Tendera, Michal; Chassany, Olivier; Ferrari, Roberto; Ford, Ian; Steg, Philippe Gabriel; Tardif, Jean-Claude; Fox, Kim
2016-01-01
To explore the effect of ivabradine on angina-related quality of life (QoL) in patients participating in the Study Assessing the Morbidity-Mortality Benefits of the If Inhibitor Ivabradine in Patients with Coronary Artery Disease (SIGNIFY) QoL substudy. QoL was evaluated in a prespecified subgroup of SIGNIFY patients with angina (Canadian Cardiovascular Society class score, ≥ 2 at baseline) using the Seattle Angina Questionnaire and a generic visual analogue scale on health status. Data were available for 4187 patients (2084 ivabradine and 2103 placebo). There were improvements in QoL in both treatment groups. The primary outcome of change in physical limitation score at 12 months was 4.56 points for ivabradine versus 3.40 points for placebo (E, 0.96; 95% confidence interval, -0.14 to 2.05; P=0.085). The ivabradine-placebo difference in physical limitation score was significant at 6 months (P=0.048). At 12 months, the visual analogue scale and the other Seattle Angina Questionnaire dimensions were higher among ivabradine-treated patients, notably angina frequency (P<0.001) and disease perception (P=0.006). Patients with the worst QoL at baseline (ie, those in the lowest tertile of score) had the best improvement in QoL for 12 months, with improvements in physical limitation and a significant reduction in angina frequency (P=0.034). The effect on QoL was maintained over the study duration, and ivabradine patients had better scores on angina frequency at every visit to 36 months. Treatment with ivabradine did not affect the primary outcome of change in physical limitation score at 12 months. It did produce consistent improvements in other self-reported QoL parameters related to angina pectoris, notably in terms of angina frequency and disease perception. URL: http://www.isrctn.com. Unique identifier: ISRCTN61576291. © 2015 American Heart Association, Inc.
Fox, Kim; Ford, Ian; Steg, Philippe Gabriel; Tardif, Jean-Claude; Tendera, Michal; Ferrari, Roberto
2015-12-07
The aim of this study was to determine the impact of emergent bradycardia and atrial fibrillation (AF) on cardiovascular outcomes in 19 083 patients with stable coronary artery disease (CAD) receiving ivabradine or placebo (SIGNIFY, Study assessInG the morbidity-mortality beNefits of the If inhibitor ivabradine in patients with coronarY artery disease). Emergent bradycardia (resting heart rate <50 b.p.m. on 12-lead electrocardiogram) with ivabradine was reported in 3572 patients (37.4%) overall, and in 2242 (37.2%) patients with Canadian Cardiovascular Society (CCS) class ≥ 2 angina. There was no difference in outcomes over the course of the study in ivabradine-treated patients with and without emergent bradycardia in the whole population (2.5 vs. 2.9% per year, respectively, for primary composite endpoint of cardiovascular death or non-fatal myocardial infarction) or in the angina subgroup (2.5 vs. 3.2% per year). Neither was there an increase in the rate of primary endpoint after emergent bradycardia was recorded compared with those without emergent bradycardia. There were 754 cases of emergent AF on treatment (2.2% per year ivabradine vs. 1.5% per year placebo) and 469 in the patients with angina (2.2 vs. 1.5% per year). While outcomes occurred more frequently in patients in whom emergent AF had been recorded, there was no treatment-placebo difference in outcomes, including stroke, and no difference in treatment effect in patients with limiting angina. Both in the overall population as well as in the angina subset, bradycardia was common in ivabradine-treated patients, but did not appear to impact outcomes. Emergent AF was relatively rare and did not appear to have an impact on outcomes relative to placebo. ISRCTN61576291. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.
Ivabradine in stable coronary artery disease without clinical heart failure.
Fox, Kim; Ford, Ian; Steg, Philippe Gabriel; Tardif, Jean-Claude; Tendera, Michal; Ferrari, Roberto
2014-09-18
An elevated heart rate is an established marker of cardiovascular risk. Previous analyses have suggested that ivabradine, a heart-rate-reducing agent, may improve outcomes in patients with stable coronary artery disease, left ventricular dysfunction, and a heart rate of 70 beats per minute or more. We conducted a randomized, double-blind, placebo-controlled trial of ivabradine, added to standard background therapy, in 19,102 patients who had both stable coronary artery disease without clinical heart failure and a heart rate of 70 beats per minute or more (including 12,049 patients with activity-limiting angina [class ≥II on the Canadian Cardiovascular Society scale, which ranges from I to IV, with higher classes indicating greater limitations on physical activity owing to angina]). We randomly assigned patients to placebo or ivabradine, at a dose of up to 10 mg twice daily, with the dose adjusted to achieve a target heart rate of 55 to 60 beats per minute. The primary end point was a composite of death from cardiovascular causes or nonfatal myocardial infarction. At 3 months, the mean (±SD) heart rate of the patients was 60.7±9.0 beats per minute in the ivabradine group versus 70.6±10.1 beats per minute in the placebo group. After a median follow-up of 27.8 months, there was no significant difference between the ivabradine group and the placebo group in the incidence of the primary end point (6.8% and 6.4%, respectively; hazard ratio, 1.08; 95% confidence interval, 0.96 to 1.20; P=0.20), nor were there significant differences in the incidences of death from cardiovascular causes and nonfatal myocardial infarction. Ivabradine was associated with an increase in the incidence of the primary end point among patients with activity-limiting angina but not among those without activity-limiting angina (P=0.02 for interaction). The incidence of bradycardia was higher with ivabradine than with placebo (18.0% vs. 2.3%, P<0.001). Among patients who had stable coronary artery disease without clinical heart failure, the addition of ivabradine to standard background therapy to reduce the heart rate did not improve outcomes. (Funded by Servier; SIGNIFY Current Controlled Trials number, ISRCTN61576291.).
Lees-Miller, James P; Guo, Jiqing; Wang, Yibo; Perissinotti, Laura L; Noskov, Sergei Y; Duff, Henry J
2015-08-01
In Europe, ivabradine has recently been approved to treat patients with angina who have intolerance to beta blockers and/or heart failure. Ivabradine is considered to act specifically on the sinoatrial node by inhibiting the If current (the funny current) to slow automaticity. However, in vitro studies show that ivabradine prolongs phase 3 repolarization in ventricular tissue. No episodes of Torsades de Pointes have been reported in randomized clinical studies. The objective of this study is to assess whether ivabradine blocked the hERG1 current. In the present study we discovered that ivabradine prolongs action potential and blocks the hERG current over a range of concentrations overlapping with those required to block HCN4. Ivabradine produced tonic, rather than use-dependent block. The mutation Y652A significantly suppressed pharmacologic block of hERG by ivabradine. Disruption of C-type inactivation also suppressed block of hERG1 by ivabradine. Molecular docking and molecular dynamics simulations indicate that ivabradine may access the inner cavity of the hERG1 via a lipophilic route and has a well-defined binding site in the closed state of the channel. Structural organization of the binding pockets for ivabradine is discussed. Ivabradine blocks hERG and prolongs action potential duration. Our study is potentially important because it indicates the need for active post marketing surveillance of ivabradine. Importantly, proarrhythmia of a number of other drugs has only been discovered during post marketing surveillance. Copyright © 2015 Elsevier Ltd. All rights reserved.
Uemura, Kazunori; Inagaki, Masashi; Zheng, Can; Kawada, Toru; Li, Meihua; Fukumitsu, Masafumi; Sugimachi, Masaru
2017-04-01
Ivabradine, a bradycardic agent, has been shown to stably reduce patient's heart rate (HR) in the setting of acute cardiac care. However, an association between atrial fibrillation (AF) risk and acute ivabradine treatment remains a controversial clinical issue, and has not been thoroughly investigated. Bradycardia and abnormal atrial refractoriness induced by ivabradine treatment may enhance vulnerability to AF induction, especially when vagal nerve is concurrently activated. We aimed to experimentally investigate the effects of acute ivabradine treatment with/without concurrent vagal activation on AF inducibility. In 16 anesthetized dogs, cervical vagal nerves were prepared for electrical stimulation (VS). AF induction rate (AFIR) was determined by atrial burst pacing. HR, atrial action potential duration (APD), atrial effective refractory period (ERP), and AFIR were obtained consecutively at baseline, during delivery of VS (VS alone), after intravenous injection of ivabradine 0.5 mg/kg (n = 8, ivabradine group) or saline (n = 8, saline group), and again during VS delivery (drug+VS). In the ivabradine group, ivabradine alone significantly lowered HR compared to baseline, while ivabradine+VS significantly lowered HR compared to VS alone. Contrary to expectations, there were no significant differences in trends of APD, temporal dispersion of APD, ERP, and AFIR between ivabradine and saline groups. Irrespective of whether ivabradine or saline was injected, VS significantly shortened APD and ERP, and increased AFIR. Interestingly, although bradycardia in response to ivabradine injection was more intense than that to VS alone, AFIR was significantly lower after ivabradine injection than during VS alone. We conclude that, despite its intense bradycardic effect, acute ivabradine treatment does not increase AF inducibility irrespective of underlying vagal activity. This study may constitute support for the safety of using ivabradine in the setting of acute cardiac care.
Choi, Hee Youn; Bae, Kyun-Seop; Cho, Sang-Heon; Ghim, Jong-Lyul; Choe, Sangmin; Jung, Jin Ah; Lim, Hyeong-Seok
2016-04-01
Ivabradine, a selective inhibitor of the pacemaker current (If ), is used for heart failure and coronary heart disease and is mainly metabolized to S18982. The purpose of this study was to explore the pharmacokinetics (PK) of ivabradine and S18982 in healthy Korean volunteers. Subjects in a phase I study were randomized to receive 2.5, 5, or 10 mg of ivabradine administered every 12 hours for 4.5 days, and serial plasma and urine concentrations of ivabradine and S18982 were measured. The plasma PK of ivabradine was best described by a 2-compartment model with mixed 0- and first-order absorption, linked to a 2-compartment model for S18982. The introduction of interoccasional variabilities and period as covariate into absorption-related parameters improved the model fit. Urine data have been applied to estimate renal and nonrenal clearance, enabling a more detailed description of the elimination process. We developed a population PK model describing the plasma and urine PK of ivabradine and S18982 in healthy Korean adult males. This model might be useful for predicting the plasma and urine PK of ivabradine, potentially helping to identify the optimal dosing regimens in various clinical situations. © 2015, The American College of Clinical Pharmacology.
Yu, Yihui; Hu, Zuoying; Li, Bing; Wang, Zhimei; Chen, Shaoliang
2018-05-22
This study aimed to investigate the effects and molecular mechanisms of ivabradine in preventing cardiac hypertrophy in an established transverse aortic constriction (TAC) mouse model. A total of 56 male C57BL/6 mice were randomly assigned into the following seven groups (8 mice per group): sham, TAC model, Iva-10 (10 mg/kg/day ivabradine), Iva-20 (20 mg/kg/day ivabradine), Iva-40 (40 mg/kg/day ivabradine), Iva-80 (80 mg/kg/day ivabradine), and Rap (rapamycin, a positive control). Echocardiography and left ventricular hemodynamics were performed. Hematoxylin-eosin (H&E), Masson's trichome staining, and TUNEL assays were conducted to evaluate cardiac hypertrophy, fibrosis, and apoptosis, respectively. Western blotting was performed to detect the expression of proteins related to the PI3K/Akt/mTOR/p70S6K pathway. Ivabradine could effectively improve left ventricular dysfunction and hypertrophy induced by TAC in a dose-independent manner. Moreover, no obvious change in heart rate (HR) was observed in the TAC and Rap groups, whereas a significant decrease in HR was found after ivabradine treatment (P < 0.05). Cardiac hypertrophy, fibrosis, and apoptosis induced by TAC were notably suppressed after either rapamycin or ivabradine treatment (P < 0.05). Ivabradine and rapamycin also decreased the expression of PI3K/Akt and mTOR induced by TAC. Ivabradine improved cardiac hypertrophy and fibrosis as well as reduced cardiomyocyte apoptosis via the PI3K/Akt/mTOR/p70S6K pathway in TAC model mice.
Clark, Andrew L; Pellicori, Pierpaolo
2014-12-01
This article provides an overview of trials relevant to the pathophysiology, prevention, and treatment of heart failure, presented at the European Society of Cardiology meeting held in Barcelona in autumn 2014. Trials reported here include PARADIGM-HF (LCZ696 versus enalapril in heart failure), CONFIRM-HF (treatment of iron deficiency in heart failure), and SIGNIFY (ivabradine in patients with stable coronary artery disease). In addition, we discuss recent developments in the treatment of atrial fibrillation and the lack of benefit with the use of beta-blockers in these patients. Finally, the article describes recent advances in the use of vagal stimulation in patients with heart failure. © 2014 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology. © 2014 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.
Metoprolol vs ivabradine in patients with mitral stenosis in sinus rhythm.
Agrawal, Vikas; Kumar, Niraj; Lohiya, Balalji; Sihag, Bhupendra K; Prajapati, Rajpal; Singh, T B; Subramanian, Geetha
2016-10-15
Severe mitral stenosis is usually symptomatic and is treated by BMV or surgery, whereas mild to moderate mitral stenosis is usually asymptomatic or mildly symptomatic and managed medically. Patients in the later group may become symptomatic during episodes of exercise and increased heart rate. Beta-blockers are frequently used in patients with mitral stenosis to control the heart rate and alleviate exercise-related symptoms. The objective of our study was to investigate the comparative efficacy of ivabradine versus metoprolol in patients with mitral stenosis in sinus rhythm. We studied 97 patients of mitral stenosis in sinus rhythm presented with exertional symptoms. The effectiveness of Metoprolol was compared with ivabradine in alleviating these exertional symptoms in a randomized, open label non crossover study. We also assessed various stress ECG parameters, 24 hour Holter parameters and 2D Echo parameters to objectively compare the effects of ivabradine and metoprolol in these patients. Ivabradine and metoprolol both were effective in controlling exertional symptoms. Significant improvement in objective parameters like TMT (work capacity, baseline heart rate and maximal heart rate) and 2D echocardiography (right ventricular systolic pressure) are seen with both drugs. Ivabradine controls the exertional symptoms significantly more than metoprolol. On head to head comparison there was a significant benefit of working capacity and heart rate at maximal exercise in favour of ivabradine. Ivabradine should be strongly considered in medical management of mitral stenosis patients where beta blockers are contraindicated such as reactive airway disease. The cost of ivabradine is higher than metoprolol which might possess constraints as most of the rheumatic heat disease patients belong to low socio economic status. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Borer, Jeffrey S; Deedwania, Prakash C; Kim, Jae B; Böhm, Michael
2016-12-15
Heart rate (HR) is a risk factor in patients with chronic systolic heart failure (HF) that, when reduced, provides outcome benefits. It is also a target for angina pectoris prevention and a risk marker in chronic coronary artery disease without HF. HR can be reduced by drugs; however, among those used clinically, only ivabradine reduces HR directly in the sinoatrial nodal cells without other known effects on the cardiovascular system. This review provides current information regarding the safety and efficacy of HR reduction with ivabradine in clinical studies involving >36,000 patients with chronic stable coronary artery disease and >6,500 patients with systolic HF. The largest trials, Morbidity-Mortality Evaluation of the I f Inhibitor Ivabradine in Patients With Coronary Disease and Left Ventricular Dysfunction and Study Assessing the Morbidity-Mortality Benefits of the I f Inhibitor Ivabradine in Patients With Coronary Artery Disease, showed no effect on outcomes. The Systolic Heart Failure Treatment With the I f Inhibitor Ivabradine Trial, a randomized controlled trial in >6,500 patients with HF, revealed marked and significant HR-mediated reduction in cardiovascular mortality or HF hospitalizations while improving quality of life and left ventricular mechanical function after treatment with ivabradine. The adverse effects of ivabradine predominantly included bradycardia and atrial fibrillation (both uncommon) and ocular flashing scotomata (phosphenes) but otherwise were similar to placebo. In conclusion, ivabradine improves outcomes in patients with systolic HF; rates of overall adverse events are similar to placebo. Copyright © 2016 Elsevier Inc. All rights reserved.
Ivabradine in acute coronary syndromes: Protection beyond heart rate lowering.
Niccoli, Giampaolo; Borovac, Josip Anđelo; Vetrugno, Vincenzo; Camici, Paolo G; Crea, Filippo
2017-06-01
Ivabradine is a heart rate reducing agent that exhibits anti-ischemic effects through the inhibition of funny electrical current in the sinus node resulting in heart rate reduction, thus enabling longer diastolic perfusion time, and reduced myocardial oxygen consumption without detrimental changes in arterial blood pressure, coronary vasomotion, and ventricular contractility. The current guideline-based clinical use of Ivabradine is reserved for patients with stable angina pectoris who cannot tolerate or whose symptoms are inadequately controlled with beta blockers. In patients with chronic heart failure and reduced ejection fraction, Ivabradine has demonstrated beneficial effects in improving clinical outcomes when added to conventional therapy. However, the role of Ivabradine in acute coronary syndromes has not been established. Based on the results from some relevant preclinical studies and a limited amount of clinical data that were reported recently, the role of Ivabradine in acute ischemic events warrants further investigation. The aim of this review is to provide an overview of the available literature on the potential role of Ivabradine in the clinical context of acute coronary syndromes. Copyright © 2017 Elsevier B.V. All rights reserved.
Effectiveness of Ivabradine in Treating Stable Angina Pectoris.
Ye, Liwen; Ke, Dazhi; Chen, Qingwei; Li, Guiqiong; Deng, Wei; Wu, Zhiqin
2016-04-01
Many studies show that ivabradine is effective for stable angina.This meta-analysis was performed to determine the effect of treatment duration and control group type on ivabradine efficacy in stable angina pectoris.Relevant articles in the English language in the PUBMED and EMBASE databases and related websites were identified by using the search terms "ivabradine," "angina," "randomized controlled trials," and "Iva." The final search date was November 2, 2015.Articles were included if they were published randomized controlled trials that related to ivabradine treatment of stable angina pectoris.Patients with stable angina pectoris were included.The patients were classified according to treatment duration (<3 vs ≥3 months) or type of control group (placebo vs beta-receptor blocker). Angina outcomes were heart rate at rest or peak, exercise duration, and time to angina onset.Seven articles were selected. There were 3747 patients: 2100 and 1647 were in the ivabradine and control groups, respectively. The ivabradine group had significantly longer exercise duration when they had been treated for at least 3 months, but not when treatment time was less than 3 months. Ivabradine significantly improved time to angina onset regardless of treatment duration. Control group type did not influence the effect of exercise duration (significant) or time to angina onset (significant).Compared with beta-blocker and placebo, ivabradine improved exercise duration and time to onset of angina in patients with stable angina. However, its ability to improve exercise duration only became significant after at least 3 months of treatment.
Rajesh, Gopalan Nair; Sajeer, Kalathingathodika; Sajeev, Chakanalil Govindan; Bastian, Cicy; Vinayakumar, Desabandhu; Muneer, Kader; Haridasan, Vellani; Mathew, Dolly; George, Biju; Krishnan, Mangalath Narayanan
2016-01-01
Beta-blockers are frequently used in patients with mitral stenosis to control the heart rate and alleviate exercise-related symptoms. The objective of our study was to examine whether ivabradine was superior to atenolol for achieving higher exercise capacity in patients with moderate mitral stenosis in sinus rhythm. We also evaluated their effects on left ventricular myocardial performance index (MPI). Eighty-two patients with moderate mitral stenosis in sinus rhythm were randomized to receive ivabradine (n=42) 5mg twice daily or atenolol (n=40) 50mg daily for 6 weeks. Transthoracic echocardiography and treadmill test were performed at baseline and after completion of 6 weeks of treatment. Mean total exercise duration in seconds markedly improved in both study groups at 6 weeks (298.57±99.05s vs. 349.12±103.53s; p=0.0001 in ivabradine group, 290.90±92.42s vs. 339.90±99.84s; p=0.0001 in atenolol group). On head-to-head comparison, there was no significant change in improvement of exercise time between ivabradine and atenolol group (p=0.847). Left ventricular MPI did not show any significant change from baseline and at 6 weeks in both drug groups (49.8%±8% vs. 48.3%±7% in ivabradine group, 52.9%±10% vs. 50.9%±10% in atenolol groups; p=0.602). Ivabradine or atenolol can be used for heart rate control in patients with moderate mitral stenosis in sinus rhythm. Ivabradine is not superior to atenolol for controlling heart rate or exercise capacity. Left ventricular MPI was unaffected by either of the drugs. Copyright © 2015 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.
Acute on Chronic Ivabradine Overdose: a Case Report.
Maskell, Kevin; Tse, Adele; Wolf, Carl E; Troendle, Michelle
2016-06-01
Ivabradine is a newly approved medication which reduces the heart rate by antagonizing the If channel. We report a case of intentional overdose on ivabradine. A 26-year-old female presented after taking 250 mg ivabradine. On arrival, her vital signs and neurologic exam were unremarkable. Within 30 min, her heart rate decreased to 31 bpm, but she remained normotensive with no change in mentation. Her bradycardia resolved after treatment with atropine. She experienced two further bradycardic episodes responsive to atropine; the second episode was associated with hypotension, responsive to a fluid bolus. For the remainder of her hospitalization, she remained hemodynamically stable without further interventions. She was dispositioned to the psychiatry service approximately 36 h post-ingestion with a heart rate of 67 bpm. Laboratory analysis confirmed a serum ivabradine concentration of 525 ng/mL, greater than 50 times the mean level in therapeutic trials. Proposed treatments for ivabradine include activated charcoal, atropine, isoproterenol, and intravenous pacing. Further study is needed to identify ideal treatment modalities.
Effectiveness of Ivabradine in Treating Stable Angina Pectoris
Ye, Liwen; Ke, Dazhi; Chen, Qingwei; Li, Guiqiong; Deng, Wei; Wu, Zhiqin
2016-01-01
Abstract Many studies show that ivabradine is effective for stable angina. This meta-analysis was performed to determine the effect of treatment duration and control group type on ivabradine efficacy in stable angina pectoris. Relevant articles in the English language in the PUBMED and EMBASE databases and related websites were identified by using the search terms “ivabradine,” “angina,” “randomized controlled trials,” and “Iva.” The final search date was November 2, 2015. Articles were included if they were published randomized controlled trials that related to ivabradine treatment of stable angina pectoris. Patients with stable angina pectoris were included. The patients were classified according to treatment duration (<3 vs ≥3 months) or type of control group (placebo vs beta-receptor blocker). Angina outcomes were heart rate at rest or peak, exercise duration, and time to angina onset. Seven articles were selected. There were 3747 patients: 2100 and 1647 were in the ivabradine and control groups, respectively. The ivabradine group had significantly longer exercise duration when they had been treated for at least 3 months, but not when treatment time was less than 3 months. Ivabradine significantly improved time to angina onset regardless of treatment duration. Control group type did not influence the effect of exercise duration (significant) or time to angina onset (significant). Compared with beta-blocker and placebo, ivabradine improved exercise duration and time to onset of angina in patients with stable angina. However, its ability to improve exercise duration only became significant after at least 3 months of treatment. PMID:27057864
Griffiths, A; Paracha, N; Davies, A; Branscombe, N; Cowie, M R; Sculpher, M
2014-07-01
Ivabradine, a specific heart rate lowering therapy, has been shown in a randomised placebo-controlled study, Systolic HF Treatment with the If Inhibitor Ivabradine Trial (SHIfT), to significantly reduce the composite end point of cardiovascular death and hospitalisation for worsening heart failure (HF) in patients with systolic HF who are in sinus rhythm and with a heart rate ≥70 bpm, when added to optimised medical therapy (HR: 0.82, 95% CI 0.75 to 0.90, p<0.0001). We assessed the cost effectiveness of ivabradine, from a UK National Health Service perspective, based on the results of SHIfT. A Markov model estimated the cost effectiveness of ivabradine compared with standard care for two cohorts of patients with HF (heart rate ≥75 bpm in line with the EU labelled indication; and heart rate ≥70 bpm in line with the SHIfT study population). Modelled outcomes included death, hospitalisation, quality of life and New York Heart Association class. Total costs and quality adjusted life years (QALYs) for ivabradine and standard care were estimated over a lifetime horizon. The incremental cost per additional QALY for ivabradine plus standard care versus standard care has been estimated as £8498 for heart rate ≥75 bpm and £13 764 for heart rate ≥70 bpm. Ivabradine is expected to have a 95% chance of being cost-effective in the EU licensed population using the current National Institute for Health and Care Excellence cost effectiveness threshold of £20 000 per QALY. These results were robust in sensitivity analyses. This economic evaluation suggests that the use of ivabradine is likely to be cost-effective in eligible patients with HF from a UK National Health Service perspective. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Vaillant, Fanny; Lauzier, Benjamin; Ruiz, Matthieu; Shi, Yanfen; Lachance, Dominic; Rivard, Marie-Eve; Bolduc, Virginie; Thorin, Eric; Tardif, Jean-Claude; Des Rosiers, Christine
2016-10-01
While heart rate reduction (HRR) is a target for the management of patients with heart disease, contradictory results were reported using ivabradine, which selectively inhibits the pacemaker I f current, vs. β-blockers like metoprolol. This study aimed at testing whether similar HRR with ivabradine vs. metoprolol differentially modulates cardiac energy substrate metabolism, a factor determinant for cardiac function, in a mouse model of dyslipidemia (hApoB +/+ ;LDLR -/- ). Following a longitudinal study design, we used 3- and 6-mo-old mice, untreated or treated for 3 mo with ivabradine or metoprolol. Cardiac function was evaluated in vivo and ex vivo in working hearts perfused with 13 C-labeled substrates to assess substrate fluxes through energy metabolic pathways. Compared with 3-mo-old, 6-mo-old dyslipidemic mice had similar cardiac hemodynamics in vivo but impaired (P < 0.001) contractile function (aortic flow: -45%; cardiac output: -34%; stroke volume: -35%) and glycolysis (-24%) ex vivo. Despite inducing a similar 10% HRR, ivabradine-treated hearts displayed significantly higher stroke volume values and glycolysis vs. their metoprolol-treated counterparts ex vivo, values for the ivabradine group being often not significantly different from 3-mo-old mice. Further analyses highlighted additional significant cardiac alterations with disease progression, namely in the total tissue level of proteins modified by O-linked N-acetylglucosamine (O-GlcNAc), whose formation is governed by glucose metabolism via the hexosamine biosynthetic pathway, which showed a similar pattern with ivabradine vs. metoprolol treatment. Collectively, our results emphasize the implication of alterations in cardiac glucose metabolism and signaling linked to disease progression in our mouse model. Despite similar HRR, ivabradine, but not metoprolol, preserved cardiac function and glucose metabolism during disease progression. Copyright © 2016 the American Physiological Society.
Kondrat'ev, A I; Dolgikh, V T; Stotskiĭ, A O
2010-01-01
To study the effect of ivabradine (coraxan, Servier) as part of combination therapy on the clinical manifestations of acute left ventricular failure (ALVF) in Braunwald class II-IIIB unstable angina in patients with type 2 diabetes mellitus (T2DM). Thirty-six T2DM patients (mean age 56 + 4.3 years) with a diagnosis of acute coronary syndrome were examined. Eighteen healthy individuals were examined as an age- and gender-matched control group. Metabolic, hemodynamic, and electrophysiological parameters were studied in all the patients on hospital stay days I and S. Ivabradine used in combination therapy for unstable angina caused reductions in the clinical manifestations of ALVF, heart rate, the number of myocardial ischemic episodes. In the ivabradine-treated patients, left ventricular ejection fraction showed a significant trend for increase. No adverse reactions were recorded. Ivabradine therapy demonstrated antiischemic and antianginal efficiencies and a good tolerability, without leading to the development of tolerance and without being followed by the development of the withdrawal syndrome.
Borer, Jeffrey S; Kansal, Anuraag R; Dorman, Emily D; Krotneva, Stanimira; Zheng, Ying; Patel, Harshali K; Tavazzi, Luigi; Komajda, Michel; Ford, Ian; Böhm, Michael; Kielhorn, Adrian
2016-09-01
Heart failure (HF) costs $21 billion annually in direct health care costs, 80% of which is directly attributable to hospitalizations. The SHIFT clinical study demonstrated that ivabradine plus standard of care (SoC) reduced HF-related and all-cause hospitalizations compared with SoC alone. To estimate the budget impact of ivabradine from a U.S. commercial payer perspective. A budget impact model estimated the per-member-per month (PMPM) impact of introducing ivabradine to existing formularies by comparing a reference scenario (SoC) and a new drug scenario (ivabradine + SoC) in hypothetical 1 million-member commercial and Medicare Advantage plans. In both scenarios, U.S. claims data were used for the reference cumulative annual rates of hospitalizations (HF, non-HF cardiovascular [CV], and non-CV), and hospitalization rates were adjusted using SHIFT data. The model controlled for mortality risk using SHIFT and U.S. life table data, and hospitalization costs were obtained from U.S. claims data: HF-related = $37,507; non-HF CV = $28,951; and non-CV = $17,904. The annualized wholesale acquisition cost of ivabradine was $4,500, with baseline use for this new drug at 2%, increasing 2% per year. Based on the approved U.S. indication, approximately 2,000 commercially insured patients from a 1 million-member commercial plan were eligible to receive ivabradine. Ivabradine resulted in a PMPM cost savings of $0.01 and $0.04 in years 1 and 3 of the core model, respectively. After including the acquisition price for ivabradine, the model showed a decrease in total costs in the commercial ($991,256 and $474,499, respectively) and Medicare populations ($13,849,262 and $4,280,291, respectively) in year 1. This decrease was driven by ivabradine's reduction in hospitalization rates. For the core model, the estimated pharmacy-only PMPM in year 1 was $0.01 for the commercial population and $0.24 for the Medicare Advantage population. Adding ivabradine to SoC led to lower average annual treatment costs. The negative PMPM budget impact indicates that ivabradine is an affordable option for U.S. payers. This study was funded by Amgen. Patel is employed by Amgen; Kielhorn was employed by Amgen at the time of the study but is no longer affiliated with Amgen. Borer, Böhm, Ford, and Komajda have received scientific support, consultative fees, and/or speakers honoraria from Servier and Amgen in connection with SHIFT, the trial underlying this analysis. Borer also has received consultative fees from Celladon, Pfizer, ARMGO, Cardiorentis, Novartis, and Takeda USA. Kansal, Dorman, Krotneva, and Zheng are employees of Evidera, which was hired to assist with this study. Tavazzi has received research grants and consultation fees from Servier in connection with this study and has had advisory board memberships with Boston Scientific, Servier, Cardiorentis, Medtronic, St. Jude Medical, and CVie Therapeutics. Study concept and design were contributed by Dorman and Keilhorn, along with the other authors. Tavazzi, Komajda, Ford, BÖhm, and Borer oversaw collection of the data. Tavazzi, Komajda, Ford, BÖhm, and Borer (along with Karl Swedberg) formed the Executive Committee of SHIFT, the trial underlying this analysis. The manuscript was written by Kansal, along with the other authors, and revised by Borer and Patel, with assistance from the other authors.
O'Connor, Daniel M; Smith, Robert S; Piras, Bryan A; Beyers, Ronald J; Lin, Dan; Hossack, John A; French, Brent A
2016-04-22
Ivabradine selectively inhibits the pacemaker current of the sinoatrial node, slowing heart rate. Few studies have examined the effects of ivabradine on the mechanical properties of the heart after reperfused myocardial infarction (MI). Advances in ultrasound speckle-tracking allow strain analyses to be performed in small-animal models, enabling the assessment of regional mechanical function. After 1 hour of coronary occlusion followed by reperfusion, mice received 10 mg/kg per day of ivabradine dissolved in drinking water (n=10), or were treated as infarcted controls (n=9). Three-dimensional high-frequency echocardiography was performed at baseline and at days 2, 7, 14, and 28 post-MI. Speckle-tracking software was used to calculate intramural longitudinal myocardial strain (Ell) and strain rate. Standard deviation time to peak radial strain (SD Tpeak Err) and temporal uniformity of strain were calculated from short-axis cines acquired in the left ventricular remote zone. Ivabradine reduced heart rate by 8% to 16% over the course of 28 days compared to controls (P<0.001). On day 28 post-MI, the ivabradine group was found to have significantly smaller end-systolic volumes, greater ejection fraction, reduced wall thinning, and greater peak Ell and Ell rate in the remote zone, as well as globally. Temporal uniformity of strain and SD Tpeak Err were significantly smaller in the ivabradine-treated group by day 28 (P<0.05). High-frequency ultrasound speckle-tracking demonstrated decreased left ventricular remodeling and dyssynchrony, as well as improved mechanical performance in remote myocardium after heart rate reduction with ivabradine. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
Majewski, Sebastian; Slomka, Sebastian; Zielinska-Wyderkiewicz, Ewa; Ciebiada, Maciej; Gorski, Pawel
2012-06-01
There is substantial evidence that heart rate (HR) is a powerful predictor of mortality in both normal individuals and in patients with cardiovascular disease. The use of β-adrenoceptor antagonists (β-blockers) has confirmed the importance of lowering elevated HR in a patient's prognosis. However, these agents can have undesirable adverse effects (AEs) and due to the risk of bronchoconstriction are contraindicated in patients with obstructive airway disease. A selective bradycardic agent, without such undesirable effects, could be of therapeutic interest. Ivabradine, a new I(f) inhibitor that acts specifically on the sino-atrial node, is a pure HR-lowering agent. The objective of this study was to assess HR-lowering efficacy and respiratory safety of ivabradine in patients with asthma and chronic obstructive pulmonary disease (COPD). This was a randomized, single-center, double-blind, placebo-controlled, crossover trial. Enrolment began in May 2009, and the last patient completed the study in January 2011. The study was conducted in an ambulatory setting. A total of 40 patients completed the study (20 asthmatic patients and 20 COPD patients). Inclusion criteria were: documented diagnosis of asthma or COPD according to international guidelines, age 18-75 years, and mean HR on Holter ECG recording of ≥60 beats/min. Exclusion criteria included disease exacerbation in a previous month or inability to understand instructions on the study procedures. All patients received ivabradine 7.5 mg twice daily for 5 days and placebo twice daily for 5 days in a crossover manner, in one of the two arms of the study, with at least 2 days of washout between treatments. The main outcome measures included the difference in HR between ivabradine and placebo treatment and change in HR in comparison with baseline. Other evaluated outcomes were differences in the peak expiratory flow rate (PEFR), the daily symptom score, rescue medication consumption, and AEs. Ivabradine produced significantly lower mean HR than placebo in both groups of patients: asthma 67.4 ± 8.38 versus 82.85 ± 11.19 beats/min (p < 0.001) and COPD 69.75 ± 8.9 versus 81.05 ± 9.75 beats/min (p < 0.001). Similar results were observed for the minimal HR as well as for the maximal noted HR. In comparision with baseline, ivabradine significantly reduced HR in both groups of studied patients (all p < 0.05), whereas placebo did not have such an effect. No significant difference, in either the asthma or the COPD group, was found between ivabradine and placebo in morning and evening peak expiratory flow rate, peak expiratory flow diurnal variability, daily symptom scores, and rescue medication usage (all p > 0.05). Both treatments were well tolerated. The incidence of AEs was low and generally similar in both periods of treatment, except for visual symptoms during treatment with ivabradine, which was reported by 5% of the patients. Our study demonstrated that selective HR reduction with ivabradine is effective in patients with asthma and COPD, with no alteration in respiratory function or symptoms over the duration of the study. Ivabradine offers an interesting alternative, as an HR-lowering agent, in patients with respiratory disease and contraindications to β-blockers. Registered at www.clinicaltrials.gov (NCT01365286).
Abdel-Salam, Zainab; Rayan, Mona; Saleh, Ayman; Abdel-Barr, Mohamed G; Hussain, Mohamed; Nammas, Wail
2015-01-01
Evidence supported a beneficial effect of ivabradine on clinical outcome of patients with systolic heart failure, and a sinus heart rate (HR) ≥ 70 bpm. We explored the effect of ivabradine, vs. placebo, added to evidence-based treatment on exercise tolerance and quality of life in patients with idiopathic dilated cardiomyopathy. We enrolled 43 consecutive patients with dilated cardiomyopathy of no apparent cause, a left ventricular ejection fraction (LVEF) < 40%, New York Heart Association class ≥ II, sinus HR ≥ 70 bpm, and background evidence-based anti-failure medications. Ischemic heart disease was ruled out. Patients were randomized (1:1) to receive ivabradine or placebo. Ivabradine was titrated up gradually till 7.5 mg twice daily, or a HR < 60 bpm, and continued for 3 months. Symptom-limited exercise tolerance test was performed, and quality of life was assessed by the Minnesota Living With Heart Failure Questionnaire at 0, and 3 months. Forty-three patients were randomized to ivabradine (n = 20), or placebo (n = 23). Mean age was 50.8 ± 14.5 years (53.5% males). Mean HR was 85 ± 12 bpm, and mean LVEF was 32 ± 6%. Mean dose of carvedilol was 31.2% of the target dose. Baseline HR, blood pressure, exercise tolerance, Minnesota questionnaire score, and left ventricular systolic function were comparable between the two groups (p > 0.05 for all). At 3 months, mean dose of ivabradine was 6.8 mg bid. Ivabradine-treated patients had a lower HR, and improved left ventricular dimensions and systolic function, versus placebo-treated ones (p < 0.05 for all). HR dropped by a mean of 14 bpm in the ivabradine group, corrected for placebo. Both exercise tolerance, and Minnesota questionnaire score were better in the ivabradine group (p < 0.05 both). Ivabradine was well-tolerated. In symptomatic patients with idiopathic dilated cardiomyopathy, the addition of ivabradine, vs. placebo, to evidence-based treatment, reduced HR, and improved functional capacity, at short-term follow-up.
Koester, Ralf; Kaehler, Jan; Ebelt, Henning; Soeffker, Gerold; Werdan, Karl; Meinertz, Thomas
2010-10-01
The anti-anginal efficacy of the selective I(f) inhibitor ivabradine has been demonstrated in controlled clinical trials. However, there is limited information about the safety and efficacy of a combined treatment of ivabradine with beta-blockers, particularly outside of clinical trials in every day practice. This analysis from the REDUCTION study evaluated the safety and efficacy of a combined therapy of beta-blockers and ivabradine in every day practice. In this multi-center study 4,954 patients with stable angina pectoris were treated with ivabradine in every day routine practice and underwent a clinical follow-up for 4 months. 344 of these patients received a co-medication with beta-blockers. Heart rate (HR), angina pectoris episodes, nitrate consumption, overall efficacy and tolerance were analyzed. After 4 months of treatment with ivabradine HR was reduced by 12.4 ± 11.6 bpm from 84.3 ± 14.6 to 72.0 ± 9.9 bpm, p < 0.0001. Angina pectoris episodes were reduced from 2.8 ± 3.3 to 0.5 ± 1.3 per week, p < 0.0001. Consumption of short-acting nitrates was reduced from 3.7 ± 5.6 to 0.7 ± 1.7 units per week, p < 0.0001. Five patients (1.5%) reported adverse drug reactions (ADR). The most common ADR were nausea and dizziness (<0.6% each). There was no clinically relevant bradycardia. Efficacy and tolerance were graded as 'very good/good' for 96 and 99% of the patients treated. Ivabradine effectively reduces heart rate and angina pectoris in combination with beta-blockers and is well tolerated by patients in every day practice.
Saggu, Daljeet K; Narain, Varun S; Dwivedi, Sudhanshu K; Sethi, Rishi; Chandra, Sharad; Puri, Aniket; Saran, Ram K
2015-06-01
Symptoms in mitral stenosis (MS) are heart rate (HR) dependent. Increase in HR reduces diastolic filling period with rise in transmitral gradient. By reducing HR, beta-blockers improve hemodynamics and relieve symptoms, but the use may be limited by side effects. The present randomized crossover study looked at comparative efficacy of ivabradine and metoprolol on symptoms, hemodynamics, and exercise parameters in patients with mild-to-moderate MS (mitral valve area, 1-2 cm) in normal sinus rhythm. Baseline clinical assessment, treadmill stress testing, and an echocardiographic Doppler evaluation were performed to determine resting HR, total exercise duration, mean gradient across mitral valve, and mean pulmonary artery systolic pressure (PASP). Patients were then allocated to either metoprolol or ivabradine to maximal tolerated doses over 6 weeks (metoprolol: 100 mg twice a day, ivabradine: 10 mg twice a day). Reevaluation was done at the end of this period, and all drugs stopped for washout over 2 weeks. Thereafter, the 2 groups were crossed over to the other drug that was continued for another 6 weeks. Assessment was again performed at the end of this period. Thirty-three patients of 34 completed the protocol. Fifteen were male, mean age was 28.9 ± 6.6 years, all were in New York Heart Association class 2, and mean resting HR was 103.5 ± 7.2/min. Mean mitral valve area was 1.56 ± 0.16 cm, mean PASP was 38.1 ± 5.1 mm Hg, and mean gradient across mitral valve was 10.6 ± 1.6 mm Hg. Significant decrease in baseline and peak exercise HR was observed at the end of follow-up with both drugs. Reduction in mitral valve gradient after ivabradine (42%) and metoprolol (37%) and reduction in PASP after both ivabradine (23%) and metoprolol (27%) were to a similar extent. Significant reduction in total exercise duration after both ivabradine and metoprolol therapy was observed. One patient developed blurring of vision with ivabradine therapy but did not require discontinuation of drug. An improvement in dyspnea of one grade was observed in all the patients by treatment with both ivabradine and metoprolol. Both metoprolol and ivabradine reduced symptoms and improved hemodynamics significantly from baseline to a similar extent. Ivabradine thus can be used effectively and safely in patients with MS in normal sinus rhythm who are intolerant or contraindicated for beta-blocker therapy.
Ferrari, R; Ford, I; Fox, K; Steg, P G; Tendera, M
2008-01-01
Ivabradine is a selective heart rate-lowering agent that acts by inhibiting the pacemaker current If in sinoatrial node cells. Patients with coronary artery disease and left ventricular dysfunction are at high risk of death and cardiac events, and the BEAUTIFUL study was designed to evaluate the effects of ivabradine on outcome in such patients receiving optimal medical therapy. This report describes the study population at baseline. BEAUTIFUL is an international, multicentre, randomized, double-blind trial to compare ivabradine with placebo in reducing mortality and cardiovascular events in patients with stable coronary artery disease and left ventricular systolic dysfunction (ejection fraction <40%). A total of 10,917 patients were randomized. At baseline, their mean age was 65 years, 83% were male, 98% Caucasian, 88% had previous myocardial infarction, 37% had diabetes, and 40% had metabolic syndrome. Mean ejection fraction was 32% and resting heart rate was 71.6 bpm. Concomitant medications included beta-blockers (87%), renin-angiotensin system agents (89%), antithrombotic agents (94%), and lipid-lowering agents (76%). Main results from BEAUTIFUL are expected in 2008, and should show whether ivabradine, on top of optimal medical treatment, reduces mortality and cardiovascular events in this population of high-risk patients. (c) 2007 S. Karger AG, Basel
Gloekler, Steffen; Traupe, Tobias; Stoller, Michael; Schild, Deborah; Steck, Hélène; Khattab, Ahmed; Vogel, Rolf; Seiler, Christian
2014-01-01
To evaluate the effect of heart rate reduction by ivabradine on coronary collateral function in patients with chronic stable coronary artery disease (CAD). This was a prospective randomised placebo-controlled monocentre trial in a university hospital setting. 46 patients with chronic stable CAD received placebo (n=23) or ivabradine (n=23) for the duration of 6 months. The main outcome measure was collateral flow index (CFI) as obtained during a 1 min coronary artery balloon occlusion at study inclusion (baseline) and at the 6-month follow-up examination. CFI is the ratio between simultaneously recorded mean coronary occlusive pressure divided by mean aortic pressure both subtracted by mean central venous pressure. During follow-up, heart rate changed by +0.2±7.8 beats/min in the placebo group, and by -8.1±11.6 beats/min in the ivabradine group (p=0.0089). In the placebo group, CFI decreased from 0.140±0.097 at baseline to 0.109±0.067 at follow-up (p=0.12); it increased from 0.107±0.077 at baseline to 0.152±0.090 at follow-up in the ivabradine group (p=0.0461). The difference in CFI between the 6-month follow-up and baseline examination amounted to -0.031±0.090 in the placebo group and to +0.040±0.094 in the ivabradine group (p=0.0113). Heart rate reduction by ivabradine appears to have a positive effect on coronary collateral function in patients with chronic stable CAD. NCT01039389.
Ivabradine: Current and Future Treatment of Heart Failure.
Thorup, Lene; Simonsen, Ulf; Grimm, Daniela; Hedegaard, Elise R
2017-08-01
In heart failure (HF), the heart cannot pump blood efficiently and is therefore unable to meet the body's demands of oxygen, and/or there is increased end-diastolic pressure. Current treatments for HF with reduced ejection fraction (HFrEF) include angiotensin-converting enzyme (ACE) inhibitors, angiotension receptor type 1 (AT 1 ) antagonists, β-adrenoceptor antagonists, aldosterone receptor antagonists, diuretics, digoxin and a combination drug with AT 1 receptor antagonist and neprilysin inhibitor. In HF, the risk of readmission for hospital and mortality is markedly higher with a heart rate (HR) above 70 bpm. Here, we review the evidence regarding the use of ivabradine for lowering HR in HF. Ivabradine is a blocker of an I funny current (I(f)) channel and causes rate-dependent inhibition of the pacemaker activity in the sinoatrial node. In clinical trials of HFrEF, treatment with ivabradine seems to improve clinical outcome, for example improved ejection fraction (EF) and less readmission for hospital, but the effect appears most pronounced in patients with HRs above 70 bpm, while the effect on cardiovascular death appears less consistent. The adverse effects of ivabradine include bradycardia, atrial fibrillation and visual disturbances, but ivabradine avoids the negative inotrope effects observed with β-adrenoceptor antagonists. In conclusion, in patients with stable HFrEF with EF<35% and HR above 70 bpm, ivabradine improves the outcome and might be a first choice of therapy, if beta-adrenoceptor antagonists are not tolerated. Further studies must show whether that can be extended to HF patients with preserved EF. © 2017 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).
Role of ivabradine and heart rate lowering in chronic heart failure: guideline update.
Chow, Sheryl L; Page, Robert Lee; Depre, Christophe
2018-06-14
This review summarizes the current management of heart failure (HF) in patients with reduced ejection fraction and the potential role of heart rate lowering agents in select populations, as recommended in the updated guidelines. Areas covered: PubMed was searched for studies that evaluated the role of heart rate lowering or ivabradine in HF management. Expert commentary: Targeting heart rate may offer benefit when added to renin-angiotensin aldosterone antagonists, and beta-blockers. Ivabradine is a heart rate lowering agent that acts on the funny current (I f ) in the sinoatrial node, thereby reducing heart rate without directly affecting cardiac contraction and relaxation. Clinical data from a phase 3 trial demonstrated that ivabradine reduced the composite endpoint of cardiovascular death or hospital admission for worsening systolic HF, while maintaining an acceptable safety profile in patients receiving standard of care therapy. These data, in addition to more recently published guidelines, suggest ivabradine as a promising new treatment option for lowering heart rate after optimizing standard therapy in select patients with chronic HF.
Böhm, Michael; Borer, Jeffrey; Ford, Ian; Gonzalez-Juanatey, Jose R; Komajda, Michel; Lopez-Sendon, Jose; Reil, Jan-Christian; Swedberg, Karl; Tavazzi, Luigi
2013-01-01
We analysed the effect of ivabradine on outcomes in heart failure (HF) patients on recommended background therapies with heart rates ≥75 bpm and <75 bpm in the SHIFT trial. A cut-off value of ≥75 bpm was chosen by the EMEA for approval for the use of ivabradine in chronic heart failure. The SHIFT population was divided by baseline heart rate ≥75 or <75 bpm. The effect of ivabradine was analysed for primary composite endpoint (cardiovascular death or HF hospitalization) and other endpoints. In the ≥75 bpm group, ivabradine reduced primary endpoint (HR 0.76, 95 % CI 0.68-0.85, P < 0.0001), all-cause mortality (HR 0.83, 95 % CI, 0.72-0.96, P = 0.0109), cardiovascular mortality (HR 0.83, 95 % CI, (0.71-0.97, P = 0.0166), HF death (HR 0.61, 95 % CI, 0.46-0.81, P < 0.0006), and HF hospitalization (HR 0.70, 95 % CI, 0.61-0.80, P < 0.0001). Risk reduction depended on heart rate after 28 days, with the best protection for heart rates <60 bpm or reductions >10 bpm. None of the endpoints was significantly reduced in the <75 bpm group, though there were trends for risk reductions in HF death and hospitalization for heart rate <60 bpm and reductions >10 bpm. Ivabradine was tolerated similarly in both groups. The effect of ivabradine on outcomes is greater in patients with heart rate ≥75 bpm with heart rates achieved <60 bpm or heart rate reductions >10 bpm predicting best risk reduction. Our findings emphasize the importance of identification of high-risk HF patients by high heart rates and their treatment with heart rate-lowering drugs such as ivabradine.
Schirmer, Stephan H; Degen, Achim; Baumhäkel, Magnus; Custodis, Florian; Schuh, Lisa; Kohlhaas, Michael; Friedrich, Erik; Bahlmann, Ferdinand; Kappl, Reinhard; Maack, Christoph; Böhm, Michael; Laufs, Ulrich
2012-05-01
Collateral arteries protect tissue from ischaemia. Heart rate correlates with vascular events in patients with arterial obstructive disease. Here, we tested the effect of heart-rate reduction (HRR) on collateral artery growth. The I(f)-channel inhibitor ivabradine reduced heart rate by 11% in wild-type and 15% in apolipoprotein E (ApoE)(-/-) mice and restored endothelium-dependent relaxation in aortic rings of ApoE(-/-) mice. Microsphere perfusion and angiographies demonstrated that ivabradine did not change hindlimb perfusion in wild-type mice but improved perfusion in ApoE(-/-) mice from 40.5 ± 15.8-60.2 ± 18.5% ligated/unligated hindlimb. Heart rate reduction (13%) with metoprolol failed to improve endothelial function and perfusion. Protein expression of endothelial nitric oxide synthase (eNOS), phosphorylated eNOS, and eNOS activity were increased in collateral tissue following ivabradine treatment of ApoE(-/-) mice. Co-treatment with nitric oxide-inhibitor N (G)-nitro-L-arginine methyl ester abolished the effects of ivabradine on arteriogenesis. Following ivabradine, classical inflammatory cytokine expression was lowered in ApoE(-/-) circulating mononuclear cells and in plasma, but unaltered in collateral-containing hindlimb tissue, where numbers of perivascular macrophages also remained unchanged. However, ivabradine reduced expression of anti-arteriogenic cytokines CXCL10and CXCL11 and of smooth muscle cell markers smoothelin and desmin in ApoE(-/-) hindlimb tissue. Endothelial nitric oxide synthase and inflammatory cytokine expression were unchanged in wild-type mice. Ivabradine did not affect cytokine production in HUVECs and THP1 mononuclear cells and had no effect on the membrane potential of HUVECs in patch-clamp experiments. Ivabradine-induced HRR stimulates adaptive collateral artery growth. Important contributing mechanisms include improved endothelial function, eNOS activity, and modulation of inflammatory cytokine gene expression.
Tondi, Lara; Fragasso, Gabriele; Spoladore, Roberto; Pinto, Giuseppe; Gemma, Marco; Slavich, Massimo; Godino, Cosmo; Salerno, Anna; Montanaro, Claudia; Margonato, Alberto
2018-05-11
: Ivabradine is a selective and specific inhibitor of If current. With its pure negative chronotropic action, it is recommended by European Society of Cardiology and American College of Cardiology/American Heart Association guidelines in symptomatic heart failure patients (NYHA ≥ 2) with ejection fraction 35% or less, sinus rhythm and heart rate (HR) at least 70 bpm, despite maximally titrated β-blocker therapy. Data supporting this indication mainly derive from the SHIFT study, in which ivabradine reduced the combined endpoint of mortality and hospitalization, despite the fact that only 26% of patients enrolled were on optimal β-blocker doses. The aim of the present analysis is to establish the real-life eligibility for ivabradine in a population of patients with systolic heart failure, regularly attending a single heart failure clinic and treated according to guideline-directed medical therapy (GDMT). The clinical cards of 308 patients with heart failure with reduced ejection fraction (HFrEF) through a 68-month period of observation were retrospectively analyzed. GDMT, including β-blocker up-titration to maximal tolerated dose, was implemented during consecutive visits at variable intervals. Demographic, clinical and echocardiographic data were collected at each visit, together with 12-leads ECG and N-terminal pro-B-type natriuretic peptide levels. Out of 308 analyzed HFrEF patients, 220 (71%) were on effective β-blocker therapy, up-titrated to effective/maximal tolerated dose (55 ± 28% of maximal dose) (HR 67 ± 10 bpm). Among the remaining 88 patients, 10 (3.2%) were on maximally tolerated β blocker and ivabradine; 21 patients (6.8%), despite being on maximal tolerated β-blocker dose, had still HR ≥70 bpm, ejection fraction 35% or less and were symptomatic NYHA ≥2, being therefore eligible for ivabradine treatment. The remaining 57 (18%) patients were not on β blocker due to either intolerance or major contraindications. Among them, 13 (4%) were taking ivabradine alone. Of the final 44 (14%) patients, 27 (9%) showed an inadequate HR control (74 ± 6 bpm). Of these, only eight (3%) patients resulted to be eligible for ivabradine introduction according to HR and ejection fraction parameters. Overall ivabradine was indicated in 52 patients (16.8%) out of 308 enrolled.In conclusion, in a carefully managed population of patients with moderate and stable HFrEF, in which optimal GDMT is properly attained, indication to ivabradine treatment is around 17%.
Ng, Fu Siong; Shadi, Iqbal T.; Peters, Nicholas S.; Lyon, Alexander R.
2013-01-01
Heart rates during ischaemia and reperfusion are possible determinants of reperfusion arrhythmias. We used ivabradine, a selective If current inhibitor, to assess the effects of heart rate reduction (HRR) during ischaemia–reperfusion on reperfusion ventricular arrhythmias and assessed potential anti-arrhythmic mechanisms by optical mapping. Five groups of rat hearts were subjected to regional ischaemia by left anterior descending artery occlusion for 8 min followed by 10 min of reperfusion: (1) Control n = 10; (2) 1 μM of ivabradine perfusion n = 10; (3) 1 μM of ivabradine + 5 Hz atrial pacing throughout ischaemia–reperfusion n = 5; (4) 1 μM of ivabradine + 5 Hz pacing only at reperfusion; (5) 100 μM of ivabradine was used as a 1 ml bolus upon reperfusion. For optical mapping, 10 hearts (ivabradine n = 5; 5 Hz pacing n = 5) were subjected to global ischaemia whilst transmembrane voltage transients were recorded. Epicardial activation was mapped, and the rate of development of ischaemia-induced electrophysiological changes was assessed. HRR observed in the ivabradine group during both ischaemia (195 ± 11 bpm vs. control 272 ± 14 bpm, p < 0.05) and at reperfusion (168 ± 13 bpm vs. 276 ± 14 bpm, p < 0.05) was associated with reduced reperfusion ventricular fibrillation (VF) incidence (20% vs. 90%, p < 0.05). Pacing throughout ischaemia–reperfusion abolished the protective effects of ivabradine (100% VF), whereas pacing at reperfusion only partially attenuated this effect (40% VF). Ivabradine, given as a bolus at reperfusion, did not significantly affect VF incidence (80% VF). Optical mapping experiments showed a delay to ischaemia-induced conduction slowing (time to 50% conduction slowing: 10.2 ± 1.3 min vs. 5.1 ± 0.7 min, p < 0.05) and to loss of electrical excitability in ivabradine-perfused hearts (27.7 ± 4.3 min vs. 14.5 ± 0.6 min, p < 0.05). Ivabradine administered throughout ischaemia and reperfusion reduced reperfusion VF incidence through HRR. Heart rate during ischaemia is a major determinant of reperfusion arrhythmias. Heart rate at reperfusion alone was not a determinant of reperfusion VF, as neither a bolus of ivabradine nor pacing immediately prior to reperfusion significantly altered reperfusion VF incidence. This anti-arrhythmic effect of heart rate reduction during ischaemia may reflect slower development of ischaemia-induced electrophysiological changes. PMID:23402927
Fox, Kim; Ford, Ian; Steg, P Gabriel; Tendera, Michal; Ferrari, Roberto
2008-09-06
Ivabradine specifically inhibits the I(f) current in the sinoatrial node to lower heart rate, without affecting other aspects of cardiac function. We aimed to test whether lowering the heart rate with ivabradine reduces cardiovascular death and morbidity in patients with coronary artery disease and left-ventricular systolic dysfunction. Between December, 2004, and December, 2006, we screened 12 473 patients at 781 centres in 33 countries. We enrolled 10 917 eligible patients who had coronary artery disease and a left-ventricular ejection fraction of less than 40% in a randomised, double-blind, placebo-controlled, parallel-group trial. 5479 patients received 5 mg ivabradine, with the intention of increasing to the target dose of 7.5 mg twice a day, and 5438 received matched placebo in addition to appropriate cardiovascular medication. The primary endpoint was a composite of cardiovascular death, admission to hospital for acute myocardial infarction, and admission to hospital for new onset or worsening heart failure. We analysed patients by intention to treat. The study is registered with ClinicalTrials.gov, number NCT00143507. Mean heart rate at baseline was 71.6 (SD 9.9) beats per minute (bpm). Median follow-up was 19 months (IQR 16-24). Ivabradine reduced heart rate by 6 bpm (SE 0.2) at 12 months, corrected for placebo. Most (87%) patients were receiving beta blockers in addition to study drugs, and no safety concerns were identified. Ivabradine did not affect the primary composite endpoint (hazard ratio 1.00, 95% CI 0.91-1.1, p=0.94). 1233 (22.5%) patients in the ivabradine group had serious adverse events, compared with 1239 (22.8%) controls (p=0.70). In a prespecified subgroup of patients with heart rate of 70 bpm or greater, ivabradine treatment did not affect the primary composite outcome (hazard ratio 0.91, 95% CI 0.81-1.04, p=0.17), cardiovascular death, or admission to hospital for new-onset or worsening heart failure. However, it did reduce secondary endpoints: admission to hospital for fatal and non-fatal myocardial infarction (0.64, 95% CI 0.49-0.84, p=0.001) and coronary revascularisation (0.70, 95% CI 0.52-0.93, p=0.016). Reduction in heart rate with ivabradine does not improve cardiac outcomes in all patients with stable coronary artery disease and left-ventricular systolic dysfunction, but could be used to reduce the incidence of coronary artery disease outcomes in a subgroup of patients who have heart rates of 70 bpm or greater.
Danchin, Nicolas
2009-01-01
Ivabradine is an I(f) current inhibitor, that has documented antianginal efficacy. The BEAUTIFUL trial tested ivabradine against placebo in a large population of 10,917 patients in sinus rhythm, with coronary artery disease and left ventricular dysfunction, defined as left ventricular ejection fraction < or =35%. Overall, there was no impact of ivabradine on the primary end-point of the trial (cardiovascular mortality, hospitalisation for myocardial infarction, new onset or worsening heart failure). In the placebo arm of the trial, baseline heart rate > or = 70 bpm was associated with an increased risk of cardiovascular mortality, myocardial infarction, heart failure and coronary revascularisation. In the subgroup of patients with a baseline heart rate > or =70 bpm, treatment with ivabradine resulted in a significant, 36% reduction in the risk of myocardial infarction and a 20% reduction in the need for coronary revascularisation. Ivabradine was well tolerated, with an increased rate of treatment discontinuation, mainly due to bradycardia, compared with placebo. Because of its safety and efficacy to control angina, ivabradine should be considered first-line antianginal treatment in coronary artery disease patients with left ventricular dysfunction and increased heart rate, already receiving beta-blocker therapy or in whom these medications are not tolerated.
Mahmoud, Kareem; Kassem, Hussien Heshmat; Baligh, Essam; ElGameel, Usama; Akl, Yosri; Kandil, Hossam
2016-10-01
Increased sympathetic tone and use of bronchodilators increase heart rate and this may worsen functional capacity in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to look at the short-term effect of the heart rate lowering drug ivabradine on clinical status in COPD patients.We randomised 80 COPD patients with sinus heart rate ≥90 bpm into either taking ivabradine 7.5 mg twice per day or placebo for two weeks. We assessed all patients using the modified Borg scale and 6-minute walk test at baseline and then again 2 weeks after randomisation.There were no significant differences in age, sex, severity of airway obstruction (measured using forceful exhalation), severity of diastolic dysfunction or pulmonary artery systolic pressure between the two groups. The ivabradine group showed significant improvement in 6-minute walk distance (from 192.6±108.8 m at baseline to 285.1±88.9 m at the end of the study) compared with the control group (230.6±68.4 at baseline and 250.4±65.8 m at the end of study) (p<0.001). This improvement in the drug group was associated with significant improvement of dyspnea on modified Borg scale (p=0.007).Lowering heart rate with ivabradine can improve exercise capacity and functional class in COPD patients with resting heart rate >90 bpm. © Royal College of Physicians 2016. All rights reserved.
Pirintr, Prapawadee; Limprasutr, Vudhiporn; Saengklub, Nakkawee; Pavinadol, Parnpradub; Yapao, Napat; Limvanicharat, Natthakarn; Kuecharoen, Hathaisiri; Kijtawornrat, Anusak
2018-05-14
Degenerative mitral valve disease (DMVD) is a common cardiac disease in geriatric dogs characterized by the degeneration of the mitral valve, leading to decreased cardiac output and activation of the sympathetic and renin-angiotensin-aldosterone system. This disease results in an increased resting heart rate (HR) and myocardial oxygen consumption (MVO 2 ). A recent publication demonstrated that dogs with asymptomatic DMVD had a significantly higher HR and systemic blood pressure (BP) than age-matched control dogs. This higher HR will eventually contribute to increased MVO 2 . This study aimed to determine the effects of a single oral dose of ivabradine on the HR, MVO 2 as assessed by the rate-pressure product, and BP in dogs with asymptomatic DMVD. Seven beagles with naturally occurring DMVD were instrumented by the Holter recorder and an oscillometric device to measure electrocardiogram and BP for 24 and 12 h, respectively. Each dog was randomly subjected to receive either placebo or ivabradine (0.5, 1.0 and 2.0 mg/kg). The results revealed that oral administration of ivabradine significantly decreased the HR and rate-pressure product in a dose-dependent manner without adverse effects. The highest dose of 2.0 mg/kg significantly reduced systolic and mean BP. Therefore, the findings imply that a single oral ivabradine administration at a dose of 1.0 mg/kg is suitable for dogs with asymptomatic DMVD to reduce the HR and MVO 2 without marked effects on BP. This may potentially make ivabradine promising for management of an elevated HR in DMVD dogs.
A case of atrial tachycardia treated with ivabradine as bridge to ablation.
Meles, Ester; Carbone, Claudio; Maggiolini, Stefano; Moretti, Paolo; DE Carlini, Caterina C; Gentile, Gaetano; Gnecchi-Ruscone, Tomaso
2015-05-01
Ivabradine is indicated in cardiac failure and ischemia to reduce sinus rate by inhibition of the pacemaker I(f) current in sinoatrial node. We report a case of an 18-year-old woman with left atrial tachyarrhythmia resistant to several antiarrhythmic drugs and to electric cardioversion who responded only to ivabradine, which significantly reduced heart rate without abolishing the arrhythmia itself. An ectopic focus in the ostium of left pulmonary veins was found and the patient was successfully ablated. We suggest that ivabradine might be therefore useful in the treatment of supraventricular tachyarrhythmias due to an enhanced automaticity. © 2015 Wiley Periodicals, Inc.
Antianginal Efficacy of Ivabradine/Metoprolol Combination in Patients With Stable Angina.
Zarifis, John; Kallistratos, Manolis; Katsivas, Apostolos
2016-12-01
Medical treatment is the main clinical strategy for controlling patients with chronic stable angina and improving their quality of life (QoL). Ivabradine treatment on top of metoprolol decreases angina symptoms and improves QoL in patients with stable angina and coronary artery disease (CAD). This is a post hoc analysis (636 CAD patients given ivabradine/metoprolol free combination) of a prospective, noninterventional study that included 2403 patients with CAD and stable angina. Data were recorded at baseline at 1 and 4 months after inclusion. Patient QoL was assessed using the EQ-5D questionnaire. From baseline to study completion; ivabradine administration on top of metoprolol decreased heart rate (HR) from 80.8 ± 9.6 to 64.2 ± 6.2 bpm (P < 0.001). Mean number of angina attacks decreased from 2.0 ± 2.0/wk to 0.2 ± 0.6/wk (P < 0.001), whereas nitroglycerin consumption decreased from 1.4 ± 1.9 times/wk to 0.1 ± 0.4 times/wk (P < 0.001). The percentage of patients in Canadian Cardiovascular Society angina class III to IV decreased from 15.4% to 1.9% (P < 0.001). The improvement of symptoms and angina class led to a significant 14.7-point increase in EQ-5D questionnaire score (P < 0.001). Patients with increased HR showed greater improvement (P = 0.001). Adherence to treatment during the entire trial was high (98%). Ivabradine combined with metoprolol significantly decreased angina symptoms and use of nitroglycerin in patients with stable angina and CAD, leading to improved QoL. The benefits observed with this combination explain the high rate of adherence to treatment. © 2016 Wiley Periodicals, Inc.
Barillà, Francesco; Pannarale, Giuseppe; Torromeo, Concetta; Paravati, Vincenzo; Acconcia, Maria Cristina; Tanzilli, Gaetano; Mangieri, Enrico; Dominici, Tania; Martino, Francesco; Pannitteri, Gaetano; Gaudio, Carlo
2016-10-01
An elevated heart rate (HR) is an independent risk factor for mortality and morbidity in patients with acute heart failure (HF). The purpose of this study was to evaluate the impact of ivabradine, a selective HR-lowering agent, in patients with cardiogenic shock (CS) complicating ST-elevation acute myocardial infarction (AMI). Patients with post-AMI CS were randomized to standard treatment (SDT, 28 patients) or to standard treatment plus ivabradine (I + SDT, 30 patients). In the presence of orotracheal intubation (OTI), ivabradine was administered by nasogastric intubation. HR, BP, New York Heart Association (NYHA) class, NT-proBNP, left ventricular ejection fraction (LVEF) and diastolic function (LVDF) were monitored at specific times after the onset of AMI. The primary (surrogate) end-point was the in-hospital halving of plasma NT-proBNP levels. The secondary end-points were cardiovascular death, hospital re-admission for worsening HF, and clinical and haemodynamic improvement. Treatment groups were statistically similar with regard to age, gender distribution, cardiovascular risk factors, number of diseased vessels and overall treated lesions, AMI site and occurrence of OTI. In-hospital mortality was double in the SDT group in comparison with the I + SDT group (14.3 vs. 6.7 %), but the difference was not statistically significant. HR, BP, NT-proBNP and LVEF favorably changed in both groups, but the change was more relevant in the I + SDT group. LVDF significantly changed only in the I + SDT group (p < 0.01). Patients in the I + SDT group did not experience adverse effects. Ivabradine in CS complicating AMI is safe, is associated with a short-term favourable outcome and can be effectively administered by nasogastric intubation.
Hidalgo, Francisco J; Anguita, Manuel; Castillo, Juan C; Rodríguez, Sara; Pardo, Laura; Durán, Enrique; Sánchez, José J; Ferreiro, Carlos; Pan, Manuel; Mesa, Dolores; Delgado, Mónica; Ruiz, Martín
2016-08-15
To analyse the effect of the early coadministration of ivabradine and beta-blockers (intervention group) versus beta-blockers alone (control group) in patients hospitalised with heart failure and reduced left ventricular ejection fraction (HFrEF). A comparative, randomised study was performed to compare the treatment strategies of beta-blockers alone versus ivabradine and beta-blockers starting 24hours after hospital admission, for acute HF in patients with an left ventricular ejection fraction (EF)<40%, sinus rhythm, and a heart rate (HR)>70bpm. A total of 71 patients were examined, 33 in the intervention group and 38 in the control group. No differences were observed with respect to their baseline characteristics or standard treatment at discharge. HR at 28days (64.3±7.5 vs. 70.3±9.3bpm, p=0.01) and at 4months (60.6±7.5 vs. 67.8±8bpm, p=0.004) after discharge were significantly lower in the intervention group. Significant differences were found with respect to the EF and brain natriuretic peptide levels at 4months. No differences in clinical events (rehospitalisation/death) were reported at 4months. No severe side effects attributable to the early administration of ivabradine were observed. The early coadministration of ivabradine and beta-blockers during hospital admission for acute HFrEF is feasible and safe, and it produces a significant decrease in HR at 28days and at 4months after hospital discharge. It also seemed to improve systolic function and functional and clinical parameters of HF patients at short-term. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Advances in the management of heart failure: the role of ivabradine
Müller-Werdan, Ursula; Stöckl, Georg; Werdan, Karl
2016-01-01
A high resting heart rate (≥70–75 b.p.m.) is a risk factor for patients with heart failure (HF) with reduced ejection fraction (EF), probably in the sense of accelerated atherosclerosis, with an increased morbidity and mortality. Beta-blockers not only reduce heart rate but also have negative inotropic and blood pressure-lowering effects, and therefore, in many patients, they cannot be given in the recommended dose. Ivabradine specifically inhibits the pacemaker current (funny current, If) of the sinoatrial node cells, resulting in therapeutic heart rate lowering without any negative inotropic and blood pressure-lowering effect. According to the European Society of Cardiology guidelines, ivabradine should be considered to reduce the risk of HF hospitalization and cardiovascular death in symptomatic patients with a reduced left ventricular EF ≤35% and sinus rhythm ≥70 b.p.m. despite treatment with an evidence-based dose of beta-blocker or a dose below the recommended dose (recommendation class “IIa” = weight of evidence/opinion is in favor of usefulness/efficacy: “should be considered”; level of evidence “B” = data derived from a single randomized clinical trial or large nonrandomized studies). Using a heart rate cutoff of ≥ 75 b.p.m., as licensed by the European Medicines Agency, treatment with ivabradine 5–7.5 mg b.i.d. reduces cardiovascular mortality by 17%, HF mortality by 39% and HF hospitalization rate by 30%. A high resting heart rate is not only a risk factor in HF with reduced EF but also at least a risk marker in HF with preserved EF, in acute HF and also in special forms of HF. In this review, we discuss the proven role of ivabradine in the validated indication “HF with reduced EF” together with interesting preliminary findings, and the potential role of ivabradine in further, specific forms of HF. PMID:27895488
Role of ivabradine in management of stable angina in patients with different clinical profiles
Kaski, Juan Carlos; Gloekler, Steffen; Ferrari, Roberto; Fox, Kim; Lévy, Bernard I; Komajda, Michel; Vardas, Panos; Camici, Paolo G
2018-01-01
In chronic stable angina, elevated heart rate contributes to the development of symptoms and signs of myocardial ischaemia by increasing myocardial oxygen demand and reducing diastolic perfusion time. Accordingly, heart rate reduction is a well-known strategy for improving both symptoms of myocardial ischaemia and quality of life (QOL). The heart rate-reducing agent ivabradine, a direct and selective inhibitor of the I f current, decreases myocardial oxygen consumption while increasing diastolic time, without affecting myocardial contractility or coronary vasomotor tone. Ivabradine is indicated for treatment of stable angina and chronic heart failure (HF). This review examines available evidence regarding the efficacy and safety of ivabradine in stable angina, when used as monotherapy or in combination with beta-blockers, in particular angina subgroups and in patients with stable angina with left ventricular systolic dysfunction (LVSD) or HF. Trials involving more than 45 000 patients receiving treatment with ivabradine have shown that this agent has antianginal and anti-ischaemic effects, regardless of age, sex, severity of angina, revascularisation status or comorbidities. This heart rate-lowering agent might also improve prognosis, reduce hospitalisation rates and improve QOL in angina patients with chronic HF and LVSD. PMID:29632676
The Role of Ivabradine in the Management of Angina Pectoris.
Giavarini, Alessandra; de Silva, Ranil
2016-08-01
Stable angina pectoris affects 2-4 % of the population in Western countries and entails an annual risk of death and nonfatal myocardial infarction of 1-2 % and 3 %, respectively. Heart rate (HR) is linearly related to myocardial oxygen consumption and coronary blood flow, both at rest and during stress. HR reduction is a key target for the prevention of ischemia/angina and is an important mechanism of action of drugs which are recommended as first line therapy for the treatment of angina in clinical guidelines. However, many patients are often unable to tolerate the doses of beta blocker or non-dihydropyridine calcium antagonists required to achieve the desired symptom control. The selective pacemaker current inhibitor ivabradine was developed as a drug for the management of patients with angina pectoris, through its ability to reduce HR specifically. The available data suggest that ivabradine is a well-tolerated and effective anti-anginal agent and it is recommended as a second-line agent for relief of angina in guidelines. However, recent clinical trials of ivabradine have failed to show prognostic benefit and have raised potential concerns about safety. This article will review the available evidence base for the current role of ivabradine in the management of patients with symptomatic angina pectoris in the context of stable coronary artery disease.
Priti, Kumari; Ranwa, Bhanwar L; Gokhroo, Rajendra K; Kishore, Kamal; Bisht, Devendra Singh; Gupta, Sajal
2017-08-01
Atrioventricular (AV) blocks are of concern with the use of beta blockers in inferior wall myocardial infarction (MI). Ivabradine lowers heart rate with a lesser risk of AV blocks. To compare ivabradine with metoprolol in acute inferior wall MI in terms of feasibility, tolerability, and efficacy. It was a prospective double-blind single-center randomized controlled study. Of 1032 patients with acute inferior wall MI, 468 eligible patients were randomized in 1:1 manner to ivabradine (group A) and metoprolol (group B). Intention to treat analysis of 426 patients (group A-232 and group B-232) was performed. The primary endpoint was 30-day incidence of major adverse cardiovascular events including death, reinfarction, complete heart block (CHB), and heart failure. Secondary endpoints included 30 days incidence of recurrent angina, readmission, first- or second-degree AV block, and tachyarrhythmias. Both the drugs decreased the mean heart rate to 62.22±2.95 (group A) vs 62.53±3.59 (group B) beats per minute (P=0.33). Ejection fraction improved in both the groups (5.15±1.93% in group A vs 5.52±2.18% in group B, P=0.065). The two groups did not differ significantly in their primary endpoints in terms of death (group A=1.72% vs group B=1.72%, OR=1.00, 95% CI=0.25-4.05, P=1.00), reinfarction (group A=0.86% vs group B=0.86%, OR=1.00, 95% CI=0.14-7.16, P=1.00), heart failure (group A=4.31% vs group B=2.59%, OR=1.70, 95% CI=0.61-4.75, P=0.31), or CHB (0% vs 2.59%, OR=0.07, 95% CI=0.00-1.34, P=0.08). There were no significant differences in the secondary endpoints of recurrent angina, readmission, and tachyarrhythmias except for more first- and second-degree AV blocks with metoprolol (12.93% vs 2.59%, OR=5.59, 95% CI=2.28-13.72, P=0.0002). Ivabradine is well tolerated and equally effective as metoprolol in acute inferior wall ST elevation myocardial infarction patients for lowering the heart rate with lesser risk of AV blocks. © 2017 John Wiley & Sons Ltd.
Rayan, Mona; Tawfik, Mazen; Alabd, Ali; Gamal, Amr
2011-08-01
To prospectively assess the safety and efficacy of ivabradine in patients with idiopathic dilated cardiomyopathy. We included 35 patients with idiopathic dilated cardiomyopathy with an ejection fraction (EF) <40% and heart rate >70 beats/min despite optimal medical therapy, according to the international guidelines in this prospective, non-randomized, single-arm, open-label safety study. Ivabradine was used as an add-on therapy to the maximally tolerated b-blocker in an increasing titrated dose till a target dose of 15 mg/day or resting heart rate of 60 beats/min for 3 months. During follow-up period the safety, patient tolerance and efficacy of this drug were assessed. All patients underwent 12-lead resting electrocardiography and Holter monitoring at inclusion and after 3 months. Statistical analysis was accomplished using paired t-test and Pearson correlation analysis. We found a significant reduction in the resting heart rate by a mean of 25.9 ± 9.4%, without a significant change of blood pressure. There was no prolongation of PR, QTc or QRS durations. Ventricular ectopic activity showed significant reduction (p<0.001). There was a significant correlation between the resting heart rate, NYHA and left ventricular ejection fraction (p<0.001 for both). One patient developed photopsia and decompensation was observed in another patient. Ivabradine is a safe and effective drug in reducing resting heart rate, improving NYHA functional class without undesirable effects on conduction parameters or ectopic activity.
Heart rate reduction and longevity in mice.
Gent, Sabine; Kleinbongard, Petra; Dammann, Philip; Neuhäuser, Markus; Heusch, Gerd
2015-03-01
Heart rate correlates inversely with life span across all species, including humans. In patients with cardiovascular disease, higher heart rate is associated with increased mortality, and such patients benefit from pharmacological heart rate reduction. However, cause-and-effect relationships between heart rate and longevity, notably in healthy individuals, are not established. We therefore prospectively studied the effects of a life-long pharmacological heart rate reduction on longevity in mice. We hypothesized, that the total number of cardiac cycles is constant, and that a 15% heart rate reduction might translate into a 15% increase in life span. C57BL6/J mice received either placebo or ivabradine at a dose of 50 mg/kg/day in drinking water from 12 weeks to death. Heart rate and body weight were monitored. Autopsy was performed on all non-autolytic cadavers, and parenchymal organs were evaluated macroscopically. Ivabradine reduced heart rate by 14% (median, interquartile range 12-15%) throughout life, and median life span was increased by 6.2% (p = 0.01). Body weight and macroscopic findings were not different between placebo and ivabradine. Life span was not increased to the same extent as heart rate was reduced, but nevertheless significantly prolonged by 6.2%.
Effect of Selective Heart Rate Slowing in Heart Failure With Preserved Ejection Fraction.
Pal, Nikhil; Sivaswamy, Nadiya; Mahmod, Masliza; Yavari, Arash; Rudd, Amelia; Singh, Satnam; Dawson, Dana K; Francis, Jane M; Dwight, Jeremy S; Watkins, Hugh; Neubauer, Stefan; Frenneaux, Michael; Ashrafian, Houman
2015-11-03
Heart failure with preserved ejection fraction (HFpEF) is associated with significant morbidity and mortality but is currently refractory to therapy. Despite limited evidence, heart rate reduction has been advocated, on the basis of physiological considerations, as a therapeutic strategy in HFpEF. We tested the hypothesis that heart rate reduction improves exercise capacity in HFpEF. We conducted a randomized, crossover study comparing selective heart rate reduction with the If blocker ivabradine at 7.5 mg twice daily versus placebo for 2 weeks each in 22 symptomatic patients with HFpEF who had objective evidence of exercise limitation (peak oxygen consumption at maximal exercise [o2 peak] <80% predicted for age and sex). The result was compared with 22 similarly treated matched asymptomatic hypertensive volunteers. The primary end point was the change in o2 peak. Secondary outcomes included tissue Doppler-derived E/e' at echocardiography, plasma brain natriuretic peptide, and quality-of-life scores. Ivabradine significantly reduced peak heart rate compared with placebo in the HFpEF (107 versus 129 bpm; P<0.0001) and hypertensive (127 versus 145 bpm; P=0.003) cohorts. Ivabradine compared with placebo significantly worsened the change in o2 peak in the HFpEF cohort (-2.1 versus 0.9 mL·kg(-1)·min(-1); P=0.003) and significantly reduced submaximal exercise capacity, as determined by the oxygen uptake efficiency slope. No significant effects on the secondary end points were discernable. Our observations bring into question the value of heart rate reduction with ivabradine for improving symptoms in a HFpEF population characterized by exercise limitation. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02354573. © 2015 The Authors.
Gao, Y; Liang, Y C; Yu, H B; Yan, X L; Xu, B G; Liu, R; Wang, N; Xu, G Q; Wang, Z L
2018-03-24
Objective: To investigate the heart rate control situation of chronic heart failure (CHF) patients who received cardiovascular implantable electronic device (CIED) therapy, and to assess the heart rate control efficacy by optimized medication adjustment. Methods: We performed a perspective study in heart failure with reduced left ventricular ejection fraction (HFrEF) patients who received CIED according to guideline recommendations, patients were enrolled from January 2012 to January 2017. Resting heart rate (RHR) recorded by electrocardiogram after 10 minutes' rest and medication usage within 1 month were recorded at baseline. RHR less than 70 beats per minute (bpm) was regarded as well controlled. β-receptor blockers and (or) ivabradine would be added in patients whose RHR were over 70 bpm. RHR after optimized medication adjustment was recorded during follow-up period. Results: One hundred and fifty patients were included in this study with average RHR (80.6±11.9) bpm. RHR was<70 bpm in 27.3% (41/150) patients at baseline and β-receptor blockers was underused in 80.7% patients (88/109) whose RHR was>70 bpm. The overall RHR decreased to (73.1±10.4) bpm and percent of patients with RHR<70 bpm increased to 70.0% (105/150) after up-titration of β-receptor blockers compared to baseline (χ 2 =52.958, P< 0.001). Ivabradine was added in the rest 45 patients and RHR was<70 bpm in 43 out of 45 patients after ivabradine use. The overall RHR decreased to (67.1±2.7) bpm and percent of RHR<70 bpm significantly increased to 98.7% (148/150) (χ 2 =44.504, P< 0.001 vs. up-titration of β-receptor blockers only). Conclusion: RHR in CHF patients who received CIED therapy is not ideally controlled in this patient cohort, individual up-titration ofβ-receptor blockers and ivabradine use may help to optimize RHR in these patients.
Lodhi, Mohasin; Dubey, Akhilesh; Narayan, Reema; Prabhu, Prabhakara; Priya, Sneh
2013-01-01
Background: Ivabradine hydrochloride is an anti-anginal drug with a biological half-life of about 2 h, and repeated daily administration is needed to maintain effective plasma level. Present investigation of buccal films of Ivabradine hydrochloride is an attempt to avoid the repeated administration and release of drug in more controlled fashion, thereby, to improve the bioavailability. Materials and Methods: Buccal patches were fabricated by solvent casting technique and were evaluated for its physical properties like physical appearance, weight uniformity, thickness, swelling index, surface pH, mucoadhesive time, and folding endurance, in vitro and ex vivo release studies. Results: A combination of hydroxypropyl methyl cellulose (HPMC) K15M and K100M with carbopol 940, PEG 6000 gave promising results. Further, the drug content of all the formulations was determined and was found to be uniform. All the formulations were subjected to in vitro release study using phosphate buffer pH 6.6. Patches exhibited drug release in the range of 90.36% ± 0.854 to 98.37% ± 0.589 at the end of six hrs. The best formulations (F2 and F5) containing the composition of HPMC K15-37.50 mg, carbopol-0.42 mg, PEG6000-16.87 mg, Aspertane-0.28 mg, Tween-0.0023 mg and HPMC K100-37.50 mg, carbopol-0.42 mg, PEG6000-16.87 mg, Aspertane-0.28 mg, Tween-0.0023 mg respectively exhibited in vitro drug release of 97.61% ± 0.589 and 98.37% ± 0.114 respectively. The results of ex vivo diffusion using goat cheek pouch revealed that the drug release rate was retarded up to seven hrs. Films prepared with permeation enhancer (Tween 80) showed faster drug release. Finally, stability studies were carried out by using human saliva for the optimized formulation (F2-F5). Conclusion: The present study indicated enormous potential of mucoadhesive buccal patches containing Ivabradine for systemic delivery with an added advantage of circumventing hepatic first pass metabolism. Further work is recommended to support its efficacy claims by long term pharmacokinetic and pharmacodynamic studies in human beings. PMID:23799205
Griffiths, Alison; Paracha, Noman; Davies, Andrew; Branscombe, Neil; Cowie, Martin R; Sculpher, Mark
2017-03-01
The aim of this article is to discuss methods used to analyze health-related quality of life (HRQoL) data from randomized controlled trials (RCTs) for decision analytic models. The analysis presented in this paper was used to provide HRQoL data for the ivabradine health technology assessment (HTA) submission in chronic heart failure. We have used a large, longitudinal EuroQol five-dimension questionnaire (EQ-5D) dataset from the Systolic Heart Failure Treatment with the I f Inhibitor Ivabradine Trial (SHIFT) (clinicaltrials.gov: NCT02441218) to illustrate issues and methods. HRQoL weights (utility values) were estimated from a mixed regression model developed using SHIFT EQ-5D data (n = 5313 patients). The regression model was used to predict HRQoL outcomes according to treatment, patient characteristics, and key clinical outcomes for patients with a heart rate ≥75 bpm. Ivabradine was associated with an HRQoL weight gain of 0.01. HRQoL weights differed according to New York Heart Association (NYHA) class (NYHA I-IV, no hospitalization: standard care 0.82-0.46; ivabradine 0.84-0.47). A reduction in HRQoL weight was associated with hospitalizations within 30 days of an HRQoL assessment visit, with this reduction varying by NYHA class [-0.07 (NYHA I) to -0.21 (NYHA IV)]. The mixed model explained variation in EQ-5D data according to key clinical outcomes and patient characteristics, providing essential information for long-term predictions of patient HRQoL in the cost-effectiveness model. This model was also used to estimate the loss in HRQoL associated with hospitalizations. In SHIFT many hospitalizations did not occur close to EQ-5D visits; hence, any temporary changes in HRQoL associated with such events would not be captured fully in observed RCT evidence, but could be predicted in our cost-effectiveness analysis using the mixed model. Given the large reduction in hospitalizations associated with ivabradine this was an important feature of the analysis. The Servier Research Group.
Jirak, Peter; Fejzic, Dzeneta; Paar, Vera; Wernly, Bernhard; Pistulli, Rudin; Rohm, Ilonka; Jung, Christian; Hoppe, Uta C; Schulze, P Christian; Lichtenauer, Michael; Yilmaz, Atilla; Kretzschmar, Daniel
2017-12-14
Chronic heart failure (CHF) represents a major cause of hospitalization and death. Recent evidence shows that novel biomarkers such as soluble suppression of tumorigenicity (sST2), growth-differentiation factor-15 (GDF-15), soluble urokinase plasminogen activator receptor (suPAR) and heart-type fatty acid binding protein (H-FABP) are correlated with inflammatory and ischemic responses in CHF patients. In this study we examined the effects of Ivabradine that inhibited the hyperpolarization-activated cyclic nucleotide-gated channel (HCN channel, also called funny current I f ), thereby leading to selective heart rate reduction and improved myocardial oxygen supply on the cardiac biomarkers sST2, GDF-15, suPAR and H-FABP in 50 CHF patients at the University Hospital of Jena. Patients were divided into three groups based on the etiology of CHF: dilated cardiomyopathy (DCM, n=20), ischemic cardiomyopathy (ICM, n=20) and hypertensive cardiomyopathy (HCM, n=10). The patients were administered Ivabradine (5 mg, bid for 3 months, and 7.5 mg bid for further 3 months). Analyses of cardiovascular biomarkers were performed at baseline as well as at 3- and 6-month follow-ups. At 6-month follow-up, GDF-15 levels were significantly reduced compared to baseline levels (P=0.0215), indicating a reduction in the progress of cardiac remodeling. H-FABP concentration was significantly lower in DCM patients compared to ICM (1.89 vs 3.24 μg/mL) and HCM patients (1.89 vs 3.80 μg/mL), and decreased over the 6-month follow-up (P=0.0151). suPAR median levels remained elevated, implying major ongoing inflammatory processes. As shown by significant decreases in GDF-15 and H-FABP levels, a reduction in ventricular remodeling and sub-clinical ischemia could be assumed. However, markers of hemodynamic stress (sST2) and inflammation (suPAR) showed no change or progression after 6 months of Ivabradine treatment in CHF patients. Further studies are necessary to validate the clinical applicability of these novel cardiovascular biomarkers.
New Medications for Heart Failure
Gordin, Jonathan S.; Fonarow, Gregg C.
2016-01-01
Heart failure is common and results in substantial morbidity and mortality. Current guideline-based therapies for heart failure with reduced ejection fraction, including beta-blockers, angiotensin converting enzyme (ACE) inhibitors, and aldosterone antagonists aim to interrupt deleterious neurohormonal pathways and have shown significant success in reducing morbidity and mortality associated with heart failure. Continued efforts to further improve outcomes in patients with heart failure with reduced ejection fraction have led to the first new-in-class medications approved for heart failure since 2005, ivabradine and sacubitril/valsartan. Ivabradine targets the If channels in the sinoatrial node of the heart, decreasing heart rate. Sacubitril/valsartan combines a neprilysin inhibitor that increases levels of beneficial vasodilatory peptides with an angiotensin receptor antagonist. On a background of previously approved, guideline-directed medical therapies for heart failure, these medications have shown improved clinical outcomes ranging from decreased hospitalizations in a select group of patients to a reduction in all-cause mortality across all pre-specified subgroups. In this review, we will discuss the previously established guideline-directed medical therapies for heart failure with reduced ejection fraction, the translational research that led to the development of these new therapies, and the results from the major clinical trials of ivabradine and sacubitril/valsartan. PMID:27038558
Seerapu, Sunitha; Srinivasan, B. P.
2010-01-01
A simple, sensitive, precise and robust reverse–phase high-performance liquid chromatographic method for analysis of ivabradine hydrochloride in pharmaceutical formulations was developed and validated as per ICH guidelines. The separation was performed on SS Wakosil C18AR, 250×4.6 mm, 5 μm column with methanol:25 mM phosphate buffer (60:40 v/v), adjusted to pH 6.5 with orthophosphoric acid, added drop wise, as mobile phase. A well defined chromatographic peak of Ivabradine hydrochloride was exhibited with a retention time of 6.55±0.05 min and tailing factor of 1.14 at the flow rate of 0.8 ml/min and at ambient temperature, when monitored at 285 nm. The linear regression analysis data for calibration plots showed good linear relationship with R=0.9998 in the concentration range of 30-210 μg/ml. The method was validated for precision, recovery and robustness. Intra and Inter-day precision (% relative standard deviation) were always less than 2%. The method showed the mean % recovery of 99.00 and 98.55 % for Ivabrad and Inapure tablets, respectively. The proposed method has been successfully applied to the commercial tablets without any interference of excipients. PMID:21695008
Reduction of resting heart rate with antianginal drugs: review and meta-analysis.
Cucherat, Michel; Borer, Jeffrey S
2012-07-01
The benefit of heart rate (HR) reduction in patients with stable coronary artery disease is well demonstrated for symptom prevention and relief, and benefits on outcomes are being actively investigated. We aimed to quantify the reduction in resting HR induced by 5 antianginal drugs frequently used for symptom prevention (diltiazem, verapamil, atenolol, metoprolol, and ivabradine) in stable angina pectoris. We identified studies published between 1966 and 2007 in PubMed, Embase, and the Cochrane database and reviewed the bibliographies to locate additional studies. Eligible studies were double-blind, randomized, placebo-controlled trials in patients with stable angina. Trials were combined using weighted mean difference and fixed-effect model meta-analysis. The main outcome measure was resting HR at the study end. For diltiazem, resting HR reduction versus placebo ranged from -0.08 beats per minute (bpm) [95% confidence interval (CI) -1.5 to +1.4] for 120 mg/d to -8.0 bpm (95% CI, -11.1 to -5.0) with 360 mg/d. For sustained-release diltiazem, there was a reduction in resting HR of -4.5 bpm (95% CI, -6.4 to -2.5), with no dose-response relationship (heterogeneity P = 0.62). Resting HR reductions for the other agents were -3.2 bpm (95% CI, -5.1 to -1.3) for verapamil (with no dose-response relationship, heterogeneity P = 0.87); -19.0 bpm (95% CI, -20.4 to -17.6) for atenolol; -13.2 bpm (95% CI, -14.7 to -11.7) for metoprolol (with greater reductions for 150 mg/d and long-acting 190 mg/d); and between -9.3 bpm (95% CI, -13.8 to -4.8) and -19.6 bpm (95% CI, -23.8 to -15.4) for ivabradine. Ivabradine, atenolol, and metoprolol give similar reductions in resting HR (-10 to -20 bpm), whereas verapamil and diltiazem produce only marginal reductions (<10 bpm).
Review of the If selective channel inhibitor ivabradine in the treatment of chronic stable angina.
Prasad, Usha K; Gray, David; Purcell, Henry
2009-02-01
Coronary heart disease is the major cause of morbidity and mortality in industrialized countries, and its prevalence is predicted to grow as the population ages. Current drugs for chronic stable angina (such as beta-blockers, calcium-channel blockers, long- and short-acting nitrates, and potassium-channel activators) are often effective, either as monotherapy or in combination, but side effects and contraindications may limit their use. The "I(f)" (for "funny") channel, discovered in 1979, is expressed mainly in the membrane of pacemaker cells present in the sinus node, the atrioventricular node, the ventricular conduction pathways, and ventricular myocytes. By determining the slope of diastolic depolarization, which in turn controls action potential frequency, it is a key determinant of heart rate and so provides a new therapeutic target for controlling angina symptoms. A new antiangina drug, ivabradine, has been developed and licensed for clinical use. It exclusively reduces the heart rate by selectively blocking the I(f) channel of the sino-atrial node. As clinical trials have shown it to be remarkably well-tolerated, ivabradine offers an alternative for patients who cannot take, or are intolerant of, beta blockade. This review provides an insight into this new agent, its historical background, mechanism of action, and pathophysiologic basis, and provides up-to-date evidence-based information on its optimum use in stable angina.
de Vries, Sieta T; van der Sar, Maartje J M; Coleman, Anna Marie; Escudero, Yvette; Rodríguez Pascual, Alfonso; Maciá Martínez, Miguel-Ángel; Cupelli, Amelia; Baldelli, Ilaria; Šipić, Ivana; Andrić, Adriana; Michan, Line; Denig, Petra; Mol, Peter G M
2018-07-01
National competent authorities (NCAs) use Direct Healthcare Professional Communications (DHPCs) to communicate new drug safety issues to healthcare professionals (HCPs). More knowledge is needed about the effectiveness of DHPCs and the extent to which they raise awareness of new safety issues among HCPs. The objective was to assess and compare general practitioners' (GPs'), cardiologists', and pharmacists' familiarity with DHPCs as communication tools, their awareness of specific drug safety issues, and the sources through which they had become aware of the specific issues. GPs, cardiologists, and pharmacists from nine European countries (Croatia, Denmark, Ireland, Italy, the Netherlands, Norway, Spain, Sweden, and the UK) completed a web-based survey. The survey was conducted in the context of the Strengthening Collaboration for Operating Pharmacovigilance in Europe (SCOPE) Joint Action. Respondents were asked about their familiarity with DHPCs in general and their awareness of safety issues that had recently been communicated and involved the following drugs: combined hormonal contraceptives, diclofenac, valproate, and ivabradine. Those HCPs who were aware of the specific safety issues were subsequently asked to indicate the source through which they had become aware of them. Differences between professions in familiarity with DHPCs and awareness were tested using a Pearson χ 2 test per country and post hoc Pearson χ 2 tests in the case of statistically significant differences. Of the 3288 included respondents, 54% were GPs, 40% were pharmacists, and 7% were cardiologists. The number of respondents ranged from 67 in Denmark to 916 in Spain. Most respondents (92%) were familiar with DHPCs, with one significant difference between the professions: pharmacists were more familiar than GPs in Italy (99 vs 90%, P = 0.004). GPs' awareness ranged from 96% for the diclofenac issue to 70% for the ivabradine issue. A similar pattern was shown for pharmacists (91% aware of the diclofenac issue to 66% of the ivabradine issue). Cardiologists' awareness ranged from 91% for the ivabradine issue to 34% for the valproate issue. Overall, DHPCs were a common source through which GPs (range: 45% of those aware of the contraceptives issue to 60% of those aware of the valproate issue), cardiologists (range: 33% for the contraceptives issue to 61% for the valproate issue), and pharmacists (range: 41% for the contraceptives issue to 51% for the ivabradine issue) had become aware of the specific safety issues, followed by information on websites or in newsletters. GPs, cardiologists, and pharmacists were to a similar extent (highly) familiar with DHPCs, but they differed in awareness levels of specific safety issues. Cardiologists were less aware of safety issues associated with non-cardiology drugs even if these had cardiovascular safety concerns. This implies that additional strategies may be needed to reach specialists when communicating safety issues regarding drugs outside their therapeutic area but with risks related to their field of specialisation. DHPCs were an important source for the different professions to become aware of specific safety issues, but other sources were also often used. NCAs should consider the use of a range of sources when communicating important safety issues to HCPs.
Nemaline myopathy and heart failure: role of ivabradine; a case report.
Sarullo, Filippo M; Vitale, Giuseppe; Di Franco, Antonino; Sarullo, Silvia; Salerno, Ylenia; Vassallo, Laura; Baviera, Emanuela Petrona; Marazia, Stefania; Mandalà, Giorgio; Lanza, Gaetano A
2015-01-19
Nemaline myopathy (NM) is a rare congenital myopathy characterized by muscle weakness, hypotonia and the presence in muscle fibers of inclusions known as nemaline bodies and a wide spectrum of clinical phenotypes, ranging from severe forms with neonatal onset to asymptomatic forms. The adult-onset form is heterogeneous in terms of clinical presentation and disease progression. Cardiac involvement occurs in the minority of cases and little is known about medical management in this subgroup of NM patients. We report a rare case of heart failure (HF) in a patient with adult-onset NM in whom ivabradine proved to be able to dramatically improve the clinical picture. We report a case of a 37-year-old man with adult-onset NM, presenting with weakness and hypotonia of the proximal limb muscles and shoulder girdle, severely limiting daily activities. He developed progressive HF over a period of 6 months while attending a rehabilitation program, with reduced left ventricular ejection fraction (LVEF = 20%), manifested by dyspnea and signs of systemic congestion. The patient was started HF therapy with enalapril, carvedilol, spironolactone and loop diuretics. Target HF doses of these drugs (including carvedilol) were not reached because of symptomatic hypotension causing a high resting heart rate (HR) ≥70 beats per minute (bpm). Further deterioration of the clinical picture occurred with several life-threatening arrhythmic episodes requiring external defibrillation. An implantable cardioverter defibrillator (ICD) was then implanted. Persistent high resting HR was successfully treated with ivabradine with HR lowering from 90 bpm to 55 bpm at 1 month follow up, LVEF rising to 50% at 3 month follow up and to 54% at 2,5 year follow up. To date no more hospitalizations for heart failure occurred. A single hospitalization due to aspiration pneumonia required insertion of a tracheostomy tube to protect airways from further aspiration. At present, the patient is attending a regular rehabilitation program with net improvement in neuromotor control and less limitations in daily activities. HF is a rare feature of NM, but it can negatively influence prognosis. Conventional HF therapy and/or heart transplant are the only reasonable strategy in these patients. Ivabradine is a useful, effective and safe drug for therapy in NM patients with HF and should be considered when resting HR remains high despite beta-blockers' full titration or beta-blockers' underdosing due to intolerance or side effects.
Villacorta, Aline Sterque; Villacorta, Humberto; Souza, Jenne Serrão de; Teixeira, José Antônio Caldas; Muradas, Maria Clara S S S; Alves, Christiane Rodrigues; Precht, Bernardo Campanário; Porto, Pilar; Ubaldo, Letícia; Mesquita, Cláudio Tinoco; Nóbrega, Antônio Cláudio Lucas da
2016-11-01
In the Systolic Heart Failure Treatment With the If Inhibitor Ivabradine Trial (SHIFT), heart rate (HR) reduction with ivabradine was associated with improved survival and reduced hospitalizations in patients with heart failure (HF). The mechanisms by which elevated HR increases mortality are not fully understood. To assess the relationship of baseline HR with clinical, neurohormonal and cardiac sympathetic activity in patients with chronic HF and elevated HR. Patients with chronic HF who were in sinus rhythm and had resting HR>70 bpm despite optimal medical treatment were included in a randomized, double-blind study comparing ivabradine versus pyridostigmine. This report refers to the baseline data of 16 initial patients. Baseline HR (before randomization to one of the drugs) was assessed, and patients were classified into two groups, with HR below or above mean values. Cardiac sympathetic activity was assessed by 123-iodine-metaiodobenzylguanidine myocardial scintigraphy. Mean HR was 83.5±11.5 bpm (range 72 to 104), and seven (43.7%) patients had HR above the mean. These patients had lower 6-min walk distance (292.3±93 vs 465.2±97.1 m, p=0.0029), higher values of N-Terminal-proBNP (median 708.4 vs 76.1, p=0.035) and lower late heart/mediastinum rate, indicating cardiac denervation (1.48±0.12 vs 1.74±0.09, p<0.001). Elevated resting HR in patients with HF under optimal medical treatment was associated with cardiac denervation, worse functional capacity, and neurohormonal activation. No SHIFT (Systolic Heart Failure Treatment With the If Inhibitor Ivabradine Trial, ou Estudo do Tratamento da Insuficiência Cardíaca Sistólica com o Inibidor de If Ivabradina), a redução da frequência cardíaca (FC) com ivabradina associou-se com melhor sobrevida e redução das hospitalizações em pacientes com insuficiência cardíaca (IC). Os mecanismos pelos quais a FC elevada aumenta a mortalidade não são totalmente compreendidos. Avaliar a relação da FC basal com atividade clínica, neuro-hormonal e simpática cardíaca em pacientes com IC crônica e FC elevada. Pacientes com IC crônica em ritmo sinusal e FC≥70 apesar de tratamento adequado foram incluídos em um estudo duplo-cego, randomizado, que comparou ivabradina com piridostigmina. Este artigo refere-se a dados basais dos primeiros 16 pacientes. A FC basal (antes da randomização para um dos medicamentos) foi avaliada, e os pacientes classificados em dois grupos, com FC abaixo ou acima dos valores médios. A atividade simpática cardíaca foi avaliada por cintilografia com metaiodobenzilguanidina marcada com iodo 123. A FC média foi 83,5±11,5 bpm (intervalo 72 a 104), e sete pacientes (43.7%) tinham FC acima da média. Esses pacientes apresentaram menor distância percorrida no teste de caminhada de 6 minutos (292,3±93 vs 465,2±97,1 m, p=0,0029), valores mais altos de N-terminal do pró-BNP (mediana 708,4 vs 76,1, p=0,035) e menor relação coração/mediastino tardia, indicando desnervação cardíaca (1,48±0,12 vs 1,74±0,09, p<0,001). A FC de repouso elevada em pacientes com IC em tratamento médico adequado associou-se com desnervação cardíaca, pior capacidade funcional e ativação neuro-hormonal.
Hanif, Muhammad; Khan, Hafeez Ullah; Afzal, Samina; Sher, Muhammad
2017-01-01
The current research focused on improvement of oral bioavailability and decrease in dosing frequency of ivabradine (Iva) in order to enhance patient compliance by formulating novel sustained release Iva loaded solid lipid microparticles (SLMs) with the help of melt emulsification technique. SLMs formulations were designed with the help of three level central composite rotatable design (CCRD) to study the impact of independent variables like lipid concentration, surfactant concentration and stirring speed on responses - percentage yield (Y,) and entrapment efficiency (Y2). Compatibility between the drug and bees wax (BW) was checked by conducting Fourier transform infrared spectroscopy (FTIR), differential scanning calorimetry (DSC) and X-ray powder diffractometry (XRD). SLMs were further evaluated for rheological behavior, zeta potential, particle size and for morphology by scanning'electron microscope (SEM). The release of drug from SLMs was conducted by USP type-Il apparatus at pH 1.2, pH 6.8 and data were analyzed by different kinetic models like zero order, first order, Higuchi model, Korsmeyer-Peppas and Hixon-Crowell models. The rheo- logical studies approved the good flow behavior of SLMs and spherical smooth surface of SLMs was observed from SEM. DSC, FTIR and XRD studies concluded the lack of any possible interaction between formulation components. The size-of SLMs ranged from 300 to 500 pm and zeta potential study showed the presence of higher negative charge (-30 to -52 mV). Response Y, varied from 53 to 90% and response Y2 ranged from 29 to 78% indicating the effect of formulation variables. The obtained outcomes were analyzed by second order polynomial equation and suggested quadratic model was also validated. SLMs released Iva from 54 to 90% at pH 6.8 and was significantly (p 0.05) affected by BW concentration. The release mechanism followed the zero order and Korsmeyer-Peppas (n 0.85) kinetic models suggesting slow erosion along with diffusion mechanism for Iva release.
Evolving therapies for the management of chronic and acute decompensated heart failure.
Cook, Jennifer C; Tran, Richard H; Patterson, J Herbert; Rodgers, Jo E
2016-11-01
The pharmacology, clinical efficacy, and safety profiles of evolving therapies for the management of chronic heart failure (HF) and acute decompensated heart failure (ADHF) are described. HF confers a significant financial burden despite the widespread use of traditional guideline-directed medical therapies such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, and aldosterone receptor antagonists, and the rates of HF-related mortality and hospitalization have remained unacceptably high. In response to a demand for novel pharmacologic agents, several therapeutic compounds have recently gained approval or are currently under review by the Food and Drug Administration. Sacubitril-valsartan has demonstrated benefit in reducing cardiovascular mortality and HF-related hospitalizations in clinical trials, while ivabradine and ferric carboxymaltose have proven efficacious in reducing HF-related hospitalizations. Lastly, the role of serelaxin in ADHF is currently under investigation in an ongoing Phase III study. While large, outcome-driven clinical trials are fundamental in informing the clinical application of these therapeutic agents, careful patient selection is imperative to ensuring similar outcomes postmarketing. In addition, optimization of current guideline-directed medical therapy remains essential as new therapies emerge and are incorporated into guideline recommendations. Additional therapeutic agents currently undergoing investigation include bucindolol hydrochloride, cimaglermin alfa, nitroxyl, omecamtiv mecarbil, TRV027, and ularitide. Clinical practitioners should remain abreast of emerging literature so that new therapeutic entities are optimally applied and positive patient outcomes are achieved. Recently introduced agents for the treatment of patients with HF include sacubitril-valsartan, ivabradine, and ferric carboxymaltose. Additional agents worthy of attention include serelaxin and other therapies currently under investigation. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.
Revisiting the Master-Signifier, or, Mandela and Repression.
Hook, Derek; Vanheule, Stijn
2015-01-01
The concept of the master-signifier has been subject to a variety of applications in Lacanian forms of political discourse theory and ideology critique. While there is much to be commended in literature of this sort, it often neglects salient issues pertaining to the role of master signifiers in the clinical domain of (individual) psychical economy. The popularity of the concept of the master (or "empty") signifier in political discourse analysis has thus proved a double-edged sword. On the one hand it demonstrates how crucial psychical processes are performed via the operations of the signifier, extending thus the Lacanian thesis that identification is the outcome of linguistic and symbolic as opposed to merely psychological processes. On the other, the use of the master signifier concept within the political realm to track discursive formations tends to distance the term from the dynamics of the unconscious and operation of repression. Accordingly, this paper revisits the master signifier concept, and does so within the socio-political domain, yet while paying particular attention to the functioning of unconscious processes of fantasy and repression. More specifically, it investigates how Nelson Mandela operates as a master signifier in contemporary South Africa, as a vital means of knitting together diverse elements of post-apartheid society, enabling the fantasy of the post-apartheid nation, and holding at bay a whole series of repressed and negated undercurrents.
Revisiting the Master-Signifier, or, Mandela and Repression
Hook, Derek; Vanheule, Stijn
2016-01-01
The concept of the master-signifier has been subject to a variety of applications in Lacanian forms of political discourse theory and ideology critique. While there is much to be commended in literature of this sort, it often neglects salient issues pertaining to the role of master signifiers in the clinical domain of (individual) psychical economy. The popularity of the concept of the master (or “empty”) signifier in political discourse analysis has thus proved a double-edged sword. On the one hand it demonstrates how crucial psychical processes are performed via the operations of the signifier, extending thus the Lacanian thesis that identification is the outcome of linguistic and symbolic as opposed to merely psychological processes. On the other, the use of the master signifier concept within the political realm to track discursive formations tends to distance the term from the dynamics of the unconscious and operation of repression. Accordingly, this paper revisits the master signifier concept, and does so within the socio-political domain, yet while paying particular attention to the functioning of unconscious processes of fantasy and repression. More specifically, it investigates how Nelson Mandela operates as a master signifier in contemporary South Africa, as a vital means of knitting together diverse elements of post-apartheid society, enabling the fantasy of the post-apartheid nation, and holding at bay a whole series of repressed and negated undercurrents. PMID:26834664
ERIC Educational Resources Information Center
Inman, Timothy O.
2017-01-01
This dissertation applies Julia Kristeva's theory of revolution in the practice of "signifiance" to religious discourse. In particular, it argues that the salient features of "signifiance" are present and active in religious speech as well as poetic language, the subject of Kristeva's doctoral thesis "Revolution in Poetic…
THE SINO-INDIAN ORIGIN OF CHEMEIA AND CHUMEIA AS SYNONYMS IN GREK, SIGNIFYING ALCHEMY
Mahdihassan, S.
1984-01-01
In China the antecedent of alchemy is represented by the god of longevity emerging from the peach. The first synthetic drug, Kim-Yeh, red colloidal gold, signified gold-cum -herbal juice. Kim-Yeh=Kimiya (Arabic) =chemeia (Greek). Translated this gave Chrusozomion=Gold Ferment, specifying the drug. Rasayana was translated as Chumeia, herbal juice-incorporate and signified the art alchemy. Chemeia was Chinese and Chumeia, Indian. Originally each signified both, a drug of longevity and the art, alchemy. Finally the art of making red gold was misunderstood as the art of making gold itself PMID:22557463
Semiotics and the Study of Occupational and Organizational Cultures.
1983-06-01
traces its roots to the teachings of Ferdinand de Saussure (1966), the father of modern structural - . - linguistics, and to the pragmatic philosophy of...For example, Saussure conceived ofthe sign as composed of the two parts (the signifier and the signified), while Pierce advocated a tripartate concept...published lectures of Saussure (1966) but also in the writings of Barthes (1967), Hawkes (1977), and Culler (1976). For the Piercian perspective, Morris
Constitutive signifiers or fetishes in Shakespeare's the Merchant of Venice?
Sokol, B J
1995-04-01
Assessments of psychodynamic structures and processes implicit in 'The Merchant of Venice' vary considerably according to whether Lacanian or object-relations tenets are applied. Aspects of the play resemble a pattern described in Lacan's seminar on E. A. Poe's story 'The purloined letter': the 'itinerary' of the 'signifier' represented by a roving letter in Poe's story closely matches in outline the adventures surrounding roving rings in Shakespeare's play. Using Poe's story as evidence, Lacan's seminar argues that human identity is a product of 'signifiers', and not vice-versa. This conclusion that human subjectivities are constituted by signifiers does not stand up well in relation to the power of the rings and other signifying physical objects appearing in Shakespeare's play and its source stories. Recently expanded understandings of Freud's ideas about fetishism better explain the often malevolent power of the play's many signifying physical objects. In these the essential potential for damage is to sound personal relations with inner and outer objects of love. Explanations emphasising that distorted object relations and damaged subjectivities may be redeemed accord well with the dramatic and poetic patterns of Shakespeare's play, indicating that it, while portraying painful dilemmas, is still a comedy.
The Effects of Sweet, Bitter, Salty and Sour Stimuli on Alpha Rhythm. A Meg Study.
Kotini, Athanasia; Anninos, Photios; Gemousakakis, Triandafillos; Adamopoulos, Adam
2016-09-01
the possible diff erences in processing gustatory stimuli in healthy subjects was investigated by magnetoencephalography (meg). meg recordings were evaluated for 10 healthy volunteers (3 men within the age range 20-46 years, 7 women within the age range 10-28 years), with four diff erent gustatory stimuli: sweet, bi" er, sour and salty. Fast fourier transform was performed on meg epochs recorded for the above conditions and the eff ect of each kind of stimuli on alpha rhythm was examined. A significant higher percent of alpha power was found irrespective of hemispheric side in all gustatory states located mainly at the occipital, le$ and right parietal lobes. One female volunteer experienced no statistically signifi cance when comparing normal with salty and sour taste respectively. Two female volunteers exhibited no statistically signifi cance when comparing their normal with their salty taste. One male volunteer experienced no statistically signifi cance when comparing the normalbitter and normal-salty states correspondingly. All the other subjects showed statistically signifi cant changes in alpha power for the 4 gustatory stimuli. The pattern of activation caused by the four stimuli indicated elevated gustatory processing mechanisms. This cortical activation might have applicability in modulation of brain status.
Practical Applications for Single Pill Combinations in the Cardiovascular Continuum
Iellamo, Ferdinando; Werdan, Karl; Narkiewicz, Krzysztof; Rosano, Giuseppe
2017-01-01
Despite the availability of new drugs and devices, the treatment of cardiovascular disease remains suboptimal. Single-pill combination therapy offers a number of potential advantages. It can combine different classes of drugs to increase efficacy while mitigating the risks of treatment-related adverse events, reduce pill burden, lower medical cost, and improve patient adherence. Furthermore, in hypertension, single pill combinations include standard to lower doses of each drug than would be necessary to achieve goals with monotherapy, which may explain their better tolerability compared with higher dose monotherapy. Combination therapy is now established in the treatment of hypertension. In ischaemic heart disease, the concept of a preventative polypill has been studied, but its benefits have not been established conclusively. However, the combination of ivabradine and beta-blockers has proven efficacy in patients with stable angina pectoris. This combination has also demonstrated benefits in patients with chronic heart failure. PMID:28785474
Zwart, Hub; Landeweerd, Laurens; van Rooij, Arjan
2014-12-01
Two decades ago, in 1994, in the context of the 4(th) EU Framework Programme, ELSA was introduced as a label for developing and funding research into the ethical, legal and social aspects of emerging sciences and technologies. Currently, particularly in the context of EU funding initiatives such as Horizon2020, a new label has been forged, namely Responsible Research and Innovation (RRI). What is implied in this metonymy, this semantic shift? What is so new about RRI in comparison to ELSA? First of all, for both labels, the signifier (S) was introduced in a top-down manner, well before the concept that was signified by it (s) had acquired a clear and stable profile. In other words, the signifier preceded (and helped or helps to shape) the research strategies actually covered by these labels (the precedence of the signifier over the signified: S/s). Moreover, the newness of RRI does not reside in its interactive and anticipatory orientation, as is suggested by authors who introduced the term, but rather in its emphases on social-economic impacts (valorisation, employment and competitiveness).
Making Single-Source Precursors of Ternary Semiconductors
NASA Technical Reports Server (NTRS)
Hepp, Aloysius; Banger, Kulbindre K.
2007-01-01
A synthesis route has been developed for the commercial manufacture of single- source precursors of chalcopyrite semiconductor absorber layers of thin-film solar photovoltaic cells. A closely related class of single-source precursors of these semiconductors, and their synthesis routes, were reported in "Improved Single-Source Precursors for Solar-Cell Absorbers" (LEW-17445-1), NASA Tech Briefs, Vol. 31, No. 6 (June 2007), page 56. The present synthesis route is better suited to commercialization because it is simpler and involves the use of commercially available agents, yet offers the flexibility needed for synthesis of a variety of precursors. A single-source precursor of the type of interest here is denoted by the general formula L2M'(mu-ER)2M(ER)2, where L signifies a Lewis base; M signifies Al, In, or Ga; M' signifies Ag or Cu; R signifies an alkyl, aryl, silyl, or perfluorocarbon group; E signifies O, S, Se, or Te; and mu signifies a bridging ligand. This compound can be synthesized in a "one-pot" procedure from ingredients that are readily available from almost any chemical supplier. In a demonstration, the following synthesis was performed: Under anaerobic conditions, InCl3 was reacted with sodium ethanethiolate in methanol in a 1:4 molar ratio to afford the ionic stable intermediate compound Na+[In(SEt)4]- (where Et signifies ethyl group). After approximately 15 minutes, a heterogeneous solution of CuCl and the Lewis base PPh3 (where Ph signifies phenyl) in a 1:2 ratio in a mixture of CH3CN and CH2Cl2 was added directly to the freshly prepared Na+[In(SEt)4]-. After 24 hours, the reaction was essentially complete. The methanolic solution was concentrated, then the product was extracted with CH2Cl2, then the product was washed with dry ether and pentane. The product in its final form was a creamy white solid. Spectroscopic and elemental analysis confirmed that the product was (PPh3)2Cu(mu-SEt)2In(mu-SEt)2, which is known to be a precursor of the ternary semiconductor CuInS2.
Presentation Extensions of the SOAP
NASA Technical Reports Server (NTRS)
Carnright, Robert; Stodden, David; Coggi, John
2009-01-01
A set of extensions of the Satellite Orbit Analysis Program (SOAP) enables simultaneous and/or sequential presentation of information from multiple sources. SOAP is used in the aerospace community as a means of collaborative visualization and analysis of data on planned spacecraft missions. The following definitions of terms also describe the display modalities of SOAP as now extended: In SOAP terminology, View signifies an animated three-dimensional (3D) scene, two-dimensional still image, plot of numerical data, or any other visible display derived from a computational simulation or other data source; a) "Viewport" signifies a rectangular portion of a computer-display window containing a view; b) "Palette" signifies a collection of one or more viewports configured for simultaneous (split-screen) display in the same window; c) "Slide" signifies a palette with a beginning and ending time and an animation time step; and d) "Presentation" signifies a prescribed sequence of slides. For example, multiple 3D views from different locations can be crafted for simultaneous display and combined with numerical plots and other representations of data for both qualitative and quantitative analysis. The resulting sets of views can be temporally sequenced to convey visual impressions of a sequence of events for a planned mission.
The Rhetoric That Dare Not Speak Its Name.
ERIC Educational Resources Information Center
Moss, Roger
1992-01-01
Suggests how Oscar Wilde uses "linguistic armory" to force the question of the apparent "normal relationships" between "signifieds" and "signifiers" that have led to the folly of belief in the absoluteness of such "normal relationships." (RS)
Wavelength-Division Multiplexing Of Bipolar Digital Signals
NASA Technical Reports Server (NTRS)
Gibbons, Ronnie D.; Ubele, John L., II
1994-01-01
In system, bipolar digital data transmitted by use of wavelength-division multiplexing on single optical fiber. Two different wavelengths used to transmit pulses signifying "positive" or "negative" bipolar digital data. Simultaneous absence of pulses at both wavelengths signifies digital "zero."
Wacker, Soren; Noskov, Sergei Yu
2018-05-01
Drug-induced abnormal heart rhythm known as Torsades de Pointes (TdP) is a potential lethal ventricular tachycardia found in many patients. Even newly released anti-arrhythmic drugs, like ivabradine with HCN channel as a primary target, block the hERG potassium current in overlapping concentration interval. Promiscuous drug block to hERG channel may potentially lead to perturbation of the action potential duration (APD) and TdP, especially when with combined with polypharmacy and/or electrolyte disturbances. The example of novel anti-arrhythmic ivabradine illustrates clinically important and ongoing deficit in drug design and warrants for better screening methods. There is an urgent need to develop new approaches for rapid and accurate assessment of how drugs with complex interactions and multiple subcellular targets can predispose or protect from drug-induced TdP. One of the unexpected outcomes of compulsory hERG screening implemented in USA and European Union resulted in large datasets of IC 50 values for various molecules entering the market. The abundant data allows now to construct predictive machine-learning (ML) models. Novel ML algorithms and techniques promise better accuracy in determining IC 50 values of hERG blockade that is comparable or surpassing that of the earlier QSAR or molecular modeling technique. To test the performance of modern ML techniques, we have developed a computational platform integrating various workflows for quantitative structure activity relationship (QSAR) models using data from the ChEMBL database. To establish predictive powers of ML-based algorithms we computed IC 50 values for large dataset of molecules and compared it to automated patch clamp system for a large dataset of hERG blocking and non-blocking drugs, an industry gold standard in studies of cardiotoxicity. The optimal protocol with high sensitivity and predictive power is based on the novel eXtreme gradient boosting (XGBoost) algorithm. The ML-platform with XGBoost displays excellent performance with a coefficient of determination of up to R 2 ~0.8 for pIC 50 values in evaluation datasets, surpassing other metrics and approaches available in literature. Ultimately, the ML-based platform developed in our work is a scalable framework with automation potential to interact with other developing technologies in cardiotoxicity field, including high-throughput electrophysiology measurements delivering large datasets of profiled drugs, rapid synthesis and drug development via progress in synthetic biology.
Empty Signifiers, Education and Politics
ERIC Educational Resources Information Center
Szkudlarek, Tomasz
2007-01-01
The paper assumes that education is part of the process of discursive construction of society. The theoretical framework on which this argument is based includes Ernesto Laclau's theory of the "ontological impossibility and political necessity of society", and the role discourse and empty signifiers play in the establishment of political…
Global Citizenship as a Floating Signifier: Lessons from UK Universities
ERIC Educational Resources Information Center
Moraes, Silvia Elisabeth
2014-01-01
In a world where people interact across countries, citizens need to find their role in the global community; therefore, global citizenship (GC) has become an influential theme in higher education. Due to its various interpretations and modes of action, in this paper GC is addressed as a floating signifier. Our main data comes from interviews with…
ERIC Educational Resources Information Center
Tanner, William E., Ed.; And Others
The six articles in this collection explore the following topics relating to rhetoric: the distinction between the truth value and the exchange value of a message and between the signifier and the signified in a message; the rhetoric of silence in modern fiction; the way in which readers are influenced not only by what writers say but by how they…
The ’Great Code’ in Shakespeare’s Henriad
1994-05-19
the ’triadic’ character of symbol [sign] use;" Ferdinand de Saussure , who analyzed "the human sign as the union of the signifier (significant) and the...would say myth) is a sign that has a "dual natureŖM. This last point comes from Saussure who expounded the idea that ’[i]n a sign, the signifier and
Autonomy and dignity: a discussion on contingency and dominance.
Van Brussel, Leen
2014-06-01
With dying increasingly becoming a medicalised experience in old age, we are witnessing a shift from concern over death itself to an interest in dying 'well'. Fierce discussions about end-of-life decision making and the permissibility of medical intervention in dying, discursively structured around the notion of a 'good' death, are evidence of this shift. This article focuses on 'autonomy' and 'dignity' as key signifiers in these discussions. Rather than being fully fixed and stable, both signifiers are contingent and carry a variety of meanings within different discursive projects. The article aims to distinguish the varieties of these signifiers by elaborating existing theoretical perspectives on autonomy and dignity, and also, starting from a perspective on mass media as sites of meaning production and contestation, to study the contingency of autonomy and dignity in Belgian newspaper coverage of four prominent euthanasia cases. By means of a discourse-theoretical textual analysis, this study exposes a dominant--yet contested--articulation of rational-personal autonomy and of dignity in external terms as something that can be obtained, retained or lost, rather than in terms of intrinsic human integrity. These logics of representation reflect a more general late modern dominance of liberal autonomy and of dignity as being closely connected to self-identity, but at the same time result in limited visibility of alternative ways of experiencing an autonomous and dignified death.
Guide to Understanding Your Sleep Study
... these numbers and alphabet soups, and a better comprehension of what they quantify and signify, here is ... constitute another sleep disorder. And yes, someone is listening to–though not measuring in decibels–your snoring, ...
NASA Technical Reports Server (NTRS)
Wade, Randall S.; Jones, Bailey
2009-01-01
A computer program loads configuration code into a Xilinx field-programmable gate array (FPGA), reads back and verifies that code, reloads the code if an error is detected, and monitors the performance of the FPGA for errors in the presence of radiation. The program consists mainly of a set of VHDL files (wherein "VHDL" signifies "VHSIC Hardware Description Language" and "VHSIC" signifies "very-high-speed integrated circuit").
France: Nukes Stuck between NATO and EU
2013-03-01
answer to the original question of whether or not Italy would want Paris providing regional deterrence is “No.” Italy would rather eradicate nuclear...financial affairs, defense, and, specifically, it has signified that Paris would offer regional nuclear deterrence for Europe. On the one hand, such...wanted to play a decisive role within European politics, financial affairs, defense, and, specifically, it has signified that Paris would offer
Drug insight: If inhibitors as specific heart-rate-reducing agents.
Borer, Jeffrey S
2004-12-01
Heart rate is determined primarily by spontaneously repeating net inward current carried by sodium ions and potassium ions through hyperpolarization-activated cyclic-nucleotide-gated channels. Within the heart, these channels are found most abundantly in sinoatrial cardiomyocytes. The channels open in response to membrane hyperpolarization, modulated by local cAMP concentrations. They permit activation of the I(f) current, which can be blocked specifically by molecules characterized by linked benzazepinone and benzocyclobutane rings, and which are devoid of effects on cardiac conduction, inotropy or peripheral vascular tone. The resulting heart-rate reduction has been effective in angina prevention in clinical trials involving 4,000 patients, using the prototype I(f) inhibitor, ivabradine. No serious adverse events have been attributed to the treatment; the most prominent side-effect is dose-related, always reversible and often transient visual symptoms that seldom result in voluntary drug discontinuation.
ERIC Educational Resources Information Center
Pekdag, Bulent; Le Marechal, Jean-Francois
2010-01-01
This article reviews numerous studies on chemistry movies. Movies, or moving pictures, are important elements of multimedia and signify a privileged or motivating means of presenting knowledge. Studies on chemistry movies show that the first movie productions in this field were devoted to university lectures or documentaries. Shorter movies were…
ERIC Educational Resources Information Center
Ranker, Jason
2017-01-01
This article presents an analysis of a digital video created by a student (age 13) in a classroom setting. Since sign functioning is a key focus in theories of meaning making as it occurs through language and through other modes, my analysis focuses on the relations between signifiers as they are inscribed in her video. This analysis explores new…
A Nonlinear Three-Dimensional Micromechanics Model for Fiber-Reinforced Laminated Composites
1993-11-01
Interfacial Properties Employed for the SCS6/Ti-15-3 Composite ......................... 150 11. Constants Employed for the LLFM Predictions of Quasi...Region m Matrix Property or Mean of the Interfacial Stress Distribution ml, m2, m3 Signifies Matrix Region n Normal to Interface r Signifies Equation...usage of the new class of titanium based com- posites in advanced aerospace structures and engines such as are targeted for the advanced tactical fighter
Urban informality as a signifier: Performing urban reordering in suburban Rio de Janeiro
Müller, Frank I
2017-01-01
Urban informality is typically ascribed to the urban poor in cities of the Global South. Drawing on Judith Butler’s concept of performativity and taking the case of Rio de Janeiro in the context of the 2016 Olympic Games, this article conceptualizes informality as a signifier and a procedural, relational category. Specifically, it shows how different class actors have employed the signifier informality (1) to legitimize the confinement of marginalized populations; (2) to justify the organized efforts of the upper middle class to protect their ‘self-enclosed’ gated communities; and (3) to warrant the formation of opposition and alliances between inhabitants, activists, and researchers on the edges of the urban order. This article offers new perspectives to better understand the relationship between informality and confinement by examining the active role that inhabitants of marginalized settlements assume in the Olympic City. PMID:28781405
NASA Astrophysics Data System (ADS)
James, Wendy Michelle
Science and engineering instructors often observe that students have difficulty using or applying prerequisite mathematics knowledge in their courses. This qualitative project uses a case-study method to investigate the instruction in a trigonometry course and a physics course based on a different methodology and set of assumptions about student learning and the nature of mathematics than traditionally used when investigating students' difficulty using or applying prerequisite mathematics knowledge. Transfer theory examined within a positivist or post-positivist paradigm is often used to investigate students' issue applying their knowledge; in contrast, this qualitative case-study is positioned using constructionism as an epistemology to understand and describe mathematical practices concerning vectors in a trigonometry and a physics course. Instructor interviews, observations of course lectures, and textbooks served as the qualitative data for in-depth study and comparison, and Saussure's (1959) concept of signifier and signified provided a lens for examining the data during analysis. Multiple recursions of within-case comparisons and across-case comparison were analyzed for differences in what the instructors and textbooks explicitly stated and later performed as their practices. While the trigonometry and physics instruction differed slightly, the two main differences occurred in the nature and use of vectors in the physics course. First, the "what" that is signified in notation and diagrams differs between contextualized and context-free situations, and second, physics instruction taught vectors very similar to trigonometry instruction when teaching the mathematics for doing physics, but once instruction focused on physics, the manner in which vector notation and diagrams are used differed from what is explicitly stated during mathematics instruction.
Severi, Stefano; Fantini, Matteo; Charawi, Lara A; DiFrancesco, Dario
2012-01-01
The cellular basis of cardiac pacemaking is still debated. Reliable computational models of the sinoatrial node (SAN) action potential (AP) may help gain a deeper understanding of the phenomenon. Recently, novel models incorporating detailed Ca2+-handling dynamics have been proposed, but they fail to reproduce a number of experimental data, and more specifically effects of ‘funny’ (If) current modifications. We therefore developed a SAN AP model, based on available experimental data, in an attempt to reproduce physiological and pharmacological heart rate modulation. Cell compartmentalization and intracellular Ca2+-handling mechanisms were formulated as in the Maltsev–Lakatta model, focusing on Ca2+-cycling processes. Membrane current equations were revised on the basis of published experimental data. Modifications of the formulation of currents/pumps/exchangers to simulate If blockers, autonomic modulators and Ca2+-dependent mechanisms (ivabradine, caesium, acetylcholine, isoprenaline, BAPTA) were derived from experimental data. The model generates AP waveforms typical of rabbit SAN cells, whose parameters fall within the experimental ranges: 352 ms cycle length, 80 mV AP amplitude, −58 mV maximum diastolic potential (MDP), 108 ms APD50, and 7.1 V s−1 maximum upstroke velocity. Rate modulation by If-blocking drugs agrees with experimental findings: 20% and 22% caesium-induced (5 mm) and ivabradine-induced (3 μm) rate reductions, respectively, due to changes in diastolic depolarization (DD) slope, with no changes in either MDP or take-off potential (TOP). The model consistently reproduces the effects of autonomic modulation: 20% rate decrease with 10 nm acetylcholine and 28% increase with 1 μm isoprenaline, again entirely due to increase in the DD slope, with no changes in either MDP or TOP. Model testing of BAPTA effects showed slowing of rate, −26%, without cessation of beating. Our up-to-date model describes satisfactorily experimental data concerning autonomic stimulation, funny-channel blockade and inhibition of the Ca2+-related system by BAPTA, making it a useful tool for further investigation. Simulation results suggest that a detailed description of the intracellular Ca2+ fluxes is fully compatible with the observation that If is a major component of pacemaking and rate modulation. PMID:22711956
ERIC Educational Resources Information Center
Maclellan, Effie
2001-01-01
A study sought to ascertain the "official" conception of numeracy in Scotland as published in Her Majesty's Inspectorate (HMI) audit reports. 300 HMI reports on 300 primary schools were examined for references to computational proficiency and understanding of number. Segments signifying proficiency were significantly more numerous than…
A New Therapeutic Paradigm for Breast Cancer Exploiting Low Dose Estrogen-Induced Apoptosis
2013-06-01
pulmonary embolism , colorectal cancer, hip fractures , and death from other causes. After a mean follow-up of 6.8 years, no signifi- cant effect of ET...20 The benefits of HT include a signifi- cantly decreased incidence of bone fractures .21 Seven hundred thirty-three women (8.6%) in the estrogen-plus...progestin group and 896 women (11.1%) in the placebo group developed a fracture (HR, 0.76; 95% CI, 0.69-0.83). Total hip bone mineral density increased
Recent advances in heart failure.
Kassi, Mahwash; Hannawi, Bashar; Trachtenberg, Barry
2018-03-01
Acute heart failure continues to be a challenge as there is limited benefit of numerous agents that have been tested. Cardiac resynchronization therapy remains standard of care, yet timing and need for implantable cardiac defibrillator has been brought into question with the recent randomized trials. Several recent advances have been made towards management of heart failure both in drug and device therapy. The purpose of this review is to provide an update on the most important recent studies on heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). Two new drugs have been added to the armamentarium for HFrEF; ivabradine and angiotensin receptor-neprilysin inhibitors (ARNIs). Initial data from a new left ventricular assist device (LVAD) pump, the HeartMate 3 (HM III), have demonstrated no reports of pump thrombosis at 6 months, but stroke and right ventricle failure continue to be a challenge with comparable rates compared with the HeartMate II. Several large studies in HFpEF failed to show improvement in outcomes and management continues to be geared towards lifestyle modification and symptom relief. Newer therapies and devices have met with great success, yet there are several therapies that provide no benefit and even harm. A careful review of the recent literature remains instrumental to the effective management of patients with heart failure.
The EMPACT Beaches Project Results from a Study on Microbiological Monitoring in Recreational Waters
The EMPACT (Environmental Monitoring for Public Access and Community Tracking) Beaches project has attempted to define which characteristics are most signifi cant with regard to monitoring approaches. This project examined five beach environments to determine the factors that mos...
Of Papers and Pens: Polysemes and Homophones in Lexical (Mis)Selection
ERIC Educational Resources Information Center
Li, Leon; Slevc, L. Robert
2017-01-01
Every word signifies multiple senses. Many studies using comprehension-based measures suggest that polysemes' senses (e.g., "paper" as in "printer paper" or "term paper") share lexical representations, whereas homophones' meanings (e.g., "pen" as in "ballpoint pen" or "pig pen")…
Murphy, J R; Wasserman, S S; Baqar, S; Schlesinger, L; Ferreccio, C; Lindberg, A A; Levine, M M
1989-01-01
Experiments were performed in Baltimore, Maryland and in Santiago, Chile, to determine the level of Salmonella typhi antigen-driven in vitro lymphocyte replication response which signifies specific acquired immunity to this bacterium and to determine the best method of data analysis and form of data presentation. Lymphocyte replication was measured as incorporation of 3H-thymidine into desoxyribonucleic acid. Data (ct/min/culture) were analyzed in raw form and following log transformation, by non-parametric and parametric statistical procedures. A preference was developed for log-transformed data and discriminant analysis. Discriminant analysis of log-transformed data revealed 3H-thymidine incorporation rates greater than 3,433 for particulate S. typhi, Ty2 antigen stimulated cultures signified acquired immunity at a sensitivity and specificity of 82.7; for soluble S. typhi O polysaccharide antigen-stimulated cultures, ct/min/culture values of greater than 1,237 signified immunity (sensitivity and specificity 70.5%). PMID:2702777
DOT National Transportation Integrated Search
2012-04-01
Louisianas crash rate is consistently among the highest in the nation, and it imposes signifi cant economic and social : costs on the state. Property damage, lost productivity, medical expenses, and infl ated motor vehicle insurance rates : impose...
Narrating Neoliberalism: Alternative Education Teachers' Conceptions of Their Changing Roles
ERIC Educational Resources Information Center
Golden, Noah Asher
2018-01-01
The signifier "alternative" in education has largely shifted from progressive or humanizing pedagogies to deficit framings requiring alternate graduation criteria. This development is part of broader neoliberal educational reform efforts that disrupt longstanding conceptions of teachers' roles. This study serves to investigate long-term…
ATTITUDES TOWARD ENVIRONMENTAL QUALITY: AREA, ETHNICITY AND SES
In a study of the San Antonio, Texas, SMSA, this report indicates that, while respondents believe the environment is deteriorating, they do not believe environmental problems are among the most important faced by the Nation. Analysis of the data shows that: (1) there is a signifi...
ERIC Educational Resources Information Center
Fang, Wang; Clarke, Anthony; Wei, Yu
2016-01-01
More than at any other time, the importance of internationalization and of establishing global partnerships in education is acknowledged by governments and higher education institutions. As a result, collaboration between institutions resulting in increased study abroad opportunities, now viewed as signifiers of internationalization, have…
ERIC Educational Resources Information Center
Langstraat, Lisa
In the writing classroom, students and instructors alike must not only theorize experience but must also experience theory. This is no easy task, for despite cultural studies' emphasis on the "subjective side of social relations," contemporary theory is heavily directed toward signifying practices, and, as Lawrence Grossberg argues,…
USDA-ARS?s Scientific Manuscript database
Huanglongbing (HLB) disease, presumably caused by Canditatus Liberibacter asiaticus (CLas), is threatening one million acres of commercial citrus groves that have an annual production value of approximately $3 billion across the U.S. The objectives of this study were to identify the earliest signifi...
"I Have Work To Do": Affirmation and Marginalization of Women Full Professors.
ERIC Educational Resources Information Center
Hamrick, Florence A.
This study examined the work roles and events that signified affirmation or marginalization among female full professors at a research university. Semistructured interviews conducted with 26 female full professors at Iowa State University covered questions in four primary areas: promotion and tenure experiences, institutional citizenship and…
Elite Schools, Postcolonial Chineseness and Hegemonic Masculinities in Singapore
ERIC Educational Resources Information Center
Goh, Daniel P. S.
2015-01-01
The educational reproduction of elite masculinity in postcolonial societies has not been properly studied. This is partly because the postcolonial masculinities of non-western elites are accomplished through the cultivation of naturalized practices signifying the body politic of the nation-state. In Singapore, same-sex elite schools of colonial…
ERIC Educational Resources Information Center
Jaiswal, Neeraj Kumar; Dhar, Rajib Lochan
2016-01-01
This study examined the moderating role of creative self-efficacy in predictions of employees' creativity through transformational leadership. Data from a dyadic sample of 424 employees and their immediate supervisors were collected and analyzed. The results signify that transformational leaders promote creativity among their subordinates.…
iTESOL: Analogous Practices in the SLA Classroom
ERIC Educational Resources Information Center
McDonald, Lisa
2010-01-01
Recent studies of emerging technologies have shown that mobile phone production now exceeds one billion devices globally per year (Johnson, Levine & Smith, 2008). With a level of production that signifies a shift in the ownership of "networked machines" from institutions to individuals, the broad appeal of portable technologies now offers…
Academic Colors...Academic Confusion.
ERIC Educational Resources Information Center
Strickland, S. Mark; Fluitt, John L.
1985-01-01
The use of colors in tassels and hood trimmings to signify the subject areas of degrees is discussed, and variations in this practice are described. Whether the color of the hood trimming should indicate the major subject studied or the subject area incorporated in the title of the degree is debated. (MLW)
[The best of clinical cardiovascular pharmacology in 2005].
Ambrosi, R; Andrejak, M; Drici, M D; Herpin, D
2006-01-01
Although the year 2005 has reinforced the therapeutic advances of 2004, with confirmation of certain concepts, the 'coxib affair' has continued to provoke arguments between pharmaceutical companies, licensing agencies as well as patients, some of whom have amalgamated into consumer groups to reject en masse placing any responsibility on the prescribers in favour of an attack on the drug licensing process itself. Among the cardiovascular drugs that will soon be licensed, only ivabradine in stable angina, and remodulin in primary pulmonary arterial hypertension are new. The therapeutic advances in 2005 regarding platelet aggregation and blood coagulation have been significant, in the human, scientific and commercial context, while hypertension has not been ignored. Another new development is the ever more precise notion of the metabolic syndrome, a target of choice for the pharmaceutical industry. The potential range of applications has been widened to include obesity, hypertension, diabetes, HDL cholesterol... The licensing authorities find themselves facing a hurdle to overcome, with novel combinations of drugs (ACE inhibitors, calcium blockers/statins, statins/aspirin, ARA2/calcium blockers...).
Effects of alpha lipoic acid on acrylamide-induced hepatotoxicity in rats.
Al-Qahtani, F A; Arafah, M; Sharma, B; Siddiqi, N J
2017-07-31
Acrylamide (ACR) is a neurotoxicant, reproductive toxicant, and carcinogen in animal species. It is used in many industries and has been found to form naturally in foods cooked at high temperatures. Alpha-lipoic acid (ALA) is a naturally occurring antioxidant whose therapeutic effect has been related to its antioxidant activity. This study was carried out to study the protective effect of alpha lipoic acid on acrylamide induced perturbations in rat liver. Four groups of rats were studied viz., control rats, acrylamide treated rats, alpha lipoic acid treated rats, and alpha lipoic acid plus acrylamide treated rats. ACR and ALA treatment alone and together caused a signifi-cant increase in hepatic reduced glutathione content while a decrease in hepatic ascorbic content was observed when compared to control group. ALA pretreatment of acrylamide exposed rats caused no a signifi-cant alteration in superoxide dismutase activity but resulted in a tendency towards restoration of glutathione peroxidase and catalase activity to near normal levels. Gel electrophoresis showed fragmentation of DNA in the treated groups. The dose of ALA used in the present study afforded partial restoration of oxidative indices altered by ACR in rat liver.
ERIC Educational Resources Information Center
Ishihara-Brito, Reiko
2013-01-01
This paper presents the findings and implications of a qualitative study conducted in Guatemala, which focused on rural, indigenous parents' perceptions of their children's schooling and educational quality. For these parents, the simple fact that their children had improved access to school signifies a satisfactory educational accomplishment;…
Carbonaceous aerosol over a Pinus taeda forest in Central North Carolina, USA
Organic aerosol is the least understood component of ambient fine particulate matter (PM2.5). Presented in this study are organic and elemental carbon (OC and EC) within ambient PM2.5 over a three-year period at a forested site in the North Carolina Piedmon. EC exhibited signifi...
Environmental Effects of Tennessee-Tombigbee Project Cutoff Bendways.
1982-08-01
Congdon 1971, Barton et al. 1972, King and Carlander 1976). The most signifi- cant result of a study of two cutoff bendways on the Lower Alabama River...34Statewide Lake and Stream Survey: Completion Report Appendix," Mississippi Game and Fish Commission Project F-8-R, Jackson, Miss. Congdon , James C. 1971
Attaining Moral Knowledge in the Church and Models of Adult Learning
ERIC Educational Resources Information Center
Shields, Richard
2009-01-01
The sacrament of reconciliation has fallen into disuse among Roman Catholics. For the Holy See this signifies a loss of a sense of sin and reconciliation, rightly connecting moral consciousness and faith in salvation with sacramental celebration. Cultural studies underscore the importance of ritual practices as an essential element of religion's…
Voseo to Tuteo Accommodation among Two Salvadoran Communities in the United States
ERIC Educational Resources Information Center
Sorenson, Travis Doug
2010-01-01
This study documents and accounts for maintenance and change in dialectal features of Salvadoran Spanish in the United States, especially "voseo", as opposed to "tuteo", terms signifying the use of the second person singular familiar pronouns vos and tu , with their corresponding verb forms. It compares two distinct Salvadoran…
Using Ozone To Clean and Passivate Oxygen-Handling Hardware
NASA Technical Reports Server (NTRS)
Torrance, Paul; Biesinger, Paul
2009-01-01
A proposed method of cleaning, passivating, and verifying the cleanliness of oxygen-handling hardware would extend the established art of cleaning by use of ozone. As used here, "cleaning" signifies ridding all exposed surfaces of combustible (in particular, carbon-based) contaminants. The method calls for exposing the surfaces of the hardware to ozone while monitoring the ozone effluent for carbon dioxide. The ozone would passivate the hardware while oxidizing carbon-based residues, converting the carbon in them to carbon dioxide. The exposure to ozone would be continued until no more carbon dioxide was detected, signifying that cleaning and passivation were complete.
Education Accountability in the Era of No Child Left Behind: What Counts versus What Matters
ERIC Educational Resources Information Center
Thompson-Shriver, Mary M.
2009-01-01
Education policy is characterized by struggles over meanings of key concepts related to schooling, teaching, and learning, especially as these meanings affect practice. In this study, I examine the notion of "accountability" as a floating signifier, analyzing its usage by the proponents of the No Child Left Behind Act (2001) and…
Adolescent Girls' Perspectives on Their Relationship with Their Nonresident Fathers
ERIC Educational Resources Information Center
Francis, Andrea Ann Marie
2012-01-01
There is an increase in the number of fathers who do not reside with their children, which signifies changes in patterns of family interaction with implications for father-daughter attachment. Using attachment, self-efficacy, and psychosocial theories as framework, the purpose of this qualitative multiple case study was to explore how girls'…
ERIC Educational Resources Information Center
Keane, Julie Thompson
2010-01-01
In 2009, the Parsons StoryCorps qualitative case study was designed to closely observe the complexity of youth engagement with digital media for self-presentation in an afterschool digital storytelling project designed to provide students with rich, varied uses of technology in a urban middle school in North Carolina. Several frameworks were…
Signifying the Accumulation Graph in a Dynamic and Multi-Representation Environment
ERIC Educational Resources Information Center
Yerushalmy, Michal; Swidan, Osama
2012-01-01
The present study focuses on the accumulation process involved in the integration of a single-variable function. Observing the work of two high-school calculus students who had not yet learned any other integral-related ideas, we analyze the emergence of the semiotic relationship between personal and mathematical meanings, as expressed through the…
On How "n" and "i" Turned out to Become Indices in Mathematical Sequences and Formulae
ERIC Educational Resources Information Center
Schubring, Gert
2011-01-01
The evolution of indexing sequences and series has been little studied so far, although this topic presents difficulties for students. This symbolisation signified, however, an important means for operating more generally with finite and infinite series. This paper investigates the first steps during the eighteenth century and then the different…
ERIC Educational Resources Information Center
Ford, Amy Carpenter
2010-01-01
This in-depth case study of classroom interaction illuminated how a white female teacher and African American students used talk to build positive authority relationships across their racial difference. Racial difference in classrooms can engender cultural misunderstandings between teachers and students around behavior, communication, and learning…
ERIC Educational Resources Information Center
Santos, Doris
2016-01-01
While carrying out a study aimed at understanding the contribution of participatory action research (PAR) to the political realm in contemporary higher education, a problematic situation was found when doing a literature review in the field of action research. This problem concerns the intermittent appearance of the "participatory"…
Understanding travel information search behaviors by levels of information technology adoption
Junghye Angela Kah; Christine A. Vogt; Kelly MacKay
2007-01-01
Although the signifi cance of the Internet has been widely discussed in previous studies, the research of e-commerce has focused primarily on organizational and business perspectives (Sigala 2004). The growing number of Internet users allows a better understanding of online tourists who seek travel information and book or purchase travel products. The levels of...
Activity Theory as a Framework for Designing the Model of College English Listening
ERIC Educational Resources Information Center
Zhang, Jianfeng
2014-01-01
Activity theory signifies that activities are at the centre of human behaviour and it has been used to study cognitive process in many fields. Nowadays, college English listening learning is time-consuming but less effective in China, so enhancing the performance of listening instruction is a very hot topic. Theoretically, activity theory is able…
ERIC Educational Resources Information Center
Schartner, Alina; Cho, Yoonjoo
2017-01-01
This paper reports on a mixed-methods case study investigating how higher education staff and students understand, experience and envision the "international university." As it is becoming clear that international student mobility is not in itself a panacea for universities seeking to internationalise, "internationalisation at…
ERIC Educational Resources Information Center
Cucarella-Ramon, Vicent
2017-01-01
The plays "Harlem Duet" (1997) by African Canadian playwright Djanet Sears and "Desdemona" (2012) by Toni Morrison signify upon European texts aiming to carve out a new definition of what it means to be black in North America. Therefore, both texts make for interesting reading in the study of (black) identity construction…
Evidence of charged puddles and induced dephasing in topological insulator thin films
NASA Astrophysics Data System (ADS)
Singh, Sourabh; Gopal, R. K.; Sarkar, Jit; Roy, Subhadip; Mitra, Chiranjib
2018-05-01
We investigate the dephasing mechanism in bulk insulating topological insulator thin films. The phase coherence length is extracted from magnetoresistance measurements at different temperatures. There is a crossover of the phase coherence length as a function of temperature signifying the role of more than one dephasing mechanism in the system. The dephasing rates have been studied systematically and explained.
ERIC Educational Resources Information Center
Grace, Andre P.
2012-01-01
In 1947 the Truman Commission on Higher Education accentuated the importance of adult education in its report entitled "Higher Education for American Democracy". In 1970 a new US "Handbook of Adult Education" signifying the move to a more professionalised field of study and practice was published. The intervening years encapsulate a time of…
ERIC Educational Resources Information Center
Derkzen, Petra; Franklin, Alex; Bock, Bettina
2008-01-01
In Britain, and Wales particularly, inclusion and equal opportunities for all became key principles guiding the work of the many partnerships that were established at the beginning of this century. A primary objective of this paper is to develop a greater understanding of the politics and processes within "partnership" as a widely used…
The N of 1 in Arts-Based Research: Reliability and Validity
ERIC Educational Resources Information Center
Siegesmund, Richard
2014-01-01
N signifies the number of data samples in a study. Traditional research values numerous data samples as this reduces the variability created by extremes. Alternatively, arts-based research privileges the outlier, the N of 1. Oftentimes, what is unique and outside the norm is the focus. There are three approaches to the N of 1 in arts-based…
Influence of Cultural Cognition, Social Aspect of Culture, and Personality on Trust
2013-12-31
of individualists whereby their satisfaction towards business negotiation stems mainly from high economic gains or personal outcomes. Therefore, it...2007) conducted a study on attributions of trustworthiness to unfamiliar trustees among Japanese and Canadians undergraduate business students. No...High means score of analytic-holism scale signifies high level of holism. No statistically significant difference was found between Malays, Chinese
HCN Channels Modulators: The Need for Selectivity
Romanelli, Maria Novella; Sartiani, Laura; Masi, Alessio; Mannaioni, Guido; Manetti, Dina; Mugelli, Alessandro; Cerbai, Elisabetta
2016-01-01
Hyperpolarization-activated, cyclic nucleotide-gated (HCN) channels, the molecular correlate of the hyperpolarization-activated current (If/Ih), are membrane proteins which play an important role in several physiological processes and various pathological conditions. In the Sino Atrial Node (SAN) HCN4 is the target of ivabradine, a bradycardic agent that is, at the moment, the only drug which specifically blocks If. Nevertheless, several other pharmacological agents have been shown to modulate HCN channels, a property that may contribute to their therapeutic activity and/or to their side effects. HCN channels are considered potential targets for developing drugs to treat several important pathologies, but a major issue in this field is the discovery of isoform-selective compounds, owing to the wide distribution of these proteins into the central and peripheral nervous systems, heart and other peripheral tissues. This survey is focused on the compounds that have been shown, or have been designed, to interact with HCN channels and on their binding sites, with the aim to summarize current knowledge and possibly to unveil useful information to design new potent and selective modulators. PMID:26975509
Duncker, D; Veltmann, C
2018-05-09
In patients with heart failure with reduced ejection fraction (HFrEF), optimal medical treatment includes beta-blockers, ACE inhibitors/angiotensinreceptor-neprilysin inhibitors (ARNI), mineralocorticoid receptor antagonists, and ivabradine when indicated. In device therapy of HFrEF, implantable cardioverter-defibrillators and cardiac resynchronization therapy (CRT) have been established for many years. CRT is the therapy of choice (class I indication) in symptomatic patients with HFrEF and a broad QRS complex with a left bundle branch block (LBBB) morphology. However, the vast majority of heart failure patients show a narrow QRS complex or a non-LBBB morphology. These patients are not candidates for CRT and alternative electrical therapies such as baroreflex activation therapy (BAT) and cardiac contractility modulation (CCM) may be considered. BAT modulates vegetative dysregulation in heart failure. CCM improves contractility, functional capacity, and symptoms. Although a broad data set is available for BAT and CCM, mortality data are still lacking for both methods. This article provides an overview of the device-based therapeutic options for patients with HFrEF.
The effects of heart rate control in chronic heart failure with reduced ejection fraction.
Grande, Dario; Iacoviello, Massimo; Aspromonte, Nadia
2018-07-01
Elevated heart rate has been associated with worse prognosis both in the general population and in patients with heart failure. Heart rate is finely modulated by neurohormonal signals and it reflects the balance between the sympathetic and the parasympathetic limbs of the autonomic nervous system. For this reason, elevated heart rate in heart failure has been considered an epiphenomenon of the sympathetic hyperactivation during heart failure. However, experimental and clinical evidence suggests that high heart rate could have a direct pathogenetic role. Consequently, heart rate might act as a pathophysiological mediator of heart failure as well as a marker of adverse outcome. This hypothesis has been supported by the observation that the positive effect of beta-blockade could be linked to the degree of heart rate reduction. In addition, the selective heart rate control with ivabradine has recently been demonstrated to be beneficial in patients with heart failure and left ventricular systolic dysfunction. The objective of this review is to examine the pathophysiological implications of elevated heart rate in chronic heart failure and explore the mechanisms underlying the effects of pharmacological heart rate control.
Verbal understanding: Integrating the conceptual analyses of Skinner, Ryle, and Wittgenstein.
Schoneberger, T
1991-01-01
Gilbert Ryle's (1949) and Ludwig Wittgenstein's (1953; 1958; 1974/78) conceptual analyses of verbal understanding are presented. For Ryle, the term understanding signifies simultaneously an acquired disposition and a behavioral episode. For Wittgenstein, it signifies simultaneously a skill and a criterial behavior. Both argued that episodes of understanding comprise heterogenious classes of behaviors, and that each member of such a class is neither a necessary nor a sufficient condition of understanding. Next, an approach integrating the analyses of Ryle and Wittgenstein with that of Skinner is presented. Lastly, it is argued that this integrated analysis adequately counters Parrott's (1984) argument that understanding, for Skinner, is potential behavior and not an event.
Verbal understanding: Integrating the conceptual analyses of Skinner, Ryle, and Wittgenstein
Schoneberger, Ted
1991-01-01
Gilbert Ryle's (1949) and Ludwig Wittgenstein's (1953; 1958; 1974/78) conceptual analyses of verbal understanding are presented. For Ryle, the term understanding signifies simultaneously an acquired disposition and a behavioral episode. For Wittgenstein, it signifies simultaneously a skill and a criterial behavior. Both argued that episodes of understanding comprise heterogenious classes of behaviors, and that each member of such a class is neither a necessary nor a sufficient condition of understanding. Next, an approach integrating the analyses of Ryle and Wittgenstein with that of Skinner is presented. Lastly, it is argued that this integrated analysis adequately counters Parrott's (1984) argument that understanding, for Skinner, is potential behavior and not an event. PMID:22477637
The symbolic economy of drugs.
Lentacker, Antoine
2016-02-01
This essay reviews four recent studies representing a new direction in the history of pharmaceuticals and pharmaceutical science. To this end, it introduces the notion of a symbolic economy of drugs, defined as the production, circulation, and reception of signs that convey information about drugs and establish trust in them. Each of the studies under review focuses on one key signifier in this symbolic economy, namely the brand, the patent, the clinical trial, and the drug itself. Drawing on Pierre Bourdieu's theory of the economy of symbolic goods, I conceptualize these signifiers as symbolic assets, that is, as instruments of communication and credit, delivering knowledge, carrying value, and producing authority. The notion of a symbolic economy is offered with a threefold intention. First, I introduce it in order to highlight the implications of historical and anthropological work for a broader theory of the economy of drugs, thus suggesting a language for interdisciplinary conversations in the study of pharmaceuticals. Second, I deploy it in an attempt to emphasize the contributions of the recent scholarship on drugs to a critical understanding of our own contemporary ways of organizing access to drugs and information about drugs. Finally, I suggest ways in which it might be of use to scholars of other commodities and technologies.
ERIC Educational Resources Information Center
Sugiharto
2015-01-01
The aims of this research were to determine the effect of cooperative learning model and learning styles on learning result. This quasi-experimental study employed a 2x2 treatment by level, involved independent variables, i.e. cooperative learning model and learning styles, and learning result as the dependent variable. Findings signify that: (1)…
ERIC Educational Resources Information Center
Lowry, Amanda J.
2010-01-01
The No Child Left Behind Act of 2001 (NCLB) calls for 100 percent proficiency in reading and mathematics by 2014. The Act was supported overwhelming by both political parties and signified a major overhaul of the Elementary and Secondary Education Act of 1965. Using a questionnaire, this study examined teachers' perceptions regarding NCLB and the…
The Pedagogy of the Body: Affect and Collective Individuation in the Classroom and on the Dancefloor
ERIC Educational Resources Information Center
Gilbert, Jeremy
2013-01-01
Much recent work in the study of popular culture has emphasized the extent to which it is not only a site of signifying practices, myths, meanings and identifications, but also an arena of intensities, of affective flows and corporeal state-changes. From this perspective, many areas of popular culture (from calisthenics to social dance to video…
Meyer, Markus; Rambod, Mehdi; LeWinter, Martin
2018-07-01
Epidemiological studies have demonstrated that high resting heart rates are associated with increased mortality. Clinical studies in patients with heart failure and reduced ejection fraction have shown that heart rate lowering with beta-blockers and ivabradine improves survival. It is therefore often assumed that heart rate lowering is beneficial in other patients as well. Here, we critically appraise the effects of pharmacological heart rate lowering in patients with both normal and reduced ejection fraction with an emphasis on the effects of pharmacological heart rate lowering in hypertension and heart failure. Emerging evidence from recent clinical trials and meta-analyses suggest that pharmacological heart rate lowering is not beneficial in patients with a normal or preserved ejection fraction. This has just begun to be reflected in some but not all guideline recommendations. The detrimental effects of pharmacological heart rate lowering are due to an increase in central blood pressures, higher left ventricular systolic and diastolic pressures, and increased ventricular wall stress. Therefore, we propose that heart rate lowering per se reproduces the hemodynamic effects of diastolic dysfunction and imposes an increased arterial load on the left ventricle, which combine to increase the risk of heart failure and atrial fibrillation. Pharmacologic heart rate lowering is clearly beneficial in patients with a dilated cardiomyopathy but not in patients with normal chamber dimensions and normal systolic function. These conflicting effects can be explained based on a model that considers the hemodynamic and ventricular structural effects of heart rate changes.
Bayes, M; Rabasseda, X; Prous, J R
2003-05-01
Gateways to Clinical Trials is a guide to the most recent clinical trials in current literature and congresses. The data in the following tables has been retrieved from the Clinical Studies knowledge area of Prous Science Integrity, the drug discovery and development portal, http://integrity.prous.com. This issue focuses on the following selection of drugs: 2F5, 2G12, abetimus sodium, ABI-007, adalimumab, adefovir dipivoxil, AE-941, alefacept, altropane, aminolevulinic acid hydrochloride, aminolevulinic acid methyl ester, aminopterin, anakinra, aprinocarsen sodium, atazanavir, atlizumab, atomoxetine hydrochloride; B7-1 vaccine, bevacizumab, biricodar dicitrate, BMS-188667, brasofensine sulfate, bryostatin 1; cantuzumab mertansine, CHS-828, cinacalcet hydrochloride, cipamfylline, creatine, CVT-3146; darbepoetin alfa, DITPA, drotrecogin alfa (activated), duloxetine hydrochloride; edatrexate, efalizumab, ENMD-0997, epoetin, erlosamide, esomeprazole magnesium, etiprednol dicloacetate, etoricoxib, everolimus, ezetimibe; fampridine, fenretinide, FTY-720; IGF-I/IGFBP-3, IL-1 cytokine trap, ilodecakin, interferon beta, ISIS-104838, ISIS-2503, ISIS-5132, ivabradine hydrochloride; lafutidine, lanthanum carbonate, l-Arginine hydrochloride, LEA29Y, lerdelimumab, levetiracetam, levobupivacaine hydrochloride, levosimendan, lopinavir; melagatran, mibefradil hydrochloride, miglustat, morphine-6-glucuronide; nesiritide; omalizumab, omapatrilat; p24-VLP, parecoxib sodium, peginterferon alfa-2a, peginterferon alfa-2b, pegsunercept, pitavastatin calcium, plevitrexed, prasterone, pregabalin, PRO-2000, prucalopride; rapacuronium bromide, rebimastat, RGA-0853, rubitecan, ruboxistaurin mesilate hydrate, RWJ-67657; S-16020-2, sarizotan, SLV-306, stiripentol; TA-CIN, tenecteplase, teriparatide, tezacitabine, tipifarnib, trabectedin, troglitazone; valdecoxib, vardenafil; Z-338, ziconotide.
Sartiani, Laura; Mannaioni, Guido; Masi, Alessio; Novella Romanelli, Maria; Cerbai, Elisabetta
2017-10-01
Hyperpolarization-activated, cyclic nucleotide-gated (HCN) channels are important members of the voltage-gated pore loop channels family. They show unique features: they open at hyperpolarizing potential, carry a mixed Na/K current, and are regulated by cyclic nucleotides. Four different isoforms have been cloned (HCN1-4) that can assemble to form homo- or heterotetramers, characterized by different biophysical properties. These proteins are widely distributed throughout the body and involved in different physiologic processes, the most important being the generation of spontaneous electrical activity in the heart and the regulation of synaptic transmission in the brain. Their role in heart rate, neuronal pacemaking, dendritic integration, learning and memory, and visual and pain perceptions has been extensively studied; these channels have been found also in some peripheral tissues, where their functions still need to be fully elucidated. Genetic defects and altered expression of HCN channels are linked to several pathologies, which makes these proteins attractive targets for translational research; at the moment only one drug (ivabradine), which specifically blocks the hyperpolarization-activated current, is clinically available. This review discusses current knowledge about HCN channels, starting from their biophysical properties, origin, and developmental features, to (patho)physiologic role in different tissues and pharmacological modulation, ending with their present and future relevance as drug targets. Copyright © 2017 by The American Society for Pharmacology and Experimental Therapeutics.
Challenges in Treatment of Inappropriate Sinus Tachycardia.
Ruzieh, Mohammed; Moustafa, Abdelmoniem; Sabbagh, Ebrahim; Karim, Mohammad M; Karim, Saima
2018-03-14
Inappropriate Sinus Tachycardia (IST) is a clinical syndrome characterized by a sinus heart rate inexplicably higher than one hundred beats per minute at rest that is associated with symptoms like palpitations, dyspnea or dizziness in the absence of primary causes of tachycardia. The diagnosis requires exclusion of other causes of tachycardia including medications/substances (such as anti-cholinergic, beta-blocker withdrawal, caffeine, and alcohol) or medical conditions (such as panic attacks, pulmonary embolism, fever, hyperthyroidism, hypovolemia, anemia, and pain). Work up should include an EKG to differentiate other causes of tachycardia, 24 hour- Holter monitor if indicated, serum thyroid levels, hemoglobin levels and toxicology screen. Electrophysiological studies are not routinely recommended, but should be considered in certain patients in whom concurrent supraventricular tachycardia is suspected. The underlying pathology in IST is yet to be completely understood. However, it is thought that the causes of IST can be broadly classified into two groups; either as an intrinsic increase in sinus node automaticity or an extrinsic cause. Among extrinsic causes, there is evolving evidence that IgG anti-β receptor antibodies are found in IST causing tachycardia. Managing patients with IST includes lifestyle modification, non-pharmacological and pharmacological interventions. Ivabradine has recently emerged as an effective treatment of IST and was shown to be superior to beta-blockers. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.
Direct Numerical Simulation of the Influence of Plasmas on Turbulent Flows
2006-12-31
studying the ability of plasmas to directly influence the turbulent fluctuations in the interior of flows. Laser energy deposition has been considered...background turbulence . Signifi- cant expansion is observed in the turbulent core. "* The blast wave is initially very strong and is not distorted by the...enough to get distorted through interaction with the turbulence . "* Statistics computed for turbulent kinetic energy and divergence of velocity
2017-05-25
NASA's Juno spacecraft carries an instrument called the Microwave Radiometer, which examines Jupiter's atmosphere beneath the planet's cloud tops. This image shows the instrument's view of the outer part of Jupiter's atmosphere. Before Juno began using this instrument, scientists expected the atmosphere to be uniform at depths greater than 60 miles (100 kilometers). But with the Microwave Radiometer, scientists have discovered that the atmosphere has variations down to at least 220 miles (350 kilometers), as deep as the instrument can see. In the cut-out image to the right, orange signifies high ammonia abundance and blue signifies low ammonia abundance. Jupiter appears to have a band around its equator high in ammonia abundance, with a column shown in orange. This is contrary to scientists' expectations that ammonia would be uniformly mixed. https://photojournal.jpl.nasa.gov/catalog/PIA21642
It's all about the six-pack: Boys' bodies in contemporary Western culture.
Drummond, Murray; Drummond, Claire
2015-12-01
This is an article about boys and their construction of masculinities. It draws on 5 years of qualitative research data from the same group of boys from early childhood through to 10 years of age in an attempt to articulate the way in which boys come to view their bodies, and other male bodies, in contemporary Western culture. The research is based on focus groups and is a part of a longitudinal study with the same cohort of boys, at a school in Adelaide, Australia. The data were analysed using inductive thematic analysis to identify key emergent themes. The results indicate that there is an emerging trend among boys from early childhood through to middle primary school surrounding the acknowledgement of male body aesthetics as a signifier of being male. The use of terminology such as 'six-pack' is now commonplace among all of the groups. The consistency around muscularity as a signifier of being a man was very high among the boys of all ages. It is clear that greater emphasis needs to be placed on younger males' and boys' awareness of the meaning of the male body in contemporary Western society. © The Author(s) 2014.
Adjuvant Activity of a Novel Metabolizable Lipid Emulsion with Inactivated Viral Vaccines
1980-06-01
glycerol and lecithin . Hamsters and mice inoculated with lipid 0 emulsion plus western or Venezuelan equine encephalitis vaccine were signifi- cantly...antibody titer. soybean lecithin (Centrolex-F, Central Soya, Ft. Immunization and challenge studies. Mice or Wayne, Ind.) was dissolved in 10 parts...vaccine combined a sterile Teflon magnetic bar. The glycerol and lecithin with LE or saline as shown in the tables of individual mixture was transferred
Towards a Semiotic Information Position Framework for Network Centric Warfare
2011-06-01
study of anything which stands for something else [10]. Swiss linguist Ferdinand de Saussure and American logician and philosopher Charles Sanders Peirce...are considered as the founders of semiotics [10]. As a linguist, Saussure was interested in the relationships between words (or signs) and he argued...to Eco, Saussure “did not define the signified any too clearly, leaving it half way between a mental image, a concept and a psychological reality
Engineering Design Handbook: Recoilless Rifle Weapon Systems.
1976-01-15
rifles also creates danger of physiological damage also exists. psychological factors which may be signifi- The extent and nature of the damage caused...the intensity of the bla&st, its disruption often cause psychological effects impulse, the position of the subject with of extreme lethargy and...General. 6. AD 3S 1 905, Capt. L. R. Creelman , A 2. David E. Walters and Edith F. Reilly, Parameiric Study of the Probability of Hit Hitting
Detecting Wear In Ball Bearings During Operation
NASA Technical Reports Server (NTRS)
Hine, Michael J.
1988-01-01
Strain-gauge signals at harmonics of ball-bearing-cage frequencies signify wear. Brief report describes experiments in continuing effort to interpret vibrations of machinery in terms of wear in ball bearing.
Emerging drugs for the treatment of angina pectoris.
Chong, Cher-Rin; Ong, Gao J; Horowitz, John D
2016-12-01
Angina pectoris, or symptomatic myocardial ischaemia, reflects an impairment of coronary blood flow, and usually a deficiency of available myocardial energetics. Treatment options vary with the precise cause, which may vary with regards to the roles of increased myocardial oxygen demand versus reduced supply. Traditionally, organic nitrates, β-adrenoceptor antagonists, and non-dihydropyridine calcium antagonists were the only commonly used prophylactic anti-anginal agents. However, many patients failed to respond adequately to such therapy, and/or were unsuitable for their use. Areas covered: A number of 'new' agents have been shown to represent ancillary forms of prophylactic anti-anginal therapy and are particularly useful in patients who are relatively unsuitable for either percutaneous or surgical revascularisation. These include modulators of myocardial metabolic efficiency, such as perhexiline, trimetazidine and ranolazine, as well as high dose allopurinol, nicorandil and ivabradine. The advantages and disadvantages of these various agents are summarized. Expert opinion: 'Optimal' medical treatment of angina pectoris now includes use of agents primarily intended to reduce risk of infarction (e.g. statins, aspirin, ACE inhibitors). In patients whose angina persists despite the use of 'standard' anti-anginal therapy, and who are not ideal for invasive revascularization options, a number of emerging drugs offer prospects of symptomatic relief.
Arif, Zeba
2016-10-26
Mediation can be an effective way of solving conflict between staff members. It signifies a willingness for people to work together to discuss their differences in a constructive way, before going down the official grievance route.
Cabana inducted into Hall of Fame
2008-05-03
Former astronaut Al Worden (left) presents Stennis Space Center Director Bob Cabana with a gold medallion signifying his induction into the U.S. Astronaut Hall of Fame at Kennedy Space Center in Florida.
20 CFR 663.105 - When must adults and dislocated workers be registered?
Code of Federal Regulations, 2010 CFR
2010-04-01
... transfer, personal interview, or an individual's application. (b) Adults and dislocated workers who receive... signified that interest by submitting personal information in response to a request from the recipient. ...
Performance plan : fiscal year 2006-2007
DOT National Transportation Integrated Search
2006-01-01
The Federal Highway Administration (FHWA) Office of Research, Development, and Technology (RD&T) made signifi cant strides in enhancing mobility and developing solutions to many of the Nations most pressing highway transportation needs. This Perfo...
Civil Engineering Corrosion Control. Volume 3. Cathodic Protection Design
1975-02-01
coatings, test stations bonds, and insulation. It is certainly not a "cure-all Its economics and feasibility mus’ always be carefully studied .. An in...General Description of Cathodic Protection. Cath- odic protection, as the name signifies, is the process by which an entire surface is transformed into a...The National Asaoeiation of Corrosion Enguler "I i ,.I-11 Standard RP-Ol-69, "Recommended Practice Por ront.ol ol." Ex - ternal Corrosion on
Air Force Logistics: A Historical Perspective (1940 to 1983)
1983-09-01
signifi- cantly influenced subsequent logistic writings. In a separate work (14:24), he noted: Too many military men tend to be too contemptuous of...many military men had become complacent in their interest in military history. That report went on to state (34:11) the study of military history is...analyzed./4 Very tight-jawed subject. Lot of service people get very mad when discuss- ing this. Lot of emotion --not always logic./3 116 *1 INSTANCES
ERIC Educational Resources Information Center
Amezaga Rivera, Lesbia Nannette
2017-01-01
Considering the signifying power of visuality to function as language as it constructs, fashions, and alters conceptualizations, and focusing on the Caribbean woman for my research, this study explored the dynamics involved in the construction of the Other by means of the colonial visual imagery and written discourse deployed by Europe and the…
Role of regional planning organizations in transportation planning across boundaries
DOT National Transportation Integrated Search
2014-06-11
The Volpe Center conducted research for the Federal Highway Administration Office of Planning that explores the implications of Regional Planning Organizations (RPO) engaging in transportation planning partnerships and projects of megaregions signifi...
Evaluating systems to reduce road improvement impacts on mountain streams.
DOT National Transportation Integrated Search
2007-08-14
Sediment is the most common pollutant affecting North Carolinas waterways, impacting a range of aquatic organisms, reducing : reservoir capacity, and hurting their aesthetic value. Construction activities, including roadway projects, are a signifi...
2010-09-21
This graphic, constructed from data obtained by NASA Cassini spacecraft, shows the percentage of cloud coverage across the surface of Saturn moon Titan. The color scale from black to yellow signifies no cloud coverage to complete cloud coverage.
Many non-scientists treat "ecology" and "environmentalism" as roughly interchangeable words, thus the word "ecologist" commonly has come to signify a particular part of the political spectrum. As used in the scientific community and in this presentation, however, ecology is loos...
Evaluation of stone/RAP interlayers under accelerated loading : tech summary.
DOT National Transportation Integrated Search
2008-08-01
The first Louisiana accelerated loading experiment, Evaluation of Louisianas Conventional and Alternative Base Courses, showed that pavement performance could be enhanced signifi cantly if a layer of stone was placed over the cement stabilized sub...
Evaluation of stone/RAP interlayers under accelerated loading : tech summary.
DOT National Transportation Integrated Search
2008-08-01
The fi rst Louisiana accelerated loading experiment, Evaluation of Louisianas Conventional and Alternative Base Courses, : showed that pavement performance could be enhanced signifi cantly if a layer of stone was placed over the cement : stabilize...
NASA Astrophysics Data System (ADS)
Reid, M. D.
2013-12-01
The demonstration of quantum teleportation of a photonic qubit from Alice to Bob usually relies on data conditioned on detection at Bob's location. I show that Bohm's Einstein-Podolsky-Rosen (EPR) paradox can be used to verify that the quantum benchmark for qubit teleportation has been reached, without postselection. This is possible for scenarios insensitive to losses at the generation station, and with efficiencies of ηB>1/3 for the teleportation process. The benchmark is obtained if it is shown that Bob can “steer” Alice's record of the qubit as stored by Charlie. EPR steering inequalities involving m measurement settings can also be used to confirm quantum teleportation, for efficiencies ηB>1/m, if one assumes trusted detectors for Charlie and Alice. Using proofs of monogamy, I show that two-setting EPR steering inequalities can signify secure teleportation of the qubit state.
Xu, Tianchi; Yin, Hongnan; Li, Xiaohong; Zhang, Lifen; Cheng, Zhenping; Zhu, Xiulin
2017-07-01
A new polymerization method, termed as step transfer-addition and radical-termination, is developed for the step-growth radical polymerization of α,ω-unconjugated dienes under irradiation of visible light at room temperature (25 °C) for the first time. α,ω-Diiodoperfluoroalkane monomers (signified as A) are added onto α,ω-unconjugated dienes (signified as B) alternatively and efficiently with the generation of perfluorocarbon-containing alternating copolymers (AB) n . Based on the combined analyses of polymerization kinetics and NMR spectra ( 1 H and 19 F), the mechanism of the novel polymerization method, including the side reaction, is proposed. This novel polymerization method provides a new strategy not only for the step-growth radical polymerization of α,ω-unconjugated dienes but also for the construction of high molecular weight perfluorocarbon-containing alternating copolymers. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Feasibility Study for Design of a Biocybernetic Communication System
1975-08-01
electrode for the Within Words variance and Between Words variance for each of the 255 data samples in the 6-sec epoch. If a given sample point was not...contributing to the computer classification of the word, the ratio of the two variances (i.e., the F-statistic) should be small. On the other hand...if the Between Word variance was signifi- cantly higher than the Within Word variance for a given sample point, we can assume with some confidence
New molecular insights into peripheral T cell lymphomas
Pileri, Stefano A.; Piccaluga, Pier Paolo
2012-01-01
Peripheral T cell lymphomas (PTCLs) are heterogeneous neoplasms and represent about 12% of all lymphoid malignancies. They are often regarded as “orphan diseases,” a designation that does not reflect their real incidence but rather signifies the difficulties encountered in their classification, diagnosis, and treatment. Here we revise the current understanding of the pathobiological characteristics of the most common nodal PTCLs by focusing on the contribution given by high-throughput technologies and the identification of potential therapeutic targets proposed by translational studies. PMID:23023716
1983-01-01
hazel alder (Alnus serrulata), and lead plant (Amerpha fruticasa) often gain dominance on low stream banks. A great variety of woody vines groww in...Early Archaic ecosystems for the Midwest may be highly signifi- cant. From 8000 to about 5000 B.P. in southwest Alabama mobile groups apparently...n-48) of the Gulf Formational or Early Woodland sites within the BWT project area. Middle to Late Woodi -nd Site Locations The summary locational
1980-03-01
to examine in this regard is their most recent military experience of signifi- cance, the Second World War . A glance at this experience reveals... Second World War , and subsequently their historians, did not think or write in "C3 terms", although there is evidence 16 they certainly considered each...techni- ques of warfare employed by the Germans in World War II while also studying the Soviet experiences and performance in that same war . Second , an
Atomistic Models of General Anesthetics for Use in in Silico Biological Studies
2015-01-01
While small molecules have been used to induce anesthesia in a clinical setting for well over a century, a detailed understanding of the molecular mechanism remains elusive. In this study, we utilize ab initio calculations to develop a novel set of CHARMM-compatible parameters for the ubiquitous modern anesthetics desflurane, isoflurane, sevoflurane, and propofol for use in molecular dynamics (MD) simulations. The parameters generated were rigorously tested against known experimental physicochemical properties including dipole moment, density, enthalpy of vaporization, and free energy of solvation. In all cases, the anesthetic parameters were able to reproduce experimental measurements, signifying the robustness and accuracy of the atomistic models developed. The models were then used to study the interaction of anesthetics with the membrane. Calculation of the potential of mean force for inserting the molecules into a POPC bilayer revealed a distinct energetic minimum of 4–5 kcal/mol relative to aqueous solution at the level of the glycerol backbone in the membrane. The location of this minimum within the membrane suggests that anesthetics partition to the membrane prior to binding their ion channel targets, giving context to the Meyer–Overton correlation. Moreover, MD simulations of these drugs in the membrane give rise to computed membrane structural parameters, including atomic distribution, deuterium order parameters, dipole potential, and lateral stress profile, that indicate partitioning of anesthetics into the membrane at the concentration range studied here, which does not appear to perturb the structural integrity of the lipid bilayer. These results signify that an indirect, membrane-mediated mechanism of channel modulation is unlikely. PMID:25303275
Psychological interventions influence patients' attitudes and beliefs about their chronic pain.
Vanhaudenhuyse, Audrey; Gillet, Aline; Malaise, Nicole; Salamun, Irène; Grosdent, Stéphanie; Maquet, Didier; Nyssen, Anne-Sophie; Faymonville, Marie-Elisabeth
2018-04-01
Patients' changing attitudes and beliefs about pain are considered as improvements in the treatment of chronic pain. Multidisciplinary approaches to pain allow modifications of coping strategies of patients, from passive to active. We investigate how two therapeutic treatments impact patients' attitudes and beliefs regarding pain, as measured with the Survey of Pain Attitudes (SOPA). We allocated 415 patients with chronic pain either to psychoeducation combined with physiotherapy, self-hypnosis combined with self-care learning, or to control groups. Pain intensity, global impression of change, and beliefs and attitudes regarding pain were assessed before and after treatment. Our main results showed a significant effect of psychoeducation/physiotherapy on control, harm, and medical cure SOPA subscales; and a significant effect of self-hypnosis/self-care on control, disability and medical cure subscales. Correlation results showed that pain perception was negatively associated with control, while positively associated with disability, and a belief that hurt signifies harm. Patients' impression of improvement was associated with greater control, lower disability, and lower belief that hurt signifies harm. The present study showed that self-hypnosis/self-care and psychoeducation/physiotherapy were associated with patients' evolution of coping strategies from passive to active, allowing them to reduce pain perception and improve their global impression of treatment effectiveness.
A magnetoencephalography study of visual processing of pain anticipation.
Machado, Andre G; Gopalakrishnan, Raghavan; Plow, Ela B; Burgess, Richard C; Mosher, John C
2014-07-15
Anticipating pain is important for avoiding injury; however, in chronic pain patients, anticipatory behavior can become maladaptive, leading to sensitization and limiting function. Knowledge of networks involved in pain anticipation and conditioning over time could help devise novel, better-targeted therapies. With the use of magnetoencephalography, we evaluated in 10 healthy subjects the neural processing of pain anticipation. Anticipatory cortical activity elicited by consecutive visual cues that signified imminent painful stimulus was compared with cues signifying nonpainful and no stimulus. We found that the neural processing of visually evoked pain anticipation involves the primary visual cortex along with cingulate and frontal regions. Visual cortex could quickly and independently encode and discriminate between visual cues associated with pain anticipation and no pain during preconscious phases following object presentation. When evaluating the effect of task repetition on participating cortical areas, we found that activity of prefrontal and cingulate regions was mostly prominent early on when subjects were still naive to a cue's contextual meaning. Visual cortical activity was significant throughout later phases. Although visual cortex may precisely and time efficiently decode cues anticipating pain or no pain, prefrontal areas establish the context associated with each cue. These findings have important implications toward processes involved in pain anticipation and maladaptive pain conditioning. Copyright © 2014 the American Physiological Society.
Effort, symptom validity testing, performance validity testing and traumatic brain injury.
Bigler, Erin D
2014-01-01
To understand the neurocognitive effects of brain injury, valid neuropsychological test findings are paramount. This review examines the research on what has been referred to a symptom validity testing (SVT). Above a designated cut-score signifies a 'passing' SVT performance which is likely the best indicator of valid neuropsychological test findings. Likewise, substantially below cut-point performance that nears chance or is at chance signifies invalid test performance. Significantly below chance is the sine qua non neuropsychological indicator for malingering. However, the interpretative problems with SVT performance below the cut-point yet far above chance are substantial, as pointed out in this review. This intermediate, border-zone performance on SVT measures is where substantial interpretative challenges exist. Case studies are used to highlight the many areas where additional research is needed. Historical perspectives are reviewed along with the neurobiology of effort. Reasons why performance validity testing (PVT) may be better than the SVT term are reviewed. Advances in neuroimaging techniques may be key in better understanding the meaning of border zone SVT failure. The review demonstrates the problems with rigidity in interpretation with established cut-scores. A better understanding of how certain types of neurological, neuropsychiatric and/or even test conditions may affect SVT performance is needed.
Plants at the pump : biofuels, climate change, and sustainability
DOT National Transportation Integrated Search
2007-01-01
In a world of rapidly rising carbon emissions and growing unease about imported oil, the appeal of renewable fuels is growing apace. Biofuels liquids produced from plant matter that can substitute for gasoline or diesel are attracting signifi...
2016-06-29
The inset perspective view from NASA Dawn space of Ceres bright spot Occator Crator is overlaid with data concerning the composition. Red signifies a high abundance of carbonates, while gray indicates a low carbonate abundance. http://photojournal.jpl.nasa.gov/catalog/PIA20694
Federal Register 2010, 2011, 2012, 2013, 2014
2011-10-07
... alternative best signifies the vision, goals, and purposes of the Complex. We will emphasize restoring and... safety and public compliance with refuge regulations. Administration plans will stress the need for...
Control of embankment settlement field verification on PCPT prediction methods : tech summary.
DOT National Transportation Integrated Search
2011-07-01
Depending on loading and embankment height, the magnitude and progression of settlement can signifi cantly impact the safety and : serviceability of the infrastructures that are constructed on saturated fi ne-grained soils. Therefore, the constructio...
Traffic and data preparation for AASHTO MEPDG analysis and designs.
DOT National Transportation Integrated Search
2011-10-01
"The Mechanistic Empirical Pavement Design Guide (MEPDG) and the : subsequent AASHTO product DARWin-ME are signifi cant advancements in : pavement design. However, they are substantially more complex than the : 1993 AASHTO Guide, which is currently u...
Sounding the field: recent works in sound studies.
Boon, Tim
2015-09-01
For sound studies, the publication of a 593-page handbook, not to mention the establishment of at least one society - the European Sound Studies Association - might seem to signify the emergence of a new academic discipline. Certainly, the books under consideration here, alongside many others, testify to an intensification of concern with the aural dimensions of culture. Some of this work comes from HPS and STS, some from musicology and cultural studies. But all of it should concern members of our disciplines, as it represents a long-overdue foregrounding of the aural in how we think about the intersections of science, technology and culture.
17 CFR 242.101 - Activities by distribution participants.
Code of Federal Regulations, 2013 CFR
2013-04-01
... section: (1) Research. The publication or dissemination of any information, opinion, or recommendation, if... distribution participant or an affiliate of the distribution participant; or (2) Investment grade... that signifies investment grade; or (3) Exempted securities. “Exempted securities” as defined in...
17 CFR 242.101 - Activities by distribution participants.
Code of Federal Regulations, 2012 CFR
2012-04-01
... section: (1) Research. The publication or dissemination of any information, opinion, or recommendation, if... distribution participant or an affiliate of the distribution participant; or (2) Investment grade... that signifies investment grade; or (3) Exempted securities. “Exempted securities” as defined in...
ERIC Educational Resources Information Center
Bandyopadhayay, Debaprasad
2000-01-01
The introduction of computational linguistics triggers a new space for communication, an electronic space for a simulated communication network, founded by the post-industrialized society. The language inaugurated by these electronic media is an electric language stripped of its signifier. The new language planning enterprise in cyberspace…
2007-01-03
KENNEDY SPACE CENTER, FLA. -- A handshake signifies the change of leadership at NASA's Kennedy Space Center as William W. Parsons (left) assumes the role as the facility's ninth director, succeeding James W. Kennedy (right), who is retiring from the agency. Photo credit: NASA/Kim Shiflett
INVESTIGATION OF CONTACT VACUUMING FOR REMEDIATION OF FUNGALLY CONTAMINATED DUCT MATERIALS
Environmental fungi become a potential Indoor Air Quality (IAQ) problem when adequate moisture and nutrients are present in building materials. Because of their potential to rapidly spread contamination throughout a building, ventilation system materials are of particular signifi...
14 CFR Appendix A to Part 1221 - Congressional Space Medal of Honor
Code of Federal Regulations, 2012 CFR
2012-01-01
... through space. The flames signify the dynamic energy of the rocket era and the imagination of the men in... courage of the astronauts in the nation's manned space program and the fire power of rockets that carry...
Rasubala, Linda; Pernapati, Lavanya; Velasquez, Ximena; Burk, James; Ren, Yan-Fang
2015-01-01
Prescription Drug Monitoring Programs (PDMP) are statewide databases that collect data on prescription of controlled substances. New York State mandates prescribers to consult the PDMP registry before prescribing a controlled substance such as opioid analgesics. The effect of mandatory PDMP on opioid drug prescriptions by dentists is not known. This study investigates the impact of mandatory PDMP on frequency and quantity of opioid prescriptions by dentists in a dental urgent care center. Based on the sample size estimate, we collected patient records of a 3-month period before and two consecutive 3-month periods after the mandatory PDMP implementation and analyzed the data on number of visits, treatment types and drug prescriptions using Chi-square tests. For patients who were prescribed pain medications, 452 (30.6%), 190 (14.1%), and 140 (9.6%) received opioid analgesics in the three study periods respectively, signifying a statistically significant reduction in the number of opioid prescriptions after implementation of the mandatory PDMP (p<0.05). Total numbers of prescribed opioid pills in a 3-month period decreased from 5096 to 1120, signifying a 78% reduction in absolute quantity. Prescriptions for non-opioid analgesics acetaminophen increased during the same periods (p<0.05). We conclude that the mandatory PDMP significantly affected the prescription pattern for pain medications by dentists. Such change in prescription pattern represents a shift towards the evidence-based prescription practices for acute postoperative pain.
Rasubala, Linda; Pernapati, Lavanya; Velasquez, Ximena; Burk, James; Ren, Yan-Fang
2015-01-01
Prescription Drug Monitoring Programs (PDMP) are statewide databases that collect data on prescription of controlled substances. New York State mandates prescribers to consult the PDMP registry before prescribing a controlled substance such as opioid analgesics. The effect of mandatory PDMP on opioid drug prescriptions by dentists is not known. This study investigates the impact of mandatory PDMP on frequency and quantity of opioid prescriptions by dentists in a dental urgent care center. Based on the sample size estimate, we collected patient records of a 3-month period before and two consecutive 3-month periods after the mandatory PDMP implementation and analyzed the data on number of visits, treatment types and drug prescriptions using Chi-square tests. For patients who were prescribed pain medications, 452 (30.6%), 190 (14.1%), and 140 (9.6%) received opioid analgesics in the three study periods respectively, signifying a statistically significant reduction in the number of opioid prescriptions after implementation of the mandatory PDMP (p<0.05). Total numbers of prescribed opioid pills in a 3-month period decreased from 5096 to 1120, signifying a 78% reduction in absolute quantity. Prescriptions for non-opioid analgesics acetaminophen increased during the same periods (p<0.05). We conclude that the mandatory PDMP significantly affected the prescription pattern for pain medications by dentists. Such change in prescription pattern represents a shift towards the evidence-based prescription practices for acute postoperative pain. PMID:26274819
Anti-asthmatic effect of Shirishadi compound through nasal spray actuation
Kajaria, Divya; Tripathi, Jyotishankar; Tiwari, Shrikant
2014-01-01
Background: Increasing morbidity and mortality of Asthma placed it among the most dreaded diseases. Prediction says that asthma along with chronic obstructive pulmonary disease become third leading cause of death by the year 2020. Despite the availability of a wide range of antiasthmatic drugs, incidence of asthma is increasing alarmingly because the relief offered by these drugs is mainly symptomatic and short-lived. Moreover, their side effects are also quite distressing. Hence, a continuous search is needed to identify effective and safe remedies to treat bronchial asthma. Aims: The present clinical study was conducted to evaluate the efficacy of Shirishadi Polyherbal compound (given through nebulizer in Aerosol form) in the management of acute and chronic uncomplicated Bronchial Asthma and to propose a novel and safer Ayurvedic treatment modality. Methods and Materials: It is a randomized, open, control clinical trial in which the effect of the drug was compared with contemporary treatment and placebo medication (normal saline) in 60 adults with mild to moderate asthma. Results: There was a (t>0.001) found in pulmonary function tests (including FEV1, FVC and PEFR)in the group treated with polyherbal drug. Improvement remain constant in consecutive follow-ups signifies that there is no reverse broncho-constriction after discontinuation of the drug. Conclusion: This study signifies that polyherbal drug - Shirishadi compound may prove beneficial future alternative remedy for asthma, and its effect is similar to that of modern contemporary drug when given through nasal route. PMID:26664235
Innovations in management of cardiac disease: drugs, treatment strategies and technology.
Foëx, P
2017-12-01
Within the last generation, the management of patients with heart disease has been transformed by advances in drug treatments, interventions and diagnostic technologies. The management of arterial hypertension saw beta-blockers demoted from first- to third-line treatment. Recent studies suggest that the goal of treatment may have to change to lower systolic blood pressures to prevent long-term organ damage. Today less than 15% of coronary revascularizations are surgical and more than 85% are done by interventional cardiologists inserting coronary stents. Thus, managing patients on dual antiplatelet therapy has become an important issue. With new generations of coronary stents, recommendations are changing fast. In the past, decisions concerning non-cardiac surgery after acute myocardial infarction were based on the delay between infarction and non-cardiac surgery. Today, the main concern is the patient's status in respect of dual antiplatelet therapy after primary percutaneous intervention. There have been advances in the management of heart failure but new drugs (ivabradine, sacubitril/valsartan) and cardiac resynchronization are recommended only in patients with an ejection fraction below 35% on optimal medication. Heart failure remains a major perioperative risk factor. Prospective studies have shown that troponin elevations represent myocardial injury (not necessarily myocardial infarction), are mostly silent and are associated with increased 30-day mortality. Monitoring (troponin assays) for myocardial injury in non-cardiac surgery (MINS) seems increasingly justified. The treatment of MINS needs further research. Technological advances, such as intelligent, portable monitors benefit not only patients with cardiac disease but all patients who have undergone major surgery and are on the wards postoperatively. © The Author 2017. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Grimmsmann, Thomas; Chenot, Jean-François; Angelow, Aniela
2015-08-01
Pentaerythrityl tetranitrate (PETN) was the most commonly prescribed long-acting nitrate in Germany. We aimed to assess whether the discontinuation of PETN reimbursability in 2011 resulted in alternative prescriptions of anti-anginal medications or in a discontinuation of anti-anginal therapy. This is an observational study using health claims data from one German federal state analysing all patients discontinuing a PETN treatment. Patients starting a new alternative anti-anginal treatment (long-acting nitrates, molsidome, ivabradine and ranolazine) were compared with patients without a new anti-anginal treatment with respect to use of short-acting nitrates, beta blockers (BBs) and calcium channel blockers (CCBs). Out of 12,909 patients, 12,763 (99%) discontinued PETN until 12/2012. Of these, 52% started an alternative anti-anginal treatment, 43% did not receive any alternative treatment and 5% were excluded from analysis. Before termination of PETN reimbursability, 65% of patients received BBs, 29% CCBs and 10% short-acting nitrates. In patients started on alternative anti-anginal treatment, prescription rates for short-acting nitrates, BBs and CCBs remained constant after discontinuing PETN. In patients without any alternative anti-anginal treatment, prescription rates for BBs and CCBs did not change meaningfully (<3%), and prescription rates for short-acting nitrates decreased from 9% to 6%. Half of the patients discontinued PETN without alternative. This did not lead to increased prescription rates of standard IHD medications or total medication number indicating that there might still be a high percentage of ischaemic heart disease patients treated unnecessarily with long-acting nitrates. The undertreatment with prognostically relevant first-line medications indicates a need for better guideline implementation activities. Copyright © 2015 John Wiley & Sons, Ltd.
DOT National Transportation Integrated Search
2010-01-01
During oxidative aging, polar and aromatic molecules interact through attractive forces to form molecular associations resulting : in signifi cant changes in the physical properties of asphalts. One consequence is that these associations have eff ect...
DOT National Transportation Integrated Search
2010-01-01
During oxidative aging, polar and aromatic molecules interact through attractive forces to form molecular associations resulting in signifi cant changes in the physical properties of asphalts. One consequence is that these associations have eff ectiv...
Development of a Sensitive DNA Assay for the AIDS Virus, HTLV-III/LAV
1989-11-19
lylphadenopathy syndrome, acquired immuno- deficiency disease syndrome (AIDS)-related complex (ARC) (including night sweats, fever, diarrhea, weight loss, oral ... candidiasis ), or AIDS (including neurological disease, opportunistic infections, or malignancies) (1). A signifi- cant number of infected individuals
Employability Deconstructed: Perceptions of Bologna Stakeholders
ERIC Educational Resources Information Center
Sin, Cristina; Neave, Guy
2016-01-01
The paper analyses employability as a floating signifier--a construct that accommodates different and often contending meanings. A preliminary analysis of scholarly literature identifies two opposed interpretations of employability--an individual responsibility versus a comprehensive context-aware construct. These are subsequently applied to the…
Prototype next generation frog foundation - preliminary evaluation : research results.
DOT National Transportation Integrated Search
2016-06-01
Conventional wisdom suggests that a solid or rigid one-piece frog is preferred because it is easy to maintain. However, testing and subsequent modeling demonstrated that a flexible frog (i.e., a two-piece frog split in the flangeway) produced signifi...
32 CFR 22.410 - Grants officers' responsibilities.
Code of Federal Regulations, 2014 CFR
2014-07-01
... AGREEMENT REGULATIONS DoD GRANTS AND AGREEMENTS-AWARD AND ADMINISTRATION Recipient Qualification Matters... responsible for determining a recipient's qualification prior to award. The grants officer's signature on the award document shall signify his or her determination that either: (a) The potential recipient meets the...
32 CFR 22.410 - Grants officers' responsibilities.
Code of Federal Regulations, 2013 CFR
2013-07-01
... AGREEMENT REGULATIONS DoD GRANTS AND AGREEMENTS-AWARD AND ADMINISTRATION Recipient Qualification Matters... responsible for determining a recipient's qualification prior to award. The grants officer's signature on the award document shall signify his or her determination that either: (a) The potential recipient meets the...
32 CFR 22.410 - Grants officers' responsibilities.
Code of Federal Regulations, 2012 CFR
2012-07-01
... AGREEMENT REGULATIONS DoD GRANTS AND AGREEMENTS-AWARD AND ADMINISTRATION Recipient Qualification Matters... responsible for determining a recipient's qualification prior to award. The grants officer's signature on the award document shall signify his or her determination that either: (a) The potential recipient meets the...
32 CFR 22.410 - Grants officers' responsibilities.
Code of Federal Regulations, 2010 CFR
2010-07-01
... AGREEMENT REGULATIONS DoD GRANTS AND AGREEMENTS-AWARD AND ADMINISTRATION Recipient Qualification Matters... responsible for determining a recipient's qualification prior to award. The grants officer's signature on the award document shall signify his or her determination that either: (a) The potential recipient meets the...
32 CFR 22.410 - Grants officers' responsibilities.
Code of Federal Regulations, 2011 CFR
2011-07-01
... AGREEMENT REGULATIONS DoD GRANTS AND AGREEMENTS-AWARD AND ADMINISTRATION Recipient Qualification Matters... responsible for determining a recipient's qualification prior to award. The grants officer's signature on the award document shall signify his or her determination that either: (a) The potential recipient meets the...
Automated Sequence Generation Process and Software
NASA Technical Reports Server (NTRS)
Gladden, Roy
2007-01-01
"Automated sequence generation" (autogen) signifies both a process and software used to automatically generate sequences of commands to operate various spacecraft. The autogen software comprises the autogen script plus the Activity Plan Generator (APGEN) program. APGEN can be used for planning missions and command sequences.
Moral discourses and pharmaceuticalised governance in households.
Dew, Kevin; Norris, Pauline; Gabe, Jonathan; Chamberlain, Kerry; Hodgetts, Darrin
2015-04-01
This article extends our understanding of the everyday practices of pharmaceuticalisation through an examination of moral concerns over medication practices in the household. Moral concerns of responsibility and discipline in relation to pharmaceutical consumption have been identified, such as passive or active medication practices, and adherence to orthodox or unorthodox accounts. This paper further delineates dimensions of the moral evaluations of pharmaceuticals. In 2010 and 2011 data were collected from 55 households across New Zealand and data collection techniques, such as photo- and diary-elicitation interviews, allowed the participants to develop and articulate reflective stories of the moral meaning of pharmaceuticals. Four repertoires were identified: a disordering society repertoire where pharmaceuticals evoke a society in an unnatural state; a disordering self repertoire where pharmaceuticals signify a moral failing of the individual; a disordering substances repertoire where pharmaceuticals signify a threat to one's physical or mental equilibrium; a re-ordering substances repertoire where pharmaceuticals signify the restoration of function. The research demonstrated that the dichotomies of orthodox/unorthodox and compliance/resistance do not adequately capture how medications are used and understood in everyday practice. Attitudes change according to why pharmaceuticals are taken and who is taking them, their impacts on social relationships, and different views on the social or natural production of disease, the power of the pharmaceutical industry, and the role of health experts. Pharmaceuticals are tied to our identity, what we want to show of ourselves, and what sort of world we see ourselves living in. The ordering and disordering understandings of pharmaceuticals intersect with forms of pharmaceuticalised governance, where conduct is governed through pharmaceutical routines, and where self-responsibility entails following the prescription of other agents. Pharmaceuticals symbolise forms of governance with different sets of roles and responsibilities. Copyright © 2014 Elsevier Ltd. All rights reserved.
What is open peer review? A systematic review.
Ross-Hellauer, Tony
2017-01-01
Background : "Open peer review" (OPR), despite being a major pillar of Open Science, has neither a standardized definition nor an agreed schema of its features and implementations. The literature reflects this, with numerous overlapping and contradictory definitions. While for some the term refers to peer review where the identities of both author and reviewer are disclosed to each other, for others it signifies systems where reviewer reports are published alongside articles. For others it signifies both of these conditions, and for yet others it describes systems where not only "invited experts" are able to comment. For still others, it includes a variety of combinations of these and other novel methods. Methods : Recognising the absence of a consensus view on what open peer review is, this article undertakes a systematic review of definitions of "open peer review" or "open review", to create a corpus of 122 definitions. These definitions are systematically analysed to build a coherent typology of the various innovations in peer review signified by the term, and hence provide the precise technical definition currently lacking. Results : This quantifiable data yields rich information on the range and extent of differing definitions over time and by broad subject area. Quantifying definitions in this way allows us to accurately portray exactly how ambiguously the phrase "open peer review" has been used thus far, for the literature offers 22 distinct configurations of seven traits, effectively meaning that there are 22 different definitions of OPR in the literature reviewed. Conclusions : I propose a pragmatic definition of open peer review as an umbrella term for a number of overlapping ways that peer review models can be adapted in line with the aims of Open Science, including making reviewer and author identities open, publishing review reports and enabling greater participation in the peer review process.
NASA Astrophysics Data System (ADS)
Ta, Jin-Xing; Han, Yu; Lan, Cheng
2016-02-01
Bulk magneto-phonon and magnetic polaritons of lateral antiferromagnetic superlattices for potential THz applications have been investigated in the framework of the effective medium theory. The dispersion relations applied for the system are displayed. In contrast with lateral FeF2/SiO2 superlattice, some fascinating polariton modes with negative group velocity signifying photonic band gap scenarios and attractive optical properties are observed from the numerical results presented with the example, lateral FeF2/TlBr superlattice.
Return to Duty Rate of Amputee Soldiers in the Current Conflicts in Afghanistan and Iraq
2010-06-01
Conclusion: During the 1980s , 11 of 469 amputees returned to active duty (2.3%). The number of amputees returning to duty has increased signifi- cantly...between 1980 and 1988, but only 11 of the 469 (2.3%) remained on active duty. The purpose of this study was to evaluate the return to duty rate of...During the 1980s and 1990s, no such designated military amputee centers were in operation. This may be one reason for the lower return to duty rate of
2009-10-21
observed in heterogeneous disorders caused by abnormalities of cell 68814_C001.indd 9 6/ 22 /2009 12:32:42 PM 10 Autism: Oxidative Stress, Infl ammation...signifi cant increase in the number of lipofuscin-containing cells in the brain of 7- to 14-year-old autistic subjects (by 69% in area 22 , 149% in...and dendritic tree of Purkinje cells in a rat cerebellum (Maeshima et al., 1998). In vitro studies have shown that that 5- HT inhibits the growth and
Noncontact Electromagnetic Vibration Source
NASA Technical Reports Server (NTRS)
Namkung, Min; Fulton, James P.; Wincheski, Buzz A.
1994-01-01
Metal aircraft skins scanned rapidly in vibration tests. Relatively simple combination of permanent magnets and electromagnet serves as noncontact vibration source for nondestructive testing of metal aircraft skins. In test, source excites vibrations, and vibration waveforms measured, then analyzed for changes in resonances signifying cracks and other flaws.
Mapping and Manipulating Facial Expression
ERIC Educational Resources Information Center
Theobald, Barry-John; Matthews, Iain; Mangini, Michael; Spies, Jeffrey R.; Brick, Timothy R.; Cohn, Jeffrey F.; Boker, Steven M.
2009-01-01
Nonverbal visual cues accompany speech to supplement the meaning of spoken words, signify emotional state, indicate position in discourse, and provide back-channel feedback. This visual information includes head movements, facial expressions and body gestures. In this article we describe techniques for manipulating both verbal and nonverbal facial…
75 FR 75617 - World AIDS Day, 2010
Federal Register 2010, 2011, 2012, 2013, 2014
2010-12-03
... orientation, gender identity, or socio-economic circumstance--will have unfettered access to high- quality, life-extending care. Signifying a renewed level of commitment and urgency, the National HIV/AIDS... quality care. The Affordable Care Act prohibits insurance companies from using HIV status and other pre...
The Pornography Controversy: Issues, Effects Research, and First Amendment Rights.
ERIC Educational Resources Information Center
O'Donnell, Victoria
Advances in media technology, specifically the videotape industry, have made pornography widely available. Opponents of pornography include religious groups, law enforcement officers, some politicians, and some feminists. A distinction is made between eroticism (occurring between consenting participants) and pornography (signifying overt or covert…
Aquifer depletion in the Lower Mississippi River Basin: challenges and solutions
USDA-ARS?s Scientific Manuscript database
The Lower Mississippi River Basin (LMRB) is an internationally-important region of intensive agricultural crop production that relies heavily on the underlying Mississippi River Valley Alluvial Aquifer (MRVAA) for irrigation. Extensive irrigation coupled with the region’s geology have led to signifi...
Politicizing Critical Pedagogies for the Logic of Late Capitalism
ERIC Educational Resources Information Center
Rice, J. A.
2008-01-01
In current critical pedagogy theory, the term "globalization" frequently signifies the rapid homogenization and structural equivalency of material and intellectual differences into a unified, transnational, capitalist rationality. For many composition scholars, this homogeneity signals an interpellation of not just subjects, but any and…
European Science Notes. Volume 39, Number 4.
1985-04-01
segrega- papers seemed to me unusually signifi- tion, may significantly improve plasma- cant. W. Esser ( Kraftwerk Union, AG, sprayed zirconia TBC coatings...forged and heat- -.- ,.- equipment and methods both by MPA and treated vessel of the same alloy. At industry ( Kraftwerk Union AG [KWU]). present, the
ERIC Educational Resources Information Center
Edutopia, 1994
1994-01-01
This document consists of the first four issues of a newsletter entitled "Edutopia." The name Edutopia signifies a version of what a technology-enriched educational system of the future would look like. The newsletter is intended to facilitate the integration of interactive multimedia and telecommunications technologies with teaching and…
Uncertainty in Early Occupational Aspirations: Role Exploration or Aimlessness?
ERIC Educational Resources Information Center
Staff, Jeremy; Harris, Angel; Sabates, Ricardo; Briddell, Laine
2010-01-01
Many youth in the United States lack clear occupational aspirations. This uncertainty in achievement ambitions may benefit socio-economic attainment if it signifies "role exploration," characterized by career development, continued education and enduring partnerships. By contrast, uncertainty may diminish attainment if it instead leads…
Preposition Entries in UK Monolingual Learners' Dictionaries: Problems and Possible Solutions.
ERIC Educational Resources Information Center
Lindstromberg, Seth
2001-01-01
Presents a selective examination of the entries of the preposition "on" in five advanced learners' dictionaries published in the United Kingdom. The principal concern is the preposition "on" as a signifier of contact with a surface--especially an upper surface. (Author/VWL)
Tarannum, Aafiya; Rao, J Raghava; Fathima, N Nishad
2018-01-25
Given the potential of productive interaction between choline-based amino acid ionic liquids (CAAILs) and collagen, we investigated the role of four CAAILs, viz., choline serinate, threoninate, lysinate, and phenylalaninate, and the changes mediated by them in the structure of collagen at different hierarchical orderings, that is, at molecular and fibrillar levels. The rheological, dielectric behavior and the secondary structural changes signify the alteration in the triple helical structure of collagen at higher concentrations of CAAILs. A marginal swelling and slight decrease in the thermal stability of rat tail tendon collagen fibers were observed for choline serinate and threoninate, albeit distortions in banding patterns were noticed for choline lysinate and phenylalaninate, suggesting chaotropicity of the ions at the fibrillar level. This signifies the changes in the hydrogen-bonding environment of collagen with increasing concentrations of CAAILs, which could be due to competitive hydrogen bonding between the carbonyl group of amino acid ionic liquids and the hydroxyl groups of collagen.
A new sauropod dinosaur from the Middle Jurassic of the United Kingdom.
Manning, Phillip L; Egerton, Victoria M; Romano, Mike
2015-01-01
A new record of a sauropodomorph dinosaur is here described from the Middle Jurassic (Aalenian) Saltwick Formation of Whitby (Yorkshire), UK. A single caudal vertebra represents an early sauropodomorph and signifies the earliest recognised eusauropod dinosaur from the United Kingdom. The absence of pleurocoels and a narrow, dorsoventrally deep, but craniocaudally short centrum, suggests a primitive sauropodomorph. Distinct spinopostzygopophyseal laminae rise from the lateral margins of the postzygapophyses and pass caudally along what remains of the neural spine, a character unique to a subgroup of sauropods that includes Barapasaurus, Omeisaurus and other neosauropods and eusauropods. The lack of phylogenetically robust characters in sauropod caudal vertebrae usually makes it difficult to establish affinities, but the absence of mild procoely excludes this specimen from both Diplodocoidea and Lithostrotia. The vertebra cannot be further distinguished from those of a wide range of basal sauropods, cetiosaurids and basal macronarians. However, this plesiomorphic vertebra still signifies the earliest stratigraphic occurrence for a British sauropod dinosaur.
Redeeming Lost Mothers: Adolescent Antiretroviral Treatment and the Making of Home in South Africa.
Vale, Beth; Thabeng, Mildred
2016-01-01
In this article, we explore how adolescent antiretroviral treatment (ART) might be signified to repair sociality in Eastern Cape homes that have been ruptured by HIV/AIDS and maternal loss. The post-apartheid period has exposed these families to new forms of social fragmentation, propelled by the disintegration of wage labor, declining marriage rates, and a rampant HIV/AIDS epidemic. Drawing on eight months of ethnographic fieldwork (August 2013-April 2014), we show that in the homes of some adolescents born with HIV, these present-day domestic ruptures were discursively connected to the past shortcomings of their dead and absent mothers. In some familial narratives lost mothers were accused of disobeying their elders, neglecting their children, and flouting custom; their social transgressions were made manifest in their child's inherited HIV. By signifying adolescent ART-taking as an enactment of the discipline and care purportedly absent in their mothers, these families might also attempt to imbue ART, beyond its biomedical function, as a means of social repair.
NASA Astrophysics Data System (ADS)
Aksoy, Erman; Yıldırım, Şahin
2017-10-01
The existence or endurance of the city is determined by social, economic, cultural, and technological factors. Therefore, transportation connections become physical signifiers of the relation between two spaces. Nevertheless, the potential for change in transportation is more dynamic when compared to other factors. Change in the infrastructure and systems of transportation become evident at the urban scale more rapidly. In addition to leading to the formation of new cities or to socio-cultural and economic development in the already-existent cities, this dynamic structure may also cause the decrease in economic power, and even the desertion of settlements. Furthermore, it functions as a leading, even determining, parameter in the formation of space, thereby in economic and social development. The fact that, throughout history, centres of communication and commerce were established at intersection, stopping and lodging points of transportation links and/or their development into residential areas attests to this interaction. In the commercial centres and life of the city, the effects of regional transportation networks and technologies surface relatively. By means of the analytical method, this study focuses on how, within the history of settlements, population increases due to the choice of location based on transportation and strategic significance, and how urban functions vary accordingly. As such, the interaction between urban development and transportation links for the Ancient City of Tios will be analysed, and the signifiers for urban development will be designated.
NASA Astrophysics Data System (ADS)
Tyagi, Shekhar; Sharma, Gaurav; Sathe, Vasant G.
2018-03-01
The competition and cooperation between ferroelectric and anti-ferro-distortion (AFD) instabilities are studied using pressure dependent Raman spectroscopy on polycrystalline powder samples of Sr1-x Ca x TiO3(x = 0.0, 0.06, 0.25, 0.35). For x = 0.0 composition, a broad polar mode is detected in the Raman spectra above 6 GPa, while for x = 0.06 composition, the polar modes appear well above 9 GPa where the AFD modes showed strong suppression. In x = 0.25 and 0.35 composition, the application of small pressure resulted in the appearance of strong AFD modes suppressing the polar modes. At elevated pressures, re-entrant polar modes are observed along with the broad AFD modes and some new peaks are also observed, signifying the lowering of local symmetry. The reappearance of polar modes is found to be related to pressure induced symmetry disorder at local level, suggesting its electronic origin. The re-entrant polar modes observed at higher pressure values are found to be significantly broad and asymmetric in nature, signifying the development of ferroelectric micro regions/nano domains coexisting with AFD. The lower symmetry at local length scale provides a conducive atmosphere for coexisting AFD and FE instabilities.
Developmental programming of appetite/satiety.
Ross, Michael G; Desai, Mina
2014-01-01
Obesity is often attributed to a Western lifestyle, a high-fat diet and decreased activity. While these factors certainly contribute to adult obesity, compelling data from our laboratory and others indicate that this explanation is oversimplified. Recent studies strongly argue that maternal/fetal under- or overnutrition predisposes the offspring to become hyperphagic and increases the risk of later obesity. Both infants small for gestational age (SGA) or infants born to obese mothers who consume a high-fat diet are at a markedly increased risk of adult obesity. Specific alterations in the fetal metabolic/energy environment directly influence the development of appetite regulatory pathways. Specifically, SGA infants demonstrate (1) impaired satiety and anorexigenic cell signaling, (2) enhanced cellular orexigenic responses, (3) programmed dysfunction of neuroprogenitor cell proliferation/differentiation, and (4) increased expression of appetite (NPY) versus satiety (POMC) neurons. In both hypothalamic tissue and ex vivo culture, SGA newborns exhibit increased levels of the nutrient sensor SIRT1, signifying reduced energy, whereas maternal high-fat-exposed newborns exhibit reduced levels of pAMPK, signifying energy excess. Via downstream regulation of bHLH neuroproliferation (Hes1) and neurodifferentiation factors (Mash1, Ngn3), neurogenesis is biased toward orexigenic and away from anorexigenic neurons, resulting in excess appetite, reduced satiety and development of obesity. Despite the developmental programming of appetite neurogenesis, the potential for neuronal remodeling raises the opportunity for novel interventions.
The Texas Experience with DepoProvera: 1980-1990.
ERIC Educational Resources Information Center
Emory, L. E.; And Others
1992-01-01
Compared sex offenders who received DepoProvera to group who had same clinical and legal problems but who refused pharmacotherapy. Both groups received group therapy, individual therapy, and sometimes family therapy. Results indicated that possible factors signifying increased likelihood of reoffense were high initial plasma testosterone,…
17 CFR 242.101 - Activities by distribution participants.
Code of Federal Regulations, 2014 CFR
2014-04-01
... section: (1) Research. The publication or dissemination of any information, opinion, or recommendation, if... the distribution participant; or (2) Investment grade nonconvertible and asset-backed securities....15c3-1 of this chapter, in one of its generic rating categories that signifies investment grade; or (3...
Medical semiotics in the 18th century: a theory of practice?
Hess, V
1998-06-01
Medical semiotics in the 18th century was more than a premodern form of diagnosis. Its structure allowed for the combination of empirically proven rules of instruction with the theoretical knowledge of the new sciences, employing the relation between the sign and the signified.
Pedagogy of/as/and Tourism: Or, Shameful Lessons
ERIC Educational Resources Information Center
Werry, Margaret
2008-01-01
The author cites the popular distinction between "traveler" and "tourist", noting that the latter has come to signify someone less enlightened, less conscientious and less distinguished than the former. Discussing critical pedagogy in terms of this paradox, she draws upon her experience in designing and teaching an…
Special Educational Needs: A Public Issue
ERIC Educational Resources Information Center
Liasidou, Anastasia
2010-01-01
This article explores the contribution of sociological scholarship to understanding and analysing the notions of "special educational needs" and "disability" and the ways in which the two notions have been reconfigured and theorised as "public issues" rather than "personal troubles". Barton's contribution is signified both in terms of his…
Inoculating against Jargonitis
ERIC Educational Resources Information Center
Sword, Helen
2012-01-01
Every discipline has its own specialized language, its membership rites, its secret handshake. In its most benign and neutral definition, jargon signifies "the technical terminology or characteristic idiom of a special activity or group." More often, however, the jingly word that Chaucer used to describe "the inarticulate utterance of birds" takes…
Redefining Rurality: Cosmopolitanism, Whiteness, and the New Latino Diaspora
ERIC Educational Resources Information Center
Sierk, Jessica
2017-01-01
In mainstream discourse, rural generally implies white, while urban signifies not-white. However, what happens when "rural" communities experience demographic change? This paper examines how students from a rural, New Latino Diaspora community in a Midwestern state complicate traditional notions of rurality. Data from participant…
The Muslim Problematic: Muslims, State Schools and Security
ERIC Educational Resources Information Center
Miah, Shamim
2016-01-01
Muslims are folk-devils that mark the ubiquitous moral panic. For some, the idea of the "Muslim problematic" signifies a long and worrying trend of creeping "Islamification" of state schools. For others, the discourse of the "Muslim problematic" reflects the ongoing racial patholigisation of Britain's minoritised…
Fixed, Fluid, and Transient: Negotiating Layers of Art Classroom Material Culture
ERIC Educational Resources Information Center
Woywod, Christine
2015-01-01
Objects of material culture have meaning. American flags, worktables, bulletin boards, interactive whiteboards, and large white-faced clocks signify "classroom" while color wheels, cupboards, cabinets, sinks, drawing supplies, and that particular scent that lingers after years of exposure to painting materials even more specifically…
Code of Federal Regulations, 2010 CFR
2010-07-01
..., signifying its agreement or alternate selection of a location and its selection of type of vending facility... owned building in which the lessor or any of its tenants have an existing restaurant or other food... substantial direct competition with such restaurant or other food operation, the requirement to provide a...
3-D surface scan of biological samples with a push-broom imaging spectrometer
USDA-ARS?s Scientific Manuscript database
The food industry is always on the lookout for sensing technologies for rapid and nondestructive inspection of food products. Hyperspectral imaging technology integrates both imaging and spectroscopy into unique imaging sensors. Its application for food safety and quality inspection has made signifi...
Sociocultural Concept of High Ability and Heart-Mind Epistemology in Confucian Societies
ERIC Educational Resources Information Center
Park, Jae
2016-01-01
This theoretical paper begins with a reflection on the dominant conceptions of "high ability", based on psychometrics, and examines claims that the ethos of a particular cultural heritage is essential to what "high ability" signifies. The article semantically distinguishes "giftedness" from "ability", using…
Code of Federal Regulations, 2010 CFR
2010-07-01
... Method employee used to purchase transportation tickets Method Indicator GTR U.S. Government Transportation Request Central Billing Account A contractor centrally billed account Government Charge Card In.../Date Fields Claimant Signature Traveler's signature, or digital representation. The signature signifies...
"No, Says the Signified": The "Logical Status" of Words in Painting.
ERIC Educational Resources Information Center
James, Carol Plyley
1985-01-01
Examines the interdependence of language and image in a poster series by Shosaku Arakawa and relates the displacement of writing from the book page to his canvases or posters to theories of performative language to show that his work is itself performance. (DF)
Koivusilta, Leena K; Lintonen, Tomi P; Rimpelä, Arja H
2007-01-01
The role of information and communication technology (ICT) in adolescents' lives was studied, with emphasis on whether there exists a digital divide based on sociodemographic background, educational career, and health. The assumption was that some groups of adolescents use ICT more so that their information utilization skills improve (computer use), while others use it primarily for entertainment (digital gaming, contacting friends by mobile phone). Data were collected by mailed survey from a nationally representative sample of 12- to 18-year-olds (n=7,292; response 70%) in 2001 and analysed using ANOVA. Computer use was most frequent among adolescents whose fathers had higher education or socioeconomic status, who came from nuclear families, and who continued studies after compulsory education. Digital gaming was associated with poor school achievement and attending vocational rather than upper secondary school. Mobile phone use was frequent among adolescents whose fathers had lower education or socioeconomic status, who came from non-nuclear families, and whose educational prospects were poor. Intensive use of each ICT form, especially of mobile phones, was associated with health problems. High social position, nuclear family, and a successful educational career signified good health in general, independently of the diverse usage of ICT. There exists a digital divide among adolescents: orientation to computer use is more common in educated well-off families while digital gaming and mobile phone use accumulate at the opposite end of the spectrum. Poorest health was reported by mobile phone users. High social background and success at school signify better health, independently of the ways of using ICT.
Dorsal metacarpal veins: anatomic variation and potential clinical implications.
Elmegarhi, Sara S; Amarin, Justin Z; Hadidi, Maher T; Badran, Darwish H; Massad, Islam M; Bani-Hani, Amjad M; Shatarat, Amjad T
2018-03-01
The dorsal metacarpal veins are frequently cannulated. Cannulation success is determined by several variable anatomic features. The objective of this study is to classify, for the first time, the anatomic variants of the dorsal metacarpal veins. In this cross-sectional study, 520 university students and staff were conveniently recruited. The dorsal metacarpal veins in 1040 hands were studied. Venous visibility was enhanced by either tourniquet application or near-infrared illumination. Variant patterns of the dorsal metacarpal veins were classified. The final analysis included 726 hands, for an exclusion rate of 30 %. Eight pattern types were identified. Three anatomic features informed the variation. Bilateral symmetry of the dorsal metacarpal veins was present in 352 participants (83 % of the total). The overall frequency distribution of variants in both hands was similar (P = 0.8). The frequency distribution of variants was subject to sexual dimorphism (P = 0.001), ethnic variation (P < 0.001), and technical variation (P < 0.001). The anatomic variants of the dorsal metacarpal veins were sorted into decreasingly frequent primary, secondary, and tertiary groups. The groups may signify a progressive increase in difficulty of peripheral cannulation, in the mentioned order. As such, primary patterns are the most common and likely the easiest to cannulate, while tertiary patterns are the least common and likely the most difficult to cannulate. The preceding premise, in tandem with the bilateral asymmetry of the veins, is clinically significant. With cannulation difficulty likely signifying an underlying tertiary pattern, the contralateral dorsal metacarpal veins are probabilistically characterized by a primary pattern and are, as such, the easier option for peripheral venous cannulation.
First Professional Degree Awards to Women.
ERIC Educational Resources Information Center
Brown, George H.
Changes in the percentage representation of women among recipients of first professional degrees are examined between the academic years 1970-71 and 1975-76. The data were collected through the annual Survey of Degrees and Other Formal Awards Conferred. A first professional degree is one that "signifies completion of the academic requirements for…
Early Adolescent Perceptions Regarding Sources of Sexual Health Information
ERIC Educational Resources Information Center
Shoemaker, Kylea K.
2017-01-01
Early adolescence includes youth approximately 11-14 years of age. This age group represents a population open to learning more information about sexuality and signifies a developmental period where effective sexuality interventions may begin (Ott & Pfieffer, 2009; Grossman et al., 2014). Early adolescence is a critical period when…
Estuarine Ecosystems: Using T & E Signature Approaches to Support STEM Integration
ERIC Educational Resources Information Center
McCulloch, Allison W.; Ernst, Jeremy V.
2012-01-01
STEM-based understandings and experiences that prepare learners beyond the classroom are of imminent need, as today's STEM education students are tomorrow's leaders in science, technology, engineering, mathematics, and education (Prabhu, 2009). Integrative STEM education signifies the intentional integration of science and mathematics with the…
49 CFR 218.23 - Blue signal display.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 49 Transportation 4 2014-10-01 2014-10-01 false Blue signal display. 218.23 Section 218.23..., DEPARTMENT OF TRANSPORTATION RAILROAD OPERATING PRACTICES Blue Signal Protection of Workers § 218.23 Blue signal display. (a) Blue signals displayed in accordance with § 218.25, 218.27, or 218.29 signify that...
49 CFR 218.23 - Blue signal display.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 49 Transportation 4 2013-10-01 2013-10-01 false Blue signal display. 218.23 Section 218.23..., DEPARTMENT OF TRANSPORTATION RAILROAD OPERATING PRACTICES Blue Signal Protection of Workers § 218.23 Blue signal display. (a) Blue signals displayed in accordance with § 218.25, 218.27, or 218.29 signify that...
49 CFR 218.23 - Blue signal display.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 49 Transportation 4 2012-10-01 2012-10-01 false Blue signal display. 218.23 Section 218.23..., DEPARTMENT OF TRANSPORTATION RAILROAD OPERATING PRACTICES Blue Signal Protection of Workers § 218.23 Blue signal display. (a) Blue signals displayed in accordance with § 218.25, 218.27, or 218.29 signify that...
49 CFR 218.23 - Blue signal display.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 49 Transportation 4 2011-10-01 2011-10-01 false Blue signal display. 218.23 Section 218.23..., DEPARTMENT OF TRANSPORTATION RAILROAD OPERATING PRACTICES Blue Signal Protection of Workers § 218.23 Blue signal display. (a) Blue signals displayed in accordance with § 218.25, 218.27, or 218.29 signify that...
49 CFR 218.23 - Blue signal display.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 49 Transportation 4 2010-10-01 2010-10-01 false Blue signal display. 218.23 Section 218.23..., DEPARTMENT OF TRANSPORTATION RAILROAD OPERATING PRACTICES Blue Signal Protection of Workers § 218.23 Blue signal display. (a) Blue signals displayed in accordance with § 218.25, 218.27, or 218.29 signify that...
The Faces of Whiteness: Pitfalls and the Critical Democrat
ERIC Educational Resources Information Center
Warren, John; Hytten, Kathy
2004-01-01
This essay stems from previously reported critical ethnographic data regarding educators participating in graduate-level classes on whiteness. The metaphor of "faces of whiteness" is adopted here to signify that individuals occupy particular stances toward White privilege and its consequences in a dynamic and nonlinear fashion. The Torpified face…
NAVO MSRC Navigator. Spring 2001
2001-01-01
preparations for UGC 2001 are almost complete. This year’s conference promises to be a good one, afford- ing us the opportunity to extend some Gulf Coast...cur- rent market pricing, and other rea- sonable estimates would not signifi- cantly alter the predicted trends. The performance model1 estimates CPU
2014-10-01
equilib- rium condition, exposure of the undrawn and drawn azo- BPA -6FDI-100 material to sequenced irradiation at 0.25 Hz generates signifi cant changes...crossed polarizers, showing green birefringence color. c) Photogenerated stress with sequenced light irradia- tion of undrawn and drawn azo- BPA -6FDI-100
The Enneagram: A Review of the Empirical and Transformational Literature
ERIC Educational Resources Information Center
Bland, Andrew M.
2010-01-01
The enneagram is an ancient system of personality development represented by a symbol signifying 9 character orientations composed of habitual patterns of perception, emotion, and behavior. By exploring their orientation, individuals can identify and transcend the strengths and limitations of their value systems and work toward an integrated…
9 CFR 71.20 - Approval of livestock facilities.
Code of Federal Regulations, 2013 CFR
2013-01-01
... shall signify the class or classes of livestock that the facility will handle.) (14) Cattle and bison: —This facility will handle cattle and bison: [Initials of operator, date] —This facility will handle cattle and bison known to be brucellosis reactors, suspects, or exposed: [Initials of operator, date...
Queering the Homeboy Aesthetic
ERIC Educational Resources Information Center
Rodriguez, Richard T.
2006-01-01
The homeboy aesthetic is identifiable as an assemblage of key signifiers: clothing (baggy pants and undershirts are perhaps the most significant), hair (or, in the current moment of the aesthetic, lack of hair), bold stance, and distinct language (think "calo" mixed with hip-hop parlance), all combining to form a distinguishable cultural…
Cohort Default Rates in Context
ERIC Educational Resources Information Center
Looney, Shannon M.
2011-01-01
Burgeoning student loan debt indicates problems not only for the country's borrowers but also for the postsecondary system. The rise in student loan defaults signifies a rise in institutional cohort default rates (CDRs)--a measure of accountability that informs the government and the general public how well an institution prepares its students for…
76 FR 50218 - Agency Information Collection Activities; Proposed Collection; Comment Request
Federal Register 2010, 2011, 2012, 2013, 2014
2011-08-12
... about the thermal performance characteristics of home insulation products. The R-value of an insulation signifies the insulation's degree of resistance to the flow of heat. This information tells consumers how... the FTC rule on ``Labeling and Advertising of Home Insulation'' (R-value Rule or Rule). That clearance...
Code of Federal Regulations, 2013 CFR
2013-01-01
... convenience the word “cotton” is used to signify vegetable hair removed from cottonseed in the usual process... including the growths sometimes referred to as Upland, Gulf, and Texas cotton, but excluding American Pima growths. (p) Official Cotton Standards. Official Cotton Standards of the United States for the color grade...
Code of Federal Regulations, 2014 CFR
2014-01-01
... convenience the word “cotton” is used to signify vegetable hair removed from cottonseed in the usual process... including the growths sometimes referred to as Upland, Gulf, and Texas cotton, but excluding American Pima growths. (p) Official Cotton Standards. Official Cotton Standards of the United States for the color grade...
Code of Federal Regulations, 2010 CFR
2010-01-01
... convenience the word “cotton” is used to signify vegetable hair removed from cottonseed in the usual process... including the growths sometimes referred to as Upland, Gulf, and Texas cotton, but excluding American Pima growths. (p) Official Cotton Standards. Official Cotton Standards of the United States for the color grade...
Code of Federal Regulations, 2012 CFR
2012-01-01
... convenience the word “cotton” is used to signify vegetable hair removed from cottonseed in the usual process... including the growths sometimes referred to as Upland, Gulf, and Texas cotton, but excluding American Pima growths. (p) Official Cotton Standards. Official Cotton Standards of the United States for the color grade...
Code of Federal Regulations, 2011 CFR
2011-01-01
... convenience the word “cotton” is used to signify vegetable hair removed from cottonseed in the usual process... including the growths sometimes referred to as Upland, Gulf, and Texas cotton, but excluding American Pima growths. (p) Official Cotton Standards. Official Cotton Standards of the United States for the color grade...
Feral, male walleye collected from the Mississippi River below the St. Paul metropolitan sewage treatment plant (STP) contained measurable levels of the estrogen-inducible, female egg protein, vitellogenin. These same fish showed significantly decreased serum androgen and signifi...
From Rupture to Resonance: Uncertainty and Scholarship in Fine Art Research Degrees
ERIC Educational Resources Information Center
Simmons, Beverley; Holbrook, Allyson
2013-01-01
This article focuses on the phenomenon of "rupture" identified in student narratives of uncertainty and scholarship experienced during the course of Fine Art research degrees in two Australian universities. Rupture captures the phenomenon of severe disruption or discontinuity in existing knowledge and typically signifies epistemological…
The Ethics of Interpretation: The Signifying Chain from Field to Analysis
ERIC Educational Resources Information Center
Lapping, Claudia
2008-01-01
This paper attempts to describe the relationship between the embodied practice of fieldwork and the written articulation of this experience. Starting from Valerie Hey's conceptualization of "rapport" as form of "intersubjective synergy", a moment of recognition of similarity within difference--similar in structure to Laclau and Moufffe's…
Discursive Positioning and Emotion in School Mathematics Practices
ERIC Educational Resources Information Center
Evans, Jeff; Morgan, Candia; Tsatsaroni, Anna
2006-01-01
Our approach to emotion in school mathematics draws on social semiotics, pedagogic discourse theory and psychoanalysis. Emotions are considered as socially organised and shaped by power relations; we portray emotion as a charge (of energy) attached to ideas or signifiers. We analyse transcripts from a small group solving problems in mathematics…
The Role of Prediction in the Teaching and Learning of Mathematics
ERIC Educational Resources Information Center
Lim, Kien H.; Buendia, Gabriela; Kim, Ok-Kyeong; Cordero, Francisco; Kasmer, Lisa
2010-01-01
The prevalence of prediction in grade-level expectations in mathematics curriculum standards signifies the importance of the role prediction plays in the teaching and learning of mathematics. In this article, we discuss benefits of using prediction in mathematics classrooms: (1) students' prediction can reveal their conceptions, (2) prediction…
Whatever Happened to Counseling in Counseling Psychology?
ERIC Educational Resources Information Center
Scheel, Michael J.; Berman, Margit; Friedlander, Myrna L.; Conoley, Collie W.; Duan, Changming; Whiston, Susan C.
2011-01-01
A suspected decline in published counseling-related research in "The Counseling Psychologist" ("TCP") and the "Journal of Counseling Psychology" ("JCP") was investigated through content analyses of the two journals from 1979 to 2008. A marked decline in counseling-related research may signify a shift in emphasis away from counseling as the most…
On Symbolic Significance of Characters in "Lord of the Flies"
ERIC Educational Resources Information Center
Li, Xiaofang; Wu, Weihua
2009-01-01
The characters in "Lord of the Flies" possess recognizable symbolic significance, which make them as the sort of people around us. Ralph stands for civilization and democracy; Piggy represents intellect and rationalism; Jack signifies savagery and dictatorship; Simon is the incarnation of goodness and saintliness. All of these…
49 CFR 1242.05 - Operating expense account number notation.
Code of Federal Regulations, 2013 CFR
2013-10-01
... group signifies applicable function assignment. ec03mr91.050 (b) For reporting purposes, four natural..., tools, supplies, fuels and lubricants (account 21-XX-XX); purchased services (accounts 31-XX-XX to 41-XX... account structure. For reporting purposes, the natural expense account numbers represented by “XX” include...
49 CFR 1242.05 - Operating expense account number notation.
Code of Federal Regulations, 2014 CFR
2014-10-01
... group signifies applicable function assignment. ec03mr91.050 (b) For reporting purposes, four natural..., tools, supplies, fuels and lubricants (account 21-XX-XX); purchased services (accounts 31-XX-XX to 41-XX... account structure. For reporting purposes, the natural expense account numbers represented by “XX” include...
49 CFR 1242.05 - Operating expense account number notation.
Code of Federal Regulations, 2012 CFR
2012-10-01
... group signifies applicable function assignment. ec03mr91.050 (b) For reporting purposes, four natural..., tools, supplies, fuels and lubricants (account 21-XX-XX); purchased services (accounts 31-XX-XX to 41-XX... account structure. For reporting purposes, the natural expense account numbers represented by “XX” include...
49 CFR 1242.05 - Operating expense account number notation.
Code of Federal Regulations, 2011 CFR
2011-10-01
... group signifies applicable function assignment. ec03mr91.050 (b) For reporting purposes, four natural..., tools, supplies, fuels and lubricants (account 21-XX-XX); purchased services (accounts 31-XX-XX to 41-XX... account structure. For reporting purposes, the natural expense account numbers represented by “XX” include...
The Paradox of Virtue: (Re)Thinking Deviance, Anorexia and Schooling
ERIC Educational Resources Information Center
Halse, Christine; Honey, Anne; Boughtwood, Desiree
2007-01-01
In this paper we posit a radical retheorization of anorexia as a form of deviance. We examine how the disciplinary practices and moral technologies typical of contemporary secondary schooling signify and enter into the articulation of three "virtue discourses" (discipline, achievement and healthism), and tease out how these "virtue…
Just Click Here: New Technology and Testing.
ERIC Educational Resources Information Center
Cutshall, Sandy
2001-01-01
With increasing emphasis on accurate assessment and accountability, computer-based testing and simulation may signify the future for teachers wishing to keep current on technology in the classroom. If career and technical education is to use new testing technology, features such as authentic assessment and criterion-based testing must be…
Computer Viruses: Prevention, Detection, and Treatment
1990-03-12
executed, also carries out its covert function, potentially undetected. This class of attack earned the term "Trojan horse" from the original of Greek ... mythology , signifying a gift which conceals a malicious purpose. 1 cause harm. The offending code may be present in a code segment the user "touches," which
ERIC Educational Resources Information Center
Kimbrough, Walter M.
2004-01-01
"Paper" was the term created in the late 1980s and early 1990s when Black fraternities and sororities first began to shorten their pledge periods, subsequently abolishing pledging in 1990. Paper signified a person who completed the membership intake process without pledging. Essentially, they followed the rules of the national organization as…
Towards Productive Critique of Large-Scale Comparisons in Education
ERIC Educational Resources Information Center
Gorur, Radhika
2017-01-01
International large-scale assessments and comparisons (ILSAs) in education have become significant policy phenomena. How a country fares in these assessments has come to signify not only how a nation's education system is performing, but also its future prospects in a global economic "race". These assessments provoke passionate arguments…
2006-01-01
molecules18 can mediate an analogous reaction15 that combines the advantages of silica encapsulation with a signifi- cant reduction in cost... Alltech , Deerfield, IL) with a mobile phase of acetonitrile and water (containing 0.05% and 0.1% trifluoroacetic acid, respectively). The concentration
Color Blind or Color Conscious?
ERIC Educational Resources Information Center
Tatum, Beverly Daniel
1999-01-01
A color-blind approach often signifies that an educator has not considered what racial/ethnic identity means to youngsters. Students want to find themselves reflected in the faces of teachers and other students. Color-conscious teachers seek out materials that positively reflect students' identities and initiate discussions about race and racism.…
The poetics of mourning and faith-based intervention in maladaptive grieving processes in Ethiopia.
Hussein, Jeylan Wolyie
2018-08-01
The paper is an inquiry into the poetics of mourning and faith-based intervention in maladaptive grieving processes in Ethiopia. The paper discusses the ways that loss is signified and analyzes the meanings of ethnocultural and psychospiritual practices employed to deal with maladaptive grief processes and their psychological and emotional after-effects. Hermeneutics provided the methodological framework and informed the analysis. The thesis of the paper is that the poetics of mourning and faith-based social interventions are interactionally based meaning making processes. The paper indicates the limitations of the study and their implications for further inquiry.
Tomillero, A; Moral, M A
2010-05-01
O(6)-Benzylguanine; (-)-Gossypol; Abatacept, AC-2592, Adalimumab, AIDSVAX gp120 B/E, Alemtuzumab, Aliskiren fumarate, ALVAC E120TMG, Ambrisentan, Amlodipine, Anakinra, Aripiprazole, Armodafinil, Atomoxetine hydrochloride, Avotermin; Bevacizumab, BIBW-2992, Bortezomib, Bosentan, Botulinum toxin type B; Canakinumab, CAT-354, Ciclesonide, CMV gB vaccine, Corifollitropin alfa, Daptomycin, Darbepoetin alfa, Dasatinib, Denosumab; EndoTAG-1, Eplerenone, Esomeprazole sodium, Eszopiclone, Etoricoxib, Everolimus, Exenatide, Ezetimibe, Ezetimibe/simvastatin; F-50040, Fesoterodine fumavate, Fondaparinux sodium, Fulvestrant; Gabapentin enacarbil, Golimumab; Imatinib mesylate, Inhalable human insulin, Insulin glargine, Ivabradine hydrochloride; Lercanidipine hydrochloride/enalapril maleate, Levosimendan, Liposomal vincristine sulfate, Liraglutide; MDV-3100, Mometasone furoate/formoterol fumavate, Multiepitope CTL peptide vaccine, Mycophenolic acid sodium salt, Nabiximols, Natalizumab, Nesiritide; Obeticholic acid, Olmesartan medoxomil, Omalizumab, Omecamtiv mecarbil; Paclitaxel-eluting stent, Paliperidone, Pegfilgrastim, Peginterferon alfa-2a, Peginterferon alfa-2b, Peginterferon alfa-2b/ ribavirin, Pemetrexed disodium, Polymyxin B nonapeptide, PORxin-302, Prasugrel, Pregabalin, Pridopidine; Ranelic acid distrontium salt, Rasagiline mesilate, rDEN4delta30-4995, Recombinant human relaxin H2, rhFSH, Rilonacept, Rolofylline, Rosiglitazone maleate/metformin hydrochloride, Rosuvastatin calcium, Rotigotine; Salcaprozic acid sodium salt, Sirolimus-eluting stent, Sitagliptin phosphate monohydrate, Sitaxentan sodium, Sorafenib, Sunitinib malate; Tadalafil, Tapentadol hydrochloride, Temsirolimus, Tenofovir, Tenofovir disoproxil fumarate, Teriparatide, Tiotropium bromide, Tocilizumab, Tolvaptan, Tozasertib, Treprostinil sodium; Ustekinumab; Vardenafil hydrochloride hydrate, Varenicline tartrate, Vatalanib succinate, Voriconazole, Vorinostat; Zotarolimus-eluting stent. Copyright 2010 Prous Science, S.A.U. or its licensors. All rights reserved.
Pozzoli, Massimo; Tavazzi, Luigi
2014-04-01
Limited data are available regarding specific differences among countries in demographic and clinical characteristics and treatment of patients with stable coronary artery disease. CLARIFY is an international, prospective and longitudinal registry including more than 33 000 patients with stable coronary artery disease enrolled in 45 countries worldwide. Data were used to compare the characteristics of patients enrolled in Italy with those enrolled in Europe and in the rest of the world. Baseline data were available for 33 283 patients, 2112 of whom from Italy and 12 614 from the remaining western European countries. Italian patients were found to be older, more frequently smoker, hypertensive and with sedentary habits. In addition, they presented more frequently a history of myocardial infarction, carotid arterial disease and chronic obstructive pulmonary disease. In addition, when compared with patients of both European and international cohorts, more Italian patients had undergone coronary angiography and angioplasty. As far as treatment was concerned, a greater number of Italian patients were taking ivabradine, angiotensin-converting enzyme inhibitors and/or angiotensin receptor blockers, nitrates, thienopyridines, while those taking beta-blockers, calcium antagonists and other antianginal medications were fewer. Among ambulatory patients with stable coronary artery disease, there are important geographic differences in terms of risk factors, clinical characteristics, surgical and pharmacological treatment.
Educating Danish School Leaders to Meet New Expectations?
ERIC Educational Resources Information Center
Moos, Lejf
2011-01-01
There is no shared understanding of what school leaders are expected to do. Schools have many external as well as internal stakeholders and each of them has different expectations as to leadership practice. Thus school leadership is a "fluid signifier". This article first outlines external expectations that school leaders are faced with…
Effect of Cultural Distance on Translation of Culture-Bound Texts
ERIC Educational Resources Information Center
Rafieyan, Vahid
2016-01-01
Sociolinguistic and sociocultural features of the source language can be ideally transferred to the target language when the translator's cultural background knowledge has a high overlap with the source language culture. This signifies the crucial role of national cultural distance from the source language society in the quality of translation of…
Rapid Growth of Psychology Programs in Turkey: Undergraduate Curriculum and Structural Challenges
ERIC Educational Resources Information Center
Sümer, Nebi
2016-01-01
Similar to the other developing countries, undergraduate psychology programs in Turkish universities have rapidly grown in the last two decades. Although this sharp increment signifies the need for psychologists, it has also caused a number of challenges for effective teaching of psychology. The department chairs (N = 42) were interviewed with an…
A Descriptive Analysis of a Problem-Based Learning Police Academy
ERIC Educational Resources Information Center
Makin, David A.
2016-01-01
In the 1970s, Egon Bitner offered a critique of police academy training, signified by the ability to train compliant soldier-bureaucrats rather than competent practitioners. Over the years, subsequent training models have been implemented, evaluated, and modified in an attempt to exceed what has been deemed adequate training. This research…
Improved Reading Gate For Vertical-Bloch-Line Memory
NASA Technical Reports Server (NTRS)
Wu, Jiin-Chuan; Stadler, Henry L.; Katti, Romney R.
1994-01-01
Improved design for reading gate of vertical-Bloch-line magnetic-bubble memory increases reliability of discrimination between binary ones and zeros. Magnetic bubbles that signify binary "1" and "0" produced by applying sufficiently large chopping currents to memory stripes. Bubbles then propagated differentially in bubble sorter. Method of discriminating between ones and zeros more reliable.
Symmetry-Driven Atomic Rearrangement at a Brownmillerite-Perovskite Interface
DOE Office of Scientific and Technical Information (OSTI.GOV)
Meyer, Tricia L.; Jeen, Hyoungjeen; Gao, Xiang
2015-12-15
To those investigating new interfacial phenomena, symmetry mismatch is of immense interest. The interfacial and bulk microstructure of the brownmillerite–perovskite interface is probed using detailed transmission electron microscopy. Unique asymmetric displacements of the tetrahedra at the interface are observed, signifying a compensation mechanism for lattice and symmetry mismatch at the interface.
Cued American English: A Variety in the Visual Mode
ERIC Educational Resources Information Center
Portolano, Marlana
2008-01-01
Cued American English (CAE) is a visual variety of English derived from a mode of communication called Cued Speech (CS). CS, or cueing, is a system of communication for use with the deaf, which consists of hand shapes, hand placements, and mouth shapes that signify the phonemic information conventionally conveyed through speech in spoken…
The "Making" of Knowledge Society in Rwanda? Translations, Tensions and Transformations
ERIC Educational Resources Information Center
Knutsson, Beniamin
2012-01-01
In the year 2000, Rwanda launched an ambitious long-term development strategy intended to render a fundamental transformation from an agrarian to a knowledge society by 2020. Knowledge society, however, could be viewed as a "floating signifier" open for a wide range of interpretations. Guided by a policy translation perspective the aim…
Beyond Jefferson: The Rhetoric of Meritocracy and the Funding of Public Education
ERIC Educational Resources Information Center
Nicholson, Barbara
2003-01-01
This article presents an excerpt of a declaration from the United States Department of Education's "Strategic Plan: 2002-2007." The declaration signifies in no uncertain terms that the battle waged by critics of alternative research methods continues, and is likely to intensify. The denigration of research methods which decline to adhere…
Traditional Occupations in a Modern World: Implications for Career Guidance and Livelihood Planning
ERIC Educational Resources Information Center
Ratnam, Anita
2011-01-01
This article is an attempt to examine the place and significance of traditional occupations as careers in today's world. The areas of tension and compatibility between ideas and values that signify modernity and the practice of traditional occupations are reviewed. The meaning of "traditional occupations" is unravelled, the potential that…
Love Me; I Celebrate Diversity
ERIC Educational Resources Information Center
Benton, Thomas H.
2006-01-01
According to this author, by now everyone in America has learned to celebrate diversity. People do so to signify that they are a good person, they are hip, trendy, and "down with the program." He claims, however, that in academe, the word "diversity" still functions as a rhetorical trump card, always uttered with the tonal…
Browne's Capgas Delusion: The Destruction of the Public University
ERIC Educational Resources Information Center
Holligan, Chris; Chiang, Kuang-Hsu
2011-01-01
The recent publication of the UK government's Browne Review 2010 on university and student funding signifies a massive step towards embedding capitalist free-market consumerist values and practices into UK higher education. This paper critically examines that paradigm shift away from public sector provision from the perspective of French Theory,…
ERIC Educational Resources Information Center
Wagle, Udaya R.
2009-01-01
Shifting focus from income to capability signifies an important milestone toward accurately measuring poverty and deprivation. This paper operationalizes capability deprivation in the United States and compares measurement outcomes among various capability approaches and between capability and income spaces. Of the three capability approaches…
Current Status, Planning and Prospects of the 1202 State Postsecondary Commissions.
ERIC Educational Resources Information Center
Fenske, Robert H., Ed.; Romesburg, Kerry D., Ed.
With the passage of the Education Amendments of 1972, the Congress of the United States introduced to the nation's educators a new academic and educational environment. Included in those amendments, under Title XII, General Provisions, was Section 1202 pertaining to the establishment of state postsecondary education commissions, signifying an…
ERIC Educational Resources Information Center
Franco, Antonia O.
2012-01-01
National and state education reforms are centered on developing higher academic expectations and standards to ensure students transitions into postsecondary options, college and career ready. What does this national emphasis signify for urban school districts that are educating a significant proportion of first-generation students and that…
Novel Functional Extended Solids at Extreme Conditions
2013-02-01
XeF8 polyhedron with a Xe-F distance 2.3 (±.1) Å - well below the metallization pressure of Xe [2,3] and F2 [4]. These findings signify...for explosives modeling and is expected to be incorporated into the explosive database such as Cheetah, etc., and (v) training graduate students and
13th Annual School Construction Report, 2008
ERIC Educational Resources Information Center
Abramson, Paul
2008-01-01
School construction completed in 2007--including new buildings, additions to existing buildings, and major retrofit of existing buildings--totaled almost $20.8B, a signifi cant increase over the $20.1B spent on construction completed in 2006. This marks the seventh year in the last eight that annual construction exceeded $20B. During the eight…
Contested Cultural Spaces: Exploring Illicit Drug-Using through "Trainspotting"
ERIC Educational Resources Information Center
Hemingway, Judy
2006-01-01
Contending that culture is one of the most potentially divisive signifiers of human activity, this paper probes some of the complexities that attend the (un)popular culture of illicit drug-using with which many young people in contemporary Britain are identified. Irvine Welsh's multi-media drugs narrative "Trainspotting" is drawn on to…
Student-Privacy Rules Show a Renewed Trust in Colleges
ERIC Educational Resources Information Center
Lake, Peter
2009-01-01
New regulations for the Family Rights and Privacy Act (Ferpa), which governs the privacy of student records, become effective this month. Announced by the Department of Education in December 2008, the regulations empower colleges to act appropriately and decisively to protect the health and safety of students and others. They also signify a new…
"There Are Other Ways To Get Happy": African American Urban Folklore. Working Papers #2.
ERIC Educational Resources Information Center
McGregory, Jerrilyn
"There are other ways to get happy," the slogan signifying "Say no to drugs!" is gaining attention within the African American community in the Philadelphia (Pennsylvania) area. "There are other ways to get happy" comes from learning about and understanding traditional elements of African American folklore. For those…
ERIC Educational Resources Information Center
Schulz, Samantha
2017-01-01
Distinct from rurality, the Australian desert has long functioned as a signifier of remoteness in the dominant imagination; a product of spatialised binary relations between "progressive" (white) mainstream or idealised white countryside, and disordered/dangerous Aboriginal periphery. Remoteness constitutes a complex racial dynamic that…
Icon and Idea: A Symbolic Reading of Pictures in a Peruvian Indian Chronicle.
ERIC Educational Resources Information Center
Adorno, Rolena
1979-01-01
An examination and categorization of over 400 full-page drawings in the 1615 "Nueva coronica y bien gobierno" of Felipe Guaman Poma de Alaya, which details life in the Peruvian Viceroyalty. Explains the function of the illustrations in the text and that of five "signifying attributes" of spatial configuration. (SB)
Nullifying Quality: The Marketisation of Higher Education
ERIC Educational Resources Information Center
Bendixen, Carsten; Jacobsen, Jens Christian
2017-01-01
The increasing dominance of educational markets means that quality of higher education has the character of open signifiers of periodic occurrence, embedded institutionally as ways of consensual communication on how to go on as smoothly as possible. This promotes the growth of context dependent and local interpretations of how to meet in agreement…
The Changing Market Structure of Local Television News.
ERIC Educational Resources Information Center
Powers, Angela
The growth in competition for revenues, along with the advent of cable, independent television and video cassette recorders (VCR), may signify a change in the market structure of local television news. To explain if and how this change may be occurring, an explanation of economic theory as well as evidence from "Broadcast and Cable…
"Inculcating" Creativity: Culture as Public Pedagogy in Singapore
ERIC Educational Resources Information Center
Lee, Terence
2014-01-01
The Singapore government has long relied on the inherent public pedagogical qualities of culture in the forms of official cultural and media policies and in the unscripted signifiers of cultural conduct, such as in the public's attitude towards the arts. The prime objective is to instrumentalise citizens on how they should become both economically…
Shake for Sigma, Pray for Pi: Classroom Orbital Overlap Analogies
ERIC Educational Resources Information Center
Dicks, Andrew P.
2011-01-01
An introductory organic classroom demonstration is discussed where analogies are made between common societal hand contact and covalent bond formation. A handshake signifies creation of a [sigma] bond ("head-on" orbital overlap), whereas the action of praying illustrates "sideways" overlap and generation of a [pi] bond. The nature of orbital and…
20 CFR 411.120 - What is a ticket under the Ticket to Work program?
Code of Federal Regulations, 2010 CFR
2010-04-01
... program? 411.120 Section 411.120 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND... employment services, vocational rehabilitation services, and other support services to the beneficiary. (b... social security number, the letters “TW,” and a number (1, 2, etc.) in the last position signifying that...
Outward Bound Giwaykiwin: Connecting to Land and Culture through Indigenous Outdoor Education
ERIC Educational Resources Information Center
Lowan, Greg
2007-01-01
Outward Bound Canada's (OBC) Giwaykiwin Program was founded in 1985 in response to a recognized need for programming specific to students from Indigenous backgrounds. The Giwaykiwin program aims to integrate Outward Bound (OB) and Indigenous philosophies and traditions. Giwaykiwin means "coming home" in Ojibwa and signifies the program's…
The School Administrator's World of Predetermined Meaning.
ERIC Educational Resources Information Center
Wake, Andrew
1979-01-01
This paper presents a view of the principalship as it is subjectively perceived by the principal. The role is constrained by a number of factors. One of these is the principal's private office that both signifies and produces the principal's unique status and position. One of the principal's primary obligations is to maintain the social structure…
Managing Emotional Manhood: Fighting and Fostering Fear in Mixed Martial Arts
ERIC Educational Resources Information Center
Vaccaro, Christian A.; Schrock, Douglas P.; McCabe, Janice M.
2011-01-01
Based on two years of fieldwork and over 100 interviews, we analyze mixed martial arts fighters' fears, how they managed them, and how they adopted intimidating personas to evoke fear in opponents. We conceptualize this process as "managing emotional manhood," which refers to emotion management that signifies, in the dramaturgical sense, masculine…
Integrating Metrics across the Marketing Curriculum: The Digital and Social Media Opportunity
ERIC Educational Resources Information Center
Spiller, Lisa; Tuten, Tracy
2015-01-01
Modern digital and social media formats have revolutionized marketing measurement, producing an abundance of data, meaningful metrics, new tools, and methodologies. This increased emphasis on metrics in the marketing industry signifies the need for increased quantitative and critical thinking content in our marketing coursework if we are to…
ERIC Educational Resources Information Center
Thompson, Julia D.; Jesiek, Brent K.
2017-01-01
This paper examines how the structural features of engineering engagement programs (EEPs) are related to the nature of their service-learning partnerships. "Structure" refers to formal and informal models, processes, and operations adopted or used to describe engagement programs, while "nature" signifies the quality of…
ERIC Educational Resources Information Center
Nieuwenhuys, Olga
2011-01-01
One of the most perplexing aspects of global childhood is how its material culture emerges, circulates, takes on hegemonic traits and becomes contested. Though debates around the impact and nature of globalization have tended to take such artefacts as McDonald's hamburgers and the Islamic veil as signifiers of the possible emergence of a global…
Connoisseurship in an Age of Distractions
ERIC Educational Resources Information Center
Hope, Samuel
2002-01-01
Today, "connoisseurship" conjures up images of fusty old men in tweeds arguing over ancient etchings or perhaps the patter of opera buffs as they pass bejeweled into the night. Connoisseurship is neither fashionable nor politically correct. It signifies a focus on works of art rather than issues of power and is foreign to a cultural…
Did You Know – Transactive Energy Provides the Next Big Step in DER Integration
DOE Office of Scientific and Technical Information (OSTI.GOV)
McDermott, Thomas E.
This is an invited blog article for the Utility Variable Generation Integration Group (UVIG) on the topic of distributed energy resource (DER) integration. Summarizes DER progress since 2004, which signifies a maturing industry. Proposes transactive energy as a means of integrating more DER without special incentives or mitigation techniques.
ERIC Educational Resources Information Center
Magiolino, Lavinia Lopes Salomao; Smolka, Ana Luiza Bustamante
2013-01-01
In this article, we discuss contributions from contemporary authors toward understanding a complex topic: human emotions. We comment on these authors' ideas and describe their ways of talking about emotions in relation to language, consciousness, meaning, and psychological instruments. After considering the distinct contributions of these authors,…
Taking Charge of Your Career Path: A Future Trend of the Workforce
ERIC Educational Resources Information Center
DiMattina, Cara; Ferris, Lisa-Anne
2013-01-01
Workplace trends portray relevant information regarding the present and future of the workforce and its members. These trends signify changes within the workplace regarding performance, retention, satisfaction and many other areas that affect the individual employee, as well as the organization and industry as a whole. Trends can be seen in…
Adhi, Mehreen; Semy, Salim K; Stein, David W; Potter, Daniel M; Kuklinski, Walter S; Sleeper, Harry A; Duker, Jay S; Waheed, Nadia K
2016-05-01
To present novel software algorithms applied to spectral-domain optical coherence tomography (SD-OCT) for automated detection of diabetic retinopathy (DR). Thirty-one diabetic patients (44 eyes) and 18 healthy, nondiabetic controls (20 eyes) who underwent volumetric SD-OCT imaging and fundus photography were retrospectively identified. A retina specialist independently graded DR stage. Trained automated software generated a retinal thickness score signifying macular edema and a cluster score signifying microaneurysms and/or hard exudates for each volumetric SD-OCT. Of 44 diabetic eyes, 38 had DR and six eyes did not have DR. Leave-one-out cross-validation using a linear discriminant at missed detection/false alarm ratio of 3.00 computed software sensitivity and specificity of 92% and 69%, respectively, for DR detection when compared to clinical assessment. Novel software algorithms applied to commercially available SD-OCT can successfully detect DR and may have potential as a viable screening tool for DR in future. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:410-417.]. Copyright 2016, SLACK Incorporated.
NASA Technical Reports Server (NTRS)
Vedantam, NandaKishore; Parthasarathy, Ramkumar N.
2004-01-01
The effects of the mean velocity profiles on the instability characteristics in the near-injector region of axisymmetric low density gas jets injected vertically upwards into a high-density gas medium were investigated using linear inviscid stability analysis. The flow was assumed to be isothermal and locally parallel. Three velocity profiles, signifying different changes in the mean velocity in the shear layer, were used in the analysis. The effects of the inhomogeneous shear layer and the Froude number (signifying the effects of gravity) on the instability for each set of mean profiles were delineated. At a large Froude number (negligible gravity), a critical density ratio was found for the three profiles at which the jet became absolutely unstable. The critical density ratio for each velocity profile was increased as the Froude number was reduced. A critical Froude number was found for the three sets of profiles, below which the jet was absolutely unstable for all the density ratios less than unity, which demarcated the jet flow into the momentum-driven regime and the buoyancy-driven regime.
Transformation of OODT CAS to Perform Larger Tasks
NASA Technical Reports Server (NTRS)
Mattmann, Chris; Freeborn, Dana; Crichton, Daniel; Hughes, John; Ramirez, Paul; Hardman, Sean; Woollard, David; Kelly, Sean
2008-01-01
A computer program denoted OODT CAS has been transformed to enable performance of larger tasks that involve greatly increased data volumes and increasingly intensive processing of data on heterogeneous, geographically dispersed computers. Prior to the transformation, OODT CAS (also alternatively denoted, simply, 'CAS') [wherein 'OODT' signifies 'Object-Oriented Data Technology' and 'CAS' signifies 'Catalog and Archive Service'] was a proven software component used to manage scientific data from spaceflight missions. In the transformation, CAS was split into two separate components representing its canonical capabilities: file management and workflow management. In addition, CAS was augmented by addition of a resource-management component. This third component enables CAS to manage heterogeneous computing by use of diverse resources, including high-performance clusters of computers, commodity computing hardware, and grid computing infrastructures. CAS is now more easily maintainable, evolvable, and reusable. These components can be used separately or, taking advantage of synergies, can be used together. Other elements of the transformation included addition of a separate Web presentation layer that supports distribution of data products via Really Simple Syndication (RSS) feeds, and provision for full Resource Description Framework (RDF) exports of metadata.
Reproducing normative and marginalized masculinities: adolescent male popularity and the outcast.
Phillips, Debby A
2005-09-01
Every day, in professional work and in our personal lives, we reproduce by words and behaviors particular understandings of life and how it works. This includes understandings about what is 'normal' and 'not normal' masculinity and who are 'normal' and 'not normal' boys and men. Being marginalized or outcast from the norm is rarely a free choice. The language that constructs normal and abnormal is not innocent and does not simply arrive in our minds transparently reflected in our behavior or in our client advice or student education. Examining words and behaviors from adolescent boys and from media sources, this research explores the role of cultural discourses in producing normative and marginalized masculinities. It builds upon recent scholarship that questions cultural prescriptions for masculinity and traditional male norms. Feminist, poststructural, psychoanalytic discourse analysis and multiple methods were used to explore links between cultural discourses of masculinity and performativity of masculinity. Practices of heterosexuality, homophobia, athleticism, economic privilege, toughness, and violence provided pathways toward achieving and/or maintaining status as the hegemonic masculine norm in adolescence. 'Popularity' signified the norm and 'outcasts' from the norm signified marginalized masculinities.
NASA Astrophysics Data System (ADS)
Srivastava, Anurag; SanthiBhushan, Boddepalli
2018-03-01
Defects are inevitable most of the times either at the synthesis, handling or processing stage of graphene, causes significant deviation of properties. The present work discusses the influence of vacancy defects on the quantum capacitance as well as thermodynamic stability of graphene, and the nitrogen doping pattern needs to be followed to attain a trade-off between these two. Density Functional Theory (DFT) calculations have been performed to analyze various vacancy defects and different possible nitrogen doping patterns at the vacancy site of graphene, with an implication for supercapacitor electrodes. The results signify that vacancy defect improves the quantum capacitance of graphene at the cost of thermodynamic stability, while the nitrogen functionalization at the vacancy improves thermodynamic stability and quantum capacitance both. It has been observed that functionalizing all the dangling carbons at the defect site with nitrogen is the key to attain high thermodynamic stability as well as quantum capacitance. Furthermore, the results signify the suitability of these functionalized graphenes for anode electrode of high energy density asymmetric supercapacitors.
Knudson, Inge M; Melcher, Jennifer R
2016-06-01
Increases in the acoustic startle response (ASR) of animals have been reported following experimental manipulations to induce tinnitus, an auditory disorder defined by phantom perception of sound. The increases in ASR have been proposed to signify the development of hyperacusis, a clinical condition defined by intolerance of normally tolerable sound levels. To test this proposal, the present study compared ASR amplitude to measures of sound-level tolerance (SLT) in humans, the only species in which SLT can be directly assessed. Participants had clinically normal/near-normal hearing thresholds, were free of psychotropic medications, and comprised people with tinnitus and without. ASR was measured as eyeblink-related electromyographic activity in response to a noise pulse presented at a range of levels and in two background conditions (noise and quiet). SLT was measured as loudness discomfort level (LDL), the lowest level of sound deemed uncomfortable, and via a questionnaire on the loudness of sounds in everyday life. Regardless of tinnitus status, ASR amplitude at a given stimulus level increased with decreasing LDL, but showed no relationship to SLT self-reported via the questionnaire. These relationships (or lack thereof) could not be attributed to hearing threshold, age, anxiety, or depression. The results imply that increases in ASR in the animal work signify decreases in LDL specifically and may not correspond to the development of hyperacusis as would be self-reported by a clinic patient.
Universal characteristics of fractal fluctuations in prime number distribution
NASA Astrophysics Data System (ADS)
Selvam, A. M.
2014-11-01
The frequency of occurrence of prime numbers at unit number spacing intervals exhibits self-similar fractal fluctuations concomitant with inverse power law form for power spectrum generic to dynamical systems in nature such as fluid flows, stock market fluctuations and population dynamics. The physics of long-range correlations exhibited by fractals is not yet identified. A recently developed general systems theory visualizes the eddy continuum underlying fractals to result from the growth of large eddies as the integrated mean of enclosed small scale eddies, thereby generating a hierarchy of eddy circulations or an inter-connected network with associated long-range correlations. The model predictions are as follows: (1) The probability distribution and power spectrum of fractals follow the same inverse power law which is a function of the golden mean. The predicted inverse power law distribution is very close to the statistical normal distribution for fluctuations within two standard deviations from the mean of the distribution. (2) Fractals signify quantum-like chaos since variance spectrum represents probability density distribution, a characteristic of quantum systems such as electron or photon. (3) Fractal fluctuations of frequency distribution of prime numbers signify spontaneous organization of underlying continuum number field into the ordered pattern of the quasiperiodic Penrose tiling pattern. The model predictions are in agreement with the probability distributions and power spectra for different sets of frequency of occurrence of prime numbers at unit number interval for successive 1000 numbers. Prime numbers in the first 10 million numbers were used for the study.
Effect of topical cyclopentolate on post-operative pain after pterygium surgery.
Goktas, Sertan; Sakarya, Yasar; Ozcimen, Muammer; Sakarya, Rabia; Alpfidan, Ismail; Ivacık, Ismail Senol; Erdogan, Erkan
2017-11-01
The aim was to evaluate the effectiveness of topical cyclopentolate following pterygium surgery for post-operative ocular pain. All participants had nasal pterygium and underwent pterygium excision and conjunctival autografting with fibrin glue. Participants were randomised into two groups. Participants in group 1 received one per cent cyclopentolate eye drops and artificial tears upon completing surgery and were prescribed self-administered drops three times daily for three days, while participants in group 2 received a control (artificial tears) in a manner identical to group 1. Data were gathered regarding post-operative pain intensity experienced during each of the three days. Pain was graded from zero to 10 according to a visual analogue scale, in which zero signified no pain and 10 signified severe, unbearable pain. This study analysed data regarding 38 participants in group 1 and 40 participants in group 2. Results were defined as median with interquartile range (IQR); median of the pain scores at days one, two and three were as follows, respectively: 4 (IQR 2), 2.5 (IQR 1) and 2 (IQR 1.25) for group 1 and 5 (IQR 1), 3 (IQR 1.75) and 3 (IQR 1) for group 2. Pain scores were significantly lower for group 1 compared with group 2 at days one, two and three (p < 0.05). Topical cyclopentolate seems to be effective and well tolerated following pterygium surgery for post-operative ocular pain. © 2017 Optometry Australia.
Spaeth, George L.; Monteiro de Barros, Daniela S.; Gheith, Moataz; Siam, Ghada Ali; Nagarsheth, Mehul
2007-01-01
Purpose To get an idea of whether the issue of what makes people healthier is studied in ophthalmology by determining the proportion of articles dealing with that subject. Methods Prospective review of all articles published in 3 consecutive issues of 7 peer-reviewed ophthalmology journals, using a grading system in which A signified an article that clearly dealt with a subject expected to have an impact on health or quality of life, or that considered health or quality of life itself directly; B indicated an article similar to A, but not directly concerned with the issue of health; C signified an article similar to B but more distantly related to health or quality of life; and D was the grade given when there was no relationship at all to health or quality of life. Grading was done independently by 3 graders. A literature review on the subject was also performed. Results Thirty-three articles received a grade of A, 229 of B, 740 of C, and 81 of D. There were more articles that had no relationship at all to health or quality of life than there were articles dealing directly with those issues. Conclusions On the basis of a review of the literature and of over 1000 articles, ophthalmologists do not appear to give much priority to issues of quality of life or health. How validly these conclusions can be generalized to general clinicians is not known. PMID:18427612
Lacan’s Construction and Deconstruction of the Double-Mirror Device
Vanheule, Stijn
2011-01-01
In the 1950s Jacques Lacan developed a set-up with a concave mirror and a plane mirror, based on which he described the nature of human identification. He also formulated ideas on how psychoanalysis, qua clinical practice, responds to identification. In this paper Lacan’s schema of the two mirrors is described in detail and the theoretical line of reasoning he aimed to articulate with aid of this spatial model is discussed. It is argued that Lacan developed his double-mirror device to clarify the relationship between the drive, the ego, the ideal ego, the ego-ideal, the other, and the Other. This model helped Lacan describe the dynamics of identification and explain how psychoanalytic treatment works. He argued that by working with free association, psychoanalysis aims to articulate unconscious desire, and bypass the tendency of the ego for misrecognition. The reasons why Lacan stressed the limits of his double-mirror model and no longer considered it useful from the early 1960s onward are examined. It is argued that his concept of the gaze, which he qualifies as a so-called “object a,” prompted Lacan move away from his double-mirror set-up. In those years Lacan gradually began to study the tension between drive and signifier. The schema of the two mirrors, by contrast, focused on the tension between image and signifier, and missed the point Lacan aimed to address in this new era of his work. PMID:21949511
The effect of progesterone and 17-β estradiol on membrane-bound HLA-G in adipose derived stem cells.
Moslehi, Akram; Hashemi-Beni, Batool; Moslehi, Azam; Akbari, Maryam Ali; Adib, Minoo
2016-07-01
Membrane-bound HLA-G (mHLA-G) discovery on adipose derived stem cells (ADSCs) as a tolerogenic and immunosuppressive molecule was very important. Many documents have shown that HLA-G expression can be controlled via some hormones such as progesterone (P4) and estradiol (E2). Therefore, this study was designed to evaluate progesterone and estradiol effects on mHLA-G in ADSCs at restricted and combination concentrations. Three independent cell lines were cultured in complete free phenol red DMEM and subcultured to achieve suffi cient cells. These cells were treated with P4, E2 and P4 plus E2 at physiologic and pregnancy concentrations for 3 days in cell culture conditions. The HLA-G positive ADSCs was measured via monoclonal anti HLA-G-FITC/MEMG-09 by means of flow cytometry in nine groups. Data were analyzed by one way ANOVA and Tukey's post hoc tests. There were no signifi cant values of the mean percentage of HLA-G positive cells in E2-treated and the combination of P4 plus E2-treated ADSCs compared to control cells (p value>0.05) but P4 had a signifi cant increase on mHLA-G in ADSCs (p value<0.05). High P4 concentration increased mHLA-G but E2 and the combination of P4 plus E2 could not change mHLA-G on ADSCs.
The effect of progesterone and 17-β estradiol on membrane-bound HLA-G in adipose derived stem cells
Moslehi, Akram; Hashemi-beni, Batool; Moslehi, Azam; Akbari, Maryam Ali
2016-01-01
Membrane-bound HLA-G (mHLA-G) discovery on adipose derived stem cells (ADSCs) as a tolerogenic and immunosuppressive molecule was very important. Many documents have shown that HLA-G expression can be controlled via some hormones such as progesterone (P4) and estradiol (E2). Therefore, this study was designed to evaluate progesterone and estradiol effects on mHLA-G in ADSCs at restricted and combination concentrations. Three independent cell lines were cultured in complete free phenol red DMEM and subcultured to achieve suffi cient cells. These cells were treated with P4, E2 and P4 plus E2 at physiologic and pregnancy concentrations for 3 days in cell culture conditions. The HLA-G positive ADSCs was measured via monoclonal anti HLA-G-FITC/MEMG-09 by means of flow cytometry in nine groups. Data were analyzed by one way ANOVA and Tukey's post hoc tests. There were no signifi cant values of the mean percentage of HLA-G positive cells in E2-treated and the combination of P4 plus E2-treated ADSCs compared to control cells (p value>0.05) but P4 had a signifi cant increase on mHLA-G in ADSCs (p value<0.05). High P4 concentration increased mHLA-G but E2 and the combination of P4 plus E2 could not change mHLA-G on ADSCs. PMID:27382350
NASA Astrophysics Data System (ADS)
Majari Kasmaee, L.; Gobal, F.
Electrochemical oxidation of L-ascorbic acid on polycrystalline silver in alkaline aqueous solutions is studied by cyclic voltammetry (CV), chronoamperometry (CA) and impedance spectroscopy (IS). The anodic electro-oxidation starts at -500 mV versus SCE and shows continued anodic oxidation in the cathodic half cycle in the CV regime signifying slowly oxidizing adsorbates. Diffusion coefficient of ascorbate ion measured under both voltammetric regimes is around 1.4 × 10 -5 cm 2 s -1. Impedance spectroscopy measures the capacitances associated with double layer and adsorption around 50 μF cm -2 and 4 mF cm -2 as well as the adsorption and decomposition resistances (rates).
Detailed α -decay study of 180Tl
NASA Astrophysics Data System (ADS)
Andel, B.; Andreyev, A. N.; Antalic, S.; Barzakh, A.; Bree, N.; Cocolios, T. E.; Comas, V. F.; Diriken, J.; Elseviers, J.; Fedorov, D. V.; Fedosseev, V. N.; Franchoo, S.; Ghys, L.; Heredia, J. A.; Huyse, M.; Ivanov, O.; Köster, U.; Liberati, V.; Marsh, B. A.; Nishio, K.; Page, R. D.; Patronis, N.; Seliverstov, M. D.; Tsekhanovich, I.; Van den Bergh, P.; Van De Walle, J.; Van Duppen, P.; Venhart, M.; Vermote, S.; Veselský, M.; Wagemans, C.
2017-11-01
A detailed α -decay spectroscopy study of 180Tl has been performed at ISOLDE (CERN). Z -selective ionization by the Resonance Ionization Laser Ion Source (RILIS) coupled to mass separation provided a high-purity beam of 180Tl. Fine-structure α decays to excited levels in the daughter 176Au were identified and an α -decay scheme of 180Tl was constructed based on an analysis of α -γ and α -γ -γ coincidences. Multipolarities of several γ -ray transitions deexciting levels in 176Au were determined. Based on the analysis of reduced α -decay widths, it was found that all α decays are hindered, which signifies a change of configuration between the parent and all daughter states.
What is open peer review? A systematic review
Ross-Hellauer, Tony
2017-01-01
Background: “Open peer review” (OPR), despite being a major pillar of Open Science, has neither a standardized definition nor an agreed schema of its features and implementations. The literature reflects this, with numerous overlapping and contradictory definitions. While for some the term refers to peer review where the identities of both author and reviewer are disclosed to each other, for others it signifies systems where reviewer reports are published alongside articles. For others it signifies both of these conditions, and for yet others it describes systems where not only “invited experts” are able to comment. For still others, it includes a variety of combinations of these and other novel methods. Methods: Recognising the absence of a consensus view on what open peer review is, this article undertakes a systematic review of definitions of “open peer review” or “open review”, to create a corpus of 122 definitions. These definitions are systematically analysed to build a coherent typology of the various innovations in peer review signified by the term, and hence provide the precise technical definition currently lacking. Results: This quantifiable data yields rich information on the range and extent of differing definitions over time and by broad subject area. Quantifying definitions in this way allows us to accurately portray exactly how ambiguously the phrase “open peer review” has been used thus far, for the literature offers 22 distinct configurations of seven traits, effectively meaning that there are 22 different definitions of OPR in the literature reviewed. Conclusions: I propose a pragmatic definition of open peer review as an umbrella term for a number of overlapping ways that peer review models can be adapted in line with the aims of Open Science, including making reviewer and author identities open, publishing review reports and enabling greater participation in the peer review process. PMID:28580134
A spiral model of musical decision-making.
Bangert, Daniel; Schubert, Emery; Fabian, Dorottya
2014-01-01
This paper describes a model of how musicians make decisions about performing notated music. The model builds on psychological theories of decision-making and was developed from empirical studies of Western art music performance that aimed to identify intuitive and deliberate processes of decision-making, a distinction consistent with dual-process theories of cognition. The model proposes that the proportion of intuitive (Type 1) and deliberate (Type 2) decision-making processes changes with increasing expertise and conceptualizes this change as movement along a continually narrowing upward spiral where the primary axis signifies principal decision-making type and the vertical axis marks level of expertise. The model is intended to have implications for the development of expertise as described in two main phases. The first is movement from a primarily intuitive approach in the early stages of learning toward greater deliberation as analytical techniques are applied during practice. The second phase occurs as deliberate decisions gradually become automatic (procedural), increasing the role of intuitive processes. As a performer examines more issues or reconsiders decisions, the spiral motion toward the deliberate side and back to the intuitive is repeated indefinitely. With increasing expertise, the spiral tightens to signify greater control over decision type selection. The model draws on existing theories, particularly Evans' (2011) Intervention Model of dual-process theories, Cognitive Continuum Theory Hammond et al. (1987), Hammond (2007), Baylor's (2001) U-shaped model for the development of intuition by level of expertise. By theorizing how musical decision-making operates over time and with increasing expertise, this model could be used as a framework for future research in music performance studies and performance science more generally.
A spiral model of musical decision-making
Bangert, Daniel; Schubert, Emery; Fabian, Dorottya
2014-01-01
This paper describes a model of how musicians make decisions about performing notated music. The model builds on psychological theories of decision-making and was developed from empirical studies of Western art music performance that aimed to identify intuitive and deliberate processes of decision-making, a distinction consistent with dual-process theories of cognition. The model proposes that the proportion of intuitive (Type 1) and deliberate (Type 2) decision-making processes changes with increasing expertise and conceptualizes this change as movement along a continually narrowing upward spiral where the primary axis signifies principal decision-making type and the vertical axis marks level of expertise. The model is intended to have implications for the development of expertise as described in two main phases. The first is movement from a primarily intuitive approach in the early stages of learning toward greater deliberation as analytical techniques are applied during practice. The second phase occurs as deliberate decisions gradually become automatic (procedural), increasing the role of intuitive processes. As a performer examines more issues or reconsiders decisions, the spiral motion toward the deliberate side and back to the intuitive is repeated indefinitely. With increasing expertise, the spiral tightens to signify greater control over decision type selection. The model draws on existing theories, particularly Evans’ (2011) Intervention Model of dual-process theories, Cognitive Continuum Theory Hammond et al. (1987), Hammond (2007), Baylor’s (2001) U-shaped model for the development of intuition by level of expertise. By theorizing how musical decision-making operates over time and with increasing expertise, this model could be used as a framework for future research in music performance studies and performance science more generally. PMID:24795673
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hahn, M.; Walton, R.
2007-01-01
Common wood-nymph butterfl ies are found throughout the United States and Canada. However, not much is known about how they overwinter or their preferences for particular grasses and habitats. In this study, the impact of prairie management plans on the abundance of the wood-nymph population was assessed, as well as the preference of these butterfl ies for areas with native or non-native grasses. The abundance of common wood-nymph butterfl ies was determined using Pollard walks; more common wood-nymph butterfl ies were found in the European grasses than were found in the burned and unburned prairie sites. The majority of themore » vegetation at each of the three sites was identifi ed and documented. Using a 1 X 3 ANOVA analysis, it was determined there were signifi cantly more butterfl ies in the European grasses than in the burned and unburned prairie sites (p < 0.0005). There was no signifi cant difference between the burned and unburned treatments of the prairie on the common wood-nymph population. A multiple variable linear regression model described the effect of temperature and wind speed on the number of observed common wood-nymph butterfl ies per hour (p = 0.026). These preliminary results need to be supplemented with future studies. Quadrat analysis of the vegetation from all three sites should be done to search for a correlation between common wood-nymph butterfl y abundance per hour and the specifi c types or quantity of vegetation at each site. The effect of vegetation height and density on the observer’s visual fi eld should also be assessed.« less
NASA Astrophysics Data System (ADS)
Ukpai, Stephen N.; Ezeh, Hilary N.; Igwe, James O.
2017-11-01
Two typical aquifer systems, namely, regional aquifer and local Perched aquifer have been delineated in the study area. The regional aquifer was identified at about 100 m depth around lowland areas, although prone to polluting effects from farming activities, erosion and weathering processes. This study investigated extents of groundwater pollution and permeability of the aquifers from water sample and grain size analyses. Results show porosity ranging from 49 to 50% and hydraulic conductivities as follows: 7.0 m/day for the sandstone of Nsukka Formation, 34.6 m/day for the outcrop of Ajali sandstone and 10.4 m/day for the sandstone at saturated subsurface zone with transmissivity of about 572 m2/day. The results signify that the regional aquifer is recharged by substantial rate of infiltrations vis-a-vis surface outcrops, and is therefore vulnerable to infiltration of pollution plumes. The groundwater is mainly acidic at pH ranging from 5.05 to 7.41 with a mean value of about 6.48, hence the pollution from dissolved iron in many places. Three main water types were identified, namely, Ca-Mg-HCO3, Ca-HCO3-Cl2 and Mg-Na-HCO3-SO4-Cl2 facies, all signifying dominance of groundwater species arising from precipitation recharge. This has resulted in the influences of surface effluents from run off as indicated by nitrate pollution in some areas. Thus, active hydrologic cycle controls the chemical facies in the water resources of the region, and with its hydraulic influence on the landscape, the quality status of groundwater, as well as the growth of agricultural products have been impaired.
"Consuming Children." Reading the Impacts of Tourism in the City of Banaras
ERIC Educational Resources Information Center
Huberman, Jenny
2005-01-01
What makes corrupt children such efficacious or nodal symbols? How and why is it that certain groups of children take on this signifying function? How do narratives about corrupt children provide people with a way of mediating and articulating more general anxieties about social change or rupture? This article begins to explore these questions by…
The Overselling of Higher Education
ERIC Educational Resources Information Center
Leef, George C.
2006-01-01
There is not enough substance behind a degree to warrant the ubiquitous belief that a stint in higher education is a "sine qua non" for success in America. While college diplomas may translate into higher-paying jobs for some, high school signifies little in the way of education these days, so jaded employers' estimates of the real value of…
Cleansing the Superdome: The Paradox of Purity and Post-Katrina Guilt
ERIC Educational Resources Information Center
Grano, Daniel A.; Zagacki, Kenneth S.
2011-01-01
The reopening of the New Orleans Superdome after Hurricane Katrina on Monday Night Football dramatized problematic rhetorical, visual, and spatial norms of purification rituals bound up in what Burke calls the paradox of purity. Hurricane Katrina was significant as a visually traumatic event in large part because it signified the ghetto as a…
Improved Usability of Locomotion Devices Using Human-Centric Taxonomy
2009-03-01
the muscle fibers to which they are attached. Our muscles work mainly in antagonistic pairs, with one muscle contracting and its antagonist...skeletal system by the muscles signifies a conversion of electrochemical energy into physical energy, and thus, constitutes the commencement of the...Function of antagonistic pairs in muscles ........................................... 22 Figure 10. Physical interaction between right leg and
ERIC Educational Resources Information Center
Chou, Yeh-Tai; Wang, Wen-Chung
2010-01-01
Dimensionality is an important assumption in item response theory (IRT). Principal component analysis on standardized residuals has been used to check dimensionality, especially under the family of Rasch models. It has been suggested that an eigenvalue greater than 1.5 for the first eigenvalue signifies a violation of unidimensionality when there…
Bullying Gets Digital Shot-in-the-Arm
ERIC Educational Resources Information Center
Froese-Germain, Bernie
2008-01-01
Online bullying or cyberbullying is one of the changes spawned by the Internet and social networking sites. Sometimes described as "old wine in a new bottle" (to signify a new form of bullying), it is one of those phenomena that has left educators--and just about everyone else--scrambling. In this article, the author details the expanding trend of…
Value Driven Information Processing and Fusion
2016-03-01
consensus approach allows a decentralized approach to achieve the optimal error exponent of the centralized counterpart, a conclusion that is signifi...SECURITY CLASSIFICATION OF: The objective of the project is to develop a general framework for value driven decentralized information processing...including: optimal data reduction in a network setting for decentralized inference with quantization constraint; interactive fusion that allows queries and
Comparing algorithms for estimating foliar biomass of conifers in the Pacific Northwest
Crystal L. Raymond; Donald McKenzie
2013-01-01
Accurate estimates of foliar biomass (FB) are important for quantifying carbon storage in forest ecosystems, but FB is not always reported in regional or national inventories. Foliar biomass also drives key ecological processes in ecosystem models. Published algorithms for estimating FB in conifer species of the Pacific Northwest can yield signifi cantly different...
Bringing Forth Mathematical Concepts: Signifying Sensorimotor Enactment in Fields of Promoted Action
ERIC Educational Resources Information Center
Abrahamson, Dor; Tminic, Dragan
2015-01-01
Inspired by Enactivist philosophy yet in dialog with it, we ask what theory of embodied cognition might best serve in articulating implications of Enactivism for mathematics education. We offer a blend of Dynamical Systems Theory and Sociocultural Theory as an analytic lens on micro-processes of action-to-concept evolution. We also illustrate the…
Reclaiming Our Roots: The Influences of Media Curriculum on the Natural Hair Movement
ERIC Educational Resources Information Center
Jeffries, Rhonda Baynes; Jeffries, Devair
2014-01-01
This article, theoretically constructed on Gramsci's notion of cultural hegemony, explores the use of Black female hair as a cultural signifier in two media texts, specifically Adrienne Kennedy's play, "Funnyhouse of a Negro," and Chris Rock's documentary, "Good Hair," in specific media texts. Analysis of the…
ERIC Educational Resources Information Center
Parker, Tara L.
2007-01-01
To what extent does eliminating remedial education impede or facilitate the opportunity to earn bachelor's degrees for underprepared students? Educating underprepared students is often viewed as one of the most challenging and complex issues facing higher education today. Recent policy decisions to end remedial education, however, signify a much…
Adherence to Standards in the Development of E-Learning Programs
ERIC Educational Resources Information Center
Novacek, Paul F.
2016-01-01
Consistent user interface standards are necessary with the development of e-learning courseware, as they are the glue that binds the users' experience with their expectations. For example, the user controls for video playback were standardized many years ago, and we all benefit knowing a right-facing triangle signifies a play function, while dual…
Coming To Know: The Role of the Concept Map--Mirror, Assistant, Master?
ERIC Educational Resources Information Center
McAleese, Ray
This paper explains the process of creating and managing concept maps, using reflection as a focus for its argument. Section 1, What is a Concept Map?, highlights the background and definition of concept mapping, explains how maps signify virtual conceptual structures, looks at structural knowledge, provides an example of a concept map, and…
NASA Technical Reports Server (NTRS)
Gladden, Roy
2007-01-01
Version 2.0 of the autogen software has been released. "Autogen" (automated sequence generation) signifies both a process and software used to implement the process of automated generation of sequences of commands in a standard format for uplink to spacecraft. Autogen requires fewer workers than are needed for older manual sequence-generation processes and reduces sequence-generation times from weeks to minutes.
Teacher Education Reform and Subaltern Voices: From Politica to Practica in Bolivia
ERIC Educational Resources Information Center
Delany-Barmann, Gloria
2010-01-01
In 1994, the National Educational Reform in Bolivia instituted reforms that called for a model of education that held at its center the knowledge and languages of Indigenous people. The types of change called for by the reforms in Bolivia signify major transformations in teacher preparation practices and a concerted emphasis on training in…
The Role of Universities in Supporting Local Agroindustry: The Case of the Piceno District in Italy
ERIC Educational Resources Information Center
Tavoletti, Ernesto
2008-01-01
This paper analyses the role of universities in supporting local agroindustry using the case of the Piceno agroindustrial district in Italy. Emerging countries' comparative advantages, made stronger by increased international trade and the rediscovery of local traditions and typicality, do not signify that there will be a less knowledge-intensive…
Signs of Change: Art Education in the Age of the iKid
ERIC Educational Resources Information Center
Unrath, Kathleen A.; Mudd, Melissa A.
2011-01-01
Over the last few years, headlines from diverse arenas--grocery store newsstands to academic literature--repeatedly voiced evidence that people are living in a transformational time. "Change" was not only the go-to buzzword of choice in the 2008 presidential campaign but also a signifier of mutations in all areas of people's lives. Therefore, this…
ERIC Educational Resources Information Center
Klein, Colleen Parton; Klein, Stephen
1984-01-01
Nursing graduates of 1980 had a significantly higher score on the political scale of the Allport Vernon Lindsey Scale of Values than did 1974 graduates, signifying that the recent group valued assertiveness, independence, and achievement to a greater degree. This increase in nontraditional values appeared to be closely tied to the socialization…
Unraveling "Braid": Puzzle Games and Storytelling in the Imperative Mood
ERIC Educational Resources Information Center
Arnott, Luke
2012-01-01
"Unraveling Braid" analyzes how unconventional, non-linear narrative fiction can help explain the ways in which video games signify. Specifically, this essay looks at the links between the semiotic features of Jonathan Blow's 2008 puzzle-platform video game Braid and similar elements in Georges Perec's 1978 novel "Life A User's Manual," as well as…
Art Has a Place: Country as a Teacher in the City
ERIC Educational Resources Information Center
Harrison, Neil; Page, Susan; Tobin, Leanne
2016-01-01
Country constitutes the very anchor of life for many Aboriginal and Torres Strait Islander people in Australia. It is central to Indigenous identities and history, and is a powerful signifier of overall health and well-being; yet, the significance of country to Indigenous people living in large urban localities such as Sydney, Australia, remains…
"'Cause Someday We All Die": Rhetoric, Agency, and the Case of the "Patient" Preferences Worksheet
ERIC Educational Resources Information Center
Keranen, Lisa
2007-01-01
"Code status" is a prominent feature of end-of-life discussions in U.S. hospitals. This essay analyzes how the rhetoric of code status articulates the terms of end-of-life decision-making in one hospital's "Patient" Preferences Worksheet. The Worksheet signifies the abandonment of the technological fix as the preferred…
Lightweight Electronic Camera for Research on Clouds
NASA Technical Reports Server (NTRS)
Lawson, Paul
2006-01-01
"Micro-CPI" (wherein "CPI" signifies "cloud-particle imager") is the name of a small, lightweight electronic camera that has been proposed for use in research on clouds. It would acquire and digitize high-resolution (3- m-pixel) images of ice particles and water drops at a rate up to 1,000 particles (and/or drops) per second.
The Growing Relationship Between South Korea and China: Consequences for North Korea
2006-03-01
vassal state. Korean kings only “rendered obeisance” to China because it “signified their cultural respect for China as the center of…the civilized...Korea Game," Far Eastern Economic Review 163, no. 24 (Jun 15 2000): 16. The authors are quoting Lee Jong Seok, a senior Pyongyang watcher at Sejong
Ivory Basements and Ivory Towers
ERIC Educational Resources Information Center
Fitzgerald, Tanya
2012-01-01
The metaphors of the ivory tower and ivory basement are used in this chapter to reflect how many women understand and experience the academy. The ivory tower signifies a place that is protected, a place of privilege and authority and a place removed from the outside world (and consequently the rigours of the market place). The ivory tower, by…
General Models for Automated Essay Scoring: Exploring an Alternative to the Status Quo
ERIC Educational Resources Information Center
Kelly, P. Adam
2005-01-01
Powers, Burstein, Chodorow, Fowles, and Kukich (2002) suggested that automated essay scoring (AES) may benefit from the use of "general" scoring models designed to score essays irrespective of the prompt for which an essay was written. They reasoned that such models may enhance score credibility by signifying that an AES system measures the same…
Beyond the Indicators: An Integrated School-Level Approach to Dropout Prevention
ERIC Educational Resources Information Center
Mac Iver, Martha Abele; Mac Iver, Douglas J.
2009-01-01
Despite decades of school improvement initiatives, many young people still do not cross the finish line of secondary education with the credential that signifies success--a high school diploma. Thousands of young people give up on school and on themselves, or schools give up on them. Without effective support from schools, communities, and…
Scanning For Hotspots In Lamp Filaments
NASA Technical Reports Server (NTRS)
Powers, Charles E.; Van Sant, Tim; Leidecker, Henning
1993-01-01
Scanning photometer designed for use in investigation of failures of incandescent lamp filaments. Maps brightness as function of position along each filament to identify bright (hot) spots, occurring at notches and signifying incipient breaks or rewelds. Also used to measure nonuniformity in outputs of such linear devices as light-emitting diodes, and to measure diffraction patterns of lenses.
Key Objectives Bank: Year 9. Key Stage 3: National Strategy.
ERIC Educational Resources Information Center
Department for Education and Skills, London (England).
In each sub-section of the "Framework for Teaching English: Years 7, 8 and 9," certain key objectives are identified in boldface print. These objectives are key because they signify skills or understanding which are crucial to pupils' language development. They are challenging for the age group and are important markers of progress. This…
ERIC Educational Resources Information Center
Gough, Noel
2017-01-01
In this essay I suggest some ways in which science teacher educators in Western neoliberal economies might facilitate learners' development of a critical literacy concerning the social and cultural changes signified by the concept of "biopolitics." I consider how such a biopolitically inflected critical literacy might find expression in…
Detailed Maintenance Planning for Military Systems with Random Lead Times and Cannibalization
2014-12-01
relativement aux systèmes d’entretien. Prendre les meilleures décisions possible signifie ici de trouver un équilibre entre les coûts d’exploitation et la...Multistage Stochastic Programming: A Scenario Tree Based Approach to Planning under Uncertainty, In Sucar, L. E., Morales , E. F., and Hoey, J
Predicting Boundary-Layer Transition on Space-Shuttle Re-Entry
NASA Technical Reports Server (NTRS)
Berry, Scott; Horvath, Tom; Merski, Ron; Liechty, Derek; Greene, Frank; Bibb, Karen; Buck, Greg; Hamilton, Harris; Weilmuenster, Jim; Campbell, Chuck;
2008-01-01
The BLT Prediction Tool ("BLT" signifies "Boundary Layer Transition") is provided as part of the Damage Assessment Team analysis package, which is utilized for analyzing local aerothermodynamics environments of damaged or repaired space-shuttle thermal protection tiles. Such analyses are helpful in deciding whether to repair launch-induced damage before re-entering the terrestrial atmosphere.
USDA-ARS?s Scientific Manuscript database
To assess log-on rates and change in mediating variables achieved from a web-based nutrition intervention for African American families, a parent and 9- to 12-year-old daughter (n=67 families) completed questionnaires measuring dietary change mediating variables. Overall log-on rate was 59%. Signifi...
Federal Register 2010, 2011, 2012, 2013, 2014
2013-11-22
... to require recurring checks of the Blade Inspection Method (BIM) indicator on each blade to determine whether the BIM indicator is signifying that the blade pressure may have been compromised by a blade crack... check procedures for BIM blades installed on the Model S-64E and S-64F helicopters. Several blade spars...
20 CFR 411.120 - What is a ticket under the Ticket to Work program?
Code of Federal Regulations, 2011 CFR
2011-04-01
... program? 411.120 Section 411.120 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND... network (EN) or a State VR agency to which a disabled beneficiary's ticket is assigned, for providing... social security number, the letters “TW,” and a number (1, 2, etc.) in the last position signifying that...
Literacy and the Millennium Development Goals: One Step Forward, Two Steps Backwards
ERIC Educational Resources Information Center
Gomez, Sofia Valdivielso
2005-01-01
Traditionally women have been signified to be "for others", never for themselves. This conceptualisation is also present in the discourses about literacy. The traditional discourse justifies women's literacy based on the need to improve family health, well-being, educational access, and so on. Thus, it is seen as a tool for other ends…
Burns in Morbidly Obese Patients,
1992-12-01
1970-1990, there were 4995 pa- and one Aspergillus wound infection. Two patients de- ’ tients admitted to the United States Army Institute of Surgical...8217 kg (296 Ib ) to 208.9 kg (459.6 lb). The average weight pulmonary embolism (0.99 Cl, I1.8%-9,1.5%) signifi- was 153.1 kg (336.8 1lb). Height ranged
Tests as Boundary Signifiers: Level 6 Tests and the Primary Secondary Divide
ERIC Educational Resources Information Center
Coldwell, Mike; Willis, Ben
2017-01-01
This paper addresses the question: How do teachers and school leaders respond to high stakes testing of pupils transitioning from primary to secondary school? It explores how a new test, the Level 6 test, operated with regard to primary/secondary school relationships in England. It draws on an analysis of qualitative interviews with teachers and…
ERIC Educational Resources Information Center
Coughenour, C. M.
An investigation was conducted to assess the effect of enterprise dominance on selected aspects of the infrastructure of agriculture. The hypothesis was that dominance of a particular type of farming in an area is signified by a set of cultural and social values that dispose the agencies serving farmers and the farmers themselves to favor…
14 CFR Appendix A to Part 1221 - Congressional Space Medal of Honor
Code of Federal Regulations, 2010 CFR
2010-01-01
... through space. The flames signify the dynamic energy of the rocket era and the imagination of the men in... courage of the astronauts in the nation's manned space program and the fire power of rockets that carry... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Congressional Space Medal of Honor A...
A Dialogic Approach to the Composing Process: Table Talk and the Romantic Essay.
ERIC Educational Resources Information Center
Haefner, Joel
Many compositionists correctly charge Romanticism with conveying the iconography of the solitary writer and with embedding that image in modern ideology. There can be little doubt that numerous Romantic texts continue to exalt and signify the concept of the lonely genius and the self-contained text. Romantic masterpieces have contributed to the…
Exploring a Dynamic Model of Trust Management
2014-06-01
individualists whereby their satisfaction towards business negotiation stems mainly from high economic gains or personal outcomes. Therefore, it...undergraduate business students. No significant differences were found in the extent to which Canadian and Japanese trustors rely on dispositional signs...analytic- holism scale signifies high level of holism. No statistically significant difference was found between Malays, Chinese, and Indians on the
Construction and Contextualization of Authority in STEM Fields: An Exploratory Paper
ERIC Educational Resources Information Center
Kuglitsch, Rebecca; Bordeaux, Julia R.
2017-01-01
In this paper, we explore how librarians can teach students to deconstruct the concept of authority using questions and considering contextual needs in STEM fields. We argue that examining the complexities of common signifiers of authority, such as peer review, citation rates, and types of sources, as well as exploring contextual factors such as…
ERIC Educational Resources Information Center
Huang, Yong-Ming; Liu, Chien-Hung; Lee, Chun-Yi; Huang, Yueh-Min
2012-01-01
Museum learning has received a lot of attention in recent years. Museum learning refers to people's use of museums to acquire knowledge. However, a problem with information overload has caused in engaging in such learning. Information overload signifies that users encounter a mass of information and need to determine whether certain information…
ERIC Educational Resources Information Center
Birnbaum, Lawrence, Ed.
This volume contains the papers presented at the fifth International Conference on the Learning Sciences (formerly the International Conference on Artificial Intelligence and Education). As the change in name signifies, a strong effort has been made to open the conference to a broader audience, including educational and cognitive psychologists…
Imaginaries of "East and West": Slippery Curricular Signifiers in Education.
ERIC Educational Resources Information Center
Aoki, Ted T.
The labels "East and West," suggest two distinct cultural wholes. "East and West" is understood as a binary of two separate preexisting entities, which can be bridged or brought together to conjoin in an "and." This image has dominated Western modernist thought in the works of historians, anthropologists, and others. Educators, like tourists or…
Dewey's Liberalisms: Depression-Era Insights for the Great Recession
ERIC Educational Resources Information Center
Rogers, John
2013-01-01
This article explores John Dewey's Depression-era analysis of "liberalism" in an effort to clarify our own neoliberal moment. As Dewey argues, liberalism is a term used in the 1930s to signify diverse and often contradictory meanings. It variously refers to a minimalist state aimed at unbinding markets (laissez-faire liberalism) or…
DOE Office of Scientific and Technical Information (OSTI.GOV)
Daga, Avinash; Sharma, Smita
First principle study of band structure calculations in the local density approximations (LDA) as well as in the generalized gradient approximations (GGA) have been used to determine the electronic structure of SrMO{sub 3} where M stands for Ti, Zr and Mo. Occurrence of band gap proves SrTiO{sub 3} and SrZrO{sub 3} to be insulating. A small band gap is observed in SrMoO{sub 3} perovskite signifies it to be metallic. Band structures are found to compare well with the available data in the literature showing the relevance of this approach. ABINIT computer code has been used to carry out all themore » calculations.« less
NASA Astrophysics Data System (ADS)
Singh, K. S.; Bhaskaran, Prasad K.
2017-12-01
This study evaluates the performance of the Advanced Research Weather Research and Forecasting (WRF-ARW) model for prediction of land-falling Bay of Bengal (BoB) tropical cyclones (TCs). Model integration was performed using two-way interactive double nested domains at 27 and 9 km resolutions. The present study comprises two major components. Firstly, the study explores the impact of five different planetary boundary layer (PBL) and six cumulus convection (CC) schemes on seven land-falling BoB TCs. A total of 85 numerical simulations were studied in detail, and the results signify that the model simulated better both the track and intensity by using a combination of Yonsei University (YSU) PBL and the old simplified Arakawa-Schubert CC scheme. Secondly, the study also investigated the model performance based on the best possible combinations of model physics on the real-time forecasts of four BoB cyclones (Phailin, Helen, Lehar, and Madi) that made landfall during 2013 based on another 15 numerical simulations. The predicted mean track error during 2013 was about 71 km, 114 km, 133 km, 148 km, and 130 km respectively from day-1 to day-5. The Root Mean Square Error (RMSE) for Minimum Central Pressure (MCP) was about 6 hPa and the same noticed for Maximum Surface Wind (MSW) was about 4.5 m s-1 noticed during the entire simulation period. In addition the study also reveals that the predicted track errors during 2013 cyclones improved respectively by 43%, 44%, and 52% from day-1 to day-3 as compared to cyclones simulated during the period 2006-2011. The improvements noticed can be attributed due to relatively better quality data that was specified for the initial mean position error (about 48 km) during 2013. Overall the study signifies that the track and intensity forecast for 2013 cyclones using the specified combinations listed in the first part of this study performed relatively better than the other NWP (Numerical Weather Prediction) models, and thereby finds application in real-time forecast.
Shin, Yun Kyung; Park, Jung Jun; Choi, Ji Sung; Lee, Jung Sick
2014-01-01
This study attempts to propose the possibility of the sex reversal in Sinonovacula constricta and Gomphina veneriformis by confirming the changes in the sex ratio with the shell length in the same population level. For analysis of sex ratio, 100 individuals of S. constricta (SL 26.5-95.0 mm) and 2385 individuals of G. veneriformis (SL 15.1-60.1 mm) were used. Sex was analyzed histologically. Both species displayed the tendency of increase in the female proportion with increase in shell length. In this study, changes in the sex ratio in accordance with the growth of S. constricta and G. veneriformis are determined to be indirect evidence that signifies their sex reversal. PMID:25949174
ERIC Educational Resources Information Center
Conley, David T.; Gaston, Paul L.
2013-01-01
The Common Core State Standards (CCSS), which aim to assure competency in English/language arts and mathematics through the K-12 curriculum, define necessary but not sufficient preparedness for success in college. The Degree Qualifications Profile (DQP), which describes what a college degree should signify, regardless of major, offers useful but…
ERIC Educational Resources Information Center
Jeffries, Rhonda; Jeffries, Devair
2014-01-01
This article explored the role of hair in Sylviane Diouf's "Bintou's Braids" and focused on the impact of hair as a cultural signifier on girls and the curriculum. The article examined the ability of this children's text to address female beauty standards and suggests the use of literary techniques, such as reader's theatre, to recognize…
Spend Billions and They Will Come
ERIC Educational Resources Information Center
Fox, Bette-Lee
2004-01-01
People look at one billion dollars in one of two ways: if it is the result of the long, hard effort of years of fundraising, they rejoice; if it signifies an astronomical budget deficit, they cringe. How, then, should people respond as a community to reaching the $1 billion mark ($1,242,436,438, to be exact) in this year's spending for public…
Effectiveness of the Civil Aviation Security Program.
1980-10-14
CEASE FUNDING OF TRAINING"OF LAW ENFORCEMENT OFFICERS SUPPORTING AIRPORT SECURITY ACTIVITIES. F. FEDERAL AIR MARSHALS PROVIDE LAW ENFORCEMENT SUPPORT...enforcement officer authority through special deputations by the U.S. Marshals Service on an annual basis. Airport Security - Continuing activities...which contributed signifi- cantly to airport security include the training of local law enforcement officers supporting airport security programs, the
Representations of the "Damaged" Child: "Child Saving" in a British Children's Charity Ad Campaign
ERIC Educational Resources Information Center
O'Dell, Lindsay
2008-01-01
This article discusses the representation of abused children as "damaged", drawing on a series of three advertising campaigns for a British children's charity. The pictures and text of the advertisements seek to elicit readers' concern for abused children by portraying them (a) as passive agents in their development and (b) as signifiers of the…
In Pursuit of Letters: A History of the Bray Schools for Enslaved Children in Colonial Virginia
ERIC Educational Resources Information Center
Bly, Antonio T.
2011-01-01
The pursuit of literacy is a central theme in the history of African Americans in the United States. In the Western tradition, as Henry Louis Gates, Jr. and others have observed, people of African descent have been written out of "culture" because they have been identified with oral traditions. In that setting, literacy signifies both…
Lee K. Cerveny; Emily Jane Davis; Rebecca McLain; Clare M. Ryan; Debra R. Whitall; Eric M. White
2018-01-01
The Northwest Forest Plan (NWFP, or Plan) signified a movement away from intensive focus on timber management that was common through the 1980s and toward an ecosystem management approach, which aims to conserve ecological conditions and restore natural resources while meeting the social, cultural, and economic needs of present and future generations (Brussard et al....
ERIC Educational Resources Information Center
Bondestam, Fredrik
2004-01-01
This article explores the effects of certain discourses as they relate to sexual harassment in a Swedish higher education setting. Using a semiological perspective, the author analyzes notions of existence, range, prevention, and stability in order to demonstrate the way they aim at signifying a limited and, from a bureaucratic point of view,…
Policy Dialogue and Target Setting: Do Current Indicators of Education for All Signify Progress?
ERIC Educational Resources Information Center
Lewin, Keith M.
2011-01-01
Governments and development agencies met at Jomtien in 1990 and Dakar in 2000 and committed themselves to achieve "Education for All" (EFA). Most aid to education is now the umbrella of EFA and its associated goals, targets and indicators. This paper selects some of the indicators used for EFA and analyses their strengths and weaknesses. Gross and…
ERIC Educational Resources Information Center
Barbosa, Ana Mae Tavares Bastos
Education should be the most efficient way of arousing the individual's cultural consciousness. A concept of "interculturality" now exists, signifying the importance of the interaction between different cultures. There must no longer be a distinction between the "high class" culture of the erudite and the "low class" culture of the lower social…
ERIC Educational Resources Information Center
Sullivan Brown, Kathleen
2007-01-01
This paper examines the burden of vouchers to be all things to all constituencies. Proponents and opponents envision vouchers as accomplishing many objectives. To some, vouchers represent an educational reform that brings change to public schools and saves children from monopolistic bureaucrats. To others, they signify a threat to the very…
A Tale Full of Sound and Fury--Signifying What? Feminism and Curriculum Policy in Australia.
ERIC Educational Resources Information Center
Yates, Lyn
The last 2 decades of curriculum policy in Australia are reviewed in this paper, with a focus on reforms concerned with females and schooling. Two general areas are examined: (1) the theoretical relationship between state power and feminist concerns about schooling; and (2) the progressive direction for schooling. The first section compares two…
Can Academic Autonomy Survive in the Knowledge Society? A Perspective from Britain
ERIC Educational Resources Information Center
Henkel, Mary
2007-01-01
The paper analyses the challenges posed to the principle of academic autonomy by the knowledge society and new conceptions of the state. It argues that these signify the breaking down of boundaries that have been critical for the justification of academic rights to self-government and freedom of inquiry. The ideal of academe as a sovereign,…
Postattack Recovery Strategies.
1980-11-01
CONTRACT DCPAOI-79-C-0217 WORK UNIT NO. 3536-C Approved for Public Release: Distribution Unlimited HI-3100-RR November 1980 HUDSON INSTITUTE - CROTON-ON...for Public Release: Distribution Unlimited FEMA REVIEW NOTICE "This report has been reviewed in the Federal Emergency Management Agency and approved...for publication . Approval does not signify that the contents necessarily reflect the views and policies of the Federal Emergency Management Agency
Joint Ventures: An Experiment in Community/Professional Co-Framing in K-12 Education
ERIC Educational Resources Information Center
Public Agenda, 2014
2014-01-01
What happens when local school leaders sit down to talk with teachers, parents, and other members of the community about the ends and means of local education? Can people bringing different perspectives and experiences to the issue agree on top goals for their communities? Can they settle on needed changes and decide what signifies genuine…
Post-Structural Methodology at the Quilting Point: Intercultural Encounters.
Gillett, Grant
Lacan's quilting point connects a network of signifiers with the lived world as a place of voices, memory, and adaptation "seen in" the mirror of language. Crossing cultures can obscure the ways we make sense of the world. Some planes of signification, in aiming to be universal in their knowledge (such as the natural sciences), try to track objects and events independent of our thoughts about them and the ways that signifiers may slide past each other. However, cross-structural comparison and the analysis of cross cultural encounters cannot treat its objects of interest that way. Thus we need a theory and methodology that effectively connects the multilayered discourses of subjectivities from diverse cultures and allows triangulation between them in relation to points of shared experience. At such points we need a critical attitude to our own framework and an openness to the uneasy reflective equilibrium that uncovers assumptions and modes of thinking that will hamper us. Quilting points are such points where different discourses converge on a single event or set of events so as to mark "vertical" connections allowing tentative alignments between ways of meaning so that we can begin to build real cross-cultural understanding.
JMS Proxy and C/C++ Client SDK
NASA Technical Reports Server (NTRS)
Wolgast, Paul; Pechkam, Paul
2007-01-01
JMS Proxy and C/C++ Client SDK (JMS signifies "Java messaging service" and "SDK" signifies "software development kit") is a software package for developing interfaces that enable legacy programs (here denoted "clients") written in the C and C++ languages to communicate with each other via a JMS broker. This package consists of two main components: the JMS proxy server component and the client C library SDK component. The JMS proxy server component implements a native Java process that receives and responds to requests from clients. This component can run on any computer that supports Java and a JMS client. The client C library SDK component is used to develop a JMS client program running in each affected C or C++ environment, without need for running a Java virtual machine in the affected computer. A C client program developed by use of this SDK has most of the quality-of-service characteristics of standard Java-based client programs, including the following: Durable subscriptions; Asynchronous message receipt; Such standard JMS message qualities as "TimeToLive," "Message Properties," and "DeliveryMode" (as the quoted terms are defined in previously published JMS documentation); and Automatic reconnection of a JMS proxy to a restarted JMS broker.
The language of "sexual minorities" and the politics of identity: a position paper.
Petchesky, Rosalind P
2009-05-01
In any highly contested political domain, language can be a potent force for change or an obstacle to understanding and coalition building across difference. This is surely the case in the global debates over sexuality and gender, where even those terms themselves have aroused heated conflicts. In this spirit, we want to challenge the uncritical use of the term "sexual minorities", based on a number of historical and conceptual problems with which that term - like the larger thicket of identities and identity politics it signifies - is encumbered. These include: ignoring history, legitimating dubious normativity, fixing biological categories, and recreating exclusions. With this struggle, we seem caught in a modernist dilemma between two desires: to name and honour difference by signifying identities and to avoid exclusivity and hierarchy by reclaiming universals. The insistence of diverse groups on naming themselves and achieving recognition of their distinctness and variety will go on as long as aspirations for democracy exist, because that is the nature and necessity of emancipatory politics. At the same time, our language needs to reflect the fluidity and complexity of sexuality and gender expressions in everyday life and their intricate interweaving with other conditions such as class, race, ethnicity, time and place.
Begotten of Corruption? Bioarchaeology and "othering" of leprosy in South Asia.
Robbins Schug, Gwen
2016-12-01
Leprosy is strongly stigmatized in South Asia, being regarded as a manifestation of extreme levels of spiritual pollution going back through one or more incarnations of the self. Stigma has significant social consequences, including surveillance, exclusion, discipline, control, and punishment; biologically speaking, internalized stigma also compounds the disfigurement and disability resulting from this disease. Stigma results from an othering process whereby difference is recognized, meaning is constituted, and eventually, sufferers may be negatively signified and marked for exclusion. This paper traces the history of leprosy's stigmatization in South Asia, using archaeology and an exegesis of Vedic texts to examine the meaning of this disease from its apparent zero-point-when it first appears but before it was differentiated and signified-in the mature Indus Age. Results suggest that early in the second millennium BCE, leprosy was perceived as treatable and efforts were apparently made to mitigate its impact on the journey to the afterworld. Ignominy to the point of exclusion does not emerge until the first millennium BCE. This paper uses archaeology to create an effective history of stigma for leprosy, destabilizing what is true about this disease and its sufferers in South Asia today. Copyright © 2016 Elsevier Inc. All rights reserved.
Bartberger, Charles E.; Dyman, Thaddeus S.; Condon, Steven M.
2003-01-01
The potential of Lower Cretaceous sandstones of the Travis Peak Formation in the northern Gulf Coast Basin to harbor a basin-centered gas accumulation was evaluated by examining (1) the depositional and diagenetic history and reservoir properties of Travis Peak sandstones, (2) the presence and quality of source rocks for generating gas, (3) the burial and thermal history of source rocks and time of gas generation and migration relative to tectonic development of Travis Peak traps, (4) gas and water recoveries from drill-stem and formation tests, (5) the distribution of abnormal pressures based on shut-in-pressure data, and (6) the presence or absence of gas-water contacts associated with gas accumulations in Travis Peak sandstones. The Travis Peak Formation (and correlative Hosston Formation) is a basinward-thickening wedge of terrigenous clastic sedimentary rocks that underlies the northern Gulf Coast Basin from eastern Texas across northern Louisiana to southern Mississippi. Clastic infl ux was focused in two main fl uvial-deltaic depocenters?one located in northeastern Texas and the other in southeastern Mississippi and northeastern Louisiana. Across the main hydrocarbon-productive trend in eastern Texas and northern Louisiana, the Travis Peak Formation is about 2,000 ft thick. Most Travis Peak hydrocarbon production in eastern Texas comes from drilling depths between 6,000 and 10,000 ft. Signifi cant decrease in porosity and permeability occurs through that depth interval. Above 8,000-ft drilling depth in eastern Texas, Travis Peak sandstone matrix permeabilities often are signifi cantly higher than the 0.1-millidarcy (mD) cutoff that characterizes tight-gas reservoirs. Below 8,000 ft, matrix permeability of Travis Peak sandstones is low because of pervasive quartz cementation, but abundant natural fractures impart signifi cant fracture permeability. Although pressure data within the middle and lower Travis Peak Formation are limited in eastern Texas, overpressured reservoirs caused by thermal generation of gas, typical of basin-centered gas accumulations, are not common in the Travis Peak Formation. Signifi cant overpressure was found in only one Travis Peak sandstone reservoir in 1 of 24 oil and gas fi elds examined across eastern Texas and northern Louisiana. The presence of gas-water contacts is perhaps the most defi nitive criterion indicating that a gas accumulation is conventional rather than a ?sweet spot? within a basin-centered gas accumulation. Hydrocarbon-water contacts within Travis Peak sandstone reservoirs were documented in 17 fi elds and probably occur in considerably more fi elds across the productive Travis Peak trend in eastern Texas and northern Louisiana. All known hydrocarbon-water contacts in Travis Peak reservoirs in eastern Texas, however, occur within sandstones in the upper 500 ft of the formation. Although no gas-water contacts have been reported within the lower three-fourths of the Travis Peak Formation in northeastern Texas, gas production from that interval is limited. The best available data suggest that most middle and lower Travis Peak sandstones are water bearing in northeastern Texas. Insuffi cient hydrocarbon charge relative to permeability of Travis Peak reservoirs might be responsible for lack of overpressure and basin-centered gas within the Travis Peak Formation. Shales interbedded with Travis Peak sandstones in eastern Texas are primarily oxidized fl ood-plain deposits with insuffi cient organic-carbon content to be signifi cant sources of oil and gas. The most likely source rocks for hydrocarbons in Travis Peak reservoirs are two stratigraphically lower units, the Jurassic-age Bossier Shale of the Cotton Valley Group, and laminated, lime mudstones of the Jurassic Smackover Formation. Hydrocarbon charge, therefore, might be suffi cient for development of conventional gas accumulations, but it is insuffi cient for
Paleosols as Archives of Environmental Change in Deep Time
NASA Astrophysics Data System (ADS)
Crowley, Quentin
2015-04-01
Paleosols develop at the geosphere-atmosphere interface and potentially provide an archive of environmental conditions at the time of their formation. Although paleosols from deep time can be difficult to recognize due to the masking of pedogenic features by metamorphism and deformation, they may record transient (i.e. time-dependent) events which are often difficult to recognize in other geological proxies. Paleosols from the Archean and Paleoproterozoic are rare and complex to study, but offer an opportunity to gain insight into what may be relatively short-scale temporal variations in the Earth's atmospheric composition. For instance, it is widely believed that atmospheric oxygen saturation rose from <10E-05 present atmospheric level (PAL) in the Archean to >10E-02 PAL at the Great Oxidation Event (GOE) at ca. 2.4 Ga. Until recently however, chemical or physical evidence from paleosols for earlier oxygenation events were generally thought to be lacking. Recent studies of paleosols from eastern India (Keonjhar Paleosol, Singhbhum Craton) and South Africa (Nsuze Paleosol, Kaapvaal Craton) have provided chemical evidence for transient Mesoarchean atmospheric oxygenation at ca. 3.0 Ga. These paleosols are considered to preserve the earliest known vestiges of terrestrial oxidative weathering, signifying a transient, early oxygen accumulation in the Earth's atmosphere. This has far-reaching implications from both atmospheric and biological evolutionary perspectives in that chemical signatures preserved in these Mesoarchean paleosols are thought to signify the presence of molecular oxygen at levels higher than those attributable to photo-dissociation of atmospheric water alone. Such elevated levels of atmospheric oxygen could only be due to the presence of a sufficiently large biomass of micro-organisms capable of oxidative photosynthesis. Although the Archean-Paleoproterozoic paleosol geological record is fragmentary and geochemical signatures are not necessarily straightforward to interpret, these paleosols provide an opportunity to study the nature and timing of atmospheric compositional changes at a crucial time in the Earth's evolutionary history.
The Room Where It Happens: A Skeptic's Analysis of the New Heart Failure Guidelines.
Packer, Milton
2016-09-01
New heart failure guidelines have been issued during the past several months, both in the United States and in Europe, in response to recent advances in and the approval of new drugs for the treatment of heart failure. Although guidelines documents are often viewed as authoritative and purely evidence-based, there are replete with meaningful (and inexplicable) inconsistencies, which derive from a review of the same body of scientific data by different groups. This satirical review highlights several examples of the entertaining foolishness of recent guideline documents in the good-natured hope that physicians will understand what the guidelines are, and more importantly, what they are not. Specifically, this paper describes the emergence of a new nonexistent disease; the strange battle between 2 bradycardic drugs (digoxin and ivabradine); the confusion that reigns over the positioning and dosing of inhibitors of the renin-angiotensin system; and the special recommendations that have been issued for certain special populations. As Otto von Bismarck remarked, guideline deliberations are like sausages; it is better not to see them being made. Yet, even after they are ready for public view, we should be cautious. Practitioners who rely on them for clinical decision-making engage in an unnecessary form of self-deception; those who read them literally and adhere to them strictly do not practice evidence-based medicine; and those who delve into them in a search for the truth are destined to be disappointed. Copyright © 2016 Elsevier Inc. All rights reserved.
Management of stable angina: A commentary on the European Society of Cardiology guidelines.
Ambrosio, Giuseppe; Mugelli, Alessandro; Lopez-Sendón, José; Tamargo, Juan; Camm, John
2016-09-01
In 2013 the European Society of Cardiology (ESC) released new guidelines on the management of stable coronary artery disease. These guidelines update and replace the previous ESC guidelines on the management of stable angina pectoris, issued in 2006. There are several new aspects in the 2013 ESC guidelines compared with the 2006 version. This opinion paper provides an in-depth interpretation of the ESC guidelines with regard to these issues, to help physicians in making evidence-based therapeutic choices in their routine clinical practice. The first new element is the definition of stable coronary artery disease itself, which has now broadened from a 'simple' symptom, angina pectoris, to a more complex disease that can even be asymptomatic. In the first-line setting, the major changes in the new guidelines are the upgrading of calcium channel blockers, the distinction between dihydropyridines and non-dihydropyridine calcium channel blockers, and the presence of important statements regarding the combination of calcium channel blockers with beta-blockers. In the second-line setting, the 2013 ESC guidelines recommend the addition of long-acting nitrates, ivabradine, nicorandil or ranolazine to first-line agents. Trimetazidine may also be considered. However, no clear distinction is made among different second-line drugs, despite different quality of evidence in favour of these agents. For example, the use of ranolazine is supported by strong and recent evidence, while data supporting the use of the traditional agents appear relatively scanty. © The European Society of Cardiology 2016.
Attitudes of medical students in Lahore, Pakistan towards the doctor–patient relationship
Krupat, Edward; Asma, Yumna; Fatima, Noor-E-; Attique, Rayan; Mahmood, Umar; Waqas, Ahmed
2015-01-01
Background. A good doctor–patient relationship is the centre stone of modern medicine. Patients are getting increasingly aware about exercising their autonomy and thus modern medicine cannot deliver all its advances to the patients if a good doctor–patient relationship is not established. We initiated this study with the aim to assess the leaning of medical students, who are the future physicians, towards either a doctor-centered or a patient-centered care, and to explore the effects of personal attributes on care such as gender, academic year, etc. Materials & Methods. A cross-sectional study was conducted between July and Sep 2013. CMH Lahore Medical and Dental College Ethical Review Committee approved the study questionnaire. The study population consisted of 1,181 medical students in years 1–5 from two medical colleges. The English version of Patient Practitioner Orientation Scale (PPOS) was used to assess attitudes of medical students towards doctor–patient relationship. PPOS yields a mean score range of 1–6, where 1 signifies tendency towards a doctor centered relationship and 6 signifies patient-centered relationship. The relationship between PPOS scores and individual characteristics like gender, academic year etc. were examined by multiple regression. Results. A total of 783 students formed the final sample (response rate = 92%). Mean PPOS score of the entire sample was 3.40 (± .49 S.D.). Mean sharing sub-scale score was 3.18 (± 0.62 S.D. Mean caring sub-scale score was 3.63 (± 0.56 S.D.). Characteristics associated with most patient-centered attitudes were advanced academic year, having a clinical rotation, foreign background and studying in a private college. Gender, having doctor parents, relationship and residence status had no bearing on the attitudes (p > 0.05). Conclusion. Despite ongoing debate and the emphasis on a patient-centered curriculum, our study suggests that the current curriculum and its teachings are not producing the results they are designed to achieve. Students should be adequately exposed to the patients from the beginning of their medical education in clinical settings which are more sympathetic to a patient-centered care. PMID:26157621
ERIC Educational Resources Information Center
Reese, Mary Anne
1979-01-01
The holding that an employee could pay the equivalent of her union dues to a charity signifies an acceptance of accommodation and tolerance for differing religious practices in a pluralistic society. Available from Tennessee Law Review Association, Inc., 1505 W. Cumberland Ave., Knoxville, TN 37916. (Author/IRT)
Where Am I in Our Schools' White Spaces? Social Justice for the Learners We Marginalise
ERIC Educational Resources Information Center
Milne, Ann
2016-01-01
We live in the world of the intensely market-driven lower case "i". Since the launch in 1998 of the "iMac", Apple Inc. has spawned a plethora of lower-case "i" devices and programmes. What do these mean? According to Steve Jobs (1998), the "i" signified "the marriage of the excitement of the internet,…
ERIC Educational Resources Information Center
James, Asena Muganda; Simiyu, Aggrey Mukasa; Riechi, Andrew
2016-01-01
Learners are the key stakeholders of a school for it to be registered by the Department of Education. However the retention of these learners in Kenya's Secondary Level Education is a great challenge in Kenya. Every secondary school dropout signifies unfulfilled objective, goal and aim for the individual as well as the community at large. The…
Historic Landscape Survey, Maxwell AFB, Alabama
2013-08-01
signifies Maxwell AFB’s historic landscapes. 2.1 The pre-military landscape Prehistory in the southeastern United States is generally designated as...the period of Native American occupation before Spanish explorers made contact in the fifteenth and sixteenth centuries. In Alabama, the prehistory ... prehistory or history is made clear.56 A historic property is determined to be either significant or not significant by applying standardized National
Simulating Civilians for Military Training: A Canadian Perspective
2010-10-01
either refer to research in anthropology , sociology, psychology, geography, computer science or a combination of these disciplines. One of the most...conveyed through subtle, non-verbal cues: stern looks or avoidance of eye contact, absence of response to friendly waving. Explicitly hostile... colours to signify changing emotions, believable 3D representations of facial expressions is still in its infancy and is an active area of research
The Psychoanalytic Concept of Jouissance and the Kindling Hypothesis
Dimitriadis, Yorgos
2017-01-01
This article aims to define the conceptual field of jouissance in Lacanian theory, and put forth the hypothesis of a relationship between certain neurophysiological mechanisms and specific clinical phenomena where jouissance is “kindled” and outside the control of the symbolic process. First, the author briefly introduces Lacan's notion of jouissance and the way it draws on Freud's theorization, and describes the preliminary stages of this conceptual field in Lacan's work. Then, the jouissance related to two other concepts: repetition, with its Freudian and Lacanian nuances, as well as the—exclusively—Lacanian concept of the object petit a. Lacan's later conceptualization of language as jouissance (the notion of lalangue) is then discussed in relation to Freud's early ideas (“Letter 52”) on the different kinds of inscriptions that help form the mental apparatus. Finally, the author tries to formulate a hypothesis regarding specific neurophysiological mechanisms, based on clinical situations where jouissance becomes “kindled” and escapes the control of the symbolic processes through the neurophysiological mechanisms of conditioning, “kindling-sensitization” and “excitotoxicity.” In these cases, jouissance can have a destructive effect on the body and can affect, among others organs, the brain—a process the author has previously described heuristically as the “psychosomatic diseases of the brain.” This would be a special mechanism of automatism that would be triggered under the specific conditions of the fragility of the signifying chain (foreclosure of the Name-of-the-Father or solidification of the signifying chain) in combination with biological factors, including genetic factors. In this process, signifiers are reduced to signals, which in turn may be reduced to stimuli, with a tendency toward self-perpetuation, while affects are reduced to emotions and moods. Thus, conditioning and kindling-sensitization could also be understood in terms of a “semiotic reduction.” Can we therefore consider that certain phenomena of automatism and certain deficits (delusional moods, schizophrenic apathy, etc.) could be seen as psychosomatic disorders of the brain? The phenomena in question might also serve—albeit at random—as a kind of shield to mitigate excessive jouissance. PMID:28983266
Energy-level repulsion by spin-orbit coupling in two-dimensional Rydberg excitons
NASA Astrophysics Data System (ADS)
Stephanovich, V. A.; Sherman, E. Ya.; Zinner, N. T.; Marchukov, O. V.
2018-05-01
We study the effects of Rashba spin-orbit coupling on two-dimensional Rydberg exciton systems. Using analytical and numerical arguments we demonstrate that this coupling considerably modifies the wave functions and leads to a level repulsion that results in a deviation from the Poissonian statistics of the adjacent level distance distribution. This signifies the crossover to nonintegrability of the system and hints at the possibility of quantum chaos emerging. Such behavior strongly differs from the classical realization, where spin-orbit coupling produces highly entangled, chaotic electron trajectories in an exciton. We also calculate the oscillator strengths and show that randomization appears in the transitions between states with different total momenta.
Kelso, Tony
2015-01-01
Many studies have examined representations of gay, lesbian, bisexual, and transgender (LGBT) people in the U.S. media. Yet they have centered on portrayals of adults or teenagers. This investigation considered a potential LGBT population that has been neglected in media research, namely gender-variant, preadolescent children. Surveying the U.S. media at large but with an emphasis on television, the article reveals that gender-creative youth are nearly invisible. When depictions of gender-variant kids do appear, they often focus on either children who express extreme gender dysphoria or in some way signify the "tragic queer" motif (or both). The implications of these findings are discussed.
Determination of shift in energy of band edges and band gap of ZnSe spherical quantum dot
NASA Astrophysics Data System (ADS)
Siboh, Dutem; Kalita, Pradip Kumar; Sarma, Jayanta Kumar; Nath, Nayan Mani
2018-04-01
We have determined the quantum confinement induced shifts in energy of band edges and band gap with respect to size of ZnSe spherical quantum dot employing an effective confinement potential model developed in our earlier communication "arXiv:1705.10343". We have also performed phenomenological analysis of our theoretical results in comparison with available experimental data and observe a very good agreement in this regard. Phenomenological success achieved in this regard confirms validity of the confining potential model as well as signifies the capability and applicability of the ansatz for the effective confining potential to have reasonable information in the study of real nano-structured spherical systems.
Abdullah-Al-Shafi, Md; Bahar, Ali Newaz; Bhuiyan, Mohammad Maksudur Rahman; Shamim, S M; Ahmed, Kawser
2018-08-01
Quantum-dot cellular automata (QCA) as nanotechnology is a pledging contestant that has incredible prospective to substitute complementary metal-oxide-semiconductor (CMOS) because of its superior structures such as intensely high device thickness, minimal power depletion with rapid operation momentum. In this study, the dataset of average output polarization (AOP) for fundamental reversible logic circuits is organized as presented in (Abdullah-Al-Shafi and Bahar, 2017; Bahar et al., 2016; Abdullah-Al-Shafi et al., 2015; Abdullah-Al-Shafi, 2016) [1-4]. QCADesigner version 2.0.3 has been utilized to survey the AOP of reversible circuits at separate temperature point in Kelvin (K) unit.
Ullrich, Susann; Kotz, Sonja A.; Schmidtke, David S.; Aryani, Arash; Conrad, Markus
2016-01-01
While linguistic theory posits an arbitrary relation between signifiers and the signified (de Saussure, 1916), our analysis of a large-scale German database containing affective ratings of words revealed that certain phoneme clusters occur more often in words denoting concepts with negative and arousing meaning. Here, we investigate how such phoneme clusters that potentially serve as sublexical markers of affect can influence language processing. We registered the EEG signal during a lexical decision task with a novel manipulation of the words' putative sublexical affective potential: the means of valence and arousal values for single phoneme clusters, each computed as a function of respective values of words from the database these phoneme clusters occur in. Our experimental manipulations also investigate potential contributions of formal salience to the sublexical affective potential: Typically, negative high-arousing phonological segments—based on our calculations—tend to be less frequent and more structurally complex than neutral ones. We thus constructed two experimental sets, one involving this natural confound, while controlling for it in the other. A negative high-arousing sublexical affective potential in the strictly controlled stimulus set yielded an early posterior negativity (EPN), in similar ways as an independent manipulation of lexical affective content did. When other potentially salient formal features at the sublexical level were not controlled for, the effect of the sublexical affective potential was strengthened and prolonged (250–650 ms), presumably because formal salience helps making specific phoneme clusters efficient sublexical markers of negative high-arousing affective meaning. These neurophysiological data support the assumption that the organization of a language's vocabulary involves systematic sound-to-meaning correspondences at the phonemic level that influence the way we process language. PMID:27588008
Novick, Richard J; Fox, Stephanie A; Stitt, Larry W; Forbes, Thomas L; Steiner, Stefan
2006-08-01
We previously applied non-risk-adjusted cumulative sum methods to analyze coronary bypass outcomes. The objective of this study was to assess the incremental advantage of risk-adjusted cumulative sum methods in this setting. Prospective data were collected in 793 consecutive patients who underwent coronary bypass grafting performed by a single surgeon during a period of 5 years. The composite occurrence of an "adverse outcome" included mortality or any of 10 major complications. An institutional logistic regression model for adverse outcome was developed by using 2608 contemporaneous patients undergoing coronary bypass. The predicted risk of adverse outcome in each of the surgeon's 793 patients was then calculated. A risk-adjusted cumulative sum curve was then generated after specifying control limits and odds ratio. This risk-adjusted curve was compared with the non-risk-adjusted cumulative sum curve, and the clinical significance of this difference was assessed. The surgeon's adverse outcome rate was 96 of 793 (12.1%) versus 270 of 1815 (14.9%) for all the other institution's surgeons combined (P = .06). The non-risk-adjusted curve reached below the lower control limit, signifying excellent outcomes between cases 164 and 313, 323 and 407, and 667 and 793, but transgressed the upper limit between cases 461 and 478. The risk-adjusted cumulative sum curve never transgressed the upper control limit, signifying that cases preceding and including 461 to 478 were at an increased predicted risk. Furthermore, if the risk-adjusted cumulative sum curve was reset to zero whenever a control limit was reached, it still signaled a decrease in adverse outcome at 166, 653, and 782 cases. Risk-adjusted cumulative sum techniques provide incremental advantages over non-risk-adjusted methods by not signaling a decrement in performance when preoperative patient risk is high.
NASA Astrophysics Data System (ADS)
Zheng, Dan; Jiao, Haifeng; Zhong, Huiying; Qiu, Jishi; Yan, Xiaojun; Duan, Qingyuan; Chai, Liyue
2017-06-01
The composition of chlorophenols in marine organisms from the southern coast of Hangzhou Bay, China, was analyzed and the health risks posed to humans assessed. A total of 19 chlorophenols from 16 types of marine organism were analyzed across nine survey sections in Hangzhou Bay. The chlorophenols were analyzed by gas chromatography-mass spectrometry using a DB-5MS quartz capillary column. The concentrations of monochlorophenol, dichlorophenol, trichlorophenol, tetrachlorophenol, and pentachlorophenol ranged from below the detection limit (ND) to 132 μg/kg, ND-51.0 μg/kg, ND-42.5 μg/kg, ND-69.0 μg/kg, and ND-9.06 μg/kg, respectively. Additionally, concentration differences between each type of chlorophenol were not signifi cant (P>0.05). However, signifi cant differences were found between monochlorophenol (F=8.13, P<0.01) and total chlorophenol (F=5.19, P<0.01) concentrations. As the noncarcinogenic risk indices were <0.1 (10-5-10-2) for all of the organisms, no high risk was posed by 2-chlorophenol, 2,4-dichlorophenol, 2,4,6-trichlorophenol, 2,4,5-trichlorophenol, 2,3,4,6-tetrachlorophenol, and pentachlorophenol to humans consuming marine organisms from the study area. Furthermore, the carcinogenic risks posed by 2,4,6-trichlorophenol and pentachlorophenol were lower than limits set by the International Commission on Radiological Protection and the US Environmental Protection Agency. However, the noncarcinogenic and carcinogenic risks posed by chlorophenols in marine organisms from four of the survey sections (Sizaopu, Niluoshan, Longshan Town and Xinhong zha) were higher than the other survey sections.
Van Buren, J
1992-01-01
The semiotics of gender are investigated in this article for the purpose of exploring the way that deep unconscious motives in relationship to cultural biases give rise to gender concepts. Theories of semiotic processes, including Jacques Lacan's concept of the psychoanalytic signifier, are explained briefly and applied to the signs of gender. The article concludes that gender concepts develop out of biology, unconscious feelings, and social patterning, and are not given, natural, and irrevocable.
1990-12-19
president of the Katowice Chamber of Commerce and Industry and secretary of the National Chamber of Commerce, by Alicja Ogieglo ; place and date not...given: "A Practice Exercise for Big Business"] [Text] [ Ogieglo ] What, in your opinion, is the signifi- cance of the large number of organizations...this, as most certainly are the representatives in the National Chamber of Commerce [KIG]. [ Ogieglo ] Precisely. You are the secretary of the National
Research on Spoken Dialogue Systems
NASA Technical Reports Server (NTRS)
Aist, Gregory; Hieronymus, James; Dowding, John; Hockey, Beth Ann; Rayner, Manny; Chatzichrisafis, Nikos; Farrell, Kim; Renders, Jean-Michel
2010-01-01
Research in the field of spoken dialogue systems has been performed with the goal of making such systems more robust and easier to use in demanding situations. The term "spoken dialogue systems" signifies unified software systems containing speech-recognition, speech-synthesis, dialogue management, and ancillary components that enable human users to communicate, using natural spoken language or nearly natural prescribed spoken language, with other software systems that provide information and/or services.
ERIC Educational Resources Information Center
Roberts, Lorna; Schostak, John
2012-01-01
For a period, in the run up to the election (2007-2008) and the months after the election, the name "Obama" signified hope for millions, not just in America but across the world. As the hope turned to disappointment, the financial crisis deepened and the Arab Spring renewed a call for a "humanity" that could transcend the differences of nations…
Control Issues for Microelectromechanical Systems
2006-04-01
par- ticular, electrostatic drives suffer from electromechani- cal instabilities such as lateral pull -in, side pull -in, and lateral instability...standard robust feed- back methods can compensate for lateral pull -in and signifi- cantly extend the range of travel of the mechanical shuttle. MEMS...DAAD19-02-1-0366 and NSF GOALI BES 0201773. REFERENCES [1] J. Bryzek, E. Abbott, A. Flannery, D. Cagle, and J. Maitan, “Control issues for MEMS,” in
Tropello, Paula Grace Dunn
2003-01-01
With issues of patient safety, the nursing shortage, and managed care fiscal constraints, hospital organizations can strategically capture market share, while insuring best care practices, if they adopt the "Magnet Status" accreditation model. This quality indicator signifies to the consumer a culture of excellence in nursing services and fulfills the priority of customer satisfaction as a marketing strategy objective.
1985-06-25
extended and over 22,000 animals were artificially inseminated . As a result of the signifi~ cant assistance which was given to the farmers and...productivity and artificial pollination, and the agronomy section carried out five experiments aimed at finding the suitable time for planting, and...has reached the 230 borders of Pakistan, India as the Russian satellite has adopted a posture towards its closest neighbor such as to be not only a
Environmental Enrichment of Laboratory Rodents: The Answer Depends on the Question
2011-01-01
that offer enhanced sensory , motor, and cognitive stimulation of brain neuronal systems in comparison with standard caging13 and, alternatively, as...benefit the animal in a signifi- cant way in terms of stimulation of positive species-typical behaviors and/or prevention of abnormal or undesirable...naturalistic nesting materials, as compared with less natural substitutes, al- lows laboratory mice to construct complex dome-shaped, multi - layered nests
[The Explore of the Security Strategy Model in Hospital Mobile Clinic New Mode].
Li, Ke; Xia, Yong; Wang, Wei
2016-03-01
The paper elaborates and analyzes the current status of mobile hospital information security, then puts forward a security new model of the mobile treatment, then its architecture and solutions is elaborated. The use of this model makes the overall security level of hospital information to be further improved and enhanced, it has a positive signifi cance to promote the overal hospital management level.
Better Together: SOF and Conventional Forces Integration in Security Force Assistance
2017-06-09
substantial investment in both American taxpayer dollars and military man- power ; but does it accomplish the assumptive hypothesis of conflict prevention...Arguably, the initial military incursions into Afghanistan and Iraq were textbook examples of American tactical and strategic prowess. The high ...conflict does not necessarily signify a failed or failing 48 state (i.e. Mexico or Ukraine) and likewise some states with “ high instability” did not
Optical Properties of the Red Sea
1993-05-01
monsoon seasons . The effect of monsoons was shown to increase signifi- cantly the optical properties in the Arabian Sea (Arnone and Oriol, 1990a). Within...the Red Sea, the monsoon influence is not as strong as in the Arabian Sea; therefore, these seasonal trends were not expected to impact significantly...objective of this report is to characterize the surface optical properties within the Red Sea and determine the seasonal significance of the monsoons
Medical Surveillance Monthly Report (MSMR). Volume 15, Number 8, October 2008
2008-10-01
intense exposures to cold can signifi cantly impact the health, well-being and operational eff ectiveness of service members and their units.1-4 Because...performance in cold weather operations. Technical note no. TN/02-2. US Army Research Institute of Environmental Medicine, Natick, Massachusetts...status as reported on deployment health assesment forms, U.S. Armed Forces, October 2007-September 2008 Pre-deployment assessment DD2795 Post
Transition from Terrorist Event Management to Consequence Management, Executive Summary
1982-03-31
8217 "This report has been reviewed in the Federal Emergency Management Agency and approved for puLlication. Approval does not signify that the contents...acts. It describes in general terms what mechanism is in place today. This description is derived from documentation reviewed and information obtained...probabilities was employed in the development of the- values expressed in the matrices. Probabilities were established by a review of several previous
USDA-ARS?s Scientific Manuscript database
Five Beauveria bassiana strains were evaluated for control of western flower thrips. Strain RSB was the most virulent, causing 69-96% mortality at concentrations of 1×104 – 1×107 conidia mL-1, 10 days after inoculation of first instars. In greenhouse trials, RSB applied to broccoli foliage signifi...
Abstracts of ARI Research Publications, FY 1978
1980-09-01
initial item pool, 49 items were identified as having signifi- cant item-to-total-score correlations and were statistically determined to address a...failing. Differences among the three groups on main gun performance measures and the previous experience of gun- ners were not statistically significant...forms of the noncognitive cod- ing speed test; and (d) a second field administration to derive norms and other statistical characteristics of the new
1985-10-01
importance of this topic and the growing number of OPR papers in these references signifies the importance of this topic..’-’ In this present review...Research (grant 79-0091), and inde- random numbers is used at each TB. To simulate de- pendent contractors of Unicorn Systems Incorporated tector noise...ACKNOWLEDGMENTS. The support of Unicorn Systems Inc. contractors and various CMU grants from AFOSR and NASA Lewis are gratefully acknowledged as is the technical
Outsourcing Strategic Services in the Colombian Defense Sector: Analysis of a Naval Aviation Case
2007-12-01
Management,” Harvard Business Review, Sept-Oct/83. 40 “Boletin Trimestral Empresas de Transporte Aereo No...to signify rotary-wing aircraft capable of transporting more than 4 tons of payload. 8 “Secretaria del Senado – Republica de Colombia” (Secretary of... de Aviacion controls the civil non-regular air transportation in Colombia. According to Aerocivil statistics, the company’s helicopters moved 57.58
The DNAPL Remediation Challenge: Is There a Case for Source Depletion?
2003-12-01
fermentation products acting as electron donors to promote reductive dechlorination of chlorinated solvents (e.g., see discussion on Sages and Bachman...has been primarily used to remove organic contamination in the vadose zone (see e.g., Stegemeier and Vinegar , 2001). Signifi cant removals of...Stegemeier, G.L., and H.J. Vinegar . 2001. Thermal conduction heating for in-situ thermal desorption of soils. In: Hazardous and Radioactive Waste Treatment
Biological Warfare Agents, Toxins, Vectors and Pests as Biological Terrorism Agents
2003-07-01
number of positive answers. According to criterion, no effective prophylaxis or therapy, positive answer signifies the absence of effective ...likelihood that the agent will be used. There are not effective prophylaxis and therapy against for the bulk of enlisted agents and toxins if used as...difficult to imagine how it would be looked like mass- vaccination often maybe simultaneously against more than one disease. Toxins are effective and
Investigation of a 129Xe magnetometer for the Neutron Electric Dipole Moment Experiment at TRIUMF
NASA Astrophysics Data System (ADS)
Lang, Michael; Nedm At Triumf Collaboration
2016-03-01
A non-zero neutron electric dipole moment (nEDM) would signify a previously unknown source of CP (or T) violation. New sources of CP violation are believed to be required to explain the baryon asymmetry of the universe. Employing a newly developed high-density UCN source, an experiment at TRIUMF aims to measure the nEDM to the level of 10-27 e . cm in its initial phase. Precession frequency differences for UCN stored in a bottle subject to parallel and anti-parallel E and B fields signify a permanent nEDM. Magnetic field instability and inhomogeneity, as well as field changes resulting from leakage currents (correlated with E fields) are the dominant systematic effects in nEDM measurements. To address this, passive and active magnetic shielding are in development along with a dual species (129Xe and 199Hg) atomic comagnetometer. Simultaneously introducing both atomic species into the UCN cell, the comagnetometer can mitigate false EDMs. 199Hg precession will be detected by Faraday rotation spectroscopy, and 129Xe precession will measured via two-photon excitation and emission. The present comagnetometer progress will be discussed, with focus on polarized 129Xe production and delivery. Work supported by the Natural Sciences and Engineering Research Council of Canada.
Exploring the Dominant Discourse of Baccalaureate Nursing Education in Iran
Yazdannik, Ahmadreza; Yousefy, Alireza; Mohammadi, Sepideh
2017-01-01
Introduction: Understanding how academic dominant discourse is implicated in the shaping of nursing identity, professional aspirations and socialization of nursing students is useful as it can lead to strategies that promote nursing profession. Materials and Methods: This is a qualitative research conducted through discourse analysis approach. Semi-structured interviews, focus group, and direct observation of undergraduate theoretical and clinical courses were used to collect the data. Participants were 71 nursing students, 20 nursing educators, and 5 nursing board staffs from five universities in Iran. Results: Data analysis resulted in the development of four main themes that represent essential discourses of nursing education. The discourses explored are theoretical and scientific nursing, domination of biomedical paradigm, caring as an empty signifier, and more than expected role of research in nursing education discourse. Conclusions: The results indicated that academics attempt to define itself based on “scientific knowledge” and faculties seek to socialize students by emphasizing the scientific/theoretical basis of nursing and research, with the dominance of biomedical discourse. It fails to conceptually grasp the reality of nursing practice, and the result is an untested and impoverished theoretical discourse. The analysis highlights the need for the formation of a strong and new discourse, which contains articulation of signifiers extracted from the nature of the profession. PMID:28382053
Processing LiDAR Data to Predict Natural Hazards
NASA Technical Reports Server (NTRS)
Fairweather, Ian; Crabtree, Robert; Hager, Stacey
2008-01-01
ELF-Base and ELF-Hazards (wherein 'ELF' signifies 'Extract LiDAR Features' and 'LiDAR' signifies 'light detection and ranging') are developmental software modules for processing remote-sensing LiDAR data to identify past natural hazards (principally, landslides) and predict future ones. ELF-Base processes raw LiDAR data, including LiDAR intensity data that are often ignored in other software, to create digital terrain models (DTMs) and digital feature models (DFMs) with sub-meter accuracy. ELF-Hazards fuses raw LiDAR data, data from multispectral and hyperspectral optical images, and DTMs and DFMs generated by ELF-Base to generate hazard risk maps. Advanced algorithms in these software modules include line-enhancement and edge-detection algorithms, surface-characterization algorithms, and algorithms that implement innovative data-fusion techniques. The line-extraction and edge-detection algorithms enable users to locate such features as faults and landslide headwall scarps. Also implemented in this software are improved methodologies for identification and mapping of past landslide events by use of (1) accurate, ELF-derived surface characterizations and (2) three LiDAR/optical-data-fusion techniques: post-classification data fusion, maximum-likelihood estimation modeling, and hierarchical within-class discrimination. This software is expected to enable faster, more accurate forecasting of natural hazards than has previously been possible.
Secure Display of Space-Exploration Images
NASA Technical Reports Server (NTRS)
Cheng, Cecilia; Thornhill, Gillian; McAuley, Michael
2006-01-01
Java EDR Display Interface (JEDI) is software for either local display or secure Internet distribution, to authorized clients, of image data acquired from cameras aboard spacecraft engaged in exploration of remote planets. ( EDR signifies experimental data record, which, in effect, signifies image data.) Processed at NASA s Multimission Image Processing Laboratory (MIPL), the data can be from either near-realtime processing streams or stored files. JEDI uses the Java Advanced Imaging application program interface, plus input/output packages that are parts of the Video Image Communication and Retrieval software of the MIPL, to display images. JEDI can be run as either a standalone application program or within a Web browser as a servlet with an applet front end. In either operating mode, JEDI communicates using the HTTP(s) protocol(s). In the Web-browser case, the user must provide a password to gain access. For each user and/or image data type, there is a configuration file, called a "personality file," containing parameters that control the layout of the displays and the information to be included in them. Once JEDI has accepted the user s password, it processes the requested EDR (provided that user is authorized to receive the specific EDR) to create a display according to the user s personality file.
Effect of E85 on Tailpipe Emissions from Light-Duty Vehicles.
Yanowitz, Janet; McCormick, Robert L
2009-02-01
E85, which consists of nominally 85% fuel grade ethanol and 15% gasoline, must be used in flexible-fuel (or "flex-fuel") vehicles (FFVs) that can operate on fuel with an ethanol content of 0-85%. Published studies include measurements of the effect of E85 on tailpipe emissions for Tier 1 and older vehicles. Car manufacturers have also supplied a large body of FFV certification data to the U.S. Environmental Protection Agency, primarily on Tier 2 vehicles. These studies and certification data reveal wide variability in the effects of E85 on emissions from different vehicles. Comparing Tier 1 FFVs running on E85 to similar non-FFVs running on gasoline showed, on average, significant reductions in emissions of oxides of nitrogen (NO x ; 54%), non-methane hydrocarbons (NMHCs; 27%), and carbon monoxide (CO; 18%) for E85. Comparing Tier 2 FFVs running on E85 and comparable non-FFVs running on gasoline shows, for E85 on average, a signifi-cant reduction in emissions of CO (20%), and no signifi-cant effect on emissions of non-methane organic gases (NMOGs). NO x emissions from Tier 2 FFVs averaged approximately 28% less than comparable non-FFVs. However, perhaps because of the wide range of Tier 2 NO x standards, the absolute difference in NO x emissions between Tier 2 FFVs and non-FFVs is not significant (P =0.28). It is interesting that Tier 2 FFVs operating on gasoline produced approximately 13% less NMOGs than non-FFVs operating on gasoline. The data for Tier 1 vehicles show that E85 will cause significant reductions in emissions of benzene and butadiene, and significant increases in emissions of formaldehyde and acetaldehyde, in comparison to emissions from gasoline in both FFVs and non-FFVs. The compound that makes up the largest proportion of organic emissions from E85-fueled FFVs is ethanol.
Wang, Chao; Rajagovindan, Rajasimhan; Han, Sahng-Min; Ding, Mingzhou
2016-01-01
Alpha oscillations (8–12 Hz) are thought to inversely correlate with cortical excitability. Goal-oriented modulation of alpha has been studied extensively. In visual spatial attention, alpha over the region of visual cortex corresponding to the attended location decreases, signifying increased excitability to facilitate the processing of impending stimuli. In contrast, in retention of verbal working memory, alpha over visual cortex increases, signifying decreased excitability to gate out stimulus input to protect the information held online from sensory interference. According to the prevailing model, this goal-oriented biasing of sensory cortex is effected by top-down control signals from frontal and parietal cortices. The present study tests and substantiates this hypothesis by (a) identifying the signals that mediate the top-down biasing influence, (b) examining whether the cortical areas issuing these signals are task-specific or task-independent, and (c) establishing the possible mechanism of the biasing action. High-density human EEG data were recorded in two experimental paradigms: a trial-by-trial cued visual spatial attention task and a modified Sternberg working memory task. Applying Granger causality to both sensor-level and source-level data we report the following findings. In covert visual spatial attention, the regions exerting top-down control over visual activity are lateralized to the right hemisphere, with the dipoles located at the right frontal eye field (FEF) and the right inferior frontal gyrus (IFG) being the main sources of top-down influences. During retention of verbal working memory, the regions exerting top-down control over visual activity are lateralized to the left hemisphere, with the dipoles located at the left middle frontal gyrus (MFG) being the main source of top-down influences. In both experiments, top-down influences are mediated by alpha oscillations, and the biasing effect is likely achieved via an inhibition-disinhibition mechanism. PMID:26834601
Zarrabi, Narges; Prosperi, Mattia; Belleman, Robert G; Colafigli, Manuela; De Luca, Andrea; Sloot, Peter M A
2012-01-01
Inferring disease transmission networks is important in epidemiology in order to understand and prevent the spread of infectious diseases. Reconstruction of the infection transmission networks requires insight into viral genome data as well as social interactions. For the HIV-1 epidemic, current research either uses genetic information of patients' virus to infer the past infection events or uses statistics of sexual interactions to model the network structure of viral spreading. Methods for a reliable reconstruction of HIV-1 transmission dynamics, taking into account both molecular and societal data are still lacking. The aim of this study is to combine information from both genetic and epidemiological scales to characterize and analyse a transmission network of the HIV-1 epidemic in central Italy.We introduce a novel filter-reduction method to build a network of HIV infected patients based on their social and treatment information. The network is then combined with a genetic network, to infer a hypothetical infection transmission network. We apply this method to a cohort study of HIV-1 infected patients in central Italy and find that patients who are highly connected in the network have longer untreated infection periods. We also find that the network structures for homosexual males and heterosexual populations are heterogeneous, consisting of a majority of 'peripheral nodes' that have only a few sexual interactions and a minority of 'hub nodes' that have many sexual interactions. Inferring HIV-1 transmission networks using this novel combined approach reveals remarkable correlations between high out-degree individuals and longer untreated infection periods. These findings signify the importance of early treatment and support the potential benefit of wide population screening, management of early diagnoses and anticipated antiretroviral treatment to prevent viral transmission and spread. The approach presented here for reconstructing HIV-1 transmission networks can have important repercussions in the design of intervention strategies for disease control.
Faculty perception of the effectiveness of EBP courses for graduate nursing students.
Zeleníková, Renáta; Beach, Michael; Ren, Dianxu; Wolff, Emily; Sherwood, Paula
2014-12-01
Effective teaching is key in preparing students to become successful evidence-based healthcare professionals. The effectiveness of graduate evidence-based practice (EBP) pedagogy is not often a subject of research studies. The purpose of this study was to determine how faculty from the 50 top graduate nursing schools in the United States perceived the effectiveness of EBP courses for graduate nursing students. A descriptive cross-sectional design was used to explore faculty perception of the effectiveness of EBP courses. A web-based survey was used for data collection. A total of 45 questionnaires were subjected to statistical analysis. The mean perception of the effectiveness of EBP courses for the whole sample, on a scale from 1 to 7, was 5.58 (min. 4.29; max. 6.73), a higher score signifying higher perceived effectiveness. The highest rated item concerned a school's access to different databases. The strongest correlations were found between the total score and the scores for items describing students' opportunities to strengthen and apply their EBP skills (rs = .66). The internal consistency of the Perception of Effectiveness of EBP Courses scale, based on standardized Cronbach's alpha, was .84, which signifies strong internal consistency. Faculty perceived themselves as most competent at the following EBP skills: (a) "Asking questions regarding patients' care" (6.56), (b) "Considering patient preferences when implementing EBP" (6.40), and (c) "Critically appraising the relevant body of evidence to address clinical questions" (6.40). To strengthen the effectiveness of EBP courses, students should have more opportunities to implement their EBP knowledge and skills after completing EBP courses. Evaluation of faculty perceptions of the effectiveness of EBP courses can help to guide the development of nursing school curricula that better integrate EBP. Further evaluation of the psychometric properties of the instrument used to measure perception of the effectiveness of EBP courses is required along with objective measures of faculty knowledge and skills in teaching EBP. © 2014 Sigma Theta Tau International.
Takada, Mitsutaka; Fujimoto, Mai; Motomura, Haruka; Hosomi, Kouichi
2016-01-01
Voltage-gated sodium channels (VGSCs) are drug targets for the treatment of epilepsy. Recently, a decreased risk of cancer associated with sodium channel-blocking antiepileptic drugs (AEDs) has become a research focus of interest. The purpose of this study was to test the hypothesis that the use of sodium channel-blocking AEDs are inversely associated with cancer, using different methodologies, algorithms, and databases. A total of 65,146,507 drug-reaction pairs from the first quarter of 2004 through the end of 2013 were downloaded from the US Food and Drug Administration Adverse Event Reporting System. The reporting odds ratio (ROR) and information component (IC) were used to detect an inverse association between AEDs and cancer. Upper limits of the 95% confidence interval (CI) of < 1 and < 0 for the ROR and IC, respectively, signified inverse associations. Furthermore, using a claims database, which contains 3 million insured persons, an event sequence symmetry analysis (ESSA) was performed to identify an inverse association between AEDs and cancer over the period of January 2005 to May 2014. The upper limit of the 95% CI of adjusted sequence ratio (ASR) < 1 signified an inverse association. In the FAERS database analyses, significant inverse associations were found between sodium channel-blocking AEDs and individual cancers. In the claims database analyses, sodium channel-blocking AED use was inversely associated with diagnoses of colorectal cancer, lung cancer, gastric cancer, and hematological malignancies, with ASRs of 0.72 (95% CI: 0.60 - 0.86), 0.65 (0.51 - 0.81), 0.80 (0.65 - 0.98), and 0.50 (0.37 - 0.66), respectively. Positive associations between sodium channel-blocking AEDs and cancer were not found in the study. Multi-methodological approaches using different methodologies, algorithms, and databases suggest that sodium channel-blocking AED use is inversely associated with colorectal cancer, lung cancer, gastric cancer, and hematological malignancies.
Understanding the bear movement in gay male culture: redefining masculinity.
Manley, Eric; Levitt, Heidi; Mosher, Chad
2007-01-01
The bear movement emerged in the gay male culture of the 1980s, but little research on this group has been conducted. The purpose of this qualitative study was to examine the meanings and functions of bear identity. Six bear-identified men participated in intensive interviews investigating this question. Results suggest that men who identify as bears consciously adopt a masculine aesthetic that signifies values of self-acceptance and maturity. The participants described the acceptance of diverse body shapes and ages within the bear community as leading to positive self-esteem and body image. Results are discussed in relation to clinical and advocacy work. They broaden the awareness of the diversity of cultures that exist within the gay community.
Sharma, Neelam; Arora, Sandeep; Madan, Jitender
2018-02-01
Once-daily oral dosage of nefopam hydrochloride loaded sustained release microspheres (NPH-MS) was investigated as novel therapeutic strategy for post-operative pain management. Microspheres were synthesized using poly-3-hydroxybutyrate and poly-(ɛ-caprolactone) by double emulsion solvent evaporation technique. NPH-MS were characterized through FTIR, PXRD and SEM. In-vitro drug release study revealed sustained behavior till 24 h. Haemolysis was <5% which signified haemocompatibility of formulation. ED50 in rat tail-flick anti-nociceptive test was found ∼18.12 mg/kg. In post-operative pain model, reversal of mechanical allodynia and thermal hyperalgesia by NPH-MS was statistically significant (p < .001) as compared with NPH till 24 h post-dose.
Cannibalism, kuru and anthropology.
Lindenbaum, Shirley
2009-01-01
This essay discusses the image and practice of cannibalism in a wide range of studies. It also presents the anthropological research on kuru which led to the proposal that cannibalism had enabled transmission of the infectious agent, as well as doubts about the hypothesis, and the assertion by some that cannibalism as a socially approved custom did not exist. The figure of the cannibal as an icon of primitivism took form in the encounter between Europe and the Americas. Cannibalism was to become the prime signifier of "barbarism" for a language of essentialized difference that would harden into the negative racism of the nineteenth century. Anthropological and medical research now challenge the derogatory image of the cannibal as we learn more about the many past consumers of human flesh, including ourselves.
Shameem, Nowsheen; Kamili, Azra N; Ahmad, Mushtaq; Masoodi, F A; Parray, Javid A
2016-01-01
This study pertains to the radical scavenging potential of and DNA protection by Helvella lacunosa, an edible mushroom from Kashmir Himalaya (India). Different solvents, on the basis of their polarities, were used to extract all solvent-soluble bioactive compounds. Seven different antioxidant methods were also used to determine extensive radical scavenging activity. The mushroom ethanol extract and butanol extract showed effective scavenging activity of radicals at 95% and 89%, respectively. At 800 µg/mg, the ethanol extract was potent enough to protect DNA from degradation by hydroxyl radicals. It is evident from these findings that the presence of antioxidant substances signifies the use of H. lacunosa as food in the mountainous valleys of the Himalayan region.
Immediate placement of endosseous implants into the extraction sockets.
Ebenezer, Vijay; Balakrishnan, K; Asir, R Vigil Dev; Sragunar, Banu
2015-04-01
Implant by definition "means any object or material, such as an alloplastic substance or other tissue, which is partial or completely inserted into the body for therapeutic, diagnostic, prosthetic, or experimental purpose." The placement of a dental implant in an extraction socket at the time of extraction or explantation is known as immediate implant placement whereas delayed placement of implant signifies the implant placement in edentulous areas where healing has completed with new bone formation after the loss of tooth/teeth. Recent idea goes by "why late when it can be done immediately." There are several advantages of immediate placement of implants, and lots of studies have been done. In this article, the advantages and disadvantages of immediate versus delayed placement of implants have been reviewed.
Truong, Thi Ngoc Lien; Tran, Dai Lam; Vu, Thi Hong An; Tran, Vinh Hoang; Duong, Tuan Quang; Dinh, Quang Khieu; Tsukahara, Toshifumi; Lee, Young Hoon; Kim, Jong Seung
2010-01-15
In this paper, we describe DNA electrochemical detection for genetically modified organism (GMO) based on multi-wall carbon nanotubes (MWCNTs)-doped polypyrrole (PPy). DNA hybridization is studied by quartz crystal microbalance (QCM) and electrochemical impedance spectroscopy (EIS). An increase in DNA complementary target concentration results in a decrease in the faradic charge transfer resistance (R(ct)) and signifying "signal-on" behavior of MWCNTs-PPy-DNA system. QCM and EIS data indicated that the electroanalytical MWCNTs-PPy films were highly sensitive (as low as 4pM of target can be detected with QCM technique). In principle, this system can be suitable not only for DNA but also for protein biosensor construction.
2014-03-20
ligands, [ 3 ] exhibit high surface area, good thermal stability, and have signifi cant synthetic versatility, ena- bling structures with tunable pore...sizes and adjustable internal functionality. [ 4 ] MOF synthesis usually follows wet solvo- thermal batch methods, producing pow- ders that require...surface areas—limiting applicability. For example, Kuesgens et al. grew HKUST-1 crystals on pulp fibers using direct solvo- thermal synthesis and found
On the Generation of Stress and Deformation in Elastic Solids by High Powered Lasers
1980-09-01
isothermal shock problems and are of particular signifi- cance in the absa rpion of x rays. However, this class would appear to be of an academic interest only...distributions, measured above and 97 below ielting , i.e., T ÷T + U and T - T + U, respectively U - d(t) + e(t)x + fVt)x0 on 0 < x < a (21a) U - a(t
1990-05-17
By any stretch of the imagination this will be a very important decade. The year 1990, which signifies the beginning of a brand -new era, also...indulging in unbridled propaganda to the effect that "communism has become bankrupt throughout the world," but also its specific policies and actions...5478): "The Serious Effects of the Cold War on Eastern Europe"] INTERNATIONAL JPRS-CAR-90-038 17 May 1990 [Text] After World War II, the countries
DOE Office of Scientific and Technical Information (OSTI.GOV)
Lincoln, Don
At any time in history, a few scientific measurements disagreed with the best theoretical predictions of the time. Currently, one such discrepancy involves the measurement of the strength of the magnetic field of a subatomic particle called a muon. In this video, Fermilab’s Dr. Don Lincoln explains this mystery and sketches ongoing efforts to determine if this disagreement signifies a discovery. If it does, this measurement will mean that we will have to rewrite the textbooks.
ERIC Educational Resources Information Center
Bannerman, Henrietta Lilian
2010-01-01
The premise of this article is the usefulness of Charles Sanders Peirce's semiotic theory when it is used in the activity of decoding or recouping meaning from "pure" dance works. It begins with a survey of the field of semiotics and although it concentrates on sign theory as formulated by Peirce, other principles of semiotics such as theories of…
SETL for Internet Data Processing
2000-01-01
early phase in the evolution of most large software systems, especially those featuring novel designs [135, 173, 66, 70, 71 ]. Second, SETL’s strong...into SETL/E [66, 61], a revision of SETL that was extended with a process creation operator and renamed ProSet [ 71 ] to signify its role in prototyping...set-oriented languages having intrinsic persistence features [60, 64, 67, 70, 71 , 62] that sought to spare the programmer the trouble of coding data
1997-04-01
to tracing historical trends in archaeological method and theory ). The literature sum- marized here is extensive and is not accessible widely to the...of new signifi- cance assessment models. The more specific objectives in undertaking this literary review and interpretive analysis of archaeological...method and theory characteristic of the ’New Archaeology’ of the late 1960s. Once these ideas had made their way into the early literature on
The Cost-Effectiveness of Military Advertising: Evidence from 2002-2004
2009-01-01
real dollars, the budgets were adjusted for CPM (cost per 1,000 advertising impressions, or audience exposures) inflation. These costs for network...budgets have doubled. During the 1990s, real spending on advertising was signifi- cantly lower. 1 CPM actually incurred by the Services (computed by...TITLE AND SUBTITLE The Cost-Effectiveness of Military Advertising : Evidence from 2002?2004 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT
Optically Powered, Optoelectronic Spatial Light Modulators
1993-04-26
operation only under certain well defined ranges of bandwidth and input power (which must be traded off against each other). We regard this "first...demonstrated in the near future. IlI. Personnel supported under AFOSR sponsorship 0* Song Yu: Princeton University, PhD student. 0 0 0 5 m Appendix I Papers...signifi- cantly affect the performance of OEIC smart pixels operating under the proposed conditions. Since the capacitance of both the photodiode and
Luk, Yiu Shiobhon; Ka, Solomon Yig Joon; Lo, Sherwin Shing Wai; Chu, Chi Yeung; Ma, Ming Wai
2012-09-01
Breast metastasis from gastric carcinoma is rare. We present a case of right breast mass with microcalcification in which the diagnosis of poorly differentiated adenocarcinoma from the stomach was made after a biopsy. Pleomorphic microcalcification was noted in the ill-defined breast mass, which is a rare feature in breast metastasis. Since breast metastasis usually signifies advanced metastatic disease, differentiating primary breast cancer from metastasis is important for appropriate treatment.
Determination of Medical Task Times in an Emergency Center Setting
1990-08-01
supraclavicular central venous line, "Wound expl." signifies wound exploration, and "thoracostomy" refers to tube thoracostomy. The task time for chest...bore line is needed for aggressive fluid resuscitation, or whenever monitoring of central venous pressure as a reflection of available blood volume...of newly annexed city territory. Most ALS responses in the central city are made within 4 min of receipt of calls. There were 68,000 EMS transports
A Software Rejuvenation Framework for Distributed Computing
NASA Technical Reports Server (NTRS)
Chau, Savio
2009-01-01
A performability-oriented conceptual framework for software rejuvenation has been constructed as a means of increasing levels of reliability and performance in distributed stateful computing. As used here, performability-oriented signifies that the construction of the framework is guided by the concept of analyzing the ability of a given computing system to deliver services with gracefully degradable performance. The framework is especially intended to support applications that involve stateful replicas of server computers.
1991-03-31
mnxeiators such as prostaglandins, leukotrienes, 10 thromboxanes, free radicals, interleukin-l, tim=r necrosis factor, interferon, lysosoail enzymes ...blood enzymes levels in comparison to the control group (Table (c)2). Although the small animals showed a signifi- cant elevation in blood enzyme leiels...large animals showed a nearly five-fold 19 higher level of most enzymes in corparison to the snall animal group. Blood triglyceride levels were
Stressing on the nucleolus in cardiovascular disease.
Hariharan, Nirmala; Sussman, Mark A
2014-06-01
The nucleolus is a multifunctional organelle with multiple roles involving cell proliferation, growth, survival, ribosome biogenesis and stress response signaling. Alteration of nucleolar morphology and architecture signifies an early response to increased cellular stress. This review briefly summarizes nucleolar response to cardiac stress signals and details the role played by nucleolar proteins in cardiovascular pathophysiology. This article is part of a Special Issue entitled: Role of the Nucleolus in Human Disease. © 2013.
Four Decades and Five manuals: U.S. Army Strategic Leadership Doctrine, 1983-2011
2011-05-19
the Chief of Staff of the Army, General Carl Vuono, addressed the professionalism of the Army as it entered the 1990s. Using the events signifying...Imperatives Guiding the Blueprint of the Army into the 1990s. Source: Terms adapted from Carl E. Vuono, “Professionalism and the Army of the 1990s,” Military...ways the different levels of leadership would meet these demands. 40 39 Carl E. Vuono
The American Experience with Pacification in Vietnam. Volume 2: Elements of Pacification
1972-03-01
Regiment elmnts conducted coordinated mortar /ground attacks throughout Dai Loc district--recently an area of CAP concern. At the time of the attack...essentially they should be very light infantry forces equipped with automatic weapons, light mortars , grenade launchers, and rugged but light com...it lasted, a signifi- cant part of USOMI- effort was channeled toward its direct support. Piai:ers and commodities, such as fertilizer and cement
Interpretation of Data from Uphole Refraction Surveys
1980-06-01
Seismic refraction Seismic refraction method Seismic surveys Subsurface exploration ""-. 20, AI0SrRACT -(CmtuamU 00MvaO eL If naaaaamr and Identlfyby...by the presence of subsurface cavities and large cavities are identifiable, the sensitivity of the method is marginal for practical use in cavity...detection. Some cavities large enough to be of engineering signifi- cance (e.g., a tunnel of h-m diameter) may be practically undetectable by this method
Developing a Model for Predicting Snowpack Parameters Affecting Vehicle Mobility,
1983-05-01
Service River Forecast System -Snow accumulation and JO ablation model. NOAA Technical Memorandum NWS HYDRO-17, National Weather Service, JS Silver Spring... Forecast System . This model indexes each phys- ical process that occurs in the snowpack to the air temperature. Although this results in a signifi...pressure P Probability Q Energy Q Specific humidity R Precipitation s Snowfall depth T Air temperature t Time U Wind speed V Water vapor
Shahani, S K; Moniz, C L; Bordekar, A D; Gupta, S M; Naik, K
1994-01-01
It is now well recognized that the presence of early pregnancy factor (EPF) can signify the occurrence of fertilization, continuation of pregnancy and the existence of a viable embryo. With this in view, a study was undertaken to observe the potential of EPF as a marker in assessing embryo viability in cases complicated with vaginal bleeding during early pregnancy. The results indicated that the sensitivity of EPF as a marker in predicting threatened or missed abortion was 78.9% and the specificity 95.6%. The positive predictive value was observed to be 93.8% and the negative predictive value 84.6%. Our studies have shown that since EPF is present in viable but absent in non-viable pregnancies, it could be a useful marker of prognostic value in threatened abortions.
Crespo-Leiro, María G; Segovia-Cubero, Javier; González-Costello, José; Bayes-Genis, Antoni; López-Fernández, Silvia; Roig, Eulàlia; Sanz-Julve, Marisa; Fernández-Vivancos, Carla; de Mora-Martín, Manuel; García-Pinilla, José Manuel; Varela-Román, Alfonso; Almenar-Bonet, Luis; Lara-Padrón, Antonio; de la Fuente-Galán, Luis; Delgado-Jiménez, Juan
2015-09-01
To estimate the percentage of heart failure patients in Spain that received the European Society of Cardiology recommended treatments, and in those that did not, to determine the reasons why. The study included 2834 consecutive ambulatory patients with heart failure from 27 Spanish hospitals. We recorded general information, the treatment indicated, and the reasons why it was not prescribed in some cases. In patients who met the criteria to receive a certain drug, true undertreatment was defined as the percentage of patients who, without justification, did not receive the drug. In total, 92.6% of ambulatory patients with low ejection fraction received angiotensin converting enzyme inhibitors or angiotensin receptor blockers, 93.3% beta-blockers, and 74.5% mineralocorticoid receptor antagonists. The true undertreatment rates were 3.4%, 1.8%, and 19.0%, respectively. Target doses were reached in 16.2% of patients receiving angiotensin converting enzyme inhibitors, 23.3% of those with angiotensin receptor blockers, 13.2% of those prescribed beta-blockers, and 23.5% of those with mineralocorticoid receptor antagonists. Among patients who could benefit from ivabradine, 29.1% received this drug. In total, 36% of patients met the criteria for defibrillator implantation and 90% of them had received the device or were scheduled for implantation, whereas 19.6% fulfilled the criteria for resynchronization therapy and 88.0% already had or would soon have the device. In patients who met the criteria, but did not undergo device implantation, the reasons were not cost-related. When justified reasons for not administering heart failure drugs were taken into account, adherence to the guideline recommendations was excellent. Exclusive use of the percentage of treated patients is a poor indicator of the quality of healthcare in heart failure. Measures should be taken to improve the attainment of optimal dosing in each patient. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.
Nwazue, Victor C; Paranjape, Sachin Y; Black, Bonnie K; Biaggioni, Italo; Diedrich, André; Dupont, William D; Robertson, David; Raj, Satish R
2014-04-10
Inappropriate sinus tachycardia (IST) and postural tachycardia syndrome (POTS) are 2 disorders characterized by sinus tachycardia. It is debated whether the pathophysiology of IST and POTS results from abnormal autonomic regulation or abnormal sinus node function. We hypothesized that intrinsic heart rate (IHR) after autonomic blockade would be increased in patients with IST but not POTS. We enrolled 48 POTS patients, 8 IST patients, and 17 healthy control (HC) subjects. Intravenous propranolol and atropine were given to block the sympathetic and parasympathetic limbs of the autonomic nervous system in order to determine the IHR. Patients with IST have a higher sympathetic contribution to heart rate when compared with POTS patients (31±13 bpm versus 12±7 bpm, P<0.001) and HC (8±4 bpm; P<0.001) and a trend to less parasympathetic contribution than POTS and HC (IST: 31±11 bpm versus POTS: 46±11 bpm versus HC: 48±11 bpm, ANOVA P=0.108). IHR was not significantly different between IST and either POTS or HC (IST: 111±11 bpm versus POTS: 108±11 bpm versus HC: 106±12 bpm, ANOVA P=0.237). IST patients have more sympathetic tone when compared with either POTS or HC, but IST patients do not have abnormal sinus node automaticity. These data suggest that the treatment of IST and POTS should focus on sympatholysis, reserving sinus node modification for patients with continued debilitating symptoms after beta-blockade and possibly ivabradine. http://clinicaltrials.gov/. Unique identifier: NCT00262470.
Antianginal Therapy for Stable Ischemic Heart Disease: A Contemporary Review.
Padala, Santosh K; Lavelle, Michael P; Sidhu, Mandeep S; Cabral, Katherine P; Morrone, Doralisa; Boden, William E; Toth, Peter P
2017-11-01
Chronic angina pectoris is associated with considerable morbidity and mortality, especially if treated suboptimally. For many patients, aggressive pharmacologic intervention is necessary in order to alleviate anginal symptoms. The optimal treatment of stable ischemic heart disease (SIHD) should be the prevention of angina and ischemia, with the goal of maximizing both quality and quantity of life. In addition to effective risk factor modification with lifestyle changes, intensive pharmacologic secondary prevention is the therapeutic cornerstone in managing patients with SIHD. Current guidelines recommend a multifaceted therapeutic approach with β-blockers as first-line treatment. Another important pharmacologic intervention for managing SIHD is nitrates. Nitrates can provide both relief of acute angina and can be used prophylactically before exposure to known triggers of myocardial ischemia to prevent angina. Additional therapeutic options include calcium channel blockers and ranolazine, an inhibitor of the late inward sodium current, that can be used alone or in addition to nitrates or β-blockers when these agents fail to alleviate symptoms. Ranolazine appears to be particularly effective for patients with microvascular angina and endothelial dysfunction. In addition, certain antianginal therapies are approved in Europe and have been shown to improve symptoms, including ivabradine, nicorandil, and trimetazidine; however, these have yet to be approved in the United States. Ultimately, there are several different medications available to the physician for managing the patient with SIHD having chronic angina, when either used alone or in combination. The purpose of this review is to highlight the most important therapeutic approaches to optimizing contemporary treatment in response to individual patient needs.
Tomillero, A; Moral, M A
2010-01-01
(-)-Epigallocatechin gallate, Abafungin, ACE-031, Adapalene/benzoyl peroxide, AE-37, Aflibercept, AGS-003, Albiglutide, Alemtuzumab, Aliskiren fumarate, ALT-801, AN-2728, Anacetrapib, API, Aprepitant, ARQ-197, Ascorbic acid, Atazanavir sulfate, ATN-224, AVI-4658, Azacitidine, Azelnidipine; Belinostat, Bevacizumab, BI-2536, Biphasic insulin aspart, Bortezomib, Bovine lactoferrin, Bryostatin 1, Budesonide/formoterol fumarate; cAC10, Canfosfamide hydrochloride, Cediranib, Clofarabine, Cocaine conjugate vaccine; Darbepoetin alfa, Dasatinib, Denosumab, Disomotide, Doripenem, Dovitinib Lactate, Dronedarone hydrochloride, Drospirenone/estradiol, Dutasteride; Ecogramostim, Entinostat, Enzastaurin hydrochloride, Erlotinib hydrochloride, Everolimus, Exenatide, Ezetimibe, Ezetimibe/simvastatin; Fampridine, Fenretinide LXS, FFR-factor VIIa, Fingolimod hydrochloride, Frovatriptan; Gefitinib, Gimatecan, GP-2/GM-CSF; Iloperidone, Imatinib mesylate, Indibulin, Ipilimumab, Ivabradine hydrochloride; Lactobacillus rhamnosus, Lapatinib ditosylate, LC-07, Lenalidomide, Linifanib, Liposomal doxorubicin, Liposomal vincristine, Litenimod, Lutein; M-118, MDX-1401, MEDI-528, Midostaurin, Miglustat, MK-0657; Natalizumab, Nesiritide, NGR-TNF, Niacin/simvastatin; Obatoclax mesylate, Olaparib, Omacetaxine mepesuccinate; Paclitaxel nanoparticles, Paclitaxel-eluting stent, Palonosetron hydrochloride, Pazopanib hydrochloride, Pegfilgrastim, Pemetrexed disodium, PER.C-flu, Perifosine, PF-02341066, Pimecrolimus, Pitrakinra, Plerixafor hydrochloride, Posaconazole; Rasburicase, Recombinant human relaxin H2, ReoT3D, Retaspimycin hydrochloride, Riferminogene pecaplasmid, Rindopepimut, Romiplostim, Ronacaleret hydrochloride, Rosuvastatin calcium, Rotigotine; Sagopilone, sALP-FcD10, SAR-245409, SCH-697243, Selumetinib, Sirolimus-eluting stent, SIR-Spheres, Sitagliptin phosphate monohydrate, Sitaxentan sodium, Sorafenib, Sunitinib malate; Tadalafil, Tandutinib, Tasimelteon, Temsirolimus, Teriparatide, Tiotropium bromide, TIV, Trabectedin, Tremelimumab, TRU-016; Vadimezan, Val8-GLP-1(7-37)OH, Vandetanib, Vernakalant hydrochloride, Voreloxin, Voriconazole, Vorinostat, Yttrium 90 (90Y) ibritumomab tiuxetan; Zeaxanthin, Ziprasidone hydrochloride, Zosuquidar trihydrochloride. Copyright 2010 Prous Science, S.A.U. or its licensors. All rights reserved.
Heart rate and use of β-blockers in Mexican stable outpatients with coronary artery disease.
Alcocer-Gamba, Marco Antonio; Martínez-Sánchez, Carlos; Verdejo-Paris, Juan; Ferrari, Roberto; Fox, Kim; Greenlaw, Nicola; Steg Philippe, Gabriel
2015-01-01
To evaluate the use of β-blockers and to monitor heart rate in Mexican patients with coronary artery disease. CLARIFY is an outpatients registry with stable CAD. A total of 33,283 patients from 45 countries were enrolled between November 2009 and July 2010 from which 1342 were Mexican patients. The mean HR pulse was 70 bpm (beats per minute). Patients in Mexico were compared with the remaining global CLARIFY population. Patients in Mexico had a higher incidence of acute myocardial infarction and percutaneous coronary intervention, and lower incidence of revascularization surgery compared with the remaining CLARIFY population. More often, Mexican patients presented with diabetes, but less often hypertension and stroke. These patients were split into three mutually exclusive groups of HR ≤ 60 (N=263), HR 61-69 (N=356) and HR ≥ 70 (N=722). Patients with elevated HR had a higher incidence of diabetes and higher diastolic blood pressure on average than those with controlled HR. Regarding the use of β-blockers, they were used in 63.3% of patients, 2.7% showed intolerance or contraindication to treatment to monitor heart rate, and ivabradine was used in 2.3%. Out of approximately 849 patients receiving treatment of β-blockers, 52.1% had ≥ 70 bpm HR. In a large proportion of Mexican patients with stable coronary disease the HR remain elevated, > 70 bpm, even with the use of β-blockers; this requires further attention. Copyright © 2014 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.
Online kinematic regulation by visual feedback for grasp versus transport during reach-to-pinch
Nataraj, Raviraj; Pasluosta, Cristian; Li, Zong-Ming
2014-01-01
Purpose This study investigated novel kinematic performance parameters to understand regulation by visual feedback (VF) of the reaching hand on the grasp and transport components during the reach-to-pinch maneuver. Conventional metrics often signify discrete movement features to postulate sensory-based control effects (e.g., time for maximum velocity to signify feedback delay). The presented metrics of this study were devised to characterize relative vision-based control of the sub-movements across the entire maneuver. Methods Movement performance was assessed according to reduced variability and increased efficiency of kinematic trajectories. Variability was calculated as the standard deviation about the observed mean trajectory for a given subject and VF condition across kinematic derivatives for sub-movements of inter-pad grasp (distance between thumb and index finger-pads; relative orientation of finger-pads) and transport (distance traversed by wrist). A Markov analysis then examined the probabilistic effect of VF on which movement component exhibited higher variability over phases of the complete maneuver. Jerk-based metrics of smoothness (minimal jerk) and energy (integrated jerk-squared) were applied to indicate total movement efficiency with VF. Results/Discussion The reductions in grasp variability metrics with VF were significantly greater (p<0.05) compared to transport for velocity, acceleration, and jerk, suggesting separate control pathways for each component. The Markov analysis indicated that VF preferentially regulates grasp over transport when continuous control is modeled probabilistically during the movement. Efficiency measures demonstrated VF to be more integral for early motor planning of grasp than transport in producing greater increases in smoothness and trajectory adjustments (i.e., jerk-energy) early compared to late in the movement cycle. Conclusions These findings demonstrate the greater regulation by VF on kinematic performance of grasp compared to transport and how particular features of this relativistic control occur continually over the maneuver. Utilizing the advanced performance metrics presented in this study facilitated characterization of VF effects continuously across the entire movement in corroborating the notion of separate control pathways for each component. PMID:24968371
Investigating the Mechanism of MenaINV-Driven Metastasis
2016-02-01
bearing control tumor or expressing Mena or MenaINV 12 weeks after injection. Data presented as mean± SEM for 3 mice per group . Statistics determined by...proteins, 12 are known PTP1B substrates; as a group , these exhibited signifi- cantly higher phosphorylation in MenaINV-expressing cells than in controls ...person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number
Producibility and Serviceability of Kevlar-49 Structures Made on Hot Layup Tools
1975-05-01
changes for a typical airframe composite part and established improved machining practices for Kevlar-49. Some of the more signifi- cant conclusions...reverse side if necessary 8nd identify by block number) Composite Materials Inlet Fairing Helicopters Hot Layup Tools (HLT) Kevlar -49 20. ABSTRACT...CLASSlFlCATlON OF THIS PAGE(Whm Data Bnlorod) 0 Demonstrate the low cost aspects of using Hot Layup Tools (HLT) to fabricate composite structures. a
The United States Air Force in Korea: A Chronology, 1950-1953
2000-01-01
War , the U.S. Air Force (USAF) Historian commissioned the Research Division, Air Force His- torical Research Agency (AFHRA), Maxwell Air Force Base...and aces. Finally, it attempts to summarize those USAF events in Korea that best illustrate the air war and the application of air power in the...sources, usually to confirm the most signifi- cant events of the air war in Korea. AFHRA historians or archivists who researched and wrote the monthly and
An examination of OLED display application to military equipment
NASA Astrophysics Data System (ADS)
Thomas, J.; Lorimer, S.
2010-04-01
OLED display technology has developed sufficiently to support small format commercial applications such as cell-phone main display functions. Revenues seem sufficient to finance both performance improvements and to develop new applications. The situation signifies the possibility that OLED technology is on the threshold of credibility for military applications. This paper will examine both performance and some possible applications for the military ground mobile environment, identifying the advantages and disadvantages of this promising new technology.
1982-12-06
different model aircraft in different wave bands (P,L, S and X). Yet, the obtained results were relatively complex and it was not easy to find regularity...hertz for the S wave band . This type of narrow wave band signifies that the drift velocity of the target viewed in the reflection center is very low... Band of Airborne Radar With Pulse Width of 0.02)4 s and Grazing Angle of 470) Key: 1. Probability exceeding horizontal coordinates 2. Clutter section 3
A New Therapeutic Paradigm for Breast Cancer Exploiting Low Dose Estrogen-Induced Apoptosis
2014-08-01
incidences of stroke, pulmonary embolism , colorectal cancer, hip fractures , and death from other causes. After a mean follow-up of 6.8 years, no signifi- cant... embolism , DVT, transient ischemic attack, osteoporotic fracture , cataracts, death, and quality of life. The data was reported at a median follow-up time...injected into the axillary mammary fat pads of ovariectomized athymic mice. The mice were then divided into 4 groups and treated as follows: placebo
1990-08-01
If you want more, call us.] IBI. 6% of enlisted personnel and 5% of officers are riiarried to another soldier. This varies by sex and pay grade. For...societal openness about sex and accessibility pregnancy-related rates for teenagers. The Only one measure of sex education-the of contraceptive services...headed households correlates positively receiving sex educalion--proved signifi- betveen countries in explaining variation ir with abortion and pr
2009-01-01
all missing. The opinion at the time was that these problems—coupled with many other issues— signifi cantly undermined the overall effectiveness of...and provide clarify- ing information. The second method involved using timely and effective press releases from MNF-I. These press releases...by Lyman Cutlar several times before to stay off his property and quit eating his potatoes . Cutlar, a Kentuckian, was an American miner who had
Lincoln, Don
2018-01-16
At any time in history, a few scientific measurements disagreed with the best theoretical predictions of the time. Currently, one such discrepancy involves the measurement of the strength of the magnetic field of a subatomic particle called a muon. In this video, Fermilabâs Dr. Don Lincoln explains this mystery and sketches ongoing efforts to determine if this disagreement signifies a discovery. If it does, this measurement will mean that we will have to rewrite the textbooks.
Medical Surveillance Monthly Report (MSMR). Volume 14, Number 6, September/October 2007
2007-10-01
can signifi cantly impact the health, well-being and operational eff ectiveness of service members and their units. Th e U.S. military has developed...Young AJ. Sustaining health and performance in cold weather operations. Technical note no. TN/02-2. US Army Research Institute of Environmental ... assesment forms, U.S. Armed Forces, October 2006-September 2007 fourths (73.5%) of deployers rated their “health in general” as “excellent” or
Soviet Foreign Policy in the Middle East: Internal and External Determinants.
1987-06-01
Soviet-Egyptian relations and four involving Soviet-Syrian relations. Each event signifies a juncture at which Soviet policymakers had to make fundmental ...actor on the international scene. In order to promote a more active global strategy many of the more rigid doctrinal principles of the Stalin era were...establishment of a national-democratic state could be viewed as a positive first step towards socialism, even if it was initially based on capitalist principles
The Enigmatic Face of the Moon
NASA Astrophysics Data System (ADS)
Galles, C. D.; Gallagher, C. J.
2011-06-01
Whilst Man's only way of observing the Moon was with the naked eye, attempts at explaining the spots on her surface remained highly speculative. The telescopic observation by Galileo of previously unknown spots, differing from the earlier ones by their variability in time, was to signify a radical change to the hereto medieval ideas on the material composition of the Moon. And curiously enough, this new scenario was a revindication of Plutarch's hypothesis construed more than a millennium before.
Final Environmental Impact Statement for Oil Refinery, Georgetown, South Carolina. Volume 1.
1984-09-01
o, Ceeld furthler ’nPact. deonoC Illy viable. Minor reduc, effects new considered minor . degradation at Savanna but mould probibly met all OMQS...significantly due to - considered minor ; large spills other developments. Minor u ’ anlikely. but potentially very adverse impact at Savannah. damaging...7o signifi cnt o siqnifIcant Impact. Minor adverse GRct at Unending n c&Wdltins. coud further - inpact. Savannah. reduce effects of weste discharge p
Joining Pipe with the Hybrid Laser-GMAW Process: Weld Test Results and Cost Analysis
2006-06-01
Recent work investigating the poten- tial benefit of applying this technology to a shipyard pipe shop suggests that signifi- cant cost savings may be...arc-based joining processes. With recent advances in com- mercial laser technology , laser suppliers can now deliver dramatically higher power systems...reasons, shipyards in the U.S. are showing growing interest in hybrid laser-GMA welding technology . Hybrid Laser-GMA for Joining Pipe Welding of pipe
Of Ivory and Smurfs: Loxodontan MapReduce Experiments for Web Search
2009-11-01
i.e., index construction may involve multiple flushes to local disk and on-disk merge sorts outside of MapReduce). Once the local indexes have been...contained 198 cores, which, with current dual -processor quad-core con- figurations, could fit into 25 machines—a far more modest cluster with today’s...signifi- cant impact on effectiveness. Our simple pruning technique was performed at query time and hence could be adapted to query-dependent
2008-01-01
1.42 0.08 AA897516 PTGER4 0.99 0.02 1.04 0.02 1.09 0.02 1.150.03 1.19 0.03 Apoptosis (BP) BC006121 AIFM2 1.02 0.05 1.05 0.03 1.10 0.04 1.27... PTGER4 ) increased signifi- cantly (P 0.05) starting at 8 h. Although not statistically significant (P = 0.065), the expression of prostaglandin
Preimpoundment Water Quality of the Wild Rice River, Norman County, Minnesota.
1980-06-01
cell counts at Twin Valley for 1977 water year 25 14. Plot of total phosphorus related to phytoplankton cell counts at Twin Valley ; 30 15. Plot...of total nitrogen related to phytoplankton cell counts at Twin Valley 31 16. Bar graph of diversity indices of phytoplankton genera, 1976, 1977...statistically signifi- cant beyond the 0.02 level. There is no apparent relation of BOD to stream- flow or to suspended-sediment, phytoplankton , and bacteria
1985-05-30
The crewmembers of Space Shuttle mission 51-F have chosen as their insignia this design by Houston artist Skip Bradley. The Space Shuttle Challenger is depicted ascending toward the heavens in search of new knowledge in the field of solar and steallar astronomy, with its Spacelab 2 payload. The constellations Leo and Orion are in the positions they will be in, relative to the sun during the flight. The nineteen stars signify that this will be the 19th STS flight.