NASA scientific and technical information program multimedia initiative

NASA Technical Reports Server (NTRS)

Cotter, Gladys A.; Kaye, Karen

1993-01-01

This paper relates the experiences of the NASA Scientific and Technical Information Program in introducing multimedia within the STI Program framework. A discussion of multimedia technology is included to provide context for the STI Program effort. The STI Program's Multimedia Initiative is discussed in detail. Parallels and differences between multimedia and traditional information systems project development are highlighted. Challenges faced by the program in initiating its multimedia project are summarized along with lessons learned. The paper concludes with a synopsis of the benefits the program hopes to provide its users through the introduction of multimedia illustrated by examples of successful multimedia projects.

A systems approach to implementation of eLearning in medical education: five MEPI schools' journeys.

PubMed

Vovides, Yianna; Chale, Selamawit Bedada; Gadhula, Rumbidzayi; Kebaetse, Masego B; Nigussie, Netsanet Animut; Suleman, Fatima; Tibyampansha, Dativa; Ibrahim, Glory Ramadhan; Ntabaye, Moshi; Frehywot, Seble; Nkomazana, Oathokwa

2014-08-01

How should eLearning be implemented in resource-constrained settings? The introduction of eLearning at four African medical schools and one school of pharmacy, all part of the Medical Education Partnership Initiative (MEPI) eLearning Technical Working Group, highlighted the need for five factors essential for successful and sustainable implementation: institutional support; faculty engagement; student engagement; technical expertise; and infrastructure and support systems. All five MEPI schools reported strengthening technical expertise, infrastructure, and support systems; four schools indicated that they were also successful in developing student engagement; and three reported making good progress in building institutional support. Faculty engagement was the one core component that all five schools needed to enhance.

Technical and Clinical Results After Percutaneous Angioplasty in Nonmedial Fibromuscular Dysplasia: Outcome After Endovascular Management of Unifocal Renal Artery Stenoses in 30 Patients

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

Barrier, Pierre, E-mail: p.barrier@gmail.com; Julien, Auriol; Guillaume, Canevet

2010-04-15

Although percutaneous transluminal renal angioplasty (PTRA) is associated with excellent results in medial fibromuscular dysplasia (FMD), the clinical and technical outcome in the less common nonmedial subtype of FMD is not clearly known. Angiographic PTRA results and clinical follow-up were documented, to report technical and clinical results in 30 patients with unifocal, nonmedial dysplastic stenoses. Balloon angioplasty was technically successful in only 65% of the lesions. Additional stenting, performed after PTRA failure in six patients, increased the initial technical success rate to 82%. Stenting was used in another lesion after restenosis, and long-term patency was achieved in only three ofmore » the seven stented lesions. Frequent restenoses and unusual complications were observed during follow-up. Stent fracture occurred in two cases. Overall, long-term clinical and technical successes were sustained in 70 and 76%, respectively. We conclude that nonmedial, unifocal renal artery dysplastic stenoses do not share the excellent prognosis of the medial type and that stenting should be avoided. Therefore, surgery should be considered in lesions remaining unresponsive to balloon dilatation, after a second PTRA attempt.« less

A History of the ARPANET: The First Decade

DTIC Science & Technology

1981-04-01

10 2.2 Major Technical Problems and Approaches 11-12 2.3 Major Changes in Objectives and Approaches 11-19 3, ,3 Scientific and Technical Results and...successful projects ever undertaken by DARPA! The program has initiated extensive changes in the Defense Department’s use of computers as well as in...the ARPANET project represents a similarly far-reaching change in the use of computers by mankind. The full impact of the technical changes set in

Endoscopic management of bile leakage after liver transplantation.

PubMed

Oh, Dong-Wook; Lee, Sung Koo; Song, Tae Jun; Park, Do Hyun; Lee, Sang Soo; Seo, Dong-Wan; Kim, Myung-Hwan

2015-05-23

Endoscopic retrograde cholangiopancreatography (ERCP) can be an effective treatment for bile leakage after liver transplantation. We evaluated the efficacy of endoscopic treatment in liver transplantation in patients who developed bile leaks. Forty-two patients who developed bile leaks after liver transplantation were included in the study. If a bile leak was observed on ERCP, a sphincterotomy was performed, and a nasobiliary catheter was then inserted. If a bile leak was accompanied by a bile duct stricture, either the stricture was dilated with balloons, followed by nasobiliary catheter insertion across the bile duct stricture, or endoscopic retrograde biliary drainage was performed. In the bile leakage alone group (22 patients), endoscopic treatment was technically successful in 19 (86.4%) and clinically successful in 17 (77.3%) cases. Among the 20 patients with bile leaks with bile duct strictures, endoscopic treatment was technically successful in 13 (65.0%) and clinically successful in 10 (50.0%) cases. Among the 42 patients who underwent ERCP, technical success was achieved in 32 (76.2%) cases and clinical success was achieved in 27 (64.3%) cases. ERCP is an effective and safe therapeutic modality for bile leaks after liver transplantation. ERCP should be considered as an initial therapeutic modality in post-liver transplantation patients.

Creating an Environmental Justice Framework for Policy Change in Childhood Asthma: A Grassroots to Treetops Approach

PubMed Central

Sargent, Katherine; Arons, Abigail; Standish, Marion; Brindis, Claire D.

2011-01-01

Objectives. The Community Action to Fight Asthma Initiative, a network of coalitions and technical assistance providers in California, employed an environmental justice approach to reduce risk factors for asthma in school-aged children. Policy advocacy focused on housing, schools, and outdoor air quality. Technical assistance partners from environmental science, policy advocacy, asthma prevention, and media assisted in advocacy. An evaluation team assessed progress and outcomes. Methods. A theory of change and corresponding logic model were used to document coalition development and successes. Site visits, surveys, policymaker interviews, and participation in meetings documented the processes and outcomes. Quantitative and qualitative data were analyzed to assess strategies, successes, and challenges. Results. Coalitions, working with community residents and technical assistance experts, successfully advocated for policies to reduce children's exposures to environmental triggers, particularly in low-income communities and communities of color. Policies were implemented at various levels. Conclusions. Environmental justice approaches to policy advocacy could be an effective strategy to address inequities across communities. Strong technical assistance, close community involvement, and multilevel strategies were all essential to effective policies to reduce environmental inequities. PMID:21836108

Outcomes of Percutaneous Coronary Interventions for Chronic Total Occlusion Performed by Highly Experienced Japanese Specialists: The First Report From the Japanese CTO-PCI Expert Registry.

PubMed

Suzuki, Yoriyasu; Tsuchikane, Etsuo; Katoh, Osamu; Muramatsu, Toshiya; Muto, Makoto; Kishi, Koichi; Hamazaki, Yuji; Oikawa, Yuji; Kawasaki, Tomohiro; Okamura, Atsunori

2017-11-13

This report describes the registry and presents an initial analysis of outcomes for the different PCI approaches taken by the specialists. Strategies for percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) are complex. The Japanese Board of CTO Interventional Specialists has developed a prospective, nonrandomized registry of patients undergoing CTO-PCIs performed by 41 highly experienced Japanese specialists. Over the study period of January 2014 to December 2015, the registry included 2,846 consecutive CTO-PCI cases undertaken in Japan. The authors compared clinical outcomes between the different PCI approaches, following the intention-to-treat principle. The overall technical success rate of the procedures was 89.9%. The specialists frequently chose a retrograde approach as the primary CTO-PCI strategy (in 27.8% of cases). The technical success rate of the primary antegrade approach was significantly better than that of the primary retrograde approach (91.0% vs. 87.3%; p < 0.0001). The technical success rate decreased to 78.0% with the rescue retrograde approach. Parallel guidewire crossing and intravascular ultrasound-guided wire crossing were performed after guidewire escalation during antegrade CTO-PCI with a high technical success rate (75.0% to 88.9%). Severe lesion calcification was a strong predictor of failed CTO-PCI. CTO-PCI performed by highly experienced specialists achieved a high technical success rate. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Programs of Study as a State Policy Mandate: A Longitudinal Study of the South Carolina Personal Pathways to Success Initiative. Unabridged Final Technical Report (Years 1-5)

ERIC Educational Resources Information Center

Hammond, Cathy; Withington, Cairen; Sharp, Julia L.; Mobley, Catherine; Drew, Sam F.; Stringfield, Samuel C.; Stipanovic, Natalie; Swiger, Caroline M.; Daugherty, Lindsay; Griffith, Cathy

2014-01-01

This final report presents findings from data collection and analysis conducted during a five-year study by the National Dropout Prevention Center (NDPC) at Clemson University, in conjunction with colleagues from the National Research Center for Career and Technical Education (NRCCTE) at the University of Louisville. This project was one of three…

Final Technical Progress Report: Development of Low-Cost Suspension Heliostat; December 7, 2011 - December 6, 2012

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

Bender, W.

2013-01-01

Final technical progress report of SunShot Incubator Solaflect Energy. The project succeeded in demonstrating that the Solaflect Suspension Heliostat design is viable for large-scale CSP installations. Canting accuracy is acceptable and is continually improving as Solaflect improves its understanding of this design. Cost reduction initiatives were successful, and there are still many opportunities for further development and further cost reduction.

Percutaneous radiofrequency ablation of hepatic tumours: factors affecting technical failure of artificial ascites formation using an angiosheath.

PubMed

Kang, T W; Lee, M W; Hye, M J; Song, K D; Lim, S; Rhim, H; Lim, H K; Cha, D I

2014-12-01

To evaluate the technical feasibility of artificial ascites formation using an angiosheath before percutaneous radiofrequency ablation (RFA) for hepatic tumours and to determine predictive factors affecting the technical failure of artificial ascites formation. This retrospective study was approved by the institutional review board. One hundred and thirteen patients underwent percutaneous RFA of hepatic tumours after trying to make artificial ascites using an angiosheath to avoid collateral thermal damage. The technical success rate of making artificial ascites using an angiosheath and conversion rate to other techniques after initial failure of making artificial ascites were evaluated. The technical success rate for RFA was assessed. In addition, potential factors associated with technical failure including previous history of transcatheter arterial chemoembolization (TACE) or RFA, type of abdominal surgery, and adjacent perihepatic structures were reviewed. Predictive factors for the technical failure of artificial ascites formation were analysed using multivariate analysis. The technical success rates of artificial ascites formation by angiosheath and that of RFA were 84.1% (95/113) and 97.3% (110/113), respectively. The conversion rate to other techniques after the failure of artificial ascites formation using an angiosheath was 15.9% (18/113). Previous hepatic resection was the sole independent predictive factor affecting the technical failure of artificial ascites formation (p<0.001, odds ratio = 29.03, 95% confidence interval: 4.56-184.69). Making artificial ascites for RFA of hepatic tumours using an angiosheath was technically feasible in most cases. However, history of hepatic resection was a significant predictive factor affecting the technical failure of artificial ascites formation. Copyright © 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Improvements in State and Local Planning for Mass Dispensing of Medical Countermeasures: The Technical Assistance Review Program, United States, 2007-2014.

PubMed

Renard, Paul G; Vagi, Sara J; Reinold, Chris M; Silverman, Brenda L; Avchen, Rachel N

2017-09-01

To evaluate and describe outcomes of state and local medical countermeasure preparedness planning, which is critical to ensure rapid distribution and dispensing of a broad spectrum of life-saving medical assets during a public health emergency. We used 2007 to 2014 state and local data collected from the Centers for Disease Control and Prevention's Technical Assistance Review. We calculated descriptive statistics from 50 states and 72 local Cities Readiness Initiative jurisdictions that participated in the Technical Assistance Review annually. From 2007 to 2014, the average overall Technical Assistance Review score increased by 13% for states and 41% for Cities Readiness Initiative jurisdictions. In 2014, nearly half of states achieved the maximum possible overall score (100), and 94% of local Cities Readiness Initiative jurisdictions achieved a score of 90 or more. Despite challenges, effective and timely medical countermeasure distribution and dispensing is possible with appropriate planning, staff, and resources. However, vigilance in training, exercising, and improving plans from lessons learned in a sustained, coordinated way is critical to ensure continued public health preparedness success.

Technical feasibility and revision efficacy of the sequential deployment of endoscopic bilateral side-by-side metal stents for malignant hilar biliary strictures: a multicenter prospective study.

PubMed

Lee, Tae Hoon; Park, Do Hyun; Lee, Sang Soo; Choi, Hyun Jong; Lee, Jun Kyu; Kim, Tae Hyeon; Kim, Jong Hyeok; Jeong, Seok; Park, Sang-Heum; Moon, Jong Ho

2013-02-01

Theoretically, the side-by-side bilateral placement of metal stents may be technically easier than stent-in-stent bilateral placement in stent revision. However, side-by-side placement can be technically challenging, as the deployment of the first stent can preclude the passage of the second stent. We explored the technical feasibility and revision efficacy of endoscopic bilateral side-by-side stent placement for malignant hilar biliary strictures. Forty-four patients with Bismuth type II or higher malignant hilar biliary strictures were enrolled in seven academic tertiary referral centers. Endoscopic placement of side-by-side bilateral metal stents with 7F thin delivery shaft was performed. The outcome measurements were the technical and functional success, adverse events, endoscopic revision success rate, and stent patency. Overall, the technical and functional success rates were 91 % (40/44), and 98 % (39/40), respectively. Two of the failed patients were converted successfully with subsequent contralateral stent-in-stent placement, and the other patients underwent percutaneous intervention. Early stent-related adverse events occurred in 10 %. The endoscopic revision rate due to stent malfunction during follow-up (median: 180 days) was 45 % (18/40; tumor ingrowth in 4 and in-stent sludge impaction/stone formation in 14 patients). The endoscopic revision success rate was 92 % (12/13). Five patients with comorbidity underwent initial percutaneous intervention. The median survival and stent patency periods were 180 and 157 days, respectively. The sequential placement of a metal stent with a 7F thin delivery shaft in bilateral side-by-side procedures may be feasible and effective for malignant hilar biliary strictures and for endoscopic stent revision.

Hawai'i P-3 Initiative: Findings from the First Year of the Evaluation. Technical Report

ERIC Educational Resources Information Center

Zellman, Gail L.; Kilburn, M. Rebecca

2011-01-01

Recent efforts to improve K-12 educational outcomes have had mixed success. One possible reason is that many students entering kindergarten lack the basic skills to succeed in school. In 2007, with support from the W. K. Kellogg Foundation, Hawai'i launched its P-3 (preschool through third-grade) initiative, the early childhood component of the…

Endoscopic Management of Bile Leakage after Liver Transplantation

PubMed Central

Oh, Dongwook; Lee, Sung Koo; Song, Tae Jun; Park, Do Hyun; Lee, Sang Soo; Seo, Dong-Wan; Kim, Myung-Hwan

2015-01-01

Background/Aims Endoscopic retrograde cholangiopancreatography (ERCP) can be an effective treatment for bile leakage after liver transplantation. We evaluated the efficacy of endoscopic treatment in liver transplantation in patients who developed bile leaks. Methods Forty-two patients who developed bile leaks after liver transplantation were included in the study. If a bile leak was observed on ERCP, a sphincterotomy was performed, and a nasobiliary catheter was then inserted. If a bile leak was accompanied by a bile duct stricture, either the stricture was dilated with balloons, followed by nasobiliary catheter insertion across the bile duct stricture, or endoscopic retrograde biliary drainage was performed. Results In the bile leakage alone group (22 patients), endoscopic treatment was technically successful in 19 (86.4%) and clinically successful in 17 (77.3%) cases. Among the 20 patients with bile leaks with bile duct strictures, endoscopic treatment was technically successful in 13 (65.0%) and clinically successful in 10 (50.0%) cases. Among the 42 patients who underwent ERCP, technical success was achieved in 32 (76.2%) cases and clinical success was achieved in 27 (64.3%) cases. Conclusions ERCP is an effective and safe therapeutic modality for bile leaks after liver transplantation. ERCP should be considered as an initial therapeutic modality in post-liver transplantation patients. PMID:25717048

Improving Quality for Child Care Centers in Greater Philadelphia: An Evaluation of Success by 6®. Technical Appendix. Publication #2016-07B

ERIC Educational Resources Information Center

Warner-Richter, Mallory; Lowe, Claire; Tout, Kathryn; Epstein, Dale; Li, Weilin

2016-01-01

The Success By 6® (SB6) initiative is designed to support early care and education centers in improving and sustaining quality in Pennsylvania's Keystone STARS Quality Rating and Improvement System (QRIS). The SB6 evaluation report examines implementation and outcomes. The findings have implications for SB6 continous quality improvement process…

Evaluation of ERDA-sponsored coal feed system development

NASA Technical Reports Server (NTRS)

Phen, R. L.; Luckow, W. K.; Mattson, L.; Otth, D.; Tsou, P.

1977-01-01

Coal feeders were evaluated based upon criteria such as technical feasibility, performance (i.e. ability to meet process requirements), projected life cycle costs, and projected development cost. An initial set of feeders was selected based on the feeders' cost savings potential compared with baseline lockhopper systems. Additional feeders were considered for selection based on: (1) increasing the probability of successful feeder development; (2) application to specific processes; and (3) technical merit. A coal feeder development program is outlined.

E3 Success Story - Sparking Powerful Change Through the Green Suppliers Network: Byrne Electrical Specialists, Inc.

EPA Pesticide Factsheets

E3 – Economy, Energy, and Environment – is a coordinated federal and local technical assistance initiative that is helping manufacturers across the nation adapt and thrive in a new business era focused on sustainability.

Improvements in State and Local Planning for Mass Dispensing of Medical Countermeasures: The Technical Assistance Review Program, United States, 2007–2014

PubMed Central

Vagi, Sara J.; Reinold, Chris M.; Silverman, Brenda L.; Avchen, Rachel N.

2017-01-01

Objectives. To evaluate and describe outcomes of state and local medical countermeasure preparedness planning, which is critical to ensure rapid distribution and dispensing of a broad spectrum of life-saving medical assets during a public health emergency. Methods. We used 2007 to 2014 state and local data collected from the Centers for Disease Control and Prevention’s Technical Assistance Review. We calculated descriptive statistics from 50 states and 72 local Cities Readiness Initiative jurisdictions that participated in the Technical Assistance Review annually. Results. From 2007 to 2014, the average overall Technical Assistance Review score increased by 13% for states and 41% for Cities Readiness Initiative jurisdictions. In 2014, nearly half of states achieved the maximum possible overall score (100), and 94% of local Cities Readiness Initiative jurisdictions achieved a score of 90 or more. Conclusions. Despite challenges, effective and timely medical countermeasure distribution and dispensing is possible with appropriate planning, staff, and resources. However, vigilance in training, exercising, and improving plans from lessons learned in a sustained, coordinated way is critical to ensure continued public health preparedness success. PMID:28892441

Importance of Adjunct Delivery Techniques to Optimize Deployment Success of Distal Protection Filters During Vein Graft Intervention.

PubMed

Kaliyadan, Antony G; Chawla, Harnish; Fischman, David L; Ruggiero, Nicholas; Gannon, Michael; Walinsky, Paul; Savage, Michael P

2017-02-01

This study assessed the impact of adjunct delivery techniques on the deployment success of distal protection filters in saphenous vein grafts (SVGs). Despite their proven clinical benefit, distal protection devices are underutilized in SVG interventions. Deployment of distal protection filters can be technically challenging in the presence of complex anatomy. Techniques that facilitate the delivery success of these devices could potentially improve clinical outcomes and promote greater use of distal protection. Outcomes of 105 consecutive SVG interventions with attempted use of a FilterWire distal protection device (Boston Scientific) were reviewed. In patients in whom filter delivery initially failed, the success of attempted redeployment using adjunct delivery techniques was assessed. Two strategies were utilized sequentially: (1) a 0.014" moderate-stiffness hydrophilic guidewire was placed first to function as a parallel buddy wire to support subsequent FilterWire crossing; and (2) if the buddy-wire approach failed, predilation with a 2.0 mm balloon at low pressure was performed followed by reattempted filter delivery. The study population consisted of 80 men and 25 women aged 73 ± 10 years. Mean SVG age was 14 ± 6 years. Complex disease (American College of Cardiology/American Heart Association class B2 or C) was present in 92%. Initial delivery of the FilterWire was successful in 82/105 patients (78.1%). Of the 23 patients with initial failed delivery, 8 (35%) had successful deployment with a buddy wire alone, 7 (30%) had successful deployment with balloon predilation plus buddy wire, 4 (17%) had failed reattempt at deployment despite adjunct maneuvers, and in 4 (17%) no additional attempts at deployment were made at the operator's discretion. Deployment failure was reduced from 21.9% initially to 7.6% after use of adjunct delivery techniques (P<.01). No adverse events were observed with these measures. Deployment of distal protection devices can be technically difficult with complex SVG disease. Adjunct delivery techniques are important to optimize deployment success of distal protection filters during SVG intervention.

Engaging Faculty for Innovative STEM Bridge Programs

ERIC Educational Resources Information Center

Goldfien, Andrea C.; Badway, Norena Norton

2014-01-01

Bridge programs, in which underprepared students gain the academic and technical skills necessary for college level courses and entry-level employment, are a promising initiative for expanding access to, and success in, community college education. For career pathways related to science, technology, engineering, or mathematics (STEM), bridge…

Advanced Stirling Convertor (ASC) Development for NASA RPS

NASA Technical Reports Server (NTRS)

Wong, Wayne A.; Wilson, Scott; Collins, Josh

2014-01-01

Sunpower's Advanced Stirling Convertor (ASC) initiated development under contract to the NASA Glenn Research Center (GRC) and after a series of successful demonstrations, the ASC began transitioning from a technology development project to flight development project. The ASC has very high power conversion efficiency making it attractive for future Radioisotope Power Systems (RPS) in order to make best use of the low plutonium-238 fuel inventory in the U.S. In recent years, the ASC became part of the NASA-Department of Energy Advanced Stirling Radioisotope Generator (ASRG) Integrated Project. Sunpower held two parallel contracts to produce ASC convertors, one with the Department of Energy/Lockheed Martin to produce the ASC-F flight convertors, and one with NASA GRC for the production of ASC-E3 engineering units, the initial units of which served as production pathfinders. The integrated ASC technical team successfully overcame various technical challenges that led to the completion and delivery of the first two pairs of flight-like ASC-E3 by 2013. However, in late Fall 2013, the DOE initiated termination of the Lockheed Martin ASRG flight development contract driven primarily by budget constraints. NASA continues to recognize the importance of high efficiency ASC power conversion for RPS and continues investment in the technology including the continuation of ASC-E3 production at Sunpower and the assembly of the ASRG Engineering Unit #2. This paper provides a summary of ASC technical accomplishments, overview of tests at GRC, plans for continued ASC production at Sunpower, and status of Stirling technology development.

Managing External Relations: The Lifeblood of Mission Success

NASA Technical Reports Server (NTRS)

Dumbacher, Daniel L.

2007-01-01

The slide presentation examines the role of customer and stakeholder relations in the success of space missions. Topics include agency transformation; an overview of project and program experience with a discussion of positions, technical accomplishments, and management lessons learned; and approaches to project success with emphasis on communication. Projects and programs discussed include the Space Shuttle Main Engine System, DC-XA Flight Demonstrator, X-33 Flight Demonstrator, Space Launch Initiative/2nd Generation Reusable Launch Vehicle, X-37 Flight Demonstrator, Constellation (pre Dr. Griffin), Safety and Mission Assurance, and Exploration Launch Projects.

Early results of percutaneous arteriovenous fistula creation with the Ellipsys Vascular Access System.

PubMed

Mallios, Alexandros; Jennings, William C; Boura, Benoit; Costanzo, Alessandro; Bourquelot, Pierre; Combes, Myriam

2018-04-18

We reviewed our initial experience creating a percutaneous arteriovenous fistula (pAVF) using a thermal resistance anastomosis device with proximal radial artery inflow. A retrospective review was conducted of all patients who underwent a pAVF creation procedure between May 2017 and October 2017. Primary end points of the study were technical success, patency by Doppler ultrasound examination or angiography, flow levels achieved, time to first use, and pAVF-related complications. A pAVF was attempted in 34 patients with technical success in 33 individuals (97%). Patency of the pAVF was 94%. Mean access flow was 946 mL/min (brachial artery measurement) at the latest follow-up visit (53-229 days; average, 141 days). At 6 weeks, all fistulas have been used or were ready for dialysis by clinical examination or ultrasound examination. Only one patient required superficialization of the upper arm cephalic vein by lipectomy. There were no adverse events related to the pAVF creation or use, nor was there need for further interventions. Successful pAVFs with proximal radial artery inflow were created with excellent initial results regarding technical success, patency, and safety. Advantages include avoidance of a surgical incision, short procedure times, good acceptance by patients, prompt access maturation, moderate flow, and low-pressure access, with possible reduction of risk for ischemic complications. Avoidance of vessel manipulation and side branch ligation might reduce risk of thrombosis and improve long-term patency and reduce need for further interventions. These early findings need to be confirmed in larger and longer follow-up studies. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

I Got 99 Problems, and eHealth Is One.

PubMed

Wass, Sofie; Vimarlund, Vivian

2017-01-01

Many eHealth initiatives are never implemented or merely end as pilot projects. Previous studies report that organisational, technical and human issues need to be properly taken into consideration if such initiatives are to be successful. The aim of this paper is to explore whether previously identified challenges within the area have remained in the Swedish eHealth setting or whether they have changed. After interviewing experts in eHealth, we present a classification of areas of concern. Recurrence of previously identified challenges was found, but also new issues were identified. The results of the study indicate that there is a need to consider organisational and semantic issues on both national and international levels. Legal and technical challenges still exist but it seems even more important to support eHealth initiatives financially, increase practitioners' knowledge in health informatics and manage new expectations from patients.

Usefulness of Cone-Beam Computed Tomography and Automatic Vessel Detection Software in Emergency Transarterial Embolization.

PubMed

Carrafiello, Gianpaolo; Ierardi, Anna Maria; Duka, Ejona; Radaelli, Alessandro; Floridi, Chiara; Bacuzzi, Alessandro; de Bucourt, Maximilian; De Marchi, Giuseppe

2016-04-01

This study was designed to evaluate the utility of dual phase cone beam computed tomography (DP-CBCT) and automatic vessel detection (AVD) software to guide transarterial embolization (TAE) of angiographically challenging arterial bleedings in emergency settings. Twenty patients with an arterial bleeding at computed tomography angiography and an inconclusive identification of the bleeding vessel at the initial 2D angiographic series were included. Accuracy of DP-CBCT and AVD software were defined as the ability to detect the bleeding site and the culprit arterial bleeder, respectively. Technical success was defined as the correct positioning of the microcatheter using AVD software. Clinical success was defined as the successful embolization. Total volume of iodinated contrast medium and overall procedure time were registered. The bleeding site was not detected by initial angiogram in 20% of cases, while impossibility to identify the bleeding vessel was the reason for inclusion in the remaining cases. The bleeding site was detected by DP-CBCT in 19 of 20 (95%) patients; in one case CBCT-CT fusion was required. AVD software identified the culprit arterial branch in 18 of 20 (90%) cases. In two cases, vessel tracking required manual marking of the candidate arterial bleeder. Technical success was 95%. Successful embolization was achieved in all patients. Mean contrast volume injected for each patient was 77.5 ml, and mean overall procedural time was 50 min. C-arm CBCT and AVD software during TAE of angiographically challenging arterial bleedings is feasible and may facilitate successful embolization. Staff training in CBCT imaging and software manipulation is necessary.

Innovations in Higher Education. Singapore at the Competitive Edge. World Bank Technical Paper No. 222.

ERIC Educational Resources Information Center

Selvaratnam, Viswanathan

This report provides an overview of Singapore's strategy for human resource development and the country's concerted effort to successfully orchestrate the many separate initiatives between 1960s to 1980s into an effective market-driven, three-tiered higher education system emphasizing technology and modernization. The study highlights the…

Evaluation, Integration and Institutionalization of Initiatives to Enhance STEM Student Success

ERIC Educational Resources Information Center

Dickson, Lisa; Mandell, Marv; Maton, Kenneth; Marcotte, Dave; Rous, Philip; McDermott, Patrice; Rutledge, Janet; LaCourse, William R.; Sutphin, Kathy Lee

2013-01-01

Many researchers, policymakers, and university administrators have called for more students to major in Science, Technology, Engineering and Mathematics (STEM) fields to address the critical need for a diverse and technically skilled workforce that is prepared to address national problems and educate its future STEM leaders. One of the questions…

GLOBAL CHANGE RESEARCH NEWS #9: ORD PROVIDES TECHNICAL SUPPORT TO EPA/OIA & DOS INITIATIVE IN EGYPT

EPA Science Inventory

This ninth edition reports on a workshop on global climate change that was held in Cairo, Egypt, on May 10-12, 1999. The workshop represented a successful partnership between EPA's Office of International Affairs, Office of Research and Development (ORD), Office of Air and Radiat...

Oak Ridge National Laboratory Institutional Plan, FY 1995--FY 2000

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

Not Available

1994-11-01

This report discusses the institutional plan for Oak Ridge National Laboratory for the next five years (1995-2000). Included in this report are the: laboratory director`s statement; laboratory mission, vision, and core competencies; laboratory plan; major laboratory initiatives; scientific and technical programs; critical success factors; summaries of other plans; and resource projections.

Optimizing Technical Education Pathways: Does Dual-Credit Course Completion Predict Students' College and Labor Market Success?

ERIC Educational Resources Information Center

Phelps, L. Allen; Chan, Hsun-Yu

2016-01-01

Post-recession Federal policy initiatives, such as secondary/postsecondary career pathways and gainful employment higher education accountability standards, prioritize the alignment of education practices with market-driven outcomes. Using longitudinal student record data merged from college and state K-12 data systems with the Unemployment…

Advanced Stirling Convertor Development for NASA Radioisotope Power Systems

NASA Technical Reports Server (NTRS)

Wong, Wayne A.; Wilson, Scott D.; Collins, Josh

2015-01-01

Sunpower Inc.'s Advanced Stirling Convertor (ASC) initiated development under contract to the NASA Glenn Research Center and after a series of successful demonstrations, the ASC began transitioning from a technology development project to a flight development project. The ASC has very high power conversion efficiency making it attractive for future Radioisotope Power Systems (RPS) in order to make best use of the low plutonium-238 fuel inventory in the United States. In recent years, the ASC became part of the NASA and Department of Energy (DOE) Advanced Stirling Radioisotope Generator (ASRG) Integrated Project. Sunpower held two parallel contracts to produce ASCs, one with the DOE and Lockheed Martin to produce the ASC-F flight convertors, and one with NASA Glenn for the production of ASC-E3 engineering units, the initial units of which served as production pathfinders. The integrated ASC technical team successfully overcame various technical challenges that led to the completion and delivery of the first two pairs of flightlike ASC-E3 by 2013. However, in late fall 2013, the DOE initiated termination of the Lockheed Martin ASRG flight development contract driven primarily by budget constraints. NASA continues to recognize the importance of high-efficiency ASC power conversion for RPS and continues investment in the technology including the continuation of ASC-E3 production at Sunpower and the assembly of the ASRG Engineering Unit #2. This paper provides a summary of ASC technical accomplishments, overview of tests at Glenn, plans for continued ASC production at Sunpower, and status of Stirling technology development.

Success Factors in Human Space Programs - Why Did Apollo Succeed Better Than Later Programs?

NASA Technical Reports Server (NTRS)

Jones, Harry W.

2015-01-01

The Apollo Program reached the moon, but the Constellation Program (CxP) that planned to return to the moon and go on to Mars was cancelled. Apollo is NASA's greatest achievement but its success is poorly understood. The usual explanation is that President Kennedy announced we were going to the moon, the scientific community and the public strongly supported it, and Congress provided the necessary funding. This is partially incorrect and does not actually explain Apollo's success. The scientific community and the public did not support Apollo. Like Apollo, Constellation was announced by a president and funded by Congress, with elements that continued on even after it was cancelled. Two other factors account for Apollo's success. Initially, the surprise event of Uri Gagarin's first human space flight created political distress and a strong desire for the government to dramatically demonstrate American space capability. Options were considered and Apollo was found to be most effective and technically feasible. Political necessity overrode both the lack of popular and scientific support and the extremely high cost and risk. Other NASA human space programs were either canceled, such as the Space Exploration Initiative (SEI), repeatedly threatened with cancellation, such as International Space Station (ISS), or terminated while still operational, such as the space shuttle and even Apollo itself. Large crash programs such as Apollo are initiated and continued if and only if urgent political necessity produces the necessary political will. They succeed if and only if they are technically feasible within the provided resources. Future human space missions will probably require gradual step-by-step development in a more normal environment.

End of FY10 report - used fuel disposition technical bases and lessons learned : legal and regulatory framework for high-level waste disposition in the United States.

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

Weiner, Ruth F.; Blink, James A.; Rechard, Robert Paul

This report examines the current policy, legal, and regulatory framework pertaining to used nuclear fuel and high level waste management in the United States. The goal is to identify potential changes that if made could add flexibility and possibly improve the chances of successfully implementing technical aspects of a nuclear waste policy. Experience suggests that the regulatory framework should be established prior to initiating future repository development. Concerning specifics of the regulatory framework, reasonable expectation as the standard of proof was successfully implemented and could be retained in the future; yet, the current classification system for radioactive waste, including hazardousmore » constituents, warrants reexamination. Whether or not consideration of multiple sites are considered simultaneously in the future, inclusion of mechanisms such as deliberate use of performance assessment to manage site characterization would be wise. Because of experience gained here and abroad, diversity of geologic media is not particularly necessary as a criterion in site selection guidelines for multiple sites. Stepwise development of the repository program that includes flexibility also warrants serious consideration. Furthermore, integration of the waste management system from storage, transportation, and disposition, should be examined and would be facilitated by integration of the legal and regulatory framework. Finally, in order to enhance acceptability of future repository development, the national policy should be cognizant of those policy and technical attributes that enhance initial acceptance, and those policy and technical attributes that maintain and broaden credibility.« less

Implementation of quality improvement techniques for management and technical processes in the ACRV project

NASA Technical Reports Server (NTRS)

Raiman, Laura B.

1992-01-01

Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

Implementation of quality improvement techniques for management and technical processes in the ACRV project

NASA Astrophysics Data System (ADS)

Raiman, Laura B.

1992-12-01

Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

STI Program Multimedia Initiative

NASA Technical Reports Server (NTRS)

Cotter, Gladys A.; Kaye, Karen

1993-01-01

This paper relates the experience of the NASA Scientific and Technical Information Program in introducing multimedia within the STI Program framework. A discussion of multimedia technology is included to provide context for the STI Program effort. The STI Program's Multimedia Initiative is discussed in detail. Parallels and differences between multimedia and traditional information systems project development are highlighted. Challenges faced by the program in initiating its multimedia project are summarized along with lessons learned. The paper concludes with a synopsis of the benefits the program hopes to provide its users through the introduction of multimedia illustrated by examples of successful multimedia projects.

Usefulness of Cone-Beam Computed Tomography and Automatic Vessel Detection Software in Emergency Transarterial Embolization

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

Carrafiello, Gianpaolo, E-mail: gcarraf@gmail.com; Ierardi, Anna Maria, E-mail: amierardi@yahoo.it; Duka, Ejona, E-mail: ejonaduka@hotmail.com

BackgroundThis study was designed to evaluate the utility of dual phase cone beam computed tomography (DP-CBCT) and automatic vessel detection (AVD) software to guide transarterial embolization (TAE) of angiographically challenging arterial bleedings in emergency settings.MethodsTwenty patients with an arterial bleeding at computed tomography angiography and an inconclusive identification of the bleeding vessel at the initial 2D angiographic series were included. Accuracy of DP-CBCT and AVD software were defined as the ability to detect the bleeding site and the culprit arterial bleeder, respectively. Technical success was defined as the correct positioning of the microcatheter using AVD software. Clinical success was definedmore » as the successful embolization. Total volume of iodinated contrast medium and overall procedure time were registered.ResultsThe bleeding site was not detected by initial angiogram in 20 % of cases, while impossibility to identify the bleeding vessel was the reason for inclusion in the remaining cases. The bleeding site was detected by DP-CBCT in 19 of 20 (95 %) patients; in one case CBCT-CT fusion was required. AVD software identified the culprit arterial branch in 18 of 20 (90 %) cases. In two cases, vessel tracking required manual marking of the candidate arterial bleeder. Technical success was 95 %. Successful embolization was achieved in all patients. Mean contrast volume injected for each patient was 77.5 ml, and mean overall procedural time was 50 min.ConclusionsC-arm CBCT and AVD software during TAE of angiographically challenging arterial bleedings is feasible and may facilitate successful embolization. Staff training in CBCT imaging and software manipulation is necessary.« less

Solar Technical Assistance Team Success Stories Video - Text Version |

Science.gov Websites

State, Local, and Tribal Governments | NREL Solar Technical Assistance Team Success Stories Video - Text Version Solar Technical Assistance Team Success Stories Video - Text Version Below is the text version for the Solar Technical Assistance Team Success Stories video. My name is Christopher

Winning the Global Skills Race: National Centers Prime Students for Success in Emerging Job Markets

ERIC Educational Resources Information Center

Murray, Corey

2007-01-01

This article talks about a joint effort between the National Science Foundation and the nation's community colleges that helps students secure jobs in technical career fields. It describes Advanced Technological Education Program (ATE), National Science Foundation's (NSF's) premier initiative with two-year colleges that was created in response to…

Native American Business Participation in E-Commerce: An Assessment of Technical Assistance and Training Needs.

ERIC Educational Resources Information Center

Bregendahl, Corry; Flora, Cornelia

A combined outreach and research initiative addressed the participation of Native American business owners in electronic commerce. E-commerce can provide many benefits to producers and consumers but does not ensure unmitigated economic success. It is only one part of a development process leading to achievement of tribes' broader social goals,…

Feasibility, efficacy, and predictive factors for the technical success of endoscopic nasogallbladder drainage: a prospective study.

PubMed

Yane, Kei; Maguchi, Hiroyuki; Katanuma, Akio; Takahashi, Kuniyuki; Osanai, Manabu; Kin, Toshifumi; Takaki, Ryo; Matsumoto, Kazuyuki; Gon, Katsushige; Matsumori, Tomoaki; Tomonari, Akiko; Nojima, Masanori

2015-03-01

Several studies have shown the useful-ness of endoscopic nasogallbladder drainage (ENGBD) in patients with acute cholecystitis. However, the procedure is difficult, and factors that affect technical success have not yet been clarified. We conducted a prospective study to eval-uate the technical feasibility, efficacy, and predictive factors for the technical success of ENGBD in patients with acute cholecystitis. All patients with moderate or severe acute cholecystitis who were enrolled underwent ENGBD between April 2009 and April 2011. Patients with surgically altered anatomy or pancreatobiliary malignancies were ex-cluded. The primary outcomes included technical success, clinical success, and complications. Factors that could affect the technical success were also examined. Of the 27 patients who underwent ENGBD during the study period, technical success was achieved in 21 (78%) and clinical improvement was achieved in 20 (95%). Early complications were encountered in four patients (15%). Gallbladder wall thickness (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.08 to 2.47) and age (OR, 1.16; 95% CI, 1.00 to 1.35) were effective predictors of technical failure. ENGBD was effective in resolving acute cholecystitis; however, this modality was technically challenging and had a limited suc-cess rate. Because of technical difficulties, ENGBD should be reserved for limited indications. (Gut Liver, 2015;9239-246).

Ultrathin endoscope-assisted self-expandable metallic stent placement following initial unsuccessful attempt in malignant upper gastrointestinal obstruction.

PubMed

Park, Se Woo; Lee, Hyuk; Park, Jun Chul; Shin, Sung Kwan; Lee, Sang Kil; Lee, Yong Chan

2014-03-01

Conventional endoscopy for self-expandable metallic stent (SEMS) placement may be technically limited in long and tortuous strictures. Therefore, we analyzed the feasibility, safety and usefulness of ultrathin endoscopy (UTE)-guided SEMS placement. This study involved 24 patients with upper gastrointestinal obstruction and unsuccessful initial attempts to place SEMS using conventional endoscopy. After completely passing a UTE across the stricture, the UTE was withdrawn, leaving a guidewire placed via the working channel. Through-the-scope SEMS placement was done using a conventional endoscope inserted along the guidewire. The primary endpoints were assessed by technical/clinical success and stent patency duration. Stents were successfully placed at target locations in all but one case with a long tortuous stricture, with 95.8% (23/24) technical success. One week after stent placement, mean gastricoutlet obstruction score improved significantly from baseline (1.74 ± 0.62 and 0.33 ± 0.48, respectively; P < 0.001). Stent migration, restenosis, and fracture occurred in four (17.4%), six (26.1%), and one (4.3%) of 23 stents, respectively. Median stent patency duration was 79 days. Mean stent patency was significantly longer in patients who received palliative chemotherapy than in those who did not (122.9 ± 11.0 and 38.3 ± 4.6, respectively; P < 0.001). UTE guidance SEMS delivery can be a feasible and safe rescue treatment method for malignant upper gastrointestinal obstruction in cases of failed attempts to place SEMS using conventional endoscopy. Our result warrants a further study to define the efficacy of this method in difficult SEMS placement cases. © 2013 The Authors. Digestive Endoscopy © 2013 Japan Gastroenterological Endoscopy Society.

Minority Energy Technical Assistance Program (METAP): Phase 1. Final technical report

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

Merrill, K.

1997-04-06

The Phase 1 Triple E (Energy, Economic development, Environment) METAP series has been a success. Its broad acceptance and considerations of exceptional quality and substance by the man seminar participants who attended in the seven cities, have made the businesses of community empowerment, education, and awareness as they relate to energy, obviously important. Many community leaders and legislators have expressed their immense gratitude to the US Department of Energy, for initiating such an important agenda within their communities. There have been over 110 legislators and almost 1,200 participants collectively, who have participated in this very valuable initiative. The participants rangemore » from community leaders and legislators to members from the private and public sectors, universities, not for profits, civic and church leaders. Highlights and accomplishments of these seminars are summarized.« less

The Successful Teacher in Technical Education: The Preparation of the Successful Teacher.

ERIC Educational Resources Information Center

Storm, George

The purposes of this study were to identify success factors in technical education teaching and to obtain subject matter recommendations for the improvement of technical teacher education. A national population of technical education directors offering post-secondary technical education programs in 1963 under Title III of the National Defense…

Is it useful to repeat an adrenal venous sampling in patients with primary hyperaldosteronism?

PubMed

Bouhanick, B; Delchier, M-C; Fauvel, J; Rousseau, H; Amar, J; Chamontin, B

2014-02-01

Adrenal venous sampling (AVS) is a challenging technical procedure and few patients had AVS procedure twice. To evaluate the reproducibility of the AVS, why AVS were repeated and the conclusions drawn from them. From 1997-2012, 12 patients underwent two AVS. A cortisol level in the adrenal vein greater than or equal to 1.1 to inferior vena cava defined a successful catheterization and a lateralization of secretion corresponded to an aldosterone-to-cortisol vein ratio greater than or equal to 2 between the one side to another. The same side of lateralization of secretion was found in 75% of them. The second AVS were due to technical failure (n=4), unproven lateralization (n=2), a lateralization opposite to the main nodule and ipsilateral to hyperplasia (n=4) on first AVS. For two patients, as the CT was normal, AVS was required again. The second AVS was successful in all patients, including those with an initial technical failure but only patient with technical failure underwent surgery, as BP and kaliemia were controlled. Lateralization on the side of hyperplasia or opposite to the biggest nodule was confirmed in two of four cases. When AVS is unsuccessful for technical reasons, it is worth doing it again but after being sure that surgery is still possibly indicated. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Accomplishments and challenges of surgical simulation.

PubMed

Satava, R M

2001-03-01

For nearly a decade, advanced computer technologies have created extraordinary educational tools using three-dimensional (3D) visualization and virtual reality. Pioneering efforts in surgical simulation with these tools have resulted in a first generation of simulators for surgical technical skills. Accomplishments include simulations with 3D models of anatomy for practice of surgical tasks, initial assessment of student performance in technical skills, and awareness by professional societies of potential in surgical education and certification. However, enormous challenges remain, which include improvement of technical fidelity, standardization of accurate metrics for performance evaluation, integration of simulators into a robust educational curriculum, stringent evaluation of simulators for effectiveness and value added to surgical training, determination of simulation application to certification of surgical technical skills, and a business model to implement and disseminate simulation successfully throughout the medical education community. This review looks at the historical progress of surgical simulators, their accomplishments, and the challenges that remain.

Promising Opportunities for Black and Latino Young Men: Findings from the Early Implementation of the Expanded Success Initiative. Technical Appendices

ERIC Educational Resources Information Center

Villavicencio, Adriana; Klevan, Sarah; Guidry, Brandon; Wulach, Suzanne

2014-01-01

This appendix describes the data collection and analytic processes used to develop the findings in the report "Promising Opportunities for Black and Latino Young Men." A central challenge was creating an analytic framework that could be uniformly applied to all schools, despite the individualized nature of their Expanded Success…

Microgravity Research, An Agency-Wide Asset: Using NASA-Generated Knowledge to Solve its Own Problems

NASA Technical Reports Server (NTRS)

2003-01-01

The National Center for Microgravity Research (NCMR) is a vital and successful operation, effectively supporting NASA's program in many ways beyond technical monitoring. NCMR is supplying leadership for certain new initiatives important to NASA's future. NASA might regard NCMR as kind of a small laboratory of innovative research management, and should support it generously.

E-Learning Initiatives for Teachers and Trainers in the Mediterranean Region: Comparative Analyses

ERIC Educational Resources Information Center

Coulon, Arnaud

2009-01-01

Teacher and trainer training is one of the most important determinants of the success of reforms in technical and vocational education and training (TVET) systems in recent years in the Mediterranean region. This is based upon the assumption that the role of teachers and trainers in the reform of TVET is a dual one; that of stakeholder and…

A proposal for risk sharing in the development of a lunar oxygen plant

NASA Technical Reports Server (NTRS)

Duke, Michael B.; Treadwell, Mead

1990-01-01

The production of lunar oxygen for use in a NASA lunar outpost program could provide a profitable investment for nongovernment development, savings for government, and an initiation of a new resource of capital financing for space industrialization. A joint endeavor to share development risks between government and nongovernment investment is proposed, based on some early assessments of technical and financial feasibility for the project. Successful initial negotiations between government and nongovernment investors can establish the requirements for financing the project with private funds.

[AWAKE CRANIOTOMY: IN SEARCH FOR OPTIMAL SEDATION].

PubMed

Kulikova, A S; Sel'kov, D A; Kobyakov, G L; Shmigel'skiy, A V; Lubnin, A Yu

2015-01-01

Awake craniotomy is a "gold standard"for intraoperative brain language mapping. One of the main anesthetic challenge of awake craniotomy is providing of optimal sedation for initial stages of intervention. The goal of this study was comparison of different technics of anesthesia for awake craniotomy. Materials and methods: 162 operations were divided in 4 groups: 76 cases with propofol sedation (2-4mg/kg/h) without airway protection; 11 cases with propofol sedation (4-5 mg/kg/h) with MV via LMA; 36 cases of xenon anesthesia; and 39 cases with dexmedetomidine sedation without airway protection. Results and discussion: brain language mapping was successful in 90% of cases. There was no difference between groups in successfulness of brain mapping. However in the first group respiratory complications were more frequent. Three other technics were more safer Xenon anesthesia was associated with ultrafast awakening for mapping (5±1 min). Dexmedetomidine sedation provided high hemodynamic and respiratory stability during the procedure.

New Treatments for Infrapopliteal Disease: Devices, Techniques, and Outcomes So Far

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

Bernstein, Ondina; Chalmers, Nicholas, E-mail: nicholas.chalmers@cmft.nhs.uk

2012-08-15

The use of endovascular treatment of infrapopliteal disease has increased in popularity in recent years. An improvement in technical success rates due to the availability of newer devices has fuelled an increased interest in the subject. The pathogenesis, indications for treatment, and outcome measures of infrapopliteal disease differ from larger vessel intervention. Diabetes and renal failure are prevalent. Neuropathy and venous disease contribute to the etiology of ulceration. Most interventions are undertaken for critical limb ischemia rather than claudication. Therefore, a range of conservative, pharmacological, and invasive therapies are provided. Conventional percutaneous transluminal angioplasty (PTA) using modern low-profile systems ismore » associated with high technical success rates. However, initial data from recent randomized, controlled trials suggest that drug-eluting stents are consistently achieving improved patency over PTA alone or over bare metal stents. This review summarizes recent advances in the treatment of infrapopliteal disease.« less

1996 DOE technical standards program workshop: Proceedings

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

NONE

1996-07-01

The workshop theme is `The Strategic Standardization Initiative - A Technology Exchange and Global Competitiveness Challenge for DOE.` The workshop goal is to inform the DOE technical standards community of strategic standardization activities taking place in the Department, other Government agencies, standards developing organizations, and industry. Individuals working on technical standards will be challenged to improve cooperation and communications with the involved organizations in response to the initiative. Workshop sessions include presentations by representatives from various Government agencies that focus on coordination among and participation of Government personnel in the voluntary standards process; reports by standards organizations, industry, and DOEmore » representatives on current technology exchange programs; and how the road ahead appears for `information superhighway` standardization. Another session highlights successful standardization case studies selected from several sites across the DOE complex. The workshop concludes with a panel discussion on the goals and objectives of the DOE Technical Standards Program as envisioned by senior DOE management. The annual workshop on technical standards has proven to be an effective medium for communicating information related to standards throughout the DOE community. Technical standards are used to transfer technology and standardize work processes to produce consistent, acceptable results. They provide a practical solution to the Department`s challenge to protect the environment and the health and safety of the public and workers during all facility operations. Through standards, the technologies of industries and governments worldwide are available to DOE. The DOE Technical Standards Program, a Department-wide effort that crosscuts all organizations and disciplines, links the Department to those technologies.« less

Mechanochemical endovenous ablation versus radiofrequency ablation in the treatment of primary small saphenous vein insufficiency (MESSI trial): study protocol for a randomized controlled trial.

PubMed

Boersma, Doeke; van Eekeren, Ramon R J P; Kelder, Hans J C; Werson, Debora A B; Holewijn, Suzanne; Schreve, Michiel A; Reijnen, Michel M P J; de Vries, Jean Paul P M

2014-10-29

Minimally invasive endothermal techniques, for example, radiofrequency ablation (RFA), have revolutionized the treatment of insufficient truncal veins and are associated with an excellent outcome. The use of thermal energy requires the instillation of tumescent anesthesia around the vein. Mechanochemical endovenous ablation (MOCA™) combines mechanical endothelial damage, using a rotating wire, with simultaneous infusion of a liquid sclerosans. Tumescent anesthesia is not required as no heat is used. Prospective studies using MOCA™ in both great and small saphenous veins showed good anatomical and clinical results with fast postoperative recovery. The MESSI trial (Mechanochemical Endovenous ablation versus radiofrequency ablation in the treatment of primary Small Saphenous vein Insufficiency) is a multicenter randomized controlled trial in which a total of 160 patients will be randomized (1:1) to MOCA™ or RFA. Consecutive patients with primary small saphenous vein incompetence, who meet the eligibility criteria, will be invited to participate in this trial. The primary endpoint is anatomic success, defined as occlusion of the treated veins objectified with duplex ultrasonography at 1 year follow-up. Secondary endpoints are post-procedural pain, initial technical success, clinical success, complications and the duration of the procedure. Initial technical success is defined as the ability to position the device adequately, treat the veins as planned and occlude the treated vein directly after the procedure has been proven by duplex ultrasonography. Clinical success is defined as an objective improvement of clinical outcome after treatment, measured with the Venous Clinical Severity Score (VCSS). Power analyses are conducted for anatomical success and post-procedural pain.Both groups will be evaluated on an intention-to-treat principle. The hypothesis of the MESSI trial is that the anatomic success rate of MOCA™ is not inferior to RFA. The second hypothesis is that post-procedural pain is significantly less after MOCA compared to RFA. NTR4613 Date of trial registration: 28 May 2014.

Fluoroscopically guided large balloon dilatation for treating congenital esophageal stenosis in children.

PubMed

Hu, Hong-Tao; Shin, Ji Hoon; Kim, Jin-Hyoung; Jang, Jong Keon; Park, Jung-Hoon; Kim, Tae-Hyung; Nam, Deok Ho; Song, Ho-Young

2015-07-01

We aimed to evaluate the safety and clinical effectiveness of fluoroscopically guided large balloon dilatation for treating congenital esophageal stenosis in children. Our study included seven children (mean age 4.0 years) who underwent a total of ten balloon dilatation sessions. The initial balloon diameters were 10-15 mm. The technical success, clinical success (improved food intake and reduced dysphagia within 1 month following the first balloon dilatation), dysphagia recurrence, and complications were retrospectively evaluated. Technical and clinical success rates were 100 %. During the mean 38-month follow-up period after the first balloon dilatation, 3 (43 %) patients underwent only one additional balloon dilatation 4-5 months after the first balloon dilatation for dysphagia recurrence. Two of them showed improvement without further recurrence, while the remaining one underwent partial esophagectomy. Well-contained transmural esophageal rupture (type 2) occurred in two (29 %, 2/7) patients and during two (20 %, 2/10) balloon dilatation sessions. All ruptures were successfully treated conservatively. Our study showed that fluoroscopically guided large balloon dilatation seems to be a simple and effective primary treatment technique for congenital esophageal stenosis in children. Esophageal ruptures were not uncommon although they were not fatal.

Development and initial evaluation of the Clinical Information Systems Success Model (CISSM).

PubMed

Garcia-Smith, Dianna; Effken, Judith A

2013-06-01

Most clinical information systems (CIS) today are technically sound, but the number of successful implementations of these systems is low. The purpose of this study was to develop and test a theoretically based integrated CIS Success Model (CISSM) from the nurse perspective. Model predictors of CIS success were taken from existing research on information systems acceptance, user satisfaction, use intention, user behavior and perceptions, as well as clinical research. Data collected online from 234 registered nurses in four hospitals were used to test the model. Each nurse had used the Cerner Power Chart Admission Health Profile for at least 3 months. Psychometric testing and factor analysis of the 23-item CISSM instrument established its construct validity and reliability. Initial analysis showed nurses' satisfaction with and dependency on CIS use predicted their perceived CIS use Net Benefit. Further analysis identified Social Influence and Facilitating Conditions as other predictors of CIS user Net Benefit. The level of hospital CIS integration may account for the role of CIS Use Dependency in the success of CIS. Based on our experience, CISSM provides a formative as well as summative tool for evaluating CIS success from the nurse's perspective. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Medtech: Potential for innovation.

PubMed

Bestetti, Gilberto

2009-10-17

Switzerland, with its ETHZ and EPFL, universities, advanced technical colleges, the CSEM, the Empa and the Paul Scherrer Institute, possesses a complete chain of knowledge and interdisciplinary competence which ranks it among the worldwide leaders in medical technology. To ensure that a wider range of excellent research results are translated into marketable products and methods, the CTI Agency for the Promotion of Innovation launched the Medtech initiative, a success story.

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

Das, Raj, E-mail: rajdas@nhs.net, E-mail: raj.das@stgeorges.nhs.uk; Lucatelli, Pierleone, E-mail: pierleone.lucatelli@gmail.com; Wang, Haofan, E-mail: wwhhff123@gmail.com

AimA clear understanding of operator experience is important in improving technical success whilst minimising patient risk undergoing endovascular procedures, and there is the need to ensure that trainees have the appropriate skills as primary operators. The aim of the study is to retrospectively analyse uterine artery embolisation (UAE) procedures performed by interventional radiology (IR) trainees at an IR training unit analysing fluoroscopy times and radiation dose as surrogate markers of technical skill.MethodsTen IR fellows were primary operator in 200 UAE procedures over a 5-year period. We compared fluoroscopy times, radiation dose and complications, after having them categorised according to threemore » groups: Group 1, initial five, Group 2, >5 procedures and Group 3, penultimate five UAE procedures. We documented factors that may affect screening time (number of vials employed and use of microcatheters).ResultsMean fluoroscopy time was 18.4 (±8.1), 17.3 (±9.0), 16.3 (±8.4) min in Groups 1, 2 and 3, respectively. There was no statistically significant difference between these groups (p > 0.05) with respect to fluoroscopy time or radiation dose. Analysis after correction for confounding factors showed no statistical significance (p > 0.05). All procedures were technically successful, and total complication rate was 4 %.ConclusionUAE was chosen as a highly standardised procedure followed by IR practitioners. Although there is a non-significant trend for shorter screening times with experience, technical success and safety were not compromised with appropriate Consultant supervision, which illustrates a safe construct for IR training. This is important and reassuring information for patients undergoing a procedure in a training unit.« less

Treatment of type II endoleak using Onyx with long-term imaging follow-up.

PubMed

Khaja, Minhaj S; Park, Auh Whan; Swee, Warren; Evans, Avery J; Fritz Angle, J; Turba, Ulku C; Sabri, Saher S; Matsumoto, Alan H

2014-06-01

The purpose of our study is to report our experience with the use of an ethylene vinyl alcohol copolymer (Onyx) in an off-label fashion for the treatment of type II endoleak after endovascular repair of the thoracic (TEVAR) and abdominal (EVAR) aorta. A retrospective review of patients with type I and/or II endoleak treated with Onyx was performed. Data regarding the technical, clinical, and imaging outcomes were collected. Technical success was defined as decreased or eliminated endoleak on the first imaging follow-up. Clinical success was defined as unchanged or decreased aneurysm sac size on subsequent follow-up. Eighteen patients (15 male, 3 female) with a mean age of 79 years (range 69-92) met inclusion criteria (16 abdominal aortic aneurysm, 2 thoracic aortic aneurysm). Sixteen patients had type II endoleak, and 2 had complex type II endoleak with a type I component. The interval between endograft placement and treatment was a mean of 30 months. Direct sac treatment approach was used in 13 patients; transarterial approach was used in 3 patients. Seven patients required the use of coils, N-butyl cyanoacrylate glue, or Amplatzer vascular plugs. The average volume of Onyx used per treatment was 5.6 mL (range 2.5-13). Duration of imaging follow-up was 0.75-72.5 months (mean 32.8). Sixteen of 18 (88.9 %) patients had initial technical and clinical success. Two of 18 patients (11.1 %) were initial technical failures, and 1 remained a failure despite a second treatment and attempted surgical ligation. Eight of 18 (44.4 %) of patients eventually required a second intervention, 5 (27.8 %) of them due to delayed clinical failure. Complications included 1 psoas hematoma, 1 transient L2 nerve paresis, and 1 intraperitoneal Onyx leak; all of these were without clinical sequelae. Onyx with or without coil/glue/Amplatzer plug embolization is safe and useful in the treatment of type II endoleak after TEVAR and EVAR. However, long-term clinical and imaging follow-up is needed for early detection and management of recurrence of the primary endoleak or the development of new, secondary endoleaks or enlargement of the aneurysm sac.

Removal of Retrievable Self-Expandable Metallic Tracheobronchial Stents: An 18-Year Experience in a Single Center.

PubMed

Park, Jung-Hoon; Kim, Pyeong Hwa; Shin, Ji Hoon; Tsauo, Jiaywei; Kim, Min Tae; Cho, Young Chul; Kim, Jin Hyoung; Song, Ho-Young

2016-11-01

The purpose of the study was to retrospectively evaluate the technical outcomes of removal of retrievable self-expandable metallic stents (REMSs) and identify predictors of technical failure in 81 patients with benign and malignant tracheobronchial strictures. A total of 98 REMSs were removed under fluoroscopic guidance in 81 patients with benign (n = 48) or malignant (n = 33) tracheobronchial strictures. Primary and secondary technical success rates and complication rate were evaluated. Technical outcomes with regard to underlying diseases were also evaluated. Logistic regression models were constructed to identify predictors of primary technical success. Primary and secondary technical success rates were 86.7 and 94.9 %, respectively. Stent removal-related complication rate was 7.1 % (7/98) and all were bleeding after stent removal. All bleeding complications were minor and managed conservatively. Primary technical success rate for benign strictures was significantly lower compared with that for malignant strictures (80.9 vs. 97.1 %, P = 0.029), but secondary technical success rate (93.7 vs. 97.1 %, P = 0.652) did not differ between the two groups. Granulation tissue formation was identified as an independent predictor of primary technical success (odds ratio 0.249, 95 % CI 0.071-0.874, P = 0.030). Removal of REMSs in patients with benign and malignant tracheobronchial strictures is safe and technically feasible. Bronchoscopic guidance may be required when the removal using a hook wire fails. The presence of granulation tissue was the negative predictor of primary technical success.

Remote navigation systems in electrophysiology.

PubMed

Schmidt, Boris; Chun, Kyoung Ryul Julian; Tilz, Roland R; Koektuerk, Buelent; Ouyang, Feifan; Kuck, Karl-Heinz

2008-11-01

Today, atrial fibrillation (AF) is the dominant indication for catheter ablation in big electrophysiologists (EP) centres. AF ablation strategies are complex and technically challenging. Therefore, it would be desirable that technical innovations pursue the goal to improve catheter stability to increase the procedural success and most importantly to increase safety by helping to avoid serious complications. The most promising technical innovation aiming at the aforementioned goals is remote catheter navigation and ablation. To date, two different systems, the NIOBE magnetic navigation system (MNS, Stereotaxis, USA) and the Sensei robotic navigation system (RNS, Hansen Medical, USA), are commercially available. The following review will introduce the basic principles of the systems, will give an insight into the merits and demerits of remote navigation, and will further focus on the initial clinical experience at our centre with focus on pulmonary vein isolation (PVI) procedures.

Is side-viewing endoscope assisted balloon dilatation better for corrosive gastric outlet obstruction?

PubMed

Katiyar, Prashant; Nijhawan, Sandeep; Saradava, Vimal; Nagaich, Neeraj; Gupta, Gaurav; Mathur, Amit; Nepalia, Subhash

2013-11-01

Endoscopic balloon dilatation (EBD) is an effective therapy for caustic-induced gastric outlet obstruction (GOO). Gaining access to the stricture site is the most important step. It is sometimes difficult to negotiate a balloon through the stricture with a front-viewing endoscope due to deformed anatomy of stomach. To overcome this technical difficulty, a side-viewing endoscope can be used. There is limited data regarding the use of side-viewing endoscopes in EBD. We here report on the short-term efficacy and safety of EBD in caustic-induced GOO. In technically difficult cases, a side-viewing endoscope was used for EBD and its efficacy and safety were assessed. The study included 25 patients with caustic-induced GOO. Patients underwent EBD using a through-the-scope balloon. Initial balloon dilatation was performed with a front-viewing endoscope. A side-viewing endoscope was used where negotiation across the stricture failed with a front-viewing endoscope. Dilatation was started at 8 mm diameter and was performed at 1-week intervals. The end point of dilatation was 15 mm diameter. In 18 patients successful balloon dilatation was possible with a front-viewing endoscope. A side-viewing endoscope was used in six patients as negotiation across the stricture was not possible with a front-viewing endoscope. In all six patients negotiation across the stricture followed by successful dilatation was successful with a side-viewing endoscope. Of the 25 patients included in this study, 24 (96%) achieved procedural success (18 with a front-viewing endoscope and 6 with a side-viewing endoscope) in 3-9 sessions. Our results show that EBD is a safe and effective option for caustic-induced GOO and in difficult cases a side-viewing endoscope can be used to achieve technical success.

The NASA "PERS" Program: Solid Polymer Electrolyte Development for Advanced Lithium-Based Batteries

NASA Technical Reports Server (NTRS)

Baldwin, Richard S.; Bennett, William R.

2007-01-01

In fiscal year 2000, The National Aeronautics and Space Administration (NASA) and the Air Force Research Laboratory (AFRL) established a collaborative effort to support the development of polymer-based, lithium-based cell chemistries and battery technologies to address the next generation of aerospace applications and mission needs. The ultimate objective of this development program, which was referred to as the Polymer Energy Rechargeable System (PERS), was to establish a world-class technology capability and U.S. leadership in polymer-based battery technology for aerospace applications. Programmatically, the PERS initiative exploited both interagency collaborations to address common technology and engineering issues and the active participation of academia and private industry. The initial program phases focused on R&D activities to address the critical technical issues and challenges at the cell level. Out of a total of 38 proposals received in response to a NASA Research Announcement (NRA) solicitation, 18 proposals (13 contracts and 5 grants) were selected for initial award to address these technical challenges. Brief summaries of technical approaches, results and accomplishments of the PERS Program development efforts are presented. With Agency support provided through FY 2004, the PERS Program efforts were concluded in 2005, as internal reorganizations and funding cuts resulted in shifting programmatic priorities within NASA. Technically, the PERS Program participants explored, to various degrees over the lifetime of the formal program, a variety of conceptual approaches for developing and demonstrating performance of a viable advanced solid polymer electrolyte possessing the desired attributes, as well as several participants addressing all components of an integrated cell configuration. Programmatically, the NASA PERS Program was very successful, even though the very challenging technical goals for achieving a viable solid polymer electrolyte material or the overall envisioned long-term, program objectives were not met due to funding reductions. The NASA PERS Program provided research opportunities and generated and disseminated a wealth of new scientific knowledge and technical competencies within the polymer electrolyte area.

Removal of Retrievable Self-Expandable Metallic Tracheobronchial Stents: An 18-Year Experience in a Single Center

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

Park, Jung-Hoon; Kim, Pyeong Hwa; Shin, Ji Hoon, E-mail: jhshin@amc.seoul.kr

2016-11-15

PurposeThe purpose of the study was to retrospectively evaluate the technical outcomes of removal of retrievable self-expandable metallic stents (REMSs) and identify predictors of technical failure in 81 patients with benign and malignant tracheobronchial strictures.Materials and MethodsA total of 98 REMSs were removed under fluoroscopic guidance in 81 patients with benign (n = 48) or malignant (n = 33) tracheobronchial strictures. Primary and secondary technical success rates and complication rate were evaluated. Technical outcomes with regard to underlying diseases were also evaluated. Logistic regression models were constructed to identify predictors of primary technical success.ResultsPrimary and secondary technical success rates were 86.7 and 94.9 %, respectively.more » Stent removal-related complication rate was 7.1 % (7/98) and all were bleeding after stent removal. All bleeding complications were minor and managed conservatively. Primary technical success rate for benign strictures was significantly lower compared with that for malignant strictures (80.9 vs. 97.1 %, P = 0.029), but secondary technical success rate (93.7 vs. 97.1 %, P = 0.652) did not differ between the two groups. Granulation tissue formation was identified as an independent predictor of primary technical success (odds ratio 0.249, 95 % CI 0.071–0.874, P = 0.030).ConclusionRemoval of REMSs in patients with benign and malignant tracheobronchial strictures is safe and technically feasible. Bronchoscopic guidance may be required when the removal using a hook wire fails. The presence of granulation tissue was the negative predictor of primary technical success.« less

Eleven Tribes Jump START Clean Energy Projects, Summer 2012 (Newsletter)

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

Not Available

This newsletter describes key activities of the DOE Office of Indian Energy Policy and Programs for Summer 2012. The U.S. Department of Energy Office of Indian Energy Policy and Programs (DOE-IE) has selected 11 Tribes - five in Alaska and six in the contiguous United States - to receive on-the-ground technical support for community-based energy efficiency and renewable energy projects as part of DOE-IE's Strategic Technical Assistance Response Team (START) Program. START finalists were selected based on the clarity of their requests for technical assistance and the ability of START to successfully work with their projects or community. Technical expertsmore » from DOE and its National Renewable Energy Laboratory (NREL) will work directly with community-based project teams to analyze local energy issues and assist the Tribes in moving their projects forward. In Alaska, the effort will be bolstered by DOE-IE's partnership with the Denali Commission, which will provide additional assistance and expertise, as well as funding to fuel the Alaska START initiative.« less

Transcatheter Coil Embolization of Splenic Artery Aneurysm

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

Yamamoto, Satoshi, E-mail: s-yama@hyo-med.ac.jp; Hirota, Shozo; Maeda, Hiroaki

2008-05-15

The purpose of this study was to evaluate clinical results and technical problems of transcatheter coil embolization for splenic artery aneurysm. Subjects were 16 patients (8 men, 8 women; age range, 40-80 years) who underwent transcatheter embolization for splenic artery aneurysm (14 true aneurysms, 2 false aneurysms) at one of our hospitals during the period January 1997 through July 2005. Two aneurysms (12.5%) were diagnosed at the time of rupture. Multiple splenic aneurysms were found in seven patients. Aneurysms were classified by site as proximal (or strictly ostial) (n = 3), middle (n = 3), or hilar (n = 10).more » The indication for transcatheter arterial embolization was a false or true aneurysm 20 mm in diameter. Embolic materials were fibered coils and interlocking detachable coils. Embolization was performed by the isolation technique, the packing technique, or both. Technically, all aneurysms were devascularized without severe complications. Embolized aneurysms were 6-40 mm in diameter (mean, 25 mm). Overall, the primary technical success rate was 88% (14 of 16 patients). In the remaining 2 patients (12.5%), partial recanalization occurred, and re-embolization was performed. The secondary technical success rate was 100%. Seven (44%) of the 16 study patients suffered partial splenic infarction. Intrasplenic branching originating from the aneurysm was observed in five patients. We conclude that transcatheter coil embolization should be the initial treatment of choice for splenic artery aneurysm.« less

Management of Postoperative Lymphoceles After Lymphadenectomy: Percutaneous Catheter Drainage With and Without Povidone-Iodine Sclerotherapy

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

Alago, William, E-mail: alagow@mskcc.org; Deodhar, Ajita; Michell, Hans

To report our single-center experience in managing symptomatic lymphoceles after lymphadenectomy for genitourinary and gynecologic malignancy and to compare clinical outcomes of percutaneous catheter drainage (PCD) alone versus PCD with transcatheter povidone-iodine sclerotherapy (TPIS). The medical records of patients who presented for percutaneous drainage of pelvic lymphoceles from February 1999 to September 2007 were retrospectively reviewed. Catheters with prolonged outputs >50 cc/day were treated with TPIS. Technical success was defined as the ability to achieve complete resolution of the lymphocele. Clinical success was defined as resolution of the patient's symptoms that prompted the intervention. Sixty-four patients with 70 pelvic lymphocelesmore » were treated. Forty-six patients (71.9 %) had PCD, and 18 patients (28.1 %) had multisession TPIS. The mean initial cavity size was 294.9 cc for those treated with TPIS and 228.2 cc for those treated with PCD alone (range 15-1,600) (p = 0.59). Mean duration of catheter drainage was 19 days (29 days with TPIS, 16 days with PCD, p = 0.001). Mean clinical follow-up was 22.6 months. Technical success was 74.3 % with PCD and 100 % with TPIS. Clinical success was 97 % with PCD and 100 % with TPIS. Postprocedural complications included pericatheter fluid leakage (n = 4), catheter dislodgement (n = 3), catheter occlusion (n = 9), and secondary infection of the collection (n = 4). PCD of symptomatic lymphoceles is an effective postoperative management technique. Initial cavity size is not an accurate predictor of the need for TPIS. When indicated, TPIS is safe and effective with catheter outputs >50 cc/day.« less

Transradial Approach for Hepatic Radioembolization: Initial Results and Technique.

PubMed

Bishay, Vivian L; Biederman, Derek M; Ward, Thomas J; van der Bom, Imramsjah Martijn J; Patel, Rahul S; Kim, Edward; Nowakowski, Francis S; Lookstein, Robert A; Fischman, Aaron M

2016-11-01

The transradial approach (TRA) has been shown to reduce the morbidity and mortality associated with arterial coronary interventions. Selective internal radiation therapy (SIRT) performed via the TRA can enhance patient comfort, compared with the traditional transfemoral approach (TFA), by allowing immediate ambulation and precluding potential complications associated with the TFA, such as closure device injury or retroperitoneal hematoma. We report our initial experience with and technique for using the TRA for SIRT. Between May 1, 2012, and April 30, 2015, a total of 574 procedures, including planning angiograms (n = 329) and infusions of 90 Y (n = 245), were performed for 318 patients (mean age, 64.5 years). Of the 245 patients who received 90 Y infusions, 52 had SIRT performed with the use of a permanent single-use implant of 90 Y resin microspheres and 193 had SIRT performed with the use of millions of small glass microspheres containing radioactive 90 Y. Procedural details, technical success, the radial artery (RA) occlusion rate noted at 30 days (as assessed via pulse examination), and the major and minor adverse events noted at 30 days were evaluated. Technical success was achieved in 561 of 574 cases (97.7%). The reasons for crossover to use of the TFA included an RA loop (n = 2), RA occlusion (n = 9), and type D response as determined by use of a Barbeau test (n = 2). Patients had undergone between zero and six previous TRA procedures. The mortality rate at 30 days was 0%. Superficial bruising occurred in 13 of 574 cases (2.3%). A grade 2 hematoma that required a second nonocclusive hemostasis cuff occurred in one case. Transient forearm numbness or pain occurred in two of 574 cases. One patient had a transient convulsive event occur after receiving intraarterial infusion of verapamil. RA occlusion occurred in nine of 574 cases (1.6%). Use of the TRA for SIRT is safe, feasible, and well tolerated and is associated with high rates of technical success and rare complications.

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.

Does Technical Success of Angioplasty in Dysfunctional Hemodialysis Accesses Correlate with Access Patency?

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

Sidhu, Arshdeep; Tan, Kong T.; Noel-Lamy, Maxime

2016-10-15

PurposeTo study if <30 % residual stenosis post angioplasty (PTA) correlates with primary access circuit patency, and if any variables predict technical success.Materials and MethodsA prospective observational study was performed between January 2009 and December 2012, wherein 76 patients underwent 154 PTA events in 56 prosthetic grafts (AVG) and 98 autogenous fistulas (AVF). Data collected included patient age, gender, lesion location and laterality, access type and location, number of prior interventions, and transonic flow rates pre- and postintervention. Impact of technical outcome on access patency was assessed. Univariate logistic regression was used to assess the impact of variables on technical success withmore » significant factors assessed with a multiple variable model.ResultsTechnical success rates of PTA in AVFs and AVGs were 79.6 and 76.7 %, respectively. Technical failures of PTA were associated with an increased risk of patency loss among circuits with AVFs (p < 0.05), but not with AVGs (p = 0.7). In AVFs, primary access patency rates between technical successes and failures at three and 6 months were 74.4 versus 61.9 % (p = 0.3) and 53.8 versus 23.8 % (p < 0.05), respectively. In AVGs, primary access patency rates between technical successes and failures at three and six months were 72.1 versus 53.9 % (p = 0.5) and 33.6 versus 38.5 % (p = 0.8), respectively. Transonic flow rates did not significantly differ among technically successful or failed outcomes at one or three months.ConclusionTechnical failures of PTA had a significant impact on access patency among AVFs with a trend toward poorer access patency within AVGs.« less

Does Technical Success of Angioplasty in Dysfunctional Hemodialysis Accesses Correlate with Access Patency?

PubMed

Sidhu, Arshdeep; Tan, Kong T; Noel-Lamy, Maxime; Simons, Martin E; Rajan, Dheeraj K

2016-10-01

To study if <30 % residual stenosis post angioplasty (PTA) correlates with primary access circuit patency, and if any variables predict technical success. A prospective observational study was performed between January 2009 and December 2012, wherein 76 patients underwent 154 PTA events in 56 prosthetic grafts (AVG) and 98 autogenous fistulas (AVF). Data collected included patient age, gender, lesion location and laterality, access type and location, number of prior interventions, and transonic flow rates pre- and postintervention. Impact of technical outcome on access patency was assessed. Univariate logistic regression was used to assess the impact of variables on technical success with significant factors assessed with a multiple variable model. Technical success rates of PTA in AVFs and AVGs were 79.6 and 76.7 %, respectively. Technical failures of PTA were associated with an increased risk of patency loss among circuits with AVFs (p < 0.05), but not with AVGs (p = 0.7). In AVFs, primary access patency rates between technical successes and failures at three and 6 months were 74.4 versus 61.9 % (p = 0.3) and 53.8 versus 23.8 % (p < 0.05), respectively. In AVGs, primary access patency rates between technical successes and failures at three and six months were 72.1 versus 53.9 % (p = 0.5) and 33.6 versus 38.5 % (p = 0.8), respectively. Transonic flow rates did not significantly differ among technically successful or failed outcomes at one or three months. Technical failures of PTA had a significant impact on access patency among AVFs with a trend toward poorer access patency within AVGs.

Building sustainable organizational capacity to deliver HIV programs in resource-constrained settings: stakeholder perspectives.

PubMed

Sharma, Anjali; Chiliade, Philippe; Michael Reyes, E; Thomas, Kate K; Collens, Stephen R; Rafael Morales, José

2013-12-13

In 2008, the US government mandated that HIV/AIDS care and treatment programs funded by the US President's Emergency Plan for AIDS Relief (PEPFAR) should shift from US-based international partners (IPs) to registered locally owned organizations (local partners, or LPs). The US Health Resources and Services Administration (HRSA) developed the Clinical Assessment for Systems Strengthening (ClASS) framework for technical assistance in resource-constrained settings. The ClASS framework involves all stakeholders in the identification of LPs' strengths and needs for technical assistance. This article examines the role of ClASS in building capacity of LPs that can endure and adapt to changing financial and policy environments. All stakeholders (n=68) in Kenya, Zambia, and Nigeria who had participated in the ClASS from LPs and IPs, the US Centers for Disease Control and Prevention (CDC), and, in Nigeria, HIV/AIDS treatment facilities (TFs) were interviewed individually or in groups (n=42) using an open-ended interview guide. Thematic analysis revealed stakeholder perspectives on ClASS-initiated changes and their sustainability. Local organizations were motivated to make changes in internal operations with the ClASS approach, PEPFAR's competitive funding climate, organizational goals, and desired patient health outcomes. Local organizations drew on internal resources and, if needed, technical assistance from IPs. Reportedly, ClASS-initiated changes and remedial action plans made LPs more competitive for PEPFAR funding. LPs also attributed their successful funding applications to their preexisting systems and reputation. Bureaucracy, complex and competing tasks, and staff attrition impeded progress toward the desired changes. Although CDC continues to provide technical assistance through IPs, declining PEPFAR funds threaten the consolidation of gains, smooth program transition, and continuity of treatment services. The well-timed adaptation and implementation of ClASS successfully engaged stakeholders who committed their own resources toward strengthening organizational capacity. The sustainability of built capacity depends on continued investment in leadership, staff retention, and quality improvement.

Building sustainable organizational capacity to deliver HIV programs in resource-constrained settings: stakeholder perspectives

PubMed Central

Sharma, Anjali; Chiliade, Philippe; Reyes, E. Michael; Thomas, Kate K.; Collens, Stephen R.; Morales, José Rafael

2013-01-01

Background In 2008, the US government mandated that HIV/AIDS care and treatment programs funded by the US President's Emergency Plan for AIDS Relief (PEPFAR) should shift from US-based international partners (IPs) to registered locally owned organizations (local partners, or LPs). The US Health Resources and Services Administration (HRSA) developed the Clinical Assessment for Systems Strengthening (ClASS) framework for technical assistance in resource-constrained settings. The ClASS framework involves all stakeholders in the identification of LPs’ strengths and needs for technical assistance. Objective This article examines the role of ClASS in building capacity of LPs that can endure and adapt to changing financial and policy environments. Design All stakeholders (n=68) in Kenya, Zambia, and Nigeria who had participated in the ClASS from LPs and IPs, the US Centers for Disease Control and Prevention (CDC), and, in Nigeria, HIV/AIDS treatment facilities (TFs) were interviewed individually or in groups (n=42) using an open-ended interview guide. Thematic analysis revealed stakeholder perspectives on ClASS-initiated changes and their sustainability. Results Local organizations were motivated to make changes in internal operations with the ClASS approach, PEPFAR's competitive funding climate, organizational goals, and desired patient health outcomes. Local organizations drew on internal resources and, if needed, technical assistance from IPs. Reportedly, ClASS-initiated changes and remedial action plans made LPs more competitive for PEPFAR funding. LPs also attributed their successful funding applications to their preexisting systems and reputation. Bureaucracy, complex and competing tasks, and staff attrition impeded progress toward the desired changes. Although CDC continues to provide technical assistance through IPs, declining PEPFAR funds threaten the consolidation of gains, smooth program transition, and continuity of treatment services. Conclusions The well-timed adaptation and implementation of ClASS successfully engaged stakeholders who committed their own resources toward strengthening organizational capacity. The sustainability of built capacity depends on continued investment in leadership, staff retention, and quality improvement. PMID:24331715

Comparison of EUS-guided tissue acquisition using two different 19-gauge core biopsy needles: a multicenter, prospective, randomized, and blinded study

PubMed Central

DeWitt, John; Cho, Chang-Min; Lin, Jingmei; Al-Haddad, Mohammad; Canto, Marcia Irene; Salamone, Ashley; Hruban, Ralph H.; Messallam, Ahmed A.; Khashab, Mouen A.

2015-01-01

Background and study aims: The optimal core biopsy needle for endoscopic ultrasound (EUS) is unknown. The principle aim of this study is to compare outcomes of EUS-fine-needle biopsy (EUS-FNB) with a new 19-gauge EUS histology needle (ProCore, Cook Medical Inc., Winston-Salem, North Carolina, United States) to a conventional 19-gauge Tru-Cut biopsy (EUS-TCB) needle (19G, Quick-Core, Cook Medical Inc.). Patients and methods: Patients referred for EUS who require possible histologic biopsy were prospectively randomized to EUS-FNB or EUS-TCB. With the initial needle, ≤ 3 biopsies were obtained until either technical failure or an adequate core was obtained. Patients with suspected inadequate biopsies were crossed over to the other needle and similarly ≤ 3 passes were obtained until adequate cores or technical failure occurred. Technical success, diagnostic histology, accuracy and complication rates were evaluated. Results: Eighty-five patients (mean 58 years; 43 male) were randomized to FNB (n = 44) and TCB (n = 41) with seven patients excluded. Procedure indication, biopsy site, mass size, number of passes, puncture site, overall technical success and adverse events were similar between the two groups. FNB specimens had a higher prevalence of diagnostic histology (85 % vs. 57 %; P = 0.006), accuracy (88 % vs. 62 %; P = 0.02), mean total length (19.4 vs. 4.3 mm; P = 0.001), mean complete portal triads from liver biopsies (10.4 vs. 1.3; P = 0.0004) and required fewer crossover biopsies compared to those of TCB (2 % vs. 65 %; P = 0.0001). Overall technical success and complication rates were comparable. Conclusion: EUS-FNB using a 19-gauge FNB needle is superior to 19-gauge EUS-TCB needle. PMID:26528504

Stewart's maxims: eight "do's" for successfully communicating silviculture to policymakers

Treesearch

R. E. Stewart

1997-01-01

Technical specialists may experience difficulties in presenting information to non-technical policymakers and having that information used. Eight maxims are discussed that should help the silviculturist successfully provide technical information to non-technical audiences so that it will be considered in the formulation of policy.

An Internship Model for Culturally Relevant Success for Native American High School Students

NASA Astrophysics Data System (ADS)

Nall, J.; Graham, E. M.

2004-12-01

Culturally relevant educational practices can be challenging to implement in the workplace. In an effort to support equity in access to undergraduate internship opportunities for Native American students, NASA Jet Propulsion Laboratory's (JPL) Education Office, Minority Education Initiatives offers a unique approach to supporting students from Native American reservation high schools in Washington State to participate in eight-week technical (Science, Technology, Engineering and Mathematics related) summer internships. This talk will address the Alliance for Learning and Vision for Americans (ALVA) program's twelve years of success based on four programmatic principals, annual review and the critical support of scientists and engineers.

Innovative grinding wheel design for cost-effective machining of advanced ceramics

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

Licht, R.H.; Kuo, P.; Liu, S.

2000-05-01

This Final Report covers the Phase II Innovative Grinding Wheel (IGW) program in which Norton Company successfully developed a novel grinding wheel for cost-effective cylindrical grinding of advanced ceramics. In 1995, Norton Company successfully completed the 16-month Phase I technical effort to define requirements, design, develop, and evaluate a next-generation grinding wheel for cost-effective cylindrical grinding of advanced ceramics using small prototype wheels. The Phase II program was initiated to scale-up the new superabrasive wheel specification to larger diameters, 305-mm to 406-mm, required for most production grinding of cylindrical ceramic parts, and to perform in-house and independent validation grinding tests.

Computerized Decision Support System Improves Fluid Resuscitation Outcomes Following Severe Burns: An Original Study

DTIC Science & Technology

2011-01-01

clinical decision- making paradigms, coupled with regula- tory and technical limitations, is just one of the hurdles that has kept advanced information...responses to assist care personnel during the resuscitation phase. CDSSs have been successfully used in the clinical setting for several years (23–24...because of clinical complications, death, or other factors were excluded. The control cohort included only patients who sur- vived for the initial 24

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

Lee, Woong Hee; Kim, Jin Hyoung, E-mail: m1fenew@daum.net; Park, Jung-Hun

Purpose: Little was known about the safety and long-term efficacy of fluoroscopically guided balloon dilation for postintubation tracheal stenosis. The purpose of this study was to evaluate the safety and long-term efficacy of fluoroscopically guided balloon dilation in patients with postintubation tracheal stenosis. Methods: From February 2000 to November 2010, 14 patients underwent fluoroscopically guided balloon dilation for postintubation tracheal stenosis. Technical success, clinical success, and complications were evaluated. Patients were followed up for recurrent symptoms. Results: In all patients, fluoroscopically guided balloon dilation was technically and clinically successful with no major complications. Following the initial procedure, six patients (43more » %) remained asymptomatic during a follow-up period. Obstructive symptoms recurred in eight patients (57 %) within 6 months (mean, 1.7 months), who were treated with repeat balloon dilation (n = 4) and other therapies. Of the four patients who underwent repeat balloon dilation, three became asymptomatic. One patient became asymptomatic after a third balloon dilation. On long-term (mean, 74 months) follow-up, 71 % of patients experienced relief of symptoms following fluoroscopically guided balloon dilation. Conclusions: Fluoroscopically guided balloon dilation may be safe, is easy to perform, and resulted in effective treatment in patients with postintubation tracheal stenosis.« less

Challenges and successes for the grantees and the Technical Advisory Group of WHO's influenza vaccine technology transfer initiative.

PubMed

Grohmann, Gary; Francis, Donald P; Sokhey, Jaspal; Robertson, James

2016-10-26

One of the aims of the WHO Global Action Plan for Influenza Vaccines (GAP) was to transfer influenza vaccine production technology to interested manufacturers and governments in developing countries, to enable greater influenza vaccine manufacturing capacity against any pandemic threat or pandemic. For this objective, the GAP was supported by an independent Technical Advisory Group (TAG) to assist WHO to select vaccine manufacturing proposals for funding and to provide programmatic support for successful grantees. While there were many challenges, for both the TAG and grantees, there were also notable successes with an additional capacity of 338-600 million pandemic vaccine doses being made possible by the programme between 2007 and 2015, and a potential capacity of more than 600 million by 2016/17 with up to one billion doses expected by 2018/19. Seasonal vaccine production was also developed in 4 countries with another 4-5 countries expected to be producing seasonal vaccine by 2018/19. The relatively small WHO investments - in time and funding - made in these companies to develop their own influenza vaccine production facilities have had quite dramatic results. Copyright © 2016 Elsevier Ltd. All rights reserved.

The NanoSustain and NanoValid project--two new EU FP7 research initiatives to assess the unique physical-chemical and toxicological properties of engineered nanomaterials.

PubMed

Reuther, Rudolf

2011-02-01

In 2010, the EU FP NanoSustain project (247989) has been successfully launched with the objective to develop innovative solutions for the sustainable use, recycling and final treatment of engineered nanomaterials (ENMs). The same year, NanoValid (263147), a large-scale integrating EU FP7 project has been initiated and contract negotiations with the European Commission commenced, to develop new reference methods and materials applicable to the unique properties of ENMs. The paper presented will give an overview on the main objectives of these 2 new European research initiatives, on main tasks to achieve objectives, and on the impact on current standardization efforts and technical innovations.

An Analysis of Costs and Cenefits Associated with Initial Contracting Technical Education and Training for Unrestricted Marine Officers

DTIC Science & Technology

2017-03-01

COSTS AND BENEFITS ASSOCIATED WITH INITIAL CONTRACTING TECHNICAL EDUCATION AND TRAINING FOR UNRESTRICTED MARINE OFFICERS by Lee A. White...WITH INITIAL CONTRACTING TECHNICAL EDUCATION AND TRAINING FOR UNRESTRICTED MARINE OFFICERS 5. FUNDING NUMBERS 6. AUTHOR(S) Lee A. White 7. PERFORMING...unlimited. AN ANALYSIS OF COSTS AND BENEFITS ASSOCIATED WITH INITIAL CONTRACTING TECHNICAL EDUCATION AND TRAINING FOR UNRESTRICTED MARINE OFFICERS

Endoscopic ultrasound-guided transmural drainage of postoperative pancreatic collections.

PubMed

Tilara, Amy; Gerdes, Hans; Allen, Peter; Jarnagin, William; Kingham, Peter; Fong, Yuman; DeMatteo, Ronald; D'Angelica, Michael; Schattner, Mark

2014-01-01

Pancreatic leak is a major cause of morbidity after pancreatectomy. Traditionally, peripancreatic fluid collections have been managed by percutaneous or operative drainage. Data for endoscopic ultrasound (EUS)-guided drainage of postoperative fluid collections are limited. Here we report on the safety, efficacy, and timing of EUS-guided drainage of postoperative peripancreatic collections. This is a retrospective review of 31 patients who underwent EUS-guided drainage of fluid collections after pancreatic resection. Technical success was defined as successful transgastric deployment of at least one double pigtail plastic stent. Clinical success was defined as resolution of the fluid collection on follow-up CT scan and resolution of symptoms. Early drainage was defined as initial transmural stent placement within 30 days after surgery. Endoscopic ultrasound-guided drainage was performed effectively with a technical success rate of 100%. Clinical success was achieved in 29 of 31 patients (93%). Nineteen of the 29 patients (65%) had complete resolution of their symptoms and collection with the first endoscopic procedure. Repeat drainage procedures, including some with necrosectomy, were required in the remaining 10 patients, with eventual resolution of collection and symptoms. Two patients who did not achieve durable clinical success required percutaneous drainage by interventional radiology. Seventeen (55%) of 31 patients had successful early drainage completed within 30 days of their operation. Endoscopic ultrasound-guided drainage of fluid collections after pancreatic resection is safe and effective. Early drainage (<30 days) of postoperative pancreatic fluid collections was not associated with increased complications in this series. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

A Comparison of Physical and Technical Performance Profiles Between Successful and Less-Successful Professional Rugby League Teams.

PubMed

Kempton, Thomas; Sirotic, Anita C; Coutts, Aaron J

2017-04-01

To examine differences in physical and technical performance profiles using a large sample of match observations drawn from successful and less-successful professional rugby league teams. Match activity profiles were collected using global positioning satellite (GPS) technology from 29 players from a successful rugby league team during 24 games and 25 players from a less-successful team during 18 games throughout 2 separate competition seasons. Technical performance data were obtained from a commercial statistics provider. A progressive magnitude-based statistical approach was used to compare differences in physical and technical performance variables between the reference teams. There were no clear differences in playing time, absolute and relative total distances, or low-speed running distances between successful and less-successful teams. The successful team possibly to very likely had lower higher-speed running demands and likely had fewer physical collisions than the less-successful team, although they likely to most likely demonstrated more accelerations and decelerations and likely had higher average metabolic power. The successful team very likely gained more territory in attack, very likely had more possessions, and likely committed fewer errors. In contrast, the less-successful team was likely required to attempt more tackles, most likely missed more tackles, and very likely had a lower effective tackle percentage. In the current study, successful match performance was not contingent on higher match running outputs or more physical collisions; rather, proficiency in technical performance components better differentiated successful and less-successful teams.

Manned Spacecraft Requirements for Materials and Processes

NASA Technical Reports Server (NTRS)

Vaughn, Timothy P.

2006-01-01

A major cause of project failure can be attributed to an emphasized focus on end products and inadequate attention to resolving development risks during the initial phases of a project. The initial phases of a project, which we will call the "study period", are critical to determining project scope and costs, and can make or break most projects. If the requirements are not defined adequately, how can the scope be adequately determined, also how can the costs of the entire project be effectively estimated, and how can the risk of project success be accurately assessed? Using the proper material specifications and standards and incorporating these specifications and standards in the design process should be considered inherently crucial to the technical success of a project as just as importantly, crucial to the cost and schedule success. This paper will intertwine several important aspects or considerations for project success: 1) Characteristics of a "Good Material Requirement"; 2) Linking material requirements to the implementation of "Design for Manufacturing"; techniques and 3) The importance of decomposing materials requirements during the study phase/development phase to mitigate project risk for the maturation of technologies before the building of hardware.

77 FR 46769 - Notice of Public Meeting, North Slope Science Initiative-Science Technical Advisory Panel

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-06

...] Notice of Public Meeting, North Slope Science Initiative--Science Technical Advisory Panel AGENCY: Bureau of Land Management, Alaska State Office, North Slope Science Initiative, Interior. ACTION: Notice of... Initiative (NSSI)-- Science Technical Advisory Panel (STAP) will meet as indicated below. DATES: The meeting...

Technical and economic assessments commercial success for IGCC technology in China

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

Xiong, T.

1998-07-01

The experiences gained from several Integrated Gasification Combined Cycle (IGCC) demonstration plants operating in the US and Europe facilitate commercial success of this advanced coal-based power generation technology. However, commercialization of coal-based IGCC technology in the West, particularly in the US, is restricted due to the low price of natural gas. On the contrary, in China--the largest coal producer and consumer in the world--a lack of natural gas supply, strong demand for air pollution control and relatively low costs of manufacturing and construction provide tremendous opportunities for IGCC applications. The first Chinese IGCC demonstration project was initiated in 1994, andmore » other potential IGCC projects are in planning. IGCC applications in re-powering, fuel switching and multi-generation also show a great market potential in China. However, questions for IGCC development in China remain; where are realistic opportunities for IGCC projects and how can these opportunities be converted into commercial success? The answers to these questions should focus on the Chinese market needs and emphasize economic benefits, not just clean, or power. High price of imported equipment, high financing costs, and the technical risk of first-of-a-kind installation barricade IGCC development in China. This paper presents preliminary technical and economic assessments for four typical IGCC applications in the Chinese marketplace: central power station, fuel switching, re-powering, and multi-generation. The major factors affecting project economics--such as plant cost, financing, prices of fuel and electricity and operating capacity factor--are analyzed. The results indicate that well-proven technology for versatile applications, preferred financing, reduction of the plant cost, environmental superiority and appropriate project structure are the key for commercial success of IGCC in China.« less

Fibrin sheaths in central venous port catheters: treatment with low-dose, single injection of urokinase on an outpatient basis.

PubMed

Chang, De-Hua; Mammadov, Kamal; Hickethier, Tilman; Borggrefe, Jan; Hellmich, Martin; Maintz, David; Kabbasch, Christoph

2017-01-01

Evaluation of the efficacy of single-shot, low-dose urokinase administration for the treatment of port catheter-associated fibrin sheaths. Forty-six patients were retrospectively evaluated for 54 episodes of port catheter dysfunction. The presence of a fibrin sheath was detected by angiographic contrast examinations. On an outpatient basis, patients subsequently received thrombolysis consisting of a single injection of urokinase (15.000 IU in 1.5 mL normal saline) through the port system. A second attempt was made in cases of treatment failure. Patients were followed up for technical success, complications and long-term outcome. Port dysfunction occurred at a median of 117 days after implantation (range: 7-825 days). The technical success after first port dysfunction by thrombolysis was 87% (40/46); thereof, initial thrombolysis was effective in 78% (36/46). Nine patients (20%) received a second dose of urokinase after previous treatment failure. Follow-up was available for 26 of 40 patients after successful thrombolysis. In 8 of these, rethrombosis occurred after a median of 98 days (range: 21-354 days), whereby rethrombolysis was effective in 5 of 7 (63%) patients. The overall success of all thrombolyses performed was 70% (45/64). No procedure-related technical or clinical complications occurred. After first favorable thrombolysis, a Kaplan-Meier analysis yielded a 30-, 90- and 180-day probability of patency of 96%, 87% and 81%. Thrombolytic therapy on an outpatient basis appears to be a safe and efficient. Three-month patency rates are comparable to more invasive treatment options, including catheter exchange over a guide wire and percutaneous fibrin sheath stripping.

Fibrin sheaths in central venous port catheters: treatment with low-dose, single injection of urokinase on an outpatient basis

PubMed Central

Chang, De-Hua; Mammadov, Kamal; Hickethier, Tilman; Borggrefe, Jan; Hellmich, Martin; Maintz, David; Kabbasch, Christoph

2017-01-01

Purpose Evaluation of the efficacy of single-shot, low-dose urokinase administration for the treatment of port catheter-associated fibrin sheaths. Methods Forty-six patients were retrospectively evaluated for 54 episodes of port catheter dysfunction. The presence of a fibrin sheath was detected by angiographic contrast examinations. On an outpatient basis, patients subsequently received thrombolysis consisting of a single injection of urokinase (15.000 IU in 1.5 mL normal saline) through the port system. A second attempt was made in cases of treatment failure. Patients were followed up for technical success, complications and long-term outcome. Results Port dysfunction occurred at a median of 117 days after implantation (range: 7–825 days). The technical success after first port dysfunction by thrombolysis was 87% (40/46); thereof, initial thrombolysis was effective in 78% (36/46). Nine patients (20%) received a second dose of urokinase after previous treatment failure. Follow-up was available for 26 of 40 patients after successful thrombolysis. In 8 of these, rethrombosis occurred after a median of 98 days (range: 21–354 days), whereby rethrombolysis was effective in 5 of 7 (63%) patients. The overall success of all thrombolyses performed was 70% (45/64). No procedure-related technical or clinical complications occurred. After first favorable thrombolysis, a Kaplan–Meier analysis yielded a 30-, 90- and 180-day probability of patency of 96%, 87% and 81%. Conclusion Thrombolytic therapy on an outpatient basis appears to be a safe and efficient. Three-month patency rates are comparable to more invasive treatment options, including catheter exchange over a guide wire and percutaneous fibrin sheath stripping. PMID:28182117

Initial Experience with the E-liac® Iliac Branch Device for the Endovascular Aortic Repair of Aorto-iliac Aneurysm.

PubMed

Anton, Susanne; Wiedner, Marcus; Stahlberg, Erik; Jacob, Fabian; Barkhausen, Jörg; Goltz, Jan Peter

2018-05-01

Occlusion of internal iliac arteries during endovascular treatment (EVAR) of abdominal aortic (AAA) and common iliac artery aneurysms might be associated with ischemic pelvic complications. This study evaluates technical and clinical success, safety and mid-term results of a novel iliac branch device (IBD) for revascularization of the internal iliac artery (IIA) during EVAR. Retrospectively, we identified 21 men (mean age 73.3 ± 6.2 years) treated for aorto-iliac aneurysms by use of a novel IBD (E-liac ® , Jotec Hechingen, Germany). We analyzed safety (30-day survival), technical (no type I and III endoleaks, "EL"), clinical (no ischemic complications) success, mid-term patency of this IBD, peri-procedural complications, occurrence of type II ELs, rate of re-interventions and additional treatment of the revascularized IIA for landing zone preparation. Twenty-three IBDs were implanted. Aneurysms of the ipsilateral IIA were present in 6/23 IIAs (26.1%). Super-selective branch embolization was performed in these patients and the landing zone for the iliac sidebranch stent-graft was within the superior gluteal artery. Mean follow-up was 341 days (range 4-1103 days). Technical success and 30-day survival were 100%. Clinical success was 95.2%. Primary patency of the IBDs was 100% at 12 months. Peri-procedural complications occurred in 3/21 patients (14.3%), none of them related to the IBD. AAA-related type II ELs were found in 6 patients (28.6%), IBD-related ELs in 4/23 IBDs (17.4%) (two type Ib, two type II endoleaks). Overall re-intervention rate was 23.8%, IBD-related 8.7%. Utilization of the E-liac ® IBD is safe and effective for the treatment of aorto-iliac aneurysms.

Endolymphatic Thoracic Duct Stent-Graft Reconstruction for Chylothorax: Approach, Technical Success, Safety, and Short-term Outcomes.

PubMed

Srinivasa, Rajiv N; Chick, Jeffrey Forris Beecham; Hage, Anthony N; Gemmete, Joseph J; Murrey, Douglas C; Srinivasa, Ravi N

2018-04-01

To report approach, technical success, safety, and short-term outcomes of thoracic duct stent-graft reconstruction for the treatment of chylothorax. Two patients, 1 (50%) male and 1 (50%) female, with mean age of 38 years (range: 16-59 years) underwent endolymphatic thoracic duct stent-graft reconstruction between September 2016 and July 2017. Patients had radiographic left-sided chylothoraces (n = 2) from idiopathic causes (n = 1) and heart transplantation (n = 1). In both (100%) patients, antegrade lymphatic access was used to opacify the thoracic duct after which retrograde access was used for thoracic duct stent-graft placement. Pelvic lymphangiography technical success, antegrade cisterna chyli cannulation technical success, thoracic duct opacification technical success, retrograde thoracic duct access technical success, thoracic duct stent-graft reconstruction technical success, ethiodized oil volume, contrast volume, estimated blood loss, procedure time, fluoroscopy time, radiation dose, clinical success, complications, deaths, and follow-up were recorded. Pelvic lymphangiography, antegrade cisterna chyli cannulation, thoracic duct opacification, retrograde thoracic duct access, and thoracic duct stent-graft reconstruction were technically successful in both (100%) patients. Mean ethiodized oil volume was 8 mL (range: 5-10 mL). Mean contrast volume was 13 mL (range: 5-20 mL). Mean estimated blood loss was 13 mL (range: 10-15 mL). Mean fluoroscopy time was 50.4 min (range: 31.2-69.7 min). Mean dose area product and reference air kerma were 954.4 μGmy 2 (range: 701-1,208 μGmy 2 ) and 83.5 mGy (range: 59-108 mGy), respectively. Chylothorax resolved in both (100%) patients. There were no minor or major complications directly related to the procedure. Thoracic duct stent-graft reconstruction may be a technically successful and safe alternative to thoracic duct embolization, disruption, and surgical ligation for the treatment of chylothorax. Additional studies are warranted. Copyright © 2017 Elsevier Inc. All rights reserved.

Introducing Development Education in Technical Universities: Successful Experiences in Spain

ERIC Educational Resources Information Center

Boni, A.; Perez-Foguet, A.

2008-01-01

This paper presents and analyses the main characteristics of successful experiences of Development Education (DE) introduced in two major Spanish Technical Universities (Technical University of Catalonia, TUC, and Technical University of Valencia, TUV) during the nineties and the beginning of the twenty-first century. In this paper, after a brief…

An Overview of Potential Methods for Maintaining Training Area Environments in Arid and Semi-Arid Climates

DTIC Science & Technology

1983-04-01

Shrubs , Ground Covers, and Vines , Technical Manual 5-830-4 (June 1976). This manual provides guidelines and prescribes standard techniques to be used...in planting and the initial care required to successfully establish trees, shrubs , ground covers, and vines . Criteria for selecting materials are...their new location. The planting of trees, shrubs , ground covers, and vines should comply with approved landscape planting plans and should be based on

Role of percutaneous abscess drainage in the management of young patients with Crohn disease.

PubMed

Pugmire, Brian S; Gee, Michael S; Kaplan, Jess L; Hahn, Peter F; Doody, Daniel P; Winter, Harland S; Gervais, Debra A

2016-05-01

Intra-abdominal abscess is a common complication of Crohn disease in children. Prior studies, primarily in adults, have shown that percutaneous abscess drainage is a safe and effective treatment for this condition; however, the data regarding this procedure and indications in pediatric patients is limited. Our aim was to determine the success rate of percutaneous abscess drainage for abscesses related to Crohn disease in pediatric patients with a focus on treatment endpoints that are relevant in the era of biological medical therapy. We retrospectively reviewed 25 cases of patients ages ≤20 years with Crohn disease who underwent percutaneous abscess drainage. Technical success was defined as catheter placement within the abscess with reduction in abscess size on post-treatment imaging. Clinical success was defined as (1) no surgery within 1 year of drainage or (2) surgical resection following drainage with no residual abscess at surgery or on preoperative imaging. Multiple clinical parameters were analyzed for association with treatment success or failure. All cases were classified as technical successes. Nineteen cases were classified as clinical successes (76%), including 7 patients (28%) who required no surgery within 1 year of percutaneous drainage and 12 patients (48%) who had elective bowel resection within 1 year. There was a statistically significant association between resumption of immunosuppressive therapy within 8 weeks of drainage and both clinical success (P < 0.01) and avoidance of surgery after 1 year (P < 0.01). Percutaneous abscess drainage is an effective treatment for Crohn disease-related abscesses in pediatric patients. Early resumption of immunosuppressive therapy is statistically associated with both clinical success and avoidance of bowel resection, suggesting a role for percutaneous drainage in facilitating prompt initiation of medical therapy and preventing surgical bowel resection.

Endovascular stent-graft repair of failed endovascular abdominal aortic aneurysm repair.

PubMed

Baril, Donald T; Silverberg, Daniel; Ellozy, Sharif H; Carroccio, Alfio; Jacobs, Tikva S; Sachdev, Ulka; Teodorescu, Victoria J; Lookstein, Robert A; Marin, Michael L

2008-01-01

Despite high initial technical success, the long-term durability of endovascular abdominal aortic aneurysm repair (EVAR) continues to be a concern. Following EVAR, patients can experience endoleaks, device migration, device fractures, or aneurysm growth that may require intervention. The purpose of this study was to review all patients treated with secondary endovascular devices at our institution for failed EVAR procedures. Over an 8-year period, 988 patients underwent EVAR, of whom 42 (4.3%) required secondary interventions involving placement of additional endovascular devices. Data regarding patient characteristics, aneurysm size, initial device type, time until failure, failure etiology, secondary interventions, and outcomes were reviewed. The mean time from initial operation until second operation was 34.1 months. Failures included type I endoleaks in 38 patients (90.5%), type III endoleaks in two patients (4.8%), and enlarging aneurysms without definite endoleaks in two patients (4.8%). The overall technical success rate for secondary repair was 92.9% (39/42). Perioperative complications occurred in nine patients (21.4%), including wound complications (n = 6), cerebrovascular accident (CVA) (n = 1), foot drop (n = 1), and death (n = 1). Mean follow-up following secondary repair was 16.4 months (range 1-50). Eighty-six percent of patients treated with aortouni-iliac devices had successful repairs compared to 45% of patients treated with proximal cuffs. Ten patients (23.8%) had persistent or recurrent type I or type III endoleaks following revision. Of these, four had tertiary interventions, including two patients who had additional devices placed. Failures following EVAR occur in a small but significant number of patients. When anatomically possible, endovascular revision offers a safe means of treating these failures. Aortouni-iliac devices appear to offer a more durable repair than the proximal cuff for treatment of proximal type I endoleaks. Midterm results indicate that these patients may require additional procedures but have a low rate of aneurysm-related mortality. Longer-term follow-up is necessary to determine the durability of these endovascular revisions.

Marketing Remote Sensing Data for North Pacific Fisheries Development and Management

NASA Technical Reports Server (NTRS)

1995-01-01

Fish poaching, drug trafficking, ocean dumping, and other illegal activities are important problems on the high seas and in national economic zones. The primary thrust of the EOCAP II project, "Marketing Remote Sensing Data for North Pacific Fisheries Development and Management", was to use space-based sensors to improve the effectiveness of marine monitoring, control, and surveillance (MCS). Our initial objectives were to concentrate on the development of MCS tools using Advanced Very High Resolution Radiometry (AVHRR) and Synthetic Aperture Radar (SAR) data. Although we have successfully completed development of an initial version of our SAR-based monitoring tool (OmniVision), project activity has resulted in a much broader application of space-based assets to marine applications. Based in part on work commenced within EOCAP II, a new company, Ocean and Coastal Environmental Sensing, Inc. (OCENS), has been launched and the development of several new software products outside of the MCS arena initiated. One of those products, SeaStation, is near completion with a Fall, 1995 release date. Equity investment in OCENS now totals $70,000-with an additional amount being sought in the first round of financing. One of the pre-eminent objectives of EOCAP II is to make contributions to the US economy and job growth through the expansion of commercial uses of remotely sensed data. OCENS and the software products it is introducing into marine and coastal zone markets responds to this primary object*e. EOCAP II funding leveraged the market and technical know-how of OCENS founders into smart products that benefit marine and coastal zone users. Although technical difficulties and geopolitical shifts damaged the commercial feasibility of initial project objectives, the flexibility of the EOCAP II program now permits long-term business success. This in no small part stems from the fact that the EOCAP program recognizes the realities of small and start-up businesses and does not attempt to force these conditions to fit the apparent needs of big government. Instead, EOCAP works with those who know their market best in order to produce successful products and expanding businesses.

Implementing a Structured Reporting Initiative Using a Collaborative Multistep Approach.

PubMed

Goldberg-Stein, Shlomit; Walter, William R; Amis, E Stephen; Scheinfeld, Meir H

To describe the successful implementation of a structured reporting initiative in a large urban academic radiology department. We describe our process, compromises, and top 10 lessons learned in overhauling traditional reporting practices and comprehensively implementing structured reporting at our institution. To achieve our goals, we took deliberate steps toward consensus building, undertook multistep template refinement, and achieved close collaboration with the technical staff, department coders, and hospital information technologists. Following institutional review board exemption, we audited radiologist compliance by evaluating 100 consecutive cases of 12 common examination types. Fisher exact test was applied to determine significance of association between trainee initial report drafting and template compliance. We produced and implemented structured reporting templates for 95% of all departmental computed tomography, magnetic resonance, and ultrasound examinations. Structured templates include specialized reports adhering to the American College of Radiology's Reporting and Data Systems (ACR's RADS) recommendations (eg, Lung-RADS and Li-RADS). We attained 94% radiologist compliance within 2 years, without any financial incentives. We provide a blueprint of how to successfully achieve structured reporting using a collaborative multistep approach. Copyright © 2017 Elsevier Inc. All rights reserved.

Experience with endovascular abdominal aortic aneurysm repair in nonagenarians.

PubMed

Baril, Donald T; Palchik, Eugene; Carroccio, Alfio; Olin, Jeffrey W; Ellozy, Sharif H; Jacobs, Tikva S; Ponzio, Marc M; Teodorescu, Victoria J; Marin, Michael L

2006-06-01

To report a single-institution experience with endovascular abdominal aortic aneurysm (AAA) repair (EVAR) in nonagenarians. A retrospective review was performed of all patients >90 years old undergoing EVAR over an 8-year period at a major academic medical center. The patient population was investigated for the presence of various comorbidities, initial aneurysm size, successful aneurysm exclusion, perioperative complications, disposition, endoleaks, secondary interventions, and overall survival. EVAR was performed in 18 male nonagenarians (mean age 92.4 years, range 90- 95). Mean aneurysm diameter was 7.3 cm (range 5.5-9.8). The cohort had an average of 3.2 comorbid conditions. Sixteen patients were treated electively, while 2 patients underwent emergent repair for contained rupture and bleeding aortoenteric fistula, respectively. Immediate technical success was 100%. Perioperative local/vascular complications occurred in 4 (22%) patients. Perioperative systemic complications occurred in 3 (17%) patients. There were 2 (11%) perioperative (<30 days) deaths. Three (17%) patients required secondary interventions. Mean survival in patients who expired during the follow-up period beyond the first 30 days was 34 months (range 8-78). Mean survival in 8 patients who are still alive is 17.4 months (range 9-39). Endovascular AAA repair in nonagenarians is associated with a high rate of technical success and relatively low morbidity rate. Survival times following successful hospital discharge are significant. Suitable patients over 90 years of age may benefit from an endovascular AAA repair.

Midterm outcomes of the Zenith Renu AAA Ancillary Graft.

PubMed

Jim, Jeffrey; Rubin, Brian G; Geraghty, Patrick J; Money, Samuel R; Sanchez, Luis A

2011-08-01

The Zenith Renu abdominal aortic aneurysm (AAA) Ancillary Graft (Cook Medical Inc, Bloomington, Ind) provides active proximal fixation for treatment of pre-existing endografts with failed or failing proximal fixation or seal. The purpose of this study was to evaluate the midterm outcomes of treatment with this device. From September 2005 to November 2006, a prospective, nonrandomized, multicenter, postmarket registry was utilized to collect physician experiences from 151 cases (89 converters and 62 main body extensions) at 95 institutions. Preoperative indications and procedural and postimplantation outcomes were collected and analyzed. Technical success and clinical success were determined as defined by the Society of Vascular Surgery reporting standards. Patients were predominantly male (87%) with a mean age of 77 years. The interval between the original endograft implantation to Renu treatment was 43.4 ± 18.7 months. The indications for treatment were endoleak (n = 111), migration (n = 136), or both (n = 94). Technical success was 98.0% with two cases of intraoperative conversion and one case of persistent type IA endoleak. The median follow-up for the cohort was 45.0 months (range, 0-56 months; interquartile range, 25.0 months). Overall, 32 cases had treatment failures that included at least one of the following: death (n = 5), type I/III endoleak (n = 18), graft infection (n = 1), thrombosis (n = 1), aneurysm enlargement >5 mm (n = 9), rupture (n = 4), conversion (n = 9, with 7 after 30 days), and migration (n = 1). Overall, the clinical success for the entire cohort during the follow-up period was 78.8% (119/151). The postmarket registry data confirm that the Zenith Renu AAA Ancillary Graft can be used to treat endovascular repairs that failed due to proximal attachment failures. The salvage treatment with the Renu device had high technical success rate and resulted in clinical success in a majority of patients (78.8%). While failed endovascular repairs can be salvaged, a clinical failure in one of five patients still emphasizes the importance of patient and device selection during initial endovascular aneurysm repair to ensure durable success. Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

Technical Assistance Program: Off to a Running Start (Newsletter)

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

Not Available

This newsletter describes key activities of the DOE Office of Indian Energy Policy and Programs for Winter 2012. Between December 2, 2011, and January 15, 2012, 46 American Indian and Alaska Native Tribes submitted applications to receive technical assistance through the program, which provides Tribes with on-the-ground technical support from DOE and National Renewable Energy Laboratory (NREL) staff to help move tribal energy efficiency and renewable energy projects forward. The applications are being considered through the Strategic Technical Assistance Response Team (START) selection process, which incorporates expert reviews and outreach to Tribes who present a need for assistance with theirmore » community-based energy efficiency and renewable energy projects. The final successful applicants will be selected based on the clarity of their requests for technical assistance and the ability of START to successfully work with each unique project or community. At least three selected Tribes in Alaska will receive technical assistance between March and May 2012, and up to five selected Tribes in the contiguous United States will receive technical assistance between March and August 2012. During the months of START Program activity, DOE and NREL experts will work in the two locations. In Alaska, START experts will work directly with community-based project teams to analyze local energy issues and provide assistance with energy projects and cost savings initiatives. This effort will be bolstered by DOE-IE's partnership with the Denali Commission, which will provide further assistance and expertise. In the lower 48 states, NREL experts will work with the selected renewable energy START projects to evaluate financial and technical feasibility and provide early development technical assistance to better position the projects for financing and construction. This on-the-ground technical assistance is part of a broader DOE-IE effort to make reliable, accurate technical information and skills-based training available to tribal communities throughout the United States. The primary goal of the START initiative, according to DOE-IE Director Tracey A. LeBeau, is to bring about the next generation of energy development in Indian Country. Through energy project planning, quality training, and technical assistance, The START program will leverage the early-stage resource characterization and pre-feasibility investments that DOE has made in Indian Country over the years, and unlock the energy resources that exist on tribal lands to help build a 21st century tribal energy economy. Working collaboratively with a select group of Tribes and Alaska Native entities, the DOE Office of Indian Energy, NREL, and the Denali Commission will empower tribal leaders to make informed energy decisions and help build capacity to bring tribal energy visions to fruition and get renewable energy projects off the ground, said LeBeau. Ultimately, these efforts will serve to further the Obama Administration and DOE's shared commitment to provide Native American and Alaska Native communities with the tools and resources they need to foster tribal energy self-sufficiency and sustainability, advancing job creation and enhancing economic competitiveness.« less

Healthy competition drives success in results-based aid: Lessons from the Salud Mesoamérica Initiative.

PubMed

El Bcheraoui, Charbel; Palmisano, Erin B; Dansereau, Emily; Schaefer, Alexandra; Woldeab, Alexander; Moradi-Lakeh, Maziar; Salvatierra, Benito; Hernandez-Prado, Bernardo; Mokdad, Ali H

2017-01-01

The Salud Mesoamérica Initiative (SMI) is a three-operation strategy, and is a pioneer in the world of results-based aid (RBA) in terms of the success it has achieved in improving health system inputs following its initial operation. This success in meeting pre-defined targets is rare in the world of financial assistance for health. We investigated the influential aspects of SMI that could have contributed to its effectiveness in improving health systems, with the aim of providing international donors, bilateral organizations, philanthropies, and recipient countries with new perspectives that can help increase the effectiveness of future assistance for health, specifically in the arena of RBA. Qualitative methods based on the criteria of relevance and effectiveness proposed by the Development Assistance Committee of the Organization for Economic Co-operation and Development. Our methods included document review, key informant interviews, a focus group discussion, and a partnership analysis. A purposive sample of 113 key informants, comprising donors, representatives from the Inter-American Development Bank, ministries of health, technical assistance organizations, evaluation organizations, and health care providers. During May-October 2016, we interviewed regarding the relevance and effectiveness of SMI. Themes emerged relative to the topics we investigated, and covered the design and the drivers of success of the initiative. The success is due to 1) the initiative's regional approach, which pressured recipient countries to compete toward meeting targets, 2) a robust and flexible design that incorporated the richness of input from stakeholders at all levels, 3) the design-embedded evaluation component that created a culture of accountability among recipient countries, and 4) the reflective knowledge environment that created a culture of evidence-based decision-making. A regional approach involving all appropriate stakeholders, and based on knowledge sharing and embedded evaluation can help ensure the effectiveness of future results-based aid programs for health in global settings.

Is a high initial World Federation of Neurosurgery (WFNS) grade really associated with a poor clinical outcome in elderly patients with ruptured intracranial aneurysms treated with coiling?

PubMed

Iosif, Christina; Di Maria, Federico; Sourour, Nader; Degos, Vincent; Bonneville, Fabrice; Biondi, Alessandra; Jean, Betty; Colonne, Chantal; Nouet, Aurelien; Chiras, Jacques; Clarençon, Frédéric

2014-05-01

Coiling of ruptured intracranial aneurysms in elderly patients remains debatable in terms of technical feasibility and clinical outcome. In this observational cohort study we aimed to assess the technical feasibility, complication profile and clinical outcomes of elderly patients with subarachnoid hemorrhage (SAH) treated with endovascular therapy. The study included 59 consecutive patients (47 women) aged ≥70 years (mean age 76 years, range 71-84) admitted to our institution with SAH from January 2002 to July 2011. The patients were treated for 66 aneurysms (regular coiling: n=62 (94%), balloon-assisted technique: n=2 (3%), stent and coil technique: n=2 (3%)). World Federation of Neurosurgery (WFNS) grade at admission was 1 in 13 patients, 2 in 23 patients, 3 in 8 patients, 4 in 11 patients and 5 in 4 patients. We analysed data by univariate and multivariate statistical analyses with an emphasis on the initial clinical situation, complications and clinical outcome. The technical success rate was 98% with a procedure-related deficit rate of 10% and procedure-related death rate of 5%. The Glasgow Outcome Scale score at 6 months was 1 in 15 patients (25.4%), 2 in 8 patients (13.6%), 3 in 14 patients (23.7%), 4 in 11 patients (18.6%) and 5 in 11 patients (18.6%). Patients admitted with a high initial WFNS grade did not differ statistically in terms of clinical outcome. The final clinical outcome was not significantly correlated with age, initial Fisher score or procedure-related complications. Endovascular treatment of elderly patients with ruptured cerebral aneurysms is feasible, safe and beneficial regardless of the presenting WFNS score.

Fluoroscopic removal of retrievable self-expandable metal stents in patients with malignant oesophageal strictures: Experience with a non-endoscopic removal system.

PubMed

Kim, Pyeong Hwa; Song, Ho-Young; Park, Jung-Hoon; Zhou, Wei-Zhong; Na, Han Kyu; Cho, Young Chul; Jun, Eun Jung; Kim, Jun Ki; Kim, Guk Bae

2017-03-01

To evaluate clinical outcomes of fluoroscopic removal of retrievable self-expandable metal stents (SEMSs) for malignant oesophageal strictures, to compare clinical outcomes of three different removal techniques, and to identify predictive factors of successful removal by the standard technique (primary technical success). A total of 137 stents were removed from 128 patients with malignant oesophageal strictures. Primary overall technical success and removal-related complications were evaluated. Logistic regression models were constructed to identify predictive factors of primary technical success. Primary technical success rate was 78.8 % (108/137). Complications occurred in six (4.4 %) cases. Stent location in the upper oesophagus (P=0.004), stricture length over 8 cm (P=0.030), and proximal granulation tissue (P<0.001) were negative predictive factors of primary technical success. If granulation tissue was present at the proximal end, eversion technique was more frequently required (P=0.002). Fluoroscopic removal of retrievable SEMSs for malignant oesophageal strictures using three different removal techniques appeared to be safe and easy. The standard technique is safe and effective in the majority of patients. The presence of proximal granulation tissue, stent location in the upper oesophagus, and stricture length over 8 cm were negative predictive factors for primary technical success by standard extraction and may require a modified removal technique. • Fluoroscopic retrievable SEMS removal is safe and effective. • Standard removal technique by traction is effective in the majority of patients. • Three negative predictive factors of primary technical success were identified. • Caution should be exercised during the removal in those situations. • Eversion technique is effective in cases of proximal granulation tissue.

A fully covered self-expandable metal stent with antimigration features for benign biliary strictures: a prospective, multicenter cohort study.

PubMed

Walter, Daisy; Laleman, Wim; Jansen, Jeroen M; van Milligen de Wit, A W M; Weusten, Bas L; van Boeckel, Petra G; Hirdes, Meike M; Vleggaar, Frank P; Siersema, Peter D

2015-05-01

Self-expandable metal stents (SEMSs) are increasingly used for the treatment of benign biliary strictures (BBSs). A new fully covered SEMS (FCSEMS) with flared ends and high conformability was designed to prevent migration of the stent. To evaluate the efficacy of a novel FCSEMS with antimigration features. Prospective cohort study. Five hospitals in the Netherlands and Belgium. Consecutive patients with BBS. FCSEMS placement for 3 months. Initial and long term clinical success, stent migration rate and safety. Thirty-eight patients (24 men; mean age, 53 ± 16 years) were included. Stent placement was technically successful in 37 patients (97%). Two patients died of an unrelated cause before stent removal, and no data on these patients were available on stricture resolution. Initial clinical success was achieved in 28 of 35 patients (80%). During follow-up after stent removal, a symptomatic recurrent stricture developed in 6 of 28 patients (21%). Overall, the long-term clinical success rate was 63% (22 of 35 patients). Stent migration occurred in 11 of 35 patients (31%), including 5 symptomatic (14%) and 6 asymptomatic (17%) migrations. In total, 11 serious adverse events occurred in 10 patients (29%), with cholangitis (n = 5) being most common. Nonrandomized study design. Good initial clinical success was achieved after placement of this novel FCSEMS, but stricture recurrence was in the upper range compared with other FCSEMSs. The antimigration design could not prevent migration in a significant number of patients with a persisting stricture. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Prospective evaluation of a newly designed T-configured stent graft system for palliative treatment of advanced hilar malignant biliary obstructions.

PubMed

Gwon, Dong Il; Ko, Gi-Young; Yoon, Hyun-Ki; Kim, Jin Hyoung; Lee, Jae Myeong; Ohm, Joon-Young; Sung, Kyu-Bo

2010-09-01

To investigate the technical and clinical safety and efficacy of using a newly designed T-configured stent graft for palliative treatment of advanced hilar malignant biliary obstructions. This is a prospective study that enrolled 30 patients who had malignant hilar obstructions from May 2007 to November 2008. All patients were treated with percutaneous transhepatic placement of two specially designed stent grafts in a T configuration. Technical success, evaluation of blocked branching ducts, complications, clinical success, stent patency time, and patient survival rates were analyzed. Stent graft deployment was technically successful in all patients. The bilirubin level and the bile duct diameter decreases were statistically significant after stent placement (P < .001), and all patients showed clinical improvement. Minor complications, including procedure-related complications (self-limiting hemobilia [n = 3], perihepatic biloma [n = 1], and acute pancreatitis [n = 1]) and rapidly resolving cholangitis (n = 5), occurred in ten patients (33.3%). Major complications, including acute cholecystitis, occurred in three patients (10%). Stent occlusion occurred in 12 patients (40%) after a mean period of 160 days (range, 82-307 days). The median survival and stent patency times were 334 days (range, 195.6-472.4 days) and 279 days (range, 194.7-363.3 days), respectively. There were no statistical differences in age, sex, Bismuth type, or number of blocked branching ducts. The initial results of percutaneous palliative treatment of advanced hilar malignancies with T-configured stent grafts suggest that they are safe and potentially clinically effective. Copyright 2010 SIR. Published by Elsevier Inc. All rights reserved.

Recent advances in endovascular treatment of aortoiliac occlusive disease.

PubMed

Kavaliauskienė, Zana; Antuševas, Aleksandras; Kaupas, Rytis Stasys; Aleksynas, Nerijus

2012-01-01

The rate of endovascular interventions for iliac occlusive lesions is continuously growing. The evolution of the technology supporting these therapeutic measures improves the results of these interventions. We performed a review of the literature to report and appreciate short- and long-term results of endovascular stenting of iliac artery occlusive lesions. The Medline database was searched to identify all the studies reporting iliac artery stenting for aortoiliac occlusive disease (Trans Atlantic Inter-Society Consensus [TASC] type A, B, C, and D) from January 2006 to July 2012. The outcomes were technical success, long-term primary and secondary patency rates, early mortality, and complications. Technical success was achieved in 91% to 99% of patients as reported in all the analyzed articles. Early mortality was described in 5 studies and ranged from 0.7% to 3.6%. The most common complications were access site hematomas, distal embolization, pseudoaneurysms, and iliac artery ruptures. The complications were most often treated conservatively or using percutaneous techniques. The 5-year primary and secondary patency rates ranged from 63% to 88% and 86% to 93%, respectively; and the 10-year primary patency rates ranged from 68% to 83%. In this article, combined percutaneous endovascular iliac stenting and infrainguinal surgical reconstructions and new techniques in the treatment of iliac stent restenosis are discussed. Iliac stenting is a feasible, safe, and effective method for the treatment of iliac occlusive disease. Initial technical and clinical success rates are high; early mortality and complication rates are low. Long-term patency is comparable with that after bypass surgery.

Development and Validation of a Novel Scoring System for Predicting Technical Success of Chronic Total Occlusion Percutaneous Coronary Interventions: The PROGRESS CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) Score.

PubMed

Christopoulos, Georgios; Kandzari, David E; Yeh, Robert W; Jaffer, Farouc A; Karmpaliotis, Dimitri; Wyman, Michael R; Alaswad, Khaldoon; Lombardi, William; Grantham, J Aaron; Moses, Jeffrey; Christakopoulos, Georgios; Tarar, Muhammad Nauman J; Rangan, Bavana V; Lembo, Nicholas; Garcia, Santiago; Cipher, Daisha; Thompson, Craig A; Banerjee, Subhash; Brilakis, Emmanouil S

2016-01-11

This study sought to develop a novel parsimonious score for predicting technical success of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) performed using the hybrid approach. Predicting technical success of CTO PCI can facilitate clinical decision making and procedural planning. We analyzed clinical and angiographic parameters from 781 CTO PCIs included in PROGRESS CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) using a derivation and validation cohort (2:1 sampling ratio). Variables with strong association with technical success in multivariable analysis were assigned 1 point, and a 4-point score was developed from summing all points. The PROGRESS CTO score was subsequently compared with the J-CTO (Multicenter Chronic Total Occlusion Registry in Japan) score in the validation cohort. Technical success was 92.9%. On multivariable analysis, factors associated with technical success included proximal cap ambiguity (beta coefficient [b] = 0.88), moderate/severe tortuosity (b = 1.18), circumflex artery CTO (b = 0.99), and absence of "interventional" collaterals (b = 0.88). The resulting score demonstrated good calibration and discriminatory capacity in the derivation (Hosmer-Lemeshow chi-square = 2.633; p = 0.268, and receiver-operator characteristic [ROC] area = 0.778) and validation (Hosmer-Lemeshow chi-square = 5.333; p = 0.070, and ROC area = 0.720) subset. In the validation cohort, the PROGRESS CTO and J-CTO scores performed similarly in predicting technical success (ROC area 0.720 vs. 0.746, area under the curve difference = 0.026, 95% confidence interval = -0.093 to 0.144). The PROGRESS CTO score is a novel useful tool for estimating technical success in CTO PCI performed using the hybrid approach. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Education and Job Training: Preparing for the 21st Century Workforce. Hearing before the Subcommittee on 21st Century Competitiveness of the Committee on Education and the Workforce, House of Representatives. One Hundred Seventh Congress, Second Session (Angola, Indiana, March 22, 2002).

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Education and the Workforce.

This is a congressional hearing on how vocational and technical education and job training work together to better prepare workers for the 21st century workforce and on successful educational and job training activities and initiatives in Indiana (IN). Testimony includes statements from United States representatives (Howard P. "Buck"…

Meteoritic basalts: the nakhlites, their parental magmas, cooling rates, and equivalents on Earth. Final technical report

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

Treiman, A.H.

1987-07-01

Proposed one-bar phase equilibrium experiments, designed to determine the compositions of the nakhlites' parental magmas, are in progress. Proposed field studies on Earth, designed to find occurrences of rocks like the nakhlites, were extraordinarily successful. Other work supported in the past year included: attendance at the 1986 national meeting of the Geological Society of America; attendance at the 18th Lunar and Planetary Science Conference; completion and publication of a study of core formation in the SNC parent body; initiation of a study of the flux of SNC meteorites onto the Earth; and initiation of petrologic study of the Angra dosmore » Reis achondrite.« less

WHO influenza vaccine technology transfer initiative: role and activities of the Technical Advisory Group.

PubMed

Francis, Donald P; Grohmann, Gary

2011-07-01

In May 2006, the WHO published a Global Pandemic Influenza Action Plan. A significant part of that plan involves the transfer of technology necessary to build production capacity in developing countries. The WHO influenza technology transfer initiative has been successful. Clearly the relatively small WHO investments made in these companies to develop their own influenza vaccine production facilities have had quite dramatic results. A few companies are already producing large amounts of influenza vaccine. Others will soon follow. Whether they are developing egg-based or planning non-egg based influenza vaccine production, all companies are optimistic that their efforts will come to fruition. Copyright © 2011 Elsevier Ltd. All rights reserved.

Transcatheter arterial embolization for endoscopically unmanageable non-variceal upper gastrointestinal bleeding.

PubMed

Lee, Han Hee; Park, Jae Myung; Chun, Ho Jong; Oh, Jung Suk; Ahn, Hyo Jun; Choi, Myung-Gyu

2015-07-01

Transcatheter arterial embolization (TAE) is a therapeutic option for endoscopically unmanageable upper gastrointestinal (GI) bleeding. We aimed to assess the efficacy and clinical outcomes of TAE for acute non-variceal upper GI bleeding and to identify predictors of recurrent bleeding within 30 days. Visceral angiography was performed in 66 patients (42 men, 24 women; mean age, 60.3 ± 12.7 years) who experienced acute non-variceal upper GI bleeding that failed to be controlled by endoscopy during a 7-year period. Clinical information was reviewed retrospectively. Outcomes included technical success rates, complications, and 30-day rebleeding and mortality rates. TAE was feasible in 59 patients. The technical success rate was 98%. Rebleeding within 30 days was observed in 47% after an initial TAE and was managed with re-embolization in 8, by endoscopic intervention in 5, by surgery in 2, and by conservative care in 12 patients. The 30-day overall mortality rate was 42.4%. In the case of initial endoscopic hemostasis failure (n = 34), 31 patients underwent angiographic embolization, which was successful in 30 patients (96.8%). Rebleeding occurred in 15 patients (50%), mainly because of malignancy. Two factors were independent predictors of rebleeding within 30 days by multivariate analysis: coagulopathy (odds ratio [OR] = 4.37; 95% confidence interval [CI]: 1.25-15.29; p = 0.021) and embolization in ≥2 territories (OR = 4.93; 95% CI: 1.43-17.04; p = 0.012). Catheterization-related complications included hepatic artery dissection and splenic embolization. TAE controlled acute non-variceal upper GI bleeding effectively. TAE may be considered when endoscopic therapy is unavailable or unsuccessful. Correction of coagulopathy before TAE is recommended.

[The LESS (Laparo-endoscopic Single-Site) procedure in urology. Technical and clinical aspects].

PubMed

Neri, F; Cindolo, L; Gidaro, S; Schips, L

2010-01-01

Minimally invasive urology is rapidly advancing, and single-site laparoscopic surgery is being explored clinically. Such laparoscopic procedures are technically challenging and require an experienced laparoscopic surgeon due to the lack of port placement triangulation and instrument clashing. In the last years several surgeons all over the world have explored the feasibility and safety of LESS using several and different ports, approaches and devices. Hundreds of procedures have been described with overall favorable intraoperative and postoperative outcomes. Our experience consists of more than 30 procedures successfully completed for adrenal, kidney disease and varicocele. To date, LESS could be considered feasible and effective using currently available devices, however it is to be considered as an initial status technique requiring further confirmatory studies and advanced laparoscopic skills.

Failed biliary cannulation: Clinical and technical outcomes after tertiary referral endoscopic retrograde cholangiopancreatography

PubMed Central

Swan, Michael P; Bourke, Michael J; Williams, Stephen J; Alexander, Sina; Moss, Alan; Hope, Rick; Ruppin, David

2011-01-01

AIM: Prospective evaluation of repeat endoscopic retrograde cholangiopancreatography (ERCP) for failed Schutz grade 1 biliary cannulation in a high-volume center. METHODS: Prospective intention-to-treat analysis of patients referred for biliary cannulation following recent unsuccessful ERCP. RESULTS: Fifty-one patients (35 female; mean age: 62.5 years; age range: 40-87 years) with previous failed biliary cannulation were referred for repeat ERCP. The indication for ERCP was primarily choledocholithiasis (45%) or pancreatic malignancy (18%). Successful biliary cannulation was 100%. The precut needle knife sphincterotomy (NKS) rate was 27.4%. Complications occurred in 3.9% (post-ERCP pancreatitis). An identifiable reason for initial unsuccessful biliary cannulation was present in 55% of cases. Compared to a cohort of 940 naïve papilla patients (female 61%; mean age: 59.9 years; age range: 18-94 years) who required sphincterotomy over the same time period, there was no statistical difference in the cannulation success rate (100% vs 98%) or post-ERCP pancreatitis (3.1% vs 3.9%). Precut NKS use was more frequent (27.4% vs 12.7%) (P = 0.017). CONCLUSION: Referral to a high-volume center following unsuccessful ERCP is associated with high technical success, with a favorable complication rate, compared to routine ERCP procedures. PMID:22174549

Angioplasty for Non-arteriosclerotic Renal Artery Stenosis: The Efficacy of Cutting Balloon Angioplasty Versus Conventional Angioplasty

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

Tanaka, Ryoichi; Higashi, Masahiro; Naito, Hiroaki

2007-07-15

Purpose. We examined the efficacy of conventional balloon angioplasty and cutting balloon angioplasty (CBA) for the treatment of non-arteriosclerotic renal artery stenosis (RAS). Materials and Methods. From 1993 to 2005, 20 patients underwent 27 percutaneous transluminal renalangioplasty (PTRA) for non-arteriosclerotic RAS (men: 8, women: 12, 25.5 +/- 2 years old; 16 fibromuscular dysplasia (FMD), 4 Takayasu disease). We evaluated the efficacy of CBA by comparing the rate of initial technical success and surgical conversion. Results. Before the clinical authorization of CBA, three of twelve patients (25 %) underwent surgical bypass due to the failure of PTRA due to the hardnessmore » of the lesion. After the approval of cutting balloon, we performed CBA in four cases (2 FMD,2 Takayasu disease) to dilate hard lesions, within which a properly sized balloon could not dilate due to their hardness, or to reduce the risk of local dissection. Initial successes were obtained in all patients (8/8, 100%) and none of the patients underwent surgical conversion. Despite of the good initial result, restenosis was observed in three cases within 6 month (3/4, 75 %). Additional interventions were performed in all patients, then, the severity of the restenotic lesion was found not to be exceeded comparing with the initial lesion. Conclusion. The cutting balloon angioplasty may be safe and useful procedure for hard lesions of RAS caused by non-arteriosclerotic disease? especially fibromuscular dysplasia. The cutting balloon may provide the initial success, but the effect on long-term patency is still controversial.« less

Technical Excellence: A Requirement for Good Engineering

NASA Technical Reports Server (NTRS)

Gill, Paul S.; Vaughan, William W.

2008-01-01

Technical excellence is a requirement for good engineering. Technical excellence has many different ways of expressing itself within engineering. NASA has initiatives that address the enhancement of the Agency's technical excellence and thrust to maintain the associated high level of performance by the Agency on current programs/projects and as it moves into the Constellation Program and the return to the Moon with plans to visit Mars. This paper addresses some of the key initiatives associated with NASA's technical excellence thrust. Examples are provided to illustrate some results being achieved and plans to enhance these initiatives.

Insight into the da Vinci® Xi - technical notes for single-docking left-sided colorectal procedures.

PubMed

Ngu, James Chi-Yong; Sim, Sarah; Yusof, Sulaiman; Ng, Chee-Yung; Wong, Andrew Siang-Yih

2017-12-01

The adoption of robot-assisted laparoscopic colorectal surgery has been hampered by issues with docking, operative duration, technical difficulties in multi-quadrant access, and cost. The da Vinci® Xi has been designed to overcome some of these limitations. We describe our experience with the system and offer technical insights to its application in left-sided colorectal procedures. Our initial series of left-sided robotic colorectal procedures was evaluated. Patient demographics and operative outcomes were recorded prospectively using a predefined database. Between March 2015 and April 2016, 54 cases of robot-assisted laparoscopic left-sided colorectal procedures were successfully completed with no cases of conversion. The majority were low anterior resections for colorectal malignancies. Using the da Vinci® Xi Surgical System, multi-quadrant surgery involving dissection from the splenic flexure to the pelvis was possible without redocking. The da Vinci® Xi simplifies the docking procedure and makes single-docking feasible for multi-quadrant left-sided colorectal procedures. Copyright © 2016 John Wiley & Sons, Ltd.

Technology transfer and commercialization initiatives at TRI/Austin: Resources and examples

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

Matzkanin, G.A.; Dingus, M.L.

1995-12-31

Located at TRI/Austin, and operated under a Department of Defense contract, is the Nondestructive Testing Information Analysis Center (NTIAC). This is a full service Information Analysis Center sponsored by the Defense Technical Information Center (DTIC), although services of NTIAC are available to other government agencies, government contractors, industry and academia. The principal objective of NTIAC is to help increase the productivity of the nation`s scientists, engineers, and technical managers involved in, or requiring, nondestructive testing by providing broad information analysis services of technical excellence. TRI/Austin is actively pursuing commercialization of several products based on results from outside funded R andmore » D programs. As a small business, TRI/Austin has limited capabilities for large scale fabrication, production, marketing or distribution. Thus, part of a successful commercialization process involves making appropriate collaboration arrangements with other organizations to augment TRI/Austin`s capabilities. Brief descriptions are given here of two recent commercialization efforts at TRI/Austin.« less

The Role of Lunar Development in Human Exploration of the Solar System

NASA Technical Reports Server (NTRS)

Mendell, Wendell W.

1999-01-01

Human exploration of the solar system can be said to have begun with the Apollo landings on the Moon. The Apollo Project was publicly funded with the narrow technical objective of landing human beings on the Moon. The transportation and life support systems were specialized technical designs, developed in a project management environment tailored to that objective. Most scenarios for future human exploration assume a similar long-term commitment of public funds to a narrowly focused project managed by a large, monolithic organization. Advocates of human exploration of space have not yet been successful in generating the political momentum required to initiate such a project to go to the Moon or to Mars. Alternative scenarios of exploration may relax some or all of the parameters of organizational complexity, great expense, narrow technical focus, required public funding, and control by a single organization. Development of the Moon using private investment is quite possibly a necessary condition for alternative scenarios to succeed.

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

PubMed

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

2015-01-01

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

Strategic Engagement of Technical Surge Capacity for Intensified Polio Eradication Initiative in Nigeria, 2012-2015.

PubMed

Yehualashet, Yared G; Mkanda, Pascal; Gasasira, Alex; Erbeto, Tesfaye; Onimisi, Anthony; Horton, Janet; Banda, Richard; Tegegn, Sisay G; Ahmed, Haruna; Afolabi, Oluwole; Wadda, Alieu; Vaz, Rui G; Nsubuga, Peter

2016-05-01

Following the 65th World Health Assembly (WHA) resolution on intensification of the Global Poliomyelitis Eradication Initiative (GPEI), the Nigerian government, with support from the World Health Organization (WHO) and other partners, implemented a number of innovative strategies to curb the transmission of wild poliovirus (WPV) in the country. One of the innovations successfully implemented since mid 2012 is the WHO's engagement of surge capacity personnel. The WHO reorganized its functional structure, adopted a transparent recruitment and deployment process, provided focused technical and management training, and applied systematic accountability framework to successfully manage the surge capacity project in close collaboration with the national counterparts and partners. The deployment of the surge capacity personnel was guided by operational and technical requirement analysis. Over 2200 personnel were engaged, of whom 92% were strategically deployed in 11 states classified as high risk on the basis of epidemiological risk analysis and compromised security. These additional personnel were directly engaged in efforts aimed at improving the performance of polio surveillance, vaccination campaigns, increased routine immunization outreach sessions, and strengthening partnership with key stakeholders at the operational level, including community-based organizations. Programmatic interventions were sustained in states in which security was compromised and the risk of polio was high, partly owing to the presence of the surge capacity personnel, who are engaged from the local community. Since mid-2012, significant programmatic progress was registered in the areas of polio supplementary immunization activities, acute flaccid paralysis surveillance, and routine immunization with the support of the surge capacity personnel. As of 19 June 2015, the last case of WPV was reported on 24 July 2014. The surge infrastructure has also been instrumental in building local capacity; supporting other public health emergencies, such as the Ebola outbreak response and measles and meningitis outbreaks; and strengthening the integrated disease surveillance and response. Due to weak health systems in the country, it is vital to maintain a reasonable level of the surge capacity for successful implementation of the 2013-2018 global polio endgame strategy and beyond. © 2016 World Health Organization; licensee Oxford Journals.

Strategic Engagement of Technical Surge Capacity for Intensified Polio Eradication Initiative in Nigeria, 2012–2015

PubMed Central

Yehualashet, Yared G.; Mkanda, Pascal; Gasasira, Alex; Erbeto, Tesfaye; Onimisi, Anthony; Horton, Janet; Banda, Richard; Tegegn, Sisay G.; Ahmed, Haruna; Afolabi, Oluwole; Wadda, Alieu; Vaz, Rui G.; Nsubuga, Peter

2016-01-01

Background. Following the 65th World Health Assembly (WHA) resolution on intensification of the Global Poliomyelitis Eradication Initiative (GPEI), the Nigerian government, with support from the World Health Organization (WHO) and other partners, implemented a number of innovative strategies to curb the transmission of wild poliovirus (WPV) in the country. One of the innovations successfully implemented since mid 2012 is the WHO's engagement of surge capacity personnel. Methods. The WHO reorganized its functional structure, adopted a transparent recruitment and deployment process, provided focused technical and management training, and applied systematic accountability framework to successfully manage the surge capacity project in close collaboration with the national counterparts and partners. The deployment of the surge capacity personnel was guided by operational and technical requirement analysis. Results. Over 2200 personnel were engaged, of whom 92% were strategically deployed in 11 states classified as high risk on the basis of epidemiological risk analysis and compromised security. These additional personnel were directly engaged in efforts aimed at improving the performance of polio surveillance, vaccination campaigns, increased routine immunization outreach sessions, and strengthening partnership with key stakeholders at the operational level, including community-based organizations. Discussion. Programmatic interventions were sustained in states in which security was compromised and the risk of polio was high, partly owing to the presence of the surge capacity personnel, who are engaged from the local community. Since mid-2012, significant programmatic progress was registered in the areas of polio supplementary immunization activities, acute flaccid paralysis surveillance, and routine immunization with the support of the surge capacity personnel. As of 19 June 2015, the last case of WPV was reported on 24 July 2014. The surge infrastructure has also been instrumental in building local capacity; supporting other public health emergencies, such as the Ebola outbreak response and measles and meningitis outbreaks; and strengthening the integrated disease surveillance and response. Due to weak health systems in the country, it is vital to maintain a reasonable level of the surge capacity for successful implementation of the 2013–2018 global polio endgame strategy and beyond. PMID:26912379

Career Technical Education Pathways Initiative Annual Report

ERIC Educational Resources Information Center

California Community Colleges, Chancellor's Office, 2014

2014-01-01

California's education system--the largest in the United States--is an essential resource for ensuring strong economic growth in the state. The Career Technical Education Pathways Initiative (the Initiative) became law in 2005 with Senate Bills 70 and 1133 and provided more than $380 million over eight years to improve career technical education…

MR-guided microwave ablation in hepatic tumours: initial results in clinical routine.

PubMed

Hoffmann, Rüdiger; Rempp, Hansjörg; Keßler, David-Emanuel; Weiß, Jakob; Pereira, Philippe L; Nikolaou, Konstantin; Clasen, Stephan

2017-04-01

Evaluation of the technical success, patient safety and technical effectiveness of magnetic resonance (MR)-guided microwave ablation of hepatic malignancies. Institutional review board approval and informed patient consent were obtained. Fifteen patients (59.8 years ± 9.5) with 18 hepatic malignancies (7 hepatocellular carcinomas, 11 metastases) underwent MR-guided microwave ablation using a 1.5-T MR system. Mean tumour size was 15.4 mm ± 7.7 (7-37 mm). Technical success and ablation zone diameters were assessed by post-ablative MR imaging. Technique effectiveness was assessed after 1 month. Complications were classified according to the Common Terminology Criteria for Adverse Events (CTCAE). Mean follow-up was 5.8 months ± 2.6 (1-10 months). Technical success and technique effectiveness were achieved in all lesions. Lesions were treated using 2.5 ± 1.2 applicator positions. Mean energy and ablation duration per tumour were 37.6 kJ ± 21.7 (9-87 kJ) and 24.7 min ± 11.1 (7-49 min), respectively. Coagulation zone short- and long-axis diameters were 31.5 mm ± 10.5 (16-65 mm) and 52.7 mm ± 15.4 (27-94 mm), respectively. Two CTCAE-2-complications occurred (pneumothorax, pleural effusion). Seven patients developed new tumour manifestations in the untreated liver. Local tumour progression was not observed. Microwave ablation is feasible under near real-time MR guidance and provides effective treatment of hepatic malignancies in one session. • Planning, applicator placement and therapy monitoring are possible without using contrast enhancement • Energy transmission from the generator to the scanner room is safely possible • MR-guided microwave ablation provides effective treatment of hepatic malignancies in one session • Therapy monitoring is possible without applicator retraction from the ablation site.

Designing Research Services: Cross-Disciplinary Administration and the Research Lifecycle

NASA Astrophysics Data System (ADS)

Madden, G.

2017-12-01

The sheer number of technical and administrative offices involved in the research lifecycle, and the lack of shared governance and shared processes across those offices, creates challenges to the successful preservation of research outputs. Universities need a more integrated approach to the research lifecycle that allows us to: recognize a research project as it is being initiated; identify the data associated with the research project; document and track any compliance, security, access, and publication requirements associated with the research and its data; follow the research and its associated components across the research lifecycle; and finally recognize that the research has come to a close so we can trigger the various preservation, access, and communications processes that close the loop, inform the public, and promote the continued progress of science. Such an approach will require cooperation, communications, and shared workflow tools that tie together (often across many years) PIs, research design methodologists, grants offices, contract negotiators, central research administrators, research compliance specialists, desktop IT support units, server administrators, high performance computing facilities, data centers, specialized data transfer networks, institutional research repositories, institutional data repositories, and research communications groups, all of which play a significant role in the technical or administrative success of research. This session will focus on progress towards improving cross-disciplinary administrative and technical cooperation at Penn State University, with an emphasis on generalizable approaches that can be adopted elsewhere.

Texas Higher Education Coordinating Board 2000 Statewide Annual Licensure Report.

ERIC Educational Resources Information Center

Texas Higher Education Coordinating Board, Austin. Div. of Community and Technical Colleges.

This report provides the licensure examination results for two-year technical associate degrees and one-year certificate programs at community and technical colleges in Texas. The Texas Higher Education Coordinating Board recognizes the success rate for licensure as an integral part of the overall success of many technical programs. The following…

New insight into California’s drought through open data

USGS Publications Warehouse

Read, Emily K.; Bucknell, Mary; Hines, Megan K.; Kreft, James M.; Lucido, Jessica M.; Read, Jordan S.; Schroedl, Carl; Sibley, David M.; Stephan, Shirley; Suftin, Ivan; Thongsavanh, Phethala; Van Den Hoek, Jamon; Walker, Jordan I.; Wernimont, Martin R; Winslow, Luke A.; Yan, Andrew N.

2015-01-01

Historically unprecedented drought in California has brought water issues to the forefront of the nation’s attention. Crucial investigations that concern water policy, management, and research, in turn, require extensive information about the quality and quantity of California’s water. Unfortunately, key sources of pertinent data are unevenly distributed and frequently hard to find. Thankfully, the vital importance of integrating water data across federal, state, and tribal, academic, and private entities, has recently been recognized and addressed through federal initiatives such as the Climate Data Initiative of President Obama’s Climate Action Plan and the Advisory Committee on Water Information’sOpen Water Data Initiative. Here, we demonstrate an application of integrated open water data, visualized and made available online using open source software, for the purpose of exploring the impact of the current California drought. Our collaborative approach and technical tools enabled a rapid, distributed development process. Many positive outcomes have resulted: the application received recognition within and outside of the Federal Government, inspired others to visualize open water data, spurred new collaborations for our group, and strengthened the collaborative relationships within the team of developers. In this article, we describe the technical tools and collaborative process that enabled the success of the application. 

Technical clarity in inter-agency negotiations: Lessons from four hydropower projects

USGS Publications Warehouse

Burkardt, Nina; Lamb, Berton Lee; Taylor, Jonathan G.; Waddle, Terry J.

1995-01-01

We investigated the effect of technical clarity on success in multi-party negotiations in the Federal Energy Regulatory Commission (FERC) licensing process. Technical clarity is the shared understanding of dimensions such as the geographic extent of the project, range of flows to be considered, important species and life stages, and variety of water uses considered. The results of four hydropower licensing consultations are reported. Key participants were interviewed to ascertain the level of technical clarity present during the consultations and the degree to which the consultations were successful. Technical clarity appears to be a prerequisite for successful outcomes. Factors that enhance technical clarity include simple project design, new rather than existing projects, precise definition of issues, a sense of urgency to reach agreement, a sense of fairness among participants, and consistency in participation. Negotiators should not neglect the critical pre-negotiation steps of defining technical issues and determining appropriate studies, deciding how to interpret studies, and agreeing on responses to study results.

Uncommon but devastating event: total fertilisation failure following intracytoplasmic sperm injection.

PubMed

Goksan Pabuccu, E; Sinem Caglar, G; Dogus Demirkiran, O; Pabuccu, R

2016-03-01

Fertilisation with intracytoplasmic sperm injection (ICSI) is a consequence of complex molecular interactions between spermatozoon and oocyte. Disruption of the process obviously prompts a frustrating event called total fertilisation failure (TFF). Up to 3% of ICSI cycles may result in TFF, and brief counselling for subsequent cycle management is indispensable. Within this perspective, ICSI cycles of a centre over a 10-year period were analysed to document TFF cases. Initial TFF after ICSI and subsequent ICSI cycle of the same cases were documented to clarify predictive factors of successful outcomes after initial TFF. In subsequent cycles, assisted oocyte activation (AOA) with calcium ionophore and Hypo-osmotic swelling test (HOST)/pentoxifilline for sperm selection was used. In the current analysis, successful fertilisation was achieved in 85% of the cases with previous TFF. The significant contributing factors for successful fertilisation in the latter cycle were: improved oocyte quantity and better sperm morphology. In conclusion, sporadic TFF event in the first and only cycle is usually a technically modifiable condition, but repeated TFF could indicate possible gamete defects, which might not be overcomed in the next modified ICSI cycle. © 2015 Blackwell Verlag GmbH.

Succession Planning for Management Staff at a Canadian Post Secondary Technical Institute.

ERIC Educational Resources Information Center

da Costa, Jose; Cembrowski, Barbara

2001-01-01

Analyzed interviews to explore how nine administrators, at three different career stages, perceived career-development and succession planning at a Canadian postsecondary technical institute. Managers attribute career success to possession of varied personal attributes, diverse work experiences, serendipity, and a fulfilling work environment. Job…

Impact of Professional Nursing Tutors on National Council Licensure Examination Success

ERIC Educational Resources Information Center

Mondeik, Shelly L.

2014-01-01

This mixed-methods study examined the impact of professional nursing tutors on National Council Licensure Examination (NCLEX) success. Thirty-eight nursing student success rates from Northcentral Technical College, a two year technical college in Wisconsin, were analyzed by using NCLEX pass rate information, professional tutoring logs, and a…

Percutaneous CT and Fluoroscopy-Guided Screw Fixation of Pathological Fractures in the Shoulder Girdle: Technical Report of 3 Cases.

PubMed

Garnon, Julien; Koch, Guillaume; Ramamurthy, Nitin; Caudrelier, Jean; Rao, Pramod; Tsoumakidou, Georgia; Cazzato, Roberto Luigi; Gangi, Afshin

2016-09-01

To review our initial experience with percutaneous CT and fluoroscopy-guided screw fixation of pathological shoulder-girdle fractures. Between May 2014 and June 2015, three consecutive oncologic patients (mean age 65 years; range 57-75 years) with symptomatic pathological shoulder-girdle fractures unsuitable for surgery and radiotherapy underwent percutaneous image-guided screw fixation. Fractures occurred through metastases (n = 2) or a post-ablation cavity (n = 1). Mechanical properties of osteosynthesis were adjudged superior to stand-alone cementoplasty in each case. Cannulated screws were placed under combined CT and fluoroscopic guidance with complementary radiofrequency ablation or cementoplasty to optimise local palliation and secure screw fixation, respectively, in two cases. Follow-up was undertaken every few weeks until mortality or most recent appointment. Four pathological fractures were treated in three patients (2 acromion, 1 clavicular, 1 coracoid). Mean size of associated lesion was 2.6 cm (range 1-4.5 cm). Technical success was achieved in all cases (100 %), without complications. Good palliation and restoration of mobility were observed in two cases at 2-3 months; one case could not be followed due to early post-procedural oncologic mortality. Percutaneous image-guided shoulder-girdle osteosynthesis appears technically feasible with good short-term efficacy in this complex patient subset. Further studies are warranted to confirm these promising initial results.

Institutionalizing Sex Education in Diverse U.S. School Districts.

PubMed

Saul Butler, Rebekah; Sorace, Danene; Hentz Beach, Kathleen

2018-02-01

This paper describes the Working to Institutionalize Sex Education (WISE) Initiative, a privately funded effort to support ready public school districts to advance and sustain comprehensive sexuality programs, and examines the degree to which WISE has been successful in increasing access to sex education, removing barriers, and highlighting best practices. The data for this study come from a set of performance indicators, guidance documents, and tools designed for the WISE Initiative to capture changes in sex education institutionalization at WISE school districts. The evaluation includes the analysis of 186 school districts across 12 states in the U.S. As a result of the WISE Initiative, 788,865 unique students received new or enhanced sex education in school classrooms and 88 school districts reached their sex education institutionalization goals. In addition to these school district successes, WISE codified the WISE Method and toolkit-a practical guide to help schools implement sex education. Barriers to implementing sexuality education can be overcome with administrative support and focused technical assistance and training, resulting in significant student reach in diverse school districts nationwide. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

A pilot demonstration project of technology application from the aerospace industry to city management (four cities program)

NASA Technical Reports Server (NTRS)

Ervin, G. F.; Blomeyer, L. S.

1972-01-01

The Four Cities Program has completed the first year of the planned two-year program. At the beginning of the first year, a variety of program initiation activities were accomplished. Contracts were negotiated; science and technology advisors were interviewed, selected and assigned; general indoctrination and integration of the advisors into city affairs occurred; technical needs were identified and related projects pursued; pilot projects for the second year were identified; inter-city coordination on technical problems began to emerge; and the general soundness of the four cities program seems to have been established. Above all, the inter-personal relationships between the advisors and their interfaces in city government appear to be functioning smoothly. The establishment of such mutual respect, trusts, and confidences are believed essential to the success of the program.

Totally implantable venous power ports of the forearm and the chest: initial clinical experience with port devices approved for high-pressure injections

PubMed Central

Goltz, J P; Noack, C; Petritsch, B; Kirchner, J; Hahn, D; Kickuth, R

2012-01-01

Objectives To evaluate the technical success, clinical outcome and safety of percutaneously placed totally implantable venous power ports (TIVPPs) approved for high-pressure injections, and to analyse their value for arterial phase CT scans. Methods Retrospectively, we identified 204 patients who underwent TIVPP implantation in the forearm (n=152) or chest (n=52) between November 2009 and May 2011. Implantation via an upper arm (forearm port, FP) or subclavian vein (chest port, CP) was performed under sonographic and fluoroscopic guidance. Complications were evaluated following the standards of the Society of Interventional Radiology. Power injections via TIVPPs were analysed, focusing on adequate functioning and catheter's tip location after injection. Feasibility of automatic bolus triggering, peak injection pressure and arterial phase aortic enhancement were evaluated and compared with 50 patients who had had power injections via classic peripheral cannulas. Results Technical success was 100%. Procedure-related complications were not observed. Catheter-related thrombosis was diagnosed in 15 of 152 FPs (9.9%, 0.02/100 catheter days) and in 1 of 52 CPs (1.9%, 0.002/100 catheter days) (p<0.05). Infectious complications were diagnosed in 9 of 152 FPs (5.9%, 0.014/100 catheter days) and in 2 of 52 CPs (3.8%, 0.003/100 catheter days) (p>0.05). Arterial bolus triggering succeeded in all attempts; the mean injection pressure was 213.8 psi. Aortic enhancement did not significantly differ between injections via cannulas and TIVPPs (p>0.05). Conclusions TIVPPs can be implanted with high technical success rates, and are associated with low rates of complications if implanted with sonographic and fluoroscopic guidance. Power injections via TIVPPs are safe and result in satisfying arterial contrast. Conventional ports should be replaced by TIVPPs. PMID:22674705

Percutaneous Management of Accidentally Retained Foreign Bodies During Image-Guided Non-vascular Procedures: Novel Technique Using a Large-Bore Biopsy System

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

Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it; Garnon, Julien, E-mail: juleiengarnon@gmail.com; Ramamurthy, Nitin, E-mail: nitin-ramamurthy@hotmail.com

ObjectiveTo describe a novel percutaneous image-guided technique using a large-bore biopsy system to retrieve foreign bodies (FBs) accidentally retained during non-vascular interventional procedures.Materials and MethodsBetween May 2013 and October 2015, five patients underwent percutaneous retrieval of five iatrogenic FBs, including a biopsy needle tip in the femoral head following osteoblastoma biopsy and radiofrequency ablation (RFA); a co-axial needle shaft within a giant desmoid tumour following cryoablation; and three post-vertebroplasty cement tails within paraspinal muscles. All FBs were retrieved immediately following original procedures under local or general anaesthesia, using combined computed tomography (CT) and fluoroscopic guidance. The basic technique involved positioningmore » a 6G trocar sleeve around the FB long axis and co-axially advancing an 8G biopsy needle to retrieve the FB within the biopsy core. Retrospective chart review facilitated analysis of procedures, FBs, technical success, and complications.ResultsMean FB size was 23 mm (range 8–74 mm). Four FBs were located within 10 mm of non-vascular significant anatomic structures. The basic technique was successful in 3 cases; 2 cases required technical modifications including using a stiff guide-wire to facilitate retrieval in the case of the post-cryoablation FB; and using the central mandrin of the 6G trocar to push a cement tract back into an augmented vertebra when initial retrieval failed. Overall technical success (FB retrieval or removal to non-hazardous location) was 100 %, with no complications.ConclusionPercutaneous image-guided retrieval of iatrogenic FBs using a large-bore biopsy system is a feasible, safe, effective, and versatile technique, with potential advantages over existing methods.« less

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

Goltz, Jan P., E-mail: Goltz@roentgen.uni-wuerzburg.de; Scholl, Anne; Ritter, Christian O.

The aim of this study is to evaluate the effectiveness and safety of percutaneously placed totally implantable venous-access ports (TIVAPs) of the forearm. Between January 2006 and October 2008, peripheral TIVAPs were implanted in 763 consecutive patients by ultrasound and fluoroscopic guidance. All catheters were implanted under local anesthesia and were tunneled subcutaneously. Indication, technical success, and complications were retrospectively analyzed according to Society of Interventional Radiology (SIR) criteria. Presence of antibiotic prophylaxis, periprocedurally administered drugs (e.g., sedation), and laboratory results at the time of implantation were analyzed. Maintenance during the service interval was evaluated. In total, 327,499 catheter-days weremore » analyzed. Technical success rate was 99.3%. Reasons for initial failure of implantation were either unexpected thrombosis of the subclavian vein, expanding tumor mass of the mediastinum, or failure of peripheral venous access due to fragile vessels. Mean follow-up was 430 days. There were 115 complications observed (15.1%, 0.03 per 100 catheter-days), of which 33 (4.3%) were classified as early (within 30 days from implantation) and 82 (10.7%) as late. Catheter-related venous thrombosis was found in 65 (8.5%) of 763 (0.02 per 100 catheter-days) TIVAPs. Infections were observed in 41 (5.4%) of 763 (0.01 per 100 catheter-days) devices. Other complications observed included dislocation of the catheter tip (0.8%), occlusion (0.1%), or rupture (0.1%) of the port catheter. Dislocated catheters were corrected during a second interventional procedure. In conclusion, implantation of percutaneously placed peripheral TIVAPs shows a high technical success rate and low risk of early complications when ultrasound and fluoroscopic guidance are used. Late complications are observed three times as often as early complications.« less

Technical attainment, practical success and practical knowledge: hermeneutical bases for child nursing care.

PubMed

de Mello, Débora Falleiros; de Lima, Regina Aparecida Garcia

2009-01-01

This reflective study aimed to present some aspects of the concepts technical attainment, practical success and practical knowledge, with a view to a broader understanding of child nursing care. Health care is considered in the perspective of reconstructive practices, characterized as contingencies, highlighting the importance of the connection between technical attainment and practical success and the valuation of practical knowledge, based on philosophical hermeneutics, in the context of practical philosophy. Child health nursing can deal with technical attainment and practical success jointly, and also understand practical knowledge in the longitudinality of care. Health promotion, disease prevention, recovery and rehabilitation of child health should be indissociably associated with contextualized realities, shared between professionals and families, aiming to follow the child's growth and development, produce narratives, identify experiences, choices and decision making to broaden health care.

Angiographic assessment of initial balloon angioplasty results.

PubMed

Gardiner, Geoffrey A; Sullivan, Kevin L; Halpern, Ethan J; Parker, Laurence; Beck, Margaret; Bonn, Joseph; Levin, David C

2004-10-01

To determine the influence of three factors involved in the angiographic assessment of balloon angioplasty-interobserver variability, operator bias, and the definition used to determine success-on the primary (technical) results of angioplasty in the peripheral arteries. Percent stenosis in 107 lesions in lower-extremity arteries was graded by three independent, experienced vascular radiologists ("observers") before and after balloon angioplasty and their estimates were compared with the initial interpretations reported by the physician performing the procedure ("operator") and an automated quantitative computer analysis. Observer variability was measured with use of intraclass correlation coefficients and SD. Differences among the operator, observers, and the computer were analyzed with use of the Wilcoxon signed-rank test and analysis of variance. For each evaluator, the results in this series of lesions were interpreted with three different definitions of success. Estimation of residual stenosis varied by an average range of 22.76% with an average SD of 8.99. The intraclass correlation coefficients averaged 0.59 for residual stenosis after angioplasty for the three observers but decreased to 0.36 when the operator was included as the fourth evaluator. There was good to very good agreement among the three independent observers and the computer, but poor correlation with the operator (P

Evolution of atherectomy devices.

PubMed

Al Khoury, G; Chaer, R

2011-08-01

Percutaneous atherectomy provides an alternative approach to the endovascular treatment of peripheral atherosclerotic occlusive disease beyond angioplasty and stenting, and has the theoretical advantage of lesion debulking and minimizing barotrauma to the vessel wall. Atherectomy has evolved greatly during the last decade, with currently four FDA approved devices for the treatment of peripheral arterial disease. Several reports have focused on the initial technical success rates, and demonstrated the safety and short as well as mid-term efficacy of atherectomy devices. This article will review the evolution of current atherectomy devices and the associated literature.

NASA GSFC Strategic Nanotechnology Interests: Symposium on High-Rate Nanoscale Printing for Devices and Structures

NASA Technical Reports Server (NTRS)

Ericsson, Aprille J.

2014-01-01

The seminars invitees include representatives from industry, nonprofit research facility and universities. The presentation provides an overview of the NASAGSFC locations, technical capabilities and applied nanotechnology interests. Initially presented are advances by the broader technological communities on current miniaturized multiscale advanced manufacturing and 3D printing products on the micro and macro scale. Briefly assessed is the potential of moving toward the nanoscale for possible space flight applications and challenges. Lastly, highlighted are GSFCs current successes in nano-technology developments and targeted future applications.

Veres needle in the pleural space.

PubMed

Jenkins, D W; McKinney, M K; Szpak, M W; Booker, J L

1983-11-01

The Veres needle is designed to allow entry into body cavities without trauma to underlying organs. Its major use has been in the induction of a pneumoperitoneum for peritoneoscopy. An initial successful evaluation of its use was in the pleural space of dogs. A subsequent analysis of complications in 69 thoracenteses using the Veres needle and 152 thoracenteses using a conventional needle favored the Veres needle (P = .05). We believe that the Veres needle is a safe and technically superior instrument for thoracentesis and that it deserves further application and study.

Supplement to a Methodology for Succession Planning for Technical Experts

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

Kirk, Bernadette Lugue; Cain, Ronald A.; Agreda, Carla L.

This report complements A Methodology for Succession Planning for Technical Experts (Ron Cain, Shaheen Dewji, Carla Agreda, Bernadette Kirk, July 2017), which describes a draft methodology for identifying and evaluating the loss of key technical skills at nuclear operations facilities. This report targets the methodology for identifying critical skills, and the methodology is tested through interviews with selected subject matter experts.

Percutaneous Aspiration Thrombectomy for the Treatment of Arterial Thromboembolic Occlusions Following Percutaneous Transluminal Angioplasty

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

Schleder, Stephan, E-mail: stephan.schleder@ukr.de; Diekmann, Matthias; Manke, Christoph

2015-02-15

PurposeThis study was designed to evaluate the technical success and the early clinical outcome of patients undergoing percutaneous aspiration thrombectomy (PAT) for the treatment of arterial thromboembolism following percutaneous infrainguinal transluminal angioplasty (PTA).MethodsIn this single-center study, during a period of 7 years retrospectively, 47 patients (22 male, 47 %) with a mean age of 73 (range 53–96) years were identified in whom PAT was performed for the treatment of thromboembolic complications of infrainguinal PTA. Primary technical success was defined as residual stenosis of <50 % in diameter after sole PAT, whereas secondary technical success was defined as residual stenosis of <50 % in diametermore » after PAT and additional PTA and/or stenting. Clinical outcome parameters (e.g., need for further intervention, minor/major amputation) were evaluated for the 30-day postinterventional period.ResultsPrimary technical success was achieved in 64 % of patients (30/47); secondary technical success was obtained in 96 % of patients (45/47). Clinical outcome data were available in 38 patients. In 87 % of patients (33/38), there was no need for further intervention within the 30-day postinterventional period. In three patients, minor amputations were conducted due to preexisting ulcerations (Rutherford Category 5 respectively).ConclusionsPAT enables endovascular treatment of iatrogenic thromboembolic complications after PTA with good technical and early clinical results and minimal morbidity.« less

Comparison of Technical and Clinical Outcome of Transjugular Portosystemic Shunt Placement Between a Bare Metal Stent and a PTFE-Stentgraft Device.

PubMed

Lauermann, J; Potthoff, A; Mc Cavert, M; Marquardt, S; Vaske, B; Rosenthal, H; von Hahn, T; Wacker, F; Meyer, B C; Rodt, Thomas

2016-04-01

To analyse technical and clinical success of transjugular intrahepatic portosystemic shunt (TIPS) in patients with portal hypertension and compare a stent and a stentgraft with regard to clinical and technical outcome and associated costs. 170 patients (56 ± 12 years, 32.9% females) treated with TIPS due to portal hypertension were reviewed. 80 patients received a stent (group 1) and 83 a stentgraft (group 2), and seven interventions were unsuccessful. Technical data, periprocedural imaging, follow-up ultrasound and clinical data were analysed with focus on technical success, patency, clinical outcome and group differences. Cost analysis was performed. Portal hypertension was mainly caused by ethyltoxic liver cirrhosis with ascites as dominant symptom (80%). Technical success was 93.5% with mean portosystemic gradient decrease from 16.1 ± 4.8 to 5.1 ± 2.1 mmHg. No significant differences in technical success and portosystemic gradient decrease between the groups were observed. Kaplan-Meier analysis yielded significant differences in primary patency after 14 days, 6 months and 2 years in favour of the stentgraft. Both groups showed good clinical results without significant difference in 1-year survival and hepatic encephalopathy rate. Costs to establish TIPS and to manage 2-year follow-up with constant patency and clinical success were 8876 € (group 1) and 9394 € (group 2). TIPS is a safe and effective procedure to manage portal hypertension. Stent and stentgraft enabled good technical and clinical results with a low complication rate. Primary patency rates are clearly in favour of the stentgraft, whereas the stent was more cost effective with similar clinical results in both groups.

Comparison of Technical and Clinical Outcome of Transjugular Portosystemic Shunt Placement Between a Bare Metal Stent and a PTFE-Stentgraft Device

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

Lauermann, J., E-mail: jostlauermann@gmail.com; Potthoff, A.; Mc Cavert, M.

PurposeTo analyse technical and clinical success of transjugular intrahepatic portosystemic shunt (TIPS) in patients with portal hypertension and compare a stent and a stentgraft with regard to clinical and technical outcome and associated costs.Materials and Methods170 patients (56 ± 12 years, 32.9 % females) treated with TIPS due to portal hypertension were reviewed. 80 patients received a stent (group 1) and 83 a stentgraft (group 2), and seven interventions were unsuccessful. Technical data, periprocedural imaging, follow-up ultrasound and clinical data were analysed with focus on technical success, patency, clinical outcome and group differences. Cost analysis was performed.ResultsPortal hypertension was mainly caused by ethyltoxicmore » liver cirrhosis with ascites as dominant symptom (80 %). Technical success was 93.5 % with mean portosystemic gradient decrease from 16.1 ± 4.8 to 5.1 ± 2.1 mmHg. No significant differences in technical success and portosystemic gradient decrease between the groups were observed. Kaplan–Meier analysis yielded significant differences in primary patency after 14 days, 6 months and 2 years in favour of the stentgraft. Both groups showed good clinical results without significant difference in 1-year survival and hepatic encephalopathy rate. Costs to establish TIPS and to manage 2-year follow-up with constant patency and clinical success were 8876 € (group 1) and 9394 € (group 2).ConclusionTIPS is a safe and effective procedure to manage portal hypertension. Stent and stentgraft enabled good technical and clinical results with a low complication rate. Primary patency rates are clearly in favour of the stentgraft, whereas the stent was more cost effective with similar clinical results in both groups.« less

A Successful Infusion Process for Enabling Lunar Exploration Technologies

NASA Technical Reports Server (NTRS)

Over, Ann P.; Klem, Mark K.; Motil, Susan M.

2008-01-01

The NASA Vision for Space Exploration begins with a more reliable flight capability to the International Space Station and ends with sending humans to Mars. An important stepping stone on the path to Mars encompasses human missions to the Moon. There is little doubt throughout the stakeholder community that new technologies will be required to enable this Vision. However, there are many factors that influence the ability to successfully infuse any technology including the technical risk, requirement and development schedule maturity, and, funds available. This paper focuses on effective infusion processes that have been used recently for the technologies in development for the lunar exploration flight program, Constellation. Recent successes with Constellation customers are highlighted for the Exploration Technology Development Program (ETDP) Projects managed by NASA Glenn Research Center (GRC). Following an overview of the technical context of both the flight program and the technology capability mapping, the process is described for how to effectively build an integrated technology infusion plan. The process starts with a sound risk development plan and is completed with an integrated project plan, including content, schedule and cost. In reality, the available resources for this development are going to change over time, necessitating some level of iteration in the planning. However, the driving process is based on the initial risk assessment, which changes only when the overall architecture changes, enabling some level of stability in the process.

Push versus pull gastrostomy in cancer patients: A single center retrospective analysis of complications and technical success rates.

PubMed

Currie, B M; Getrajdman, G I; Covey, A M; Alago, W; Erinjeri, J P; Maybody, M; Boas, F E

2018-04-28

To compare the technical success and complication rates of push versus pull gastrostomy tubes in cancer patients, and to examine their dependence on operator experience. A retrospective review was performed of 304 cancer patients (170 men, 134 women; mean age 60.3±12.6 [SD], range: 19-102 years) referred for primary gastrostomy tube placement, 88 (29%) of whom had a previously unsuccessful attempt at percutaneous endoscopic gastrostomy (PEG) placement. Analyzed variables included method of insertion (push versus pull), indication for gastrostomy, technical success, operator experience, and procedure-related complications within 30 days of placement. Gastrostomy tubes were placed for feeding in 189 patients and palliative decompression in 115 patients. Technical success was 91%: 78% after endoscopy had previously been unsuccessful and 97% when excluding failures associated with prior endoscopy. In the first 30 days, there were 29 minor complications (17.2%) associated with push gastrostomies, and only 8 minor complications (7.5%) with pull gastrostomies (P<0.05). There was no significant difference in major complications (push gastrostomy 5.3%, pull gastrostomy 5.6%). For decompressive gastrostomy tubes, the pull technique resulted in lower rates of both minor and major complications. There was no difference in complications or technical success rates for more versus less experienced operators. Pull gastrostomy tube placement had a lower rate of complications than push gastrostomy tube placement, especially when the indication was decompression. The technical success rate was high, even after a failed attempt at endoscopic placement. Both the rates of success and complications were independent of operator experience. Copyright © 2018 Société française de radiologie. Published by Elsevier Masson SAS. All rights reserved.

The importance of defining technical issues in interagency environmental negotiations

USGS Publications Warehouse

Lamb, B.L.; Burkardt, N.; Taylor, J.G.

2001-01-01

The role of technical clarity in successful multiparty negotiations was studied. Investigations involved in-depth interviews with the principal participants in six consultations conducted under the U.S. Federal Energy Regulatory Commission’s hydroelectric power project licensing procedures. Technical clarity was especially important in these cases because they concerned science-based questions. The principal issues in the six cases were fish passage, instream flow for fish habitat, and entrainment of fish in hydropower turbines. It was concluded that technical clarity was one of the most critical elements in resolving these conflicts. In the least successful negotiations, parties failed to address the basic values of the dispute before plunging into technical studies. The results of those studies usually highlighted the potential for negative outcomes and increased polarization between the participants. In the most successful negotiations, the various parties shared an understanding of each of their basic values. These shared understandings led to technical studies that cast the negotiation in a positive light and illuminated possible solutions.

Ultrasound-guided lumbar puncture in pediatric patients: technical success and safety.

PubMed

Pierce, David B; Shivaram, Giri; Koo, Kevin S H; Shaw, Dennis W W; Meyer, Kirby F; Monroe, Eric J

2018-06-01

Disadvantages of fluoroscopically guided lumbar puncture include delivery of ionizing radiation and limited resolution of incompletely ossified posterior elements. Ultrasound (US) allows visualization of critical soft tissues and the cerebrospinal fluid (CSF) space without ionizing radiation. To determine the technical success and safety of US-guided lumbar puncture in pediatric patients. A retrospective review identified all patients referred to interventional radiology for lumbar puncture between June 2010 and June 2017. Patients who underwent lumbar puncture with fluoroscopic guidance alone were excluded. For the remaining procedures, technical success and procedural complications were assessed. Two hundred and one image-guided lumbar punctures in 161 patients were included. Eighty patients (43%) had previously failed landmark-based attempts. One hundred ninety-six (97.5%) patients underwent lumbar puncture. Five procedures (2.5%) were not attempted after US assessment, either due to a paucity of CSF or unsafe window for needle placement. Technical success was achieved in 187 (95.4%) of lumbar punctures attempted with US guidance. One hundred seventy-seven (90.3%) were technically successful with US alone (age range: 2 days-15 years, weight range: 1.9-53.1 kg) and an additional 10 (5.1%) were successful with US-guided thecal access and subsequent fluoroscopic confirmation. Three (1.5%) cases were unsuccessful with US guidance but were subsequently successful with fluoroscopic guidance. Of the 80 previously failed landmark-based lumbar punctures, 77 (96.3%) were successful with US guidance alone. There were no reported complications. US guidance is safe and effective for lumbar punctures and has specific advantages over fluoroscopy in pediatric patients.

Brownfields and Land Revitalization Programmatic Information

EPA Pesticide Factsheets

This asset contains resources provided by EPA's Brownfields and Land Revitalization program that can be used for the assessment, cleanup, and redevelopment of brownfields sites and land revitalization activities. To help implement the program, EPA provides information on the Brownfields law, success stories from Brownfields grantees, technical information and resources to aid in the assessment and cleanup of brownfields properties, partnerships to promote the cleanup and reuse of Brownfields, and initiatives that explore sector-based solutions, enhance environmental quality, spur economic development, and revitalize communities. This asset includes fact sheets, success stories, training, policy, and guidance documents. Regulatory authority for the collection and use of this information is found in the Small Business Liability Relief and Brownfields Revitalization Act of 2002 (the Brownfields Law), which amended the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) of 1980.

Deployment of the MARSIS Radar Antennas On-Board Mars Express

NASA Technical Reports Server (NTRS)

Denis, Michel; Moorhouse, A.; Smith, A.; McKay, Mike; Fischer, J.; Jayaraman, P.; Mounzer, Z.; Schmidt, R.; Reddy, J.; Ecale, E.;

Transition management - An analysis of strategic considerations for effective implementation

NASA Technical Reports Server (NTRS)

Hunsucker, John L.; Loos, David

1989-01-01

Six managerial guidelines are identified for facilitating successful change in an organization. They are: (1) the need for a catalyst to initiate change; (2) the setting of organizational goals which take into account the impact of technical, political, and cultural factors; (3) requiring a transition team to guide the change; (4) a demonstration by top management of a commitment to the change as well as their acting as change agents; (5) the utilization of employee participation and good communication to help overcome employee resistance; and (6) the evaluation of the change program as important to the success of present and future change programs. A description of each guideline is presented, and its importance is examined. Available options are also presented for management to deal with each of the guidelines.

Bilateral metal stents for hilar biliary obstruction using a 6Fr delivery system: outcomes following bilateral and side-by-side stent deployment.

PubMed

Law, Ryan; Baron, Todd H

2013-09-01

Controversy exists on optimal endoscopic management for palliation of malignant hilar obstruction, with advocates for metal "side-by-side" (SBS) and "stent-in-stent" (SIS) techniques. We sought to evaluate the technical feasibility, efficacy, and outcomes of bilateral biliary self-expanding metal stents (SEMS) for treatment of malignant hilar obstruction using a stent with a 6Fr delivery system. This was a single-center, retrospective review of all patients who underwent bilateral placement of Zilver® biliary SEMS for malignant hilar obstruction from January 2010 to August 2012. Patients underwent endoscopic retrograde cholangiopancreatography with placement of stents using either the SIS or SBS stent techniques. Twenty-four patients (19 men, mean age 63 years) underwent bilateral stenting for malignant hilar obstruction during the study period. Seventeen and seven patients underwent the SBS and SIS technique, respectively. Cholangiocarcinoma (n=14) was the most common cause of hilar obstruction. Initial technical success was achieved in 24/24 (100%) of patients; however, 12 (50%) patients required re-intervention during the study period (median 98 days). Comparison of the SBS and SIS groups revealed no statistical difference with respect to need for re-intervention (P=0.31), successful re-intervention (P=0.60), or procedural length (P=0.89). Use of bilateral Zilver® SEMS in either the SBS or SIS configuration is safe, technically feasible, and effective for drainage of malignant hilar obstruction; however, duration of stent patency and procedure-free survival remain variable.

76 FR 33332 - Announcement of Funding Awards for the Technical Assistance and Capacity Building under the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-08

... of key Departmental objectives, including but not limited to, energy efficiency and green building... Awards for the Technical Assistance and Capacity Building under the Transformation Initiative Program...) for the Technical Assistance and Capacity Building under the Transformation Initiative program for...

Percutaneous Thermal Ablation with Ultrasound Guidance. Fusion Imaging Guidance to Improve Conspicuity of Liver Metastasis

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

Hakime, Antoine, E-mail: thakime@yahoo.com; Yevich, Steven; Tselikas, Lambros

PurposeTo assess whether fusion imaging-guided percutaneous microwave ablation (MWA) can improve visibility and targeting of liver metastasis that were deemed inconspicuous on ultrasound (US).Materials and MethodsMWA of liver metastasis not judged conspicuous enough on US was performed under CT/US fusion imaging guidance. The conspicuity before and after the fusion imaging was graded on a five-point scale, and significance was assessed by Wilcoxon test. Technical success, procedure time, and procedure-related complications were evaluated.ResultsA total of 35 patients with 40 liver metastases (mean size 1.3 ± 0.4 cm) were enrolled. Image fusion improved conspicuity sufficiently to allow fusion-targeted MWA in 33 patients. The time requiredmore » for image fusion processing and tumors’ identification averaged 10 ± 2.1 min (range 5–14). Initial conspicuity on US by inclusion criteria was 1.2 ± 0.4 (range 0–2), while conspicuity after localization on fusion imaging was 3.5 ± 1 (range 1–5, p < 0.001). Technical success rate was 83% (33/40) in intention-to-treat analysis and 100% in analysis of treated tumors. There were no major procedure-related complications.ConclusionsFusion imaging broadens the scope of US-guided MWA to metastasis lacking adequate conspicuity on conventional US. Fusion imaging is an effective tool to increase the conspicuity of liver metastases that were initially deemed non visualizable on conventional US imaging.« less

A High-Value, Low-Cost Bubble Continuous Positive Airway Pressure System for Low-Resource Settings: Technical Assessment and Initial Case Reports

PubMed Central

Brown, Jocelyn; Machen, Heather; Kawaza, Kondwani; Mwanza, Zondiwe; Iniguez, Suzanne; Lang, Hans; Gest, Alfred; Kennedy, Neil; Miros, Robert; Richards-Kortum, Rebecca; Molyneux, Elizabeth; Oden, Maria

2013-01-01

Acute respiratory infections are the leading cause of global child mortality. In the developing world, nasal oxygen therapy is often the only treatment option for babies who are suffering from respiratory distress. Without the added pressure of bubble Continuous Positive Airway Pressure (bCPAP) which helps maintain alveoli open, babies struggle to breathe and can suffer serious complications, and frequently death. A stand-alone bCPAP device can cost $6,000, too expensive for most developing world hospitals. Here, we describe the design and technical evaluation of a new, rugged bCPAP system that can be made in small volume for a cost-of-goods of approximately $350. Moreover, because of its simple design—consumer-grade pumps, medical tubing, and regulators—it requires only the simple replacement of a <$1 diaphragm approximately every 2 years for maintenance. The low-cost bCPAP device delivers pressure and flow equivalent to those of a reference bCPAP system used in the developed world. We describe the initial clinical cases of a child with bronchiolitis and a neonate with respiratory distress who were treated successfully with the new bCPAP device. PMID:23372661

A Prospective Observational Study of Technical Difficulty With GlideScope-Guided Tracheal Intubation in Children.

PubMed

Zhang, Bin; Gurnaney, Harshad G; Stricker, Paul A; Galvez, Jorge A; Isserman, Rebecca S; Fiadjoe, John E

2018-05-09

The GlideScope Cobalt is one of the most commonly used videolaryngoscopes in pediatric anesthesia. Although visualization of the airway may be superior to direct laryngoscopy, users need to learn a new indirect way to insert the tracheal tube. Learning this indirect approach requires focused practice and instruction. Identifying the specific points during tube placement, during which clinicians struggle, would help with targeted education. We conducted this prospective observational study to determine the incidence and location of technical difficulties using the GlideScope, the success rates of various corrective maneuvers used, and the impact of technical difficulty on success rate. We conducted this observational study at our quaternary pediatric hospital between February 2014 and August 2014. We observed 200 GlideScope-guided intubations and documented key intubation-related outcomes. Inclusion criteria for patients were <6 years of age and elective surgery requiring endotracheal intubation. We documented the number of advancement maneuvers required to intubate the trachea, the location where technical difficulty occurred, the types of maneuvers used to address difficulties, and the tracheal intubation success rate. We used a bias-corrected bootstrapping method with 300 replicates to determine the 95% confidence interval (CI) around the rate of difficulty with an intubation attempt. After excluding attempts by inexperienced clinicians, there were 225 attempts in 187 patients, 58% (131 of 225; bootstrap CI, 51.6%-64.6%]) of the attempts had technical difficulties. Technical difficulty was most likely to occur when inserting the tracheal tube between the plane of the arytenoid cartilages to just beyond the vocal cords: "zone 3." Clockwise rotation of the tube was the most common successful corrective maneuver in zone 3. The overall tracheal intubation success rate was 98% (CI, 95%-99%); however, the first attempt success rate was only 80% (CI, 74%-86%). Patients with technical difficulty had more attempts (median [interquartile range], 2 [1-3] than those without technical difficulty median (interquartile range, 1 [1-1; P value <.01]). A variety of clinicians experience technical difficulties with the GlideScope Cobalt videolaryngoscope in children. These difficulties result in more tracheal intubation attempts, an important risk factor for intubation-associated complications. Targeted education of clinicians may reduce the incidence of technical difficulties.

Salpingitis Isthmica Nodosa: Technical Success and Outcome of Fluoroscopic Transcervical Fallopian Tube Recanalization

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

Houston, J. Graeme; Machan, Lindsay S.

1998-01-15

Purpose: To evaluate the technical success and outcome of fallopian tube recanalization (FTR) in salpingitis isthmica nodosa (SIN). Methods: SIN is a well-recognized pathological condition affecting the proximal fallopian tube and is associated with infertility and ectopic pregnancy. We reviewed the presentations, films, and case records of all patients attending for FTR for infertility from 1990 to 1994. Technical success and total, intrauterine, and ectopic pregnancy rates at follow-up were determined. Results: SIN was observed in 22 of 349 (6%) patients. FTR was attempted in 34 tubes in these 22 patients. Technical success was achieved in 23 of 34 (68%)more » tubes affected by SIN. In 5 of the 11 failed recanalizations, failure was due to distal obstruction. At least one tube was patent on selective postprocedural salpingography in 17 of 22 (77%) patients. There were no recorded perforations or complications. At follow-up (mean 14 months), total, intrauterine, and ectopic pregnancy rates were 23%, 18%, and 4.5%, respectively. Conclusion: FTR in SIN is technically successful and, compared with previously reported results in unselected infertility patients, is associated with only a slightly less favorable intrauterine pregnancy rate and a comparable ectopic pregnancy rate. The findings of SIN at FTR should not discourage attempted fluoroscopic transcervical recanalization.« less

Four malaria success stories: how malaria burden was successfully reduced in Brazil, Eritrea, India, and Vietnam.

PubMed

Barat, Lawrence M

2006-01-01

While many countries struggle to control malaria, four countries, Brazil, Eritrea, India, and Vietnam, have successfully reduced malaria burden. To determine what led these countries to achieve impact, published and unpublished reports were reviewed and selected program and partner staff were interviewed to identify common factors that contributed to these successes. Common success factors included conducive country conditions, a targeted technical approach using a package of effective tools, data-driven decision-making, active leadership at all levels of government, involvement of communities, decentralized implementation and control of finances, skilled technical and managerial capacity at national and sub-national levels, hands-on technical and programmatic support from partner agencies, and sufficient and flexible financing. All these factors were essential in achieving success. If the goals of Roll Back Malaria are to be achieved, governments and their partners must take the lessons learned from these program successes and apply them in other affected countries.

Green Manufacturing

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

Patten, John

Green Manufacturing Initiative (GMI): The initiative provides a conduit between the university and industry to facilitate cooperative research programs of mutual interest to support green (sustainable) goals and efforts. In addition to the operational savings that greener practices can bring, emerging market demands and governmental regulations are making the move to sustainable manufacturing a necessity for success. The funding supports collaborative activities among universities such as the University of Michigan, Michigan State University and Purdue University and among 40 companies to enhance economic and workforce development and provide the potential of technology transfer. WMU participants in the GMI activities includedmore » 20 faculty, over 25 students and many staff from across the College of Engineering and Applied Sciences; the College of Arts and Sciences' departments of Chemistry, Physics, Biology and Geology; the College of Business; the Environmental Research Institute; and the Environmental Studies Program. Many outside organizations also contribute to the GMI's success, including Southwest Michigan First; The Right Place of Grand Rapids, MI; Michigan Department of Environmental Quality; the Michigan Department of Energy, Labor and Economic Growth; and the Michigan Manufacturers Technical Center.« less

Newborn screening: a review of history, recent advancements, and future perspectives in the era of next generation sequencing.

PubMed

Almannai, Mohammed; Marom, Ronit; Sutton, V Reid

2016-12-01

The purpose of this review is to summarize the development and recent advancements of newborn screening. Early initiation of medical care has modified the outcome for many disorders that were previously associated with high morbidity (such as cystic fibrosis, primary immune deficiencies, and inborn errors of metabolism) or with significant neurodevelopmental disabilities (such as phenylketonuria and congenital hypothyroidism). The new era of mass spectrometry and next generation sequencing enables the expansion of the newborn screen panel, and will help to address technical issues such as turnaround time, and decreasing false-positive and false-negative rates for the testing. The newborn screening program is a successful public health initiative that facilitates early diagnosis of treatable disorders to reduce long-term morbidity and mortality.

Percutaneous CT and Fluoroscopy-Guided Screw Fixation of Pathological Fractures in the Shoulder Girdle: Technical Report of 3 Cases

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

Garnon, Julien, E-mail: juliengarnon@gmail.com; Koch, Guillaume, E-mail: Guillaume.koch@gmail.com; Ramamurthy, Nitin, E-mail: Nitin-ramamurthy@hotmail.com

ObjectiveTo review our initial experience with percutaneous CT and fluoroscopy-guided screw fixation of pathological shoulder-girdle fractures.Materials and MethodsBetween May 2014 and June 2015, three consecutive oncologic patients (mean age 65 years; range 57–75 years) with symptomatic pathological shoulder-girdle fractures unsuitable for surgery and radiotherapy underwent percutaneous image-guided screw fixation. Fractures occurred through metastases (n = 2) or a post-ablation cavity (n = 1). Mechanical properties of osteosynthesis were adjudged superior to stand-alone cementoplasty in each case. Cannulated screws were placed under combined CT and fluoroscopic guidance with complementary radiofrequency ablation or cementoplasty to optimise local palliation and secure screw fixation, respectively, in two cases. Follow-up wasmore » undertaken every few weeks until mortality or most recent appointment.ResultsFour pathological fractures were treated in three patients (2 acromion, 1 clavicular, 1 coracoid). Mean size of associated lesion was 2.6 cm (range 1–4.5 cm). Technical success was achieved in all cases (100 %), without complications. Good palliation and restoration of mobility were observed in two cases at 2–3 months; one case could not be followed due to early post-procedural oncologic mortality.ConclusionPercutaneous image-guided shoulder-girdle osteosynthesis appears technically feasible with good short-term efficacy in this complex patient subset. Further studies are warranted to confirm these promising initial results.« less

Preparing Students for Success in California's Community Colleges. Technical Appendix

ERIC Educational Resources Information Center

Mejia, Marisol Cuellar; Rodriguez, Olga; Johnson, Hans

2016-01-01

This document presents the technical appendix that accompanies the full report, "Preparing Students for Success in California's Community Colleges." The appendix includes Data and Methods. [Supported with funding from the Sutton Family Fund. For the full report, see ED570976.

Dilatation by Soehendra stent retriever is feasible and effective in multiple deployment of metallic stents to malignant hilar biliary strictures.

PubMed

Kato, Hironari; Kawamoto, Hirofumi; Noma, Yasuhiro; Sonoyama, Takayuki; Tsutsumi, Koichiro; Fujii, Masakuni; Okada, Hiroyuki; Yamamoto, Kazuhide

2013-01-01

The endoscopic management of malignant hilar biliary strictures using multiple metallic stents (MS) is technically demanding, in the initial deployment of MS and the recovery from MS occlusion with deployment of multiple plastic stents (PS). We evaluated the outcomes of the application of a Soehendra stent retriever (SSR) as a dilator of intractable strictures. Fifty-nine patients with malignant hilar biliary strictures had multiple MS inserted using a partial stent-in-stent procedure. When we encountered intractable strictures, we adopted SSR to dilate the stricture and the interstice of the MS. We evaluated the success rate of MS or PS deployment after SSR application and procedural complications. Five of 59 patients (8%) were subjected to SSR application for the initial MS deployment. MS were successfully deployed in all of these patients (100%). MS occlusion was noted in 27 patients. We applied SSR to seven patients (26%) for the deployment of multiple PS after MS occlusion. In five patients (71%), successful PS deployment was achieved after the SSR application. No complications related to dilatation using SSR occurred in any patient. SSR proved to be a potent dilator of difficult strictures in the management of malignant hilar biliary strictures.

Implementation of E-Government in Mexico: The Case of Infonavit

NASA Astrophysics Data System (ADS)

Herrera, Lizbeth; Gil-Garcia, J. Ramon

The implementation of information and communication technologies (ICTs) in the public sector is a strategy for administrative reform that has grown in ­importance in recent years. The use of ICT in government can help to improve the ­efficiency, quality, and transparency of public services and reduce the operating costs of bureaucracy. ICTs have also opened a new communication channel for government to provide public services to citizens without intermediaries. However, the ­implementation of an ICT initiative is not a simple process. Organizations ­frequently invest a great amount of resources into ICT initiatives, but the results they obtain often do not meet expectations. This observation is particularly true in some developing countries. Based on a case study of a Mexican federal agency, this ­chapter analyzes a successful strategy involving three ICT projects, taking into consideration institutional, organizational, and managerial aspects. Overall, the results of this study show that having a strategic plan that aligns the ICT project objectives with the overarching organizational goals leads to successful implementation because the technical, organizational, and institutional resources are ­managed in an integrated fashion. The chapter also reports on specific factors that had an impact on the characteristics and success of the three ICT projects.

Prospective Multicenter Study on the Challenges Inherent to Using Large Cell-Type Stents for Bilateral Stent-in-Stent Placement in Patients with Inoperable Malignant Hilar Biliary Obstruction.

PubMed

Yang, Min Jae; Kim, Jin Hong; Hwang, Jae Chul; Yoo, Byung Moo; Lee, Sang Hyub; Ryu, Ji Kon; Kim, Yong-Tae; Woo, Sang Myung; Lee, Woo Jin; Jeong, Seok; Lee, Don Haeng

2018-06-22

Although endoscopic bilateral stent-in-stent placement is challenging, many recent studies have reported promising outcomes regarding technical success and endoscopic reintervention. This study aimed to evaluate the technical feasibility of stent-in-stent placement using large cell-type stents in patients with inoperable malignant hilar biliary obstruction. Forty-three patients with inoperable malignant hilar biliary obstruction from four academic centers were prospectively enrolled from March 2013 to June 2015. Bilateral stent-in-stent placement using two large cell-type stents was successfully performed in 88.4% of the patients (38/43). In four of the five cases with technical failure, the delivery sheath of the second stent became caught in the hook-cross-type vertex of the large cell of the first stent, and subsequent attempts to pass a guidewire and stent assembly through the mesh failed. Functional success was achieved in all cases with technical success. Stent occlusion occurred in 63.2% of patients (24/38), with a median patient survival of 300 days. The median stent patency was 198 days. The stent patency rate was 82.9%, 63.1%, and 32.1% at 3, 6, and 12 months, respectively. Endoscopic re-intervention was performed in 14 patients, whereas 10 underwent percutaneous drainage. Large cell-type stents for endoscopic bilateral stent-in-stent placement showed acceptable functional success and stent patency when technically successful. However, the technical difficulty associated with the entanglement of the second stent delivery sheath in the hook-cross-type vertex of the first stent may preclude large cell-type stents from being considered as a dedicated standard tool for stent-in-stent placement.

Technical success, technique efficacy and complications of minimally-invasive imaging-guided percutaneous ablation procedures of breast cancer: A systematic review and meta-analysis.

PubMed

Mauri, Giovanni; Sconfienza, Luca Maria; Pescatori, Lorenzo Carlo; Fedeli, Maria Paola; Alì, Marco; Di Leo, Giovanni; Sardanelli, Francesco

2017-08-01

To systematically review studies concerning imaging-guided minimally-invasive breast cancer treatments. An online database search was performed for English-language articles evaluating percutaneous breast cancer ablation. Pooled data and 95% confidence intervals (CIs) were calculated. Technical success, technique efficacy, minor and major complications were analysed, including ablation technique subgroup analysis and effect of tumour size on outcome. Forty-five studies were analysed, including 1,156 patients and 1,168 lesions. Radiofrequency (n=577; 50%), microwaves (n=78; 7%), laser (n=227; 19%), cryoablation (n=156; 13%) and high-intensity focused ultrasound (HIFU, n=129; 11%) were used. Pooled technical success was 96% (95%CI 94-97%) [laser=98% (95-99%); HIFU=96% (90-98%); radiofrequency=96% (93-97%); cryoablation=95% (90-98%); microwave=93% (81-98%)]. Pooled technique efficacy was 75% (67-81%) [radiofrequency=82% (74-88); cryoablation=75% (51-90); laser=59% (35-79); HIFU=49% (26-74)]. Major complications pooled rate was 6% (4-8). Minor complications pooled rate was 8% (5-13%). Differences between techniques were not significant for technical success (p=0.449), major complications (p=0.181) or minor complications (p=0.762), but significant for technique efficacy (p=0.009). Tumour size did not impact on variables (p>0.142). Imaging-guided percutaneous ablation techniques of breast cancer have a high rate of technical success, while technique efficacy remains suboptimal. Complication rates are relatively low. • Imaging-guided ablation techniques for breast cancer are 96% technically successful. • Overall technique efficacy rate is 75% but largely inhomogeneous among studies. • Overall major and minor complication rates are low (6-8%).

Use of Nitinol Stents Following Recanalization of Central Venous Occlusions in Hemodialysis Patients

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

Rajan, Dheeraj K., E-mail: dheeraj.rajan@uhn.on.ca; Saluja, Jasdeep S.

2007-07-15

Purpose. To retrospectively review the patency of endovascular interventions with nitinol stent placement for symptomatic central venous occlusions in hemodialysis patients. Methods. A retrospective review of all patients who underwent endovascular interventions for dysfunctional hemodialysis grafts and fistulas was performed from April 2004 to August 2006. A total of 6 patients presented with arm and/or neck and facial swelling and left brachiocephalic vein occlusion. The study group consisted of 3 men and 3 women with a mean age of 79.5 years (SD 11.2 years). Of these 6 patients, 1 had a graft and 5 had fistulas in the left arm.more » The primary indication for nitinol stent placement was technical failure of angioplasty following successful traversal of occluded central venous segments. Patency was assessed from repeat fistulograms and central venograms performed when patients redeveloped symptoms or were referred for access dysfunction determined by the ultrasound dilution technique. No patients were lost to follow-up. Results. Nitinol stent placement to obtain technically successful recanalization of occluded venous segments was initially successful in 5 of 6 patients (83%). In 1 patient, incorrect stent positioning resulted in partial migration to the superior vena cava requiring restenting to prevent further migration. Clinical success was observed in all patients (100%). Over the follow-up period, 2 patients underwent repeat intervention with angioplasty alone. Primary patency was 83.3% (95% CI 0.5-1.2) at 3 months, and 66.7% at 6 and 12 months (0.2-1.1, 0.1-1.2). Secondary patency was 100% at 12 months with 3 patients censored over that time period. Mean primary patency was 10.4 months with a mean follow-up of 12.4 months. No complications related to recanalization of the occluded central venous segments were observed. Conclusion. Our initial experience has demonstrated that use of nitinol stents for central venous occlusion in hemodialysis patients is associated with good mid-term patency and may exceed historical observations with prior use of Wallstents.« less

Using a modified Learning Potential Assessment Device and Mediated Learning Experiences to Assess Minority Student Progress and Program Goals in an Undergraduate Research Based Geoscience Program Serving American Indians

NASA Astrophysics Data System (ADS)

Mitchell, L. W.

2002-12-01

During the initiation of a new program at the University of North Dakota designed to promote American Indians to engage in geoscience research and complete geoscience related degrees, an evaluation procedure utilizing a modified Learning Potential Assessment Device (LPAD) and Mediated Learning Experiences (MLE) to assess minority student progress was implemented. The program, called Indians Into Geosciences (INGEOS), utilized a modified form of the Learning Potential Assessment Device first to assess cultural factors, determination, and other baseline information, and second, utilized a series of Mediated Learning Experiences to enhance minority students' opportunities in a culturally appropriate, culturally diverse, and scientifically challenging manner in an effort to prepare students for competitive research careers in the geosciences. All of the LPADs and MLEs corresponded directly to the three goals or eight objectives of INGEOS. The three goals of the INGEOS program are: 1) increasing the number of American Indians earning degrees at all levels, 2) engaging American Indians in challenging and technically based scientific research, and 3) preparing American Indians for successful geoscience careers through multicultural community involvement. The eight objectives of the INGEOS program, called the Eight Points of Success, are: 1) spiritual health, 2) social health, 3) physical health, 4) mental health, 5) financial management, 6) research involvement, 7) technical exposure, and 8) multicultural community education. The INGEOS program goals were evaluated strictly quantitatively utilizing a variety of data sources such as grade point averages, number of credits earned, research project information, and developed products. The INGEOS Program goals reflected a combined quantitative score of all participants, whereas the objectives reflected qualitative measures and are specific for each INGEOS participant. Initial results indicate that those participants which show progress through Mediated Learning Experiences within all of the Eight Points of Success, have a higher likelihood of contributing to all three of the INGEOS programs goals.

The Ability of Standardized Test Instruments to Differentiate Membership in Different Vocational-Technical Curricula. Project MINI-SCORE, Final Technical Report.

ERIC Educational Resources Information Center

Pucel, David J.; And Others

Using post-secondary vocational education students as the populations, these two sub-studies of the Project MINI-SCORE sought to determine the extent to which pre-enrollment standardized test data can be used to predict vocational success. For the purpose of the study, vocational success was defined either as successful graduation or successful…

Field Test of the Methodology for Succession Planning for Technical Experts

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

Cain, Ronald A.; Kirk, Bernadette Lugue; Agreda, Carla L.

This report complements A Methodology for Succession Planning for Technical Experts (Ron Cain, Shaheen Dewji, Carla Agreda, Bernadette Kirk, July 2017), which describes a methodology for identifying and evaluating the loss of key technical skills at nuclear operations facilities. This report targets the methodology for identifying critical skills, hereafter referred to as “core competencies”. The methodology has been field tested by interviewing selected retiring subject matter experts (SMEs).

The Vocational-Technical Resource Consortia Serving Business and Industry in Ohio. Digest of Study: Operational Procedures for Successful Vocational-Technical Resource Consortia in Serving Business and Industry in Ohio.

ERIC Educational Resources Information Center

Frasier, James E.; Stanton, William

This publication reports the development of the vocational-technical resource consortia in Ohio and identifies the operational procedures associated with successful programs. Five exemplary consortia were studied in some depth; however, data were obtained from all of the 23 consortia in the state. The research indicates that the consortium is an…

Percutaneous biliary approach as a successful rescue procedure after failed endoscopic therapy for drainage in advanced hilar tumors.

PubMed

Jang, Sung Ill; Hwang, Jin-Hyeok; Lee, Kwang-Hun; Yu, Jeong-Sik; Kim, Hee Wook; Yoon, Chang Jin; Lee, Yoon Suk; Paik, Kyu Hyun; Lee, Sang Hyub; Lee, Dong Ki

2017-04-01

Palliative endoscopic or percutaneous biliary drainage is used for unresectable advanced hilar cancer (HC). The best option for drainage in Bismuth type III or IV HC has not been established. The aims of this study are to identify factors predictive of endoscopic stenting failure and evaluate the effectiveness of rescue percutaneous stenting in patients with advanced HC. Data from 110 patients with inoperable advanced HC were retrospectively reviewed. All received bilateral self-expandable metallic stents. Patients were divided into three groups: I, successful initial endoscopic stenting; II, unsuccessful initial endoscopic stenting, followed by percutaneous stenting; and III, initial percutaneous stenting. We analyzed clinical results and radiologic tumor characteristics. Baseline characteristics and clinical outcomes of all groups were similar, except the hospital stay was longer in group III than group I. Technical success rate was higher in groups II and III (100%) than in group I (72.4%). The functional success rate, stent patency time, patient survival time, and complication rate were similar between groups. Endoscopic stenting failed because of guide-wire passage failure (n = 12) or stent passage failure (n = 7). The only factor significantly associated with endoscopic failure was a smaller left intrahepatic duct-common bile duct angle. As clinical outcomes were generally similar between approaches, percutaneous stenting is recommended for patients with Bismuth type III or IV advanced HC. Acute left intrahepatic duct-common bile duct angulation predicts endoscopic stenting failure. If endoscopic stenting fails, immediate conversion to the percutaneous approach is a necessary and effective rescue method. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

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

Pierce, Eric M.; Freshley, Mark D.; Hubbard, Susan S.

In this report, we start by examining previous efforts at linking science and DOE EM research with cleanup activities. Many of these efforts were initiated by creating science and technology roadmaps. A recurring feature of successfully implementing these roadmaps into EM applied research efforts and successful cleanup is the focus on integration. Such integration takes many forms, ranging from combining information generated by various scientific disciplines, to providing technical expertise to facilitate successful application of novel technology, to bringing the resources and creativity of many to address the common goal of moving EM cleanup forward. Successful projects identify and focusmore » research efforts on addressing the problems and challenges that are causing “failure” in actual cleanup activities. In this way, basic and applied science resources are used strategically to address the particular unknowns that are barriers to cleanup. The brief descriptions of the Office of Science basic (Environmental Remediation Science Program [ERSP]) and EM’s applied (Groundwater and Soil Remediation Program) research programs in subsurface science provide context to the five “crosscutting” themes that have been developed in this strategic planning effort. To address these challenges and opportunities, a tiered systematic approach is proposed that leverages basic science investments with new applied research investments from the DOE Office of Engineering and Technology within the framework of the identified basic science and applied research crosscutting themes. These themes are evident in the initial portfolio of initiatives in the EM groundwater and soil cleanup multi-year program plan. As stated in a companion document for tank waste processing (Bredt et al. 2008), in addition to achieving its mission, DOE EM is experiencing a fundamental shift in philosophy from driving to closure to enabling the long-term needs of DOE and the nation.« less

Transcatheter Embolisation of Proximal Type 1 Endoleaks Following Endovascular Aneurysm Sealing (EVAS) Using the Nellix Device: Technique and Outcomes

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

Ameli-Renani, S., E-mail: seyedameli@doctors.org.uk; Morgan, R. A., E-mail: Robert.morgan@stgeorges.nhs.uk

2015-10-15

AimTo evaluate the technical success and mid-term outcomes following transcatheter embolisation of type 1a endoleak after Nellix endovascular aneurysm sealing (EVAS).Materials and MethodsSeven patients (5 men; mean age 83; range 79–90) underwent transcatheter embolisation between July 2013 and August 2014. The average time from EVAS to embolisation was 136 days (range 6–301) and from endoleak diagnosis to embolisation was 20 days (range 2–50). Embolisation was performed with coils and Onyx in six cases and Onyx only in one case. Technical success, imaging and clinical outcomes of embolisation were reviewed. Technical success was defined as elimination of the endoleak on completion angiography and first imaging follow-up.more » Clinical success was defined as unchanged or decreased aneurysm sac size on subsequent follow-up (average 8 months; range 103–471 days).ResultsAll cases were technically successful. One patient required a second endovascular procedure following Onyx reflux into the Nellix endograft and another patient required surgical closure of a brachial puncture site. All patients are endoleak free with stable sac size on the latest available follow-up imaging.ConclusionIf a type 1 endoleak occurs after EVAS, embolisation using Onyx with or without coils is feasible and effective with high technical success and freedom from endoleak recurrence at mid-term follow-up.« less

13 CFR 124.107 - What is potential for success?

Code of Federal Regulations, 2010 CFR

2010-01-01

... eligibility is based have substantial business management experience; (ii) The applicant has demonstrated technical experience to carry out its business plan with a substantial likelihood for success if admitted to... will also consider the technical and managerial experience of the applicant concern's managers, the...

Career Technical Education Pathways Initiative

ERIC Educational Resources Information Center

California Community Colleges, Chancellor's Office, 2013

2013-01-01

California's education system--the largest in the United States--is an essential resource for ensuring strong economic growth in the state. The Career Technical Education Pathways Initiative (referred to as the Initiative in this report), which became law in 2005, brings together community colleges, K-12 school districts, employers, organized…

Pathways to Sustainability: 8-year follow-up from the PROSPER Project

PubMed Central

Welsh, Janet A.; Chilenski, Sarah M.; Johnson, Lesley; Greenberg, Mark T.; Spoth, Richard L.

2016-01-01

The large-scale dissemination of evidence-based practices (EBPs) is often hindered by problems with sustaining initiatives past a period of initial grant funding. Communities often have difficulty generating resources needed to sustain and grow their initiatives, resulting in limited public health impact. The PROSPER project, initiated in 2001, provided community coalitions with intensive technical assistance around marketing, communications, and revenue generating strategies. Past reports from PROSPER have indicated that these coalitions were successful with sustaining their programming, and that sustainability could be predicted by early aspects of team functioning and leadership. The current study examines financial sustainability eight years following the discontinuation of grant funding, with an emphasis on sources of revenue and the relationships between revenue generation, team functioning, and EBP participation. This study used four waves of data related to resource generation collected between 2004-2010 by PROSPER teams in Iowa and Pennsylvania. Teams reported annually on the amount and sources of funding procured, as well as annual reports of team functioning and leadership and annual reports of EBP participation by youth and parents. Data revealed that teams' overall revenue generation increased over time. There was significant variation in success with revenue generation at both the community level and across the two states. Teams accessed a variety of sources. Cash revenue generation was positively and predictively associated with EBP participation, but relationships with team functioning and leadership ratings varied significantly by state. State level differences in in-kind support were also apparent. The results indicated that there are different pathways to sustainability, and that no one method works for all teams. The presence of state level infrastructures available to support prevention appeared to account for significant differences in sustainability success between Pennsylvania and Iowa. PMID:26892601

Complete major amputation of the upper extremity: Early results and initial treatment algorithm.

PubMed

Märdian, Sven; Krapohl, Björn D; Roffeis, Jana; Disch, Alexander C; Schaser, Klaus-Dieter; Schwabe, Philipp

2015-03-01

Traumatic major amputations of the upper extremity are devastating injuries. These injuries have a profound impact on patient's quality of life and pose a burden on social economy. The aims of the current study were to report about the initial management of isolated traumatic major upper limb amputation from the time of admission to definitive soft tissue closure and to establish a distinct initial management algorithm. We recorded data concerning the initial management of the patient and the amputated body part in the emergency department (ED) (time from admission to the operation, Injury Severity Score [ISS], cold ischemia time from injury to ED, and total cold ischemia time). The duration, amount of surgical procedures, the time to definitive soft tissue coverage, and the choice of flap were part of the documentation. All intraoperative and postoperative complications were recorded. All patients were successfully replanted (time from injury to ED, 59 ± 4 minutes; ISS16; time from admission to operating room 57 ± 10 minutes; total cold ischemia time 203 ± 20 minutes; total number of procedures 7.3 ± 2.5); definitive soft tissue coverage could be achieved 23 ± 14 days after injury. Two thromboembolic complications occurred, which could be treated by embolectomy during revision surgery, and we saw one early infection, which could be successfully managed by serial debridements in our series. The management of complete major amputations of the upper extremity should be reserved for large trauma centers with enough resources concerning technical, structural, and personnel infrastructure to meet the demands of surgical reconstruction as well as the postoperative care. Following a distinct treatment algorithm is mandatory to increase the rate of successful major replantations, thus laying the foundation for promising secondary functional reconstructive efforts. Therapeutic study, level V.

Pathways to Sustainability: 8-Year Follow-Up From the PROSPER Project.

PubMed

Welsh, Janet A; Chilenski, Sarah M; Johnson, Lesley; Greenberg, Mark T; Spoth, Richard L

2016-06-01

The large-scale dissemination of evidence-based practices (EBPs) is often hindered by problems with sustaining initiatives past a period of initial grant funding. Communities often have difficulty generating resources needed to sustain and grow their initiatives, resulting in limited public health impact. The PROSPER project, initiated in 2001, provided community coalitions with intensive technical assistance around marketing, communications, and revenue generating strategies. Past reports from PROSPER have indicated that these coalitions were successful with sustaining their programming, and that sustainability could be predicted by early aspects of team functioning and leadership. The current study examines financial sustainability 8 years following the discontinuation of grant funding, with an emphasis on sources of revenue and the relationships between revenue generation, team functioning, and EBP participation. This study used four waves of data related to resource generation collected between 2004 and 2010 by PROSPER teams in Iowa and Pennsylvania. Teams reported annually on the amount and sources of funding procured, as well as annual reports of team functioning and leadership and annual reports of EBP participation by youth and parents. Data revealed that teams' overall revenue generation increased over time. There was significant variation in success with revenue generation at both the community level and across the two states. Teams accessed a variety of sources. Cash revenue generation was positively and predictively associated with EBP participation, but relationships with team functioning and leadership ratings varied significantly by state. State level differences in in-kind support were also apparent. The results indicated that there are different pathways to sustainability, and that no one method works for all teams. The presence of state level infrastructures available to support prevention appeared to account for significant differences in sustainability success between Pennsylvania and Iowa.

Double-double bend achromat cell upgrade at the Diamond Light Source: From design to commissioning

NASA Astrophysics Data System (ADS)

Bartolini, R.; Abraham, C.; Apollonio, M.; Bailey, C. P.; Cox, M. P.; Day, A.; Fielder, R. T.; Hammond, N. P.; Heron, M. T.; Holdsworth, R.; Kay, J.; Martin, I. P. S.; Mhaskar, S.; Miller, A.; Pulampong, T.; Rehm, G.; Rial, E. C. M.; Rose, A.; Shahveh, A.; Singh, B.; Thomson, A.; Walker, R. P.

2018-05-01

Diamond has recently successfully commissioned a major change in the lattice consisting of the substitution of a standard double-bend achromat (DBA) cell with a modified four-bend achromat (4BA) cell called "double-double bend achromat" (DDBA). This work stems from the original studies initiated in 2012 towards a Diamond upgrade and provides the benefit of an additional straight section in the ring available for insertion devices. This paper reviews the DDBA design and layout, the implications for technical subsystems, the associated engineering challenges and the main results of the commissioning completed in April 2017.

Initial Efforts toward Mission-Representative Imaging Surveys from Aerial Explorers

NASA Technical Reports Server (NTRS)

Pisanich, Greg; Plice, Laura; Ippolito, Corey; Young, Larry A.; Lau, Benton; Lee, Pascal

2004-01-01

Numerous researchers have proposed the use of robotic aerial explorers to perform scientific investigation of planetary bodies in our solar system. One of the essential tasks for any aerial explorer is to be able to perform scientifically valuable imaging surveys. The focus of this paper is to discuss the challenges implicit in, and recent observations related to, acquiring mission-representative imaging data from a small fixed-wing UAV, acting as a surrogate planetary aerial explorer. This question of successfully performing aerial explorer surveys is also tied to other topics of technical investigation, including the development of unique bio-inspired technologies.

Spontaneous vegetation succession at different central European mining sites: a comparison across seres.

PubMed

Prach, Karel; Lencová, Kamila; Rehounková, Klára; Dvořáková, Helena; Jírová, Alena; Konvalinková, Petra; Mudrák, Ondřej; Novák, Jan; Trnková, Romana

2013-11-01

We performed detrended correspondence analysis (DCA) ordination to compare seven successional seres running in stone quarries, coal mining spoil heaps, sand and gravel pits, and extracted peatlands in the Czech Republic in central Europe. In total, we obtained 1,187 vegetation samples containing 705 species. These represent various successional stages aged from 1 to 100 years. The successional seres studied were more similar in their species composition in the initial stages, in which synathropic species prevailed, than in later successional stages. This vegetation differentiation was determined especially by local moisture conditions. In most cases, succession led to a woodland, which usually established after approximately 20 years. In very dry or wet places, by contrast, where woody species were limited, often highly valuable, open vegetation developed. Except in the peatlands, the total number of species and the number of target species increased during succession. Participation of invasive aliens was mostly unimportant. Spontaneous vegetation succession generally appears to be an ecologically suitable and cheap way of ecosystem restoration of heavily disturbed sites. It should, therefore, be preferred over technical reclamation.

76 FR 55943 - Notice of Public Meeting, North Slope Science Initiative-Science Technical Advisory Panel

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-09

...] Notice of Public Meeting, North Slope Science Initiative--Science Technical Advisory Panel AGENCY: Bureau of Land Management, Alaska State Office, North Slope Science Initiative, Interior. ACTION: Notice of public meeting. SUMMARY: In accordance with the Federal Land Policy and Management Act (FLPMA) and the...

76 FR 10388 - Notice of Public Meeting, North Slope Science Initiative-Science Technical Advisory Panel

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-24

...] Notice of Public Meeting, North Slope Science Initiative--Science Technical Advisory Panel AGENCY: Bureau of Land Management, Alaska State Office, North Slope Science Initiative, Interior. ACTION: Notice of public meeting. SUMMARY: In accordance with the Federal Land Policy and Management Act (FLPMA) and the...

75 FR 79017 - Notice of Public Meeting, North Slope Science Initiative-Science Technical Advisory Panel

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-17

...] Notice of Public Meeting, North Slope Science Initiative--Science Technical Advisory Panel AGENCY: Bureau of Land Management, Alaska State Office, North Slope Science Initiative, Interior. ACTION: Notice of public meeting. SUMMARY: In accordance with the Federal Land Policy and Management Act (FLPMA) and the...

77 FR 21806 - Notice of Public Meeting, North Slope Science Initiative-Science Technical Advisory Panel

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-11

...] Notice of Public Meeting, North Slope Science Initiative--Science Technical Advisory Panel AGENCY: Bureau of Land Management, Alaska State Office, North Slope Science Initiative, Interior. ACTION: Notice of public meeting. SUMMARY: In accordance with the Federal Land Policy and Management Act (FLPMA) and the...

75 FR 17433 - Notice of Public Meeting, North Slope Science Initiative-Science Technical Advisory Panel

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-06

...] Notice of Public Meeting, North Slope Science Initiative--Science Technical Advisory Panel AGENCY: Bureau of Land Management, Alaska State Office, North Slope Science Initiative, Interior. ACTION: Notice of public meeting. SUMMARY: In accordance with the Federal Land Policy and Management Act (FLPMA) and the...

75 FR 52370 - Notice of Public Meeting, North Slope Science Initiative-Science Technical Advisory Panel

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-25

...] Notice of Public Meeting, North Slope Science Initiative-Science Technical Advisory Panel AGENCY: Bureau of Land Management, Alaska State Office, North Slope Science Initiative, Interior. ACTION: Notice of public meeting. SUMMARY: In accordance with the Federal Land Policy and Management Act (FLPMA) and the...

78 FR 4870 - Notice of Public Meeting, North Slope Science Initiative-Science Technical Advisory Panel

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-23

...] Notice of Public Meeting, North Slope Science Initiative--Science Technical Advisory Panel AGENCY: Bureau of Land Management, Alaska State Office, North Slope Science Initiative, Interior. ACTION: Notice of public meeting. SUMMARY: In accordance with the Federal Land Policy and Management Act (FLPMA) and the...

Contraceptive security, information flow, and local adaptations: family planning Morocco.

PubMed

Chandani, Y; Breton, G

2001-12-01

Many developing countries increasingly recognize and acknowledge family planning as a critical part of socio-economic development. However, with few health dollars to go around, countries tend to provide essential drugs for curative care, rather than for family planning products. Donors have historically provided free contraceptives for family planning services. Whether products are donated or purchased by the country, a successful family planning program depends on an uninterrupted supply of products, beginning with the manufacturer and ending with the customer. Any break in the supply chain may cause a family planning program to fail. A well-functioning logistics system can manage the supply chain and ensure that the customers have the products they need, when they need them. Morocco was selected for the case study. The researchers had ready access to key informants and information about the Logistics Management Information System. Because the study had time and resource constraints, research included desktop reviews and interview, rather than data collection in the field. The case study showed that even in a challenging environment an LMIS can be successfully deployed and fully supported by the users. It is critical to customize the system to a country-specific situation to ensure buy-in for the implementation. Significant external support funding and technical expertise are critical components to ensure the initial success of the system. Nonetheless, evidence from the case study shows that, after a system has been implemented, the benefits may not ensure its institutionalization. Other support, including local funding and technical expertise, is required.

Revascularization for critical limb ischemia using the SpiderFX embolic protection device in the below-the-knee circulation: initial results.

PubMed

Ward, Thomas J; Piechowiak, Rachel L; Patel, Rahul S; Fischman, Aaron M; Nowakowski, F Scott; Kim, Edward; Ellozy, Sharif H; Faries, Peter L; Lookstein, Robert A

2014-10-01

To examine the safety and efficacy of the SpiderFX embolic protection device (EPD) in the below-the-knee (BTK) circulation in patients with critical limb ischemia (CLI). A single-center retrospective review was performed to identify patients with CLI and single-vessel runoff in whom the SpiderFX EPD was used in the BTK circulation. Technical success and device-related complications were the primary endpoints. Retrieval of macroscopic debris in the EPD, 1-year freedom from major adverse limb events (MALEs), and 30-day perioperative death were also evaluated. A major amputation, surgical bypass, endovascular thrombectomy, or endovascular thrombolysis was considered a MALE. Thirty-six patients (21 men; mean age, 75.8 y) treated between 2008 and 2013 had endovascular revascularization with use of the SpiderFX EPD in the BTK circulation. The SpiderFX EPD was successfully deployed in all cases; the technical success rate of revascularization was 100%. Two minor and zero major complications were observed related to the SpiderFX. Two MALEs, a major amputation and a subsequent surgical bypass, were observed in the cohort. All MALEs occurred within 1 year of treatment (1-y freedom from MALE rate, 90%). Debris was retrieved in the SpiderFX device in 47% of patients. The use of the SpiderFX EPD in the BTK circulation in patients with CLI is safe and frequently retrieves debris. Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.

INTERNATIONAL COOPERATION ON RADIOLOGICAL THREAT REDUCTION PROGRAMS IN RUSSIA

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

Landers, Christopher C.; Tatyrek, Aaron P.

Since its inception in 2004, the United States Department of Energy’s Global Threat Reduction Initiative (GTRI) has provided the Russian Federation with significant financial and technical assistance to secure its highly vulnerable and dangerous radiological material. The three program areas of this assistance are the removal of radioisotope thermoelectric generators (RTG), the physical protection of vulnerable in-use radiological material of concern, and the recovery of disused or abandoned radiological material of concern. Despite the many successes of the GTRI program in Russia, however, there is still a need for increased international cooperation in these efforts. Furthermore, concerns exist over howmore » the Russian government will ensure that the security of its radiological materials provided through GTRI will be sustained. This paper addresses these issues and highlights the successes of GTRI efforts and ongoing activities.« less

Towards a typology of business process management professionals: identifying patterns of competences through latent semantic analysis

NASA Astrophysics Data System (ADS)

Müller, Oliver; Schmiedel, Theresa; Gorbacheva, Elena; vom Brocke, Jan

2016-01-01

While researchers have analysed the organisational competences that are required for successful Business Process Management (BPM) initiatives, individual BPM competences have not yet been studied in detail. In this study, latent semantic analysis is used to examine a collection of 1507 BPM-related job advertisements in order to develop a typology of BPM professionals. This empirical analysis reveals distinct ideal types and profiles of BPM professionals on several levels of abstraction. A closer look at these ideal types and profiles confirms that BPM is a boundary-spanning field that requires interdisciplinary sets of competence that range from technical competences to business and systems competences. Based on the study's findings, it is posited that individual and organisational alignment with the identified ideal types and profiles is likely to result in high employability and organisational BPM success.

Transformational leadership, initiating structure, and substitutes for leadership: a longitudinal study of research and development project team performance.

PubMed

Keller, Robert T

2006-01-01

Transformational leadership, initiating structure, and selected substitutes for leadership were studied as longitudinal predictors of performance in 118 research and development (R&D) project teams from 5 firms. As hypothesized, transformational leadership predicted 1-year-later technical quality, schedule performance, and cost performance and 5-year-later profitability and speed to market. Initiating structure predicted all the performance measures. The substitutes of subordinate ability and an intrinsically satisfying task each predicted technical quality and profitability, and ability predicted speed to market. Moderator effects for type of R&D work were hypothesized and found whereby transformational leadership was a stronger predictor of technical quality in research projects, whereas initiating structure was a stronger predictor of technical quality in development projects. Implications for leadership theory and research are discussed. (c) 2006 APA, all rights reserved.

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

Ohta, Kengo, E-mail: yesterday.is.yesterday@gmail.com; Shimohira, Masashi, E-mail: mshimohira@gmail.com; Sasaki, Shigeru, E-mail: ssasaki916@yahoo.co.jp

PurposeThe aim of this study is to analyze the technical and clinical success rates and safety of transarterial fiducial marker placement for image-guided proton therapy for malignant liver tumors.Methods and MaterialsFifty-five patients underwent this procedure as an interventional treatment. Five patients had 2 tumors, and 4 tumors required 2 markers each, so the total number of procedures was 64. The 60 tumors consisted of 46 hepatocellular carcinomas and 14 liver metastases. Five-mm-long straight microcoils of 0.018 inches in diameter were used as fiducial markers and placed in appropriate positions for each tumor. We assessed the technical and clinical success ratesmore » of transarterial fiducial marker placement, as well as the complications associated with it. Technical success was defined as the successful delivery and placement of the fiducial coil, and clinical success was defined as the completion of proton therapy.ResultsAll 64 fiducial coils were successfully installed, so the technical success rate was 100 % (64/64). Fifty-four patients underwent proton therapy without coil migration. In one patient, proton therapy was not performed because of obstructive jaundice due to bile duct invasion by hepatocellular carcinoma. Thus, the clinical success rate was 98 % (54/55). Slight bleeding was observed in one case, but it was stopped immediately and then observed. None of the patients developed hepatic infarctions due to fiducial marker migration.ConclusionTransarterial fiducial marker placement appears to be a useful and safe procedure for proton therapy for malignant liver tumors.« less

Succession Planning for Management Staff at a Western Canadian Postsecondary Technical Institute.

ERIC Educational Resources Information Center

Cembrowski, Barbara Joan; da Costa, Jose L.

This study used naturalistic inquiry to gain an understanding of how managerial personnel perceived career development and succession planning at a postsecondary technical institute in Canada. A total of nine individuals in three different career development stages completed semistructured interviews. It was found that managers perceived the…

Case Studies in Industry/TAFE Liaison: Success Factors.

ERIC Educational Resources Information Center

Anderson, Tony

This study examines what makes cooperative arrangements between industry and Technical and Further Education (TAFE) in Australia successful. A literature review highlighted the importance of the provision of high quality technical education that meets the needs of the client. A range of innovative or entrepreneurial examples of industry/TAFE…

Technical and Clinical Outcomes Following Colonic Stenting: A Seven-Year Analysis of 268 Procedures.

PubMed

Little, M W; Oakley, T; Briggs, J H; Sutcliffe, J A; Allouni, A K; Makris, G; Bratby, M J; Tapping, C R; Patel, R; Wigham, A; Anthony, S; Phillips-Hughes, J; Uberoi, R

2016-10-01

To assess the factors contributing to the technical and clinical success of colorectal stenting for large bowel obstruction. 268 cases of colonic stenting for large bowel obstruction were performed in 249 patients of mean age of 72 years (28-98) between 2006 and 2013. The majority of strictures were due to malignant disease, 244/268 (91 %). Diverticular strictures accounted for 24/268 (9 %). Overall technical success rate was 81 % (217/268), with a clinical success rate of 65 % (174/268). Duration of symptoms ranged from 0 to 180 days (mean 8 days). Technical success rate was seen to decrease with increasing symptom duration. For symptom duration of less than 1 week, technical success was 85.4 % (181/212) versus 69.6 % (39/56) for those with symptoms of greater than a week (p < 0.05). Clinical success rates fell from 71.3 % (107/150) to 59.3 % (70/118) (p < 0.05) when attempting to stent lesions of greater than 5 cm. There was also a significant reduction in clinical success when stenting lesions on a bend rather than a straight segment of colon 75.7 % (109/144) versus 59.7 % (74/124) (p < 0.05). A total of 20 (7.46 %) perforations were identified during the study. Stent migration occurred in 6.6 % of cases. In-stent stenosis occurred in 3.3 %. The overall 30-day all cause mortality rate was 9 %. Lesion size, location and duration of obstructive symptoms are statistically significant determinants of patient outcome. These factors could be used to advise patient selection for colonic stenting or direct progression to surgical intervention.

Technical Communication, Knowledge Management, and XML.

ERIC Educational Resources Information Center

Applen, J. D.

2002-01-01

Describes how technical communicators can become involved in knowledge management. Examines how technical communicators can teach organizations to design, access, and contribute to databases; alert them to new information; and facilitate trust and sharing. Concludes that successful technical communicators would do well to establish a culture that…

A Compendium of Energy Conservation Success Stories

DOE R&D Accomplishments Database

1988-09-01

Three-quarters of DOE's Conservation R and D funds have been devoted to technology research and development: basic and applied research, exploratory R and D, engineering feasibility studies, pilot-scale prototype R and D, and technology demonstration. Non R and D projects have involved technology assessment program planning and analysis, model development, technology transfer and consumer information, health effects and safety research, and technical support for rule making. The success stories summarized in this compendium fall into three general categories: Completed Technology Success Stories, projects that have resulted in new energy-saving technologies that are presently being used in the private sector; Technical Success Stories, projects that have produced or disseminated important scientific/technical information likely to result in future energy savings; Program Success Stories, non-R and D activities that have resulted in nationally significant energy benefits. The Energy Conservation research and development program at DOE is managed by the Office of Conservation under the direction of the Deputy Assistant Secretary for Conservation. Three subordinate Program Offices correspond to the buildings, transportation, and industrial end-use sectors. A fourth subordinate Program Office{endash}Energy Utilization Research{endash}sponsors research and technical inventions for all end-use sectors.

Identifying Effective Strategies to Providing Technical Support to One-to-One Programs

ERIC Educational Resources Information Center

Thomas, Mark W.

2013-01-01

The problem of this study was that while one-to-one initiatives in the K-12 environment are growing, the technical support personnel that work in these environments are experiencing problems supporting these initiatives. The purposes of this study were to: (a) identify common problems of providing technical support in a one-to-one laptop program,…

Vascular Plug Assisted Retrograde Transvenous Obliteration (PARTO) for Gastric Varix Bleeding Patients in the Emergent Clinical Setting

PubMed Central

Yang, Heechul; Lee, Chun Kyon; Kim, Gun Bea

2016-01-01

Purpose To evaluate the technical feasibility and safety of vascular plug assisted retrograde transvenous obliteration (PARTO) for bleeding gastric varix performed in the emergent clinical setting and describe the mid-term clinical results. Materials and Methods From April 2012 to January 2015, emergent PARTO was tried in total 9 patients presented with active gastric varix bleeding. After initial insufficient or failure of endoscopic approach, they underwent PARTO in the emergent clinical setting. Gelatin sponge embolization of both gastrorenal (GR) shunt and gastric varix was performed after retrograde transvenous placement of a vascular plug in GR shunt. Coil assisted RTO (CARTO) was performed in one patient who had challenging GR shunt anatomy for vascular plug placement. Additional embolic materials, such as microcoils and NBCA glue-lipiodol mixture, were required in three patients to enhance complete occlusion of GR shunt or obliteration of competitive collateral vessels. Clinical success was defined as no variceal rebleeding and disappearance of gastric varix. Results All technical and clinical success–i.e., complete GR shunt occlusion and offending gastric varix embolization with immediate bleeding control–was achieved in all 9 patients. There was no procedure-related complication. All cases showed successful clinical outcome during mean follow up of 17 months (12–32 months), evidenced by imaging studies, endoscopy and clinical data. In 4 patients, mild worsening of esophageal varices or transient ascites was noted as portal hypertensive related change. Conclusion Emergent PARTO is technically feasible and safe, with acceptable mid-term clinical results, in treating active gastric varix bleeding. PMID:27189294

Using Population Dose to Evaluate Community-level Health Initiatives.

PubMed

Harner, Lisa T; Kuo, Elena S; Cheadle, Allen; Rauzon, Suzanne; Schwartz, Pamela M; Parnell, Barbara; Kelly, Cheryl; Solomon, Loel

2018-05-01

Successful community-level health initiatives require implementing an effective portfolio of strategies and understanding their impact on population health. These factors are complicated by the heterogeneity of overlapping multicomponent strategies and availability of population-level data that align with the initiatives. To address these complexities, the population dose methodology was developed for planning and evaluating multicomponent community initiatives. Building on the population dose methodology previously developed, this paper operationalizes dose estimates of one initiative targeting youth physical activity as part of the Kaiser Permanente Community Health Initiative, a multicomponent community-level obesity prevention initiative. The technical details needed to operationalize the population dose method are explained, and the use of population dose as an interim proxy for population-level survey data is introduced. The alignment of the estimated impact from strategy-level data analysis using the dose methodology and the data from the population-level survey suggest that dose is useful for conducting real-time evaluation of multiple heterogeneous strategies, and as a viable proxy for existing population-level surveys when robust strategy-level evaluation data are collected. This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is sponsored by Kaiser Permanente, Community Health. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

75 FR 159 - Notice of Public Meeting, North Slope Science Initiative, Science Technical Advisory Panel, Alaska

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-04

...] Notice of Public Meeting, North Slope Science Initiative, Science Technical Advisory Panel, Alaska AGENCY: Bureau of Land Management, Alaska State Office, North Slope Science Initiative, Interior. ACTION: Notice of public meeting. SUMMARY: In accordance with the Federal Land Policy and Management Act (FLPMA) and...

A Portfolio of Community College Initiatives in Rural Economic Development.

ERIC Educational Resources Information Center

Thomas, Margaret G.

Community colleges across the United States have initiated programs that are making an impact on the productivity of rural America and its residents. Profiles of 20 community and technical college initiatives in rural economic development are contained in this report intended for use by community and technical college administrators. The programs…

The National Technical Association: A Hallmark for Access and Success

NASA Astrophysics Data System (ADS)

Jearld, A., Jr.

2017-12-01

Minority Technical Organizations (MTO) are under-utilized as a valuable resource that can help develop the next generation of scientists and engineers. For over 90 years, the National Technical Association (NTA) (www.ntaonline.org) has been the premiere technical association for scientists, engineers, architects, technologist, educators, and technical business entrepreneurs for people of color, offering professional development, mentoring and awards recognition to technical professionals. NTA and its partners are developing a diverse workforce by emphasizing enhanced access opportunities to skills development for youth among underrepresented STEM populations. Established in 1925 by Charles Summer Duke, the first African American to receive an engineering degree from Harvard University, NTA served as the model organization for more than 40 other minority technical organizations that began forming in the 1970's. NTA has served as consultants to the US government on the status of African Americans in science and engineering. The first technical organization to establish community based technical mentoring programs targeting minorities, NTA shares information and assists institutions in identifying minority talent. Members developed the first science and engineering curriculum at Historically Black Colleges and Universities (HBCU's), and are working to produce more students with geoscience degrees to ensure greater career placement with increased minority participation in the geosciences. NTA addresses the lack of access, support, and the need for networking through the longest running annual conference for technical practitioners of color. A hallmark of NTA has been access and success through inter-organizational collaborations with communities of scholars, highly experienced professionals and students to discuss the definition of what is successful geoscience education, research, and employment.

Building and measuring infrastructure and capacity for community health assessment and health improvement planning in Florida.

PubMed

Abarca, Christine; Grigg, C Meade; Steele, Jo Ann; Osgood, Laurie; Keating, Heidi

2009-01-01

COMPASS (Comprehensive Assessment, Strategic Success) is the Florida Department of Health's community health assessment and health improvement planning initiative. Since 2002, COMPASS built state and county health department infrastructure to support a comprehensive, systematic, and integrated approach to community health assessment and planning. To assess the capacity of Florida's 67 county health departments (CHDs) to conduct community health assessment and planning and to identify training and technical assistance needs, COMPASS surveyed the CHDs using a Web-based instrument annually from 2004 through 2008. Response rate to the survey was 100 percent annually. In 2007, 96 percent of CHDs reported conducting assessment and planning within the past 3 years; 74 percent used the MAPP (Mobilizing for Action through Planning and Partnerships) framework. Progress was greater for the organizational and assessment phases of the MAPP-based work; only 10 CHDs had identified strategic priorities in 2007, and even fewer had implemented strategies for improving health. In 2007, the most frequently requested types of training were measuring success, developing goals and action plans, and using qualitative data; technical assistance was most frequently requested for program evaluation and writing community health status reports. Florida's CHDs have increased their capacity to conduct community health assessment and planning. Questions remain about sustaining these gains with limited resources.

Enhanced Capabilities for Subcritical Experiments (ECSE) Risk Management Plan

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

Urban, Mary Elizabeth

Risk is a factor, element, constraint, or course of action that introduces an uncertainty of outcome that could impact project objectives. Risk is an inherent part of all activities, whether the activity is simple and small, or large and complex. Risk management is a process that identifies, evaluates, handles, and monitors risks that have the potential to affect project success. The risk management process spans the entire project, from its initiation to its successful completion and closeout, including both technical and programmatic (non-technical) risks. This Risk Management Plan (RMP) defines the process to be used for identifying, evaluating, handling, andmore » monitoring risks as part of the overall management of the Enhanced Capabilities for Subcritical Experiments (ECSE) ‘Project’. Given the changing nature of the project environment, risk management is essentially an ongoing and iterative process, which applies the best efforts of a knowledgeable project staff to a suite of focused and prioritized concerns. The risk management process itself must be continually applied throughout the project life cycle. This document was prepared in accordance with DOE O 413.3B, Program and Project Management for the Acquisition of Capital Assets, its associated guide for risk management DOE G 413.3-7, Risk Management Guide, and LANL ADPM AP-350-204, Risk and Opportunity Management.« less

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

Laborda, Alicia, E-mail: alaborda@unizar.es; Medrano, Joaquin, E-mail: oauieao@gmail.com; Blas, Ignacio de, E-mail: deblas@unizar.es

PurposeThis study was designed to evaluate the clinical outcome and patients' satisfaction after a 5 year follow-up period for pelvic congestion syndrome (PCS) coil embolization in patients who suffered from chronic pelvic pain that initially consulted for lower limb venous insufficiency.MethodsA total of 202 patients suffering from chronic pelvic pain were recruited prospectively in a single center (mean age 43.5 years; range 27-57) where they were being treated for lower limb varices. Inclusion criteria were: lower limb varices and chronic pelvic pain (>6 months), >6 mm pelvic venous caliber in ultrasonography, and venous reflux or presence of communicating veins. Bothmore » ovarian and hypogastric veins were targeted for embolization. Pain level was assessed before and after embolotherapy and during follow-up using a visual analog scale (VAS). Technical and clinical success and recurrence of leg varices were studied. Patients completed a quality questionnaire. Clinical follow-up was performed at 1, 3, and 6 months and every year for 5 years.ResultsTechnical success was 100 %. Clinical success was achieved in 168 patients (93.85 %), with complete disappearance of symptoms in 60 patients (33.52 %). Pain score (VAS) was 7.34 {+-} 0.7 preprocedural versus 0.78 {+-} 1.2 at the end of follow-up (P < 0.0001). Complications were: groin hematoma (n = 6), coil migration (n = 4), and reaction to contrast media (n = 1). Twenty-three cases presented abdominal pain after procedure. In 24 patients (12.5 %), there was recurrence of their leg varices within the follow-up. The mean degree of patients' satisfaction was 7.4/9.ConclusionsCoil embolization of PCS is an effective and safe procedure, with high clinical success rate and degree of satisfaction.« less

Management of pancreatic collections with a novel endoscopically placed fully covered self-expandable metal stent: a national experience (with videos).

PubMed

Chandran, Sujievvan; Efthymiou, Marios; Kaffes, Arthur; Chen, John Wei; Kwan, Vu; Murray, Michael; Williams, David; Nguyen, Nam Quoc; Tam, William; Welch, Christine; Chong, Andre; Gupta, Saurabh; Devereaux, Ben; Tagkalidis, Peter; Parker, Frank; Vaughan, Rhys

2015-01-01

Recent medical literature on novel lumen-apposing stents for the treatment of pancreatic fluid collections (PFCs) is limited by small numbers, solo operators, and single-center experience. To evaluate a recently developed lumen-apposing, fully covered self-expandable metal stent (FCSEMS) in the management of PFCs. Retrospective case series. Thirteen tertiary and private health care centers across Australia. Forty-seven patients (median age 51 years) who underwent endoscopic management of PFCs. Insertion of FCSEMS after PFC puncture under EUS guidance. A subgroup of 9 patients underwent direct endoscopic necrosectomy. Technical and clinical success rate, adverse event rate. The technical success rate was 53 of 54 patients (98.1%), and the initial clinical success rate was 36 of 47 (76.6%), which was sustained for more than 6 months in 34 of 36 (94.4%). Early adverse events included 4 cases (7.4%) of stent migration during direct endoscopic necrosectomy, 4 cases (7.4%) of sepsis, 1 case (1.9%) of bleeding, and 1 case (1.9%) of stent migration into the fistula tract. Late adverse events were 6 (11.1%) spontaneous stent migrations, 3 (5.6%) recurrent stent occlusions, 3 (5.6%) tissue ingrowth/overgrowth, and 2 (3.7%) bleeding into PFC. The majority of stents inserted (48 of 54, 88.9%) and removed (31 of 35, 88.6%) in our study were described by the operator as superior to pigtail stents with regard to ease of use. Retrospective study. Although FCSEMSs are technically easier to insert and remove compared with traditional pigtail stents, there are significant limitations to the widespread use of FCSEMSs in the management of PFCs. These include cost, adverse events, and lower-than-expected resolution rates. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Smart roadside initiative gap analysis : trucking technology utilization.

DOT National Transportation Integrated Search

2014-04-01

This technical memorandum synthesizes and summarizes the American Transportation Research Institutes (ATRI) findings for Subtask 2.3 of the Smart Roadside Initiative (SRI) Gap Analysis. As part of this task, ATRI: 1. completed a technical literatu...

The Preclose Technique in Percutaneous Endovascular Aortic Repair: A Systematic Literature Review and Meta-analysis

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

Jaffan, Abdel Aziz A., E-mail: aajaffan@gmail.com; Prince, Ethan A., E-mail: eprince@lifespan.org; Hampson, Christopher O., E-mail: christopherohampson@gmail.com

2013-06-15

Purpose. To establish the efficacy and safety of the preclose technique in total percutaneous endovascular aortic repair (PEVAR).MethodsA systematic literature search of Medline database was conducted for series on PEVAR published between January 1999 and January 2012.ResultsThirty-six articles comprising 2,257 patients and 3,606 arterial accesses were included. Anatomical criteria used to exclude patients from undergoing PEVAR were not uniform across all series. The technical success rate was 94 % per arterial access. Failure was unilateral in the majority (93 %) of the 133 failed PEVAR cases. The groin complication rate in PEVAR was 3.6 %; a minority (1.6 %) ofmore » these groin complications required open surgery. The groin complication rate in failed PEVAR cases converted to groin cutdown was 6.1 %. A significantly higher technical success rate was achieved when arterial access was performed via ultrasound guidance. Technical failure rate was significantly higher with larger sheath size ({>=}20F). Conclusion. The preclose technique in PEVAR has a high technical success rate and a low groin complication rate. Technical success tends to increase with ultrasound-guided arterial access and decrease with larger access. When failure occurs, it is unilateral in the majority of cases, and conversion to surgical cutdown does not appear to increase the operative risk.« less

Proceedings of the magnetic fusion energy blanket and shield workshop. A technical assessment. Volume I

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

Powell, J.R.; Fillo, J.A.; Twining, B.G.

1975-08-01

The first volume of these Proceedings is devoted to summarizing the results of the activities of the five technical area Study Groups. These Study Groups played a major role in the Workshop since it was their mission to identify key research and development requirements in their technical areas, etimate the prospects for success of research and development projects directed toward fulfilling these requirements, and determine appropriate time scales for the initiation and completion of these efforts. The determination of which new scientific and technological knowledge, data, and techniques will be required to achieve the Division of Magnetic Fusion Energy programmore » goals, and the construction of an evaluated compilation of research and development needs along with suggestions for levels of effort needed to achieve these goals were among the objectives of the Study Groups. The Conclusions and Recommendations of the Study Groups are summaries of the individual Study Group's findings prepared by the chairmen and co-chairmen/secretaries. These findings were presented to all the Workshop participants in a plenary session, and the discussion and comments on the findings are included in this volume.« less

Adrenal Vein Sampling for Conn's Syndrome: Diagnosis and Clinical Outcomes.

PubMed

Deipolyi, Amy R; Bailin, Alexander; Wicky, Stephan; Alansari, Shehab; Oklu, Rahmi

2015-06-19

Adrenal vein sampling (AVS) is the gold standard test to determine unilateral causes of primary aldosteronism (PA). We have retrospectively characterized our experience with AVS including concordance of AVS results and imaging, and describe the approach for the PA patient in whom bilateral AVS is unsuccessful. We reviewed the medical records of 85 patients with PA and compared patients who were treated medically and surgically on pre-procedure presentation and post-treatment outcomes, and evaluated how technically unsuccessful AVS results were used in further patient management. Out of the 92 AVS performed in 85 patients, AVS was technically successful bilaterally in 58 (63%) of cases. Either unsuccessful AVS prompted a repeat AVS, or results from the contralateral side and from CT imaging were used to guide further therapy. Patients who were managed surgically with adrenalectomy had higher initial blood pressure and lower potassium levels compared with patients who were managed medically. Adrenalectomy results in significantly decreased blood pressure and normalization of potassium levels. AVS can identify surgically curable causes of PA, but can be technically challenging. When one adrenal vein fails to be cannulated, results from the contralateral vein can be useful in conjunction with imaging and clinical findings to suggest further management.

A Novel Model for Teaching Primary Care in a Community Practice Setting: Tufts at Tech Community Veterinary Clinic.

PubMed

McCobb, Emily; Rozanski, Elizabeth A; Malcolm, Elizabeth L; Wolfus, Gregory; Rush, John E

Providing veterinary students with opportunities to develop clinical skills in a realistic, hands-on environment remains a challenge for veterinary education. We have developed a novel approach to teaching clinical medicine to fourth-year veterinary students and technical high school students via development of a primary care clinic embedded within a technical high school. The primary care clinic targets an underserved area of the community, which includes many of the participating high school students. Support from the veterinary community for the project has been strong as a result of communication, the opportunity for veterinarians to volunteer in the clinic, and the careful targeting of services. Benefits to veterinary students include the opportunity to build clinical competencies and confidence, as well as the exposure to a diverse client population. The financial model of the clinic is described and initial data on outcomes for case load, clinic income, veterinary student evaluations, and high school students' success in passing the veterinary assisting examination are reported. This clinical model, involving a partnership between a veterinary school and a technical high school, may be adoptable to other clinical teaching situations.

Positive and Negative Experiences of Career Technical Secondary Students in Online Courses

ERIC Educational Resources Information Center

Harms, David Mathew

2016-01-01

Research indicates that secondary students who are successful in online classes share common traits. However, many secondary career technical education (CTE) students taking online courses do not demonstrate the traits identified for success. CTE students may not benefit from online classes unless they are designed with their needs in mind. The…

Career and Technical Education (CTE) Student Success in Community Colleges: A Conceptual Model

ERIC Educational Resources Information Center

Hirschy, Amy S.; Bremer, Christine D.; Castellano, Marisa

2011-01-01

Career and technical education (CTE) students pursuing occupational associate's degrees or certificates differ from students seeking academic majors at 2-year institutions in several ways. This article examines several theoretical models of student persistence and offers a conceptual model of student success focused on CTE students in community…

Lincoln Advanced Science and Engineering Reinforcement (LASER) program

NASA Technical Reports Server (NTRS)

Williams, Willie E.

1989-01-01

Lincoln University, under the Lincoln Advanced Science and Engineering Reinforcement (LASER) Program, has identified and successfully recruited over 100 students for majors in technical fields. To date, over 70 percent of these students have completed or will complete technical degrees in engineering, physics, chemistry, and computer science. Of those completing the undergraduate degree, over 40 percent have gone on to graduate and professional schools. This success is attributable to well planned approaches to student recruitment, training, personal motivation, retention, and program staff. Very closely coupled to the above factors is a focus designed to achieve excellence in program services and student performance. Future contributions by the LASER Program to the pool of technical minority graduates will have a significant impact. This is already evident from the success of the students that began the first year of the program. With program plans to refine many of the already successful techniques, follow-on activities are expected to make even greater contributions to the availability of technically trained minorities. For example, undergraduate research exposure, broadened summer, and co-op work experiences will be enhanced.

Iridium: failures & successes

NASA Astrophysics Data System (ADS)

Christensen, CarissaBryce; Beard, Suzette

2001-03-01

This paper will provide an overview of the Iridium business venture in terms of the challenges faced, the successes achieved, and the causes of the ultimate failure of the venture — bankruptcy and system de-orbit. The paper will address technical, business, and policy issues. The intent of the paper is to provide a balanced and accurate overview of the Iridium experience, to aid future decision-making by policy makers, the business community, and technical experts. Key topics will include the history of the program, the objectives and decision-making of Motorola, the market research and analysis conducted, partnering strategies and their impact, consumer equipment availability, and technical issues — target performance, performance achieved, technical accomplishments, and expected and unexpected technical challenges. The paper will use as sources trade media and business articles on the Iridium program, technical papers and conference presentations, Wall Street analyst's reports, and, where possible, interviews with participants and close observers.

Risk factors for technical failure of endoscopic double self-expandable metallic stent placement by partial stent-in-stent method.

PubMed

Kawakubo, Kazumichi; Kawakami, Hiroshi; Toyokawa, Yoshihide; Otani, Koichi; Kuwatani, Masaki; Abe, Yoko; Kawahata, Shuhei; Kubo, Kimitoshi; Kubota, Yoshimasa; Sakamoto, Naoya

2015-01-01

Endoscopic double self-expandable metallic stent (SEMS) placement by the partial stent-in-stent (PSIS) method has been reported to be useful for the management of unresectable hilar malignant biliary obstruction. However, it is technically challenging, and the optimal SEMS for the procedure remains unknown. The aim of this study was to identify the risk factors for technical failure of endoscopic double SEMS placement for unresectable malignant hilar biliary obstruction (MHBO). Between December 2009 and May 2013, 50 consecutive patients with MHBO underwent endoscopic double SEMS placement by the PSIS method. We retrospectively evaluated the rate of successful double SEMS placement and identified the risk factors for technical failure. The technical success rate for double SEMS placement was 82.0% (95% confidence interval [CI]: 69.2-90.2). On univariate analysis, the rate of technical failure was high in patients with metastatic disease and unilateral placement. Multivariate analysis revealed that metastatic disease was a significant risk factor for technical failure (odds ratio: 9.63, 95% CI: 1.11-105.5). The subgroup analysis after double guidewire insertion showed that the rate of technical success was higher in the laser-cut type SEMS with a large mesh and thick delivery system than in the braided type SEMS with a small mesh and thick delivery system. Metastatic disease was a significant risk factor for technical failure of double SEMS placement for unresectable MHBO. The laser-cut type SEMS with a large mesh and thin delivery system might be preferable for the PSIS procedure. © 2014 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

The Undergraduate Student Instrument Project (USIP) - building the STEM workforce by providing exciting, multi-disciplinary, student-led suborbital flight projects.

NASA Astrophysics Data System (ADS)

Dingwall, B. J.

2015-12-01

NASA's Science Mission Directorate (SMD) recognizes that suborbital carriers play a vital role in training our country's future science and technology leaders. SMD created the Undergraduate Student Instrument Project (USIP) to offer students the opportunity to design, build, and fly instruments on NASA's unique suborbital research platforms. This paper explores the projects, the impact, and the lessons learned of USIP. USIP required undergraduate teams to design, build, and fly a scientific instrument in 18 months or less. Students were required to form collaborative multidisciplinary teams to design, develop and build their instrument. Teams quickly learned that success required skills often overlooked in an academic environment. Teams quickly learned to share technical information in a clear and concise manner that could be understood by other disciplines. The aggressive schedule required team members to hold each other accountable for progress while maintaining team unity. Unanticipated problems and technical issues led students to a deeper understanding of the need for schedule and cost reserves. Students exited the program with a far deeper understanding of project management and team dynamics. Through the process of designing and building an instrument that will enable new research transforms students from textbook learners to developers of new knowledge. The initial USIP project funded 10 undergraduate teams that flew a broad range of scientific instruments on scientific balloons, sounding rockets, commercial rockets and aircraft. Students were required to prepare for and conduct the major reviews that are an integral part of systems development. Each project conducted a Preliminary Design Review, Critical Design Review and Mission Readiness review for NASA officials and flight platform providers. By preparing and presenting their designs to technical experts, the students developed a deeper understanding of the technical and programmatic project pieces that were necessary for success. A student survey was conducted to assess the impact of USIP. Over 90% of students reported a significant improvement in their technical and project management skills. Perhaps more importantly, 88% of students reported that they have a far better appreciation for the value of multi-disciplinary teams.

Developing Software to “Track and Catch” Missed Follow-up of Abnormal Test Results in a Complex Sociotechnical Environment

PubMed Central

Smith, M.; Murphy, D.; Laxmisan, A.; Sittig, D.; Reis, B.; Esquivel, A.; Singh, H.

2013-01-01

Summary Background Abnormal test results do not always receive timely follow-up, even when providers are notified through electronic health record (EHR)-based alerts. High workload, alert fatigue, and other demands on attention disrupt a provider’s prospective memory for tasks required to initiate follow-up. Thus, EHR-based tracking and reminding functionalities are needed to improve follow-up. Objectives The purpose of this study was to develop a decision-support software prototype enabling individual and system-wide tracking of abnormal test result alerts lacking follow-up, and to conduct formative evaluations, including usability testing. Methods We developed a working prototype software system, the Alert Watch And Response Engine (AWARE), to detect abnormal test result alerts lacking documented follow-up, and to present context-specific reminders to providers. Development and testing took place within the VA’s EHR and focused on four cancer-related abnormal test results. Design concepts emphasized mitigating the effects of high workload and alert fatigue while being minimally intrusive. We conducted a multifaceted formative evaluation of the software, addressing fit within the larger socio-technical system. Evaluations included usability testing with the prototype and interview questions about organizational and workflow factors. Participants included 23 physicians, 9 clinical information technology specialists, and 8 quality/safety managers. Results Evaluation results indicated that our software prototype fit within the technical environment and clinical workflow, and physicians were able to use it successfully. Quality/safety managers reported that the tool would be useful in future quality assurance activities to detect patients who lack documented follow-up. Additionally, we successfully installed the software on the local facility’s “test” EHR system, thus demonstrating technical compatibility. Conclusion To address the factors involved in missed test results, we developed a software prototype to account for technical, usability, organizational, and workflow needs. Our evaluation has shown the feasibility of the prototype as a means of facilitating better follow-up for cancer-related abnormal test results. PMID:24155789

Developing software to "track and catch" missed follow-up of abnormal test results in a complex sociotechnical environment.

PubMed

Smith, M; Murphy, D; Laxmisan, A; Sittig, D; Reis, B; Esquivel, A; Singh, H

2013-01-01

Abnormal test results do not always receive timely follow-up, even when providers are notified through electronic health record (EHR)-based alerts. High workload, alert fatigue, and other demands on attention disrupt a provider's prospective memory for tasks required to initiate follow-up. Thus, EHR-based tracking and reminding functionalities are needed to improve follow-up. The purpose of this study was to develop a decision-support software prototype enabling individual and system-wide tracking of abnormal test result alerts lacking follow-up, and to conduct formative evaluations, including usability testing. We developed a working prototype software system, the Alert Watch And Response Engine (AWARE), to detect abnormal test result alerts lacking documented follow-up, and to present context-specific reminders to providers. Development and testing took place within the VA's EHR and focused on four cancer-related abnormal test results. Design concepts emphasized mitigating the effects of high workload and alert fatigue while being minimally intrusive. We conducted a multifaceted formative evaluation of the software, addressing fit within the larger socio-technical system. Evaluations included usability testing with the prototype and interview questions about organizational and workflow factors. Participants included 23 physicians, 9 clinical information technology specialists, and 8 quality/safety managers. Evaluation results indicated that our software prototype fit within the technical environment and clinical workflow, and physicians were able to use it successfully. Quality/safety managers reported that the tool would be useful in future quality assurance activities to detect patients who lack documented follow-up. Additionally, we successfully installed the software on the local facility's "test" EHR system, thus demonstrating technical compatibility. To address the factors involved in missed test results, we developed a software prototype to account for technical, usability, organizational, and workflow needs. Our evaluation has shown the feasibility of the prototype as a means of facilitating better follow-up for cancer-related abnormal test results.

National Leaders in Innovation. Washington's Community and Technical Colleges

ERIC Educational Resources Information Center

Washington State Board for Community and Technical Colleges, 2015

2015-01-01

Washington's community and technical colleges set a national example for innovative policies, practices and research for student success. Washington's community and technical college system ranks 12th in the nation for graduation rates, and 7th for certificates and degrees produced. Olympic College and Renton Technical College in March 2015 were…

The Data Warehouse: Keeping It Simple. MIT Shares Valuable Lessons Learned from a Successful Data Warehouse Implementation.

ERIC Educational Resources Information Center

Thorne, Scott

2000-01-01

Explains why the data warehouse is important to the Massachusetts Institute of Technology community, describing its basic functions and technical design points; sharing some non-technical aspects of the school's data warehouse implementation that have proved to be important; examining the importance of proper training in a successful warehouse…

A success paradigm for project managers in the aerospace industry

NASA Astrophysics Data System (ADS)

Bauer, Barry Jon

Within the aerospace industry, project managers traditionally have been selected based on their technical competency. While this may lead to brilliant technical solutions to customer requirements, a lack of management ability can result in failed programs that over-run on cost, are late to critical path schedules, fail to fully utilize the diversity of talent available within the program team, and otherwise disappoint key stakeholders. This research study identifies the key competencies that a project manager should possess in order to successfully lead and manage a project in the aerospace industry. The research attempts to show evidence that within the aerospace industry, it is perceived that management competency is more important to project management success than only technical competence.

Ultrasound-Guided Angioplasty of Dysfunctional Vascular Access for Haemodialysis. The Pros and Cons

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

García-Medina, J., E-mail: josegmedina57@gmail.com; García-Alfonso, J. J., E-mail: juanjozarandieta@gmail.com

PurposeTo describe the benefits and the disadvantages of angioplasty in dialysis fistulas using only ultrasound guidance.Materials and MethodsThis is a prospective study in 132 failing or non-maturing arteriovenous accesses that underwent 189 ultrasound-guided balloon angioplasties. The technical success was defined as non-use of X-ray fluoroscopy during the procedure.Results127 procedures (67%) were successfully completed without fluoroscopy. Most failures were due to difficulty to traverse aneurismal segments, as well as anastomotic stenoses. Including initial failures, the primary patency rates at 6, 12 months and 2 years were 75 ± 3, 41 ± 3 and 14 ± 2%, respectively.ConclusionEndovascular repair of the dysfunctional vascular access for haemodialysis under ultrasound guidance ismore » feasible and safe in roughly two-thirds of cases.« less

High temperature molten salt containment

NASA Astrophysics Data System (ADS)

Wang, K. Y.; West, R. E.; Kreith, F.; Lynn, P. P.

1985-05-01

The feasibility of several design options for high-temperature, sensible heat storage containment is examined. The major concerns for a successful containment design include heat loss, corrosive tolerance, structural integrity, and cost. This study is aimed at identifying the most promising high-temperature storage tank among eight designs initially proposed. The study is based on the heat transfer calculations and the structure study of the tank wall and the tank foundation and the overall cost analyses. The results indicate that the single-tank, two-media sloped wall tank has the potential of being lowest in cost. Several relevant technical uncertainties that warrant further research efforts are also identified.

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

Mark, H.

A development history and development status evaluation is presented for weapons technologies capable of serving as defenses against nuclear-tipped ballistic missiles. The decisive turning-point in this history was the March 23, 1983 announcement by President Reagan of the Strategic Defense Initiative (SDI). Due to President Reagan's emphasis on population protection, 'global' defense systems have tended to dominate SDI design efforts. The most important SDI technical achievements to date encompass (1) miniature homig devices, (2) the upgrade of the Patriot SAM for missile-interception capabilities, (3) light exoatmospheric projectiles, such as 'Brilliant Pebbles', (4) successful laser-communications experiments, and (5) the warhead/decoy-discriminating Firepondmore » lidar system. 7 refs.« less

Endovascular Treatment of Pulsatile Tinnitus by Sigmoid Sinus Aneurysm: Technical Note and Review of the Literature.

PubMed

Cuellar, Hugo; Maiti, Tanmoy; Patra, Devi Prasad; Savardekar, Amey; Sun, Hai; Nanda, Anil

2018-05-01

Pulse-synchronous tinnitus is rare, and it almost always points toward a vascular pathology. We encountered a 56-year-old patient presenting with a 3-month history of right-side tinnitus who was found to have a sigmoid sinus aneurysm after initial imaging. The patient was managed successfully with dual endovascular access and stent placement across the aneurysm, with a subsequent complete symptomatic relief. Description of the endovascular management of sigmoid sinus aneurysm is not infrequent in the literature. This report provides a brief review of the available literature specifically addressing the management strategies. Copyright © 2018 Elsevier Inc. All rights reserved.

Application Frontiers of "Designer Fluid Mechanics"--Visions Versus Reality or An Attempt to Answer the Perennial Question "Why Isn't It Used?"

NASA Technical Reports Server (NTRS)

Bushnell, Dennis M.

2004-01-01

Any new concept must successfully transit two sequential filters between research initiation and application, a technical filter (does it work?) and a technological filter (does it make sense in the real world? ). In general, the research community is not sufficiently knowledgeable regarding the myriad metrics of the technological filter and therefore non (application) useful research is conducted in some cases and in others the research is not carried far enough to allow technological evaluation. It is becoming imperative that the research community be more knowledgeable concerning, and in many cases work with, the application community.

New tools and approaches to newborn screening: ready to open Pandora's box?

PubMed

Ficicioglu, Can

2017-05-01

The landscape of newborn screening (NBS) is changing as new tools are developed. We must acknowledge that NBS is a very important and extraordinarily positive initiative especially for rare and serious inherited disorders; however, lessons learned from current NBS should guide the future of NBS as we enter the era of "omics" that will expand NBS for many other genetic disorders. In this article, I will first discuss new tools such as genomics and metabolomics for NBS. I will then turn to assessing how best to take advantage of new technical developments while considering the best interests of patients and the success of newborn screening.

Measurement standards for interdisciplinary medical rehabilitation.

PubMed

Johnston, M V; Keith, R A; Hinderer, S R

1992-12-01

Rehabilitation must address problems inherent in the measurement of human function and health-related quality of life, as well as problems in diagnosis and measurement of impairment. This educational document presents an initial set of standards to be used as guidelines for development and use of measurement and evaluation procedures and instruments for interdisciplinary, health-related rehabilitation. Part I covers general measurement principles and technical standards, beginning with validity, the central consideration for use of measures. Subsequent sections focus on reliability and errors of measurement, norms and scaling, development of measures, and technical manuals and guides. Part II covers principles and standards for use of measures. General principles of application of measures in practice are discussed first, followed by standards to protect persons being measured and then by standards for administrative applications. Many explanations, examples, and references are provided to help professionals understand measurement principles. Improved measurement will ensure the basis of rehabilitation as a science and nourish its success as a clinical service.

Evaluation of the instream flow incremental methodology by U.S. Fish and Wildlife Service field users

USGS Publications Warehouse

Armour, Carl L.; Taylor, Jonathan G.

1991-01-01

This paper summarizes results of a survey conducted in 1988 of 57 U.S. Fish and Wildlife Service field offices. The purpose was to document opinions of biologists experienced in applying the Instream Flow Incremental Methodology (IFIM). Responses were received from 35 offices where 616 IFIM applications were reported. The existence of six monitoring studies designed to evaluate the adequacy of flows provided at sites was confirmed. The two principal categories reported as stumbling blocks to the successful application of IFIM were beliefs that the methodology is technically too simplistic or that it is too complex to apply. Recommendations receiving the highest scores for future initiatives to enhance IFIM use were (1) training and workshops for field biologists; and (2) improving suitability index (SI) curves and computer models, and evaluating the relationship of weighted useable area (WUA) to fish responses. The authors concur that emphasis for research should be on addressing technical concerns about SI curves and WUA.

Integrated corridor management initiative : demonstration phase evaluation – Dallas technical capability analysis test plan.

DOT National Transportation Integrated Search

2012-08-01

This report presents the test plan for conducting the Technical Capability Analysis for the United States Department of Transportation (U.S. DOT) evaluation of the Dallas U.S. 75 Integrated Corridor Management (ICM) Initiative Demonstration. The ICM ...

Promoting gender parity in basic education: Lessons from a technical cooperation project in Yemen

NASA Astrophysics Data System (ADS)

Yuki, Takako; Mizuno, Keiko; Ogawa, Keiichi; Mihoko, Sakai

2013-06-01

Many girls are not sent to school in Yemen, despite basic education being free as well as compulsory for all children aged 6-15. Aiming to improve girls' enrolment by increasing parental and community involvement, the Japan International Cooperation Agency (JICA) offered a technical cooperation project in June 2005 called Broadening Regional Initiative for Developing Girls' Education (BRIDGE). Phase 1 of this project ran for three and a half years, piloting a participatory school management model supported by school grants in six districts of the Taiz Governorate in the Southwest of Yemen. To find out how successful this approach has been in a traditional society, the authors of this paper analysed the gender parity index (GPI) of the project's pilot schools. Based on data collected at three points in time (in the initial and final years of the project, and two years after the project's end), their findings suggest that interventions in school management which strongly emphasise girls' education can be effective in improving gender parity rather quickly, regardless of the schools' initial conditions. However, the authors also observe that the pilot schools' post-project performance in terms of gender parity is mixed. While the local government allocated budgets for school grants to all pilot schools even after the project's end, training and monitoring activities were cut back. The authors further observe that the variation in performance appears to be significantly correlated with school leaders' initial perceptions of gender equality and with the number of female teachers employed. These findings point to the importance of providing schools with continuous long-term guidance and of monitoring those which implement school improvement programmes.

Successful revascularization of chronic total occlusion of lower extremity arteries: a wire only and bail out use of re-entry device approach.

PubMed

Langhoff, R; Stumpe, S; Treitl, M; Schulte, K L

2013-10-01

The management of progressive peripheral artery disease experienced a vast change in paradigms over the last decades for the benefit of minimal invasive therapy as a first-line strategy. With the constant development of new devices, materials and dedicated access strategies, more complex lesions can be managed but the limitations to successfully treat chronic total occlusions are still the challenge to re-enter the true lumen. The aim of this retrospective study was to investigate, if a "wire only" strategy leads to an acceptable success rate in a mixed cohort of CTO lesions and to what extend re-entry devices are used. We retrospectively analyzed patients treated at the Vascular Center Berlin between 2011 and 2013 with chronic total occlusion out of a prospective conducted database (Endovascular MILestones - EMIL) for demographics, risk factors, co-morbidities, technical success rates, lesion characteristics and use of guidewires as well as re-entry systems. A total of 128 patients with 146 lesions, which represent a subgroup of all the cases performed in our center, following a predefined treatment algorithm for chronic total occlusions (CTOs), have been analyzed. We achieved a technical success in 133 (91.1%) of all cases following a "wire only" strategy. Out of 13 (8.9%) CTOs with technical failure in 7 (53.9%) CTOs a re-entry device (Off-Road®) with a 100% technical success has been used. In 91.1% of chronic total occlusion lesions the use of 2 wires only (88.7%) led to a successful recanalization. A "wire only" strategy followed by the use of a re-entry device as a bail out strategy, led to a total of 140 (96%) lesions to be successfully recanalized. In more than 90% of all cases with chronic total occlusion of peripheral lower extremity arteries, endovascular intervention has been successful following a "wire only" strategy. When deciding to use a re-entry device, in case of a failure of a proper wire re-entry at the reconstitution point, a technical success rate of 100% was achieved. Therefore following a strict wire algorithm and considering the use of a re-entry system as a bail out strategy will lead to a successful minimal invasive management of chronic total occlusion in nearly 100% of the cases with TASC II A - D lesions.

Management for CBD stone-related mild to moderate acute cholangitis: urgent versus elective ERCP.

PubMed

Jang, Sang Eon; Park, Sang Wook; Lee, Ban Seok; Shin, Cheol Min; Lee, Sang Hyub; Kim, Jin-Wook; Jeong, Sook-Hyang; Kim, Nayoung; Lee, Dong Ho; Park, Joo Kyung; Hwang, Jin-Hyeok

2013-07-01

There is no doubt that urgent biliary decompression needs to be done in case of severe acute cholangitis. However, it remains to be determined how early biliary decompression should be performed and elective intervention would be comparable to urgent intervention, in case of mild to moderate choledocholithiasis associated cholangitis. One hundred ninety-five patients were enrolled who were diagnosed with mild to moderate cholangitis with common bile duct (CBD) stones between January 2006 and August 2010. They were divided into two groups according to door to intervention time, and urgent (≤24 h, n = 130) versus elective (>24 h, n = 82). Primary outcomes of this study were technical success rate (CBD stones removal) and clinical success rate (improvement of cholangitis) between the two groups. Hospital stay and intervention-related complications were also evaluated. There was no statistically significant difference in technical, clinical success rate and intervention-related complications between the urgent and elective groups (P = 0.737, 0.285, 0.398, respectively). Patients in the urgent group had significantly shorter hospitalization than in the elective group (6.8 vs. 9.2 days, P < 0.001), and furthermore, intervention to discharge time was also significantly shorter by 1.1 days in the urgent group (P = 0.035). In terms of laboratory parameters, initial CRP level was the only factor correlated with hospital stay and intervention to discharge time. This study demonstrates that urgent ERCP would be recommended in the management of patients with CBD stone-related mild to moderate acute cholangitis because of the advantage of short hospital stay and intervention to discharge time.

Technical and Clinical Outcomes Following Colonic Stenting: A Seven-Year Analysis of 268 Procedures

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

Little, M. W.; Oakley, T.; Briggs, J. H.

AimsTo assess the factors contributing to the technical and clinical success of colorectal stenting for large bowel obstruction.Methodology268 cases of colonic stenting for large bowel obstruction were performed in 249 patients of mean age of 72 years (28–98) between 2006 and 2013. The majority of strictures were due to malignant disease, 244/268 (91 %). Diverticular strictures accounted for 24/268 (9 %).ResultsOverall technical success rate was 81 % (217/268), with a clinical success rate of 65 % (174/268). Duration of symptoms ranged from 0 to 180 days (mean 8 days). Technical success rate was seen to decrease with increasing symptom duration. For symptom duration of less than 1 week,more » technical success was 85.4 % (181/212) versus 69.6 % (39/56) for those with symptoms of greater than a week (p < 0.05). Clinical success rates fell from 71.3 % (107/150) to 59.3 % (70/118) (p < 0.05) when attempting to stent lesions of greater than 5 cm. There was also a significant reduction in clinical success when stenting lesions on a bend rather than a straight segment of colon 75.7 % (109/144) versus 59.7 % (74/124) (p < 0.05). A total of 20 (7.46 %) perforations were identified during the study. Stent migration occurred in 6.6 % of cases. In-stent stenosis occurred in 3.3 %. The overall 30-day all cause mortality rate was 9 %.ConclusionLesion size, location and duration of obstructive symptoms are statistically significant determinants of patient outcome. These factors could be used to advise patient selection for colonic stenting or direct progression to surgical intervention.« less

Coronary angioplasty with second generation Monorail catheters.

PubMed

Pande, A K; Meier, B; Urban, P; Villavicencio, R; de la Serna, F; Moles, V

1991-07-01

The Monorail system (Schneider) consists of a balloon catheter in which the guidewire passes through the balloon itself, exits the catheter proximal to the balloon, and runs alongside its small shaft (3 French) through the length of the guiding catheter. It offers distinct advantages over conventional systems of coronary angioplasty. It facilitates contrast injections and permits rapid balloon exchanges. This system was used for coronary angioplasty in 273 unselected consecutive patients (age 59 +/- 10, mean 35 to 73 years). There were 216 patients (84%) undergoing single-vessel and 57 patients (16%) with multi-vessel coronary angioplasty. A total of 335 coronary stenoses were dilated, which included 35 total occlusions. The size of balloon used ranged from 2.0 to 4.25 mm (3.0 +/- 0.5 mm) and the severity of stenosis was 85 +/- 11%. Technical success was defined as a residual stenosis of less than 50% as determined angiographically. Clinical success was defined as technical success, and absence of a major inhospital complication defined as absence of myocardial infarction, lack of need for coronary arterial bypass surgery, and survival. The Monorail system was technically successful in 294/300 stenotic lesions (98%). It was clinically successful for 281 lesions (94%). Of the 35 total occlusions, technical success was obtained in 25 (71%). The residual stenosis of successful cases was 26 +/- 21%. The Monorail system was also successful in 5 patients with stenosis of more than 90% in whom conventional systems failed. The complications included acute occlusion causing acute myocardial infarction in 13 cases (5%), emergency coronary arterial bypass surgery in 1 patient (0.4%), and death in 4 patients (1.5%).(ABSTRACT TRUNCATED AT 250 WORDS)

Technical Preparation: Preparing Students for Success. A Position Paper Presented by the Wisconsin Association of Secondary Vocational Administrators 1991-1992.

ERIC Educational Resources Information Center

Peterson, Charlene; And Others

Technical Preparation (Tech Prep) programs include basic skills and competencies to improve students' school-to-work transition. The following elements characterize Tech Prep: designed for grades 9-14, leading to an technical associate degree; parallels college preparatory program; offers technical program of study in business enterprise,…

Traumatic cervical internal carotid artery pseudoaneurysm in a child refractory to initial endovascular treatment: case report and technical considerations.

PubMed

Wang, Arthur; Santarelli, Justin G; Stiefel, Michael F

2016-12-01

Optimal management of extracranial carotid artery dissections (eCAD) in pediatric patients is not well documented, and endovascular interventions are rarely reported. A 10-year-old girl sustained multiple systemic injuries in a motor vehicle accident, including an eCAD with pseudoaneurysm. She initially failed both aspirin and endovascular stenting with progressive enlargement of a traumatic cervical carotid pseudoaneurysm and stenosis. Second-stage endovascular stent placement with coiling resulted in successful occlusion of the pseudoaneurysm. At 30-month imaging follow-up, the parent vessel remained patent with no evidence of the pseudoaneurysm. In the setting of poly-trauma, management of eCAD can be complex especially in the pediatric population. There is little data on the endovascular treatment of eCAD in children. Failed endovascular therapies are extremely rare. Our report supports surveillance imaging as repeat endovascular treatment may be necessary.

The core learning objectives education model: an approach to the teaching of core concepts in the clinical clerkship.

PubMed

Rapp, David E; Lyon, Mark B; Orvieto, Marcelo A; Zagaja, Gregory P

2005-10-01

The classical approach to the undergraduate medical clerkship has several limitations, including variability of clinical exposure and method of examination. As a result, the clerkship experience does not ensure exposure to and reinforcement of the fundamental concepts of a given specialty. This article reviews the classic approach to clerkship education within the undergraduate medical education. Specific attention is placed on clinical exposure and clerkship examination. We describe the introduction of the Core Learning Objective (CLO) educational model at the University of Chicago Section of Urology. This model is designed to provide an efficient exposure to and evaluation of core clerkship learning objectives. The CLO model has been successfully initiated, focusing on both technical and clinical skill sets. The proposed model has been introduced with positive initial results and should allow for an efficient approach to the teaching and evaluation of core objectives in clerkship education.

A randomized wait-list controlled analysis of the implementation integrity of team-initiated problem solving processes.

PubMed

Newton, J Stephen; Horner, Robert H; Algozzine, Bob; Todd, Anne W; Algozzine, Kate

2012-08-01

Members of Positive Behavior Interventions and Supports (PBIS) teams from 34 elementary schools participated in a Team-Initiated Problem Solving (TIPS) Workshop and follow-up technical assistance. Within the context of a randomized wait-list controlled trial, team members who were the first recipients of the TIPS intervention demonstrated greater implementation integrity in using the problem-solving processes during their team meetings than did members of PBIS Teams in the Wait-List Control group. The success of TIPS at improving implementation integrity of the problem-solving processes is encouraging and suggests the value of conducting additional research focused on determining whether there is a functional relation between use of these problem-solving processes and actual resolution of targeted student academic and social problems. Copyright © 2012 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Systems Engineering Technical Authority: A Path to Mission Success

NASA Technical Reports Server (NTRS)

Andary, James F.; So, Maria M.; Breindel, Barry

2008-01-01

The systems engineering of space missions to study planet Earth has been an important focus of the National Aeronautics and Space Administration (NASA) since its inception. But all space missions are becoming increasingly complex and this fact, reinforced by some major mishaps, has caused NASA to reevaluate their approach to achieving safety and mission success. A new approach ensures that there are adequate checks and balances in place to maximize the probability of safety and mission success. To this end the agency created the concept of Technical Authority which identifies a key individual accountable and responsible for the technical integrity of a flight mission as well as a project-independent reporting path. At the Goddard Space Flight Center (GSFC) this responsibility ultimately begins with the Mission Systems Engineer (MSE) for each satellite mission. This paper discusses the Technical Authority process and then describes some unique steps that are being taken at the GSFC to support these MSEs in meeting their responsibilities.

Policy Considerations for Commercializing Natural Gas and Biomass CCUS

NASA Astrophysics Data System (ADS)

Abrahams, L.; Clavin, C.

2017-12-01

Captured CO2 from power generation has been discussed as an opportunity to improve the environmental sustainability of fossil fuel-based electricity generation and likely necessary technological solution necessary for meeting long-term climate change mitigation goals. In our presentation, we review the findings of a study of natural gas CCUS technology research and development and discuss their applications to biomass CCUS technology potential. Based on interviews conducted with key stakeholders in CCUS technology development and operations, this presentation will discuss these technical and economic challenges and potential policy opportunities to support commercial scale CCUS deployment. In current domestic and electricity and oil markets, CCUS faces economic challenges for commercial deployment. In particular, the economic viability of CCUS has been impacted by the sustained low oil prices that have limited the potential for enhanced oil recovery (EOR) to serve as a near-term utilization opportunity for the captured CO2. In addition, large scale commercial adoption of CCUS is constrained by regulatory inconsistencies and uncertainties across the United States, high initial capital costs, achieving familiarity with new technology applications to existing markets, developing a successful performance track record to acquire financing agreements, and competing against well-established incumbent technologies. CCUS also has additional technical hurdles for measurement, verification, and reporting within states that have existing policy and regulatory frameworks for climate change mitigation. In addition to fossil-fuel based CCUS, we will discuss emerging opportunities to utilize CCUS fueled by gasified biomass resulting in carbon negative power generation with expanded economic opportunities associated with the enhanced carbon sequestration. Successful technology development of CCUS technology requires a portfolio of research leading to technical advances, advances in financial instruments to leverage the benefits of multiple commodity markets (e.g. natural gas, oil, biomass), and policy instruments that address regulatory hurdles posed CCUS technology deployment.

Evaluation of a novel, hybrid model (Mumbai EUS II) for stepwise teaching and training in EUS-guided biliary drainage and rendezvous procedures.

PubMed

Dhir, Vinay; Itoi, Takao; Pausawasdi, Nonthalee; Khashab, Mouen A; Perez-Miranda, Manuel; Sun, Siyu; Park, Do Hyun; Iwashita, Takuji; Teoh, Anthony Y B; Maydeo, Amit P; Ho, Khek Yu

2017-11-01

 EUS-guided biliary drainage (EUS-BD) and rendezvous (EUS-RV) are acceptable rescue options for patients with failed endoscopic retrograde cholangiopancreatography (ERCP). However, there are limited training opportunities at most centers owing to low case volumes. The existing models do not replicate the difficulties encountered during EUS-BD. We aimed to develop and validate a model for stepwise learning of EUS-BD and EUS-RV, which replicates the actual EUS-BD procedures.  A hybrid model was created utilizing pig esophagus and stomach, with a synthetic duodenum and biliary system. The model was objectively assessed on a grade of 1 - 4 by two experts. Twenty-eight trainees were given initial training with didactic lectures and live procedures. This was followed by hands-on training in EUS-BD and EUS-RV on the hybrid model. Trainees were assessed for objective criteria of technical difficulties.  Both the experts graded the model as very good or above for all parameters. All trainees could complete the requisite steps of EUS-BD and EUS-RV in a mean time of 11 minutes (8 - 18 minutes). Thirty-six technical difficulties were noted during the training (wrong scope position, 13; incorrect duct puncture, 12; guidewire related problems, 11). Technical difficulties peaked for EUS-RV, followed by hepaticogastrostomy (HGS) and choledochoduodenostomy (CDS) (20, 9, and 7, P  = 0.001). At 10 days follow-up, nine of 28 trainees had successfully performed three EUS-RV and seven EUS-BD procedures independently.  The Mumbai EUS II hybrid model replicates situations encountered during EUS-RV and EUS-BD. Stepwise mentoring improves the chances of success in EUS-RV and EUS-BD procedures.

Transcatheter Arterial Embolization of Angiographically Visible and Occult Renal Capsular Artery Hemorrhage in 28 Patients.

PubMed

Park, Hyo Jung; Shin, Ji Hoon; Han, Ki-Chang; Yoon, Hyun-Ki; Ko, Gi-Young; Sung, Kyu-Bo

2016-07-01

To evaluate the effectiveness and safety of transcatheter arterial embolization to control bleeding from the renal capsular artery (RCA). Embolization was performed in 28 patients (14 men; mean age, 49.7 y). Presence and type of previous invasive procedures, initial presentation, and coagulation profile were reviewed. Any preceding abdominal computed tomography (CT) findings were analyzed. Angiographic findings were categorized as active bleeding, suspicious for bleeding, or no bleeding. Technical and clinical success and clinical outcomes were evaluated. Changes in hemoglobin level and transfusion volume of packed red blood cells (pBRCs) before and after embolization were evaluated with the paired t test and Wilcoxon signed-rank test, respectively. Technical and clinical success rates of therapeutic embolization for active bleeding (n = 11) were 90.9% and 80%, respectively. One case of technical failure (5.9%) and 3 cases of postembolization bleeding (18.7%) were noted in the prophylactic embolization group in patients with suspicion of bleeding (n = 13) or no bleeding (n = 4). Transient renal insufficiency occurred in 4 patients (14.3%). The average hemoglobin level and volume of transfused pBRCs changed from 8.1 g/dL to 9.9 g/dL and from 871 mL to 543 mL, respectively (P < .05). Extravasation of contrast media or acute hematoma in the right subhepatic or perirenal space on CT was noted in 21 patients (78%). Embolization can provide an effective and safe method to control RCA bleeding. Perirenal invasive procedures and signs of active or recent right subhepatic or perirenal hemorrhage should raise the suspicion of an RCA source. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

Long-term results of Talent endografts for endovascular abdominal aortic aneurysm repair.

PubMed

Verhoeven, Bart A N; Waasdorp, Evert J; Gorrepati, Madhu L; van Herwaarden, Joost A; Vos, Jan Albert; Wille, Jan; Moll, Frans L; Zarins, Christopher K; de Vries, Jean Paul P M

2011-02-01

Since the introduction of endovascular aneurysm repair (EVAR), long-term follow-up studies reporting single-device results are scarce. In this study, we focus on EVAR repair with the Talent stent graft (Medtronic, Santa Rosa, Calif). Between July 2000 and December 2007, 365 patients underwent elective EVAR with a Talent device. Patient data were gathered prospectively and evaluated retrospectively. By American Society of Anesthesiologists category, 74% were categories III and IV. Postoperative computed tomography (CT) scanning was performed before discharge, at 3, 12 months, and yearly thereafter. Data are presented according to reporting standards for EVAR. The mean proximal aortic neck diameter was 27 mm (range, 16-36 mm), with a neck length <15 mm in 31% (data available for 193 patients). Deployment of endografts was successful in 361 of 365 patients (99%). Initially, conversion to laparotomy was necessary in four patients. Primary technical success determined by results from computed tomography (CT) scans before discharge was achieved in 333 patients (91%). Proximal type I endoleaks were present in 28 patients (8%) during follow-up, and 14 of these patients needed additional treatment for type I endoleak. The 30-day mortality for the whole Talent group was 1.1% (4 of 365). Follow-up to 84 months is reported for 24 patients. During follow-up, 122 (33%) patients died; in nine, death was abdominal aortic aneurysm (AAA)-related (including 30-day mortality). Kaplan-Meier estimates revealed primary clinical success rates of 98% at 1 year, 93% at 2 years, 88% at 3 years, 79% at 4 years, 64% at 5 years, 51% at 6 years, and 48% at 7 years. Secondary interventions were performed in 73 of 365 patients (20%). Ten conversions for failed endografts were performed. Life-table yearly risk for AAA-related reintervention was 6%, yearly risk for conversion to open repair was 1.1%, yearly risk for total mortality was 8.9%, and yearly risk for AAA-related mortality was 0.8%. Initially, technical success of endovascular aneurysm repair (EVAR) using the Talent endograft is high, with acceptable yearly risk for AAA-related mortality and conversion. However, a substantial amount of mainly endovascular reinterventions is necessary during long-term follow-up to achieve these results. Copyright © 2011 Society for Vascular Surgery. All rights reserved.

49 CFR 845.22 - Technical panel.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Technical panel. 845.22 Section 845.22... Technical panel. The Director, Bureau of Accident Investigation, or the Director, Bureau of Field Operations, shall designate members of the Board's technical staff to participate in the hearing and initially...

The effect of gender on early and intermediate results of endovascular aneurysm repair.

PubMed

Nordness, Paul J; Carter, Glen; Tonnessen, Britt; Charles Sternbergh, W; Money, Samuel R

2003-11-01

Results of endovascular aneurysm repair (EVAR) may be gender dependent. Between September 1997 and September 2001, 118 AneuRx aortic grafts were placed for aneurysmal disease. During this period, 17 females and 101 males were treated with this device. A prospective database was maintained and supplemented with retrospectively gathered information to evaluate early and mid-term end points. A total of 113 devices were deployed in 118 attempts. Length of procedure was greater for females (3.3 +/- 1.75 vs. 2.3 +/- 0.8 hr, p = 0.05) and they were more likely to have significant arterial dissections (12% vs. 1%, p = 0.05). The mortality rates at 1 month were 12% for females and 0% for males ( p = 0.02); the complication rates at 1 month were 41% for females and 15% for males ( p = 0.02). Although technical success was not significantly different between the sexes, assisted primary technical success (requiring endovascular assistance) and assisted secondary technical success (requiring open surgical assistance) were significantly different (71% vs. 96%, p = 0.003; and 76% vs. 98%, p = 0.004, respectively). Clinical success at 1 month was 59% for females and 84% for males ( p = 0.02). This difference was also significant when assessing 1-month assisted primary clinical success (59% vs. 90%, p = 0.003) and assisted secondary clinical success as well (71% vs. 96%, p = 0.003). Clinical success and assisted primary clinical success were not different at 6- or 12-month intervals, however, assisted secondary clinical successes differed at both time intervals (56% vs. 83%, p = 0.02; and 56% vs. 81%, p = 0.05, respectively). As-yet undetermined factors appear to predispose females to complications and technical difficulties in the short term. Endovascular and open procedures required to achieve ongoing clinical success in the following months appear to favor males to a greater degree than females.

Should Technical Education Be More Liberal?

ERIC Educational Resources Information Center

Heckman, Richard T.

Due to the increasing emphasis on technology and the trend toward downsizing and multiculturalism in today's workplace, graduates of technical education programs need non-technical thinking and problem solving skills to stay successfully employed. Historically, however, a dichotomy has existed between vocational and liberal education, which has…

NASA/DOD Aerospace Knowledge Diffusion Research Project. Paper 46: Technical communications in aerospace: A comparison across four countries

NASA Technical Reports Server (NTRS)

Kennedy, John M.; Pinelli, Thomas E.; Hecht, Laura Frye; Barclay, Rebecca O.

1995-01-01

In this paper we describe the preliminary analysis of four groups of aerospace engineering and science students -- student members of the American Institute of Aeronautics and Astronautics (AIAA) and students from universities in Japan, Russia, and Great Britain. We compare: (1) the demographic characteristics of the students; (2) factors that affected their career decision; (3) their career goals and aspirations; (4) their training in technical communication; and (5) their training in techniques for finding and using aerospace scientific and technical information (STI). Many employers in the US aerospace industry think there is a need for increased training of engineering students in technical communication. Engineers in the US and other countries believe that technical communication skills are critical for engineers' professional success. All students in our study agree about the importance of technical communication training for professional success, yet relatively few are happy with the instruction they receive. Overall, we conclude that additional instruction in technical communication and accessing STI would make it easier for students to achieve their career goals.

Combined Arterial Infusion and Stent Implantation Compared with Metal Stent Alone in Treatment of Malignant Gastroduodenal Obstruction

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

Wang Zhongmin, E-mail: wzm0722@hotmail.co; Chen Kemin, E-mail: ckm0722@hotmail.co; Gong Ju

Many patients with malignant gastroduodenal obstruction have an unresectable primary lesion and distant metastases, which may prompt palliative management to allow the patient to eat and to improve the quality of life. Intraluminal metallic stent implantation (MSI) under fluoroscopic guidance has been reported to be an effective option for symptomatic relief in these patients, with a good safety record. An alternative, dual interventional therapy (DIT), has been used during the last decade, in which prosthesis insertion is followed by intra-arterial chemotherapy via the tumor-feeding arteries. The aim of this study was to compare success rates, complication rates, and survival timemore » between MSI and DIT in patients who presented with gastroduodenal obstruction from advanced upper gastrointestinal tract cancer. All consecutive patients with malignant gastroduodenal obstruction seen at our center between October 2002 and August 2007 were retrospectively studied. Patients were treated palliatively by either MSI or DIT by the patient's or the next of kin's decision. Outcomes included technical and clinical success, complication rates, and survival. Of the 164 patients with malignant gastric and duodenal outlet obstructions, 80 (49%) underwent stent insertion as the primary therapy, while the remaining 84 (51%) received DIT. Clinical characteristics were similar between the two groups. In the MSI cohort initial stent implantation was successful in 73 patients (91%), two stents were used in 5 patients, and delayed additional stent insertion for stent obstruction related to tumor overgrowth was required in 3 patients during follow-up. In the DIT cohort the technical success rate was 94%, 3 patients required two stents, and stent obstruction occurred in 2 patients after initial stent placement. Early postprocedural clinical success, indicated by average dysphagia score, improved significantly in both groups: MSI group, from 4.56 to 1.51 (P < 0.01); and DIT group, from 4.38 to 1.48 (p < 0.01). There were no short-term complications. Late complications including hematemesis (n = 3), migration (n = 12), and stent occlusion due to tumor overgrowth (n = 5) were evenly distributed between the groups. In the DIT group chemotherapy-induced neutropenia and transient renal dysfunction were detected in six patients, which improved after symptomatic management. Mean survival time after the procedure was 5.9 and 11.1 months for MSI and DIT, respectively (P < 0.001). In conclusion, both MSI and DIT offer effective palliation for malignant gastroduodenal obstruction, but DIT appears to offer superior survival over MSI alone. Ideally, a prospective randomized trial comparing these two techniques should be carried out to validate this result.« less

What Do We Learn about Technical Communication in Hungary through My Students and My Hungarian Colleagues: An Initial Investigation

ERIC Educational Resources Information Center

Ding, Daniel D.

2018-01-01

Very few articles exist that document technical communication in Hungary. My Fulbright research reveals two general points: First, technical communication pedagogy stresses correct use of professional terms and phrases in technical translations or technical articles for fictional audiences. Second, it does not emphasize the importance of…

Training Providers of Services to Persons with Developmental Disabilities. Level I. Technical Committee Report and Curriculum Guide. Invest in Success.

ERIC Educational Resources Information Center

Idaho State Dept. of Education, Boise. Div. of Vocational Education.

Under the Idaho state system for curriculum development in vocational education, Technical Committees made up solely of industry personnel are responsible for drawing up task lists for each program. A Technical Committee Report is prepared on completion of the committees assignment. This Technical Committee Report presents a task list that…

[SUVA (Swiss Accident Insurance Fund) and silicosis. Silicosis in Switzerland. Development of technological dust control].

PubMed

Bachofen, G

1983-01-01

In Switzerland the technical measures against quartz dust started in 1948 when wet drilling was compulsoryly introduced, initially in underground mining. The miners using the first wet drilling machines had serious problems with water, and only with the introduction of carriage drilling machines in 1963 did the method fully break through. Dust caused by blasting operations and by loading of the resultant material was limited by ventilation and sprinkling of water. In 1966 the first full-face cutting machines were used, and it was necessary to install a dust chamber behind the drill from which dust could be taken to a dust arrester. The problem of dust limitation when using boom cutters at sectional areas of more than 20 sq. meters without a pilot tunnel has not been resolved. Since 1970, dust in quarries and stone-cutter workshops has been successfully combated by the use of exhaust pumps in combination with filters. The use of quartz sand to clean metal pieces (sandblast) was forbidden in 1960. Today, materials of the same value, but quartz-free, are available. In foundries, dust production can be limited by continuous automation and installation of exhaust pumps in moulding units. For more than 30 years now the technical equipment has been available for successful prevention of quartz dust emissions. However, at some plants it is still difficult to persuade the personnel to use the protective equipment.

Opening Doors of Opportunity to Develop the Future Nuclear Workforce - 13325

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

Mets, Mindy

2013-07-01

The United States' long-term demand for highly skilled nuclear industry workers is well-documented by the Nuclear Energy Institute. In addition, a study commissioned by the SRS Community Reuse Organization concludes that 10,000 new nuclear workers are needed in the two-state region of Georgia and South Carolina alone. Young adults interested in preparing for these nuclear careers must develop specialized skills and knowledge, including a clear understanding of the nuclear workforce culture. Successful students are able to enter well-paying career fields. However, the national focus on nuclear career opportunities and associated training and education programs has been minimal in recent decades.more » Developing the future nuclear workforce is a challenge, particularly in the midst of competition for similar workers from various industries. In response to regional nuclear workforce development needs, the SRS Community Reuse Organization established the Nuclear Workforce Initiative (NWI{sup R}) to promote and expand nuclear workforce development capabilities by facilitating integrated partnerships. NWI{sup R} achievements include a unique program concept called NWI{sup R} Academies developed to link students with nuclear career options through firsthand experiences. The academies are developed and conducted at Aiken Technical College and Augusta Technical College with support from workforce development organizations and nuclear employers. Programs successfully engage citizens in nuclear workforce development and can be adapted to other communities focused on building the future nuclear workforce. (authors)« less

Technical College Instructors' Perceptions of the Impact of Online Readiness and of Student Support Services on Student Success in Online Courses

ERIC Educational Resources Information Center

Dowd, Nathan

2012-01-01

The purpose of this study is to determine how Wisconsin Technical College (WTCS) administrators and online instructors perceive the impact of online learner readiness and student support services to be on student success in online courses. The study used a modified three-round Delphi technique to determine to collect data. The results indicated…

INTEREST AND INTELLECTUAL INDICES RELATED TO SUCCESSFUL AND NON-SUCCESSFUL MALE COLLEGE STUDENTS IN TECHNICAL AND ASSOCIATE DEGREE PROGRAMS. FINAL REPORT.

ERIC Educational Resources Information Center

HECKER, DONALD L.; TAYLOR, RONALD G.

THE PURPOSE OF THE PROJECT WAS TO STUDY THE DIFFERENCES AND SIMILARITIES IN INTEREST, ABILITY, AND PREVIOUS ACHIEVEMENT PATTERNS OF 941 MEN STUDENTS WHO ENROLLED IN VARIOUS TECHNICAL AND ASSOCIATE DEGREE 2-YEAR PROGRAMS AND TO DETERMINE WHICH VARIABLES COULD DIFFERENTIATE BETWEEN STUDENTS WHO COMPLETED, CHANGED TO AN ALTERNATE PROGRAM, OR WITHDREW…

Additional Final Area Designations and Technical Amendment for the 2012 Annual Fine Particle Standard Established in 2012 - Mar 2015

EPA Pesticide Factsheets

EPA is establishing or revising initial area designations and a technical amendment to correct an inadvertent error in the initial designation for one area for the 2012 annual national ambient air quality standards for fine particle pollution.

Storyboarding: A Concrete Way to Generate Effective Visuals.

ERIC Educational Resources Information Center

Larkin, Greg

1996-01-01

Advances the idea that storyboarding, long associated with scriptwriting, advertising, and more recently with technical manuals, can be successfully applied to an even broader variety of technical documents. Applies storyboarding techniques to designing technical proposals to suggest methods of incorporating more visuals into documents, as well as…

How Engineers Perceive the Importance of Ethics in Finland

ERIC Educational Resources Information Center

Taajamaa, Ville; Majanoja, Anne-Maarit; Bairaktarova, Diana; Airola, Antti; Pahikkala, Tapio; Sutinen, Erkki

2018-01-01

Success in complex and holistic engineering practices requires more than problem-solving abilities and technical competencies. Engineering education must offer proficient technical competences and also train engineers to think and act ethically. A technical "engineering-like" focus and demand have made educators and students overlook the…

Primary Self-Expandable Nitinol Stent Placement in Focal Lesions of Infrarenal Abdominal Aorta: Long Term Results

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

Lastovickova, Jarmila, E-mail: jala@medicon.cz; Peregrin, Jan H.

Purpose. To evaluate the technical and clinical success, safety and long term results of percutaneous transluminal angioplasty/self-expandable nitinol stent placement of infrarenal abdominal aorta focal lesions. Materials and Methods. Eighteen patients underwent PTA of focal atherosclerotic occlusive disease of distal abdominal aorta. Two symptomatic occlusions and 16 stenoses in 10 male and 8 female patients (mean age 68.2 years) were treated with primary self-expandable nitinol stent placement. Results. Primary self-expandable nitinol stent placement was technically successful in all 18 procedures; clinical success was achieved in 100% of patients. No complications associated with the procedure occurred. During the 49.4 months ofmore » mean follow up (range 3-96, 4 months) all treated aortic segments remained patent. Conclusions. Endovascular treatment (primary self-expandable nitinol stent placement) of focal atherosclerotic lesions of distal abdominal aorta is a safe method with excellent primary technical and clinical success rates and favourable Long term results.« less

Initiatives in Technical and Further Education. Numbers 3 and 4.

ERIC Educational Resources Information Center

National TAFE Clearinghouse, Adelaide (Australia).

These two issues contain abstracts of 127 and 118 documents, respectively, related to the field of technical and further education that are available through the Australian Technical and Further Education (TAFE) Clearinghouse system. These types of materials are included: research reports/technical reports, evaluation studies, curriculum materials…

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

Lawrence, Thomas M.; Boudreau, Marie-Claude; Helsen, Lieve

Recent advances in information and communications technology (ICT) have initiated development of a smart electrical grid and smart buildings. Buildings consume a large portion of the total electricity production worldwide, and to fully develop a smart grid they must be integrated with that grid. Buildings can now be 'prosumers' on the grid (both producers and consumers), and the continued growth of distributed renewable energy generation is raising new challenges in terms of grid stability over various time scales. Buildings can contribute to grid stability by managing their overall electrical demand in response to current conditions. Facility managers must balance demandmore » response requests by grid operators with energy needed to maintain smooth building operations. For example, maintaining thermal comfort within an occupied building requires energy and, thus an optimized solution balancing energy use with indoor environmental quality (adequate thermal comfort, lighting, etc.) is needed. Successful integration of buildings and their systems with the grid also requires interoperable data exchange. However, the adoption and integration of newer control and communication technologies into buildings can be problematic with older legacy HVAC and building control systems. Public policy and economic structures have not kept up with the technical developments that have given rise to the budding smart grid, and further developments are needed in both technical and non-technical areas.« less

Adrenal Vein Sampling for Conn’s Syndrome: Diagnosis and Clinical Outcomes

PubMed Central

Deipolyi, Amy R.; Bailin, Alexander; Wicky, Stephan; Alansari, Shehab; Oklu, Rahmi

2015-01-01

Adrenal vein sampling (AVS) is the gold standard test to determine unilateral causes of primary aldosteronism (PA). We have retrospectively characterized our experience with AVS including concordance of AVS results and imaging, and describe the approach for the PA patient in whom bilateral AVS is unsuccessful. We reviewed the medical records of 85 patients with PA and compared patients who were treated medically and surgically on pre-procedure presentation and post-treatment outcomes, and evaluated how technically unsuccessful AVS results were used in further patient management. Out of the 92 AVS performed in 85 patients, AVS was technically successful bilaterally in 58 (63%) of cases. Either unsuccessful AVS prompted a repeat AVS, or results from the contralateral side and from CT imaging were used to guide further therapy. Patients who were managed surgically with adrenalectomy had higher initial blood pressure and lower potassium levels compared with patients who were managed medically. Adrenalectomy results in significantly decreased blood pressure and normalization of potassium levels. AVS can identify surgically curable causes of PA, but can be technically challenging. When one adrenal vein fails to be cannulated, results from the contralateral vein can be useful in conjunction with imaging and clinical findings to suggest further management. PMID:26854152

Technical success from endovascular aneurysm repair in the post-marketing era: a multicenter prospective trial.

PubMed

Naslund, Thomas C; Becker, Stacey Y

2003-01-01

Evaluation of post-marketing success with the Ancure Endovascular Graft (AEG) was accomplished by review of a multicenter, prospective trial involving 46 centers and 163 patients. A second cohort of patients (n = 350) treated with the AEG under a controlled-use interval prior to the prospective trial was simultaneously evaluated. Technical success in both groups of patients (96.9% and 97.4%, respectively) was similar to what was reported in pre-market clinical trials. Operative implantation complications unique to the AEG included graft limb stenosis/occlusion in 35.6 and 31.4%, contralateral pull wire being caught on hooks in 33.7 and 28%, failure to seal (type I endoleak) in 17.2 and 18.3%, jacket guard being stuck in 12.9 and 11%, contralateral wire being stuck in 6.8 and 7.1%, high jacket retraction force in 16 and 8.5%, and inability to retract jacket in 1.8 and 0.5% of patients involved in the multicenter trial and controlled-use interval, respectively. One of four patients undergoing conversion in the prospective trial had graft misdeployment as a mode of failure. Three were converted for access failure. The 30-day mortality rate in the prospective trial was 3.7%. Interventions to resolve implantation-related events included stenting, guide catheter manipulations, wire exchanges, and delivery catheter disassembly. These interventions were successful in virtually every case. Open surgical procedures were not needed to correct these operative problems. Results from this study demonstrate excellent technical success with the AEG in the post-market era. Interventions to resolve implantation complications, when utilized, are highly successful in facilitating AEG implantation and providing technical success.

Fluoroscopically Guided Transcervical Fallopian Tube Recanalization of Post-Sterilization Reversal Mid-Tubal Obstructions

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

Houston, J. Graeme; Anderson, David; Mills, John

2000-03-15

Purpose: To assess the technical success and early outcome of fluoroscopically guided transcervical fallopian tube recanalization (FTR) in mid-tubal occlusion following sterilization reversal surgery.Methods: From July 1995 to January 1998, patients with greater than 12 months secondary infertility underwent hysterosalpingography (HSG). FTR was performed in proximal or mid-tubal occlusion. Cases of FTR in mid-tubal occlusion were included in this study. Technical success (defined as complete tubal patency) using a standard guidewire and hydrophilic glidewire, the number of patients with at least one patent tube, and the intrauterine and ectopic pregnancy rates were determined.Results: Twenty-six infertile patients with previous sterilization reversalmore » underwent HSG. Eight of 26 (31%) patients (mean age 32 years, range 23-37 years), had attempted FTR for mid-tubal occlusion at the site of surgical anastomosis. Fourteen tubes were attempted as there were two previous salpingectomies. Technical success was achieved in eight of 14 (57%) tubes attempted, resulting in five of eight (62%) patients having at least one patent tube. At follow-up (mean 18 months, range 12-28 months) in these five patients there was one intrauterine pregnancy. There were no ectopic pregnancies.Conclusions: FTR in mid-tubal obstruction in infertile patients following sterilization reversal surgery is technically feasible and may result in intrauterine pregnancy. In this small group there was a lower technical success rate and lower pregnancy rate than in unselected proximal tubal occlusion.« less

Core ITAC for Career-Focused Education. Integrated Technical & Academic Competencies.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. Vocational Instructional Materials Lab.

This document introduces the underlying principles and components of Ohio's Integrated Technical and Academic Competencies (ITAC) system of career-focused education, which combines high-level academics and technical skills with a real-life context for learning that maximizes students' present and future academic and career success. The document…

Technical Secondary Schools and the Labour Market: Some Results from a Tracer Study in Kenya.

ERIC Educational Resources Information Center

Narman, Anders

1988-01-01

Reports tracer studies of Kenyan youths leaving technical school to determine their success at obtaining gainful employment. Almost 43% were neither in formal schooling nor training, nor employed a year after leaving, although technical skills were seen as useful, particularly in private life. (DP)

NPS Draws CTE Educators from around the Country

ERIC Educational Resources Information Center

Emeagwali, N. Susan

2010-01-01

In this article, the author describes the Association for Career and Technical Education's (ACTE) National Policy Seminar (NPS) which successfully brought hundreds of career and technical educators to Arlington, Virginia. The event, which was held March 8-10, provided career and technical education (CTE) professionals with an opportunity to keep…

Multidisciplinary team simulation for the operating theatre: a review of the literature.

PubMed

Tan, Shaw Boon; Pena, Guilherme; Altree, Meryl; Maddern, Guy J

2014-01-01

Analyses of adverse events inside the operating theatre has demonstrated that many errors are caused by failure in non-technical skills and teamwork. While simulation has been used successfully for teaching and improving technical skills, more recently, multidisciplinary simulation has been used for training team skills. We hypothesized that this type of training is feasible and improves team skills in the operating theatre. A systematic search of the literature for studies describing true multidisciplinary operating theatre team simulation was conducted in November and December 2012. We looked at the characteristics and outcomes of the team simulation programmes. 1636 articles were initially retrieved. Utilizing a stepwise evaluation process, 26 articles were included in the review. The studies reveal that multidisciplinary operating theatre simulation has been used to provide training in technical and non-technical skills, to help implement new techniques and technologies, and to identify latent weaknesses within a health system. Most of the studies included are descriptions of training programmes with a low level of evidence. No randomized control trial was identified. Participants' reactions to the training programme were positive in all studies; however, none of them could objectively demonstrate that skills acquired from simulation are transferred to the operating theatre or show a demonstrable benefit in patient outcomes. Multidisciplinary operating room team simulation is feasible and widely accepted by participants. More studies are required to assess the impact of this type of training on operative performance and patient safety. © 2013 Royal Australasian College of Surgeons.

Align, share responsibility and collaborate: potential considerations to aid in e-health policy development.

PubMed

Ragaban, Nouran; Day, Karen; Orr, Martin

2012-01-01

Policies that support strategic development and implementation are related to health ICT implementation successes. This research aimed to explore the question, 'Why have we not seen more successful ICT implementation in healthcare, and what does policy have to do with success?' Healthcare systems are faced with rising costs, increased prevalence of chronic diseases and diminishing resources. E-health initiatives have gained acceptance in addressing these crucial health sector issues. National governments and healthcare organisations are finding it necessary to have health Information and Communications Technology (ICT) systems in place. However, poorly developed health information policies, lack of a clear business plan and ineffective leadership contribute to failure of ICT implementation in healthcare. This study uses a Grounded Theory approach, in which a series of data gathering activities will be completed. The first author attended the Health Information Management & Systems Society (HIMSS) Policy Summit in the USA in 2011. Five Summit participants were approached individually and informally discussed the 'meaningful use' policy and how it influences ICT implementation in healthcare. Field notes were made and analysed for themes relating to the research question. There were three overlapping concepts that all of the participants indicated as primary considerations for policymakers. The alignment aspect stresses the need to align e-health initiatives with overall health policy, ensuring that e-health is incorporated with other healthcare investments. The shared responsibility theme involves the need for e-health initiatives to be recognised as a priority along all levels of government, i.e. local, state, federal, and national. This stresses the importance of health ICT development and implementation in a joint government direction. The last theme is collaboration with stakeholders, including clear division of tasks and clarity about technical and non-technical expectations. Engaging and working with stakeholders in a collaborative and consensus-driven way can help realise common goals. The concepts of alignment, shared responsibility and collaboration regarding e-health policy are not new; the fact that they are still being raised in discussion and addressed in recent literature indicates that they are still an issue today. An examination of policy tools to help aid in more cohesive practice can possibly help inform and influence future e-health initiatives. E-health policy development and implementation varies due to differing health system infrastructure, funding and interests. Artefacts such as the summary of the 'meaningful use' policy could be used to leverage the effects of alignment, shared responsibility and collaboration. The next step from this research will be to examine the New Zealand National Health IT Plan's summary diagram (an artefact itself) and what role it plays in aspects of e-health policy development.

ARC-2011-ACD11-0152-006

NASA Image and Video Library

2011-08-25

Aeronautics Technical Seminar with Dennis Koehler, Vice President, Science Applications International Corporation (and former FAA executive) presenting 'Beyond the Technical: Procedural, Operational and Economic Factors 'POET' for NextGen Success

A methodological framework to support the initiation, design and institutionalization of participatory modeling processes in water resources management

NASA Astrophysics Data System (ADS)

Halbe, Johannes; Pahl-Wostl, Claudia; Adamowski, Jan

2018-01-01

Multiple barriers constrain the widespread application of participatory methods in water management, including the more technical focus of most water agencies, additional cost and time requirements for stakeholder involvement, as well as institutional structures that impede collaborative management. This paper presents a stepwise methodological framework that addresses the challenges of context-sensitive initiation, design and institutionalization of participatory modeling processes. The methodological framework consists of five successive stages: (1) problem framing and stakeholder analysis, (2) process design, (3) individual modeling, (4) group model building, and (5) institutionalized participatory modeling. The Management and Transition Framework is used for problem diagnosis (Stage One), context-sensitive process design (Stage Two) and analysis of requirements for the institutionalization of participatory water management (Stage Five). Conceptual modeling is used to initiate participatory modeling processes (Stage Three) and ensure a high compatibility with quantitative modeling approaches (Stage Four). This paper describes the proposed participatory model building (PMB) framework and provides a case study of its application in Québec, Canada. The results of the Québec study demonstrate the applicability of the PMB framework for initiating and designing participatory model building processes and analyzing barriers towards institutionalization.

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

Iguchi, Toshihiro, E-mail: iguchi@ba2.so-net.ne.jp; Hiraki, Takao, E-mail: takaoh@tc4.so-net.ne.jp; Gobara, Hideo, E-mail: gobara@cc.okayama-u.ac.jp

PurposeThe aim of the study was to retrospectively evaluate simultaneous multiple hook wire placement outcomes before video-assisted thoracoscopic surgery (VATS).Materials and MethodsThirty-eight procedures were performed on 35 patients (13 men and 22 women; mean age, 59.9 years) with 80 lung lesions (mean diameter 7.9 mm) who underwent simultaneous multiple hook wire placements for preoperative localizations. The primary endpoints were technical success, complications, procedure duration, and VATS outcome; secondary endpoints included comparisons between technical success rates, complication rates, and procedure durations of the 238 single-placement procedures performed. Complications were also evaluated.ResultsIn 35 procedures including 74 lesions, multiple hook wire placements were technically successful;more » in the remaining three procedures, the second target placement was aborted because of massive pneumothorax after the first placement. Although complications occurred in 34 procedures, no grade 3 or above adverse event was observed. The mean procedure duration was 36.4 ± 11.8 min. Three hook wires dislodged during patient transport to the surgical suite. Seventy-four successfully marked lesions were resected. Six lesions without hook wires were successfully resected after detection by palpation with an additional mini-thoracotomy or using subtle pleural changes as a guide. The complication rates and procedure durations of multiple-placement procedures were significantly higher (P = 0.04) and longer (P < 0.001) than those in the single-placement group, respectively, while the technical success rate was not significantly different (P = 0.051).ConclusionsSimultaneous multiple hook wire placements before VATS were clinically feasible, but increased the complication rate and lengthened the procedure time.« less

Initial Assessment of CSA Group Niobium Boron Based Coatings on 4340 Steel

DTIC Science & Technology

2017-07-01

Technical Report ARWSB-TR-17026 Initial Assessment of CSA Group Niobium- Boron Based Coatings on 4340 Steel C.P. Mulligan...REPORT TYPE Technical 3. DATES COVERED (From - To) 4. TITLE AND SUBTITLE Initial Assessment of CSA Group Niobium- Boron Based Coatings on 4340...metallographic mounts reported as (1) thin and (2) thick Niobium- Boron (Nb-B) type coatings on steel. CSA Group is interested in providing coatings for potential

Flow-diverting Stent in the Treatment of Cervical Carotid Dissection and Pseudoaneurysm: Review of Literature and Case Report.

PubMed

Baptista-Sincos, Anna Paula Weinhardt; Simplício, Aline Bigatão; Sincos, Igor Rafael; Leaderman, Alex; Neto, Fernando Saliture; Moraes, Adjaldes; Aun, Ricardo

2018-01-01

The endovascular technique has been recommended over the past few years to extracranial carotid dissection and pseudoaneurysm with promising results, especially after medical therapy failure. Flow-diverting stents are an alternative for complex cases. These stents have proven to be effective treatment devices for intracranial aneurysms. The reference list of Pham's systematic review, published in 2011, and Seward's literature review, published in 2015, was considered, as well as all new articles with eligible features. Search was conducted on specific databases: MEDLINE and Literatura Latino-Americana e do Caribe em Ciências da Saúde. For carotid dissection and pseudoaneurysm, our review yielded 3 published articles including 12 patients. The technical success rate of flow-diverting stent was 100% with no procedural complication described. Mean clinical follow-up was 27.2 months (range 5-48), and in 5 months' angiographic follow-up, all lesions had healed. No new neurological events were reported during the clinical follow-up. Flow diverter stent use on intracranial and peripheral vascular surgery demonstrates satisfactory initial results, but it is still under investigation. There are very few cases treated till now and the initial results with flow-diverting stents to cervical carotid dissection are promising. In well-selected cases, where simple embolization or conventional stent is not appropriate, this technic may be considered. Copyright © 2017 Elsevier Inc. All rights reserved.

Transcalar networks for policy transfer and implementation: the case of global health policies for malaria and HIV/AIDS in Cameroon.

PubMed

Ngoasong, Michael Zisuh

2011-01-01

This paper explores the nature and type of policy transfer promoted by global health partnerships to facilitate access to medication in Cameroon and the associated implementation challenges. Using concepts from policy transfer, multi-level governance and the politics of scale, the paper conceptualizes the social spaces (global-national-local linkages) through which global health policies are negotiated as transcalar networks. The framework is used to analyse policy documents, technical and media reports and journal articles focusing on two global health partnerships (GHPs)-Roll Back Malaria and the Accelerating Access Initiative-in Cameroon. Both GHPs helped to create the national Malaria and HIV/AIDS programmes in Cameroon, respectively. Global policies are negotiated through dialogue processes involving global, national and local partners who constitute the national HIV/AIDS and malaria committees. Successful policy transfer is evident from the consensual nature of decision-making. Analysis of policy implementation reveals that GHPs offer a 'technical fix' based on specific medical intervention programmes with a relatively limited focus on disease prevention. The GHP approach imposes new governance challenges due to policy resistance strategies (strategic interests of international agencies and country-specific challenges). Evidence of this is seen in the existence of several overlapping programmes and initiatives that distort accountability and governance mechanisms defined by the national committees. Finally, the implications of these challenges for achieving access to medication are discussed.

Understanding and predicting the dynamics of tokamak discharges during startup and rampdown

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

Jackson, G. L.; Politzer, P. A.; Humphreys, D. A.

Understanding the dynamics of plasma startup and termination is important for present tokamaks and for predictive modeling of future burning plasma devices such as ITER. We report on experiments in the DIII-D tokamak that explore the plasma startup and rampdown phases and on the benchmarking of transport models. Key issues have been examined such as plasma initiation and burnthrough with limited inductive voltage and achieving flattop and maximum burn within the technical limits of coil systems and their actuators while maintaining the desired q profile. Successful rampdown requires scenarios consistent with technical limits, including controlled H-L transitions, while avoiding verticalmore » instabilities, additional Ohmic transformer flux consumption, and density limit disruptions. Discharges were typically initiated with an inductive electric field typical of ITER, 0.3 V/m, most with second harmonic electron cyclotron assist. A fast framing camera was used during breakdown and burnthrough of low Z impurity charge states to study the formation physics. An improved 'large aperture' ITER startup scenario was developed, and aperture reduction in rampdown was found to be essential to avoid instabilities. Current evolution using neoclassical conductivity in the CORSICA code agrees with rampup experiments, but the prediction of the temperature and internal inductance evolution using the Coppi-Tang model for electron energy transport is not yet accurate enough to allow extrapolation to future devices.« less

Percutaneous Coronary Revascularization for Chronic Total Occlusions: A Novel Predictive Score of Technical Failure Using Advanced Technologies.

PubMed

Galassi, Alfredo R; Boukhris, Marouane; Azzarelli, Salvatore; Castaing, Marine; Marzà, Francesco; Tomasello, Salvatore D

2016-05-09

The aims of this study were to describe the 10-year experience of a single operator dedicated to chronic total occlusion (CTO) and to establish a model for predicting technical failure. During the last decade, the interest in percutaneous coronary interventions (PCIs) of chronic total occlusions (CTOs) has increased, allowing the improvement of success rate. One thousand nineteen patients with CTO underwent 1,073 CTO procedures performed by a single CTO-dedicated operator. The study population was subdivided into 2 groups by time period: period 1 (January 2005 to December 2009, n = 378) and period 2 (January 2010 to December 2014, n = 641). Observations were randomly assigned to a derivation set and a validation set (in a 2:1 ratio). A prediction score was established by assigning points for each independent predictor of technical failure in the derivation set according to the beta coefficient and summing all points accrued. Lesions attempted in period 2 were more complex in comparison with those in period 1. Compared with period 1, both technical and clinical success rates significantly improved (from 87.8% to 94.4% [p = 0.001] and from 77.6% to 89.9% [p < 0.001], respectively). A prediction score for technical failure including age ≥75 years (1 point), ostial location (1 point), and collateral filling Rentrop grade <2 (2 points) was established, stratifying procedures into 4 difficulty groups: easy (0), intermediate (1), difficult (2), and very difficult (3 or 4), with decreasing technical success rates. In derivation and validation sets, areas under the curve were comparable (0.728 and 0.772, respectively). With growing expertise, the success rate has increased despite increasing complexity of attempted lesions. The established model predicted the probability of technical failure and thus might be applied to grading the difficulty of CTO procedures. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Identifying the Value of the ACT Score as a Predictor of Student Success in Respiratory Care, Radiography, and Nursing at Southeast Kentucky Community and Technical College

ERIC Educational Resources Information Center

Parrott-Robbins, Rebecca Jon

2010-01-01

The purpose of this study was to investigate--by utilizing data obtained from the Kentucky Community and Technical College System (KCTCS) PeopleSoft database-- whether the American College Testing (ACT) assessment was a predictor of student success for students who had graduated from respiratory, radiography, and nursing programs at Southeast…

Analysis of the Relationships of the Selection of Applicants for Retraining Schools at James Connally Technical Institute and Success in Gaining Training-Related Employment and a Salary Increase.

ERIC Educational Resources Information Center

Kuntz, Elmer Lee

Relationships were investigated between (1) General Aptitude Test Battery scores and trainee selection criteria in a manpower training program at the James Connally Technical Institute, Waco, Texas, and (2) trainee success in gaining training related employment and a salary increase. Subjects (244 trainees taking eight classes in mechanics,…

Doing business in space: How to get there from here

NASA Technical Reports Server (NTRS)

Wood, P. W.; Stark, P. M.

1984-01-01

A step by step process is described through which an existing enterprise or an entrepreneurial venture can initiate and carry out a new space venture. Throughout this process the business and technical aspects must be advanced in parallel with each other. Each depends on the other for its continued success, and companies may be unable to complete the venture if one or the other is neglected. The existing NASA programs and the experience of early trailblazers provide sufficient examples and opportunities for other firms to undertake new ventures with confidence. With the introduction of NASA's Commercial Space Policy, both the opportunities and the ease with which ventures can be carried out should increase significantly.

[The second kidney transplantation in Spain].

PubMed

Virseda Rodríguez, Julio Antonio

2015-05-01

The first two living donor kidney transplants in our country (isotransplant and homotransplant respectively) were reported in 1961. We reviewed the clinical history of the renal homotransplant performed between father and son, more than half a century ago, by Carlos Younger de la Peña and Ramiro Rivera at "La Paloma' Clinic in Madrid. We comment on the organizational, legal, immunobiological and technical difficulties in those times when the successful future of transplantation was barely in sight. From the XXI Century we can see the long path of renal transplantation during the XX century. Despite all the initial troubles and failures our present must recognize, and so does it, the work and dedication of the pioneers.

Sacral nerve stimulation for neuromodulation of the lower urinary tract.

PubMed

Hubsher, Chad P; Jansen, Robert; Riggs, Dale R; Jackson, Barbara J; Zaslau, Stanley

2012-10-01

Sacral neuromodulation (SNM) has become a standard treatment option for patients suffering from urinary urge incontinence, urgency-frequency, and/or nonobstructive urinary retention refractory to conservative and pharmacologic treatment. Since its initial development, the manufacturer of InterStim therapy (Medtronic, Inc., Minneapolis, MN, USA), has introduced technical modifications, while surgeons and researchers have adapted and published various innovations and alterations of the implantation technique. In this article, we feature our SNM technique including patient selection, comprehensive dialogue/evaluation, procedure details, and appropriate follow up. Although there is often great variability in patients with lower urinary tract dysfunction, we maintain that great success can be achieved with a systematic and methodical approach to SNM.

Quality and productivity drive innovation and improvement at United Technologies Aerospace Operations, Inc.

NASA Technical Reports Server (NTRS)

Jamar, L. G.

1986-01-01

Quality and innovation are the hallmarks of the national space program. In programs that preceded the Shuttle Program the emphasis was on meeting the risks and technical challenges of space with safety, quality, reliability, and success. At United Technologies Aerospace Operations, Inc. (UTAO), the battle has developed along four primary fronts. These fronts include programs to motivate and reward people, development and construction of optimized processes and facilities, implementation of specifically tailored management systems, and the application of appropriate measurement and control systems. Each of these initiatives is described. However, to put this quality and productivity program in perspective, UTAO and its role in the Shuttle Program are described first.

Prospective multicenter study on robot-assisted laparoscopic extravesical ureteral reimplantation (RALUR-EV): Outcomes and complications.

PubMed

Boysen, William R; Akhavan, Ardavan; Ko, Joan; Ellison, Jonathan S; Lendvay, Thomas S; Huang, Jonathan; Garcia-Roig, Michael; Kirsch, Andrew; Koh, Chester J; Schulte, Marion; Noh, Paul; Monn, M Francesca; Whittam, Benjamin; Kawal, Trudy; Shukla, Aseem; Srinivasan, Arun; Gundeti, Mohan S

2018-02-20

Robot-assisted laparoscopic extravesical ureteral reimplantation (RALUR-EV) is a minimally invasive alternative to open surgery. We have previously reported retrospective outcomes from our study group, and herein provide an updated prospective analysis with a focus on success rate, surgical technique, and complications among surgeons who have overcome the initial learning curve. To assess the safety and efficacy of RALUR-EV in children, among experienced surgeons. We reviewed our prospective database of children undergoing RALUR-EV by pediatric urologists at eight academic centers from 2015 to 2017. Radiographic success was defined as absence of vesicoureteral reflux (VUR) on postoperative voiding cystourethrogram. Complications were graded using the Clavien scale. Univariate regression analysis was performed to assess for association among various patient and technical factors and radiographic failure. In total, 143 patients were treated with RALUR-EV for primary VUR (87 unilateral, 56 bilateral; 199 ureters). The majority of ureters (73.4%) had grade III or higher VUR preoperatively. Radiographic resolution was present in 93.8% of ureters, as shown in the summary table. Ureteral complications occurred in five ureters (2.5%) with mean follow-up of 7.4 months (SD 4.0). Transient urinary retention occurred in four patients following bilateral procedure (7.1%) and in no patients after unilateral. On univariate analysis, there were no patient or technical factors associated with increased odds of radiographic failure. We report a radiographic success rate of 93.8% overall, and 94.1% among children with grades III-V VUR. In contemporary series, alternate management options such as endoscopic injection and open UR have reported radiographic success rates of 90% and 93.5% respectively. We were unable to identify specific patient or technical factors that influenced outcomes, although immeasurable factors such as tissue handling and intraoperative decision-making could not be assessed. Ureteral complications requiring operative intervention were rare and occurred with the same incidence reported in a large open series. Limitations include lack of long-term follow-up and absence of radiographic follow-up on a subset of patients. Radiographic resolution of VUR following RALUR is on par with contemporary open series, and the incidence of ureteral complications is low. RALUR should be considered as one of several viable options for management of VUR in children. Copyright © 2018. Published by Elsevier Ltd.

Multimedia

NASA Technical Reports Server (NTRS)

Kaye, Karen

1993-01-01

Multimedia initiative objectives for the NASA Scientific and Technical Information (STI) program are described. A multimedia classification scheme was developed and the types of non-print media currently in use are inventoried. The NASA STI Program multimedia initiative is driven by a changing user population and technical requirements in the areas of publications, dissemination, and user and management support.

The "Technical and Vocational Education Initiative": Enclaves in British Schools.

ERIC Educational Resources Information Center

Saunders, Murray

The Technical and Vocational Education Initiative (TVEI) is intended as a pilot, on a massive scale, of particular approaches, with a systematic need to identify TVEI effects on students, staff, resources, and curricula. TVEI has a strong tendency toward the development of pilot enclaves in terms of its administrative, curricular,…

Technical Operating Procedures for Providing Funding to Natural Resource Trustees to Conduct an Initiation of Assessment of Natural Resource Damages Under the Oil Pollution Act of 1990

DOT National Transportation Integrated Search

1996-06-01

Technical Operating Procedures (TOPS) for Providing Funding to Natural Resources : Trustees To Conduct An Initiation of Assessment of Natural Resource Damages : under the Oil Pollution Act of 1990 have been developed to provide guidance on : funding ...

Proceedings of the regional technical workshop on transportation and transit facilitation : regional initiative on transport integration, South Asia region, Bangkok, April 19-21, 1999, volume 1 : summary

DOT National Transportation Integrated Search

1999-01-01

The World Bank in partnership with United Nations Economic and Social Commission for Asia and the Pacific (ESCAP) sponsored the Regional Technical Workshop on Transport and Transit Facilitation under the Initiative. Participants included public and p...

Technology in education: A guidebook for developing a science and math education support program

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

Wagner, C.L.

1992-09-01

Education is vital to survival and success in an increasingly technical world, and the quality of education is the responsibility of everyone students, teachers, parents, industry, and government. Any technical organization wanting to contribute to that success through its local education system can do so easily and effectively through careful planning. This report details that planning process and includes methods to (1) identify the interests, strengths, and resources of the technical organization; (2) identify the needs of the local education system; (3) interface with local school system administration, principals, and teachers; and (4) develop a unique plan to match themore » organization's strengths and resources with the needs of the school system. Following these getting started'' activities is the actual program that the Engineering Technology Division implemented in a local elementary school, including the curriculum, topics, and actual lesson plans used by technical personnel in the classroom. Finally, there are enrichment activities for teachers and students, suggestions for measuring the success of an education support program, and an overview of student responses to questions about the overall program.« less

Technology in education: A guidebook for developing a science and math education support program

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

Wagner, C.L.

1992-09-01

Education is vital to survival and success in an increasingly technical world, and the quality of education is the responsibility of everyone students, teachers, parents, industry, and government. Any technical organization wanting to contribute to that success through its local education system can do so easily and effectively through careful planning. This report details that planning process and includes methods to (1) identify the interests, strengths, and resources of the technical organization; (2) identify the needs of the local education system; (3) interface with local school system administration, principals, and teachers; and (4) develop a unique plan to match themore » organization`s strengths and resources with the needs of the school system. Following these ``getting started`` activities is the actual program that the Engineering Technology Division implemented in a local elementary school, including the curriculum, topics, and actual lesson plans used by technical personnel in the classroom. Finally, there are enrichment activities for teachers and students, suggestions for measuring the success of an education support program, and an overview of student responses to questions about the overall program.« less

Colorectal endoscopic submucosal dissection: Recent technical advances for safe and successful procedures

PubMed Central

Yamamoto, Katsumi; Michida, Tomoki; Nishida, Tsutomu; Hayashi, Shiro; Naito, Masafumi; Ito, Toshifumi

2015-01-01

Endoscopic submucosal dissection (ESD) is very useful in en bloc resection of large superficial colorectal tumors but is a technically difficult procedure because the colonic wall is thin and endoscopic maneuverability is poor because of colonic flexure and extensibility. A high risk of perforation has been reported in colorectal ESD. To prevent complications such as perforation and unexpected bleeding, it is crucial to ensure good visualization of the submucosal layer by creating a mucosal flap, which is an exfoliated mucosa for inserting the tip of the endoscope under it. The creation of a mucosal flap is often technically difficult; however, various types of equipment, appropriate strategy, and novel procedures including our clip-flap method, appear to facilitate mucosal flap creation, improving the safety and success rate of ESD. Favorable treatment outcomes with colorectal ESD have already been reported in many advanced institutions, and appropriate understanding of techniques and development of training systems are required for world-wide standardization of colorectal ESD. Here, we describe recent technical advances for safe and successful colorectal ESD. PMID:26468335

Changing the S and MA [Safety and Mission Assurance] Paradigm

NASA Technical Reports Server (NTRS)

Malone, Roy W., Jr.

2010-01-01

Objectives: 1) Optimize S&MA organization to best facilitate Shuttle transition in 2010, successfully support Ares developmental responsibilities, and minimize the impacts of the gap between last Shuttle flight and start of Ares V Project. 2) Improve leveraging of critical skills and experience between Shuttle and Ares. 3) Split technical and supervisory functions to facilitate technical penetration. 4) Create Chief Safety and Mission Assurance Officer (CSO) stand-alone position for successfully implementation of S&MA Technical Authority. 5) Minimize disruption to customers. 6) Provide early involvement of S&MA leadership team and frequent/open communications with S&MA team members and steak-holders.

An adequate level of training for technically competent colonoscopic polypectomy.

PubMed

Boo, Sun-Jin; Jung, Ji Hoon; Park, Jae Ho; Na, Soo-Young; Kim, Seon Ok; Park, Sang Hyoung; Yang, Dong-Hoon; Kim, Kyung-Jo; Ye, Byong Duk; Myung, Seung-Jae; Yang, Suk-Kyun; Kim, Jin-Ho; Byeon, Jeong-Sik

2015-07-01

The purpose of this study is to investigate the learning curve for colonoscopic polypectomy (CP) by trainee endoscopists. The amount of training required to achieve technical competence for CP is uncertain. The CP times and en bloc resection rates of three experienced colonoscopists were obtained from 240 procedures. These data were compared to those of three gastroenterology trainees who performed 750 CP procedures. A trainee procedure was deemed to be a success if en bloc resection was obtained and the CP time was within twice the median CP time of the experienced colonoscopists. Trainees were deemed to be technically competent when they achieved a CP success rate of greater than or equal to 80%. The median CP times and en bloc resection rates for the experienced colonoscopists and trainees were 79 s (range, 20-301 s) and 99.6% (239/240), and 118 s (range, 36-1051 s) and 95.6% (717/750), respectively. The trainee success rate of CP was 72% (540/750). The success rate of the procedure was associated with increased trainee experience (p = 0.003) and reached 80% after 250 procedures. The CP time significantly decreased (p < 0.001) and en bloc resection rate significantly increased (p = 0.011) as trainee experience accumulated. The level of experience was an independent predictor for successful CP. The achievement of technical competence with CP was associated with an accumulation of approximately 250 procedures. These findings suggest that dedicated education and training programs for CP are warranted.

Evaluation of the short- and long-term effectiveness and safety of fully covered self-expandable metal stents for drainage of pancreatic fluid collections: results of a Spanish nationwide registry.

PubMed

Vazquez-Sequeiros, Enrique; Baron, Todd H; Pérez-Miranda, Manuel; Sánchez-Yagüe, Andres; Gornals, Joan; Gonzalez-Huix, Ferran; de la Serna, Carlos; Gonzalez Martin, Juan Angel; Gimeno-Garcia, Antonio Z; Marra-Lopez, Carlos; Castellot, Ana; Alberca, Fernando; Fernandez-Urien, Ignacio; Aparicio, Jose Ramon; Legaz, Maria Luisa; Sendino, Oriol; Loras, Carmen; Subtil, Jose Carlos; Nerin, Juan; Perez-Carreras, Mercedes; Diaz-Tasende, Jose; Perez, Gustavo; Repiso, Alejandro; Vilella, Angels; Dolz, Carlos; Alvarez, Alberto; Rodriguez, Santiago; Esteban, Jose Miguel; Juzgado, Diego; Albillos, Agustin

2016-09-01

Initial reports suggest that fully covered self-expandable metal stents (FCSEMSs) may be better suited for drainage of dense pancreatic fluid collections (PFCs), such as walled-off pancreatic necrosis. The primary aim was to analyze the effectiveness and safety of FCSEMSs for drainage of different types of PFCs in a large cohort. The secondary aim was to investigate which type of FCSEMS is superior. This was a retrospective, noncomparative review of a nationwide database involving all hospitals in Spain performing EUS-guided PFC drainage. From April 2008 to August 2013, all patients undergoing PFC drainage with an FCSEMS were included in a database. The main outcome measurements were technical success, short-term (2 weeks) and long-term (6 months) effectiveness, adverse events, and need for surgery. The study included 211 patients (pseudocyst/walled-off pancreatic necrosis, 53%/47%). The FCSEMSs used were straight biliary (66%) or lumen-apposing (34%). Technical success was achieved in 97% of patients (95% confidence interval [CI], 93%-99%). Short-term- and long-term clinical success was obtained in 94% (95% CI, 89%-97%) and 85% (95% CI, 79%-89%) of patients, respectively. Adverse events occurred in 21% of patients (95% CI, 16%-27%): infection (11%), bleeding (7%), and stent migration and/or perforation (3%). By multivariate analysis, patient age (>58 years) and previous failed drainage were the most important factors associated with negative outcome. An FCSEMS is effective and safe for PFC drainage. Older patients with a history of unsuccessful drainage are more likely to fail EUS-guided drainage. The type of FCSEMS does not seem to influence patient outcome. Copyright © 2016 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

School-to-work program participation and the post-high school employment of young adults with disabilities

PubMed Central

Shandra, Carrie L.; Hogan, Dennis P.

2014-01-01

Previous research on the education-to-employment transition for students with disabilities has suggested that participation in school-to-work programs is positively associated with post-high school success. This article utilizes data from the National Longitudinal Survey of Youth 1997 (NLSY97) to extend these findings in several ways. First, we assess the efficacy of specific types of school-based and work-based initiatives, including job shadowing, mentoring, cooperative education, school-sponsored enterprise, technical preparation, internships, and career major. Next, we extend the usual focus on the employment outcomes of work status and financial compensation to consider job-specific information on the receipt of fringe benefits. Overall, results from longitudinal multivariate analyses suggest that transition initiatives are effective in facilitating vocational success for this population; however, different aspects of school-to-work programs are beneficial for different aspects of employment. School-based programs are positively associated with stable employment and full-time work while work-based programs most consistently increase the likelihood that youth with disabilities will be employed in jobs that provide fringe benefits. Analyses also indicate that – once individuals with disabilities are stably employed – they can be employed in “good” jobs that provide employee benefits. PMID:25309111

The Effects of Solid Modeling and Visualization on Technical Problem Solving

ERIC Educational Resources Information Center

Koch, Douglas

2011-01-01

The purpose of this study was to determine whether or not the use of solid modeling software increases participants' success in solving a specified technical problem and how visualization affects their ability to solve a technical problem. Specifically, the study sought to determine if (a) students' visualization skills affect their problem…

Blurring the Lines: Leveraging Internet Technology for Successful Blending of Secondary/Post-Secondary Technical Education

ERIC Educational Resources Information Center

Ryan, Kenneth; Kopischke, Kevin

2008-01-01

The Remote Automation Management Platform (RAMP) is a real-time, interactive teaching tool which leverages common off-the-shelf internet technologies to provide high school learners extraordinary access to advanced technical education opportunities. This outreach paradigm is applicable to a broad range of advanced technical skills from automation…

Solar Energy - It's Growth, Development, and Use

Science.gov Websites

Report, June 1978 Solar Energy and Your Home: Questions and Answers, DOE Technical Report, January 1984 Solar Air Collectors: How Much Can You Save?, DOE Technical Report, April 1985 Building Design Guidelines for Solar Energy Technologies, DOE Technical Report, January 1989 OUT Success Stories: Solar

Collaborating for Success: Team Teaching the Engineering Technical Thesis

ERIC Educational Resources Information Center

Keating, Terrence; Long, Mike

2012-01-01

This paper will examine the collaborative teaching process undertaken at College of the North Atlantic-Qatar (CNA-Q) by Engineering and the Communication faculties to improve the overall quality of engineering students' capstone projects known as the Technical Thesis. The Technical Thesis is divided into two separate components: a proposal stage…

The Rebirth of a Career and Technical Education Program.

ERIC Educational Resources Information Center

Reese, Susan

2003-01-01

Describes how a Milwaukee high school sustained its career and technical education programs by cultivating business-industry partnerships and developing a successful heating, ventilation, air conditioning, and refrigeration curriculum. (JOW)

A Socio-technical assessment of the success of picture archiving and communication systems: the radiology technologist’s perspective

PubMed Central

2013-01-01

Background With the increasing prevalence of Picture Archiving and Communication Systems (PACS) in healthcare institutions, there is a growing need to measure their success. However, there is a lack of published literature emphasizing the technical and social factors underlying a successful PACS. Methods An updated Information Systems Success Model was utilized by radiology technologists (RTs) to evaluate the success of PACS at a large medical center in Taiwan. A survey, consisting of 109 questionnaires, was analyzed by Structural Equation Modeling. Results Socio-technical factors (including system quality, information quality, service quality, perceived usefulness, user satisfaction, and PACS dependence) were proven to be effective measures of PACS success. Although the relationship between service quality and perceived usefulness was not significant, other proposed relationships amongst the six measurement parameters of success were all confirmed. Conclusions Managers have an obligation to improve the attributes of PACS. At the onset of its deployment, RTs will have formed their own subjective opinions with regards to its quality (system quality, information quality, and service quality). As these personal concepts are either refuted or reinforced based on personal experiences, RTs will become either satisfied or dissatisfied with PACS, based on their perception of its usefulness or lack of usefulness. A satisfied RT may play a pivotal role in the implementation of PACS in the future. PMID:24053458

Bedside inferior vena cava filter placement by intravascular ultrasound in critically ill patients is safe and effective for an extended time.

PubMed

Glocker, Roan J; Awonuga, Oluwafunmi; Novak, Zdenek; Pearce, Benjamin J; Patterson, Mark; Matthews, Thomas C; Jordan, William D; Passman, Marc A

2014-10-01

Bedside inferior vena cava filter (IVCF) placement by intravascular ultrasound (IVUS) guidance has previously been shown to be a safe and effective technique, especially for critically ill patients, with initial experience of a prospectively implemented algorithm. The purpose of this study was to evaluate the effectiveness of IVUS-guided filter placement in critically ill patients with experience now extending out 5 years from implementation. All patients undergoing bedside IVUS-guided IVCF placement from 2008 to 2012 were identified. Records were reviewed on the basis of IVCF reporting standards. Outcomes data including technical success, complications, and mortality were analyzed at 30 days. During the 5-year period, 398 patients underwent attempted bedside IVCF placement by IVUS. Technical feasibility was possible in 396 cases (99.5%); two bedside procedures were aborted because of inadequate IVUS visualization. Overall technical success was achieved in 393 of 396 (99.2%), with malpositioned IVCF in three cases. An optional IVCF was used in 372 (93.9%) and a permanent IVCF in 24 (6.1%). Single-puncture technique was performed in 388 (97.4%); additional dual access was required in 10 (2.6%). Periprocedural complications were rare (3.0%) and included malpositioning that required retrieval and repositioning or an additional IVCF (3), filter tilt ≥20 degrees (4), arteriovenous fistulas (2), insertion site thrombosis (2), and hematoma (1). Comparison of the first 100 procedures performed within the sample population with the last 100 procedures revealed an overall success rate of 96% in the first 100 compared with 100% in the last 100 (P = .043). There were no deaths related to pulmonary embolism or IVCF-related problems. On the basis of 5 years of experience with bedside IVCF placement in critically ill patients, the IVUS-guided IVCF technique continues to be a safe and effective option in this high-risk population, with a time-dependent improvement in outcome measures. Copyright © 2014 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

NASA's Space Launch Transitions: From Design to Production

NASA Technical Reports Server (NTRS)

Askins, Bruce; Robinson, Kimberly

2016-01-01

NASA's Space Launch System (SLS) successfully completed its Critical Design Review (CDR) in 2015, a major milestone on the journey to an unprecedented era of exploration for humanity. CDR formally marked the program's transition from design to production phase just four years after the program's inception and the first such milestone for a human launch vehicle in 40 years. While challenges typical of a complex development program lie ahead, CDR evaluators concluded that the design is technically and programmatically sound and ready to press forward to Design Certification Review (DCR) and readiness for launch of Exploration Mission 1 (EM-1) in the 2018 timeframe. SLS is prudently based on existing propulsion systems, infrastructure and knowledge with a clear, evolutionary path as required by mission needs. In its initial configuration, designated Block I, SLS will a minimum of 70 metric tons (t) of payload to low Earth orbit (LEO). It can evolve to a 130 t payload capacity by upgrading its engines, boosters, and upper stage, dramatically increasing the mass and volume of human and robotic exploration while decreasing mission risk, increasing safety, and simplifying ground and mission operations. CDR was the central programmatic accomplishment among many technical accomplishments that will be described in this paper. The government/industry SLS team successfully test fired a flight-like five-segment solid rocket motor, as well as seven hotfire development tests of the RS-25 core stage engine. The majority of the major test article and flight barrels, rings, and domes for the core stage liquid oxygen, liquid hydrogen, engine section, intertank, and forward skirt were manufactured at NASA's Michoud Assembly Facility. Renovations to the B-2 test stand for stage green run testing were completed at NASA Stennis Space Center. Core stage test stands are rising at NASA Marshall Space Flight Center. The modified Pegasus barge for core stage transportation from manufacturing to testing and launch sites was delivered. The Interim Cryogenic Propulsion System test article was also completed. This paper will discuss these and other technical and programmatic successes and challenges over the past year and provide a preview of work ahead before the first flight of this new capability.

College Success of Technical College Preparation and Dual Credit Program Students versus Non-Program Students: A Comparative Analysis at a Midwestern Community College

ERIC Educational Resources Information Center

Payton-Adams, Minnie

2014-01-01

The purpose of this quantitative study was to examine the impact of the number of college credits earned in Technical College Preparation (Tech Prep) and Dual Credit (College Now) programs as a predictor of continued success after high school, as measured by first-year college GPA at a Midwest Community College. This study looked at how the…

High School Career and Technical Education Participation and Initial College Enrollment: Evidence from Arkansas

ERIC Educational Resources Information Center

Dougherty, Shaun M.

2016-01-01

This paper uses rich administrative data from Arkansas to understand whether and how high school career and technical education (CTE) programs are related to initial enrollment in college after high school. This descriptive work is designed to inform how other state and local policymakers understand the potential role of high school CTE…

An Empirical System for Assessing the Impact of Aptitude Requirement Adjustments on Air Force Initial Skills Training.

ERIC Educational Resources Information Center

Mumford, Michael D.; And Others

A multivariate modeling approach was developed to assess the impact of changes in aptitude requirement minimums on U.S. Air Force technical training outcomes. Initially, interviews were conducted with technical training personnel to identify significant student inputs, course content, and training outcome variables. Measures of these variables…

NASA as a Convener: Government, Academic and Industry Collaborations Through the NASA Human Health and Performance Center

NASA Technical Reports Server (NTRS)

Davis, Jeffrey R.; Richard, Elizabeth E.

2011-01-01

On October 18, 2010, the NASA Human Health and Performance center (NHHPC) was opened to enable collaboration among government, academic and industry members. Membership rapidly grew to 60 members (http://nhhpc.nasa.gov ) and members began identifying collaborative projects as detailed below. In addition, a first workshop in open collaboration and innovation was conducted on January 19, 2011 by the NHHPC resulting in additional challenges and projects for further development. This first workshop was a result of the SLSD successes in running open innovation challenges over the past two years. In 2008, the NASA Johnson Space Center, Space Life Sciences Directorate (SLSD) began pilot projects in open innovation (crowd sourcing) to determine if these new internet-based platforms could indeed find solutions to difficult technical problems. From 2008 to 2010, the SLSD issued 34 challenges, 14 externally and 20 internally. The 14 external challenges were conducted through three different vendors: InnoCentive, Yet2.com and TopCoder. The 20 internal challenges were conducted using the InnoCentive platform, customized to NASA use, and promoted as NASA@Work. The results from the 34 challenges involved not only technical solutions that were reported previously at the 61st IAC, but also the formation of new collaborative relationships. For example, the TopCoder pilot was expanded by the NASA Space Operations Mission Directorate to the NASA Tournament Lab in collaboration with Harvard Business School and TopCoder. Building on these initial successes, the NHHPC workshop in January of 2011, and ongoing NHHPC member discussions, several important collaborations are in development: Space Act Agreement between NASA and GE for collaborative projects, NASA and academia for a Visual Impairment / Intracranial Hypertension summit (February 2011), NASA and the DoD through the Defense Venture Catalyst Initiative (DeVenCI) for a technical needs workshop (June 2011), NASA and the San Diego Zoo in Biomimicry, NASA and the FAA Center of Excellence for Commercial Space Flight for collaborative projects, NASA and the FDA concerning automatic external defibrillators, and NASA and Tufts University for an education pilot. These and other collaborations will be detailed in the paper demonstrating that a government-sponsored convening entity (the NHHPC) can facilitate industry, academic, and non-profit collaborations for products of mutual benefit.

Advancing Innovation Through Collaboration: Implementation of the NASA Space Life Sciences Strategy

NASA Technical Reports Server (NTRS)

Davis, Jeffrey R.; Richard, Elizabeth E.

2010-01-01

On October 18, 2010, the NASA Human Health and Performance center (NHHPC) was opened to enable collaboration among government, academic and industry members. Membership rapidly grew to 90 members (http://nhhpc.nasa.gov ) and members began identifying collaborative projects as detailed in this article. In addition, a first workshop in open collaboration and innovation was conducted on January 19, 2011 by the NHHPC resulting in additional challenges and projects for further development. This first workshop was a result of the SLSD successes in running open innovation challenges over the past two years. In 2008, the NASA Johnson Space Center, Space Life Sciences Directorate (SLSD) began pilot projects in open innovation (crowd sourcing) to determine if these new internet-based platforms could indeed find solutions to difficult technical problems. From 2008 to 2010, the SLSD issued 34 challenges, 14 externally and 20 internally. The 14 external challenges were conducted through three different vendors: InnoCentive, Yet2.com and TopCoder. The 20 internal challenges were conducted using the InnoCentive platform, customized to NASA use, and promoted as NASA@Work. The results from the 34 challenges involved not only technical solutions that were reported previously at the 61st IAC, but also the formation of new collaborative relationships. For example, the TopCoder pilot was expanded by the NASA Space Operations Mission Directorate to the NASA Tournament Lab in collaboration with Harvard Business School and TopCoder. Building on these initial successes, the NHHPC workshop in January of 2011, and ongoing NHHPC member discussions, several important collaborations have been developed: (1) Space Act Agreement between NASA and GE for collaborative projects (2) NASA and academia for a Visual Impairment / Intracranial Hypertension summit (February 2011) (3) NASA and the DoD through the Defense Venture Catalyst Initiative (DeVenCI) for a technical needs workshop (June 2011) (4) NASA and the San Diego Zoo for a joint challenge in biomimicry (5) NASA and the FAA Center of Excellence for Commercial Space Flight for five collaborative projects (6) NASA and ESA for a Space Medicine Workshop (July 2011) (7) NASA and Tufts University for an education pilot (8) Establishment of long-term contracts (August 2011) to enable future challenges (9) Establishment of a new Center of Excellence for Collaborative Innovation (July 2011) for all federal agencies in the US

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

Tapping, C. R.; Ahmed, M.; Scott, P. M.

The purpose of this study was to evaluate the technical success, complications, long-term clinical outcome, and patency after primary infrarenal aortic stenting for aortic and aortoiliac stenosis. Between January 1999 and January 2006, 22 consecutive patients underwent endovascular treatment because of infrarenal aortic stenosis with and without common iliac stenosis (10 men; mean age 64 {+-} 14 years). Eleven (11 of 22) patients had an isolated aortic stenosis, whereas 11 of 22 had aortic stenosis that extended into the common iliac arteries (CIAs). Thirteen patients were Rutherford classification type 3, and 9 patients were type 4. Statistical analysis included pairedmore » Student t test and Kaplan-Meier life table analysis; p < 0.05 was considered significant. Technical and initial clinical success was achieved in all patients. There were three (14 %) procedure-related complications, which included two access-point pseudoaneurysms and one non-flow-limiting left external iliac dissection. Patients were followed-up for a mean period of 88 months (range 60-132). Mean preprocedure ankle brachial pressure indexes (ABPI) were 0.60 {+-} -0.15 (right) and 0.61 {+-} -0.16 (left). After the procedure they were 0.86 {+-} -0.07 (right) and 0.90 {+-} -0.09 (left). The increase in ABPI was significant (p < 0.05), and this continued throughout follow-up. Four (18 %) patients had recurrence of symptoms during follow-up. These occurred at 36, 48, 48, and 50 months after the original procedure. All four patients were successfully treated with repeat angioplasty procedures. There was a significant difference in primary patency between isolated aortic stenosis (100 %) and aortoiliac stenosis (60 %) (p = 0.031). Cumulative follow-up was 1920 months yielding a reintervention rate of 0.025/events/year. Primary stenting of infrarenal stenosis is safe and successful with a low reintervention rate. It should be considered as first-line treatment for patients with infrarenal aortic stenotic disease.« less

Orbital express capture system: concept to reality

NASA Astrophysics Data System (ADS)

Stamm, Shane; Motaghedi, Pejmun

2004-08-01

The development of autonomous servicing of on-orbit spacecraft has been a sought after objective for many years. A critical component of on-orbit servicing involves the ability to successfully capture, institute mate, and perform electrical and fluid transfers autonomously. As part of a Small Business Innovation Research (SBIR) grant, Starsys Research Corporation (SRC) began developing such a system. Phase I of the grant started in 1999, with initial work focusing on simultaneously defining the parameters associated with successful docking while designing to those parameters. Despite the challenge of working without specific requirements, SRC completed development of a prototype design in 2000. Throughout the following year, testing was conducted on the prototype to characterize its performance. Having successfully completed work on the prototype, SRC began a Phase II SBIR effort in mid-2001. The focus of the second phase was a commercialization effort designed to augment the prototype model into a more flight-like design. The technical requirements, however, still needed clear definition for the design to progress. The advent of the Orbital Express (OE) program provided much of that definition. While still in the proposal stages of the OE program, SRC began tailoring prototype redesign efforts to the OE program requirements. A primary challenge involved striking a balance between addressing the technical requirements of OE while designing within the scope of the SBIR. Upon award of the OE contract, the Phase II SBIR design has been fully developed. This new design, designated the Mechanical Docking System (MDS), successfully incorporated many of the requirements of the OE program. SRC is now completing dynamic testing on the MDS hardware, with a parallel effort of developing a flight design for OE. As testing on the MDS progresses, the design path that was once common to both SBIR effort and the OE program begins to diverge. The MDS will complete the scope of the Phase II SBIR work, while the new mechanism, the Orbital Express Capture System, will emerge as a flight-qualified design for the Orbital Express program.

Lower extremity computed tomography angiography can help predict technical success of endovascular revascularization in the superficial femoral and popliteal artery.

PubMed

Itoga, Nathan K; Kim, Tanner; Sailer, Anna M; Fleischmann, Dominik; Mell, Matthew W

2017-09-01

Preprocedural computed tomography angiography (CTA) assists in evaluating vascular morphology and disease distribution and in treatment planning for patients with lower extremity peripheral artery disease (PAD). The aim of the study was to determine the predictive value of radiographic findings on CTA and technical success of endovascular revascularization of occlusions in the superficial femoral artery-popliteal (SFA-pop) region. Medical records and available imaging studies were reviewed for patients undergoing endovascular intervention for PAD between January 2013 and December 2015 at a single academic institution. Radiologists reviewed preoperative CTA scans of patients with occlusions in the SFA-pop region. Radiographic criteria previously used to evaluate chronic occlusions in the coronary arteries were used. Technical success, defined as restoration of inline flow through the SFA-pop region with <30% stenosis at the end of the procedure, and intraoperative details were evaluated. From 2013 to 2015, there were 407 patients who underwent 540 endovascular procedures for PAD. Preprocedural CTA scans were performed in 217 patients (53.3%), and 84 occlusions in the SFA-pop region were diagnosed. Ten occlusions were excluded as no endovascular attempt to cross the lesion was made because of extensive disease or concomitant iliac intervention. Of the remaining 74 occlusions in the SFA-pop region, 59 were successfully treated (80%) and 15 were unsuccessfully crossed (20%). The indications for revascularization were claudication in 57% of patients and critical limb ischemia in the remaining patients. TransAtlantic Inter-Society Consensus A, B, and C occlusions were treated with 87% success, whereas D occlusions were treated with 68% success (P = .047). There were nine occlusions with 100% vessel calcification that was associated with technical failure (P = .014). Longer lengths of occlusion were also associated with technical failure (P = .042). Multiple occlusions (P = .55), negative remodeling (P = .69), vessel runoff (P = .56), and percentage of vessel calcification (P = .059) were not associated with failure. On multivariable analysis, 100% calcification remained the only significant predictor of technical failure (odds ratio, 9.0; 95% confidence interval, 1.8-45.8; P = .008). Analysis of preoperative CTA shows 100% calcification as the best predictor of technical failure of endovascular revascularization of occlusions in the SFA-pop region. Further studies are needed to determine the cost-effectiveness of obtaining preoperative CTA for lower extremity PAD. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

The Future Cybersecurity Workforce: Going Beyond Technical Skills for Successful Cyber Performance.

PubMed

Dawson, Jessica; Thomson, Robert

2018-01-01

One of the challenges in writing an article reviewing the current state of cyber education and workforce development is that there is a paucity of quantitative assessment regarding the cognitive aptitudes, work roles, or team organization required by cybersecurity professionals to be successful. In this review, we argue that the people who operate within the cyber domain need a combination of technical skills, domain specific knowledge, and social intelligence to be successful. They, like the networks they operate, must also be reliable, trustworthy, and resilient. Defining the knowledge, skills, attributes, and other characteristics is not as simple as defining a group of technical skills that people can be trained on; the complexity of the cyber domain makes this a unique challenge. There has been little research devoted to exactly what attributes individuals in the cyber domain need. What research does exist places an emphasis on technical and engineering skills while discounting the important social and organizational influences that dictate success or failure in everyday settings. This paper reviews the literature on cyber expertise and cyber workforce development to identify gaps and then argues for the important contribution of social fit in the highly complex and heterogenous cyber workforce. We then identify six assumptions for the future of cybersecurity workforce development, including the requirement for systemic thinkers, team players, a love for continued learning, strong communication ability, a sense of civic duty, and a blend of technical and social skill. Finally, we make recommendations for social and cognitive metrics which may be indicative of future performance in cyber work roles to provide a roadmap for future scholars.

Develop a Comprehensive Technical Training and Data Collection Program for Structural Welders and Fitters: Technical Proposal

DTIC Science & Technology

2006-05-30

implementation Final Report 4 TECHNICAL PLAN AND RESULTS Task 1: Initiate the Project Management System Two senior NGSS production management...1 Technical Plan and Results...Third the system is hosted on a handheld unit which provides the foremen with an efficient daily planning tool. The Pilot System which entails

75 FR 68606 - Chetco River Gravel Mining Executive and Technical Teams; Notification of Availability of Documents.

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-08

... Executive and Technical Teams; Notification of Availability of Documents. AGENCY: U.S. Army Corps of... public all work products of the Chetco River Gravel Mining Executive and Technical Teams. These work... INFORMATION: The Executive and Technical Teams were established in 2007 as part of an initiative to evaluate...

Promoting Policy, Systems, and Environment Change to Prevent Chronic Disease: Lessons Learned From the King County Communities Putting Prevention to Work Initiative.

PubMed

Cheadle, Allen; Cromp, DeAnn; Krieger, James W; Chan, Nadine; McNees, Molly; Ross-Viles, Sarah; Kellogg, Ryan; Rahimian, Afsaneh; MacDougall, Erin

2016-01-01

Initiatives that convene community stakeholders to implement policy, systems, environment, and infrastructure (PSEI) change have become a standard approach for promoting community health. To assess the PSEI changes brought about by the King County, Washington, Communities Putting Prevention to Work initiative and describe how initiative structures and processes contributed to making changes. The impact evaluation used a logic model design, linking PSEI changes to longer-term behavioral impacts in healthy eating active living and tobacco use and exposure. Qualitative methods, including stakeholder interviews and surveys, were used to identify initiative success factors. Communities Putting Prevention to Work activities occurred throughout King County, with a focus on 7 low-income communities in South Seattle/King County. The focus communities had a combined population of 652 000, or 35% of the county total, with lower incomes and higher rates of physical inactivity, tobacco use, poor diet, and chronic disease. Twenty-four PSEI strategies were pursued by organizations in sectors including schools, local governments, and community organizations, supported by the public health department. There were 17 healthy eating active living strategies (eg, enhancements to school menus, city planning policies) and 7 tobacco strategies (eg, smoke-free policies in schools, housing, and hospitals). PSEI changes made and numbers of residents reached. Twenty-two of the 24 strategies achieved significant progress toward implementing PSEI changes. The most common success factor was a "dyad" consisting of a dedicated technical assistance provider-either an outside consultant or public health department staff-working closely with a champion from the participating organizations to bring about PSEI changes. An initiative structure that creates and supports external consultant/internal organizational champion dyads in key community sectors offers a promising approach that may be adopted by similar community health efforts in the future.

Classification of antecedents towards safety use of health information technology: A systematic review.

PubMed

Salahuddin, Lizawati; Ismail, Zuraini

2015-11-01

This paper provides a systematic review of safety use of health information technology (IT). The first objective is to identify the antecedents towards safety use of health IT by conducting systematic literature review (SLR). The second objective is to classify the identified antecedents based on the work system in Systems Engineering Initiative for Patient Safety (SEIPS) model and an extension of DeLone and McLean (D&M) information system (IS) success model. A systematic literature review (SLR) was conducted from peer-reviewed scholarly publications between January 2000 and July 2014. SLR was carried out and reported based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. The related articles were identified by searching the articles published in Science Direct, Medline, EMBASE, and CINAHL databases. Data extracted from the resultant studies included are to be analysed based on the work system in Systems Engineering Initiative for Patient Safety (SEIPS) model, and also from the extended DeLone and McLean (D&M) information system (IS) success model. 55 articles delineated to be antecedents that influenced the safety use of health IT were included for review. Antecedents were identified and then classified into five key categories. The categories are (1) person, (2) technology, (3) tasks, (4) organization, and (5) environment. Specifically, person is attributed by competence while technology is associated to system quality, information quality, and service quality. Tasks are attributed by task-related stressor. Organisation is related to training, organisation resources, and teamwork. Lastly, environment is attributed by physical layout, and noise. This review provides evidence that the antecedents for safety use of health IT originated from both social and technical aspects. However, inappropriate health IT usage potentially increases the incidence of errors and produces new safety risks. The review cautions future implementation and adoption of health IT to carefully consider the complex interactions between social and technical elements propound in healthcare settings. Copyright © 2015. Published by Elsevier Ireland Ltd.

A multifaceted program to prevent ventilator-associated pneumonia: impact on compliance with preventive measures.

PubMed

Bouadma, Lila; Mourvillier, Bruno; Deiler, Véronique; Le Corre, Bertrand; Lolom, Isabelle; Régnier, Bernard; Wolff, Michel; Lucet, Jean-Christophe

2010-03-01

To determine the effect of a 2-yr multifaceted program aimed at preventing ventilator-acquired pneumonia on compliance with eight targeted preventive measures. Pre- and postintervention observational study. A 20-bed medical intensive care unit in a teaching hospital. A total of 1649 ventilator-days were observed. The program involved all healthcare workers and included a multidisciplinary task force, an educational session, direct observations with performance feedback, technical improvements, and reminders. It focused on eight targeted measures based on well-recognized published guidelines, easily and precisely defined acts, and directly concerned healthcare workers' bedside behavior. Compliance assessment consisted of five 4-wk periods (before the intervention and 1 month, 6 months, 12 months, and 24 months thereafter). Hand-hygiene and glove-and-gown use compliances were initially high (68% and 80%) and remained stable over time. Compliance with all other preventive measures was initially low and increased steadily over time (before 2-yr level, p < .0001): backrest elevation (5% to 58%) and tracheal cuff pressure maintenance (40% to 89%), which improved after simple technical equipment implementation; orogastric tube use (52% to 96%); gastric overdistension avoidance (20% to 68%); good oral hygiene (47% to 90%); and nonessential tracheal suction elimination (41% to 92%). To assess overall performance of the last six preventive measures, using ventilator-days as the unit of analysis, a composite score for preventive measures applied (range, 0-6) was developed. The median (interquartile range) composite scores for the five successive assessments were 2 (1-3), 4 (3-5), 4 (4-5), 5 (4-6), and 5 (4-6) points; they increased significantly over time (p < .0001). Ventilator-acquired pneumonia prevalence rate decreased by 51% after intervention (p < .0001). Our active, long-lasting program for preventing ventilator-acquired pneumonia successfully increased compliance with preventive measures directly dependent on healthcare workers' bedside performance. The multidimensional framework was critical for this marked, progressive, and sustained change.

Using the Stop Transmission of Polio (STOP) Program to Develop a South Sudan Expanded Program on Immunization Workforce.

PubMed

Tchoualeu, Dieula D; Hercules, Margaret A; Mbabazi, William B; Kirbak, Anthony L; Usman, Abdulmumini; Bizuneh, Ketema; Sandhu, Hardeep S

2017-07-01

In 2009, the international Stop Transmission of Polio (STOP) program began supporting the Global Polio Eradication Initiative in the Republic of South Sudan to address shortages of human resources and strengthen acute flaccid paralysis surveillance. Workforce capacity support is provided to the South Sudan Expanded Program on Immunization by STOP volunteers, implementing partners, and non-governmental organizations. In 2013, the Polio Technical Advisory Group recommended that South Sudan transition key technical support from external partners to national staff as part of the Polio Eradication and Endgame Strategic Plan, 2013-2018. To assist in this transition, the South Sudan Expanded Program on Immunization human resources development project was launched in 2015. This 3-year project aims to build national workforce capacity as a legacy of the STOP program by training 56 South Sudanese at national and state levels with the intent that participants would become Ministry of Health staff on their successful completion of the project. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

A study of the talent training project management for semiconductor industry in Taiwan: the application of a hybrid data envelopment analysis approach.

PubMed

Kao, Ling-Jing; Chiu, Shu-Yu; Ko, Hsien-Tang

2014-01-01

The purpose of this study is to evaluate the training institution performance and to improve the management of the Manpower Training Project (MTP) administered by the Semiconductor Institute in Taiwan. Much literature assesses the efficiency of an internal training program initiated by a firm, but only little literature studies the efficiency of an external training program led by government. In the study, a hybrid solution of ICA-DEA and ICA-MPI is developed for measuring the efficiency and the productivity growth of each training institution over the period. The technical efficiency change, the technological change, pure technical efficiency change, scale efficiency change, and the total factor productivity change were evaluated according to five inputs and two outputs. According to the results of the study, the training institutions can be classified by their efficiency successfully and the guidelines for the optimal level of input resources can be obtained for each inefficient training institution. The Semiconductor Institute in Taiwan can allocate budget more appropriately and establish withdrawal mechanisms for inefficient training institutions.

Test Plan: WIPP bin-scale CH TRU waste tests

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

Molecke, M.A.

1990-08-01

This WIPP Bin-Scale CH TRU Waste Test program described herein will provide relevant composition and kinetic rate data on gas generation and consumption resulting from TRU waste degradation, as impacted by synergistic interactions due to multiple degradation modes, waste form preparation, long-term repository environmental effects, engineered barrier materials, and, possibly, engineered modifications to be developed. Similar data on waste-brine leachate compositions and potentially hazardous volatile organic compounds released by the wastes will also be provided. The quantitative data output from these tests and associated technical expertise are required by the WIPP Performance Assessment (PA) program studies, and for the scientificmore » benefit of the overall WIPP project. This Test Plan describes the necessary scientific and technical aspects, justifications, and rational for successfully initiating and conducting the WIPP Bin-Scale CH TRU Waste Test program. This Test Plan is the controlling scientific design definition and overall requirements document for this WIPP in situ test, as defined by Sandia National Laboratories (SNL), scientific advisor to the US Department of Energy, WIPP Project Office (DOE/WPO). 55 refs., 16 figs., 19 tabs.« less

The Asia-RiCE activity with data cube

NASA Astrophysics Data System (ADS)

Oyoshi, K.; Sobue, S.; LE Toan, T.; Lam, N. D.

2017-12-01

The Asia-RiCE initiative (http://www.asia-rice.org) has been organized to enhance rice production estimates through the use of Earth observation satellites data, and seeks to ensure that Asian rice crops are appropriately represented within GEO Global Agriculture Monitoring (GEO-GLAM) to support FAO Agriculture Market Information System (FAO-AMIS). Asia-RiCE is composed of national teams that are actively contributing to the Crop Monitor for AMIS and developing technical demonstrations of rice crop monitoring activities using both Synthetic Aperture Radar (SAR) data (Radarsat-2 from 2013; Sentinel-1 and ALOS-2 from 2015.From 2016 after the successful rice crop area and growing estimation using SAR in a technical demonstration site (provincial level), wall-to-wall (national scale) excurse as phase 2 has been implemented in Vietnam and Indonesia in cooperation with ministry of agriculture and space agencies. This paper reports this year activity of 2017 accomplishment and way forward, especially for analysis ready data (ARD) definition of SAR to ingest to CEOS data cube to provide national scale service in Vietnam and Indonesia.

Inner-City Energy and Environmental Education Consortium

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

Not Available

1993-06-11

The numbers of individuals with adequate education and training to participate effectively in the highly technical aspects of environmental site cleanup are insufficient to meet the increasing demands of industry and government. Young people are particularly sensitive to these issues and want to become better equipped to solve the problems which will confront them during their lives. Educational institutions, on the other hand, have been slow in offering courses and curricula which will allow students to fulfill these interests. This has been in part due to the lack of federal funding to support new academic programs. This Consortium has beenmore » organized to initiate focused educational effort to reach inner-city youth with interesting and useful energy and environmental programs which can lead to well-paying and satisfying careers. Successful Consortium programs can be replicated in other parts of the nation. This report describes a pilot program in Washington, DC, Philadelphia, and Baltimore with the goal to attract and retain inner-city youth to pursue careers in energy-related scientific and technical areas, environmental restoration, and waste management.« less

Ethical questions must be considered for electronic health records.

PubMed

Spriggs, Merle; Arnold, Michael V; Pearce, Christopher M; Fry, Craig

2012-09-01

National electronic health record initiatives are in progress in many countries around the world but the debate about the ethical issues and how they are to be addressed remains overshadowed by other issues. The discourse to which all others are answerable is a technical discourse, even where matters of privacy and consent are concerned. Yet a focus on technical issues and a failure to think about ethics are cited as factors in the failure of the UK health record system. In this paper, while the prime concern is the Australian Personally Controlled Electronic Health Record (PCEHR), the discussion is relevant to and informed by the international context. The authors draw attention to ethical and conceptual issues that have implications for the success or failure of electronic health records systems. Important ethical issues to consider as Australia moves towards a PCEHR system include: issues of equity that arise in the context of personal control, who benefits and who should pay, what are the legitimate uses of PCEHRs, and how we should implement privacy. The authors identify specific questions that need addressing.

A Study of the Talent Training Project Management for Semiconductor Industry in Taiwan: The Application of a Hybrid Data Envelopment Analysis Approach

PubMed Central

Kao, Ling-Jing; Chiu, Shu-Yu; Ko, Hsien-Tang

2014-01-01

The purpose of this study is to evaluate the training institution performance and to improve the management of the Manpower Training Project (MTP) administered by the Semiconductor Institute in Taiwan. Much literature assesses the efficiency of an internal training program initiated by a firm, but only little literature studies the efficiency of an external training program led by government. In the study, a hybrid solution of ICA-DEA and ICA-MPI is developed for measuring the efficiency and the productivity growth of each training institution over the period. The technical efficiency change, the technological change, pure technical efficiency change, scale efficiency change, and the total factor productivity change were evaluated according to five inputs and two outputs. According to the results of the study, the training institutions can be classified by their efficiency successfully and the guidelines for the optimal level of input resources can be obtained for each inefficient training institution. The Semiconductor Institute in Taiwan can allocate budget more appropriately and establish withdrawal mechanisms for inefficient training institutions. PMID:24977192

Data Publication: The Evolving Lifecyle

NASA Astrophysics Data System (ADS)

Studwell, S.; Elliott, J.; Anderson, A.

2015-12-01

Datasets are recognized as valuable information entities in their own right that, now and in the future, need to be available for citation, discovery, retrieval and reuse. The U.S. Department of Energy's Office of Scientific and Technical Information (OSTI) provides Digital Object Identifiers (DOIs) to DOE-funded data through partnership with DataCite. The Geothermal Data Repository (GDR) has been using OSTI's Data ID Service since summer, 2014 and is a success story for data publishing in several different ways. This presentation attributes the initial success to the insistence of DOE's Geothermal Technologies Office on detailed planning, robust data curation, and submitter participation. OSTI widely disseminates these data products across both U.S. and international platforms and continually enhances the Data ID Service to facilitate better linkage between published literature, supplementary data components, and the underlying datasets within the structure of the GDR repository. Issues of granularity in DOI assignment, the role of new federal government guidelines on public access to digital data, and the challenges still ahead will be addressed.

Office of River Protection Advanced Low-Activity Waste Glass Research and Development Plan

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

Kruger, A. A.; Peeler, D. K.; Kim, D. S.

2015-11-23

The U.S. Department of Energy Office of River Protection (ORP) has initiated and leads an integrated Advanced Waste Glass (AWG) program to increase the loading of Hanford tank wastes in glass while meeting melter lifetime expectancies and process, regulatory, and product performance requirements. The integrated ORP program is focused on providing a technical, science-based foundation for making key decisions regarding the successful operation of the Hanford Tank Waste Treatment and Immobilization Plant (WTP) facilities in the context of an optimized River Protection Project (RPP) flowsheet. The fundamental data stemming from this program will support development of advanced glass formulations, keymore » product performance and process control models, and tactical processing strategies to ensure safe and successful operations for both the low-activity waste (LAW) and high-level waste vitrification facilities. These activities will be conducted with the objective of improving the overall RPP mission by enhancing flexibility and reducing cost and schedule.« less

The impact of Chagas disease control in Latin America: a review.

PubMed

Dias, J C P; Silveira, A C; Schofield, C J

2002-07-01

Discovered in 1909, Chagas disease was progressively shown to be widespread throughout Latin America, affecting millions of rural people with a high impact on morbidity and mortality. With no vaccine or specific treatment available for large-scale public health interventions, the main control strategy relies on prevention of transmission, principally by eliminating the domestic insect vectors and control of transmission by blood transfusion. Vector control activities began in the 1940s, initially by means of housing improvement and then through insecticide spraying following successful field trials in Brazil (Bambui Research Centre), with similar results soon reproduced in São Paulo, Argentina, Venezuela and Chile. But national control programmes only began to be implemented after the 1970s, when technical questions were overcome and the scientific demonstration of the high social impact of Chagas disease was used to encourage political determination in favour of national campaigns (mainly in Brazil). Similarly, large-scale screening of infected blood donors in Latin America only began in the 1980s following the emergence of AIDS. By the end of the last century it became clear that continuous control in contiguous endemic areas could lead to the elimination of the most highly domestic vector populations - especially Triatoma infestans and Rhodnius prolixus - as well as substantial reductions of other widespread species such as T. brasiliensis, T. sordida, and T. dimidiata, leading in turn to interruption of disease transmission to rural people. The social impact of Chagas disease control can now be readily demonstrated by the disappearance of acute cases and of new infections in younger age groups, as well as progressive reductions of mortality and morbidity rates in controlled areas. In economic terms, the cost-benefit relationship between intervention (insecticide spraying, serology in blood banks) and the reduction of Chagas disease (in terms of medical and social care and improved productivity) is highly positive. Effective control of Chagas disease is now seen as an attainable goal that depends primarily on maintaining political will, so that the major constraints involve problems associated with the decentralisation of public health services and the progressive political disinterest in Chagas disease. Counterbalancing this are the political and technical cooperation strategies such as the "Southern Cone Initiative" launched in 1991. This international approach, coordinated by PAHO, has been highly successful, already reaching elimination of Chagas disease transmission in Uruguay, Chile, and large parts of Brazil and Argentina. The Southern Cone Initiative also helped to stimulate control campaigns in other countries of the region (Paraguay, Bolivia, Peru) which have also reached tangible regional successes. This model of international activity has been shown to be feasible and effective, with similar initiatives developed since 1997 in the Andean Region and in Central America. At present, Mexico and the Amazon Region remain as the next major challenges. With consolidation of operational programmes in all endemic countries, the future focus will be on epidemiological surveillance and care of those people already infected. In political terms, the control of Chagas disease in Latin America can be considered, so far, as a victory for international scientific cooperation, but will require continuing political commitment for sustained success.

Mechanical Thrombectomy of Occluded Hemodialysis Native Fistulas and Grafts Using a Hydrodynamic Thrombectomy Catheter: Preliminary Experience

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

Sahni, Vikram, E-mail: vassahni@hotmail.com; Kaniyur, Sunil; Malhotra, Anmol

2005-12-15

The purpose of this study was to evaluate the efficacy and safety of a new hydrodynamic percutaneous thrombectomy catheter in the treatment of thrombosed hemodialysis fistulas and grafts. Twenty-two patients (median age: 47 years; range: 31-79 years) underwent mechanical thrombectomy for thrombosed hemodialysis fistulas or polytetrafluoroethylene (PTFE) grafts. In all cases, an Oasis hydrodynamic catheter was used. Five patients had native fistulas and 17 had PTFE grafts. Six patients required repeat procedures. All patients with native fistulas and 15 of the 17 with PTFE grafts also underwent angioplasty of the venous limb following the thrombectomy. Major outcome measures included technicalmore » success, clinical success, primary and secondary patency, and complication rates. Twenty-eight procedures were performed in total. The technical success rate was 100% and 90% and clinical success was 86% and 76% for native fistulas and grafts, respectively. The primary patency at 6 months was 50% and 59% for fistulas and grafts, respectively, and the secondary patency at 6 months was 75% and 70% for fistulas and grafts, respectively. Two patients died of unrelated causes during the follow-up period. The Oasis catheter is an effective mechanical device for the percutaneous treatment of thrombosed hemodialysis access. Our initial success rate showed that the technique is safe in the treatment of both native fistulas and grafts.« less

Succession planning for technical experts

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

Kirk, Bernadette Lugue; Cain, Ronald A.; Dewji, Shaheen A.

This report describes a methodology for identifying, evaluating, and mitigating the loss of key technical skills at nuclear operations facilities. The methodology can be adapted for application within regulatory authorities and research and development organizations, and can be directly applied by international engagement partners of the Department of Energy’s National Nuclear Security Administration (NNSA). The resultant product will be of direct benefit to two types of NNSA missions: (1) domestic human capital development programs tasked to provide focused technical expertise to succeed an aging nuclear operations workforce, and (2) international safeguards programs charged with maintaining operational safeguards for developing/existing nuclearmore » power program in nations where minimal available resources must be used effectively. This report considers succession planning and the critical skills necessary to meet an institution’s goals and mission. Closely tied to succession planning are knowledge management and mentorship. In considering succession planning, critical skill sets are identified and are greatly dependent on the subject matter expert in question. This report also provides examples of critical skills that are job specific.« less

Empiric transcatheter arterial embolization for massive bleeding from duodenal ulcers: efficacy and complications.

PubMed

Ichiro, Ikushima; Shushi, Higashi; Akihiko, Ishii; Yasuhiko, Iryo; Yasuyuki, Yamashita

2011-07-01

To evaluate the efficacy and safety of empiric transcatheter arterial embolization (TAE) for patients with massive bleeding from duodenal ulcers. During January 2000 and December 2009, 59 patients with duodenal ulcer bleeding in whom TAE was attempted after endoscopic therapy failed were retrospectively analyzed. The patients were divided into empiric TAE (n = 36) and identifiable TAE (n = 23) groups according to angiographic findings with or without identification of the bleeding sites. The technical and clinical success rate, recurrent bleeding rate, procedure-related complications, and clinical outcomes were evaluated. The technical and clinical success rates of TAE were 100% and 83%. The recurrent bleeding rate, clinical success, duodenal stenosis, and 30-day mortality after TAE were not significantly different between the empiric and identifiable TAE groups. A high rate of technical and clinical success was obtained with empiric TAE comparable to identifiable TAE in patients with massive bleeding from duodenal ulcers. There were no severe complications. Empiric TAE is an effective and safe method when a bleeding site cannot determined by angiography. Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.

Expanding Access to Vocational-Technical Education in Massachusetts. White Paper No. 136

ERIC Educational Resources Information Center

Ardon, Ken; Fraser, Alison L.

2015-01-01

It is clear from assessment, graduation, and follow-up data that career-vocational technical education (CVTE), as it is practiced in Massachusetts, is a success. CVTE is becoming so popular that there are up to 5,000 more applicants for places in Massachusetts' vocational technical schools than there are openings, creating waiting lists. This…

University-government relationships in the training of technical writers-editors

NASA Technical Reports Server (NTRS)

Stohrer, Freda F.; Pinelli, Thomas E.

1979-01-01

Traditional and nontraditional methods of training technical writers-editors are reviewed. Combining work experience with classroom instruction in the form of cooperative education provides a method of strengthening the Federal career service in professional occupations. The NASA Langley experience that successfully introduced students to the special demands of technical writing and editing is described.

A Study of Relationships Between Student Scores on Various Predictor Measures and Vocational Success of Students Who Were Followed Up One and Five Years Following Training in Selected Private Trade, Technical, and Business Schools.

ERIC Educational Resources Information Center

Cox, Steven Grahn

The primary purpose of this study was to investigate the relationships which exist between various predictor measures obtained on students while in training at private post-high school trade, technical, and business schools and a particular global definition of vocational success. The data were collected from 518 students who responded to mailed…

30 CFR 700.12 - Petitions to initiate rulemaking.

Code of Federal Regulations, 2010 CFR

2010-07-01

... statement of the facts, technical justification, and law which require issuance, amendment, or repeal of a... of the petition, the Director shall determine if the petition sets forth facts, technical.... Facts, technical justification or law previously considered in a petition or rulemaking on the same...

US-Guided, Direct Puncture Retrograde Thoracic Duct Access, Lymphangiography, and Embolization: Feasibility and Efficacy.

PubMed

Guevara, Carlos J; Rialon, Kristy L; Ramaswamy, Raja S; Kim, Seung K; Darcy, Michael D

2016-12-01

To describe technical details, success rate, and advantages of direct puncture of the thoracic duct (TD) under direct ultrasound (US) guidance at venous insertion in the left neck. All patients who underwent attempted thoracic duct embolization (TDE) via US-guided retrograde TD access in the left neck were retrospectively reviewed. Indications for lymphangiography were iatrogenic chyle leak, pulmonary lymphangiectasia, and plastic bronchitis. Ten patients with mean age 41.4 years (range, 21 d to 72 y) underwent US-guided TD access via the left neck. Technical details, procedural times, and clinical outcomes were evaluated. TD access time was defined as time from start of procedure to successful access of TD, and total procedural time was defined from start of procedure until TDE. All attempts at TD access via the neck were successful. Technical and clinical success of TDE was 60%. There were no complications. Mean TD access time was 17 minutes (range, 2-47 min), and mean total procedure time was 49 minutes (range, 25-69 min). Mean follow-up time was 5.4 months (range, 3-10 months). TDE via US-guided access in the left neck is technically feasible and safe with a potential decrease in procedure time and elimination of oil-based contrast material. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

Open Archives Initiative (OAI) Services | OSTI, US Dept of Energy Office of

Science.gov Websites

Scientific and Technical Information skip to main content Sign In Create Account OSTI.GOV title logo U.S. Department of Energy Office of Scientific and Technical Information Search terms: Advanced Sign In Create Account This page is being shared by OSTI.GOV. Open Archives Initiative (OAI) Services

The NASA Scientific and Technical Information (STI) Program's Implementation of Open Archives Initiative (OAI) for Data Interoperability and Data Exchange.

ERIC Educational Resources Information Center

Rocker, JoAnne; Roncaglia, George J.; Heimerl, Lynn N.; Nelson, Michael L.

Interoperability and data-exchange are critical for the survival of government information management programs. E-government initiatives are transforming the way the government interacts with the public. More information is to be made available through Web-enabled technologies. Programs such as the NASA's Scientific and Technical Information (STI)…

An English Language Curriculum for Technical Students. Practical Papers in English Education, Volume 2.

ERIC Educational Resources Information Center

Hutchinson, Tom; And Others

This curriculum for technical students aims at linking the identity of the learner, his initial linguistic and technical competence, and his expectations with the competence expected of him on entering the technical college. The materials of the curriculum make use of a wide variety of information and data sources such as school-level science…

Ultrasound-guided axillary nerve block for ED incision and drainage of deltoid abscess.

PubMed

Lyons, Claire; Herring, Andrew A

2017-07-01

Deltoid abscesses are common and painful, often a consequence of injection drug use and seen frequently in emergency departments (EDs). The required incision and drainage can be completed successfully with effective pain relief using a peripheral nerve block. The brachial plexus nerve block works well, however it is technically complex with a low, but potentially serious, risk of complications such as phrenic nerve paralysis. Selective blockade of the axillary nerve eliminates the risks associated with a brachial plexus block, while providing more specific anesthesia for the deltoid region. Our initial experience suggests that the axillary nerve block (ANB) is a technically simple, safe, and effective way to manage the pain of deltoid abscesses and the necessary incision and drainage (I&D). The block involves using ultrasound guidance to inject a 20mL bolus of local anesthetic into the quadrangular space surrounding the axillary nerve (inferior to the posterolateral aspect of the acromion, near the overlap of the long head of triceps brachii and teres minor). Once injected the local will anesthetize the axillary nerve resulting in analgesia of the cutaneous area of the lateral shoulder and the deeper tissues including the deltoid muscle. Further research will clarify questions about the volume and concentration of local anesthetic, the role of injected adjuncts, and expected duration of analgesia and anesthesia. Herein we present a description of an axillary nerve block successfully used for deltoid abscess I&D in the ED. Copyright © 2017 Elsevier Inc. All rights reserved.

Percutaneous endoscopic sigmoid colostomy for irrigation in the management of bowel dysfunction of adults with central neurologic disease.

PubMed

Ramwell, A; Rice-Oxley, M; Bond, A; Simson, J N L

2011-10-01

Bowel dysfunction results in a major lifestyle disruption for many patients with severe central neurologic disease. Percutaneous endoscopic sigmoid colostomy for irrigation (PESCI) allows antegrade irrigation of the distal large bowel for the management of both incontinence and constipation. This study prospectively assessed the safety and efficacy of PESCI. A PESCI tube was placed endoscopically in the sigmoid colon of 25 patients to allow antegrade irrigation. Control of constipation and fecal incontinence was improved for 21 (84%) of the 25 patients. These patients were followed up for 6-83 months (mean, 43 months), with long-term success for 19 (90%) of the patients. No PESCI had to be removed for technical reasons or for PESCI complications. Late removal of the PESCI was necessary for 2 of the 21 patients. A modified St. Marks Fecal Incontinence Score to assess bowel function before and after PESCI showed a highly significant improvement (P < 0.0001). There were no procedure-related deaths. Complications included minor sepsis at the initial PESCI tube site in four patients and bumper migration in two patients, but there were no complications related to the button device. This study showed that PESCI is a simple, safe, and effective technique for distal antegrade irrigation in the management bowel dysfunction for selected patients with central neurologic disease. A successful PESCI is very likely to continue functioning satisfactorily for a long time without technical problems or local complications.

Covered Biodegradable Stent: New Therapeutic Option for the Management of Esophageal Perforation or Anastomotic Leak

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

Cerna, Marie; Koecher, Martin, E-mail: martin.kocher@seznam.cz; Valek, Vlastimil

2011-12-15

Purpose: This study was designed to evaluate our experience with the treatment of postoperative anastomotic leaks and benign esophageal perforations with covered biodegradable stents. Materials and Methods: From 2008 to 2010, we treated five men with either an anastomotic leak or benign esophageal perforation by implanting of covered biodegradable Ella-BD stents. The average age of the patients was 60 (range, 38-74) years. Postoperative anastomotic leaks were treated in four patients (1 after esophagectomy, 1 after resection of diverticulum, 2 after gastrectomy). In one patient, perforation occurred as a complication of the treatment of an esophageal rupture (which occurred during amore » balloon dilatation of benign stenosis) with a metallic stent. Results: Seven covered biodegradable stents were implanted in five patients. Primary technical success was 100%. Clinical success (leak sealing) was achieved in four of the five patients (80%). Stent migration occurred in three patients. In two of these patients, the leak had been sealed by the time of stent migration, therefore no reintervention was necessary. In one patient an additional stent had to be implanted. Conclusion: The use of biodegradable covered stents for the treatment of anastomotic leaks or esophageal perforations is technically feasible and safe. The initial results are promising; however, larger number of patients will be required to evaluate the capability of these biodegradable stents in the future. The use of biodegradable material for coverage of the stent is essential.« less

Lumen-apposing covered self-expandable metal stents for short benign gastrointestinal strictures: a multicenter study.

PubMed

Yang, Dennis; Nieto, Jose M; Siddiqui, Ali; Riff, Brian P; DiMaio, Christopher J; Nagula, Satish; Ismail, Amr M; Ngamreungphong, Saowanee; Khashab, Mouen A; Wagh, Mihir S; Tzimas, Demetrios; Buscaglia, Jonathan M; Strand, Daniel S; Wang, Andrew Y; Chauhan, Shailendra S; Forsmark, Christopher E; Draganov, Peter V

2017-04-01

Background and study aim  Use of the fully covered self-expandable metal stent (SEMS) for benign luminal gastrointestinal (GI) stricture (BLGS) has been limited by the migration rate. The role of the lumen-apposing metal stent (LAMS) for BLGS is not well defined. We assessed the safety, feasibility, and efficacy of LAMS for the treatment of BLGS. Patients and methods  This was an observational, open-label, retrospective, single-arm, multicenter consecutive case series of patients undergoing LAMS placement for BLGS. Technical success was defined as successful placement of the LAMS. Short- and long-term clinical success rates were defined as symptom improvement/resolution with indwelling stent and after stent removal, respectively. All adverse events and additional interventions were recorded. Results  A total of 30 patients (mean age 51.6 years; 63.3 % women) underwent LAMS placement for GI strictures (83.9 % anastomotic). Median stricture diameter and length were 4.5 mm (range 2 - 10 mm) and 8 mm (range 5 - 10 mm), respectively. Technical success was achieved in 29 patients (96.7 %), with an adverse event rate of 13.3 %. The stent migration rate was 8.0 % (2/25) on follow-up endoscopy. Short-term clinical success was achieved in 90.0 % (27/30) at a median of 60 days (interquartile range [IQR] 40 - 90 days). Most patients (19/23; 82.6 %) experienced sustained symptom improvement/resolution without the need for additional interventions at a median follow-up of 100 days (IQR 60 - 139 days) after LAMS removal. Conclusion  This multicenter study demonstrated that LAMS placement represents a safe, feasible, and effective therapeutic option for patients with BLGS and is associated with a low stent migration rate. Our initial findings suggest that future prospective comparative studies are needed on the use of LAMS, endoscopic dilation, and conventional SEMS. . © Georg Thieme Verlag KG Stuttgart · New York.

Surgery or EUS-guided choledochoduodenostomy for malignant distal biliary obstruction after ERCP failure

PubMed Central

Artifon, Everson L.A.; Loureiro, Jarbas F.; Baron, Todd H.; Fernandes, Kaie; Kahaleh, Michel; Marson, Fernando P.

2015-01-01

Background and Objectives: Endoscopic retrograde cholangiopancreatography (ERCP) is the method of choice for drainage in patients with distal malignant biliary obstruction, but it fails in up to 10% of cases. Percutaneous transhepatic cholangiography (PTC) and surgical bypass are the traditional drainage alternatives. This study aimed to compare technical and clinical success, quality of life, and survival of surgical biliary bypass or hepaticojejunostomy (HJT) and endoscopic ultrasound (EUS)-guided choledochoduodenostomy (CDT) in patients with distal malignant bile duct obstruction and failed ERCP. Patients and Methods: A prospective, randomized trial was conducted. From March 2011 to September 2013, 32 patients with malignant distal biliary obstruction and failed ERCP were studied. The HJT group consisted of 15 patients and the CDT group consisted of 14 patients. Technical and clinical success, quality of life, and survival were assessed prospectively. Results: Technical success was 94% (15/16) in the HJT group and 88% (14/16) in the CDT group (P = 0.598). Clinical success occurred in 14 (93%) patients in the HJT group and in 10 (71%) patients in the CDT group (P = 0.169). During follow-up, a statistically significant difference was seen in mean functional capacity scores, physical health, pain, social functioning, and emotional and mental health aspects in both techniques (P < 0.05). The median survival time in both groups was the same (82 days). Conclusion: Data relating to technical and clinical success, quality of life, and survival were similar in patients who underwent HJT and CDT drainage after failed ERCP for malignant distal biliary obstruction. PMID:26374583

Retrograde Transpedal Access for Revascularization of Below-the-Knee Arteries in Patients with Critical Limb Ischemia after an Unsuccessful Antegrade Transfemoral Approach.

PubMed

Goltz, J P; Planert, M; Horn, M; Wiedner, M; Kleemann, M; Barkhausen, J; Stahlberg, E

2016-10-01

To evaluate the safety and technical and clinical success of endovascular below-the-knee (BTK) artery revascularization by a retrograde transpedal access. We retrospectively identified 16/172 patients (9.3 %) with endovascular BTK revascularization in whom a transfemoral approach had failed and transpedal access had been attempted. The dorsal pedal (n = 13) or posterior tibial (n = 3) artery was accessed using a dedicated access set and ultrasound guidance. The procedure was finished in antegrade fashion by plain old balloon angioplasty (POBA). Comorbidities, vessel diameter and calcification at the access site were recorded. The analyzed outcomes were technical success, procedural complications, procedure time, crossing (guidewire beyond lesion and intra-luminal) and procedural (residual stenosis < 30 % after POBA) success, and limb salvage. Diabetes, coronary artery disease and hypertension were present in 15 patients (93.8 %), and both renal impairment and previous amputations in 7 (43.8 %). Pedal access vessel calcification was present in 5/16 patients (31.3 %). The mean diameter was 1.75 +/-0.24 mm. The procedure time was 92.4 +/-23 min. The success rate for achieving retrograde access was 100 %. Retrograde crossing was successful in 12/16 patients (75.0 %). Procedural success was observed in 10/16 patients (68.8 %). Minor complications occurred in 2/16 patients (12.5 %). The rate of limb salvage was 72.9 %, and the overall survival was 100 % at 12 months. Major amputations after revascularization occurred in 2/16 patients (12.5 %). If an antegrade transfemoral approach to BTK lesions fails, a retrograde transpedal approach may nevertheless facilitate treatment. This approach appears to be safe and offers high technical and acceptable clinical success rates. • Retrograde approaches via transpedal or transtibial vessels are safe and offer high technical success.• One problem after technically successful puncture might be the re-entry following subintimal retrograde lesion crossing.• After a failed attempt at antegrade revascularization of a BTK occlusion, a retrograde approach should be performed. Citation Format: • Goltz JP, Planert M, Horn M et al. Retrograde Transpedal Access for Revascularization of Below-the-Knee Arteries in Patients with Critical Limb Ischemia after an Unsuccessful Antegrade Transfemoral Approach. Fortschr Röntgenstr 2016; 188: 940 - 948. © Georg Thieme Verlag KG Stuttgart · New York.

Polio eradication initiative in India: deconstructing the GPEI.

PubMed

Sathyamala, C; Mittal, Onkar; Dasgupta, Rajib; Priya, Ritu

2005-01-01

The Global Polio Eradication Initiative (GPEI) promised eradication of polio by the year 2000 and certification of eradication by 2005. The first deadline is already a matter of history. With the reporting of polio cases in 2004, the new deadline for polio eradication by 2004 is postponed further. This article seeks to argue that the scientific and technical bodies spear-heading the GPEI, including the WHO, UNICEF, and the U.S. Centers for Disease Control, have formulated a conceptually flawed strategy and that it is not weak political will that is the central obstacle in this final push for global eradication. The validity of the claims of "near success" by the proponents of the GPEI is also examined in detail. By taking India as a case study, the authors examine the achievements of the GPEI in nine years of intense effort since 1995. They conclude that the GPEI is yet another exercise in mismanaging the health priorities and programs in developing countries in the era of globalization.

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

Nichols, Teresa A.; Lapsa, Melissa Voss

Oak Ridge National Laboratory (ORNL) is both the largest science and energy laboratory of the US Department of Energy (DOE) and one of the oldest national laboratories still operating at its original site. These characteristics provide the Sustainable Campus Initiative (SCI) both a unique opportunity and a unique challenge to integrate sustainability into facilities and activities. As outlined in this report, SCI is leveraging the outcomes of ORNL’s DOE-sponsored research and development programs to maximize the efficient use of energy and natural resources across ORNL. Wherever possible, ORNL is integrating technical innovations into new and existing facilities, systems, and processesmore » with a widespread approach to achieving Executive Order 13514. ORNL continues to pursue and deploy innovative solutions and initiatives to advance regional, national, and worldwide sustainability and continues to transform its culture and engage employees in supporting sustainability at work, at home, and in the community. Table 1 summarizes ORNL's FY 2013 performance and planned actions to attain future goals. ORNL has achieved numerous successes during FY 2013, which are described in detail throughout this document.« less

48 CFR 2415.305 - Proposal evaluation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... technical portion of each proposal to the TEP Chairperson or his or her designee. The cost/price portion of each proposal shall be retained by the Contracting Officer pending initial technical evaluation by the TEP. (3) Technical evaluation. The TEP shall rate each proposal based on the evaluation factors...

47 CFR 24.415 - Technical content of applications; maintenance of list of station locations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... of list of station locations. 24.415 Section 24.415 Telecommunication FEDERAL COMMUNICATIONS... list of station locations. (a) All applications required by this part shall contain all technical... number of general technical requirements. (b) Each application (except applications for initial licenses...

47 CFR 24.415 - Technical content of applications; maintenance of list of station locations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... of list of station locations. 24.415 Section 24.415 Telecommunication FEDERAL COMMUNICATIONS... list of station locations. (a) All applications required by this part shall contain all technical... number of general technical requirements. (b) Each application (except applications for initial licenses...

47 CFR 24.415 - Technical content of applications; maintenance of list of station locations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... of list of station locations. 24.415 Section 24.415 Telecommunication FEDERAL COMMUNICATIONS... list of station locations. (a) All applications required by this part shall contain all technical... number of general technical requirements. (b) Each application (except applications for initial licenses...

47 CFR 24.415 - Technical content of applications; maintenance of list of station locations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... of list of station locations. 24.415 Section 24.415 Telecommunication FEDERAL COMMUNICATIONS... list of station locations. (a) All applications required by this part shall contain all technical... number of general technical requirements. (b) Each application (except applications for initial licenses...

47 CFR 24.415 - Technical content of applications; maintenance of list of station locations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... of list of station locations. 24.415 Section 24.415 Telecommunication FEDERAL COMMUNICATIONS... list of station locations. (a) All applications required by this part shall contain all technical... number of general technical requirements. (b) Each application (except applications for initial licenses...

Final Technical Report

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

Eggeman, Tim; O'Neill, Brian

2016-08-17

ZeaChem Inc. and US DOE successfully demonstrated the ZeaChem process for producing sugars and ethanol from high-impact biomass feedstocks. The project was executed over a 5-year period under a $31.25 million cooperative agreement (80:20 Federal:ZeaChem cost share). The project was managed by dividing it into three budget periods. Activities during Budget Period 1 were limited to planning, permitting, and other pre-construction planning. Budget Period 2 activities included engineering, procurement, construction, commissioning, start-up and initial operations through the Independent Engineer Test Runs. The scope of construction was limited to the Chem Frac and Hydrogenolysis units, as the Core Facility was alreadymore » in place. Construction was complete in December 2012, and the first cellulosic ethanol was produced in February 2013. Additional operational test runs were conducted during Budget Period 3 (completed June 2015) using hybrid poplar, corn stover, and wheat straw feedstocks, resulting in the production of cellulosic ethanol and various other biorefinery intermediates. The research adds to the understanding of the Chem Frac and Hydrogenolysis technologies in that the technical performance of each unit was measured, and the resulting data and operational experience can be used as the basis for engineering designs, thus mitigating risks for deployment in future commercial facilities. The Chem Frac unit was initially designed to be operated as two-stage dilute acid hydrolysis, with first stage conditions selected to remove the hemicellulose fraction of the feedstock, and the second stage conditions selected to remove the cellulose fraction. While the Chem Frac unit met or exceeded the design capacity of 10 ton(dry)/day, the technical effectiveness of the Chem Frac unit was below expectations in its initial two-stage dilute acid configuration. The sugars yields were low, the sugars were dilute, and the sugars had poor fermentability caused by excessive inhibitors from wood breakdown products, resulting in a non-viable process from an economic point of view. Later runs with the Chem Frac unit switched to a configuration that used dilute acid pretreatment followed by enzymatic hydrolysis. This change improved yield, increased sugar concentrations, and improved fermentability of sugars. The Hydrogenolysis unit met or exceeded all expectations with respect to unit capacity, technical performance, and economic performance. The US DOE funds for the project were provided through the American Recovery and Reinvestment Act of 2009. In addition to the scientific/technical merit of the project, this project benefited the public through the creation of approximately 75 onsite direct construction-related jobs, 25 direct on-going operations-related jobs, plus numerous indirect jobs, and thus was well aligned with the goals of the American Recovery and Reinvestment Act of 2009.« less

NATIONAL RESPONSE TEAM TECHNICAL ASSISTANCE ...

EPA Pesticide Factsheets

This document provides technical information on a wide range of activities to aid in response to intentional release of anthrax in urban environments. It includes initial actions when a potential release is discovered, health and safety issues for responders, sampling and analysis methods, decontamination technologies, decontamination waste disposal, and communication with public. This document provides technical information on a wide range of activities to aid in response to intentional release of anthrax in urban environments. It includes initial actions when a potential release is discovered, health and safety issues for responders, sampling and analysis methods, decontamination technologies, decontamination waste disposal, and communication with public.

Retrospective analysis of technical success rate and procedure-related complications of 867 percutaneous CT-guided needle biopsies of lung lesions.

PubMed

Mills, M; Choi, J; El-Haddad, G; Sweeney, J; Biebel, B; Robinson, L; Antonia, S; Kumar, A; Kis, B

2017-12-01

To investigate the technical success rate and procedure-related complications of computed tomography (CT)-guided needle biopsy of lung lesions and to identify the factors that are correlated with the occurrence of procedure-related complications. This was a single- institution retrospective study of 867 consecutive CT-guided needle biopsies of lung lesions performed on 772 patients in a tertiary cancer centre. The technical success rate and complications were correlated with patient, lung lesion, and procedure-related variables. The technical success rate was 87.2% and the mortality rate was 0.12%. Of the 867 total biopsies 25.7% were associated with pneumothorax, and 6.5% required chest tube drainage. The haemothorax rate was 1.8%. There was positive correlation between the development of pneumothorax and smaller lesion diameter (p<0.001), longer transparenchymal distance (p<0.001), and prone position (p=0.027). There was positive correlation between the need for chest tube placement and longer transparenchymal distance (p=0.007) and smaller lesion diameter (p=0.018). Lesions in the left lower lobe had the lowest rates of pneumothorax (p=0.008) and chest tube drainage (p=0.018). Patients whose pneumothoraces were diagnosed on the follow-up chest X-ray, but not on the immediate post-procedural CT scan had significantly higher requirement for chest tube drainage (p=0.039). CT-guided lung biopsy has a high rate of technical success and a low rate of major complications. The present study has revealed several variables that can be used to identify high-risk procedures. A post-procedural chest X-ray within hours after the procedure is highly recommended to identify high-risk patients who require chest tube placement. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Systematic review of recent evidence for the safety and efficacy of elective endovascular repair in the management of infrarenal abdominal aortic aneurysm.

PubMed

Drury, D; Michaels, J A; Jones, L; Ayiku, L

2005-08-01

Conventional management of abdominal aortic aneurysm (AAA) is by open repair and is associated with a mortality rate of 2-6 per cent. Endovascular aneurysm repair (EVAR) is an alternative technique first introduced in 1991. A systematic review was undertaken of the evidence for the safety and efficacy of elective EVAR in the management of asymptomatic infrarenal AAA. Thirteen electronic bibliographical databases were searched, covering biomedical, health-related, science and social science literature. Outcomes were assessed with respect to efficacy (successful deployment, technical success, conversion rates and secondary intervention rates) and safety (30-day mortality rate, procedure morbidity rates and technical issues-endoleaks, graft thrombosis, stenosis and migration). Of 606 reports identified, 61 met the inclusion criteria (three randomized and 15 non-randomized controlled trials, and 43 uncontrolled studies). There were 29 059 participants in total; 19,804 underwent EVAR. Deployment was successful in 97.6 per cent of cases. Technical success (complete aneurysm exclusion) was 81.9 per cent at discharge and 88.8 per cent at 30 days. Secondary intervention to treat endoleak or maintain graft patency was required in 16.2 per cent of patients. Mean stay in the intensive care unit and mean hospital stay were significantly shorter following EVAR. The 30-day mortality rate for EVAR was 1.6 per cent (randomized controlled trials) and 2.0 per cent in nonrandomized trials and case series. Technical complications comprised stent migration (4.0 per cent), graft limb thrombosis (3.9 per cent), endoleak (type I, 6.8 per cent; type II, 10.3 per cent; type III, 4.2 per cent) and access artery injury (4.8 per cent). EVAR is technically effective and safe, with lower short-term morbidity and mortality rates than open surgery. However, there is a need for extended follow-up as the long-term success of EVAR in preventing aneurysm-related deaths is not yet known.

Management of large bowel obstruction with self-expanding metal stents. A multicentre retrospective study of factors determining outcome.

PubMed

Geraghty, J; Sarkar, S; Cox, T; Lal, S; Willert, R; Ramesh, J; Bodger, K; Carlson, G L

2014-06-01

UK cancer guidelines recommend patients with colonic obstruction due to suspected malignancy be considered for stenting with a self-expanding metal stent (SEMS). Considerable variation in practice exists due to a lack of expertise, technical difficulties and other, as yet ill-defined features. This retrospective multi-centre study aims to determine the outcome following colonic stenting for large bowel obstruction and identify factors associated with successful intervention. A regional programme of colonic stenting for large bowel obstruction, in five UK centres from 2005 to 2010 was evaluated for outcome including technical and clinical success, survival, complications and reoperation. A SEMS was inserted in 334 patients, including 264 (79.0%) for palliation and 52 (15.6%) as a bridge to surgery. Technical success was achieved in 292 (87.4%) patients, with 46 (13.8%) experiencing a complication or technical failure. Reoperation was required in 39 (14.8%) patients stented for palliation of colorectal cancer of whom 16 (6.1%) subsequently required a colostomy. A one-stage primary anastomosis was achieved in 35 (67.3%) of the 52 patients undergoing stenting as a bridge to resection. Technical success did not vary by indication or site of obstruction (P = 0.60) but was higher for operators who had performed more than 10 procedures (OR 3.34, P = 0.001). ASA grade ≥3 predicted a worse clinical outcome (OR 0.43, P = 0.04). The through-the-scope (TTS) endoscopy technique was more successful than radiological placement alone (90.3% vs 74.8%, P < 0.001). Experienced operators using a TTS technique achieved a better outcome for the emergency management of large bowel obstruction. Older, sicker patients and those with extracolonic and benign strictures fared less well. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

Facet joint injections as a means of reducing the need for vertebroplasty in insufficiency fractures of the spine.

PubMed

Wilson, David J; Owen, Sara; Corkill, Rufus A

2011-08-01

Recent publications compared treatment of vertebral fractures reporting improvement in the majority but with no significant difference between the local anaesthetic and vertebroplasty groups. Potential explanations include placebo response or therapeutic response to the "control procedure". We investigated whether preliminary facet joint injection can identify those patients whose pain arises from paravertebral structures rather than the vertebral insufficiency fracture itself. Patients referred for treatment by vertebroplasty were first offered local anaesthetic and steroid facet joint injection (FJI) at the most painful level. Those who failed to respond were offered a vertebroplasty. Ninety one patients referred, 16 went straight to vertebroplasty. Sixty one of 75 were initially offered FJI. Twenty one were successful; two relapsed, had further FJIs with good results; three declined treatment; 5 had temporary benefit; 1 died from unrelated causes. Of 29 who failed to respond to FJIs, 24 underwent vertebroplasty and 23 had a successful outcome. A third of patients technically suitable for vertebroplasty responded beneficially to FJI. In this group the pain mediator maybe one of instability and overload on the facet joints produced by adjacent wedge fracture. This protocol allows more selective and more successful vertebroplasty.

Design and Requirements Creep In A Build-To-Print Mission

NASA Technical Reports Server (NTRS)

Peabody, Sharon A.; Otero, Veronica

2017-01-01

Build-to-Print designs, or rebuilds of flight proven designs, are attractive to mission stakeholders, as they give the appearance of minimal engineering development cost, risk, and schedule. The reality is that seldom is a project an exact duplicate of a predecessor. Mission reclassification, improvements in hardware, and science objective changes can all serve as a source of requirements and design creep and have ramifications often not fully anticipated during initial proposals. The Thermal Infrared Sensor Instrument (TIRS) was a late addition to the LandSat-8 program to provide infrared imaging to measure evapotranspiration for water cycle management. To meet the launch requirements for LandSat-8, instrument design life requirements were relaxed, the sensor development expedited, and technology development was minimized. Consequently, TIRS was designed as a higher risk instrument, with less redundancy than an instrument critical to mission success. After the successful LandSat-8 launch in 2013 and instrument performance, a rebuild of the instrument for the next LandSat spacecraft was included in the baseline mission success criteria. This paper discusses the technical challenges encountered during the rebuild of the TIRS-2 (Thermal Infrared Sensor 2) instrument and the resultant impacts on the thermal system design.

Attributes of Successful Actions to Restore Lakes and ...

EPA Pesticide Factsheets

As more success is achieved in restoring lakes and estuaries from the impacts of nutrient pollution, there is increased opportunity to evaluate the scientific, social, and policy factors associated with achieving restoration goals. We examined case studies where deliberate actions to reduce nutrient pollution and restore ecosystems resulted in ecological recovery. Prospective cases were identified from scientific literature and technical documents for lakes and estuaries with: (1) scientific evidence of nutrient pollution; (2) restoration actions taken to mitigate nutrient pollution; and (3) documented ecologicalimprovement. Using these criteria, we identified 9 estuaries and 7 lakes spanning countries, climatic regions, physical types, depths, and watershed areas. Among 16 case studies ultimately included, 8 achieved improvements short of stated restoration goals. Five more were successful initially, but condition subsequently declined. Three of the case studies achieved their goals fully and are currently managing to maintain the restored condition. We examined each case to identify both common attributesof nutrient management, grouped into ‘themes’, and variations on those attributes, which were coded into categorical variables based on thorough review of documents associated with each case. The themes and variables were organized into a broad conceptual model illustrating how they relate to each other and to nutrient management outcomes. We then explored

A subperiosteal maxillary implant causing severe osteolysis.

PubMed

Maï, Nguyen Tan; Jean-Baptiste, Caruhel; Hossein, Khonsari Roman

2018-06-22

Subperiosteal implant denture therapy was initially introduced in 1942 in Sweden and was then used worldwide for the treatment of fully edentulous maxillary or mandibular arches with advanced bone atrophy. Most authors describe decent success rates for mandibular subperiosteal implants in cases with major bone atrophy but follow-up studies for maxillary subperiosteal implants are not available. Here, we report a case of severe maxillary osteolysis secondary to the placement of a subperiosteal in-house implant. Subperiosteal implants are rarely used today but patients still carrying these devices with severe complications can be challenging to manage. New technical advances, including the use of surgical planification and additive manufacturing, may lead to a new interest in subperiosteal implants. Copyright © 2018. Published by Elsevier Masson SAS.

Two Micron Laser Technology Advancements at NASA Langley Research Center

NASA Technical Reports Server (NTRS)

Singh, Upendra N.

2010-01-01

An Independent Laser Review Panel set up to examine NASA s space-based lidar missions and the technology readiness of lasers appropriate for space-based lidars indicated a critical need for an integrated research and development strategy to move laser transmitter technology from low technical readiness levels to the higher levels required for space missions. Based on the review, a multiyear Laser Risk Reduction Program (LRRP) was initiated by NASA in 2002 to develop technologies that ensure the successful development of the broad range of lidar missions envisioned by NASA. This presentation will provide an overview of the development of pulsed 2-micron solid-state laser technologies at NASA Langley Research Center for enabling space-based measurement of wind and carbon dioxide.

Centennial Challenges Program

NASA Technical Reports Server (NTRS)

Ortega, Sam; Eberly, Eric

2015-01-01

NASA's Centennial Challenges Program was initiated in 2005 to directly engage the public in the process of advanced technology development. The program offers incentive prizes to generate revolutionary solutions to problems of interest to NASA and the nation. The program seeks innovations from diverse and nontraditional sources. Competitors are not supported by government funding and awards are only made to successful teams when the challenges are met. In keeping with the spirit of the Wright Brothers and other American innovators, the Centennial Challenge prizes are offered to independent inventors including small businesses, student groups, and individuals. These independent inventors are sought to generate innovative solutions for technical problems of interest to NASA and the nation and to provide them with the opportunity to stimulate or create new business ventures.

Promoting family planning through women's development.

PubMed

Gulhati, K

1986-12-01

Private initiatives in developing countries have been successful in increasing women's desire for family planning by enabling them to earn more income. These approaches have incorporated a woman-to-woman strategy in which women train others not only in how to earn an income from producing and marketing products, but also in the skills needed to establish and manage their own organizations. Private voluntary organizations play an especially crucial role in training project managers. The Center for Development and Population Activities, for example, has held 19 Women in Management workshops and channels funds and technical assistance for projects in health, family planning, nutrition, and income generation. Women who move from managerial to policymaking positions are most able to help other women raise their political, social, and economic status.

Examination of Faculty Expectations of Technical College Administrators as an Important Factor in High Performing Environments

ERIC Educational Resources Information Center

Dupuis, Phyllis A.

2009-01-01

Popular thought supports the notion that faculty expectations of technical college administrators appear to be linked to the success or failure of an institution at accomplishing its mission. These expectations provide the basis for the development of relationships that foster the growth of technical training and thus the growth of a skilled…

Integrated Technical Curriculum. Curriculum Developed for Project Second Chance II: Tech Reading, Tech Science, Tech Math, Automotive.

ERIC Educational Resources Information Center

Sorensen, Mary K.; And Others

This integrated technical curriculum is designed to enroll and retain adult high school noncompleters in occupational programs by providing them with the remedial and content-area reading instruction needed for success in an automotive program. The following topics are covered in the four units: (1) skills for reading technical materials (basics…

Laboratory Directed Research and Development 1998 Annual Report

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

Pam Hughes; Sheila Bennett eds.

1999-07-14

The Laboratory's Directed Research and Development (LDRD) program encourages the advancement of science and the development of major new technical capabilities from which future research and development will grow. Through LDRD funding, Pacific Northwest continually replenishes its inventory of ideas that have the potential to address major national needs. The LDRD program has enabled the Laboratory to bring to bear its scientific and technical capabilities on all of DOE's missions, particularly in the arena of environmental problems. Many of the concepts related to environmental cleanup originally developed with LDRD funds are now receiving programmatic support from DOE, LDRD-funded work inmore » atmospheric sciences is now being applied to DOE's Atmospheric Radiation Measurement Program. We also have used concepts initially explored through LDRD to develop several winning proposals in the Environmental Management Science Program. The success of our LDRD program is founded on good management practices that ensure funding is allocated and projects are conducted in compliance with DOE requirements. We thoroughly evaluate the LDRD proposals based on their scientific and technical merit, as well as their relevance to DOE's programmatic needs. After a proposal is funded, we assess progress annually using external peer reviews. This year, as in years past, the LDRD program has once again proven to be the major enabling vehicle for our staff to formulate new ideas, advance scientific capability, and develop potential applications for DOE's most significant challenges.« less

The health sector reforms and the efficiency of public hospitals in Turkey: provincial markets.

PubMed

Sulku, Seher Nur

2012-10-01

Turkey initiated the 'Health Transformation Programme' (HTP) in 2003 to align its health care system with the European Union and OECD countries. This study investigates the impact of these reforms on the efficiency of public hospitals. Our study would contribute to the existing literature with a comprehensive analysis of the health system in a developing country. We employ the data envelopment approach and the Malmquist index to comparatively examine before and after the reform years. Our analyses compare the performances of public hospitals served in provincial markets. Inputs of number of beds, number of primary care physician, and number of specialists, and how they are used to produce outputs of inpatient discharges, outpatient visits and surgical operations are investigated. Indeed, as the performance indicators dead rate, hospital bed occupation rate and average length of stay are considered. The HTP was generally successful in boosting productivity due to advancements in technology and technical efficiency but in the socio-economically disadvantaged provinces productivity gains have not been achieved. The average technical efficiency gains took place because of the significantly improved scale efficiencies, as the average pure technical efficiency slightly improved. Lastly, the hospital performance indicators have not improved in the short run. It appears that the expected benefits from the health reforms in Turkey have been partially achieved in the short run.

Expanded Guidance for NASA Systems Engineering. Volume 2: Crosscutting Topics, Special Topics, and Appendices

NASA Technical Reports Server (NTRS)

Hirshorn, Steven R.

2017-01-01

Historically, most successful NASA projects have depended on effectively blending project management, systems engineering, and technical expertise among NASA, contractors, and third parties. Underlying these successes are a variety of agreements (e.g., contract, memorandum of understanding, grant, cooperative agreement) between NASA organizations or between NASA and other Government agencies, Government organizations, companies, universities, research laboratories, and so on. To simplify the discussions, the term "contract" is used to encompass these agreements. This section focuses on the NASA systems engineering activities pertinent to awarding a contract, managing contract performance, and completing a contract. In particular, NASA systems engineering interfaces to the procurement process are covered, since the NASA engineering technical team plays a key role in the development and evaluation of contract documentation. Contractors and third parties perform activities that supplement (or substitute for) the NASA project technical team accomplishment of the NASA common systems engineering technical process activities and requirements outlined in this guide. Since contractors might be involved in any part of the systems engineering life cycle, the NASA project technical team needs to know how to prepare for, allocate or perform, and implement surveillance of technical activities that are allocated to contractors.

The NASA Scientific and Technical Information (STI) Program's Implementation of Open Archives Initiation (OAI) for Data Interoperability and Data Exchange

NASA Technical Reports Server (NTRS)

Rocker, JoAnne; Roncaglia, George J.; Heimerl, Lynn N.; Nelson, Michael L.

2002-01-01

Interoperability and data-exchange are critical for the survival of government information management programs. E-government initiatives are transforming the way the government interacts with the public. More information is to be made available through web-enabled technologies. Programs such as the NASA's Scientific and Technical Information (STI) Program Office are tasked to find more effective ways to disseminate information to the public. The NASA STI Program is an agency-wide program charged with gathering, organizing, storing, and disseminating NASA-produced information for research and public use. The program is investigating the use of a new protocol called the Open Archives Initiative (OAI) as a means to improve data interoperability and data collection. OAI promotes the use of the OAI harvesting protocol as a simple way for data sharing among repositories. In two separate initiatives, the STI Program is implementing OAI In collaboration with the Air Force, Department of Energy, and Old Dominion University, the NASA STI Program has funded research on implementing the OAI to exchange data between the three organizations. The second initiative is the deployment of OAI for the NASA technical report server (TRS) environment. The NASA TRS environment is comprised of distributed technical report servers with a centralized search interface. This paper focuses on the implementation of OAI to promote interoperability among diverse data repositories.

The Future Cybersecurity Workforce: Going Beyond Technical Skills for Successful Cyber Performance

PubMed Central

Dawson, Jessica; Thomson, Robert

2018-01-01

One of the challenges in writing an article reviewing the current state of cyber education and workforce development is that there is a paucity of quantitative assessment regarding the cognitive aptitudes, work roles, or team organization required by cybersecurity professionals to be successful. In this review, we argue that the people who operate within the cyber domain need a combination of technical skills, domain specific knowledge, and social intelligence to be successful. They, like the networks they operate, must also be reliable, trustworthy, and resilient. Defining the knowledge, skills, attributes, and other characteristics is not as simple as defining a group of technical skills that people can be trained on; the complexity of the cyber domain makes this a unique challenge. There has been little research devoted to exactly what attributes individuals in the cyber domain need. What research does exist places an emphasis on technical and engineering skills while discounting the important social and organizational influences that dictate success or failure in everyday settings. This paper reviews the literature on cyber expertise and cyber workforce development to identify gaps and then argues for the important contribution of social fit in the highly complex and heterogenous cyber workforce. We then identify six assumptions for the future of cybersecurity workforce development, including the requirement for systemic thinkers, team players, a love for continued learning, strong communication ability, a sense of civic duty, and a blend of technical and social skill. Finally, we make recommendations for social and cognitive metrics which may be indicative of future performance in cyber work roles to provide a roadmap for future scholars. PMID:29946276

Robotic-Assisted Versus Manual Prostatic Arterial Embolization for Benign Prostatic Hyperplasia: A Comparative Analysis.

PubMed

Bagla, Sandeep; Smirniotopoulos, John; Orlando, Julie C; Piechowiak, Rachel

2017-03-01

Prostatic artery embolization (PAE) is a safe and efficacious procedure for benign prostatic hyperplasia (BPH), though is technically challenging. We present our experience of technical and clinical outcomes of robotic and manual PAE in patients with BPH. IRB-approved retrospective study of 40 consecutive patients 49-81 years old with moderate or severe grade BPH from May 2014 to July 2015: 20 robotic-assisted PAE (group 1), 20 manual PAE (group 2). Robotic-assisted PAE was performed using the Magellan Robotic System. American Urological Association (AUA-SI) score, cost, technical and clinical success, radiation dose, fluoroscopy, and procedure time were reviewed. Statistical analysis was performed within and between each group using paired t test and one-way analysis of variance respectively, at 1 and 3 months. No significant baseline differences in age and AUA-SI between groups. Technical success was 100% (group 1) and 95% (group 2). One unsuccessful subject from group 2 returned for a successful embolization using robotic assistance. Fluoroscopy and procedural times were similar between groups, with a non-significant lower patient radiation dose in group 1 (30,632.8 mGy/cm 2 vs 35,890.9, p = 0.269). Disposable cost was significantly different between groups with the robotic-assisted PAE incurring a higher cost (group 1 $4530.2; group 2 $1588.5, p < 0.0001). Clinical improvement was significant in both arms at 3 months: group 1 mean change in AUA-SI of 8.3 (p = 0.006), group 2: 9.6 (p < 0.0001). No minor or major complications occurred. Robotic-assisted PAE offers technical success comparable to manual PAE, with similar clinical improvement with an increased cost.

Fluoroscopy-assisted vs fluoroless endoscopic ultrasound-guided transmural drainage of pancreatic fluid collections: A comparative study.

PubMed

Consiglieri, Claudia F; Gornals, Joan B; Busquets, Juli; Peláez, Nuria; Secanella, Lluis; De-La-Hera, Meritxell; Sanzol, Resurrección; Fabregat, Joan; Castellote, José

2018-01-01

The need for fluoroscopy guidance in patients undergoing endoscopic ultrasound-guided transmural drainage (EUS-TMD) of peripancreatic fluid collections (PFCs) remains unclear. The aim of this study was to compare general outcomes of EUS-TMD of PFCs under fluoroscopy (F) vs fluoroless (FL). This is a comparative study with a retrospective analysis of a prospective and consecutive inclusion database at a tertiary centre, from 2009 to 2015. All patients were symptomatic pseudocyst (PSC) and walled-off pancreatic necrosis (WON). Two groups were assigned depending on availability of fluoroscopy. The groups were heterogeneous in terms of their demographic characteristics, PFCs and procedure. The main outcome measures included technical and clinical success, incidences, adverse events (AEs), and follow-up. Fifty EUS-TMD of PFCs from 86 EUS-guided drainages were included during the study period. Group F included 26 procedures, PSC 69.2%, WON 30.8%, metal stents 61.5% (46.1% lumen-apposing stent) and plastic stents 38.5%. Group FL included 24 procedures, PSC 37.5%, WON 62.5%, and metal stents 95.8% (lumen-apposing stents). Technical success was 100% in both groups, and clinical success was similar (F 88.5%, FL 87.5%). Technical incidences and intra-procedure AEs were only described in group F (7.6% and 11.5%, respectively) and none in group FL. Procedure time was less in group FL (8min, p=0.0341). Fluoroless in the EUS-TMD of PFCs does not involve more technical incidences or intra-procedure AEs. Technical and clinical success was similar in the two groups. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Percutaneous Cryoablation of Clinical T2 (> 7 cm) Renal Masses: Technical Considerations, Complications, and Short-Term Outcomes.

PubMed

Moynagh, Michael R; Schmit, Grant D; Thompson, Robert H; Boorjian, Stephen A; Woodrum, David A; Curry, Timothy B; Atwell, Thomas D

2015-06-01

To determine the technical success, safety, and preliminary clinical outcome of percutaneous cryoablation of large (> 7 cm) renal masses. Twelve patients underwent percutaneous cryoablation for treatment of renal tumors measuring greater than 7 cm (clinical stage II, T2aN0M0) between 2004 and 2013. Median patient age was 75 years (range, 46-84 y), median Charlson comorbidity index was 5 (range, 4-9), and median maximal tumor diameter was 8.4 cm (range, 7.2-9.7 cm). Seven of the 12 patients underwent superselective intraarterial tumor embolization before cryoablation. Technical success, procedural complications, renal function, and oncologic and survival outcomes were evaluated for each patient. All cryoablation procedures were technically successful in a single treatment session, with no mortalities at 30 days. Two patients (17%) experienced major complications related to postprocedural hemorrhage. Median change in estimated glomerular filtration rate within 7 days following cryoablation treatment was 11 mL/min (range, 7-14 mL/min). One patient with baseline stage IV chronic kidney disease and a major bleeding complication required temporary dialysis in the periprocedural period. In 11 patients (92%) who had follow-up beyond 3 months after the procedure (mean, 19 mo; range, 4-49 mo), recurrence-free survival and overall survival rates at 2 years were 100% and 91%, respectively. Percutaneous cryoablation of large (> 7 cm) renal masses was technically successful, with effective preliminary clinical outcomes. However, major complications are more common with cryoablation of stage T2 tumors than is typically encountered with treatment of smaller stage T1 tumors. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

The Aortic Bifurcation Angle as a Factor in Application of the Outback for Femoropopliteal Lesions in Ipsilateral Versus Contralateral Approaches.

PubMed

Raskin, Daniel; Khaitovich, Boris; Balan, Shmuel; Silverberg, Daniel; Halak, Moshe; Rimon, Uri

2018-01-01

To assess the technical success of the Outback reentry device in contralateral versus ipsilateral approaches for femoropopliteal arterial occlusion. A retrospective review of patients treated for critical limb ischemia (CLI) using the Outback between January 2013 and July 2016 was performed. Age, gender, length and site of the occlusion, approach site, aortic bifurcation angle, and reentry site were recorded. Calcification score was assigned at both aortic bifurcation and reentry site. Technical success was assessed. During the study period, a total of 1300 endovascular procedures were performed on 489 patients for CLI. The Outback was applied on 50 femoropopliteal chronic total occlusions. Thirty-nine contralateral and 11 ipsilateral antegrade femoral were accessed. The device was used successfully in 41 patients (82%). There were nine failures, all in the contralateral approach group. Six due to inability to deliver the device due to acute aortic bifurcation angle and three due to failure to achieve luminal reentry. Procedural success was significantly affected by the aortic bifurcation angle (p = 0.013). The Outback has high technical success rates in treatment of femoropopliteal occlusion, when applied from either an ipsi- or contralateral approach. When applied in contralateral access, acute aortic bifurcation angle predicts procedural failure.

A WORKABLE DEFINITION OF SUCCESS

EPA Science Inventory

The most desirable definition of success from the point of view of environmental stewardship is to treat the entire plume to MCLs. Technically, has proven impossible to attain at many sites. A less desirable definition of success is to contain the source of contamination and tr...

A Green Campus Culture in Wisconsin

ERIC Educational Resources Information Center

Jorgensen, Haley

2006-01-01

This article features information about the Nicolet Area Technical College in Rhinelander, Wisconsin for preserving the environment as a school-wide initiative. In 2003, Nicolet became the first of the state's 16 technical colleges to embrace a campus-wide focus on renewable energy. In cooperation with the Wisconsin Technical College System…

76 FR 35103 - Training and Qualification Requirements for Check Airmen and Flight Instructors; Technical Amendment

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-16

... which initial and transition flight training must include an in-flight element. Technical Amendment This.... 28471; Amendment Nos. 121-355 and 135-125] RIN 2120-AF08 Training and Qualification Requirements for Check Airmen and Flight Instructors; Technical Amendment AGENCY: Federal Aviation Administration (FAA...

The Technical Communicator as Corporate Spokesperson: A Public Relations Primer.

ERIC Educational Resources Information Center

Troester, Rod; Warburton, Terrence L.

2001-01-01

Examines the changing role of the technical communication professional in the rapidly evolving environment of organizational life. Presents five principles that serve as an initial step in laying a foundation for the preparation of technical communicators for the challenges and opportunities awaiting in contemporary organizations and the…

47 CFR 24.815 - Technical content of applications; maintenance of list of station locations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... of list of station locations. 24.815 Section 24.815 Telecommunication FEDERAL COMMUNICATIONS... list of station locations. (a) All applications required by this part shall contain all technical... describe a number of general technical requirements. (b) Each application (except applications for initial...

47 CFR 24.815 - Technical content of applications; maintenance of list of station locations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... of list of station locations. 24.815 Section 24.815 Telecommunication FEDERAL COMMUNICATIONS... list of station locations. (a) All applications required by this part shall contain all technical... describe a number of general technical requirements. (b) Each application (except applications for initial...

47 CFR 24.815 - Technical content of applications; maintenance of list of station locations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... of list of station locations. 24.815 Section 24.815 Telecommunication FEDERAL COMMUNICATIONS... list of station locations. (a) All applications required by this part shall contain all technical... describe a number of general technical requirements. (b) Each application (except applications for initial...

47 CFR 24.815 - Technical content of applications; maintenance of list of station locations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... of list of station locations. 24.815 Section 24.815 Telecommunication FEDERAL COMMUNICATIONS... list of station locations. (a) All applications required by this part shall contain all technical... describe a number of general technical requirements. (b) Each application (except applications for initial...

Implementation of a health management mentoring program: year-1 evaluation of its impact on health system strengthening in Zambézia Province, Mozambique

PubMed Central

Edwards, Laura J.; Moisés, Abú; Nzaramba, Mathias; Cassimo, Aboobacar; Silva, Laura; Mauricio, Joaquim; Wester, C. William; Vermund, Sten H.; Moon, Troy D.

2015-01-01

Background: Avante Zambézia is an initiative of a Non-Governmental Organization (NGO), Friends in Global Health, LLC (FGH) and the Vanderbilt Institute for Global Health (VIGH) to provide technical assistance to the Mozambican Ministry of Health (MoH) in rural Zambézia Province. Avante Zambézia developed a district level Health Management Mentorship (HMM) program to strengthen health systems in ten of Zambézia’s 17 districts. Our objective was to preliminarily analyze changes in four domains of health system capacity after the HMM’s first year: accounting, Human Resources (HRs), Monitoring and Evaluation (M&E), and transportation management. Methods: Quantitative metrics were developed in each domain. During district visits for weeklong, on-site mentoring, the health management mentoring teams documented each indicator as a success ratio percentage. We analyzed data using linear regressions of each indicator’s mean success ratio across all districts submitting a report over time. Results: Of the four domains, district performance in the accounting domain was the strongest and most sustained. Linear regressions of mean monthly compliance for HR objectives indicated improvement in three of six mean success ratios. The M&E capacity domain showed the least overall improvement. The one indicator analyzed for transportation management suggested progress. Conclusion: Our outcome evaluation demonstrates improvement in health system performance during a HMM initiative. Evaluating which elements of our mentoring program are succeeding in strengthening district level health systems is vital in preparing to transition fiscal and managerial responsibility to local authorities. PMID:26029894

Youth advocacy as a tool for environmental and policy changes that support physical activity and nutrition: an evaluation study in San Diego County.

PubMed

Linton, Leslie S; Edwards, Christine C; Woodruff, Susan I; Millstein, Rachel A; Moder, Cheryl

2014-03-27

As evidence grows about the benefits of policy and environmental changes to support active living and healthy eating, effective tools for implementing change must be developed. Youth advocacy, a successful strategy in the field of tobacco control, should be evaluated for its potential in the field of obesity prevention. San Diego State University collaborated with the San Diego County Childhood Obesity Initiative to evaluate Youth Engagement and Action for Health! (YEAH!), a youth advocacy project to engage youth and adult mentors in advocating for neighborhood improvements in physical activity and healthy eating opportunities. Study objectives included documenting group process and success of groups in engaging in community advocacy with decision makers. In 2011 and 2012, YEAH! group leaders were recruited from the San Diego County Childhood Obesity Initiative's half-day train-the-trainer seminars for adult leaders. Evaluators collected baseline and postproject survey data from youth participants and adult group leaders and interviewed decision makers. Of the 21 groups formed, 20 completed the evaluation, conducted community assessments, and advocated with decision makers. Various types of decision makers were engaged, including school principals, food service personnel, city council members, and parks and recreation officials. Eleven groups reported change(s) implemented as a result of their advocacy, 4 groups reported changes pending, and 5 groups reported no change as a result of their efforts. Even a brief training session, paired with a practical manual, technical assistance, and commitment of adult leaders and youth may successfully engage decision makers and, ultimately, bring about change.

Implementation of a health management mentoring program: year-1 evaluation of its impact on health system strengthening in Zambézia Province, Mozambique.

PubMed

Edwards, Laura J; Moisés, Abú; Nzaramba, Mathias; Cassimo, Aboobacar; Silva, Laura; Mauricio, Joaquim; Wester, C William; Vermund, Sten H; Moon, Troy D

2015-03-12

Avante Zambézia is an initiative of a Non-Governmental Organization (NGO), Friends in Global Health, LLC (FGH) and the Vanderbilt Institute for Global Health (VIGH) to provide technical assistance to the Mozambican Ministry of Health (MoH) in rural Zambézia Province. Avante Zambézia developed a district level Health Management Mentorship (HMM) program to strengthen health systems in ten of Zambézia's 17 districts. Our objective was to preliminarily analyze changes in four domains of health system capacity after the HMM's first year: accounting, Human Resources (HRs), Monitoring and Evaluation (M&E), and transportation management. Quantitative metrics were developed in each domain. During district visits for weeklong, on-site mentoring, the health management mentoring teams documented each indicator as a success ratio percentage. We analyzed data using linear regressions of each indicator's mean success ratio across all districts submitting a report over time. Of the four domains, district performance in the accounting domain was the strongest and most sustained. Linear regressions of mean monthly compliance for HR objectives indicated improvement in three of six mean success ratios. The M&E capacity domain showed the least overall improvement. The one indicator analyzed for transportation management suggested progress. Our outcome evaluation demonstrates improvement in health system performance during a HMM initiative. Evaluating which elements of our mentoring program are succeeding in strengthening district level health systems is vital in preparing to transition fiscal and managerial responsibility to local authorities. © 2015 by Kerman University of Medical Sciences.

Washington's Community and Technical Colleges' Student Achievement Initiative: Lessons Learned since the 2012 Revision and Considerations for New Allocation Model. Research Report 16-1

ERIC Educational Resources Information Center

Washington State Board for Community and Technical Colleges, 2016

2016-01-01

In January 2012, a system-wide task force came together for a nearly year-long process of revising the community and technical college system's performance-based funding (PBF) system, the Student Achievement Initiative. This review was consistent with national experts' recommendations for continuous evaluation of PBF systems to ensure overall…

Does ASA classification impact success rates of endovascular aneurysm repairs?

PubMed

Conners, Michael S; Tonnessen, Britt H; Sternbergh, W Charles; Carter, Glen; Yoselevitz, Moises; Money, Samuel R

2002-09-01

The purpose of this study was to evaluate the technical success, clinical success, postoperative complication rate, need for a secondary procedure, and mortality rate with endovascular aneurysm repair (EAR), based on the physical status classification scheme advocated by the American Society of Anesthesiologists (ASA). At a single institution 167 patients underwent attempted EAR. Query of a prospectively maintained database supplemented with a retrospective review of medical records was used to gather statistics pertaining to patient demographics and outcome. In patients selected for EAR on the basis of acceptable anatomy, technical and clinical success rates were not significantly different among the different ASA classifications. Importantly, postoperative complication and 30-day mortality rates do not appear to significantly differ among the different ASA classifications in this patient population.

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

Raudsepp, E.

A test is given to determine if an engineer suffers from one of the three barriers to technical success: fear of success, fear of failure, or perfectionism. As in most such tests, the middle way is best. Successful engineers know that perfection cannot be attained, that they don't have time to worry about failure or success, and that by aiming and perservering in doing things well, success can be achieved.

7 CFR 652.4 - Technical service standards.

Code of Federal Regulations, 2011 CFR

2011-01-01

... must approve all new technologies and innovative practices, including interim standards and specifications, prior to a TSP initiating technical services for those technologies and practices. (c) A TSP must...

Pathways and Challenges to Innovation in Aerospace

NASA Technical Reports Server (NTRS)

Terrile, Richard J.

2010-01-01

This paper explores impediments to innovation in aerospace and suggests how successful pathways from other industries can be adopted to facilitate greater innovation. Because of its nature, space exploration would seem to be a ripe field of technical innovation. However, engineering can also be a frustratingly conservative endeavor when the realities of cost and risk are included. Impediments like the "find the fault" engineering culture, the treatment of technical risk as almost always evaluated in terms of negative impact, the difficult to account for expansive Moore's Law growth when making predictions, and the stove-piped structural organization of most large aerospace companies and federally funded research laboratories tend to inhibit cross-cutting technical innovation. One successful example of a multi-use cross cutting application that can scale with Moore's Law is the Evolutionary Computational Methods (ECM) technique developed at the Jet Propulsion Lab for automated spectral retrieval. Future innovations like computational engineering and automated design optimization can potentially redefine space exploration, but will require learning lessons from successful innovators.

The VOICES/VOCES success story: effective strategies for training, technical assistance and community-based organization implementation.

PubMed

Hamdallah, Myriam; Vargo, Sue; Herrera, Jennifer

2006-08-01

The Centers for Disease Control and Prevention's Diffusion of Effective Behavioral Interventions (DEBI) project successfully disseminated VOICES/VOCES, a brief video-based HIV risk reduction intervention targeting African American and Latino heterosexual men and women at risk for HIV infection. Elements of the dissemination strategy included a comprehensive and user-friendly intervention kit, comprising (a) an implementationmanual and othermaterials necessary for conducting the intervention (b) a Training of Facilitators (TOF) curriculum used to teach agency staff how to implement the EBI in their setting, (c) a network of expert trainers who attend a training institute to become adept at using the TOF curriculum to train facilitators, (d) a comprehensive training coordination center to plan and deliver TOF trainings, (e) proactive technical assistance to trainers, and (f) post-TOF technical assistance for local implementers. This article reports on those strategies and a local CBO's successful participation in DEBI, resulting implementation of VOICES/VOCES, with unique approaches to adaptation and tailoring.

Education Industry, 2006

DTIC Science & Technology

2006-01-01

resulted in the U.S. Department of Education referring to it as Career and Technical Education (CTE). Minuteman High School, a highly successful...whole, and ultimately the students and the nation, will suffer the consequences. 7 Vocational Education The challenge for Career and Technical Education (CTE

Evaluation of a novel, hybrid model (Mumbai EUS II) for stepwise teaching and training in EUS-guided biliary drainage and rendezvous procedures

PubMed Central

Dhir, Vinay; Itoi, Takao; Pausawasdi, Nonthalee; Khashab, Mouen A.; Perez-Miranda, Manuel; Sun, Siyu; Park, Do Hyun; Iwashita, Takuji; Teoh, Anthony Y. B.; Maydeo, Amit P.; Ho, Khek Yu

2017-01-01

Background and aims  EUS-guided biliary drainage (EUS-BD) and rendezvous (EUS-RV) are acceptable rescue options for patients with failed endoscopic retrograde cholangiopancreatography (ERCP). However, there are limited training opportunities at most centers owing to low case volumes. The existing models do not replicate the difficulties encountered during EUS-BD. We aimed to develop and validate a model for stepwise learning of EUS-BD and EUS-RV, which replicates the actual EUS-BD procedures. Methods  A hybrid model was created utilizing pig esophagus and stomach, with a synthetic duodenum and biliary system. The model was objectively assessed on a grade of 1 – 4 by two experts. Twenty-eight trainees were given initial training with didactic lectures and live procedures. This was followed by hands-on training in EUS-BD and EUS-RV on the hybrid model. Trainees were assessed for objective criteria of technical difficulties. Results  Both the experts graded the model as very good or above for all parameters. All trainees could complete the requisite steps of EUS-BD and EUS-RV in a mean time of 11 minutes (8 – 18 minutes). Thirty-six technical difficulties were noted during the training (wrong scope position, 13; incorrect duct puncture, 12; guidewire related problems, 11). Technical difficulties peaked for EUS-RV, followed by hepaticogastrostomy (HGS) and choledochoduodenostomy (CDS) (20, 9, and 7, P  = 0.001). At 10 days follow-up, nine of 28 trainees had successfully performed three EUS-RV and seven EUS-BD procedures independently. Conclusions  The Mumbai EUS II hybrid model replicates situations encountered during EUS-RV and EUS-BD. Stepwise mentoring improves the chances of success in EUS-RV and EUS-BD procedures. PMID:29250585

Parasites and vectors carry no passport: how to fund cross-border and regional efforts to achieve malaria elimination

PubMed Central

2012-01-01

Background Tremendous progress has been made in the last ten years in reducing morbidity and mortality caused by malaria, in part because of increases in global funding for malaria control and elimination. Today, many countries are striving for malaria elimination. However, a major challenge is the neglect of cross-border and regional initiatives in malaria control and elimination. This paper seeks to better understand Global Fund support for multi-country initiatives. Methods Documents and proposals were extracted and reviewed from two main sources, the Global Fund website and Aidspan.org. Documents and reports from the Global Fund Technical Review Panel, Board, and Secretariat documents such as guidelines and proposal templates were reviewed to establish the type of policies enacted and guidance provided from the Global Fund on multi-country initiatives and applications. From reviewing this information, the researchers created 29 variables according to eight dimensions to use in a review of Round 10 applications. All Round 10 multi-country applications (for HIV, malaria and tuberculosis) and all malaria multi-country applications (6) from Rounds 1 – 10 were extracted from the Global Fund website. A blind review was conducted of Round 10 applications using the 29 variables as a framework, followed by a review of four of the six successful malaria multi-country grant applications from Rounds 1 – 10. Findings During Rounds 3 – 10 of the Global Fund, only 5.8% of grants submitted were for multi-country initiatives. Out of 83 multi-country proposals submitted, 25.3% were approved by the Technical Review Panel (TRP) for funding, compared to 44.9% of single-country applications. The majority of approved multi-country applications were for HIV (76.2%), followed by malaria (19.0%), then tuberculosis (4.8%). TRP recommendations resulted in improvements to application forms, although guidance was generally vague. The in-depth review of Round 10 multi-country proposals showed that applicants described their projects in one of two ways: a regional ‘network approach’ by which benefits are derived from economies of scale or from enhanced opportunities for mutual support and learning or the development of common policies and approaches; or a ‘cross-border’ approach for enabling activities to be more effectively delivered towards border-crossing populations or vectors. In Round 10, only those with a ‘network approach’ were recommended for funding. The Global Fund has only ever approved six malaria multi-country applications. Four approved applications stated strong arguments for a multi-country initiative, combining both ‘cross-border’ and ‘network’ approaches. Conclusion With the cancellation of Round 11 and the proposal that the Global Fund adopt a more targeted and strategic approach to funding, the time is opportune for the Global Fund to develop a clear consensus about the key factors and criteria for funding malaria specific multi-country initiatives. This study found that currently there was a lack of guidance on the key features that a successful multi-country proposal needs to be approved and that applications directed towards the ‘network’ approach were most successful in Round 10. This type of multi-country proposal may favour other diseases such as HIV, whereas the need for malaria control and elimination is different, focusing on cross-border coordination and delivery of interventions to specific groups. The Global Fund should seek to address these issues and give better guidance to countries and regions and investigate disease-specific calls for multi-country and regional applications. PMID:23057734

An Evaluation of the Science Education Component of the Cross River State Science and Technical Education Project

ERIC Educational Resources Information Center

Ekuri, Emmanuel Etta

2012-01-01

The Cross River State Science and Technical Education Project was introduced in 1992 by edict number 9 of 20 December 1991, "Cross River State Science and Technical Education Board Edit, 20 December, 1991", with the aim of improving the quality of science teaching and learning in the state. As the success of the project depends…

History, a projection of the future: A rotary wing perspective

NASA Technical Reports Server (NTRS)

Huston, Robert J.

1996-01-01

The success and failure of past vehicle concepts is reviewed in an attempt to highlight some of the advanced vehicle concepts attempted in the past failed because of a lack of appreciation, by both the sponsors and the developer, for the technical and societal requirements critical to their success. This paper will review the history of some attempts to provide both good hover and forward flight efficiency and will point out some of the technical and societal obstacles encountered. Two examples, that of the tiltrotor and tiltwing vehicles. will be highlighted show the different paths followed by a successful and an unsuccessful concept. The outlook for future VTOL/rotary wing concepts will be evaluated.

Endoscopic bilateral stent-in-stent placement for malignant hilar obstruction using a large cell type stent.

PubMed

Park, Jin Myung; Lee, Sang Hyub; Chung, Kwang Hyun; Jang, Dong Kee; Ryu, Ji Kon; Kim, Yong-Tae; Lee, Jae Min; Paik, Woo Hyun

2016-12-01

Bilateral stent-in-stent (SIS) self-expandable metal stent placement is technically challenging for palliation of unresectable malignant hilar obstruction. In the SIS technique, the uniform large cell type biliary stent facilitates contralateral stent deployment through the mesh of the first metallic stent. This study aimed to assess the technical success and clinical effectiveness of this technique with a uniform large cell type biliary stent. Thirty-one patients who underwent bilateral SIS placement using a large cell type stent were reviewed retrospectively. All patients showed malignant hilar obstruction (Bismuth types II, III, IV) with different etiologies. Sixteen (51.6%) patients were male. The mean age of the patients was 67.0+/-14.0 years. Most patients were diagnosed as having hilar cholangiocarcinoma (58.1%) and gallbladder cancer (29.0%). Technical success rate was 83.9%. Success was achieved more frequently in patients without masses obstructing the biliary confluence (MOC) than those with MOC (95.2% vs 60.0%, P=0.03). Functional success rate was 77.4%. Complications occurred in 29.0% of the patients. These tended to occur more frequently in patients with MOC (50.0% vs 19.0%, P=0.11). Median time to recurrent biliary obstruction was 188 days and median survival was 175 days. The large cell type stent can be used efficiently for bilateral SIS placement in malignant hilar obstruction. However, the risk of technical failure increases in patients with MOC, and caution is needed to prevent complications for these patients.

Primary and revision efficacy of cross-wired metallic stents for endoscopic bilateral stent-in-stent placement in malignant hilar biliary strictures.

PubMed

Lee, T H; Moon, J H; Kim, J H; Park, D H; Lee, S S; Choi, H J; Cho, Y D; Park, S H; Kim, S J

2013-01-01

Endoscopic bilateral drainage for inoperable malignant hilar biliary strictures (HBS) using metal stents is considered to be technically difficult. Furthermore, endoscopic revision of bilateral stenting after occlusion can be challenging. This study was performed to evaluate the long-term efficacy of endoscopic bilateral stent-in-stent placement of cross-wired metallic stents in high-grade malignant HBS and planned endoscopic bilateral revision. A total of 84 patients with inoperable high-grade malignant HBS were enrolled from three academic tertiary referral centers. Two cross-wired metal stents were inserted using a bilateral stent-in-stent placement method. Bilateral endoscopic revision was also performed during follow-up using either identical metal stents or plastic stents. The main outcome measurements were technical and functional success, complications, stent patency, and endoscopic revision efficacy. The technical and clinical success rates of endoscopic bilateral stent-in-stent placement of cross-wired metallic stents were 95.2% (80/84) and 92.9% (78/84), respectively. Median patency (range) and survival were 238 days (10-429) and 256 days (10-1130), respectively. Obstruction of primary bilateral stents occurred in 30.8% (24/78) of patients with functionally successful stent placement. The technical and clinical success rates of planned bilateral endoscopic revision for occluded stents were 83.3% (20/24) and 79.2% (19/24), respectively. For revision, bilateral metallic stents were placed in 11 patients (55.0%); the remaining patients received plastic stents. Palliative endoscopic bilateral stent-in-stent placement of cross-wired metallic stents was effective in patients with inoperable HBS. Revision endoscopic bilateral stenting may be feasible and successful in cases where the primary deployed metal stents are occluded. © Georg Thieme Verlag KG Stuttgart · New York.

Unenhanced Cone Beam Computed Tomography and Fusion Imaging in Direct Percutaneous Sac Injection for Treatment of Type II Endoleak: Technical Note

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

Carrafiello, Gianpaolo, E-mail: gcarraf@gmail.com; Ierardi, Anna Maria; Radaelli, Alessandro

AimTo evaluate safety, feasibility, technical success, and clinical success of direct percutaneous sac injection (DPSI) for the treatment of type II endoleaks (T2EL) using anatomical landmarks on cone beam computed tomography (CBCT) and fusion imaging (FI).Materials and MethodsEight patients with T2EL were treated with DPSI using CBCT as imaging guidance. Anatomical landmarks on unenhanced CBCT were used for referencing T2EL location in the first five patients, while FI between unenhanced CBCT and pre-procedural computed tomography angiography (CTA) was used in the remaining three patients. Embolization was performed with thrombin, glue, and ethylene–vinyl alcohol copolymer. Technical and clinical success, iodinated contrastmore » utilization, procedural time, fluoroscopy time, and mean radiation dose were registered.ResultsDPSI was technically successful in all patients: the needle was correctly positioned at the first attempt in six patients, while in two of the first five patients the needle was repositioned once. Neither minor nor major complications were registered. Average procedural time was 45 min and the average administered iodinated contrast was 13 ml. Mean radiation dose of the procedure was 60.43 Gy cm{sup 2} and mean fluoroscopy time was 18 min. Clinical success was achieved in all patients (mean follow-up of 36 months): no sign of T2EL was reported in seven patients until last CT follow-up, while it persisted in one patient with stability of sac diameter.ConclusionsDPSI using unenhanced CBCT and FI is feasible and provides the interventional radiologist with an accurate and safe alternative to endovascular treatment with limited iodinated contrast utilization.« less

Vertebral artery origin stent placement with distal protection: technical and clinical results.

PubMed

Qureshi, A I; Kirmani, J F; Harris-Lane, P; Divani, A A; Ahmed, S; Ebrihimi, A; Al Kawi, A; Janjua, N

2006-05-01

To report the feasibility, safety, and 1-month results of performing stent placement for vertebral origin stenosis with the use of a distal protection device. Distal protection devices have been shown to reduce the number of cerebral emboli and subsequent ischemic events when used as adjuncts to percutaneous carotid intervention; however, one case of the use of a distal protection device for vertebral artery has been reported in the literature. We retrospectively determined rates of technical success and 1-month stroke or death associated with stent placement by using distal protection (Filter EX; Boston Scientific, Natick, Mass) in patients with symptomatic vertebral artery origin stenosis. Technical success was defined as successful deployment of distal protection device and stent at target lesion followed by successful retrieval of the device and a final residual stenosis of less than 30%. Other outcomes ascertained included any stroke, death, and semiquantitative assessment of particulate material retained by the filter device. The mean age of the 12 treated patients was 68 years (range, 52-88 years) and the group included 9 men and 3 women. The mean percentage of vertebral artery origin stenosis was 71 +/- 6%. Femoral and radial approaches were used in 9 and 3 cases, respectively. Technical success was achieved in 11 of the 12 patients in whom distal protection device placement was attempted. Postprocedure residual stenosis was 5 +/- 4%. Eight devices held macroscopically visible embolic debris (large and small amounts in 3 and 5 devices, respectively). No stroke or death was observed in the 1-month follow-up. The present study demonstrates the feasibility of performing stent placement for vertebral artery origin stenosis by using a distal protection device. Further studies are required to determine the effectiveness of this approach for vertebral artery origin atherosclerosis.

Technical Advisory Team (TAT) report on the rocket sled test accident of October 9, 2008.

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

Stofleth, Jerome H.; Dinallo, Michael Anthony; Medina, Anthony J.

2009-01-01

This report summarizes probable causes and contributing factors that led to a rocket motor initiating prematurely while employees were preparing instrumentation for an AIII rocket sled test at SNL/NM, resulting in a Type-B Accident. Originally prepared by the Technical Advisory Team that provided technical assistance to the NNSA's Accident Investigation Board, the report includes analyses of several proposed causes and concludes that the most probable source of power for premature initiation of the rocket motor was the independent battery contained in the HiCap recorder package. The report includes data, evidence, and proposed scenarios to substantiate the analyses.

How to Improve the Design and Delivery of High-Quality Technical Assistance. Newsletter

ERIC Educational Resources Information Center

Center for Comprehensive School Reform and Improvement, 2005

2005-01-01

Educators often use the term technical assistance to define services delivered or received in the pursuit of school- and district-improvement initiatives. More specifically, technical assistance can be defined as any assistance that identifies, selects, or designs research-based solutions and practices to support school improvement (Mattson &…

Measuring Pollution Prevention

EPA Pesticide Factsheets

Measuring results is an essential component of any successful P2 program and is one way to determine the success of a technical assistance or training effort. This page introduces the concept of P2 measurement.

Success Factors of E-Learning Projects: A Technical Perspective

ERIC Educational Resources Information Center

Alhomod, Sami; Shafi, Mohd Mudasir

2013-01-01

The aim of this study is to identify the success factors of e learning programs in King Saud University from an engineer and technician's point of view. An extensive study of existing literature was done to determine the 11 success factors of e learning program. The factors identified as success factors are: Sufficient Users Training,…

Barriers and Facilitators to Implementing a Change Initiative in Long-Term Care Using the INTERACT® Quality Improvement Program.

PubMed

Tappen, Ruth M; Wolf, David G; Rahemi, Zahra; Engstrom, Gabriella; Rojido, Carolina; Shutes, Jill M; Ouslander, Joseph G

Implementation of major organizational change initiatives presents a challenge for long-term care leadership. Implementation of the INTERACT® (Interventions to Reduce Acute Care Transfers) quality improvement program, designed to improve the management of acute changes in condition and reduce unnecessary emergency department visits and hospitalizations of nursing home residents, serves as an example to illustrate the facilitators and barriers to major change in long-term care. As part of a larger study of the impact of INTERACT® on rates of emergency department visits and hospitalizations, staff of 71 nursing homes were called monthly to follow-up on their progress and discuss successful facilitating strategies and any challenges and barriers they encountered during the yearlong implementation period. Themes related to barriers and facilitators were identified. Six major barriers to implementation were identified: the magnitude and complexity of the change (35%), instability of facility leadership (27%), competing demands (40%), stakeholder resistance (49%), scarce resources (86%), and technical problems (31%). Six facilitating strategies were also reported: organization-wide involvement (68%), leadership support (41%), use of administrative authority (14%), adequate training (66%), persistence and oversight on the part of the champion (73%), and unfolding positive results (14%). Successful introduction of a complex change such as the INTERACT® quality improvement program in a long-term care facility requires attention to the facilitators and barriers identified in this report from those at the frontline.

Implementation of m-health applications in Botswana: telemedicine and education on mobile devices in a low resource setting.

PubMed

Littman-Quinn, Ryan; Mibenge, Chikoti; Antwi, Cynthia; Chandra, Amit; Kovarik, Carrie L

2013-02-01

Although Botswana has recently been categorised as an upper middle income country, it is burdened by a scarcity of resources, both human and technological. There are barriers to patients' access to specialized care and healthcare providers' access to medical knowledge. Over the past three years, the Botswana-University of Pennsylvania Partnership (BUP) has piloted four mobile telemedicine projects in the specialties of women's health (cervical cancer screening utilizing visual inspection with acetic acid), radiology, oral medicine and dermatology. Mobile telemedicine has been used in 11 locations in Botswana, training a total of 24 clinicians and successfully contributing to the management of 643 cases. In addition to mobile telemedicine, BUP has initiated an m-learning programme with the University of Botswana School of Medicine. While successfully providing patients and providers with improved access to healthcare resources, the m-health projects have faced numerous technical and social challenges. These include malfunctioning mobile devices, unreliable IT infrastructure, accidental damage to mobile devices, and cultural misalignment between IT and healthcare providers. BUP has worked with its local partners to develop solutions to these problems. To ensure sustainability, m-health programmes must have strategic goals that are aligned with those of the national health and education system, and the initiatives must be owned and led by local stakeholders. Whenever possible, open source technology and local IT expertise and infrastructure should be employed.

[Sacral neuromodulation in urology - development and current status].

PubMed

Schwalenberg, T; Stolzenburg, J-U; Kriegel, C; Gonsior, A

2012-01-01

Sacral neuromodulation (SNM) in urology is employed to treat refractory lower urinary tract dysfunction as well as chronic pelvic pain. Electrical stimulation of the sacral afferents (S2 - S4) causes activation and conditioning of higher autonomic and somatic neural structures and thereby influences the efferents controlling the urinary bladder, the rectum and their related sphincter systems. It is therefore possible to treat overactivity as well as hypocontractility and functional bladder neck obstruction. SNM treatment is conducted biphasically. Initially, test electrodes are placed to evaluate changes in micturition and pain parameters. If, in this first phase - called peripheral nerve evaluation (PNE test) - sufficient improvements are observed, the patient progresses to phase two which involves implantation of the permanent electrodes and impulse generator system. In recent years, the "two stage approach" with initial implantation of the permanent electrodes has been favoured as it increases treatment success rates. Long-term success rates of SNM vary significantly in the literature (50 - 80 %) due to heterogeneous patient populations as well as improved surgical approaches. With the introduction of "tined lead electrodes" (2002), tissue damage is reduced to a minimum. Technical innovation, financial feasibility (reimbursed in Germany since 2004) and wider application, especially in otherwise therapy-refractory patients or complex dysfunctions of the pelvis, have established SNM as a potent treatment option in urology. © Georg Thieme Verlag KG Stuttgart · New York.

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

Butler, Nicholas; McCaw, Erica E.; Wright, Kyle A.

The Global Threat Reduction Initiative (GTRI) reduces and protects vulnerable nuclear and radiological material located at civilian sites worldwide from sabotage, theft or diversion. The GTRI has worked successfully with foreign countries to remove and protect nuclear and radioactive materials including high-activity sources used in medical, commercial, and research applications. There are many barriers to successful bilateral cooperation that must be overcome including language, preconceived perceptions, long distances, and different views on the threat and protection requirements. Successful cooperation is often based on relationships and building trusting relationships takes time. In the case of Dominican Republic, the GTRI first receivedmore » contact in 2008 from the Government of Dominican Republic. They requested cooperation that was similar to the tri-partite cooperation between Colombia, Mexico and the United States. Throughout the region it was widely known that the GTRI’s cooperation with the Government of Colombia was a resounding success resulting in the securing of forty sites; the consolidation of numerous disused/orphan sources at a secure national storage facility; and, the development of a comprehensive approach to security including, inter alia, training and sustainability. The Government of Colombia also showcased this comprehensive approach to thirteen Central American and Caribbean countries at a GTRI regional security conference held in Panama in October 2004. In 2007, Colombia was an integral component of GTRI multi-lateral cooperation initiation in Mexico. As a result, twenty two of Mexico’s largest radioactive sites have been upgraded in the past eighteen months. These two endeavors served as catalysts for cooperation opportunities in the Dominican Republic. Representatives from the Colombian government were aware of GTRI’s interest in initiating cooperation with the Government of Dominican Republic and to facilitate this cooperation, they traveled to the Dominican Republic and provided briefings and presentations which demonstrated its successful cooperation with the GTRI. Shortly after that visit, the Government of Dominican Republic agreed to move forward and requested that the cooperative efforts in Dominican Republic be performed in a tripartite manner, leveraging the skills, experience, and resources of the Colombians, and the financial and technical support of the United States. As a result, two of Dominican Republic’s largest radioactive sites had security upgrades in place within 90 days of the cooperation visit in December 2008.« less

In Philadelphia: Pride, Hope and Success.

ERIC Educational Resources Information Center

Holmes, Marion B. W.

1980-01-01

Focusing on successful vocational programs for Blacks, this article describes two differently structured secondary-level schools located in Philadelphia, Pennsylvania: (1) Murrell Dobbins Area Vocational-Technical School and (2) A. Philip Randolph Skills Center. (LRA)

Transjugular intrahepatic porto-systemic shunt in the elderly: Palliation for complications of portal hypertension.

PubMed

Syed, Mubin I; Karsan, Hetal; Ferral, Hector; Shaikh, Azim; Waheed, Uzma; Akhter, Talal; Gabbard, Alan; Morar, Kamal; Tyrrell, Robert

2012-02-27

To present a dedicated series of transjugular intrahepatic porto-systemic shunts (TIPS) in the elderly since data is sparse on this population group. A retrospective review was performed of patients at least 65 years of age who underwent TIPS at our institutions between 1997 and 2010. Twenty-five patients were referred for TIPS. We deemed that 2 patients were not considered appropriate candidates due to their markedly advanced liver disease. Of the 23 patients suitable for TIPS, the indications for TIPS placement was portal hypertension complicated by refractory ascites alone (n = 9), hepatic hydrothorax alone (n = 2), refractory ascites and hydrothorax (n = 1), gastrointestinal bleeding alone (n = 8), gastrointestinal bleeding and ascites (n = 3). Of these 23 attempted TIPS procedure patients, 21 patients had technically successful TIPS procedures. A total of 29 out of 32 TIPS procedures including revisions were successful in 21 patients with a mean age of 72.1 years (range 65-82 years). Three of the procedures were unsuccessful attempts at TIPS and 8 procedures were successful revisions of our existing TIPS. Sixteen of 21 patients who underwent successful TIPS (excluding 5 patients lost to follow-up) were followed for a mean of 14.7 mo. Ascites and/or hydrothorax was controlled following technically successful procedures in 12 of 13 patients. Bleeding was controlled following technically successful procedures in 10 out of 11 patients. We have demonstrated that TIPS is an effective procedure to control refractory complications of portal hypertension in elderly patients.

Intraarticular Sacroiliac Joint Injection Under Computed Tomography Fluoroscopic Guidance: A Technical Note to Reduce Procedural Time and Radiation Dose

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

Paik, Nam Chull, E-mail: pncspine@gmail.com

2016-07-15

PurposeA technique for computed tomography fluoroscopy (CTF)-guided intraarticular (IA) sacroiliac joint (SIJ) injection was devised to limit procedural time and radiation dose.MethodsOur Institutional Review Board approved this retrospective analysis and waived the requirement for informed consent. Overall, 36 consecutive diagnostic or therapeutic IA SIJ injections (unilateral, 20; bilateral, 16) performed in 34 patients (female, 18; male, 16) with a mean age of 45.5 years (range 20–76 years) under CTF guidance were analyzed, assessing technical success (i.e., IA contrast spread), procedural time, and radiation dose.ResultsAll injections were successful from a technical perspective and were free of serious complications. Respective median proceduralmore » times and effective doses of SIJ injection were as follows: unilateral, 5.28 min (range 3.58–8.00 min) and 0.11 millisievert (mSv; range 0.07–0.24 mSv); and bilateral, 6.72 min (range 4.17–21.17 min) and 0.11 mSv (range 0.09–0.51 mSv).ConclusionsGiven the high rate of technical success achieved in limited time duration and with little radiation exposure, CTF-guided IA SIJ injection is a practical and low-risk procedure.« less

Approval of Modified Seating Systems Initially Approved Under A Technical Standard Order

DOT National Transportation Integrated Search

1997-06-03

The Advisory Circular (AC) provides information, clarification, and procedural : guidance concerning the approval and installation of modified Technical Standard : Order (TSO) seating systems in U.S. type certificated aircraft.

The New Jersey Police Technical Assistance Program

DOT National Transportation Integrated Search

2007-03-01

The Police Technical Assistance Program (PTAP), a federal model, was adopted to support the New Jersey Department of Transportation (NJDOT)s safety mission. Several activities were included in this initiative: conducting assessments, providing tec...

Pathways to Self-Sufficiency: Successful Entrepreneurship for Refugees

ERIC Educational Resources Information Center

Fong, Rowena; Busch, Noel Bridget; Armour, Marilyn; Heffron, Laurie Cook; Chanmugam, Amy

2007-01-01

This study examined the successes and challenges of refugee entrepreneurs by interviewing 50 refugees, service providers, and technical assistance providers. Qualitative data analyses revealed that successes and challenges occurred both at the individual and family levels as well as at the community and agency levels. The findings underscore the…

Exploring Career Success of Late Bloomers from the TVET Background

ERIC Educational Resources Information Center

Omar, Zoharah; Krauss, Steven Eric; Sail, Rahim M.; Ismail, Ismi Arif

2011-01-01

Purpose: The purpose of this paper is to explore objective and subjective career success and to identify factors contributing to career success among a sample of technical and vocational education and training (TVET) "late bloomers" working in Malaysia. Design/methodology/approach: Incorporating a mixed method design, the authors…

Predictors of Postsecondary Success

ERIC Educational Resources Information Center

Hein, Vanessa; Smerdon, Becky; Sambolt, Megan

2013-01-01

The purpose of this brief is to provide information to state, district, and school personnel seeking support to determine whether their students are on a path to postsecondary success. The College and Career Readiness and Success Center (CCRS Center) has received technical assistance requests from a number of states regarding factors that predict…

College Graduation Rates for Minority Students in a Selective Technical University: Will Participation in a Summer Bridge Program Contribute to Success?

PubMed

Murphy, Terrence E; Gaughan, Monica; Hume, Robert; Moore, S Gordon

2010-03-01

There are many approaches to solving the problem of underrepresentation of some racial and ethnic groups and women in scientific and technical disciplines. Here, the authors evaluate the association of a summer bridge program with the graduation rate of underrepresented minority (URM) students at a selective technical university. They demonstrate that this 5-week program prior to the fall of the 1st year contains elements reported as vital for successful student retention. Using multivariable survival analysis, they show that for URM students entering as fall-semester freshmen, relative to their nonparticipating peers, participation in this accelerated summer bridge program is associated with higher likelihood of graduation. The longitudinal panel data include more than 2,200 URM students.

College Graduation Rates for Minority Students in a Selective Technical University: Will Participation in a Summer Bridge Program Contribute to Success?

PubMed Central

Murphy, Terrence E.; Gaughan, Monica; Hume, Robert; Moore, S. Gordon

2012-01-01

There are many approaches to solving the problem of underrepresentation of some racial and ethnic groups and women in scientific and technical disciplines. Here, the authors evaluate the association of a summer bridge program with the graduation rate of underrepresented minority (URM) students at a selective technical university. They demonstrate that this 5-week program prior to the fall of the 1st year contains elements reported as vital for successful student retention. Using multivariable survival analysis, they show that for URM students entering as fall-semester freshmen, relative to their nonparticipating peers, participation in this accelerated summer bridge program is associated with higher likelihood of graduation. The longitudinal panel data include more than 2,200 URM students. PMID:23136456

Managing change: an overview.

PubMed

Lorenzi, N M; Riley, R T

2000-01-01

As increasingly powerful informatics systems are designed, developed, and implemented, they inevitably affect larger, more heterogeneous groups of people and more organizational areas. In turn, the major challenges to system success are often more behavioral than technical. Successfully introducing such systems into complex health care organizations requires an effective blend of good technical and good organizational skills. People who have low psychological ownership in a system and who vigorously resist its implementation can bring a "technically best" system to its knees. However, effective leadership can sharply reduce the behavioral resistance to change-including to new technologies-to achieve a more rapid and productive introduction of informatics technology. This paper looks at four major areas-why information system failures occur, the core theories supporting change management, the practical applications of change management, and the change management efforts in informatics.

Stent placement with the monorail technique for treatment of mesenteric artery stenosis.

PubMed

Schaefer, Philipp J; Schaefer, Fritz K W; Hinrichsen, Holger; Jahnke, Thomas; Charalambous, Nikolas; Heller, Martin; Mueller-Huelsbeck, Stefan

2006-04-01

To analyze the immediate and midterm success of stenting of mesenteric arteries by a monorail technique in patients with chronic mesenteric ischemia. In this prospective case series, 19 patients (11 male, 8 female; mean age, 62.9 +/- 10.4 y; range, 36-82 y) with 23 symptomatic stenoses of mesenteric arteries were treated with stent placement by a monorail technique in a radiologic intervention center over a period of 4.5 years. Clinical examinations and duplex sonography were used to evaluate the stents' patency and clinical success. Kaplan-Meier graphs were calculated to analyze the patency and freedom-from-symptom rate. Initial technical success rate was 22/23 (96%). Mean follow-up was 17 months (range, 1-58 mo). Primary patency and primary clinical success rates were 82% and 78%, respectively. According to Kaplan-Meier tables, the patency rates were 96%, 87%, 76%, and 61% at 0, 1, 15, and 24 months, respectively, and the freedom-from-symptom rates were 95%, 90%, 72%, and 54% at 0, 1, 24, and 30 months, respectively. No peri-interventional complications occurred. Two patients died of cardiac failure in the hospital within 30 days after intervention; deaths were not related to the intervention. Stent placement by a monorail technique in mesenteric arteries is an effective and safe treatment for symptomatic stenoses in patients with chronic mesenteric ischemia after a mean follow-up of 17 months.

Safe and successful endoscopic initial treatment and long-term eradication of gastric varices by endoscopic ultrasound-guided Histoacryl (N-butyl-2-cyanoacrylate) injection.

PubMed

Gubler, Christoph; Bauerfeind, Peter

2014-09-01

Optimal endoscopic treatment of gastric varices is still not standardized nowadays. Actively bleeding varices may prohibit a successful endoscopic injection therapy of Histoacryl® (N-butyl-2-cyanoacrylate). Since 2006, we have treated gastric varices by standardized endoscopic ultrasound (EUS) guided Histoacryl injection therapy without severe adverse events. We present a large single-center cohort over 7 years with a standardized EUS-guided sclerotherapy of all patients with gastric varices. Application was controlled by fluoroscopy to immediately detect any glue embolization. Only perforating veins located within the gastric wall were treated. In the follow up, we repeated this treatment until varices were eradicated. Utmost patients (36 of 40) were treated during or within 24 h of active bleeding. About 32.5% of patients were treated while visible bleeding. Histoacryl injection was always technically successful and only two patients suffered a minor complication. Acute bleeding was stopped in all patients. About 15% (6 of 40) of patients needed an alternative rescue treatment in the longer course. Three patients got a transjugular portosystemic shunt and another three underwent an orthotopic liver transplantation. Mean long-term survival of 60 months was excellent. Active bleeding of gastric varices can be treated successfully without the necessity of gastric rinsing with EUS-guided injection of Histoacryl.

Staff Considerations in Technical Services: The Chameleon Approach.

ERIC Educational Resources Information Center

Foster, Constance L.

1988-01-01

Discusses the need to cope effectively with technological transitions in library technical services and to plan for successful staff development. The areas discussed include changing job skills, financial planning, ergonomics, innovative partnerships, training, and an emphasis on human resources development. (21 references) (Author/CLB)

An Online Approach to Teaching International Outsourcing in Technical Communication Classes

ERIC Educational Resources Information Center

St. Amant, Kirk

2005-01-01

The growth of international online access has given rise to a new production method--international outsourcing--that has important implications for technical communication practices. Successful interactions within international outsourcing require individuals to understand how cultural factors could affect online interactions. Today's technical…

Partnering for Student Transfer Success

ERIC Educational Resources Information Center

Washington State Board for Community and Technical Colleges, 2015

2015-01-01

Washington's community and technical colleges, private non-profit baccalaureate, and public baccalaureate colleges and universities have a proud history of partnering to serve students. Nowhere is this cooperation more evident than in the smooth transfer process from community and technical colleges into four-year colleges and universities. This…

Transarterial Embolization of Type II Endoleaks after EVAR: The Role of Ethylene Vinyl Alcohol Copolymer (Onyx)

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

Mueller-Wille, Rene, E-mail: rene.mueller-wille@ukr.de; Wohlgemuth, Walter A., E-mail: walter.wohlgemuth@ukr.de; Heiss, Peter, E-mail: peter.heiss@ukr.de

2013-10-15

Purpose: To determine the feasibility and efficacy of transarterial endoleak embolization using the liquid embolic agent ethylene vinyl alcohol copolymer (Onyx). Methods: Over a 7-year period eleven patients (6 women, 5 men; mean age 68 years, range 37-83 years) underwent transarterial embolization of a type II endoleak after endovascular aortic aneurysm repair using the liquid embolic agent Onyx. Two patients (18 %) had a simple type II endoleak with only one artery in communication with the aneurysm sac, whereas 9 patients (82 %) had a complex type II endoleak with multiple communicating vessels. We retrospectively analyzed the technical and clinicalmore » success of transarterial type II endoleak embolization with Onyx. Complete embolization of the nidus was defined as technical success. Embolization was considered clinically successful when volume of the aneurysm sac was stable or decreased on follow-up CT scans. Result: Mean follow-up time was 26.0 (range 6-50) months. Clinical success was achieved in 8 of 11 patients (73 %). Transarterial nidus embolization with Onyx was technically successful in 6 of 11 patients (55 %). In three cases the nidus was embolized without direct catheterization from a more distal access through the network of collateral vessels. Conclusion: Onyx is a favorable embolic agent for transarterial endoleak embolization. To achieve the best clinical results, complete occlusion of the nidus is mandatory.« less

Owning the program technical baseline for future space systems acquisition: program technical baseline tracking tool

NASA Astrophysics Data System (ADS)

Nguyen, Tien M.; Guillen, Andy T.; Hant, James J.; Kizer, Justin R.; Min, Inki A.; Siedlak, Dennis J. L.; Yoh, James

2017-05-01

The U.S. Air Force (USAF) has recognized the needs for owning the program and technical knowledge within the Air Force concerning the systems being acquired to ensure success. This paper extends the previous work done by the authors [1-2] on the "Resilient Program Technical Baseline Framework for Future Space Systems" and "Portfolio Decision Support Tool (PDST)" to the development and implementation of the Program and Technical Baseline (PTB) Tracking Tool (PTBTL) for the DOD acquisition life cycle. The paper describes the "simplified" PTB tracking model with a focus on the preaward phases and discusses how to implement this model in PDST.

Pancreas transplantation. An initial experience with systemic and portal drainage of pancreatic allografts.

PubMed Central

Rosenlof, L K; Earnhardt, R C; Pruett, T L; Stevenson, W C; Douglas, M T; Cornett, G C; Hanks, J B

1992-01-01

Pancreas transplantation has evolved dramatically since its introduction in 1966. As new centers for transplantation have developed, the evaluation of complications associated with pancreas transplantation has led to advances in surgical technique. Furthermore, surgical alterations of the pancreas resulting from transplantation (systemic release of insulin and denervation) are of unproven consequence on glucose metabolism. Since 1988, the authors have performed 21 transplants (16 combined pancreas/kidney, 3 pancreas alone, which includes 1 retransplantation, 1 pancreas after previous kidney transplant, and 1 "cluster") in 20 patients aged 18 to 49 years; mean, 35 +/- 1 years. Overall patient survival is 95%. Three pancreatic grafts failed within the first year because of technical failure; one additional pancreas was lost to an immunologic event on postoperative day 449, for an overall pancreatic graft survival of 81%. No renal grafts were lost. To evaluate causes of graft failure, demographic data were compared, which included age and sex of the donor and the recipient, operative time, intraoperative blood transfusion, and ischemic time of the graft. No statistically significant differences were found between groups except for ischemic time (11.7 +/- 6.4 hours for the technical success group versus 19.8 +/- 3.7 hours for the technical failure group; p less than 0.05 by unpaired Student's t test). Quadruple immunosuppression was used, which included prednisone, cyclosporine, azathioprine, and antilymphoblast globulin. A mean of 1.2 (range, 0 to 3) rejection episodes per patient occurred. Mean hospital stay was 24 +/- 11 days. Surgical and infectious complications were evaluated by comparing the technical success (TS) group (n = 17) with the technical failure (TF) group. Surgical complications in the TS group revealed a mean of 1.3 episodes per patient, whereas the TF group had 3.7 episodes per patient. The TS also had a reduced incidence of infectious complications compared with the TF (1.7 versus 4.3 episodes per patient). Cytomegalovirus was common in both groups, accounting for 11 infectious episodes, and occurred on a mean postoperative day of 38. Mean postoperative HbA1C levels dropped to 5 +/- 1% from 11 +/- 3%. The authors developed a new technique that incorporates portal drainage of the pancreatic venous effluent in three recipients. Preoperative metabolic studies disclosed a mean fasting glucose of 211 +/- 27 mg/dL and a mean stimulated glucose value of 434 +/- 41 mg/dL for all patients; the mean fasting insulin was 23 +/- 4 microU/mL.(ABSTRACT TRUNCATED AT 400 WORDS) Images FIG. 5. PMID:1632680

User acceptability--a critical success factor for picture archiving and communication system implementation.

PubMed

Crivianu-Gaita, D; Babyn, P; Gilday, D; O'Brien, B; Charkot, E

2000-05-01

The Department of Diagnostic Imaging at the Hospital for Sick Children (HSC), Toronto, implemented a picture archiving and communication system (PACS) during the last year. This report describes our experience from the point of view of user acceptability. Based on objective data, the following key success factors were identified: user involvement in PACS planning, training, technical support, and rollout of pilot projects. Although technical factors are critical and must be addressed, the main conclusion of our study is that other nontechnical factors need to be recognized and resolved. Recognition of the importance of these factors to user acceptance and clear communication and consultation will help reduce negative user attitudes and increase the chance of a successful PACS implementation.

Context-specific energy strategies: coupling energy system visions with feasible implementation scenarios.

PubMed

Trutnevyte, Evelina; Stauffacher, Michael; Schlegel, Matthias; Scholz, Roland W

2012-09-04

Conventional energy strategy defines an energy system vision (the goal), energy scenarios with technical choices and an implementation mechanism (such as economic incentives). Due to the lead of a generic vision, when applied in a specific regional context, such a strategy can deviate from the optimal one with, for instance, the lowest environmental impacts. This paper proposes an approach for developing energy strategies by simultaneously, rather than sequentially, combining multiple energy system visions and technically feasible, cost-effective energy scenarios that meet environmental constraints at a given place. The approach is illustrated by developing a residential heat supply strategy for a Swiss region. In the analyzed case, urban municipalities should focus on reducing heat demand, and rural municipalities should focus on harvesting local energy sources, primarily wood. Solar thermal units are cost-competitive in all municipalities, and their deployment should be fostered by information campaigns. Heat pumps and building refurbishment are not competitive; thus, economic incentives are essential, especially for urban municipalities. In rural municipalities, wood is cost-competitive, and community-based initiatives are likely to be most successful. Thus, the paper shows that energy strategies should be spatially differentiated. The suggested approach can be transferred to other regions and spatial scales.

Can Economics Provide Insights into Trust Infrastructure?

NASA Astrophysics Data System (ADS)

Vishik, Claire

Many security technologies require infrastructure for authentication, verification, and other processes. In many cases, viable and innovative security technologies are never adopted on a large scale because the necessary infrastructure is slow to emerge. Analyses of such technologies typically focus on their technical flaws, and research emphasizes innovative approaches to stronger implementation of the core features. However, an observation can be made that in many cases the success of adoption pattern depends on non-technical issues rather than technology-lack of economic incentives, difficulties in finding initial investment, inadequate government support. While a growing body of research is dedicated to economics of security and privacy in general, few theoretical studies in this area have been completed, and even fewer that look at the economics of “trust infrastructure” beyond simple “cost of ownership” models. This exploratory paper takes a look at some approaches in theoretical economics to determine if they can provide useful insights into security infrastructure technologies and architectures that have the best chance to be adopted. We attempt to discover if models used in theoretical economics can help inform technology developers of the optimal business models that offer a better chance for quick infrastructure deployment.

Fast 3-T MR-guided transrectal prostate biopsy using an in-room tablet device for needle guide alignment: a feasibility study.

PubMed

Overduin, Christiaan G; Heidkamp, Jan; Rothgang, Eva; Barentsz, Jelle O; de Lange, Frank; Fütterer, Jurgen J

2018-05-22

To assess the feasibility of adding a tablet device inside the scanner room to assist needle-guide alignment during magnetic resonance (MR)-guided transrectal prostate biopsy. Twenty patients with one cancer-suspicious region (CSR) with PI-RADS score ≥ 4 on diagnostic multiparametric MRI were prospectively enrolled. Two orthogonal scan planes of an MR fluoroscopy sequence (~3 images/s) were aligned to the CSR and needle-guide pivoting point. Targeting was achieved by manipulating the needle-guide under MR fluoroscopy feedback on the in-room tablet device. Technical feasibility and targeting success were assessed. Complications and biopsy procedure times were also recorded. Needle-guide alignment with the in-room tablet device was technically successful in all patients and allowed sampling after a single alignment step in 19/20 (95%) CSRs (median size 14 mm, range: 4-45). Biopsy cores contained cancer in 18/20 patients. There were no per-procedural or post-biopsy complications. Using the tablet device, the mean time to first biopsy was 5.8 ± 1.0 min and the mean total procedure time was 23.7 ± 4.1 min. Use of an in-room tablet device to assist needle-guide alignment was feasible and safe during MR-guided transrectal prostate biopsy. Initial experience indicates potential for procedure time reduction. • Performing MR-guided prostate biopsy using an in-room tablet device is feasible. • CSRs could be sampled after a single alignment step in 19/20 patients. • The mean procedure time for biopsy with the tablet device was 23.7 min.

Added Value of Contrast-Enhanced Ultrasound on Biopsies of Focal Hepatic Lesions Invisible on Fusion Imaging Guidance.

PubMed

Kang, Tae Wook; Lee, Min Woo; Song, Kyoung Doo; Kim, Mimi; Kim, Seung Soo; Kim, Seong Hyun; Ha, Sang Yun

2017-01-01

To assess whether contrast-enhanced ultrasonography (CEUS) with Sonazoid can improve the lesion conspicuity and feasibility of percutaneous biopsies for focal hepatic lesions invisible on fusion imaging of real-time ultrasonography (US) with computed tomography/magnetic resonance images, and evaluate its impact on clinical decision making. The Institutional Review Board approved this retrospective study. Between June 2013 and January 2015, 711 US-guided percutaneous biopsies were performed for focal hepatic lesions. Biopsies were performed using CEUS for guidance if lesions were invisible on fusion imaging. We retrospectively evaluated the number of target lesions initially invisible on fusion imaging that became visible after applying CEUS, using a 4-point scale. Technical success rates of biopsies were evaluated based on histopathological results. In addition, the occurrence of changes in clinical decision making was assessed. Among 711 patients, 16 patients (2.3%) were included in the study. The median size of target lesions was 1.1 cm (range, 0.5-1.9 cm) in pre-procedural imaging. After CEUS, 15 of 16 (93.8%) focal hepatic lesions were visualized. The conspicuity score was significantly increased after adding CEUS, as compared to that on fusion imaging (p < 0.001). The technical success rate of biopsy was 87.6% (14/16). After biopsy, there were changes in clinical decision making for 11 of 16 patients (68.8%). The addition of CEUS could improve the conspicuity of focal hepatic lesions invisible on fusion imaging. This dual guidance using CEUS and fusion imaging may affect patient management via changes in clinical decision-making.

Percutaneous Treatment of Coronary Chronic Total Occlusion Part 2: Technical Approach

PubMed Central

Galassi, Alfredo; Grantham, Aaron; Kandzari, David; Lombardi, William; Moussa, Issam; Thompson, Craig; Werner, Gerald; Chambers, Charles

2014-01-01

Dual injection is recommended for nearly all chronic total occlusion (CTO) percutaneous coronary intervention (PCI) to determine the optimal crossing strategy and guide wire advancement into the distal true lumen. Strategies that provide enhanced guide catheter support (such as long sheaths, large-bore guiding catheters, use of guide catheter extensions, and anchor techniques) are important for maximising the success rate and efficiency of CTO PCI. Use of a microcatheter or over-the-wire balloon is strongly recommended in CTO PCI for enhancing the penetrating power of the guidewire, enabling change in tip shape and allowing guidewire change (stiff CTO guidewires are not optimal for crossing non-occluded coronary segments). Adherence to a procedural strategy that standardises CTO technique and facilitates procedural success is recommended. Such a strategy would permit stepwise decision-making for antegrade and retrograde methods; inform guidewire selection; and incorporate alternative approaches for instances of initial failure. Given the paucity of long-term outcomes with use of novel crossing techniques (antegrade dissection/re-entry and retrograde), antegrade wire escalation is the preferred CTO crossing technique, if technically feasible. Using measures to minimise radiation exposure (including but not limited to use of 7.5 frames per second fluoroscopy and use of low magnification) and contrast administration is recommended. CTO PCI is best performed at centres with dedicated CTO PCI experience and expertise. Use of crossing difficulty prediction tools, such as the J-CTO score, can facilitate the selection of cases with a high likelihood of quick crossing that can be attempted at less experienced centres. PMID:29588803

Successful endoscopic removal of a rare, large impacted pancreatic duct stone using grasping forceps: A case report with video.

PubMed

Liu, Qin; Wang, Yiping; Zeng, Hongze; Hu, Bing

2018-04-01

As a main complication of chronic pancreatitis (CP), pancreatic duct stones (PDSs) are often associated with ductal obstruction resulting in increasing intraductal and parenchymal pressure and long-lasting pain. There are many methods for removing PDSs. However, for large stones, it is technically difficult to remove them entirely by endoscopic retrograde cholangiopancreatography (ERCP). A 57-year-old man presented with a chief complaint of severe epigastric pain radiating to his back 3 or 4 times annually for 2 years. The abdominal computed tomography scan revealed dilation of the proximal pancreatic duct with an irregular high-density calcification shadow located at the head of the pancreas. A pancreatic stent was placed initially by ERCP to relieve epigastric pain and alleviate symptom. Repeated ERCP was subsequently performed 2 months later to extract the impacted large pancreatic stone. By using grasping forceps, the huge coralloid stone (272 × 0 mm) was successfully extracted in an en bloc manner. Then, a 7-French × 5 cm plastic pancreatic stent was placed for 2 weeks. The patient was free of any pancreatic pain during the 2-year follow-up. Generally, for large or impacted pancreatic stones, endoscopic removal is technically difficult to achieve. Pancreatic stenting can be an effective method of alleviating abdominal pain and facilitating subsequent endoscopic lithoextraction. Extraction of large stones with grasping forceps can be an alternative approach instead of extracorporeal shock wave lithotripsy or surgery when stones are impacted at the papilla's orifice and partially protruding into the duodenal lumen.

NASA's Space Launch System Transitions From Design To Production

NASA Technical Reports Server (NTRS)

Askins, Bruce R.; Robinson, Kimberly F.

2016-01-01

NASA's Space Launch System (SLS) successfully completed its Critical Design Review (CDR) in 2015, a major milestone on the journey to an unprecedented era of exploration for humanity. CDR formally marked the program's transition from design to production phase just four years after the program's inception and the first such milestone for a human launch vehicle in 40 years. While challenges typical of a complex development program lie ahead, CDR evaluators concluded that the design is technically and programmatically sound and ready to press forward to Design Certification Review (DCR) and readiness for launch of Exploration Mission 1 (EM-1) in the 2018 timeframe. SLS is prudently based on existing propulsion systems, infrastructure and knowledge with a clear, evolutionary path as required by mission needs. In its initial configuration, designated Block 1, SLS will a minimum of 70 metric tons (t) (154,324 pounds) of payload to low Earth orbit (LEO). It will evolve to a 130 t (286,601 pound) payload capacity by upgrading its engines, boosters, and upper stage, dramatically increasing the mass and volume of human and robotic exploration while decreasing mission risk, increasing safety, and simplifying ground and mission operations. CDR was the central programmatic accomplishment among many technical accomplishments that will be described in this paper. The government/industry SLS team successfully test-fired a flight-like five-segment solid rocket motor, as well as seven hotfire development tests of the RS-25 core stage engine. The majority of the major test article and flight barrels, rings, and domes for the core stage liquid oxygen, liquid hydrogen, engine section, intertank, and forward skirt were manufactured at NASA's Michoud Assembly Facility in New Orleans, Louisiana. Renovations to the B-2 test stand for stage green run testing were completed at NASA's Stennis Space Center (SSC), near Bay St. Louis, Mississippi. Core stage test stands are reaching completion at NASA's Marshall Space Flight Center in Huntsville, Alabama. The modified Pegasus barge for core stage transportation from manufacturing to testing and launch sites was delivered to SSC. The Interim Cryogenic Propulsion System test article was also completed. This paper will discuss these and other technical and programmatic successes and challenges over the past year and provide a preview of work ahead before the first flight of this new capability.

Integration of a CAD System Into an MDO Framework

NASA Technical Reports Server (NTRS)

Townsend, J. C.; Samareh, J. A.; Weston, R. P.; Zorumski, W. E.

1998-01-01

NASA Langley has developed a heterogeneous distributed computing environment, called the Framework for Inter-disciplinary Design Optimization, or FIDO. Its purpose has been to demonstrate framework technical feasibility and usefulness for optimizing the preliminary design of complex systems and to provide a working environment for testing optimization schemes. Its initial implementation has been for a simplified model of preliminary design of a high-speed civil transport. Upgrades being considered for the FIDO system include a more complete geometry description, required by high-fidelity aerodynamics and structures codes and based on a commercial Computer Aided Design (CAD) system. This report presents the philosophy behind some of the decisions that have shaped the FIDO system and gives a brief case study of the problems and successes encountered in integrating a CAD system into the FEDO framework.

[Severe infective endocarditis through the history].

PubMed

Rouzé, S; Leguerrier, A; Verhoye, J P; Flécher, E

2017-02-01

The history of infective endocarditis (IE) is a good example of medical progress. Initially incurable, endocarditis, when diagnosed, was synonym of death. After significant diagnostic progress, thanks to Osler's contribution especially, the first surgeries and antibacterial drugs obtained very few successful cures. We had to wait until Flamming's discovery to observe frequent cures thanks to antibiotics. Surgery manages to push possibilities of cure a bit further. However, paravalvular extensions, described since the first surgical case of IE, was a real technical matter. Thus, the second half of 20th century was devoted to overcoming this surgical challenge. In this historical review, we describe the story of severe IE, especially with paravalvular involvement, by highlighting major progress - clinical and surgical, that allows its current management. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Geologic coal assessment: The interface with economics

USGS Publications Warehouse

Attanasi, E.D.

2001-01-01

Geologic resource assessments describe the location, general characteristics, and estimated volumes of resources, whether in situ or technically recoverable. Such compilations are only an initial step in economic resource evaluation. This paper identifies, by examples from the Illinois and Appalachian basins, the salient features of a geologic assessment that assure its usefulness to downstream economic analysis. Assessments should be in sufficient detail to allocate resources to production units (mines or wells). Coal assessments should include the spatial distribution of coal bed characteristics and the ability to allocate parts of the resource to specific mining technologies. For coal bed gas assessment, the production well recoveries and well deliverability characteristics must be preserved and the risk structure should be specified so dryholes and noncommercial well costs are recovered by commercially successful wells. ?? 2001 International Association for Mathematical Geology.

Entrepreneurial Attitude and Entrepreneurial Efficacy of Technical Secondary School Students

ERIC Educational Resources Information Center

Zaidatol Akmaliah, Lope Pihie; Bagheri, Afsaneh

2010-01-01

Entrepreneurial attitude and entrepreneurial efficacy are considered to be two important factors influencing students' intention and success in becoming entrepreneurs. This study was conducted to determine the entrepreneurial attitude and entrepreneurial efficacy of 3000 students following technical subjects in the secondary schools of Malaysia.…

Life science research and drug discovery at the turn of the 21st century: the experience of SwissBioGrid.

PubMed

den Besten, Matthijs; Thomas, Arthur J; Schroeder, Ralph

2009-04-22

It is often said that the life sciences are transforming into an information science. As laboratory experiments are starting to yield ever increasing amounts of data and the capacity to deal with those data is catching up, an increasing share of scientific activity is seen to be taking place outside the laboratories, sifting through the data and modelling "in silico" the processes observed "in vitro." The transformation of the life sciences and similar developments in other disciplines have inspired a variety of initiatives around the world to create technical infrastructure to support the new scientific practices that are emerging. The e-Science programme in the United Kingdom and the NSF Office for Cyberinfrastructure are examples of these. In Switzerland there have been no such national initiatives. Yet, this has not prevented scientists from exploring the development of similar types of computing infrastructures. In 2004, a group of researchers in Switzerland established a project, SwissBioGrid, to explore whether Grid computing technologies could be successfully deployed within the life sciences. This paper presents their experiences as a case study of how the life sciences are currently operating as an information science and presents the lessons learned about how existing institutional and technical arrangements facilitate or impede this operation. SwissBioGrid gave rise to two pilot projects: one for proteomics data analysis and the other for high-throughput molecular docking ("virtual screening") to find new drugs for neglected diseases (specifically, for dengue fever). The proteomics project was an example of a data management problem, applying many different analysis algorithms to Terabyte-sized datasets from mass spectrometry, involving comparisons with many different reference databases; the virtual screening project was more a purely computational problem, modelling the interactions of millions of small molecules with a limited number of protein targets on the coat of the dengue virus. Both present interesting lessons about how scientific practices are changing when they tackle the problems of large-scale data analysis and data management by means of creating a novel technical infrastructure. In the experience of SwissBioGrid, data intensive discovery has a lot to gain from close collaboration with industry and harnessing distributed computing power. Yet the diversity in life science research implies only a limited role for generic infrastructure; and the transience of support means that researchers need to integrate their efforts with others if they want to sustain the benefits of their success, which are otherwise lost.

Expandable metal stents for endoscopic bilateral stent-within-stent placement for malignant hilar biliary obstruction.

PubMed

Chahal, Prabhleen; Baron, Todd H

2010-01-01

Placement of biliary stents is effective for palliation of unresectable hilar malignant biliary obstruction. However, when bilateral self-expandable metal stents (SEMSs) are used, placement can be technically challenging. In many studies, side-by-side placement is performed, although it is unclear whether this is the most anatomical and functional approach. We sought to assess the technical feasibility and effectiveness of deploying bilateral SEMSs with a stent-within-stent approach using commercially available stents with a large cell width. Retrospective study. Tertiary care medical center. Patients with malignant biliary hilar obstruction referred for endoscopic palliation of obstructive jaundice. Technical success, ie, successful bilateral SEMS placement across the stricture; functional success, ie, decrease in pretreatment bilirubin level; early and late complications; and stent patency. Bilateral biliary drainage was attempted and successfully established in 21 patients with malignant hilar obstruction (15 men, 6 women; mean age 63.7 [standard deviation 13.9] years), resulting in clinical improvement of obstructive symptoms. Median follow-up was 6.14 months (interquartile range 3.5-9.5 months). There were 1 (5%) early and 7 (33%) late stent occlusions that required endoscopic reintervention. The 30-day mortality rate was 10% (2 deaths). Retrospective study of a series of cases treated at a tertiary care center by expert endoscopists. This simple technique was performed by using an open-cell expandable metal stent is technically feasible and easy and allows bilateral placement of SEMSs in patients with unresectable hilar malignancy. 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

["TECHNIKA I NAUKA" ["SCIENCE AND TECHNOLOGY"] (1958-)--MAGAZINE OF THE ASSOCIATION OF POLISH ENGINEERS IN GREAT BRITAIN].

PubMed

Chwastyk-Kowalczyk, Jolanta

2015-01-01

This article presents the history of establishment, functioning and the role of "Science and Technology"--quarterly of the Association of Polish Engineers in Great Britain--in shaping Polish technical thought in the environment of Polish engineers and technicians living in exile. The analysis of the content of the journal published in London in the years 1958-2008 made it evident that this official scientific organ of Polish technical intelligentsia edited in 500 copies reaches members of engineering, technical and scientific milieu across many continents. Despite the fact that Polish language dominates in the articles and thanks to the interdisciplinary character of their content - science and technology, biology, the humanities, sociology and others--the journal makes it possible for the reader to participate in an intellectual adventure. "Science and Technology" was created in 1958 on the initiative of Eng. Prof. Roman Wajda in Great Britain, with support of other Polish technical associations abroad, and embraced the achievements and organisational life of the Polish technical milieu dispersed around the world. On the basis of the London Society's archive materials and old annual volumes of the journal, the author listed editors-in-chief, composition of editorial committees, collaborators, determined editing costs, changeable periodicity, successive print shops, seats of editorial office that always followed the Association in Great Britain. She also showed the effort of a handful of members of editorial committees, working on a voluntary basis to obtain materials for the journal; the role of the journal linking Polish engineers and technicians in exile and its function as a link with the Country, as well as its role in the sphere of information and propaganda. Finally, the author made an analysis of the journal's content, focusing on categories of articles published in "Science and Technology" in the years 1958-2008. Methods used by the author in the article: archival, analysis of the press content: qualitative and quantitative.

Collecting and Reporting P2 Results: Regional Measurement Guidance

EPA Pesticide Factsheets

Measuring results is an essential component of any successful P2 program and is one way to determine the success of a technical assistance or training effort. This PDF defines some terms of P2 measurement.

The Presidential Address to the Association for Career and Technical Education Research: Using Standards to Reform Teacher Preparation in Career and Technical Education--A Successful Reformation

ERIC Educational Resources Information Center

Whittington, M. Susie

2005-01-01

This article presents the presidential address at the annual conference of the Association for Career and Technical Education Research by M. Susie Whittington, ACTER President 2005. The purpose of the presidential address is to examine a current issue facing the profession, and pose challenges to the membership in the context of that issue. In her…

The transfer of land resources information into the public sector—The Texas experience

NASA Astrophysics Data System (ADS)

Wermund, E. G.

1980-03-01

Mapping of land resources and environmental geology was initiated in Texas toward better communication of geology to the public policy sector. Relevant mapping parameters have included terrain, substrate, active processes, economic resources, and hydrology as well as physical, chemical, and biologic properties. Land resources maps and reports have been prepared for public agencies and published for technical and nontechnical readers; sales of these articles are one indicator of public policy transfer. Single lectures or participation in symposia and colloquia for scientific societies have been valuable only for peer review or as a means to sharpen communicative skills. The most successful mechanisms of public policy transfer have been (1) in-state workshops and short courses for elected officials, Governmental employees, and interested citizens; (2) legislative testimonies; (3) active participation on interagency committees; (4) reviews and comments on planning statements; and (5) a temporary loan of personnel to another agency. Areas where these methods successfully have impacted public policy are reflected in the present quality of Section 208, Section 701, and coastal zone management planning; applications for surface-mining permits; and environmental impact statement records in Texas.

Review of indicators for cross-sectoral optimization of nosocomial infection prophylaxis – a perspective from structurally- and process-oriented hygiene

PubMed Central

Hübner, Nils-Olaf; Fleßa, Steffen; Jakisch, Ralf; Assadian, Ojan; Kramer, Axel

2012-01-01

In the care of patients, the prevention of nosocomial infections is crucial. For it to be successful, cross-sectoral, interface-oriented hygiene quality management is necessary. The goal is to apply the HACCP (Hazard Assessment and Critical Control Points) concept to hospital hygiene, in order to create a multi-dimensional hygiene control system based on hygiene indicators that will overcome the limitations of a procedurally non-integrated and non-cross-sectoral view of hygiene. Three critical risk dimensions can be identified for the implementation of three-dimensional quality control of hygiene in clinical routine: the constitution of the person concerned, the surrounding physical structures and technical equipment, and the medical procedures. In these dimensions, the establishment of indicators and threshold values enables a comprehensive assessment of hygiene quality. Thus, the cross-sectoral evaluation of the quality of structure, processes and results is decisive for the success of integrated infection prophylaxis. This study lays the foundation for hygiene indicator requirements and develops initial concepts for evaluating quality management in hygiene. PMID:22558049

Implementation science: promoting science-based approaches to prevent teen pregnancy.

PubMed

Philliber, Susan; Nolte, Kim

2008-09-01

This paper reports the results of a project funded by the Centers for Disease Control and Prevention intended to promote the use of science-based approaches to teen pregnancy prevention. As with other efforts to promote diffusion of innovations, adoption of these successful programs faced a number of barriers including lack of knowledge of programs that work, lack of funding for training and materials, devaluing science-based approaches, complexity of successful programs, politics, funding streams and compatibility with particular community characteristics. Nevertheless, five state and three national teen pregnancy organizations provided intensive technical assistance, produced materials, and provided training to encourage use of programs that work. Local barriers to their work included the fact that teen pregnancy rates were already dropping, instability of funding to pay for such programs, turnover of agency staff, the need for intensive follow-up to promote adoption, the internal organization of the initiative, and the fragility of local teen pregnancy prevention coalitions. Still, in each of five states, there was increased adoption of science-based approaches to prevent teen pregnancy.

Improvement to visualization of nodes in breast cancer patients following audit: are we seeing the problem?

PubMed

Paterson, Carolyn L; Hendry, Fraser R; Bolster, Alison A

2018-06-01

Successful localization of nodes in breast cancer patients depends upon the effectiveness of the lymphoscintigraphy technique employed. A benefit of performing imaging as part of this procedure is that it allows sites to audit their technique. An audit of breast cancer patients at the Glasgow Royal Infirmary (GRI) hospital showed nodes to be visualized in only 81% of patients. Current guidelines state that nodes should be seen in more than 95% of patients. A period of investigation and review led to changes being made to the injection and imaging technique employed at the GRI site. Following these changes a re-audit was performed that showed that the node visualization rate has successfully been increased to 97%, thereby meeting the standards set in the guidelines. This technical note details the results of the initial audit and re-audit, and explains the investigation and changes made to clinical procedures at the GRI site to improve the node visualization rate. The challenges that can occur when performing breast sentinel node procedures are also discussed.

[Business intelligence in radiology. Challenges and opportunities].

PubMed

Escher, A; Boll, D

2015-10-01

Due to economic pressures and need for higher transparency, a ubiquitous availability of administrative information is needed. Therefore radiology managers should consider implementing business intelligence (BI) solutions. BI is defined as a systemic approach to support decision-making in business administration. It is an important part of the overall strategy of an organization. Implementation and operation is initially associated with costs and for a successful launch important prerequisites must be fulfilled. First, a suitable product must be selected, followed by the technical and organizational implementation. After consideration of the type of data to be collected and a system of key performance indicators must be established. BI replaces classic retrospective business reporting with multidimensional and multifactorial analyses, real-time monitoring, and predictive analyses. The benefits of BI include the rapid availability of important information and the depth of possible data analysis. The simple and intuitive use of modern BI applications by the users themselves (!) combined with a continuous availability of information is the key to success. Professional BI will be an important part of management in radiology in the future.

Single molecule microscopy in 3D cell cultures and tissues.

PubMed

Lauer, Florian M; Kaemmerer, Elke; Meckel, Tobias

2014-12-15

From the onset of the first microscopic visualization of single fluorescent molecules in living cells at the beginning of this century, to the present, almost routine application of single molecule microscopy, the method has well-proven its ability to contribute unmatched detailed insight into the heterogeneous and dynamic molecular world life is composed of. Except for investigations on bacteria and yeast, almost the entire story of success is based on studies on adherent mammalian 2D cell cultures. However, despite this continuous progress, the technique was not able to keep pace with the move of the cell biology community to adapt 3D cell culture models for basic research, regenerative medicine, or drug development and screening. In this review, we will summarize the progress, which only recently allowed for the application of single molecule microscopy to 3D cell systems and give an overview of the technical advances that led to it. While initially posing a challenge, we finally conclude that relevant 3D cell models will become an integral part of the on-going success of single molecule microscopy. Copyright © 2014 Elsevier B.V. All rights reserved.

The reentry catheter: a second chance for endoluminal reentry at difficult lower extremity subintimal arterial recanalizations.

PubMed

Etezadi, Vahid; Benenati, James F; Patel, Parag J; Patel, Rahul S; Powell, Alex; Katzen, Barry T

2010-05-01

From January 2005 to July 2008, a retrospective study was conducted at a single institution to investigate technical success of the use of a reentry device (Outback LTD reentry catheter) in aortoiliac and femoropopliteal artery recanalization in 34 patients (18 men; mean age +/- SD, 72 years +/- 11) in whom the conventional guide wires and catheters failed to reenter the true lumen. True lumen reentry was achieved in 87% (n = 23) and 91% (n = 11) of patients with femoropopliteal and aortoiliac occlusions, respectively. The overall technical success rate with the device was 88% (n = 34). The device success rate in Transatlantic Inter-Society Consensus II class D lesions was significantly lower than in lower lesion classes (71.4% vs 100%; P < .05). No procedure-related complications were encountered. In conclusion, the use of the reentry catheter enhances the likelihood of successful subintimal recanalization of chronic occlusions in femoropopliteal and aortoiliac arteries.

The role of non-technical skills in surgery

PubMed Central

Agha, Riaz A.; Fowler, Alexander J.; Sevdalis, Nick

2015-01-01

Non-technical skills are of increasing importance in surgery and surgical training. A traditional focus on technical skills acquisition and competence is no longer enough for the delivery of a modern, safe surgical practice. This review discusses the importance of non-technical skills and the values that underpin successful modern surgical practice. This narrative review used a number of sources including written and online, there was no specific search strategy of defined databases. Modern surgical practice requires; technical and non-technical skills, evidence-based practice, an emphasis on lifelong learning, monitoring of outcomes and a supportive institutional and health service framework. Finally these requirements need to be combined with a number of personal and professional values including integrity, professionalism and compassionate, patient-centred care. PMID:26904193

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

This fact provides information on the Strategic Technical Assistance Response Team (START) Program, a U.S. Department of Energy Office of Indian Energy Policy and Programs (DOE-IE) initiative to provide technical expertise to support the development of next-generation energy projects in Indian Country.

The Native Telehealth Outreach and Technical Assistance Program: a community-based approach to the development of multimedia-focused health care information.

PubMed

Dick, Rhonda Wiegman; Manson, Spero M; Hansen, Amy L; Huggins, Annie; Trullinger, Lori

2007-01-01

The development and dissemination of culturally relevant health care information has traditionally taken a "top-down" approach. Governmental funding agencies and research institutions have too often dictated the importance and focus of health-related research and information dissemination. In addition, the digital divide has affected rural communities in such a way that their members often do not possess the knowledge or experience necessary to use technological resources. And, even when they do, their skills may be limited, adequate only for implementing applications and programs designed by others who live and work outside of these communities. This need became the driving force in the creation of the Native Telehealth Outreach and Technical Assistance Program. The goal of the program is to equip Native community members, at both the lay and professional levels, with the means to use technology to address tribal health care needs. The transfer of relevant technical knowledge and skills enables participants to develop projects which enhance the community-wide dissemination of health care information. Nine community health advocates and professionals participated in the initial cohort. Eight of the participants successfully developed multimedia-based projects including Web sites, interactive CD-ROMs, and video focusing on a variety of health concerns. At the conclusion of the 18-month program period, projects were disseminated throughout rural communities. The NTOTAP staff continues to evaluate the use of these projects and their benefits within the rural communities.

The evaluation of a framework for measuring the non-technical ward round skills of final year nursing students: An observational study.

PubMed

Murray, Kara; McKenzie, Karen; Kelleher, Michael

2016-10-01

The importance of non-technical skills (NTS) to patient outcomes is increasingly being recognised, however, there is limited research into how such skills can be taught and evaluated in student nurses in relation toward rounds. This pilot study describes an evaluation of a NTS framework that could potentially be used to measure ward round skills of student nurses. The study used an observational design. Potential key NTS were identified from existing literature and NTS taxonomies. The proposed framework was then used to evaluate whether the identified NTS were evident in a series of ward round simulations that final year general nursing students undertook as part of their training. Finally, the views of a small group of qualified nurse educators, qualified nurses and general nursing students were sought about whether the identified NTS were important and relevant to practice. The proposed NTS framework included seven categories: Communication, Decision Making, Situational Awareness, Teamwork and Task Management, Student Initiative and Responsiveness to Patient. All were rated as important and relevant to practice. The pilot study suggests that the proposed NTS framework could be used as a means of evaluating student nurse competencies in respect of many non-technical skills required for a successful ward round. Further work is required to establish the validity of the framework in educational settings and to determine the extent to which it is of use in a non-simulated ward round setting. Copyright © 2016 Elsevier Ltd. All rights reserved.

Vehicle Integrated Performance Analysis, the VIPA Experience: Reconnecting with Technical Integration

NASA Technical Reports Server (NTRS)

McGhee, David S.

2005-01-01

Today's NASA is facing significant challenges and changes. The Exploration initiative indicates a large increase in projects with limited increase in budget. The Columbia report has criticized NASA for its lack of insight and technical integration impacting its ability to provide safety. The Aldridge report is advocating NASA find new ways of doing business. Very early in the Space Launch Initiative (SLI) program a small team of engineers at MSFC were asked to propose a process for performing a system level assessment of a launch vehicle. The request was aimed primarily at providing insight and making NASA a "smart buyer." Out of this effort the VIPA team was created. The difference between the VIPA effort and many integration attempts is that VIPA focuses on using experienced people from various disciplines and a process which focuses them on a technically integrated assessment. Most previous attempts have focused on developing an all encompassing software tool. In addition, VIPA anchored its process formulation in the experience of its members and in early developmental Space Shuttle experience. The primary reference for this is NASA-TP-2001-210092, "Launch Vehicle Design Process: Characterization, Technical Integration, and Lessons Learned," and discussions with its authors. The foundations of VIPA's process are described. The VIPA team also recognized the need to drive detailed analysis earlier in the design process. Analyses and techniques typically done in later design phases, are brought forward using improved computing technology. The intent is to allow the identification of significant sensitivities, trades, and design issues much earlier in the program. This process is driven by the T-model for Technical Integration described in the aforementioned reference. VIPA's approach to performing system level technical integration is discussed in detail. Proposed definitions are offered to clarify this discussion and the general systems integration dialog. VIPA's capabilities and process can now be used to significantly enhance the development and monitoring of realizable project requirements. This is done through the use of VIPA's V-model. Starting with a given concept, VIPA's assessment validates the concept's stated performance, identifies significant issues either with the concept or the requirements, and then re-integrates these issues to determine impacts. This process is discussed along with a description of how it may be integrated into a program's insight and review process. The VIPA process has been employed successfully on several projects including SLI, Orbital Space Plane (OSP), and several heavy lift concepts for Exploration. It has also been proposed for use on the Jupiter Icy Moon (JIMO) spacecraft. The VIPA process has gained favor with both engineering and project organizations for being responsive and insightful. Selected results from these assessments will be presented.

Primary infrarenal aortic stenting with or without iliac stenting for isolated and aortoiliac stenoses: single-centre experience with long-term follow-up.

PubMed

Tapping, C R; Ahmed, M; Scott, P M; Lakshminarayan, R; Robinson, G J; Ettles, D F; Shrivastava, V

2013-02-01

The purpose of this study was to evaluate the technical success, complications, long-term clinical outcome, and patency after primary infrarenal aortic stenting for aortic and aortoiliac stenosis. Between January 1999 and January 2006, 22 consecutive patients underwent endovascular treatment because of infrarenal aortic stenosis with and without common iliac stenosis (10 men; mean age 64 ± 14 years). Eleven (11 of 22) patients had an isolated aortic stenosis, whereas 11 of 22 had aortic stenosis that extended into the common iliac arteries (CIAs). Thirteen patients were Rutherford classification type 3, and 9 patients were type 4. Statistical analysis included paired Student t test and Kaplan-Meier life table analysis; p < 0.05 was considered significant. Technical and initial clinical success was achieved in all patients. There were three (14 %) procedure-related complications, which included two access-point pseudoaneurysms and one non-flow-limiting left external iliac dissection. Patients were followed-up for a mean period of 88 months (range 60-132). Mean preprocedure ankle brachial pressure indexes (ABPI) were 0.60 ± -0.15 (right) and 0.61 ± -0.16 (left). After the procedure they were 0.86 ± -0.07 (right) and 0.90 ± -0.09 (left). The increase in ABPI was significant (p < 0.05), and this continued throughout follow-up. Four (18 %) patients had recurrence of symptoms during follow-up. These occurred at 36, 48, 48, and 50 months after the original procedure. All four patients were successfully treated with repeat angioplasty procedures. There was a significant difference in primary patency between isolated aortic stenosis (100 %) and aortoiliac stenosis (60 %) (p = 0.031). Cumulative follow-up was 1920 months yielding a reintervention rate of 0.025/events/year. Primary stenting of infrarenal stenosis is safe and successful with a low reintervention rate. It should be considered as first-line treatment for patients with infrarenal aortic stenotic disease.

A Quiet Revolution--International Influence, Domestic Elites and the Transformation of Higher Technical Education in Ireland 1959-72

ERIC Educational Resources Information Center

Walsh, John

2011-01-01

The upgrading of higher technical education which began in the 1960s marked the most influential intervention by the Irish government in the third-level sector since the establishment of the independent Irish state. A series of reforming initiatives extended educational opportunity and transformed the status of technical education at higher level.…

The Development of a Project-Based Collaborative Technical Writing Model Founded on Learner Feedback in a Tertiary Aeronautical Engineering Program

ERIC Educational Resources Information Center

Tatzl, Dietmar; Hassler, Wolfgang; Messnarz, Bernd; Fluhr, Holger

2012-01-01

The present article describes and evaluates collaborative interdisciplinary group projects initiated by content lecturers and an English-as-a-Foreign-Language (EFL) instructor for the purpose of teaching technical writing skills in an aeronautical engineering degree program. The proposed technical writing model is assessed against the results of a…

Hybrid treatment of aortic arch disease

PubMed Central

Metzger, Patrick Bastos; Rossi, Fabio Henrique; Moreira, Samuel Martins; Issa, Mario; Izukawa, Nilo Mitsuru; Dinkhuysen, Jarbas J.; Spina Neto, Domingos; Kambara, Antônio Massamitsu

2014-01-01

Introduction The management of thoracic aortic disease involving the ascending aorta, aortic arch and descending thoracic aorta are technically challenging and is an area in constant development and innovation. Objective To analyze early and midterm results of hybrid treatment of arch aortic disease. Methods Retrospective study of procedures performed from January 2010 to December 2012. The end points were the technical success, therapeutic success, morbidity and mortality, neurologic outcomes, the rate of endoleaks and reinterventions. Results A total of 95 patients treated for thoracic aortic diseases in this period, 18 underwent hybrid treatment and entered in this study. The average ages were 62.3 years. The male was present in 66.7%. The technical and therapeutic success was 94.5% e 83.3%. The perioperative mortality rate of 11.1%. There is any death during one-year follow- up. The reoperation rates were 16.6% due 2 cases of endoleak Ia and one case of endoleak II. There is any occlusion of anatomic or extra anatomic bypass during follow up. Conclusion In our study, the hybrid treatment of aortic arch disease proved to be a feasible alternative of conventional surgery. The therapeutic success rates and re- interventions obtained demonstrate the necessity of thorough clinical follow-up of these patients in a long time. PMID:25714205

Seismic microzonation in Latin America and the Caribbean: social, cultural, economic and political aspects

NASA Astrophysics Data System (ADS)

Murria, J.

2009-04-01

The lack of success, not to say failure, of seismic microzonation projects in the Latin America and Caribbean nations-and for that matter elsewhere in the world-should not be attributed to the lack of technical and scientific expertise of our engineers and scientists as there exists in our continent sufficient knowledge and information about the techniques and procedures that have been successfully used elsewhere in the world in the implementation of seismic microzonation projects. The main constrains to the implementation of seismic microzonation projects in Latin America and the Caribbean are of an economic, social, political, and cultural aspects rather than the purely scientific and engineering aspects. Another very important factor contributing to this lack of success has been the apparent failure of the scientific and technical community to convince decision makers (both official and private) that the sound implementation of seismic microzonation projects are a valid instrument to mitigate the negative effects that earthquakes have on the population, on the physical infrastructure and on the environment. An attempt will be made in this paper to analyze these "non technical" aspects and try to arrive at some conclusions as well as to some possible lines of action for the successful implementation of seismic microzonation projects in the seismic risk prone Latin American and Caribbean nations.

Radiographic technical quality of root canal treatment performed ex vivo by dental students at Valencia University Medical and Dental School, Spain

PubMed Central

Faus-Matoses, Vicente; Alegre-Domingo, Teresa; Faus-Llácer, Vicente J.

2014-01-01

Objectives: To evaluate radiographically the quality of root canal fillings and compare manual and rotary preparation performed on extracted teeth by undergraduate dental students. Study Design: A total of 561 premolars and molars extracted teeth were prepared using nickel-titanium rotary files or manual instrumentation and filled with gutta-percha using a cold lateral condensation technique, by 4th grade undergraduate students. Periapical radiographs were used to assess the technical quality of the root canal filling, evaluating three variables: length, density and taper. These data were recorded, scored and used to study the “technical success rate” and the “overall score”. The length of each root canal filling was classified as acceptable, short and overfilled, based on their relationship with the radiographic apex. Density and taper of filling were evaluated based on the presence of voids and the uniform tapering of the filling, respectively. Statistical analysis was used to evaluate the quality of root canal treatment, considering p < 0.05 as a statistical significant level. Results: The percentage of technical success was 44% and the overall score was 7.8 out of 10. Technical success and overall score were greater with rotary instruments (52% against 28% with a manual one, p < 0.001; 8.3 against 6.7 respectively, p < 0.001). Conclusions: It appears that inexperienced operators perform better root canal treatment (RCT) with the use of rotary instrumentation. Key words:Dental education, endodontics, rotary instrumentation, radiographs, root canal treatment, undergraduate students. PMID:24121911

Sociotechnical Walkthrough: A Means for Knowledge Integration

ERIC Educational Resources Information Center

Herrmann, Thomas; Loser, Kai-Uwe; Jahnke, Isa

2007-01-01

Purpose: The purpose of this research is to show that for the successful development of socio-technical systems it is essential that various stakeholders are able to integrate their different knowledge and perspectives. A method that supports knowledge integration in the course of introduction and development of socio-technical systems is the…

UMIST, IDN, NTUA, TUM, ULB: A Successful European Exchange Programme.

ERIC Educational Resources Information Center

Borne, Pierre; Singh, Madan G.

1989-01-01

Describes the exchange programs that existed for a decade in the fields of automatic control and computer science including the University of Manchester Institute of Science and Technology, the "Institut Industriel du Nord," the National Technical University of Athens, the Technical University of Munich, and the Free University of…

Seven Keys to Successful Study.

ERIC Educational Resources Information Center

Edwards, Peter

Written for secondary, technical, and technical and further education (TAFE) students, this book aims to make learning easier and more enjoyable by showing students how to use a series of basic study skills called "keys." The book offers an explanation, examples, graphic illustrations, and activities for each skill. Chapters include: (1)…

Biomass power for rural development: Phase 2. Technical progress report, April 1--June 30, 1998

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

Neuhauser, E.

1998-11-01

The project undertaken by the Salix Consortium is a multi-phased, multi-partner endeavor. Phase-1 focused on initial development and testing of the technology and agreements necessary to demonstrate commercial willow production in Phase-2. The Phase-1 objectives have been successfully completed: preparing final design plans for two utility pulverized coal boilers, developing fuel supply plans for the project, obtaining power production commitments from the power companies for Phase-2, obtaining construction and environmental permits, and developing an experimental strategy for crop production and power generation improvements needed to assure commercial success. The R and D effort also addresses environmental issues pertaining to introductionmore » of the willow energy system. Beyond those Phase-1 requirements the Consortium has already successfully demonstrated cofiring at Greenidge Station and developed the required nursery capacity for acreage scale-up. This past summer 105 acres were prepared in advance for the spring planting in 1998. Having completed the above tasks, the Consortium is well positioned to begin Phase-2. In phase-2 every aspect of willow production and power generation from willow will be demonstrated. The ultimate objective of Phase-2 is to transition the work performed under the Rural Energy for the Future project into a thriving, self-supported energy crop enterprise.« less

Robotic-Assisted Versus Manual Prostatic Arterial Embolization for Benign Prostatic Hyperplasia: A Comparative Analysis

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

Bagla, Sandeep, E-mail: sandeep.bagla@gmail.com; Smirniotopoulos, John; Orlando, Julie C.

PurposeProstatic artery embolization (PAE) is a safe and efficacious procedure for benign prostatic hyperplasia (BPH), though is technically challenging. We present our experience of technical and clinical outcomes of robotic and manual PAE in patients with BPH.Materials and MethodsIRB-approved retrospective study of 40 consecutive patients 49–81 years old with moderate or severe grade BPH from May 2014 to July 2015: 20 robotic-assisted PAE (group 1), 20 manual PAE (group 2). Robotic-assisted PAE was performed using the Magellan Robotic System. American Urological Association (AUA-SI) score, cost, technical and clinical success, radiation dose, fluoroscopy, and procedure time were reviewed. Statistical analysis was performedmore » within and between each group using paired t test and one-way analysis of variance respectively, at 1 and 3 months.ResultsNo significant baseline differences in age and AUA-SI between groups. Technical success was 100% (group 1) and 95% (group 2). One unsuccessful subject from group 2 returned for a successful embolization using robotic assistance. Fluoroscopy and procedural times were similar between groups, with a non-significant lower patient radiation dose in group 1 (30,632.8 mGy/cm{sup 2} vs 35,890.9, p = 0.269). Disposable cost was significantly different between groups with the robotic-assisted PAE incurring a higher cost (group 1 $4530.2; group 2 $1588.5, p < 0.0001). Clinical improvement was significant in both arms at 3 months: group 1 mean change in AUA-SI of 8.3 (p = 0.006), group 2: 9.6 (p < 0.0001). No minor or major complications occurred.ConclusionsRobotic-assisted PAE offers technical success comparable to manual PAE, with similar clinical improvement with an increased cost.« less

Duct Diameter and Size of Stones Predict Successful Extracorporeal Shock Wave Lithotripsy and Endoscopic Clearance in Patients With Chronic Pancreatitis and Pancreaticolithiasis.

PubMed

Lapp, Robert T; Wolf, J Stuart; Faerber, Gary J; Roberts, William W; McCarthy, Sean T; Anderson, Michelle A; Wamsteker, Erik-Jan; Elta, Grace H; Scheiman, James M; Kwon, Richard S

2016-09-01

The need for endoscopic therapy before extracorporeal shock wave lithotripsy (SWL) to facilitate pancreatic duct stone removal is unclear. Predictive factors associated with successful fragmentation and subsequent complete duct clearance are variable. We hypothesize pancreatic duct strictures and large stones, but not pre-SWL endotherapy, correlate with successful fragmentation and complete duct clearance. A retrospective cohort study of patients with pancreaticolithiasis who underwent SWL and endoscopic retrograde cholangiopancreatography between January 2009 and June 2014 was evaluated. Thirty-seven patients were treated. Technical success (TS) of fragmentation was achieved in 22 patients (60%). Technical success was associated with fewer stones and SWL sessions and smaller stone and duct size. By multivariate logistic regression, only duct dilation was associated with TS. Endoscopic success of complete duct clearance was achieved in 29 patients (80%). Endoscopic success was more frequent with stones 12 mm or less and with successful TS. By multivariate logistic regression, stones greater than 12 mm were associated with endoscopic failure. Pre-SWL endotherapy does not affect stone fragmentation. Patients with a dilated duct (>8 mm) and pancreatic stones 12 mm or greater were associated with unsuccessful TS and endoscopic success, respectively, and may benefit from early referral for surgical decompression.

ACE: A distributed system to manage large data archives

NASA Technical Reports Server (NTRS)

Daily, Mike I.; Allen, Frank W.

1993-01-01

Competitive pressures in the oil and gas industry are requiring a much tighter integration of technical data into E and P business processes. The development of new systems to accommodate this business need must comprehend the significant numbers of large, complex data objects which the industry generates. The life cycle of the data objects is a four phase progression from data acquisition, to data processing, through data interpretation, and ending finally with data archival. In order to implement a cost effect system which provides an efficient conversion from data to information and allows effective use of this information, an organization must consider the technical data management requirements in all four phases. A set of technical issues which may differ in each phase must be addressed to insure an overall successful development strategy. The technical issues include standardized data formats and media for data acquisition, data management during processing, plus networks, applications software, and GUI's for interpretation of the processed data. Mass storage hardware and software is required to provide cost effective storage and retrieval during the latter three stages as well as long term archival. Mobil Oil Corporation's Exploration and Producing Technical Center (MEPTEC) has addressed the technical and cost issues of designing, building, and implementing an Advanced Computing Environment (ACE) to support the petroleum E and P function, which is critical to the corporation's continued success. Mobile views ACE as a cost effective solution which can give Mobile a competitive edge as well as a viable technical solution.

Transjugular intrahepatic porto-systemic shunt in the elderly: Palliation for complications of portal hypertension

PubMed Central

Syed, Mubin I; Karsan, Hetal; Ferral, Hector; Shaikh, Azim; Waheed, Uzma; Akhter, Talal; Gabbard, Alan; Morar, Kamal; Tyrrell, Robert

2012-01-01

AIM: To present a dedicated series of transjugular intrahepatic porto-systemic shunts (TIPS) in the elderly since data is sparse on this population group. METHODS: A retrospective review was performed of patients at least 65 years of age who underwent TIPS at our institutions between 1997 and 2010. Twenty-five patients were referred for TIPS. We deemed that 2 patients were not considered appropriate candidates due to their markedly advanced liver disease. Of the 23 patients suitable for TIPS, the indications for TIPS placement was portal hypertension complicated by refractory ascites alone (n = 9), hepatic hydrothorax alone (n = 2), refractory ascites and hydrothorax (n = 1), gastrointestinal bleeding alone (n = 8), gastrointestinal bleeding and ascites (n = 3). RESULTS: Of these 23 attempted TIPS procedure patients, 21 patients had technically successful TIPS procedures. A total of 29 out of 32 TIPS procedures including revisions were successful in 21 patients with a mean age of 72.1 years (range 65-82 years). Three of the procedures were unsuccessful attempts at TIPS and 8 procedures were successful revisions of our existing TIPS. Sixteen of 21 patients who underwent successful TIPS (excluding 5 patients lost to follow-up) were followed for a mean of 14.7 mo. Ascites and/or hydrothorax was controlled following technically successful procedures in 12 of 13 patients. Bleeding was controlled following technically successful procedures in 10 out of 11 patients. CONCLUSION: We have demonstrated that TIPS is an effective procedure to control refractory complications of portal hypertension in elderly patients. PMID:22400084

Analysis of the Final DENALI Trial Data: A Prospective, Multicenter Study of the Denali Inferior Vena Cava Filter.

PubMed

Stavropoulos, S William; Chen, James X; Sing, Ronald F; Elmasri, Fakhir; Silver, Mitchell J; Powell, Alex; Lynch, Frank C; Abdel Aal, Ahmed Kamel; Lansky, Alexandra; Muhs, Bart E

2016-10-01

To report the final 2-year data on the efficacy and safety of a nitinol retrievable inferior vena cava (IVC) filter for protection against pulmonary embolism (PE). This was a prospective multicenter trial of 200 patients with temporary indications for caval filtration who underwent implantation of the Denali IVC filter. After filter placement, all patients were followed for 2 years after placement or 30 days after filter retrieval. The primary endpoints were technical success of filter implantation in the intended location and clinical success of filter placement and retrieval. Secondary endpoints were incidence of clinically symptomatic recurrent PE, new or propagating deep vein thrombosis (DVT), and filter-related complications including migration, fracture, penetration, and tilt. Filter placement was technically successful in 199 patients (99.5%). Filters were clinically successful in 190 patients (95%). The rate of PE was 3% (n = 6), with 5 patients having a small subsegmental PE and 1 having a lobar PE. New or worsening DVT was noted in 26 patients (13%). Filter retrieval was attempted 125 times in 124 patients and was technically successful in 121 patients (97.6%). The mean filter dwell time at retrieval was 200.8 days (range, 5-736 d). There were no instances of filter fracture, migration, or tilt greater than 15° at the time of filter retrieval or during follow-up. The Denali IVC filter exhibited high success rates for filter placement and retrieval while maintaining a low complication rate in this clinical trial. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

The Role of Project Science in the Chandra X-Ray Observatory

NASA Technical Reports Server (NTRS)

O'Dell, Stephen L.; Weisskopf, Martin C.

2006-01-01

The Chandra X-Ray Observatory, one of NASA's Great Observatories, has an outstanding record of scientific and technical success. This success results from the efforts of a team comprising NASA, its contractors, the Smithsonian Astrophysical Observatory, the instrument groups, and other elements of the scientific community, including thousands of scientists who utilize this powerful facility for astrophysical research. We discuss the role of NASA Project Science in the formulation, development, calibration, and operation of the Chandra X-ray Observatory. In addition to representing the scientific community within the Project, Project Science performed what we term "science systems engineering". This activity encompasses translation of science requirements into technical requirements and assessment of the scientific impact of programmatic and technical trades. We briefly describe several examples of science systems engineering conducted by Chandra Project Science.

Controller evaluation of initial data link terminal air traffic control services : final report

DOT National Transportation Integrated Search

1991-01-01

This document details the results the first Federal Aviation Administration : Technical Center investigation of the initial terminal air traffic control : services developed for transmission using Data Link technology. Initial Data : Link services we...