998 YY2. The reexamination showed once again the importance of placing data on at least an internal system to achieve accurate night-to-night calibrations.

The factors associated with longitudinal changes in liver stiffness in patients with chronic hepatitis B

PubMed Central

Yo, In Ku; Park, Jin Woong; Lee, Jong Joon; Lee, Jung Hyun; Won, In Sik; Na, Sun Young; Jang, Pil Kyu; Park, Pyung Hwa; Choi, Duck Joo; Kim, Yun Soo; Kim, Ju Hyun

2015-01-01

Background/Aims Liver stiffness (LS) as assessed by transient elastography (TE) can change longitudinally in patients with chronic hepatitis B (CHB). The aim of this study was to identify the factors that improve LS. Methods Between April 2007 and December 2012, 151 patients with CHB who underwent two TE procedures with an interval of about 2 years were enrolled. Ninety-six of the 151 patients were treated with nucleos(t)ide analogues [the antiviral therapy (+) group], while the remaining 55 patients were not [the antiviral therapy (-) group]. The two groups of patients were stratified according to whether they exhibited an improvement or a deterioration in LS during the study period (defined as an LS change of ≤0 or >0 kPa, respectively, over a 1-year period), and their data were compared. Results No differences were observed between the antiviral therapy (+) and (-) groups with respect to either their clinical characteristics or their initial LS. The observed LS improvement was significantly greater in the antiviral therapy (+) group than in the antiviral therapy (-) group (-3.0 vs. 0.98 kPa, P=0.011). In the antiviral therapy (+) group, the initial LS was higher in the LS improvement group (n=63) than in the LS deterioration group (n=33; 7.9 vs. 4.8 kPa, P<0.001). However, there were no differences in any other clinical characteristic. In the antiviral therapy (-) group, the initial LS was also higher in the LS improvement group (n=29) than in the LS deterioration group (n=26; 8.3 vs. 6.5 kPa, P=0.021), with no differences in any other clinical characteristic. Conclusions A higher initial LS was the only factor associated with LS improvement in patients with CHB in this study. PMID:25834800

The factors associated with longitudinal changes in liver stiffness in patients with chronic hepatitis B.

PubMed

Yo, In Ku; Kwon, Oh Sang; Park, Jin Woong; Lee, Jong Joon; Lee, Jung Hyun; Won, In Sik; Na, Sun Young; Jang, Pil Kyu; Park, Pyung Hwa; Choi, Duck Joo; Kim, Yun Soo; Kim, Ju Hyun

2015-03-01

Liver stiffness (LS) as assessed by transient elastography (TE) can change longitudinally in patients with chronic hepatitis B (CHB). The aim of this study was to identify the factors that improve LS. Between April 2007 and December 2012, 151 patients with CHB who underwent two TE procedures with an interval of about 2 years were enrolled. Ninety-six of the 151 patients were treated with nucleos(t)ide analogues [the antiviral therapy (+) group], while the remaining 55 patients were not [the antiviral therapy (-) group]. The two groups of patients were stratified according to whether they exhibited an improvement or a deterioration in LS during the study period (defined as an LS change of ≤0 or >0 kPa, respectively, over a 1-year period), and their data were compared. No differences were observed between the antiviral therapy (+) and (-) groups with respect to either their clinical characteristics or their initial LS. The observed LS improvement was significantly greater in the antiviral therapy (+) group than in the antiviral therapy (-) group (-3.0 vs. 0.98 kPa, P=0.011). In the antiviral therapy (+) group, the initial LS was higher in the LS improvement group (n=63) than in the LS deterioration group (n=33; 7.9 vs. 4.8 kPa, P<0.001). However, there were no differences in any other clinical characteristic. In the antiviral therapy (-) group, the initial LS was also higher in the LS improvement group (n=29) than in the LS deterioration group (n=26; 8.3 vs. 6.5 kPa, P=0.021), with no differences in any other clinical characteristic. A higher initial LS was the only factor associated with LS improvement in patients with CHB in this study.

Archeological Data Recovery at Algiers Point. Volume 1.

DTIC Science & Technology

1984-10-15

the Mississippi River directly across from the Vieux Carre, the Historic French Quarter of New Orleans. Algiers initially was settled in 1718 by early... French colonists, and today it is home to the large scale ship repair and dry dock facilities that support the Port of New Orleans. The Algiers Point...fourth period, from 1977 to the present, simply represents current occupation and land use. The initial, or Colonial period, began with French

Breeding biology of Mottled Ducks on agricultural lands in southwestern Louisiana

USGS Publications Warehouse

Durham, R.S.; Afton, A.D.

2006-01-01

Breeding biology of Anas fulvigula maculosa (Mottled Ducks) has been described in coastal marsh and associated habitats, but little information is available for agricultural habitats in Louisiana. We located nests to determine nest-initiation dates and clutch sizes during the primary breeding season (February-May) in 1999 (n = 29) and 2000 (n = 37) on agricultural lands in southwestern Louisiana. In 1999, 60% of located nests were initiated between 22 March and 10 April, whereas in 2000, only 22% of nests were initiated during the same time period. Average clutch size was 0.9 eggs smaller in 2000 than in 1999. Annual differences in reproductive parameters corresponded with extremely dry conditions caused by low rainfall before the laying period in 2000. Flooded rice fields appear to be important loafing and feeding habitat of Mottled Ducks nesting in agricultural lands, especially during drought periods when other wetland types are not available or where natural wetlands have been eliminated.

Effect of cultivating conditions on alpha-galactosidase production by a novel Aspergillus foetidus ZU-G1 strain in solid-state fermentation.

PubMed

Liu, Cai-qin; Chen, Qi-he; Cheng, Qian-jun; Wang, Jin-ling; He, Guo-qing

2007-05-01

The work is intended to achieve optimum culture conditions of alpha-galactosidase production by a mutant strain Aspergillus foetidus ZU-G1 in solid-state fermentation (SSF). Certain fermentation parameters involving moisture content, incubation temperature, cultivation period of seed, inoculum volume, initial pH value, layers of pledget, load size of medium and period of cultivation were investigated separately. The optimal cultivating conditions of alpha-galactosidase production in SSF were 60% initial moisture of medium, 28 degrees C incubation temperature, 18 h cultivation period of seed, 10% inoculum volume, 5.0 approximately 6.0 initial pH of medium, 6 layers of pledget and 10 g dry matter loadage. Under the optimized cultivation conditions, the maximum alpha-galactosidase production was 2 037.51 U/g dry matter near the 144th hour of fermentation.

Effect of cultivating conditions on α-galactosidase production by a novel Aspergillus foetidus ZU-G1 strain in solid-state fermentation

PubMed Central

Liu, Cai-qin; Chen, Qi-he; Cheng, Qian-jun; Wang, Jin-ling; He, Guo-qing

2007-01-01

The work is intended to achieve optimum culture conditions of α-galactosidase production by a mutant strain Aspergillus foetidus ZU-G1 in solid-state fermentation (SSF). Certain fermentation parameters involving moisture content, incubation temperature, cultivation period of seed, inoculum volume, initial pH value, layers of pledget, load size of medium and period of cultivation were investigated separately. The optimal cultivating conditions of α-galactosidase production in SSF were 60% initial moisture of medium, 28 °C incubation temperature, 18 h cultivation period of seed, 10% inoculum volume, 5.0~6.0 initial pH of medium, 6 layers of pledget and 10 g dry matter loadage. Under the optimized cultivation conditions, the maximum α-galactosidase production was 2 037.51 U/g dry matter near the 144th hour of fermentation. PMID:17542067

Numerical simulation study on the distribution law of smoke flow velocity in horizontal tunnel fire

NASA Astrophysics Data System (ADS)

Liu, Yejiao; Tian, Zhichao; Xue, Junhua; Wang, Wencai

2018-02-01

According to the fluid similarity theory, the simulation experiment system of mining tunnel fire is established. The grid division of experimental model roadway is carried on by GAMBIT software. By setting the boundary and initial conditions of smoke flow during fire period in FLUENT software, using RNG k-Ɛ two-equation turbulence model, energy equation and SIMPLE algorithm, the steady state numerical simulation of smoke flow velocity in mining tunnel is done to obtain the distribution law of smoke flow velocity in tunnel during fire period.

IODP Expedition 352 (Bonin Forearc): First Results

NASA Astrophysics Data System (ADS)

Pearce, J. A.; Reagan, M. K.; Stern, R. J.; Petronotis, K. E.

2014-12-01

IODP Expedition #352 (Testing Subduction Initiation and Ophiolite Models by Drilling the Outer Izu-Bonin-Mariana Forearc: July 30-Sept. 29, 2014) is just underway at the time of writing. It is testing the Stern-Bloomer hypothesis that subduction initiation (SI) was followed by a strongly extensional period of slab sinking and trench roll-back and then by a transitional period leading to the establishment of significant slab-parallel plate motion and hence normal subduction. The Expedition aims to carry out offset drilling at two sites near 28°30'N in the Bonin forearc. Ideally, these together will give the vertical volcanic stratigraphy needed to trace the geodynamic and petrogenetic processes associated with SI, and provide the complete reference section required for comparison with volcanic sequences of possible SI origin found on land in ophiolite complexes and elsewhere. We predict, but need to confirm, a c. 1.0-1.5km sequence with basal, MORB-like forearc basalts (known as FAB) marking the initial period of extension, boninites characterizing the transitional period, and tholeiitic and calc-alkaline lavas marking the establishment of normal arc volcanism. Study of such a sequence will enable us to understand the chemical gradients within and across these volcanic units, to reconstruct mantle flow and melting processes during the course of SI, and to test the hypothesis that fore-arc lithosphere created during SI is the birthplace of most supra-subduction zone ophiolites. Here, we present the first Expedition results, including (a) the volcanic stratigraphic record and subdivision into lava units, (b) the classifications and interpretations made possible by shipboard (portable XRF and ICP) analyses and down-hole measurements, and (c) the biostratigraphic, magnetic, mineralogical, sedimentary and structural constraints on the geological history of the SI section and the interactions between magmatic, hydrothermal and tectonic activity during its evolution.

Suicide in Greece 1992-2012: A time-series analysis.

PubMed

Papaslanis, Theodoros; Kontaxakis, Vassilis; Christodoulou, Christos; Konstantakopoulos, George; Kontaxaki, Maria-Irini; Papadimitriou, George N

2016-08-01

Since 2008, Greece has entered a long period of economic crisis with adverse effects on various aspects of daily life. In this frame, it is quite important to examine the suicide trends in Greece. Our analysis covered the period 1992-2012. 2012 was the last year for which official suicide data were available. The inclusion of data for pre-crisis period enabled us to assess trends in suicide preceding the economic crisis, starting in 2008. Trends in sex- and age-adjusted standardized suicide rates (SSR) were analyzed using joinpoint regression. Total SSR presented statistically significant annual decrease of 0.89% (95% confidence interval (CI): -1.7, -0.1) during the period 1992-2008. After 2009, the trend in total SSR increased statistically significant annual increase (12.48%; 95% CI: 0.3%, 26.1%). SSR in males presented an initial period of modest annual decrease (-0.84%; 95% CI: -1.6%, -0.1%), during the period 1992-2008. After 2009, an annual increase by 9.25% (95% CI: 2.7%, 16.3%) was revealed. No change in female SSR trend was observed during the studied period. According to the results of this study, there is clear evidence of an increase in the overall SSR and male SSR in Greece during the period of the current financial crisis. © The Author(s) 2016.

Linking long-term planetary N-body simulations with periodic orbits: application to white dwarf pollution

NASA Astrophysics Data System (ADS)

Antoniadou, Kyriaki I.; Veras, Dimitri

2016-12-01

Mounting discoveries of debris discs orbiting newly formed stars and white dwarfs (WDs) showcase the importance of modelling the long-term evolution of small bodies in exosystems. WD debris discs are, in particular, thought to form from very long-term (0.1-5.0 Gyr) instability between planets and asteroids. However, the time-consuming nature of N-body integrators which accurately simulate motion over Gyrs necessitates a judicious choice of initial conditions. The analytical tools known as periodic orbits can circumvent the guesswork. Here, we begin a comprehensive analysis directly linking periodic orbits with N-body integration outcomes with an extensive exploration of the planar circular restricted three-body problem (CRTBP) with an outer planet and inner asteroid near or inside of the 2:1 mean motion resonance. We run nearly 1000 focused simulations for the entire age of the Universe (14 Gyr) with initial conditions mapped to the phase space locations surrounding the unstable and stable periodic orbits for that commensurability. In none of our simulations did the planar CRTBP architecture yield a long-time-scale (≳0.25 per cent of the age of the Universe) asteroid-star collision. The pericentre distance of asteroids which survived beyond this time-scale (≈35 Myr) varied by at most about 60 per cent. These results help affirm that collisions occur too quickly to explain WD pollution in the planar CRTBP 2:1 regime, and highlight the need for further periodic orbit studies with the eccentric and inclined TBP architectures and other significant orbital period commensurabilities.

Orthopedic surgery postgraduate year 1 intern curriculum improves initial orthopedic in-training examination performance.

PubMed

Roberts, Craig S; Nyland, John; Broome, Brandon

2012-04-01

To determine the efficacy of an educational curriculum designed for orthopedic surgery postgraduate year 1 (PGY-1) interns to improve initial Orthopedic In-Training Examination (OITE) performance. A retrospective cohort study was performed that evaluated the PGY-1 intern OITE performance of one residency training program (n = 55) during 7-year periods before (1996-2002) and after structured curriculum implementation (2003-2009). Linear regression analysis revealed insignificant changes in median PGY-1 intern OITE percentile rank during the precurriculum period (R = 0.08, P = 0.53). Postcurriculum period comparisons revealed significantly improving PGY-1 intern OITE percentile rank (R = 0.46, P = 0.048). Pre- and postcurriculum median US Medical Licensing Examination (USMLE) Step I scores did not display statistically significant differences (218.2 ± 6.6 vs 229.1 ± 13.8, Mann-Whitney U test, z = -1.5, P = 0.10). Spearman rho correlations revealed a moderate relation (r = 0.61) between postcurriculum PGY-1 intern OITE percentile rank and USMLE Step I score, but not during the precurriculum period. A moderate relation (r = 0.50) also was observed between postcurriculum USMLE Step I score and average OITE percentile rank during the 5-year residency program, but not during the precurriculum period. PGY-1 intern OITE percentile rank improved significantly with the addition of a specially designed educational curriculum. The stronger USMLE Step I score and PGY-1 intern OITE percentile rank relation observed during the postcurriculum period suggests that interns who participated in the educational curriculum were better prepared to translate general medical and patient care knowledge into orthopedic surgery knowledge.

Time dependency of the prediction skill for the North Atlantic subpolar gyre in initialized decadal hindcasts

NASA Astrophysics Data System (ADS)

Brune, Sebastian; Düsterhus, André; Pohlmann, Holger; Müller, Wolfgang A.; Baehr, Johanna

2017-11-01

We analyze the time dependency of decadal hindcast skill in the North Atlantic subpolar gyre within the time period 1961-2013. We compare anomaly correlation coefficients and temporal interquartile ranges of total upper ocean heat content and sea surface temperature for three differently initialized sets of hindcast simulations with the global coupled model MPI-ESM. All initializations use weakly coupled assimilation with the same full value nudging in the atmospheric component and different assimilation techniques for oceanic temperature and salinity: (1) ensemble Kalman filter assimilating EN4 observations and HadISST data, (2) nudging of anomalies to ORAS4 reanalysis, (3) nudging of full values to ORAS4 reanalysis. We find that hindcast skill depends strongly on the evaluation time period, with higher hindcast skill during strong multiyear trends, especially during the warming in the 1990s and lower hindcast skill in the absence of such trends. Differences between the prediction systems are more pronounced when investigating any 20-year subperiod within the entire hindcast period. In the ensemble Kalman filter initialized hindcasts, we find significant correlation skill for up to 5-8 lead years, albeit along with an overestimation of the temporal interquartile range. In the hindcasts initialized by anomaly nudging, significant correlation skill for lead years greater than two is only found in the 1980s and 1990s. In the hindcasts initialized by full value nudging, correlation skill is consistently lower than in the hindcasts initialized by anomaly nudging in the first lead years with re-emerging skill thereafter. The Atlantic meridional overturning circulation reacts on the density changes introduced by oceanic nudging, this limits the predictability in the subpolar gyre in the first lead years. Overall, we find that a model-consistent assimilation technique can improve hindcast skill. Further, the evaluation of 20 year subperiods within the full hindcast period provides essential insights to judge the success of both the assimilation and the subsequent hindcast quality.

Delay of insulin initiation in patients with type 2 diabetes mellitus inadequately controlled with oral hypoglycemic agents (analysis of patient- and physician-related factors): A prospective observational DIPP-FACTOR study in Korea.

PubMed

Kim, Sin Gon; Kim, Nam Hoon; Ku, Bon Jeong; Shon, Ho Sang; Kim, Doo Man; Park, Tae Sun; Kim, Yong-Seong; Kim, In Joo; Choi, Dong Seop

2017-05-01

To assess the time to initiation of insulin therapy, and concurrently investigate both patient- and physician-related factors associated with delaying insulin therapy in Korean patients with type 2 diabetes uncontrolled by oral hypoglycemic agents (OHAs). This prospective, observational disease registry study was carried out across 69 centers in Korea. Type 2 diabetes patients who had received two or more OHAs within the past 5 years, had a glycated hemoglobin ≥8% in the past 6 months and had not received insulin were included. Data recorded on data collection forms during a 12-month period were analyzed. Of 2168 patients enrolled, 1959 were evaluated and classified as the insulin-initiated or insulin-delayed group. Insulin was prescribed for just 20% of the patients during a 1-year follow-up period, and less than half (44.5%) of the patients who were taking two OHAs started insulin after 6 years. Patient-related factors for delay in insulin initiation included older age, shorter duration of diabetes and lower glycated hemoglobin. Physician-related factors included age (~50 to <60 years), sex (women) and number (<1000) of patients consulted per month. Patient refusal (33.6%) and physicians' concerns of patient non-compliance (26.5%) were the major physician-reported reasons for delaying insulin therapy. Inconvenience of insulin therapy (51.6%) and fear of injection (48.2%) were the major reasons for patient refusal. Insulin initiation is delayed in patients with type 2 diabetes uncontrolled by two or more OHAs in Korea. Patient- and physician-related factors associated with this delay need to be addressed for better diabetes management. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

Differences Between African-American and European-American Women in the Association of Childhood Sexual Abuse With Initiation of Marijuana Use and Progression to Problem Use.

PubMed

Sartor, Carolyn E; Agrawal, Arpana; Grant, Julia D; Duncan, Alexis E; Madden, Pamela A F; Lynskey, Michael T; Heath, Andrew C; Bucholz, Kathleen K

2015-07-01

Childhood sexual abuse (CSA) is associated with elevated risk of early marijuana use and cannabis use disorder (CUD). Both the prevalence of CSA and the course of marijuana use differ between African Americans and European Americans. The current study aimed to determine whether these differences manifest in racial/ ethnic distinctions in the association of CSA with early and problem use of marijuana. Data were derived from female participants in a female twin study and a high-risk family study of substance use (n = 4,193, 21% African-American). Cox proportional hazard regression analyses using CSA to predict initiation of marijuana use and progression to CUD symptom(s) were conducted separately by race/ethnicity. Sibling status on the marijuana outcome was used to adjust for familial influences. CSA was associated with both stages of marijuana use in African-American and European-American women. The association was consistent over the risk period (hazard ratio [HR] = 1.57, 95% confidence interval [CI] [1.37, 1.79] for initiation; HR = 1.51, 95% CI [1.21, 1.88] for CUD symptom onset) in European-American women. In African-American women, the HRs for initiation were 2.52 (95% CI [1.52, 4.18]) before age 15, 1.82 (95% CI [1.36, 2.44]) at ages 15-17, and nonsignificant after age 17. In the CUD symptom model, CSA predicted onset only at age 21 and older (HR = 2.17, 95% CI [1.31, 3.59]). The association of CSA with initiation of marijuana use and progression to problem use is stable over time in European-American women, but in African-American women, it varies by developmental period. Findings suggest the importance of considering race/ethnicity in prevention efforts with this high-risk population.

Differences Between African-American and European- American Women in the Association of Childhood Sexual Abuse With Initiation of Marijuana Use and Progression to Problem Use

PubMed Central

Sartor, Carolyn E.; Agrawal, Arpana; Grant, Julia D.; Duncan, Alexis E.; Madden, Pamela A. F.; Lynskey, Michael T.; Heath, Andrew C.; Bucholz, Kathleen K.

2015-01-01

Objective: Childhood sexual abuse (CSA) is associated with elevated risk of early marijuana use and cannabis use disorder (CUD). Both the prevalence of CSA and the course of marijuana use differ between African Americans and European Americans. The current study aimed to determine whether these differences manifest in racial/ ethnic distinctions in the association of CSA with early and problem use of marijuana. Method: Data were derived from female participants in a female twin study and a high-risk family study of substance use (n = 4,193, 21% African-American). Cox proportional hazard regression analyses using CSA to predict initiation of marijuana use and progression to CUD symptom(s) were conducted separately by race/ethnicity. Sibling status on the marijuana outcome was used to adjust for familial influences. Results: CSA was associated with both stages of marijuana use in African-American and European-American women. The association was consistent over the risk period (hazard ratio [HR] = 1.57, 95% confidence interval [CI] [1.37, 1.79] for initiation; HR = 1.51, 95% CI [1.21, 1.88] for CUD symptom onset) in European-American women. In African-American women, the HRs for initiation were 2.52 (95% CI [1.52, 4.18]) before age 15, 1.82 (95% CI [1.36, 2.44]) at ages 15–17, and nonsignificant after age 17. In the CUD symptom model, CSA predicted onset only at age 21 and older (HR = 2.17, 95% CI [1.31, 3.59]). Conclusions: The association of CSA with initiation of marijuana use and progression to problem use is stable over time in European-American women, but in African-American women, it varies by developmental period. Findings suggest the importance of considering race/ethnicity in prevention efforts with this high-risk population. PMID:26098032

Medical and non-medical predictors of initiating long-term use of proton pump inhibitors: a nationwide cohort study of first-time users during a 10-year period.

PubMed

Haastrup, P F; Paulsen, M S; Christensen, R D; Søndergaard, J; Hansen, J M; Jarbøl, D E

2016-07-01

Studies of the increasing use of proton pump inhibitors (PPIs) have mainly focused on prevalent long-term use and associations with gastrointestinal morbidity and comedication. Little is known about non-medical characteristics of first-time users of PPI, and predictors of initiating long-term use of PPIs. To describe medical and non-medical characteristics of first-time PPI users during a 10-year period and to analyse predictors of initiation of long-term use (>60 defined daily doses (DDDs) within 6 months) of PPIs. A nationwide cohort study of first-time users of PPI. Data were collected from Danish national registers. Individuals redeeming their first prescription for a PPI (omeprazole, lansoprazole, pantoprazole, rabeprazole, esomeprazole) in 2001 and 2011 were identified. Redemption of more than 60 DDDs of PPI within 6 months defined long-term use. Logistic regression models were used to determine the associations between previous diagnoses, comedication and socio-economic characteristics and initiation of long-term use of PPIs in 2011. From 2001 to 2011 incidence of first-time users increased with an incidence rate ratio of 1.53 and mean quantity of PPI redeemed at first prescription increased by 44.6%. In 2011 a total of 37.6% redeemed >60 DDDs within 6 months, and 96% of the long-term users did not have a diagnosis registered which indicated treatment. New onset long-term use was significantly associated with low income and low educational level when adjusting for other predisposing variables. Proton pump inhibitor treatment is increasingly initiated with larger quantities prescribed for indications that are unidentifiable from the registers. Morbidity and comedication seem to be the strongest predictors of new onset long-term use of PPIs. However, there is also an independent social gradient. © 2016 John Wiley & Sons Ltd.

Factors influencing warfarin response in hospitalized patients

PubMed Central

Abdel-Aziz, Mahmoud I.; Ali, Mostafa A. Sayed; Hassan, Ayman K.M.; Elfaham, Tahani H.

2015-01-01

The objective of this study was to investigate the influence of simultaneous factors that potentially keep patients far from achieving target INR range at discharge in hospitalized patients. Prospective cross-sectional observational study conducted at the Cardiology Department and Intensive Care Unit (ICU) of the Assiut University Hospitals. One-hundred and twenty patients were enrolled in the study from July 2013 to January 2014. Outcome measures were discharge INRs, bleeding and thromboembolic episodes. Bivariate analysis and multinomial logistic regression were conducted to determine independent risk factors that can keep patients outside target INR range. Patients who were newly initiated warfarin on hospital admission were given low initiation dose (2.8 mg ± 0.9). They were more likely to have INR values below 1.5 during hospital stay, 13 (27.7%) patients compared with 9 (12.3%) previously treated patients, respectively (p = .034). We found that the best predictors of achieving below target INR range relative to within target INR range were; shorter hospital stay periods (OR, 0.82 for every day increase [95% CI, 0.72–0.94]), being a male patient (OR, 2.86 [95% CI, 1.05–7.69]), concurrent infection (OR, 0.21 [95% CI, 0.07–0.59]) and new initiation of warfarin therapy on hospital admission (OR, 3.73 [95% CI, 1.28–10.9]). Gender, new initiation of warfarin therapy on hospital admission, shorter hospital stay periods and concurrent infection can have a significant effect on discharge INRs. Initiation of warfarin without giving loading doses increases the risk of having INRs below 1.5 during hospital stay and increases the likelihood of a patient to be discharged with INR below target range. Following warfarin dosing nomograms and careful monitoring of the effect of various factors on warfarin response should be greatly considered. PMID:26702259

Longitudinal Study of Motor Performance and Its Relation to Motor Capacity in Children with Cerebral Palsy

ERIC Educational Resources Information Center

van Eck, Mirjam; Dallmeijer, Annet J.; Voorman, Jeanine M.; Becher, Jules G.

2009-01-01

Aim: The aim of this study was to describe the course of motor performance and analyse its relationship with motor capacity over a period of 3 years in 104 children (66 males, 38 females; 43% of those initially invited) with cerebral palsy (CP) aged 9, 11, and 13 years at the start of the study. Forty-one had hemiplegia, 42 diplegia, 21…

Breastfeeding initiation: An in-depth qualitative analysis of the perspectives of women and midwives using Social Cognitive Theory.

PubMed

Edwards, M E; Jepson, R G; McInnes, R J

2018-02-01

to explore women's and midwives' expectations, knowledge and experiences of breastfeeding initiation using Social Cognitive Theory. a qualitative study using focus group discussions and individual interviews. Breastfeeding initiation was defined for this study as a process within the first 48hours after birth. Data were analysed using qualitative inductive analysis then further deductive analysis using Social Cognitive Theory (SCT). a purposefully selected sample of primigravid antenatal and postnatal women (n=18) and practising midwives (n=18) from one Health Board area in Scotland. attachment of the baby to the breast at birth was hindered by sleepy babies and the busy unfamiliar hospital environment. These resulted in mothers struggling to maintain their motivation to breastfeed and to develop low self-efficacy. Instinctive attachment was rare. Midwives who considered it was normal for babies to be sleepy and unable to attach or feed at birth did not facilitate instinctive baby behaviour. Midwives sometimes experienced lack of autonomy and environmental circumstances that made women centred care difficult. Furthermore caring for high numbers of women, dependent on their help, resulted in reduced self-efficacy for providing effective breastfeeding support. interviewing both women and midwives specifically about initiation of breastfeeding has allowed for deeper insights into this critical period and enabled a comparison between the data obtained from mothers and midwives. The findings suggest that instinctive attachment is not an expectation of either mothers or midwives and results in a loss of breastfeeding confidence in both. to facilitate initiation there is a need for more research to develop appropriate maternal and midwifery skills, and make changes to the cultural environment in hospitals. Social Cognitive Theory could be used as a framework in both the antenatal and immediate postnatal period to develop strategies and materials to increase women's and midwives' self-efficacy specifically in initiation. Copyright © 2017 Elsevier Ltd. All rights reserved.

New closed analytical solutions for geometrically thick fluid tori around black holes. Numerical evolution and the onset of the magneto-rotational instability

NASA Astrophysics Data System (ADS)

Witzany, V.; Jefremov, P.

2018-06-01

Context. When a black hole is accreting well below the Eddington rate, a geometrically thick, radiatively inefficient state of the accretion disk is established. There is a limited number of closed-form physical solutions for geometrically thick (nonselfgravitating) toroidal equilibria of perfect fluids orbiting a spinning black hole, and these are predominantly used as initial conditions for simulations of accretion in the aforementioned mode. However, different initial configurations might lead to different results and thus observational predictions drawn from such simulations. Aims: We aim to expand the known equilibria by a number of closed multiparametric solutions with various possibilities of rotation curves and geometric shapes. Then, we ask whether choosing these as initial conditions influences the onset of accretion and the asymptotic state of the disk. Methods: We have investigated a set of examples from the derived solutions in detail; we analytically estimate the growth of the magneto-rotational instability (MRI) from their rotation curves and evolve the analytically obtained tori using the 2D magneto-hydrodynamical code HARM. Properties of the evolutions are then studied through the mass, energy, and angular-momentum accretion rates. Results: The rotation curve has a decisive role in the numerical onset of accretion in accordance with our analytical MRI estimates: in the first few orbital periods, the average accretion rate is linearly proportional to the initial MRI rate in the toroids. The final state obtained from any initial condition within the studied class after an evolution of ten or more orbital periods is mostly qualitatively identical and the quantitative properties vary within a single order of magnitude. The average values of the energy of the accreted fluid have an irregular dependency on initial data, and in some cases fluid with energies many times its rest mass is systematically accreted.

Effect of a Synbiotic Yogurt on Levels of Fecal Bifidobacteria, Clostridia, and Enterobacteria

PubMed Central

Palaria, Amrita; Johnson-Kanda, Ivy

2012-01-01

While ingestion of synbiotic yogurts containing Bifidobacterium animalis subsp. lactis and inulin is increasing, their effect on certain microbial groups in the human intestine is unclear. To further investigate this, a large-scale, crossover-design, placebo-controlled study was utilized to evaluate the effect of a synbiotic yogurt containing B. animalis subsp. lactis Bb-12 and inulin on the human intestinal bifidobacteria, clostridia, and enterobacteria. Fecal samples were collected at 14 time points from 46 volunteers who completed the study, and changes in the intestinal bacterial levels were monitored using real-time PCR. Strain Bb-12 could not be detected in feces after 2 weeks of washout. A live/dead PCR procedure indicated that the Bb-12 strain detected in the fecal samples was alive. A significant increase (P < 0.001) in the total bifidobacterial numbers was seen in both groups of subjects during the final washout period compared to the prefeeding period. This increase in total bifidobacteria corresponded with a significant decrease (P < 0.05) in numbers of clostridia but not enterobacteria. No significant differences in numbers of bifidobacteria, clostridia, or enterobacteria were observed between the probiotic and placebo groups during any of the feeding periods. However, subgrouping subjects based on lower initial bifidobacterial numbers or higher initial clostridial numbers did show corresponding significant differences between the synbiotic yogurt and placebo groups. This was not observed for a subgroup with higher initial enterobacterial numbers. While this synbiotic yogurt can increase bifidobacterial numbers and decrease clostridial numbers (but not enterobacterial numbers) in some individuals, it cannot modulate these microbial groups in the majority of individuals. PMID:22101054

Anxiety symptoms as a moderator of the reciprocal links between forms of aggression and peer victimization in middle childhood.

PubMed

Cooley, John L; Frazer, Andrew L; Fite, Paula J; Brown, Shaquanna; DiPierro, Moneika

2017-09-01

The current short-term longitudinal study evaluated whether anxiety symptoms moderated the bidirectional associations between forms (i.e., physical and relational) of aggression and peer victimization over a 1-year period during middle childhood. Participants were 228 predominantly Caucasian children (50.4% boys; M = 8.32 years, SD = .95 years) in the second through fourth grades and their homeroom teachers. Children completed a self-report measure of anxiety symptoms at Time 1. Peer victimization was assessed using self-reports at Time 1 and approximately 1 year later (Time 2), and teachers provided ratings of children's aggressive behavior at both time points. A series of cross-lagged path analysis models indicated that high (+1 SD) initial levels of anxiety symptoms exacerbated the prospective link from Time 1 relational aggression to Time 2 peer victimization; conversely, when initial levels of anxiety symptoms were low (-1 SD), relational aggression predicted lower levels of subsequent peer victimization. Time 1 peer victimization was also found to predict lower levels of Time 2 physical aggression when initial levels of anxiety symptoms were low, and Time 1 anxiety symptoms were uniquely related to higher levels of relational aggression over a 1-year period. Regions of significance were calculated to further decompose significant interactions, which did not differ according to gender. Study findings are discussed within a social information processing theoretical framework, and directions for future research and implications for practice are reviewed. Specifically, co-occurring anxiety symptoms may need to be addressed in interventions for both aggression and peer victimization during middle childhood. © 2017 Wiley Periodicals, Inc.

Somatosensory-evoked spikes on electroencephalography (EEG): longitudinal clinical and EEG aspects in 313 children.

PubMed

Fonseca, Lineu Corrêa; Tedrus, Gloria M A S

2012-01-01

Somatosensory-evoked spikes (ESp) are high-voltage potentials registered on the EEG, which accompany each of the percussions on the feet or hands. The objective of this research was to study the longitudinal clinical and EEG aspects of children with ESp. A total of 313 children, 53.7% male, showing ESp on the EEG and with an average initial age of 6.82 (range from 2 to 14 years) were followed for a mean period of 35.7 months. In the initial evaluation, 118 (37.7%) had a history of nonfebrile epileptic seizures (ES). Epileptiform activity (EA) was observed on the EEG in 61% and showed a significantly greater occurrence in children with ES than in those without (P = .000). Of the 118 showing seizures from the start, 53 (44.9%) continued to have seizures; of the 195 without seizures at the start, only 13 (6.67%) developed them. Thus, only 66 (21.1%) children showed ES during the follow-up. ESp disappeared in 237 (75.7%) cases and EA in 221 (70.6%). In the children with ES, it was found that the presence of EA on the first EEG did not indicate continuation of the ES throughout the remaining period, while the 13 children who presented their first ES in a later period showed a greater occurrence of EA on the initial EEG than those who did not develop ES (P = .001). Evidence of brain injury was observed in 43 (13.7%) children and was associated with a greater continuity of the ES during the study (P = .018). ESp, EA, and ES tend to disappear, suggesting an age-dependent phenomenon. The finding of ESp, particularly in the absence of any evidence of brain injury, indicates a low association with ES and benign outcome.

The Contribution of Soil Moisture Information to Forecast Skill: Two Studies

NASA Technical Reports Server (NTRS)

Koster, Randal

2010-01-01

This talk briefly describes two recent studies on the impact of soil moisture information on hydrological and meteorological prediction. While the studies utilize soil moisture derived from the integration of large-scale land surface models with observations-based meteorological data, the results directly illustrate the potential usefulness of satellite-derived soil moisture information (e.g., from SMOS and SMAP) for applications in prediction. The first study, the GEWEX- and ClIVAR-sponsored GLACE-2 project, quantifies the contribution of realistic soil moisture initialization to skill in subseasonal forecasts of precipitation and air temperature (out to two months). The multi-model study shows that soil moisture information does indeed contribute skill to the forecasts, particularly for air temperature, and particularly when the initial local soil moisture anomaly is large. Furthermore, the skill contributions tend to be larger where the soil moisture initialization is more accurate, as measured by the density of the observational network contributing to the initialization. The second study focuses on streamflow prediction. The relative contributions of snow and soil moisture initialization to skill in streamflow prediction at seasonal lead, in the absence of knowledge of meteorological anomalies during the forecast period, were quantified with several land surface models using uniquely designed numerical experiments and naturalized streamflow data covering mUltiple decades over the western United States. In several basins, accurate soil moisture initialization is found to contribute significant levels of predictive skill. Depending on the date of forecast issue, the contributions can be significant out to leads of six months. Both studies suggest that improvements in soil moisture initialization would lead to increases in predictive skill. The relevance of SMOS and SMAP satellite-based soil moisture information to prediction are discussed in the context of these studies.

48 CFR 48.104-1 - Determining sharing period.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CONTRACT MANAGEMENT VALUE ENGINEERING Policies and Procedures 48.104-1 Determining sharing period. (a.... (c) For engineering-development contracts and contracts containing low-rate-initial-production or...

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.

Regulatory focus as a mediator of the influence of initiating structure and servant leadership on employee behavior.

PubMed

Neubert, Mitchell J; Kacmar, K Michele; Carlson, Dawn S; Chonko, Lawrence B; Roberts, James A

2008-11-01

In this research, the authors test a model in which the regulatory focus of employees at work mediates the influence of leadership on employee behavior. In a nationally representative sample of 250 workers who responded over 2 time periods, prevention focus mediated the relationship of initiating structure to in-role performance and deviant behavior, whereas promotion focus mediated the relationship of servant leadership to helping and creative behavior. The results indicate that even though initiating structure and servant leadership share some variance in explaining other variables, each leadership style incrementally predicts disparate outcomes after controlling for the other style and dispositional tendencies. A new regulatory focus scale, the Work Regulatory Focus (WRF) Scale, also was developed and initially validated for this study. Implications for the results and the WRF Scale are discussed.

43 CFR 2450.4 - Protests: Initial classification decision.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Protests: Initial classification decision... CLASSIFICATION SYSTEM Petition-Application Procedures § 2450.4 Protests: Initial classification decision. (a) For a period of 30 days after the proposed classification decision has been served upon the parties...

On the Development of Turbulent Wakes from Vortex Streets

NASA Technical Reports Server (NTRS)

Roshko, Anatol

1954-01-01

Wake development behind circular cylinders at Reynolds numbers from 40 to 10,000 was investigated in a low-speed wind tunnel. Standard hot-wire techniques were used to study the velocity fluctuations. The Reynolds number range of periodic vortex shedding is divided into two distinct subranges. At r=40 to 150, called the stable range, regular vortex streets are formed and no turbulent velocity fluctuations accompany the periodic formation of vortices. The range r=150 to 300 is a transition range to a regime called the irregular range, in which turbulent velocity fluctuations accompany the periodic formation of vortices. The turbulence is initiated by laminar-turbulent transition in the free layers which spring from the separation points on the cylinder. The transition first occurs in the range r=150 to 300. Spectrum and statistical measurements were made to study the velocity fluctuations.

STS pricing policy

NASA Technical Reports Server (NTRS)

Lee, C. M.; Stone, B.

1982-01-01

In 1977 NASA published Shuttle Reimbursement Policies for Civil U.S. Government, DOD and Commercial and Foreign Users. These policies were based on the principle of total cost recovery over a period of time with a fixed flat price for initial period to time to enhance transition. This fixed period was to be followed with annual adjustments thereafter, NASA is establishing a new price for 1986 and beyond. In order to recover costs, that price must be higher than the initial fixed price through FY 1985. NASA intends to remain competitive. Competitive posture includes not only price, but other factors such as assured launch, reliability, and unique services. NASA's pricing policy considers all these factors.

Temporal morphologic changes in human colorectal carcinomas following xenografting.

PubMed

Barkla, D H; Tutton, P J

1983-03-01

The temporal morphologic changes of human colorectal carcinomas following xenografting into immunosuppressed mice were investigated by the use of light and transmission electron microscopy. The results show that colorectal carcinomas undergo a series of morphologic changes during the initial 30-day period following transplantation. During the initial 1-5-day period the majority of tumor cells die, and during the following 5-10-day period the necrotic debris created during the 1-5-day period is removed by host-supplied inflammatory cells. Only small groups of peripherally placed tumor cells survived at the end of the first 10 days. During the 10-20-day period the tumor cell populations of xenografts were reestablished by a morphologically heterogeneous population of tumor cells, and during the 20-30 day period consolidation of this process continued and some xenografts showed macroscopic evidence of growth. The authors hypothesize that human colorectal carcinomas, like the antecedent epithelium, contain subpopulations of undifferentiated cells that give rise to populations of more-differentiated cells.

Effect of initial conditions and of intra-event rainfall intensity variability on shallow landslide triggering return period

NASA Astrophysics Data System (ADS)

Peres, David Johnny; Cancelliere, Antonino

2016-04-01

Assessment of shallow landslide hazard is important for appropriate planning of mitigation measures. Generally, return period of slope instability is assumed as a quantitative metric to map landslide triggering hazard on a catchment. The most commonly applied approach to estimate such return period consists in coupling a physically-based landslide triggering model (hydrological and slope stability) with rainfall intensity-duration-frequency (IDF) curves. Among the drawbacks of such an approach, the following assumptions may be mentioned: (1) prefixed initial conditions, with no regard to their probability of occurrence, and (2) constant intensity-hyetographs. In our work we propose the use of a Monte Carlo simulation approach in order to investigate the effects of the two above mentioned assumptions. The approach is based on coupling a physically based hydrological and slope stability model with a stochastic rainfall time series generator. By this methodology a long series of synthetic rainfall data can be generated and given as input to a landslide triggering physically based model, in order to compute the return period of landslide triggering as the mean inter-arrival time of a factor of safety less than one. In particular, we couple the Neyman-Scott rectangular pulses model for hourly rainfall generation and the TRIGRS v.2 unsaturated model for the computation of transient response to individual rainfall events. Initial conditions are computed by a water table recession model that links initial conditions at a given event to the final response at the preceding event, thus taking into account variable inter-arrival time between storms. One-thousand years of synthetic hourly rainfall are generated to estimate return periods up to 100 years. Applications are first carried out to map landslide triggering hazard in the Loco catchment, located in highly landslide-prone area of the Peloritani Mountains, Sicily, Italy. Then a set of additional simulations are performed in order to compare the results obtained by the traditional IDF-based method with the Monte Carlo ones. Results indicate that both variability of initial conditions and of intra-event rainfall intensity significantly affect return period estimation. In particular, the common assumption of an initial water table depth at the base of the pervious strata may lead in practice to an overestimation of return period up to one order of magnitude, while the assumption of constant-intensity hyetographs may yield an overestimation by a factor of two or three. Hence, it may be concluded that the analysed simplifications involved in the traditional IDF-based approach generally imply a non-conservative assessment of landslide triggering hazard.

Study of the Mechanism of Liquid Slag Infiltration for Lubrication in Slab Continuous Casting

NASA Astrophysics Data System (ADS)

Zhang, Shaoda; Wang, Qiangqiang; He, Shengping; Wang, Qian

2018-04-01

Consistent and uniform lubrication of the solidifying shell, especially in the meniscus, is crucial for the smooth continuous casting operation and production of strands free of surface defects. Thus, the current study established a coupled model to study the inflow behavior of liquid slag to the mold-strand channel, taking the solidification of steel and slag and the periodic oscillation of mold into account. The difficulties and solutions for the simulation were described in detail. The predicted profiles of the slag rim and initial shell were in good agreement with the reports. The main results indicated that liquid slag could be squeezed out and back into the slag pool in a negative strip period while a large amount of liquid slag could infiltrate into the mold-strand channel. Thus, the amount of slag consumed in the negative strip period was relatively small compared with that in the positive strip period. The predicted variation of slag consumption during mold oscillation was periodic, and the average value was 0.274 kg/m2, which agreed well with the slag consumption in industrial practice. The current model can predict and optimize the oscillation parameters aiming at stable lubrication conditions.

Reproductive history and risk of type 2 diabetes mellitus in postmenopausal women: findings from the Women's Health Initiative.

PubMed

LeBlanc, Erin S; Kapphahn, Kristopher; Hedlin, Haley; Desai, Manisha; Parikh, Nisha I; Liu, Simin; Parker, Donna R; Anderson, Matthew; Aroda, Vanita; Sullivan, Shannon; Woods, Nancy F; Waring, Molly E; Lewis, Cora E; Stefanick, Marcia

2017-01-01

The aim of the study was to understand the association between women's reproductive history and their risk of developing type 2 diabetes. We hypothesized that characteristics signifying lower cumulative endogenous estrogen exposure would be associated with increased risk. Prospective cohort analysis of 124,379 postmenopausal women aged 50 to 79 years from the Women's Health Initiative (WHI). We determined age of menarche and final menstrual period, and history of irregular menses from questionnaires at baseline, and calculated reproductive length from age of menarche and final menstrual period. Presence of new onset type 2 diabetes was from self-report. Using multivariable Cox proportional hazards models, we assessed associations between reproductive variables and incidence of type 2 diabetes. In age-adjusted models, women with the shortest (<30 y) reproductive periods had a 37% (95% CI, 30-45) greater risk of developing type 2 diabetes than women with medium-length reproductive periods (36-40 y). Women with the longest (45+ y) reproductive periods had a 23% (95% CI, 12-37) higher risk than women with medium-length periods. These associations were attenuated after full adjustment (HR 1.07 [1.01, 1.14] for shortest and HR 1.09 [0.99, 1.22] for longest, compared with medium duration). Those with a final menstrual period before age 45 and after age 55 had an increased risk of diabetes (HR 1.04; 95% CI, 0.99-1.09 and HR 1.08; 95% CI, 1.01-1.14, respectively) compared to those with age of final menstrual period between 46 and 55 years. Timing of menarche and cycle regularity was not associated with risk after full adjustment. Reproductive history may be associated with type 2 diabetes risk. Women with shorter and longer reproductive periods may benefit from lifestyle counseling to prevent type 2 diabetes.

Dispersively formed quasi-periodic fast magnetosonic wavefronts due to the eruption of a nearby mini-filament

NASA Astrophysics Data System (ADS)

Shen, Yuandeng; Song, Tengfei; Liu, Yu

2018-06-01

Observational analysis is performed to study the excitation mechanism and propagation properties of a quasi-periodic fast-propagating (QFP) magnetosonic wave. The QFP wave was associated with the eruption of a nearby mini-filament and a small B4 Geostationary Operational Environmental Satellite (GOES) flare, which may indicate that the generation of a QFP wave does not require much flare energy. The propagation of the QFP wave was along a bundle of funnel-shaped open loops with a speed of about 1100 ± 78 km s-1 and an acceleration of -2.2 ± 1.1 km s-2. Periodicity analysis indicates that the periods of the QFP wave are 43 ± 6 and 79 ± 18 s. For the first time, we find that the periods of the QFP wave and the accompanying flare are inconsistent, which is different from the findings reported in previous studies. We propose that the present QFP wave was possibly caused by the mechanism of dispersive evolution of the initially broad-band disturbance resulting from the nearby mini-filament eruption.

Influence of different beverages on the force degradation of intermaxillary elastics: an in vitro study.

PubMed

Leão Filho, Jorge César Borges; Gallo, Daphine Beatriz; Santana, Regis Meller; Guariza-Filho, Odilon; Camargo, Elisa Souza; Tanaka, Orlando Motohiro

2013-01-01

The aim of this study was to evaluate in vitro the effects of frequently ingested beverages on force degradation of intermaxillary elastics. One hundred and eighty 1/4-inch intermaxillary elastics (TP Orthodontics) were immersed into six different beverages: (1) Coca-Cola®; (2) Beer; (3) Orange juice; (4) Red wine; (5) Coffee and (6) artificial saliva (control). The period of immersion was 15 min for the first and second cycles and 30 min for the third to fifth cycles. Tensile forces were read in a tensile testing machine before and after the five immersion cycles. One-way repeated measures ANOVA was used to identify significant differences. Force degradation was seen in all evaluated groups and at all observation periods (p<0.05). A greater degree of degradation was present at the initial periods, decreasing gradually over time. However, no statistically significant differences were seen among groups at the same periods, showing that different groups behaved similarly. The chemical nature of the evaluated beverages was not able to influence the degree of force degradation at all observation periods.

Using antibiograms to improve antibiotic prescribing in skilled nursing facilities.

PubMed

Furuno, Jon P; Comer, Angela C; Johnson, J Kristie; Rosenberg, Joseph H; Moore, Susan L; MacKenzie, Thomas D; Hall, Kendall K; Hirshon, Jon Mark

2014-10-01

Antibiograms have effectively improved antibiotic prescribing in acute-care settings; however, their effectiveness in skilled nursing facilities (SNFs) is currently unknown. To develop SNF-specific antibiograms and identify opportunities to improve antibiotic prescribing. Cross-sectional and pretest-posttest study among residents of 3 Maryland SNFs. Antibiograms were created using clinical culture data from a 6-month period in each SNF. We also used admission clinical culture data from the acute care facility primarily associated with each SNF for transferred residents. We manually collected all data from medical charts, and antibiograms were created using WHONET software. We then used a pretest-posttest study to evaluate the effectiveness of an antibiogram on changing antibiotic prescribing practices in a single SNF. Appropriate empirical antibiotic therapy was defined as an empirical antibiotic choice that sufficiently covered the infecting organism, considering antibiotic susceptibilities. We reviewed 839 patient charts from SNF and acute care facilities. During the initial assessment period, 85% of initial antibiotic use in the SNFs was empirical, and thus only 15% of initial antibiotics were based on culture results. Fluoroquinolones were the most frequently used empirical antibiotics, accounting for 54.5% of initial prescribing instances. Among patients with available culture data, only 35% of empirical antibiotic prescribing was determined to be appropriate. In the single SNF in which we evaluated antibiogram effectiveness, prevalence of appropriate antibiotic prescribing increased from 32% to 45% after antibiogram implementation; however, this was not statistically significant ([Formula: see text]). Implementation of antibiograms may be effective in improving empirical antibiotic prescribing in SNFs.

Reducing Overutilization of Testing for Clostridium difficile Infection in a Pediatric Hospital System: A Quality Improvement Initiative.

PubMed

Klatte, J Michael; Selvarangan, Rangaraj; Jackson, Mary Anne; Myers, Angela L

2016-01-01

Study objectives included addressing overuse of Clostridium difficile laboratory testing by decreasing submission rates of nondiarrheal stool specimens and specimens from children ≤12 months of age and determining resultant patient and laboratory cost savings associated with decreased testing. A multifaceted initiative was developed, and components included multiple provider education methods, computerized order entry modifications, and automatic declination from laboratory on testing stool specimens of nondiarrheal consistency and from children ≤12 months old. A run chart, demonstrating numbers of nondiarrheal plus infant stool specimens submitted over time, was developed to analyze the initiative's impact on clinicians' test-ordering practices. A p-chart was generated to evaluate the percentage of these submitted specimens tested biweekly over a 12-month period. Cost savings for patients and the laboratory were assessed at the study period's conclusion. Run chart analysis revealed an initial shift after the interventions, suggesting a temporary decrease in testing submission; however, no sustained differences in numbers of specimens submitted biweekly were observed over time. On the p-chart, the mean percentage of specimens tested before the intervention was 100%. After the intervention, the average percentage of specimens tested dropped to 53.8%. Resultant laboratory cost savings totaled nearly $3600, and patient savings on testing charges were ∼$32 000. Automatic laboratory declination of nondiarrheal stools submitted for CDI testing resulted in a sustained decrease in the number of specimens tested, resulting in significant laboratory and patient cost savings. Despite multiple educational efforts, no sustained changes in physician ordering practices were observed. Copyright © 2016 by the American Academy of Pediatrics.

Smoking patterns, depression, and sociodemographic variables among Flemish women during pregnancy and the postpartum period.

PubMed

De Wilde, Katrien S; Trommelmans, Leen C; Laevens, Hans H; Maes, Lea R; Temmerman, Marleen; Boudrez, Hedwig L

2013-01-01

Relationships among feelings of depression, smoking behavior, and educational level during pregnancy have been documented. Feelings of depression may contribute to persistent smoking during pregnancy. No longitudinal studies assessing feelings of depression in women with different antepartum and postpartum smoking patterns are available. The aim was to determine relationships between depressive symptoms, sociodemographic characteristics, and smoking pattern during and after pregnancy. An observational, prospective, noninterventional study was conducted. Data were collected during two stages of pregnancy (T0: <;16 weeks and T1: 32-34 weeks) and postpartum (T2: >6 weeks) in 523 Flemish women. Feelings of depression (measured using the Beck Depression Inventory [BDI]), smoking behavior, and sociodemographic variables were analyzed using a general linear mixed model implemented in SAS Proc MIXED. Smokers and initial smokers reported significantly more depressive symptoms at all time points compared with recent ex-smokers, nonsmokers, and initial nonsmokers (p <; .001). The three-way interaction among time point, smoking pattern, and educational level was significant (p = .02). Evolution of mean BDI over time differed by educational level. Among participants with a secondary school certificate or less, differences were observed between smokers and nonsmokers, recent ex-smokers and initial nonsmokers, and nonsmokers and initial nonsmokers. Among participants with a college or university degree, no differences were observed. A wide variety of smoking patterns were observed during pregnancy and early postpartum. Smoking patterns were associated with depression and showed complex interactions with educational level. Assessment and intervention for both smoking and depression are needed throughout the perinatal period to support the health of mothers, their infants, and families.

The Use of Pre-Storm Boundary-Layer Baroclinicity in Determining and Operationally Implementing the Atlantic Surface Cyclone Intensification Index

NASA Astrophysics Data System (ADS)

Cione, Joseph; Pietrafes, Leonard J.

The lateral motion of the Gulf Stream off the eastern seaboard of the United States during the winter season can act to dramatically enhance the low-level baroclinicity within the coastal zone during periods of offshore cold advection. The ralative close proximity of the Gulf Stream current off the mid-Atlantic coast can result in the rapid and intense destabilization of the marine atmospheric boundary layer directly above and shoreward of the Gulf Stream within this region. This airmass modification period often precedes either wintertime coastal cyclogenesis or the cyclonic re-development of existing mid-latitude cyclones. A climatological study investigating the relationship between the severity of the pre-storm, cold advection period and subsequent cyclogenic intensification was undertaken by Cione et al. in 1993. Findings from this study illustrate that the thermal structure of the continental airmass as well as the position of the Gulf Stream front relative to land during the pre-storm period (i.e., 24-48 h prior to the initial cyclonic intensification) are linked to the observed rate of surface cyclonic deepening for storms that either advected into or initially developed within the Carolina-southeast Virginia offshore coastal zone. It is a major objective of this research to test the potential operational utility of this pre-storm low level baroclinic linkage to subsequent cyclogenesis in an actual National Weather Service (NWS) coastal winter storm forecast setting.The ability to produce coastal surface cyclone intensity forecasts recently became available to North Carolina State University researchers and NWS forecasters. This statistical forecast guidance utilizes regression relationships derived from a nine-season (January 1982-April 1990), 116-storm study conducted previously. During the period between February 1994 and February 1996, the Atlantic Surface Cyclone Intensification Index (ASCII) was successfully implemented in an operational setting by the NWS at the Raleigh-Durham (RAH) forecast office for 10 winter storms. Analysis of these ASCII forecasts will be presented.

Open chest cardiac massage offers no benefit over closed chest compressions in patients with traumatic cardiac arrest.

PubMed

Bradley, Matthew J; Bonds, Brandon W; Chang, Luke; Yang, Shiming; Hu, Peter; Li, Hsiao-Chi; Brenner, Megan L; Scalea, Thomas M; Stein, Deborah M

2016-11-01

Open chest cardiac massage (OCCM) is a commonly performed procedure after traumatic cardiac arrest (TCA). OCCM has been reported to be superior to closed chest compressions (CCC) in animal models and in non-TCA. The purpose of this study is to prospectively compare OCCM versus CCC in TCA using end-tidal carbon dioxide (ETCO2), the criterion standard for determining the effectiveness of chest compressions and detection of return of spontaneous circulation (ROSC), as the surrogate for cardiac output and marker for adequacy of resuscitation. This prospective observational study enrolled patients over a 9-month period directly presenting to a level 1 trauma center after TCA. Continuous high-resolution ETCO2 measurements were collected every 6 seconds for periods of CCC and OCCM, respectively. Patients receiving CCC only were compared with patients receiving CCC followed by OCCM. Student's t tests were used to compare ETCO2 within and between groups. Thirty-three patients were enrolled (16 OCCM, 17 CCC-only). Mean time of CCC before OCCM was 66 seconds. Within the OCCM group, final, peak, mean, and median ETCO2 levels significantly increased when comparing the initial CCC period to the OCCM interval. Using a time-matched comparison, significant increases were observed in the final and peak but not mean and median values when comparing the first minute of CCC to the remaining time in the CCC-only group. However, when periods of OCCM were compared with equivalent periods of CCC-only, there were no differences in the initial, final, peak, mean, or median ETCO2 values. Correspondingly, no difference in rates of ROSC was observed between groups (OCCM 23.5% vs. CCC 38.9%; p = 0.53). Although we could not control for confounders, we found no significant improvement in ETCO2 or ROSC with OCCM. With newer endovascular techniques for aortic occlusion, thoracotomy solely for performing OCCM provides no benefit over CCC. Therapeutic study, level III.

Effect of viewing smoking in movies on adolescent smoking initiation: a cohort study.

PubMed

Dalton, Madeline A; Sargent, James D; Beach, Michael L; Titus-Ernstoff, Linda; Gibson, Jennifer J; Ahrens, M Bridget; Tickle, Jennifer J; Heatherton, Todd F

2003-07-26

Exposure to smoking in movies has been linked with adolescent smoking initiation in cross-sectional studies. We undertook a prospective study to ascertain whether exposure to smoking in movies predicts smoking initiation. We assessed exposure to smoking shown in movies in 3547 adolescents, aged 10-14 years, who reported in a baseline survey that they had never tried smoking. Exposure to smoking in movies was estimated for individual respondents on the basis of the number of smoking occurrences viewed in unique samples of 50 movies, which were randomly selected from a larger sample pool of popular contemporary movies. We successfully re-contacted 2603 (73%) students 13-26 months later for a follow-up interview to determine whether they had initiated smoking. Overall, 10% (n=259) of students initiated smoking during the follow-up period. In the highest quartile of exposure to movie smoking, 17% (107) of students had initiated smoking, compared with only 3% (22) in the lowest quartile. After controlling for baseline characteristics, adolescents in the highest quartile of exposure to movie smoking were 2.71 (95% CI 1.73-4.25) times more likely to initiate smoking compared with those in the lowest quartile. The effect of exposure to movie smoking was stronger in adolescents with non-smoking parents than in those whose parent smoked. In this cohort, 52.2% (30.0-67.3) of smoking initiation can be attributed to exposure to smoking in movies. Our results provide strong evidence that viewing smoking in movies promotes smoking initiation among adolescents.

Initial cash/asset ratio and asset prices: an experimental study.

PubMed

Caginalp, G; Porter, D; Smith, V

1998-01-20

A series of experiments, in which nine participants trade an asset over 15 periods, test the hypothesis that an initial imbalance of asset/cash will influence the trading price over an extended time. Participants know at the outset that the asset or "stock" pays a single dividend with fixed expectation value at the end of the 15th period. In experiments with a greater total value of cash at the start, the mean prices during the trading periods are higher, compared with those with greater amount of asset, with a high degree of statistical significance. The difference is most significant at the outset and gradually tapers near the end of the experiment. The results are very surprising from a rational expectations and classical game theory perspective, because the possession of a large amount of cash does not lead to a simple motivation for a trader to bid excessively on a financial instrument. The gradual erosion of the difference toward the end of trading, however, suggests that fundamental value is approached belatedly, offering some consolation to the rational expectations theory. It also suggests that there is a time scale on which an evolution toward fundamental value occurs. The experimental results are qualitatively compatible with the price dynamics predicted by a system of differential equations based on asset flow. The results have broad implications for the marketing of securities, particularly initial and secondary public offerings, government bonds, etc., where excess supply has been conjectured to suppress prices.

Initial cash/asset ratio and asset prices: An experimental study

PubMed Central

Caginalp, Gunduz; Porter, David; Smith, Vernon

1998-01-01

A series of experiments, in which nine participants trade an asset over 15 periods, test the hypothesis that an initial imbalance of asset/cash will influence the trading price over an extended time. Participants know at the outset that the asset or “stock” pays a single dividend with fixed expectation value at the end of the 15th period. In experiments with a greater total value of cash at the start, the mean prices during the trading periods are higher, compared with those with greater amount of asset, with a high degree of statistical significance. The difference is most significant at the outset and gradually tapers near the end of the experiment. The results are very surprising from a rational expectations and classical game theory perspective, because the possession of a large amount of cash does not lead to a simple motivation for a trader to bid excessively on a financial instrument. The gradual erosion of the difference toward the end of trading, however, suggests that fundamental value is approached belatedly, offering some consolation to the rational expectations theory. It also suggests that there is a time scale on which an evolution toward fundamental value occurs. The experimental results are qualitatively compatible with the price dynamics predicted by a system of differential equations based on asset flow. The results have broad implications for the marketing of securities, particularly initial and secondary public offerings, government bonds, etc., where excess supply has been conjectured to suppress prices. PMID:11038619

Impact of asthma, exposure period, and filters on human responses during exposures to ozone and its initiated chemistry products.

PubMed

Fadeyi, M O; Tham, K W; Wu, W Y

2015-10-01

The impact of asthma, exposure period, and filter condition downstream of the mixing box of air-conditioning system on building occupants' perceptual response, work performance, and salivary α-amylase secretion during exposures to ozone and its initiated chemistry products is studied. The experiments were conducted in a field environmental chamber (FEC) (240 m(3)) simulating an office environment. Experiments were conducted during periods when the air-handling system operated with new or used pleated panel filters at constant recirculation (7/h) and ventilation (1/h) rates. Average ozone and secondary organic aerosols (ozone-initiated chemistry products) measured during non-asthmatic and asthmatic subjects' 3-h exposures in the FEC were in the ranges approximately 20-37 ppb and approximately 1.6-3 μg/m(3), respectively. Asthmatic subjects' perceived odor intensity and sensory (eye, nose, and throat) irritation ratings were generally lower than those of non-asthmatic subjects, possibly explaining why asthmatic subjects accept perceived air quality more than non-asthmatic subjects. However, asthmatic subjects' perceived physiological-like symptom ratings (flu, chest tightness, and headache) and concentrations of secreted salivary α-amylase were generally higher than those of non-asthmatic subjects. Asthmatic subjects had significantly lower accuracy than non-asthmatic subjects in a task that required higher concentration although they had higher work speed. Filter condition did not make any significant difference for subjects' responses. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Twenty Years of Prescribed Burning Influence the Development of Direct-Seeded Longleaf Pine on a Wet Pine Site in Louisiana

Treesearch

James D. Haywood; Harold E. Grelen

2000-01-01

Prescribed burning treatments were applied over a 20 yr period in a commonly randomized field study to determine the effects of various fire regimes on vegetation in a direct seeded standof longleaf pine (Pinus palustris Mill.). Seeding was done in November 1968. The study area was broadcast-burned about 16 months after seeding. The initial...

Experimental Study of Impinging Jets Flow-Fields

DTIC Science & Technology

2016-07-27

1 Grant # N000141410830 Experimental Study of Impinging Jet Flow-Fields Final Report for Period: Jun 15, 2014 – Jun 14, 2016 PI: Dennis K...impinging jet model in the absence of any jet heating. The results of the computations had been compared with the experimental data produced in the...of the validity of the computations, and also of the experimental approach. Figure 12a. Initial single

The Legal Quality of Articles Published in School Psychology Journals: An Initial Report Card

ERIC Educational Resources Information Center

Zirkel, Perry A.

2014-01-01

As a follow-up to a companion study (Zaheer & Zirkel, in press) that focused on the legal content in school psychology, this analysis examined legal quality. The companion study found that only 35 of the more than 7,000 articles in five leading journals of school psychology for the period 1970-2013 met rather relaxed standards for being law…

A STUDY OF CURRICULUM CHANGES IN SELECTED TWO-YEAR COLLEGES INITIATED BY THE EVALUATION PROCESS USED BY THE MIDDLE STATES ASSOCIATION.

ERIC Educational Resources Information Center

BRASE, PETER CHARLES, JR.

DURING THE 1-YEAR PERIOD FOLLOWING ACCREDITATION COMMITTEE VISITS TO FOUR JUNIOR COLLEGES, THE AUTHOR VISITED THESE INSTITUTIONS AND STUDIED THEIR SELF-EVALUATION REPORTS AND THE VISITING COMMITTEE REPORTS, IN AN EFFORT TO DETERMINE THE EFFECTS OF THE ACCREDITATION PROCESS ON THE QUALITY OF INSTRUCTION. WHILE ACTIONS WERE TAKEN AS RESULTS OF BOTH…

Building as We Go: Secondary Schools, Community Colleges, and Universities in Partnership--The Early College High School Initiative

ERIC Educational Resources Information Center

Bush, V. Barbara

2017-01-01

The purpose of this study was to examine the perceptions of key informants about the processes of institutional change and collaboration involved in the development of three early college high schools (ECHS)s over a 4-year period. The 15 study participants were members of early college high school councils and included high school principals,…

Potential of Non Formal Basic Education in Promoting Women Education in Pakistan

ERIC Educational Resources Information Center

Jumani, Nabi Bux; Rahman, Fazal-ur; Bibi, Khadija

2011-01-01

The present study aimed to assess the performance of a non-formal basic education (NFBE) schools project initiated in the province of Punjab with the assistance of the Japan International Co-operation Agency (JICA). The study was conducted in 120 NFBE schools in four districts of Punjab and it lasted for a period of three months. It was a survey…

Stability of nitrate-ion concentrations in simulated deposition samples used for quality-assurance activities by the U.S. Geological Survey

USGS Publications Warehouse

Willoughby, T.C.; See, R.B.; Schroder, L.J.

1989-01-01

Three experiments were conducted to determine the stability of nitrate-ion concentrations in simulated deposition samples. In the four experiment-A solutions, nitric acid provided nitrate-ion concentrations ranging from 0.6 to 10.0 mg/L and that had pH values ranging from 3.8 to 5.0. In the five experiment-B solutions, sodium nitrate provided nitrate-ion concentrations ranging from 0.5 to 3.0 mg/L. The pH was adjusted to about 4.5 for each of the solutions by addition of sulfuric acid. In the four experiment-C solutions, nitric acid provided nitrate-ion concentrations ranging from 0.5 to 3.0 mg/L. Major cation and anion concentrations were added to each solution to simulate natural deposition. Aliquots were removed from the 13 original solutions and analyzed by ion chromatography about once a week for 100 days to determine if any changes occurred in nitrate-ion concentrations throughout the study period. No substantial changes were observed in the nitrate-ion concentrations in solutions that had initial concentrations below 4.0 mg/L in experiments A and B, although most of the measured nitrate-ion concentrations for the 100-day study were below the initial concentrations. In experiment C, changes in nitrate-ion concentrations were much more pronounced; the measured nitrate-ion concentrations for the study period were less than the initial concentrations for 62 of the 67 analyses. (USGS)

Stability of alemtuzumab solutions at room temperature.

PubMed

Goldspiel, Justin T; Goldspiel, Barry R; Grimes, George J; Yuan, Peng; Potti, Gopal

2013-03-01

The 24-hour stability of alemtuzumab solutions prepared at concentrations not included in the product label and stored in glass or polyolefin containers at room temperature was evaluated. Triplicate solutions of alemtuzumab (6.67, 40, and 120 μg/mL) in 0.9% sodium chloride were prepared in either glass bottles or polyolefin containers and stored at room temperature under normal fluorescent lighting conditions. The solutions were analyzed by a validated stability-indicating high-performance liquid chromatography (HPLC) assay at time zero and 8, 14, and 24 hours after preparation; solution pH values were measured and the containers visually inspected at all time points. Stability was defined as the retention of ≥90% of the initial alemtuzumab concentration. HPLC analysis indicated that the percentage of the initial alemtuzumab concentration retained was >90% for all solutions evaluated, with no significant changes over the study period. The most dilute alemtuzumab solution (6.67 μg/mL) showed some degradation (91% of the initial concentration retained at hour 24), whereas the retained concentration was >99% for all other preparations throughout the study period. Solution pH values varied by drug concentration but did not change significantly over 24 hours. No evidence of particle formation was detected in any solution by visual inspection at any time during the study. Solutions of alemtuzumab 6.67 μg/mL stored in glass bottles and solutions of 40 and 120 μg/mL stored in polyolefin containers were stable for at least 24 hours at room temperature.

29 CFR 417.13 - Initial decision of Administrative Law Judge.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 2 2010-07-01 2010-07-01 false Initial decision of Administrative Law Judge. 417.13 Section 417.13 Labor Regulations Relating to Labor OFFICE OF LABOR-MANAGEMENT STANDARDS, DEPARTMENT OF... § 417.13 Initial decision of Administrative Law Judge. Within 25 days following the period for...

ACTION OF TRITIATED TETANUS TOXIN AND TOXOID UPON THE ANTIBODY-FORMING MECHANISM. Period Covered : April 1, 1963-March 31, 1964

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

Speirs, R.

1963-12-01

Progress is reported in studies on the localization of tritiated polysaccharides in immunized and non-immunized mice, mechanisms of hypersensitivity and immunity, the initiation of antibody production in irradiated mice, and the augmentation of immunity in mice by cell-free extracts. (C.H.)

Research Knowledge Assessment: A Study of MSW Students' Acquisition and Retention of Research Knowledge

ERIC Educational Resources Information Center

Secret, Mary; Abell, Melissa L.; Ward, Christopher J.; Charles, Jennifer L. K.; Perkins, Nathan H.

2017-01-01

In response to the need for meaningful data about student learning in research courses, we developed and implemented the Research Knowledge Assessment instrument to measure MSW student acquisition, application, and retention of research knowledge over a 3-year period across the research curriculum. Initial findings indicated that students entered…

Changes in Career Intent during Initial Tour of Active Duty.

ERIC Educational Resources Information Center

Shenk, Faye

The study was designed to determine the predictability of an Air Force officer's career decision and to evaluate relationships between career decision and various demographic, environmental, and attitudinal factors. Information on this group was compiled for the period before commissioning and through five years of active duty. The report presents…

Black and White in School: Trust, Tension, or Tolerance?

ERIC Educational Resources Information Center

Schofield, Janet Ward

The study on which this book is based examined the development of social relationships among black and white students in a new, desegregated urban middle school. In the initial phase, information was gathered from classroom observation, interviews, and a wide variety of supplementary sources over a three-year period beginning with summer…

Evaluation of 2, 4-D Ester and Triclopyr Amine Against Waterlily and Spatterdock

DTIC Science & Technology

2008-03-01

watermilfoil control (Elliston and Steward 1972, Green and Westerdahl 1990). Results from this initial study also indicate that triclopyr may be less...of Eurasian watermilfoil to various concentrations and exposure periods of 2,4-D. Hyacinth Control J. 10:38-40. Green, W. R., and H. E. Westerdahl

Microbial community and chemical characteristics of swine manure during maturation

USDA-ARS?s Scientific Manuscript database

Standardizing diet formulation studies that are designed to lower emission is needed for properly evaluating the impact diets have on emissions. Three groups of 12 pigs (84 kg initial BW) were feed a standard corn-soybean mean diet over a 13 wk period to determine how the length of manure storage af...

Challenges of Literacy Coaching in High School

ERIC Educational Resources Information Center

Gross, Patricia A.

2012-01-01

This qualitative case study examined a state-run, foundation-funded initiative to introduce literacy coaching in a medium-sized urban high school district over a period of two years. Data analyses revealed the complex development and multiple understandings of the process of literacy coaching on the secondary level. The role of the coaches…

Influence of long-term land application of class B biosolids on soil bacterial diversity

USDA-ARS?s Scientific Manuscript database

This project evaluated the influence of annual land applications of Class B biosolids on soil bacterial diversity monitored over a 20 year period. Each annual land application was followed by a cotton crop. The study was initiated in 1986 at the University of Arizona Marana Agricultural Center, 21 m...

Landscapes, Spatial Justice and Learning Communities

ERIC Educational Resources Information Center

Armstrong, Felicity

2012-01-01

This paper draws on a study of a community-based adult education initiative, "Cumbria Credits," which took place during the period of serious economic decline which hit sections of the farming and the wider community in Cumbria during 2001. It draws on the principles underpinning Edward Soja's notion of "spatial justice" to explore transformations…

Area Wide Field Study on Effect of Three Chitin Synthesis Inhibitor Baits on Populations of Coptotermes formosanus Shiraki and Reticulitermes flavipes (Kollar) (Isoptera: Rhinotermitidae)

USDA-ARS?s Scientific Manuscript database

Periodic sampling of 43 independent monitors, initially active with Formosan subterranean termite, Coptotermes formosanus Shiraki, or the eastern subterranean termite, Reticulitermes flavipes (Kollar) was conducted to evaluate the effects of cellulose baits containing one of three chitin synthesis i...

Young People's Safety Beliefs after a Spinal Cord Injury Health Promotion and Awareness Presentation

ERIC Educational Resources Information Center

Watling, David P.; Bishara, Jason D.; Zeeman, Heidi

2018-01-01

Objective: Adolescence is presented as a vulnerable period for accidental injury, particularly spinal cord injury, given young people's propensity for risky behaviours. School-based health promotion initiatives provide opportunities for education about the risks associated with dangerous behaviours. In this study, we aimed to describe young…

The Magellan Project: Developing Global Citizens through Independent Study Abroad

ERIC Educational Resources Information Center

Haring-Smith, Tori

2011-01-01

In January 2005, when this author became president of Washington & Jefferson College (W&J), one of her first initiatives was to expand the international program. A private, residential liberal arts college about 25 miles outside of Pittsburgh, W&J had undergone a period of significant growth, with enrollment increasing from 1,000 to…

Mother-Infant Activities: The Initial Step in Language Development in the Deaf-Blind Child.

ERIC Educational Resources Information Center

Vitagliano, James; Purdy, Susan

1987-01-01

The exploratory study examined the effectiveness of the Van Dijk method of developing language skills with four deaf-blind infants and their mothers over a two-month period. Findings indicated increased expressive/elocutionary communicative output with concomitant reduction in self-stimulatory, abusive, and tantrum-like behaviors. (DB)

Analysis of the finescale timing of repeated signals: does shell rapping in hermit crabs signal stamina?

PubMed

Briffa; Elwood

2000-01-01

Hermit crabs, Pagurus bernhardus, sometimes exchange shells after a period of shell rapping, when the initiating or attacking crab brings its shell rapidly and repeatedly into contact with the shell of the noninitiator or defender in a series of bouts. Bouts are separated by pauses, and raps within bouts are separated by very short periods called 'gaps'. Since within-contest variation is missed when signals are studied by averaging performance rates over entire contests, we analysed the fine within-bout structure of this repeated, aggressive signal. We found that the pattern is consistent with high levels of fatigue in initiators. The duration of the gaps between individual raps increased both within bouts and from bout to bout, and we conclude that this activity is costly to perform. Furthermore, long pauses between bouts is correlated with increased vigour of rapping in the subsequent bout, which suggests that the pause allows for recovery from fatigue induced by rapping. These between-bout pauses may be assessed by noninitiators and provide a signal of stamina. Copyright 2000 The Association for the Study of Animal Behaviour.

Evaluation of NU-WRF Rainfall Forecasts for IFloodS

NASA Technical Reports Server (NTRS)

Wu, Di; Peters-Lidard, Christa; Tao, Wei-Kuo; Petersen, Walter

2016-01-01

The Iowa Flood Studies (IFloodS) campaign was conducted in eastern Iowa as a pre- GPM-launch campaign from 1 May to 15 June 2013. During the campaign period, real time forecasts are conducted utilizing NASA-Unified Weather Research and Forecasting (NU-WRF) model to support the everyday weather briefing. In this study, two sets of the NU-WRF rainfall forecasts are evaluated with Stage IV and Multi-Radar Multi-Sensor (MRMS) Quantitative Precipitation Estimation (QPE), with the objective to understand the impact of Land Surface initialization on the predicted precipitation. NU-WRF is also compared with North American Mesoscale Forecast System (NAM) 12 kilometer forecast. In general, NU-WRF did a good job at capturing individual precipitation events. NU-WRF is also able to replicate a better rainfall spatial distribution compare with NAM. Further sensitivity tests show that the high-resolution makes a positive impact on rainfall forecast. The two sets of NU-WRF simulations produce very close rainfall characteristics. The Land surface initialization do not show significant impact on short term rainfall forecast, and it is largely due to the soil conditions during the field campaign period.

Preharvest Interval Periods and their relation to fruit growth stages and pesticide formulations.

PubMed

Alister, Claudio; Araya, Manuel; Becerra, Kevin; Saavedra, Jorge; Kogan, Marcelo

2017-04-15

The aim of this study was to evaluate the effect of pesticide formulations and fruit growth stages on the Pre-harvest Interval Period (PHI). Results showed that pesticide formulations did not affect the initial deposit and dissipation rate. However, the fruit growth stage at the application time showed a significant effect on the above-mentioned parameters. Fruit diameter increases in one millimeter pesticide dissipation rates were reduced in -0.033mgkg -1 day -1 (R 2 =0.87; p<0.001) for grapes and -0.014mgkg -1 day -1 (R 2 =0.85; p<0.001) for apples. The relation between solar radiation, air humidity and temperature, and pesticide dissipation rates were dependent on fruit type. PHI could change according to the application time, because of the initial amount of pesticide deposit in the fruits and change in the dissipation rates. Because Maximum Residue Level are becoming more restrictive, it is more important to consider the fruit growth stage effects on pesticide when performing dissipation studies to define PHI. Copyright © 2016. Published by Elsevier Ltd.

Stability and compatibility of the mixture of tramadol, ketorolac, metoclopramide and ranitidine in a solution for intravenous perfusion.

PubMed

Cabrera, J; Mancuso, M; Cabrera-Fránquiz, F; Limiñana, J; Díez, A

2011-01-01

To determine whether a mixture for intravenous perfusion containing tramadol (5 mg/ml), ranitidine (1.5 mg/ml), ketorolac (1.5 mg/ml) and metoclopramide (0.5 mg/ml) in a 0.9% sodium chlorides solution is compatible and stable at room temperature during a 48-hour period. We tested the mixture for stability using the HPLC technique (high performance liquid chromatography), with parallel visual assessments of any changes in colour, appearance of precipitate or phase separation indicating incompatibilities between the components. At the end of the trial, chromatography data showed a mean metoclopramide concentration between 100% and 105% of the initial level, while concentrations of tramadol, ketorolac and ranitidine were between 99% and 102% of initial levels. There was no evidence of incompatibility between the drugs at any time during the study period. The combination is stable as a solution and its components are physically and chemically compatible in the concentrations used in the study, during at least 48 hours at room temperature. Copyright © 2008 SEFH. Published by Elsevier Espana. All rights reserved.

Nonuniform dependence on initial data for compressible gas dynamics: The periodic Cauchy problem

NASA Astrophysics Data System (ADS)

Keyfitz, B. L.; Tığlay, F.

2017-11-01

We start with the classic result that the Cauchy problem for ideal compressible gas dynamics is locally well posed in time in the sense of Hadamard; there is a unique solution that depends continuously on initial data in Sobolev space Hs for s > d / 2 + 1 where d is the space dimension. We prove that the data to solution map for periodic data in two dimensions although continuous is not uniformly continuous.

Associations of Openness and Conscientiousness With Walking Speed Decline: Findings From the Health, Aging, and Body Composition Study

PubMed Central

Costa, Paul T.; Terracciano, Antonio; Ferrucci, Luigi; Faulkner, Kimberly; Coday, Mathilda (Mace) C.; Ayonayon, Hilsa N.; Simonsick, Eleanor M.

2012-01-01

Objectives. The objective of this study was to explore the associations between openness to experience and conscientiousness, two dimensions of the five-factor model of personality, and usual gait speed and gait speed decline. Method. Baseline analyses were conducted on 907 men and women aged 71–82 years participating in the Cognitive Vitality substudy of the Health, Aging, and Body Composition study. The longitudinal analytic sample consisted of 740 participants who had walking speed assessed 3 years later. Results. At baseline, gait speed averaged 1.2 m/s, and an average decline of 5% over the 3-year follow-up period was observed. Higher conscientiousness was associated with faster initial walking speed and less decline in walking speed over the study period, independent of sociodemographic characteristics. Lifestyle factors and disease status appear to play a role in the baseline but not the longitudinal association between conscientiousness and gait speed. Openness was not associated with either initial or decline in gait speed. Discussion. These findings extend the body of evidence suggesting a protective association between conscientiousness and physical function to performance-based assessment of gait speed. Future studies are needed to confirm these associations and to explore mechanisms that underlie the conscientiousness mobility connection in aging adults. PMID:22451484

Analytical study of the critical behavior of the nonlinear pendulum

NASA Astrophysics Data System (ADS)

Lima, F. M. S.

2010-11-01

The dynamics of a simple pendulum consisting of a small bob and a massless rigid rod has three possible regimes depending on its total energy E: Oscillatory (when E is not enough for the pendulum to reach the top position), "perpetual ascent" when E is exactly the energy needed to reach the top, and nonoscillatory for greater energies. In the latter regime, the pendulum rotates periodically without velocity inversions. In contrast to the oscillatory regime, for which an exact analytic solution is known, the other two regimes are usually studied by solving the equation of motion numerically. By applying conservation of energy, I derive exact analytical solutions to both the perpetual ascent and nonoscillatory regimes and an exact expression for the pendulum period in the nonoscillatory regime. Based on Cromer's approximation for the large-angle pendulum period, I find a simple approximate expression for the decrease of the period with the initial velocity in the nonoscillatory regime, valid near the critical velocity. This expression is used to study the critical slowing down, which is observed near the transition between the oscillatory and nonoscillatory regimes.

The time course of corticospinal excitability during a simple reaction time task.

PubMed

Kennefick, Michael; Maslovat, Dana; Carlsen, Anthony N

2014-01-01

The production of movement in a simple reaction time task can be separated into two time periods: the foreperiod, which is thought to include preparatory processes, and the reaction time interval, which includes initiation processes. To better understand these processes, transcranial magnetic stimulation has been used to probe corticospinal excitability at various time points during response preparation and initiation. Previous research has shown that excitability decreases prior to the "go" stimulus and increases following the "go"; however these two time frames have been examined independently. The purpose of this study was to measure changes in CE during both the foreperiod and reaction time interval in a single experiment, relative to a resting baseline level. Participants performed a button press movement in a simple reaction time task and excitability was measured during rest, the foreperiod, and the reaction time interval. Results indicated that during the foreperiod, excitability levels quickly increased from baseline with the presentation of the warning signal, followed by a period of stable excitability leading up to the "go" signal, and finally a rapid increase in excitability during the reaction time interval. This excitability time course is consistent with neural activation models that describe movement preparation and response initiation.

The Madden-Julian Oscillation and its Impact on Northern Hemisphere Weather Predictability during Wintertime

NASA Technical Reports Server (NTRS)

Jones, Charles; Waliser, Duane E.; Lau, K. M.; Stern, W.

2003-01-01

The Madden-Julian Oscillation (MJO) is known as the dominant mode of tropical intraseasonal variability and has an important role in the coupled-atmosphere system. This study used twin numerical model experiments to investigate the influence of the MJO activity on weather predictability in the midlatitudes of the Northern Hemisphere during boreal winter. The National Aeronautics and Space Administration (NASA) Goddard laboratory for the Atmospheres (GLA) general circulation model was first used in a 10-yr simulation with fixed climatological SSTs to generate a validation data set as well as to select initial conditions for active MJO periods and Null cases. Two perturbation numerical experiments were performed for the 75 cases selected [(4 MJO phases + Null phase) _ 15 initial conditions in each]. For each alternative initial condition, the model was integrated for 90 days. Mean anomaly correlations in the midlatitudes of the Northern Hemisphere (2O deg N_60 deg.N) and standardized root-mean-square errors were computed to validate forecasts and control run. The analyses of 500-hPa geopotential height, 200-hPa Streamfunction and 850-hPa zonal wind component systematically show larger predictability during periods of active MJO as opposed to quiescent episodes of the oscillation.

Nitric oxide production by cultured human aortic smooth muscle cells: stimulation by fluid flow

NASA Technical Reports Server (NTRS)

Papadaki, M.; Tilton, R. G.; Eskin, S. G.; McIntire, L. V.

1998-01-01

This study demonstrated that exposure of cultured human aortic smooth muscle cells (SMC) to fluid flow resulted in nitric oxide (NO) production, monitored by nitrite and guanosine 3',5'-cyclic monophosphate production. A rapid burst in nitrite production rate was followed by a more gradual increase throughout the period of flow exposure. Neither the initial burst nor the prolonged nitrite production was dependent on the level of shear stress in the range of 1.1-25 dyn/cm2. Repeated exposure to shear stress after a 30-min static period restimulated nitrite production similar to the initial burst. Ca(2+)-calmodulin antagonists blocked the initial burst in nitrite release. An inhibitor of nitric oxide synthase (NOS) blocked nitrite production, indicating that changes in nitrite reflect NO production. Treatment with dexamethasone or cycloheximide had no effect on nitrite production. Monoclonal antibodies directed against the inducible and endothelial NOS isoforms showed no immunoreactivity on Western blots, whereas monoclonal antibodies directed against the neuronal NOS gave specific products. These findings suggest that human aortic SMC express a constitutive neuronal NOS isoform, the enzymatic activity of which is modulated by flow.

Extreme multistability analysis of memristor-based chaotic system and its application in image decryption

NASA Astrophysics Data System (ADS)

Li, Chuang; Min, Fuhong; Jin, Qiusen; Ma, Hanyuan

2017-12-01

An active charge-controlled memristive Chua's circuit is implemented, and its basic properties are analyzed. Firstly, with the system trajectory starting from an equilibrium point, the dynamic behavior of multiple coexisting attractors depending on the memristor initial value and the system parameter is studied, which shows the coexisting behaviors of point, period, chaos, and quasic-period. Secondly, with the system motion starting from a non-equilibrium point, the dynamics of extreme multistability in a wide initial value domain are easily conformed by new analytical methods. Furthermore, the simulation results indicate that some strange chaotic attractors like multi-wing type and multi-scroll type are observed when the observed signals are extended from voltage and current to power and energy, respectively. Specially, when different initial conditions are taken, the coexisting strange chaotic attractors between the power and energy signals are exhibited. Finally, the chaotic sequences of the new system are used for encrypting color image to protect image information security. The encryption performance is analyzed by statistic histogram, correlation, key spaces and key sensitivity. Simulation results show that the new memristive chaotic system has high security in color image encryption.

An open trial assessment of "The Number Race", an adaptive computer game for remediation of dyscalculia

PubMed Central

Wilson, Anna J; Revkin, Susannah K; Cohen, David; Cohen, Laurent; Dehaene, Stanislas

2006-01-01

Background In a companion article [1], we described the development and evaluation of software designed to remediate dyscalculia. This software is based on the hypothesis that dyscalculia is due to a "core deficit" in number sense or in its access via symbolic information. Here we review the evidence for this hypothesis, and present results from an initial open-trial test of the software in a sample of nine 7–9 year old children with mathematical difficulties. Methods Children completed adaptive training on numerical comparison for half an hour a day, four days a week over a period of five-weeks. They were tested before and after intervention on their performance in core numerical tasks: counting, transcoding, base-10 comprehension, enumeration, addition, subtraction, and symbolic and non-symbolic numerical comparison. Results Children showed specific increases in performance on core number sense tasks. Speed of subitizing and numerical comparison increased by several hundred msec. Subtraction accuracy increased by an average of 23%. Performance on addition and base-10 comprehension tasks did not improve over the period of the study. Conclusion Initial open-trial testing showed promising results, and suggested that the software was successful in increasing number sense over the short period of the study. However these results need to be followed up with larger, controlled studies. The issues of transfer to higher-level tasks, and of the best developmental time window for intervention also need to be addressed. PMID:16734906

Perform Tests and Document Results and Analysis of Oxide Layer Effects and Comparisons

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

Collins, E. D.; DelCul, G. D.; Spencer, B. B.

2014-08-30

During the initial feasibility test using actual used nuclear fuel (UNF) cladding in FY 2012, an incubation period of 30–45 minutes was observed in the initial dry chlorination. The cladding hull used in the test had been previously oxidized in a dry air oxidation pretreatment prior to removal of the fuel. The cause of this incubation period was attributed to the resistance to chlorination of an oxide layer imparted by the dry oxidation pretreatment on the cladding. Subsequently in 2013, researchers at the Korea Atomic Energy Institute (KAERI) reported on their chlorination study [R1] on ~9-gram samples of unirradiated ZirloTMmore » cladding tubes that had been previously oxidized in air at 500oC for various time periods to impart oxide layers of varying thickness. In early 2014, discussions with Indefinite Delivery, Indefinite Quantity (IDIQ) contracted technical consultants from Westinghouse described their previous development (and patents) [R2] on methods of chemical washing to remove some or all of the hydrous oxide layer imparted on UNF cladding during irradiation in light water reactors (LWRs) . Thus, the Oak Ridge National Laboratory (ORNL) study, described herein, was planned to extend the KAERI study on the effects of anhydrous oxide layers, but on larger ~100-gram samples of unirradiated zirconium alloy cladding tubes, and to investigate the effects of various methods of chemical pretreatment prior to chlorination with 100% chlorine on the average reaction rates and Cl2 usage efficiencies.« less

Development and psychometric evaluation of the Personal Growth Initiative Scale-II.

PubMed

Robitschek, Christine; Ashton, Matthew W; Spering, Cynthia C; Geiger, Nathaniel; Byers, Danielle; Schotts, G Christian; Thoen, Megan A

2012-04-01

The original Personal Growth Initiative Scale (PGIS; Robitschek, 1998) was unidimensional, despite theory identifying multiple components (e.g., cognition and behavior) of personal growth initiative (PGI). The present research developed a multidimensional measure of the complex process of PGI, while retaining the brief and psychometrically sound properties of the original scale. Study 1 focused on scale development, including theoretical derivation of items, assessing factor structure, reducing number of items, and refining the scale length using samples of college students. Study 2 consisted of confirmatory factor analysis with 3 independent samples of college students and community members. Lastly, Study 3 assessed test-retest reliability over 1-, 2-, 4-, and 6-week periods and tests of concurrent and discriminant validity using samples of college students. The final measure, the Personal Growth Initiative Scale-II (PGIS-II), includes 4 subscales: Readiness for Change, Planfulness, Using Resources, and Intentional Behavior. These studies provide exploratory and confirmatory evidence for the 4-factor structure, strong internal consistency for the subscales and overall score across samples, acceptable temporal stability at all assessed intervals, and concurrent and discriminant validity of the PGIS-II. Future directions for research and clinical practice are discussed.

Implementation Intention for Initiating Intuitive Eating and Active Embodiment in Obese Patients Using a Smartphone Application.

PubMed

Brevers, Damien; Rogiers, Anne; Defontaine, Alexis; Cheron, Guy; Clarinval, Anne-Marie; Foucart, Jennifer; Bouchez, Anne; Bolly, Véronique; Tsartsafloudakis, Laura; Jottrand, Pénélope; Minner, Pierre; Bechara, Antoine; Kornreich, Charles; Verbanck, Paul

2017-01-01

This article describes a study protocol, which aims to explore and describe the feasibility of a mobile-phone application for initiating intuitive eating and intuitive exercising in patients who are following an ambulatory treatment for obesity. Intuitive eating refers to one's ability to make food choices based on one's awareness of his/her body's response. Intuitive exercising encourages people in finding enjoyable ways of being physically active. These two components will be trained using an implementation intention procedure, that is, behavioral plans that aim at creating a strong link between a specified situation and a response. We aim to recruit up to 80 overweight and obese patients over a period of 2 years. The smartphone application will be assessed on the basis of (i) data obtained through a 4-week use period, (ii) self-report measures taken before and after the use of the mobile application, and (iii) feedbacks from participants after the use of the mobile application. This pilot study will allow us to better understand the applicability of the use of mobile application within ambulatory treatment settings, and to adapt the design of the app necessary for building cross-sectional studies investigating its efficacy.

The most common nonconformities encountered during the assessments of medical laboratories in Hong Kong using ISO 15189 as accreditation criteria

PubMed Central

Ho, Bella; Ho, Eric

2012-01-01

Introduction: ISO 15189 was a new standard published in 2003 for accrediting medical laboratories. We believe that some requirements of the ISO 15189 standard are especially difficult to meet for majority of laboratories. The aim of this article was to present the frequency of nonconformities to requirements of the ISO 15189 accreditation standard, encountered during the assessments of medical laboratories in Hong Kong, during 2004 to 2009. Materials and methods: Nonconformities reported in assessments based on ISO 15189 were analyzed in two periods – from 2004 to 2006 and in 2009. They are categorized according to the ISO 15189 clause numbers. The performance of 27 laboratories initially assessed between 2004 and 2006 was compared to their performance in the second reassessment in 2009. Results: For management requirements, nonconformities were most frequently reported against quality management system, quality and technical records and document control; whereas for technical requirements, they were reported against examination procedures, equipment, and assuring quality of examination procedures. There was no major difference in types of common nonconformities reported in the two study periods. The total number of nonconformities reported in the second reassessment of 27 laboratories in 2009 was almost halved compared to their initial assessments. The number of significant nonconformities per laboratory significantly decreased (P = 0.023). Conclusion: Similar nonconformities were reported in the two study periods though the frequency encountered decreased. The significant decrease in number of significant nonconformities encountered in the same group of laboratories in the two periods substantiated that ISO15189 contributed to quality improvement of accredited laboratories. PMID:22838190

The most common nonconformities encountered during the assessments of medical laboratories in Hong Kong using ISO 15189 as accreditation criteria.

PubMed

Ho, Bella; Ho, Eric

2012-01-01

ISO 15189 was a new standard published in 2003 for accrediting medical laboratories. We believe that some requirements of the ISO 15189 standard are especially difficult to meet for majority of laboratories. The aim of this article was to present the frequency of nonconformities to requirements of the ISO 15189 accreditation standard, encountered during the assessments of medical laboratories in Hong Kong, during 2004 to 2009. Nonconformities reported in assessments based on ISO 15189 were analyzed in two periods - from 2004 to 2006 and in 2009. They are categorized according to the ISO 15189 clause numbers. The performance of 27 laboratories initially assessed between 2004 and 2006 was compared to their performance in the second reassessment in 2009. For management requirements, nonconformities were most frequently reported against quality management system, quality and technical records and document control; whereas for technical requirements, they were reported against examination procedures, equipment, and assuring quality of examination procedures. There was no major difference in types of common nonconformities reported in the two study periods. The total number of nonconformities reported in the second reassessment of 27 laboratories in 2009 was almost halved compared to their initial assessments. The number of significant nonconformities per laboratory significantly decreased (P = 0.023). Similar nonconformities were reported in the two study periods though the frequency encountered decreased. The significant decrease in number of significant nonconformities encountered in the same group of laboratories in the two periods substantiated that 15015189 contributed to quality improvement of accredited laboratories.

Diminishing availability of publicly funded slots for antiretroviral initiation among HIV-infected ART-eligible patients in Uganda.

PubMed

Geng, Elvin H; Bwana, Mwebesa B; Kabakyenga, Jerome; Muyindike, Winnie; Emenyonu, Nneka I; Musinguzi, Nicholas; Mugyenyi, Peter; Martin, Jeffrey N; Bangsberg, David R

2010-11-24

The impact of flat-line funding in the global scale up of antiretroviral therapy (ART) for HIV-infected patients in Africa has not yet been well described. We evaluated ART-eligible patients and patients starting ART at a prototypical scale up ART clinic in Mbarara, Uganda between April 1, 2009 and May 14, 2010 where four stakeholders sponsor treatment - two PEPFAR implementing organizations, the Ugandan Ministry of Health - Global Fund (MOH-GF) and a private foundation named the Family Treatment Fund (FTF). We assessed temporal trends in the number of eligible patients, the number starting ART and tabulated the distribution of the stakeholders supporting ART initiation by month and quartile of time during this interval. We used survival analyses to assess changes in the rate of ART initiation over calendar time. A total of 1309 patients who were eligible for ART made visits over the 14 month period of the study and of these 819 started ART. The median number of ART eligible patients each month was 88 (IQR: 74 to 115). By quartile of calendar time, PEPFAR and MOH sponsored 290, 192, 180, and 49 ART initiations whereas the FTF started 1, 2, 1 and 104 patients respectively. By May of 2010 (the last calendar month of observation) FTF sponsored 88% of all ART initiations. Becoming eligible for ART in the 3(rd) (HR = 0.58, 95% 0.45-0.74) and 4(th) quartiles (HR = 0.49, 95% CI: 0.36-0.65) was associated with delay in ART initiation compared to the first quartile in multivariable analyses. During a period of flat line funding from multinational donors for ART programs, reductions in the number of ART initiations by public programs (i.e., PEPFAR and MOH-GF) and delays in ART initiation became apparent at the a large prototypical scale-up ART clinic in Uganda.

The initial antibody response to HIV-1: induction of ineffective early B cell responses against GP41 by the transmitted/founder virus

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

Chavez, Leslie L; Perelson, Alan

2008-01-01

A window of opportunity for immune responses to extinguish HIV -1 exists from the moment of transmission through establishment of the latent pool of HIV -I-infected cells. A critical time to study the initial immune responses to the transmitted/founder virus is the eclipse phase of HIV-1 infection (time from transmission to the first appearance of plasma virus) but, to date, this period has been logistically difficult to analyze. Studies in non-human primates challenged with chimeric simianhuman immunodeficiency virus have shown that neutralizing antibodies, when present at the time of infection, can prevent virus infection.

Life-Time Risk for Substance Use Among Offspring of Abusive Family Environment From the Community

PubMed Central

Nomura, Yoko; Hurd, Yasmin L.; Pilowsky, Daniel J.

2018-01-01

The current study examined the cumulative risk, age of initiation, and functional impairments among adults with substance use problems (N = 1748) by child abuse status. Child abuse was associated with earlier initiation of marijuana, cocaine, and heroin use, and had greater risks for all the drugs studied (hazard ratios, 1.7–3.2). Furthermore, child abuse was associated with increased medical and functional impairments, including ER visits, health problems, drug dealing, drug dependence, and drug cravings. Provision of social services and parenting education during the perinatal period may prevent the long-term impact of child abuse on substance use and related impairments. The study’s limitations are noted. PMID:22780838

A novel sensitivity-based method for damage detection of structures under unknown periodic excitations

NASA Astrophysics Data System (ADS)

Naseralavi, S. S.; Salajegheh, E.; Fadaee, M. J.; Salajegheh, J.

2014-06-01

This paper presents a technique for damage detection in structures under unknown periodic excitations using the transient displacement response. The method is capable of identifying the damage parameters without finding the input excitations. We first define the concept of displacement space as a linear space in which each point represents displacements of structure under an excitation and initial condition. Roughly speaking, the method is based on the fact that structural displacements under free and forced vibrations are associated with two parallel subspaces in the displacement space. Considering this novel geometrical viewpoint, an equation called kernel parallelization equation (KPE) is derived for damage detection under unknown periodic excitations and a sensitivity-based algorithm for solving KPE is proposed accordingly. The method is evaluated via three case studies under periodic excitations, which confirm the efficiency of the proposed method.

Global existence of strong solutions to the three- dimensional incompressible Navier-Stokes equations with special boundary conditions

NASA Astrophysics Data System (ADS)

Riley, Douglas A.

We study the three-dimensional incompressible Navier- Stokes equations in a domain of the form W'×(0,e) . First, we assume W' is a C3 bounded domain and impose no-slip boundary conditions on 6W'×(0,e ) , and periodic conditions on W'×0,e . Physically, this models fluid flow through a pipe with cross-section W' where the inlet and outlet conditions are assumed periodic. Secondly, we assume W'=(0,l4) ×(0,l5) and impose periodic boundary conditions. This problem is of interest mathematically, and has been more widely considered than the pipe flow problem. For both sets of boundary conditions, we show that a strong solution exists for all time with conditions on the initial data and forcing. We start by recalling that if the forcing function and initial condition do not depend on x3, then a global strong solution exists which also does not depend on x3. Here (x1,x2,x3) ∈W≡W'×( 0,e) . With this observation as motivation, and using an additive decomposition introduced by Raugel and Sell, we split the initial data and forcing into a portion independent of x3 and a remainder. In our first result, we impose a smallness condition on the remainder and assume the forcing function is square- integrable in time as a function into L2(W) . With these assumptions, we prove a global existence theorem that does not require a smallness condition on e or on the portion of the initial condition and forcing independent of x3. However, these quantities do affect the allowable size of the remainder. For our second result, we assume the forcing is only bounded in time as a function into L2(W) . In this case, we need a smallness condition on the initial data, the forcing, and e to obtain global existence. The interesting observation is that the allowable sizes for the initial data and forcing grow as e-->0 . Thus, we obtain a `thin-domain' result as originally obtained by Raugel and Sell. In fact, our results allow the portion of the initial data and forcing independent of x3 to grow at a faster rate as e-->0 than previously obtained.