Incorporating Human Dosimetry and Exposure into High-Throughput In Vitro Toxicity Screening

EPA Science Inventory

Many chemicals in commerce today have undergone limited or no safety testing. To reduce the number of untested chemicals and prioritize limited testing resources, several governmental programs are using high-throughput in vitro screens for assessing chemical effects across multip...

Evolutionarily stable range limits set by interspecific competition.

PubMed

Price, Trevor D; Kirkpatrick, Mark

2009-04-22

A combination of abiotic and biotic factors probably restricts the range of many species. Recent evolutionary models and tests of those models have asked how a gradual change in environmental conditions can set the range limit, with a prominent idea being that gene flow disrupts local adaptation. We investigate how biotic factors, explicitly competition for limited resources, result in evolutionarily stable range limits even in the absence of the disruptive effect of gene flow. We model two competing species occupying different segments of the resource spectrum. If one segment of the resource spectrum declines across space, a species that specializes on that segment can be driven to extinction, even though in the absence of competition it would evolve to exploit other abundant resources and so be saved. The result is that a species range limit is set in both evolutionary and ecological time, as the resources associated with its niche decline. Factors promoting this outcome include: (i) inherent gaps in the resource distribution, (ii) relatively high fitness of the species when in its own niche, and low fitness in the alternative niche, even when resource abundances are similar in each niche, (iii) strong interspecific competition, and (iv) asymmetric interspecific competition. We suggest that these features are likely to be common in multispecies communities, thereby setting evolutionarily stable range limits.

Evolutionarily stable range limits set by interspecific competition

PubMed Central

Price, Trevor D.; Kirkpatrick, Mark

2009-01-01

A combination of abiotic and biotic factors probably restricts the range of many species. Recent evolutionary models and tests of those models have asked how a gradual change in environmental conditions can set the range limit, with a prominent idea being that gene flow disrupts local adaptation. We investigate how biotic factors, explicitly competition for limited resources, result in evolutionarily stable range limits even in the absence of the disruptive effect of gene flow. We model two competing species occupying different segments of the resource spectrum. If one segment of the resource spectrum declines across space, a species that specializes on that segment can be driven to extinction, even though in the absence of competition it would evolve to exploit other abundant resources and so be saved. The result is that a species range limit is set in both evolutionary and ecological time, as the resources associated with its niche decline. Factors promoting this outcome include: (i) inherent gaps in the resource distribution, (ii) relatively high fitness of the species when in its own niche, and low fitness in the alternative niche, even when resource abundances are similar in each niche, (iii) strong interspecific competition, and (iv) asymmetric interspecific competition. We suggest that these features are likely to be common in multispecies communities, thereby setting evolutionarily stable range limits. PMID:19324813

An accurate and affordable test for the rapid diagnosis of sickle cell disease could revolutionize the outlook for affected children born in resource-limited settings.

PubMed

Williams, Thomas N

2015-09-23

Each year, at least 280,000 children are born with sickle cell disease (SCD) in resource-limited settings. For cost, logistic and political reasons, the availability of SCD testing is limited in such settings and consequently 50-90 % of affected children die undiagnosed before their fifth birthday. The recent development of a point of care method for the diagnosis of SCD - the Sickle SCAN™ device - could afford such children the prompt access to appropriate services that has transformed the outlook for affected children in resource-rich areas. In research published in BMC Medicine, Kanter and colleagues describe a small but carefully conducted study involving 208 children and adults, in which they found that by using Sickle SCAN™ it was possible to diagnose the common forms of SCD with 99 % sensitivity and 99 % specificity, in under 5 minutes. If repeatable both in newborn babies and under real-life conditions, and if marketed at an affordable price, Sickle SCAN™ could revolutionize the survival prospects for children born with SCD in resource-limited areas.Please see related article: http://dx.doi.org/10.1186/s12916-015-0473-6.

Competency Testing for Limited-English-Proficient Students.

ERIC Educational Resources Information Center

Gold, Norman C.

The competency testing movement will yield few improvements in the schools and will create arbitrary barriers to progress for some students. Although it may stimulate educational improvement for limited-English-proficient (LEP) students, as for other students, by giving cohesion to the curriculum, guiding scarce resources for remediation,…

A missing ancestry - Genetic Testing | NIH MedlinePlus the Magazine

MedlinePlus

... Testing - From Genetics Home Reference: the benefits, costs, risks, and limitations of genetic testing Genetic Testing Registry -A publicly funded medical genetics information resource developed for physicians, other health care providers, and researchers MedlinePlus — Genetic Testing CLINSEQ®: ...

A Diagnosis of Lynch Syndrome - Genetic Testing | NIH MedlinePlus the Magazine

MedlinePlus

... Testing - From Genetics Home Reference: the benefits, costs, risks, and limitations of genetic testing Genetic Testing Registry -A publicly funded medical genetics information resource developed for physicians, other health care providers, and researchers MedlinePlus — Genetic Testing CLINSEQ®: ...

Competition for Left Hemisphere Resources: Right Hemisphere Superiority at Abstract Verbal Information Processing.

ERIC Educational Resources Information Center

Polson, Martha C.; And Others

A study tested a multiple-resources model of human information processing wherein the two cerebral hemispheres are assumed to have separate, limited-capacity pools of undifferentiated resources. The subjects were five right-handed males who had demonstrated right visual field-left hemisphere (RVF-LH) superiority for processing a centrally…

Model Test Bed for Evaluating Wave Models and Best Practices for Resource Assessment and Characterization

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

Neary, Vincent Sinclair; Yang, Zhaoqing; Wang, Taiping

A wave model test bed is established to benchmark, test and evaluate spectral wave models and modeling methodologies (i.e., best practices) for predicting the wave energy resource parameters recommended by the International Electrotechnical Commission, IEC TS 62600-101Ed. 1.0 ©2015. Among other benefits, the model test bed can be used to investigate the suitability of different models, specifically what source terms should be included in spectral wave models under different wave climate conditions and for different classes of resource assessment. The overarching goal is to use these investigations to provide industry guidance for model selection and modeling best practices depending onmore » the wave site conditions and desired class of resource assessment. Modeling best practices are reviewed, and limitations and knowledge gaps in predicting wave energy resource parameters are identified.« less

Point-of-care diagnostics: extending the laboratory network to reach the last mile.

PubMed

Drain, Paul K; Rousseau, Christine

2017-03-01

More point-of-care (POC) diagnostic tests are becoming available for HIV diagnosis and treatment in resource-limited settings. These novel technologies have the potential to foster decentralized HIV care and treatment for the benefit of clinical laboratories, HIV clinics, and HIV-infected patients. There continue to be many business, technological, and operational challenges that limit product development and regulatory approval, which limits products available for the required operational and cost-effectiveness studies and delays policy adoption and implementation. Although the rapid HIV diagnostic test has been widely successful, the pathways for POC CD4 cell count and HIV viral load assay analyzers have been more challenging. We describe significant hurdles for product development, approval, and implementation, which include the business case, technical development, clinical impact, and integrating laboratory and clinical networks. The objective of this review is to highlight the obstacles for developing and implementing appropriate strategies for POC HIV testing assays to improve the clinical services for HIV-infected patients in resource-limited settings.

Resources for Radiation Test Data

NASA Technical Reports Server (NTRS)

O'Bryan, Martha V.; Casey, Megan C.; Lauenstein, Jean-Marie; LaBel, Ken

2016-01-01

The performance of electronic devices in a space radiation environment is often limited by susceptibility to single-event effects (SEE), total ionizing dose (TID), and displacement damage (DD). Interpreting the results of SEE, TID, and DD testing of complex devices is quite difficult given the rapidly changing nature of both technology and the related radiation issues. Radiation testing is performed to establish the sensitivities of candidate spacecraft electronics to single-event upset (SEU), single-event latchup (SEL), single-event gate rupture (SEGR), single-event burnout (SEB), single-event transients (SETs), TID, and DD effects. Knowing where to search for these test results is a valuable resource for the aerospace engineer or spacecraft design engineer. This poster is intended to be a resource tool for finding radiation test data.

An Effort to Improve Teacher Perceptions and Knowledge of Cyberbullying: A Pre-Post Assessment

ERIC Educational Resources Information Center

Nesshengel-Hopp, Marleny T.

2017-01-01

Cyberbullying is a growing concern, confounded by the limited training resources available for teachers. The problem undertaken in this study was determining the most effective way to teach teachers about cyberbullying given the limited 1-hour time constraint of a typical school in-service activity. Using a pre-test, post-test experimental…

Recent advances in tuberculosis diagnostics in resource-limited settings.

PubMed

Seki, Mitsuko; Kim, Chang-Ki; Hayakawa, Satoshi; Mitarai, Satoshi

2018-04-19

Smear-negative and drug-resistant cases of tuberculosis (TB) disease necessitate the development of new diagnostic methods, especially in resource-limited settings. To improve the current TB situations, sensitive and specific TB point-of-care tests (POCTs) should be developed. This review addresses the current status of TB, novel diagnostic methodologies for TB, and the impact of those new diagnostics on TB control in such situations. Moreover, the perspective of TB management based on laboratory examinations is described. Smear microscopy with sputum samples is the only laboratory examination available in many resource-limited settings and is still used globally. Several nucleic acid amplification tests (NATs) have been developed. The World Health Organization (WHO) endorsed novel diagnostics based on NATs and updated their definition of a bacteriologically confirmed case requiring the biological specimen to be positive by smear microscopy, culture, or the WHO-recommended rapid diagnostic protocols. The use of new diagnostics increased the number of bacteriologically confirmed TB cases. Novel diagnostics are now available, but their sensitivity is still lower than that of conventional liquid culture method. To address the increasing incidence of TB, more resources including novel diagnostics as POCTs with higher sensitivity must be allocated to healthcare systems.

Processing capacity under perceptual and cognitive load: a closer look at load theory.

PubMed

Fitousi, Daniel; Wenger, Michael J

2011-06-01

Variations in perceptual and cognitive demands (load) play a major role in determining the efficiency of selective attention. According to load theory (Lavie, Hirst, Fockert, & Viding, 2004) these factors (a) improve or hamper selectivity by altering the way resources (e.g., processing capacity) are allocated, and (b) tap resources rather than data limitations (Norman & Bobrow, 1975). Here we provide an extensive and rigorous set of tests of these assumptions. Predictions regarding changes in processing capacity are tested using the hazard function of the response time (RT) distribution (Townsend & Ashby, 1978; Wenger & Gibson, 2004). The assumption that load taps resource rather than data limitations is examined using measures of sensitivity and bias drawn from signal detection theory (Swets, 1964). All analyses were performed at two levels: the individual and the aggregate. Hypotheses regarding changes in processing capacity were confirmed at the level of the aggregate. Hypotheses regarding resource and data limitations were not completely supported at either level of analysis. And in all of the analyses, we observed substantial individual differences. In sum, the results suggest a need to expand the theoretical vocabulary of load theory, rather than a need to discard it.

DEVELOPMENT OF EPA'S TOXCAST PROGRAM FOR PRIORITIZING THE TOXICITY TESTING OF ENVIRONMENTAL CHEMICALS.

EPA Science Inventory

EPA is developing methods for utilizing computational chemistry, high-throughput screening (HTS)and genomic technologies to predict potential toxicity and prioritize the use of limited testing resources.

Lipid and lipoprotein testing in resource-limited laboratories.

PubMed

Myers, Gary L

2003-01-01

The role of total cholesterol (TC) and lipoproteins in the assessment of coronary heart disease (CHD) is firmly established from population and intervention studies. Total and low-density lipoprotein cholesterol (LDLC) levels are positively associated with CHD, and high-density lipoprotein cholesterol (HDLC) levels are negatively associated with CHD. Efforts to identify and treat people at increased risk based on cholesterol and lipoprotein levels have led to more lipid testing and the need for very reliable test results. Thus, quality laboratory services are an essential component of healthcare delivery and play a vital role in any strategy to reduce morbidity and mortality from CHD. In laboratories with limited resources, establishing laboratory capability to measure CHD risk markers may be a considerable challenge. Laboratories face problems in selecting proper techniques, difficulties in equipment availability and maintenance, and shortage of supplies, staffing, and supervision. The Centers for Disease Control and Prevention (CDC) has been providing technical assistance for more than 30 years to laboratories that measure lipids and lipoproteins and is willing to provide technical assistance as needed for other laboratories to develop this capability. CDC can provide technical assistance to establish lipid and lipoprotein testing capability to support a CHD public health program in areas with limited laboratory resources. This assistance includes: selecting a suitable testing instrument; providing training for laboratory technicians; establishing a simple quality control plan; and instructing staff on how to prepare frozen serum control materials suitable for assessing accuracy of lipid and lipoprotein testing.

Developing a Screening Algorithm for Type II Diabetes Mellitus in the Resource-Limited Setting of Rural Tanzania.

PubMed

West, Caroline; Ploth, David; Fonner, Virginia; Mbwambo, Jessie; Fredrick, Francis; Sweat, Michael

2016-04-01

Noncommunicable diseases are on pace to outnumber infectious disease as the leading cause of death in sub-Saharan Africa, yet many questions remain unanswered with concern toward effective methods of screening for type II diabetes mellitus (DM) in this resource-limited setting. We aim to design a screening algorithm for type II DM that optimizes sensitivity and specificity of identifying individuals with undiagnosed DM, as well as affordability to health systems and individuals. Baseline demographic and clinical data, including hemoglobin A1c (HbA1c), were collected from 713 participants using probability sampling of the general population. We used these data, along with model parameters obtained from the literature, to mathematically model 8 purposed DM screening algorithms, while optimizing the sensitivity and specificity using Monte Carlo and Latin Hypercube simulation. An algorithm that combines risk assessment and measurement of fasting blood glucose was found to be superior for the most resource-limited settings (sensitivity 68%, sensitivity 99% and cost per patient having DM identified as $2.94). Incorporating HbA1c testing improves the sensitivity to 75.62%, but raises the cost per DM case identified to $6.04. The preferred algorithms are heavily biased to diagnose those with more severe cases of DM. Using basic risk assessment tools and fasting blood sugar testing in lieu of HbA1c testing in resource-limited settings could allow for significantly more feasible DM screening programs with reasonable sensitivity and specificity. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Teasing apart plant community responses to N enrichment: the roles of resource limitation, competition and soil microbes.

PubMed

Farrer, Emily C; Suding, Katharine N

2016-10-01

Although ecologists have documented the effects of nitrogen enrichment on productivity, diversity and species composition, we know little about the relative importance of the mechanisms driving these effects. We propose that distinct aspects of environmental change associated with N enrichment (resource limitation, asymmetric competition, and interactions with soil microbes) drive different aspects of plant response. We test this in greenhouse mesocosms, experimentally manipulating each factor across three ecosystems: tallgrass prairie, alpine tundra and desert grassland. We found that resource limitation controlled productivity responses to N enrichment in all systems. Asymmetric competition was responsible for diversity declines in two systems. Plant community composition was impacted by both asymmetric competition and altered soil microbes, with some contributions from resource limitation. Results suggest there may be generality in the mechanisms of plant community change with N enrichment. Understanding these links can help us better predict N response across a wide range of ecosystems. © 2016 John Wiley & Sons Ltd/CNRS.

International Neurocognitive Normative Study: Neurocognitive Comparison Data in Diverse Resource Limited Settings: AIDS Clinical Trials Group A5271

PubMed Central

Robertson, K; Jiang, H; Evans, SR; Marra, CM; Berzins, B; Hakim, J; Sacktor, N; Silva, M Tulius; Campbell, TB; Nair, A; Schouten, J; Kumwenda, J; Supparatpinyo, K; Tripathy, S.; Kumarasamy, N; La Rosa, A; Montano, S; Mwafongo, A; Firnhaber, C; Sanne, I; Naini, L.; Amod, F; Walawander, A

2016-01-01

Summary ACTG A5271 collected neurocognitive normative comparison test data in 2400 at-risk HIV seronegative participants from Brazil, India, Malawi, Peru, South Africa, Thailand and Zimbabwe. The participants were enrolled in strata by site (10 levels), age (2 levels), education (2 levels), and gender (2 levels). These data provide necessary normative data infrastructure for future clinical research and care in these diverse resource limited settings. Infrastructure for conducting neurological research in resource limited settings (RLS) is limited. The lack of neurological and neuropsychological (NP) assessment, and normative data needed for clinical interpretation impede research and clinical care. Here we report on ACTG 5271, which provided neurological training of clinical site personnel, and collected neurocognitive normative comparison data in diverse settings. At 10 sites in seven RLS countries, we provided training for NP assessments. We collected normative comparison data on HIV- participants from Brazil (n=240), India (n=480), Malawi (n=481), Peru (n=239), South Africa (480), Thailand (n=240) and Zimbabwe (n=240). Participants had a negative HIV test within 30 days before standardized NP exams were administered at baseline, and 770 at six-months. Participants were enrolled in 8 strata, gender (female and male), education (<10 years and ≥ 10 years), and age (<35 years and ≥35 years). Of 2400 enrolled, 770 completed the six-month follow up. As expected, significant between-country differences were evident in all the neurocognitive test scores (p<.0001). There was variation between the age, gender and education strata on the neurocognitive tests. Age and education were important variables for all tests; older participants had poorer performance and those with higher education had better performance. Women had better performance on verbal learning/memory and speed of processing tests, while men performed better on motor tests. This study provides the necessary neurocognitive normative data needed to build infrastructure for future neurological and neurocognitive studies in diverse RLS. These normative data are a much-needed resource for both clinicians and researchers. PMID:26733457

Resource limitation and responses to rivals in males of the fruit fly Drosophila melanogaster.

PubMed

Mason, J S; Rostant, W G; Chapman, T

2016-10-01

Diet has a profound direct and indirect effect on reproductive success in both sexes. Variation in diet quality and quantity can significantly alter the capacity of females to lay eggs and of males to deliver courtship. Here, we tested the effect of dietary resource limitation on the ability of male Drosophila melanogaster to respond adaptively to rivals by extending their mating duration. Previous work carried out under ad libitum diet conditions showed that males exposed to rivals prior to mating significantly extend mating duration, transfer more ejaculate proteins and achieve higher reproductive success. Such adaptive responses are predicted to occur because male ejaculate production may be limited. Hence, ejaculate resources require allocation across different reproductive bouts, to balance current vs. future reproductive success. However, when males suffer dietary limitation, and potentially have fewer reproductive resources to apportion, we expect adaptive allocation of responses to rivals to be minimized. We tested this prediction and found that males held on agar-only diets for 5-7 days lost the ability to extend mating following exposure to rivals. Interestingly, extended mating was retained in males held on low yeast/sugar: no sugar/yeast diet treatments, but was mostly lost when males were maintained on 'imbalanced' diets in which there was high yeast: no sugar and vice versa. Overall, the results show that males exhibit adaptive responses to rivals according to the degree of dietary resource limitation and to the ratio of individual diet components. © 2016 The Authors. Journal of Evolutionary Biology published by John Wiley & Sons Ltd on behalf of European Society for Evolutionary Biology.

TESTING AND EVALUATION IN THE BIOLOGICAL SCIENCES.

ERIC Educational Resources Information Center

NELSON, CLARENCE H.

THIS REPORT OF THE CUEBS PANEL ON EDUCATION AND TESTING SERVES AS A RESOURCE FOR THE INSTRUCTOR PREPARING COURSE EXAMINATIONS. THE MAJOR TOPICS DISCUSSED ARE (1) THE PROCEDURES IN PREPARING AN ACHIEVEMENT TEST, (2) THE CATEGORIZATION AND CODING OF TEST ITEMS, AND (3) THE ADVANTAGES AND LIMITATIONS OF VARIOUS TESTING PROCEDURES. OVER 1300 OBJECTIVE…

Chronic Inhibition, Self-Control and Eating Behavior: Test of a ‘Resource Depletion’ Model

PubMed Central

Hagger, Martin S.; Panetta, Giulia; Leung, Chung-Ming; Wong, Ging Ging; Wang, John C. K.; Chan, Derwin K. C.; Keatley, David A.; Chatzisarantis, Nikos L. D.

2013-01-01

The current research tested the hypothesis that individuals engaged in long-term efforts to limit food intake (e.g., individuals with high eating restraint) would have reduced capacity to regulate eating when self-control resources are limited. In the current research, body mass index (BMI) was used as a proxy for eating restraint based on the assumption that individuals with high BMI would have elevated levels of chronic eating restraint. A preliminary study (Study 1) aimed to provide evidence for the assumed relationship between eating restraint and BMI. Participants (N = 72) categorized into high or normal-range BMI groups completed the eating restraint scale. Consistent with the hypothesis, results revealed significantly higher scores on the weight fluctuation and concern for dieting subscales of the restraint scale among participants in the high BMI group compared to the normal-range BMI group. The main study (Study 2) aimed to test the hypothesized interactive effect of BMI and diminished self-control resources on eating behavior. Participants (N = 83) classified as having high or normal-range BMI were randomly allocated to receive a challenging counting task that depleted self-control resources (ego-depletion condition) or a non-depleting control task (no depletion condition). Participants then engaged in a second task in which required tasting and rating tempting cookies and candies. Amount of food consumed during the taste-and-rate task constituted the behavioral dependent measure. Regression analyses revealed a significant interaction effect of these variables on amount of food eaten in the taste-and-rate task. Individuals with high BMI had reduced capacity to regulate eating under conditions of self-control resource depletion as predicted. The interactive effects of BMI and self-control resource depletion on eating behavior were independent of trait self-control. Results extend knowledge of the role of self-control in regulating eating behavior and provide support for a limited-resource model of self-control. PMID:24146942

Management of Electronic Test Equipment. Volume 4. DoD Policy.

DTIC Science & Technology

1986-07-01

sources of supply , the PIL should not mandate sole source dependenc . but rather limit the variety to a minimum of two items. To clarify the controversy...equipment/ supplies on-hand, equipment readiness, and training. The resource area C-ratings are based on stated criteria. The criteria for equipment...respectively). The UNITREP leaves it up to the Military Services whether to include test equipment in the equipment/ supplies on-hand resource area. Although

THE TOXCAST PROGRAM FOR PRIORITIZING TOXICITY TESTING OF ENVIRONMENTAL CHEMICALS

EPA Science Inventory

The United States Environmental Protection Agency (EPA) is developing methods for utilizing computational chemistry, high-throughput screening (HTS) and various toxicogenomic technologies to predict potential for toxicity and prioritize limited testing resources towards chemicals...

Competition for nutrients and light: testing advances in resource competition with a natural phytoplankton community.

PubMed

Burson, Amanda; Stomp, Maayke; Greenwell, Emma; Grosse, Julia; Huisman, Jef

2018-05-01

A key challenge in ecology is to understand how nutrients and light affect the biodiversity and community structure of phytoplankton and plant communities. According to resource competition models, ratios of limiting nutrients are major determinants of species composition. At high nutrient levels, however, species interactions may shift to competition for light, which might make nutrient ratios less relevant. The "nutrient-load hypothesis" merges these two perspectives, by extending the classic model of competition for two nutrients to include competition for light. Here, we test five key predictions of the nutrient-load hypothesis using multispecies competition experiments. A marine phytoplankton community sampled from the North Sea was inoculated in laboratory chemostats provided with different nitrogen (N) and phosphorus (P) loads to induce either single resource limitation or co-limitation of N, P, and light. Four of the five predictions were validated by the experiments. In particular, different resource limitations favored the dominance of different species. Increasing nutrient loads caused changes in phytoplankton species composition, even if the N:P ratio of the nutrient loads remained constant, by shifting the species interactions from competition for nutrients to competition for light. In all treatments, small species became dominant whereas larger species were competitively excluded, supporting the common view that small cell size provides a competitive advantage under resource-limited conditions. Contrary to expectation, all treatments led to coexistence of diatoms, cyanobacteria and green algae, resulting in a higher diversity of species than predicted by theory. Because the coexisting species comprised three phyla with different photosynthetic pigments, we speculate that niche differentiation in the light spectrum might play a role. Our results show that mechanistic resource competition models that integrate nutrient-based and light-based approaches provide an important step forward to understand and predict how changing nutrient loads affect community composition. © 2018 The Authors Ecology published by Wiley Periodicals, Inc. on behalf of Ecological Society of America.

Effects of temperature on consumer-resource interactions.

PubMed

Amarasekare, Priyanga

2015-05-01

Understanding how temperature variation influences the negative (e.g. self-limitation) and positive (e.g. saturating functional responses) feedback processes that characterize consumer-resource interactions is an important research priority. Previous work on this topic has yielded conflicting outcomes with some studies predicting that warming should increase consumer-resource oscillations and others predicting that warming should decrease consumer-resource oscillations. Here, I develop a consumer-resource model that both synthesizes previous findings in a common framework and yields novel insights about temperature effects on consumer-resource dynamics. I report three key findings. First, when the resource species' birth rate exhibits a unimodal temperature response, as demonstrated by a large number of empirical studies, the temperature range over which the consumer-resource interaction can persist is determined by the lower and upper temperature limits to the resource species' reproduction. This contrasts with the predictions of previous studies, which assume that the birth rate exhibits a monotonic temperature response, that consumer extinction is determined by temperature effects on consumer species' traits, rather than the resource species' traits. Secondly, the comparative analysis I have conducted shows that whether warming leads to an increase or decrease in consumer-resource oscillations depends on the manner in which temperature affects intraspecific competition. When the strength of self-limitation increases monotonically with temperature, warming causes a decrease in consumer-resource oscillations. However, if self-limitation is strongest at temperatures physiologically optimal for reproduction, a scenario previously unanalysed by theory but amply substantiated by empirical data, warming can cause an increase in consumer-resource oscillations. Thirdly, the model yields testable comparative predictions about consumer-resource dynamics under alternative hypotheses for how temperature affects competitive and resource acquisition traits. Importantly, it does so through empirically quantifiable metrics for predicting temperature effects on consumer viability and consumer-resource oscillations, which obviates the need for parameterizing complex dynamical models. Tests of these metrics with empirical data on a host-parasitoid interaction yield realistic estimates of temperature limits for consumer persistence and the propensity for consumer-resource oscillations, highlighting their utility in predicting temperature effects, particularly warming, on consumer-resource interactions in both natural and agricultural settings. © 2014 The Author. Journal of Animal Ecology © 2014 British Ecological Society.

Parent Involvement in Elementary School Libraries

ERIC Educational Resources Information Center

Copeland, Michele Rzewski

2012-01-01

In the 21st century, school libraries are under pressure to innovate. Library budgets are frequently slashed as districts struggle with limited fiscal resources, while library personnel are increasingly expected to provide students with resources they need to help them pass high stakes tests. In an effort to meet student needs with limited…

HIV Drug Resistance Testing in a Resource Limited Setting with High Viral Diversity: The First Twenty Eight Months Experience.

PubMed

Ngo-Malabo, Elodie Teclaire; Ngoupo, Paul Alain; Sadeuh-Mba, Serge Alain; Akongnwi, Emmanuel; Banaï, Robert; Ngono, Laure; Bilong-Bilong, Charles Felix; Kfutwah, Anfumbom; Njouom, Richard

2017-01-01

First line antiretroviral therapy in a resource-limited setting consists of nucleotide and non-nucleotide reverse transcriptase inhibitors. Protease inhibitors are the hub of second line therapy. The decision to change antiretroviral therapy for a patient is frequently presumptive because of the lack of genotypic resistance tests in routine follow-up. We describe here the resistance profiles observed in patients with varying terms of antiretroviral therapy in Cameroon after implementation of HIV genotypic resistance testing in routine practice. HIV genotypic resistance testing was carried out on consecutive samples received between August 2013 and November 2015. Protease (Prot) and reverse transcriptase (Rt) genes of the HIV genome were amplified, sequenced and analyzed for drug resistance mutations following the algorithm set up by the French National Agency for research on HIV/AIDS and viral hepatitis. Specimens from a total of 167 patients infected with non-B HIV subtypes were received during the study period. Overall 61.7% patients had viral loads of more than 3log copies/ml, suggesting treatment failure. Among the 72 patients on first line, 56 (77.8%) were resistant to Lamivudine, 57 (79.1%) to Efavirenz and 58 (80.6%) to Nevirapine. Overall, more patients (75.0%) on first line antiretroviral therapy harbored multi-drug resistance compared to their counterparts on second line (25.8%). This study revealed that a group of patients with antiretroviral therapy failure harbored multi-drug resistance mutations related to the majority of drugs in the first line regimen. Therefore, HIV resistance testing could be a useful tool to improve HIV care in resource limited settings like Cameroon where treatment options are limited. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Evaluating the Psychometric Characteristics of Generated Multiple-Choice Test Items

ERIC Educational Resources Information Center

Gierl, Mark J.; Lai, Hollis; Pugh, Debra; Touchie, Claire; Boulais, André-Philippe; De Champlain, André

2016-01-01

Item development is a time- and resource-intensive process. Automatic item generation integrates cognitive modeling with computer technology to systematically generate test items. To date, however, items generated using cognitive modeling procedures have received limited use in operational testing situations. As a result, the psychometric…

Using a geographic information system to enhance patient access to point-of-care diagnostics in a limited-resource setting.

PubMed

Ferguson, William J; Kemp, Karen; Kost, Gerald

2016-03-01

Rapid and accurate diagnosis drives evidence-based care in health. Point-of-care testing (POCT) aids diagnosis by bringing advanced technologies closer to patients. Health small-world networks are constrained by natural connectivity in the interactions between geography of resources and social forces. Using a geographic information system (GIS) we can understand how populations utilize their health networks, visualize their inefficiencies, and compare alternatives. This project focuses on cardiac care resource in rural Isaan, Thailand. A health care access analysis was created using ArcGIS Network Analyst 10.1 from data representing aggregated population, roads, health resource facilities, and diagnostic technologies. The analysis quantified cardiac health care access and identified ways to improve it using both widespread and resource-limited strategies. Results indicated that having diagnostic technologies closer to populations streamlines critical care paths. GIS allowed us to compare the effectiveness of the implementation strategies and put into perspective the benefits of adopting rapid POCT within health networks. Geospatial analyses derive high impact by improving alternative diagnostic placement strategies in limited-resource settings and by revealing deficiencies in health care access pathways. Additionally, the GIS provides a platform for comparing relative costs, assessing benefits, and improving outcomes. This approach can be implemented effectively by health ministries seeking to enhance cardiac care despite limited resources.

Evaluating the Comparability of Paper- and Computer-Based Science Tests across Sex and SES Subgroups

ERIC Educational Resources Information Center

Randall, Jennifer; Sireci, Stephen; Li, Xueming; Kaira, Leah

2012-01-01

As access and reliance on technology continue to increase, so does the use of computerized testing for admissions, licensure/certification, and accountability exams. Nonetheless, full computer-based test (CBT) implementation can be difficult due to limited resources. As a result, some testing programs offer both CBT and paper-based test (PBT)…

EPAS TOXCAST PROGRAM FOR PREDICTING HAZARD AND PRIORITIZING TOXICITY TESTING OF ENVIRONMENTAL CHEMICALS(S).

EPA Science Inventory

EPAs National Center for Computational Toxicology is developing methods that apply computational chemistry, high-throughput screening (HTS) and genomic technologies to predict potential toxicity and prioritize the use of limited testing resources.

Application of exercise ECG stress test in the current high cost modern-era healthcare system.

PubMed

Vaidya, Gaurang Nandkishor

Exercise electrocardiogram (ECG) tests boasts of being more widely available, less resource intensive, lower cost and absence of radiation. In the presence of a normal baseline ECG, an exercise ECG test is able to generate a reliable and reproducible result almost comparable to Technitium-99m sestamibi perfusion imaging. Exercise ECG changes when combined with other clinical parameters obtained during the test has the potential to allow effective redistribution of scarce resources by excluding low risk patients with significant accuracy. As we look towards a future of rising healthcare costs, increased prevalence of cardiovascular disease and the need for proper allocation of limited resources; exercise ECG test offers low cost, vital and reliable disease interpretation. This article highlights the physiology of the exercise ECG test, patient selection, effective interpretation, describe previously reported scores and their clinical application in today's clinical practice. Copyright © 2017. Published by Elsevier B.V.

Molecular Oncology Testing in Resource-Limited Settings

PubMed Central

Gulley, Margaret L.; Morgan, Douglas R.

2015-01-01

Cancer prevalence and mortality are high in developing nations, where resources for cancer control are inadequate. Nearly one-quarter of cancers in resource-limited nations are infection related, and molecular assays can capitalize on this relationship by detecting pertinent pathogen genomes and human gene variants to identify those at highest risk for progression to cancer, to classify lesions, to predict effective therapy, and to monitor tumor burden over time. Prime examples are human papillomavirus in cervical neoplasia, Helicobacter pylori and Epstein-Barr virus in gastric adenocarcinoma and lymphoma, and hepatitis B or C virus in hepatocellular cancer. Research is underway to engineer devices that overcome social, economic, and technical barriers limiting effective laboratory support. Additional challenges include an educated workforce, infrastructure for quality metrics and record keeping, and funds to sustain molecular test services. The combination of well-designed interfaces, novel and robust electrochemical technology, and telemedicine tools will promote adoption by frontline providers. Fast turnaround is crucial for surmounting loss to follow-up, although increased use of cell phones, even in rural areas, enhances options for patient education and engagement. Links to a broadband network facilitate consultation and centralized storage of medical data. Molecular technology shows promise to address gaps in health care through rapid, user-friendly, and cost-effective devices reflecting clinical priorities in resource-poor areas. PMID:25242061

Detection of Hepatitis B Virus DNA among Chronic and potential Occult HBV patients in resource-limited settings by Loop-Mediated Isothermal Amplification assay.

PubMed

Akram, Arifa; Islam, S M Rashedul; Munshi, Saif Ullah; Tabassum, Shahina

2018-05-16

Transmission of Hepatitis B Virus (HBV) usually occurs due to the transfusion of blood or blood products from chronic HBV (CHB) or occult HBV infected (OBI) patients. Besides serological tests e.g. HBsAg and anti-HBc (total), detection of HBV-DNA is necessary for the diagnosis of OBI patients. Different nucleic acid tests (NATs) including real-time-Polymerase Chain Reaction (qPCR) are used for the detect HBV-DNA. The NATs are expensive and require technical expertise which are barriers to introducing them in resource-limited settings. This study was undertaken to evaluate the use of Loop-Mediated Isothermal Amplification (LAMP) assay as an alternative to qPCR for the detection of HBV-DNA in CHB and potential OBI patients in resource-limited settings. Following the published protocols with some modifications, a LAMP assay was developed for detection of HBV-DNA by either using a heat block followed by detection in an agarose gel or using a qPCR thermocycler. The LAMP assay was applied to supernatant prepared from heat treated serum collected from CHB and potential OBI patients. HBV viral load in serum was measured by qPCR using a single step HBV-DNA quantification kit. Among 200 samples tested, qPCR was capable to detect HBV-DNA in 25.5% of cases, whereas LAMP assay detected HBV-DNA in 43.5% cases. The qPCR was able to detect 11 (9.16%) potential OBI cases, whereas LAMP assay identified HBV-DNA in 43 (35.83%) cases. In addition to tests for HBsAg and/or anti-HBc (total), detection of HBV-DNA by LAMP assay may aid in preventing post-transfusion HBV infection in resource-limited settings. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

EPA'S TOXCAST PROGRAM FOR PREDICTING HAZARD AND PRIORITIZING TOXICITY TESTING OF ENVIRONMENTAL CHEMICALS

EPA Science Inventory

EPA is developing methods for utilizing computational chemistry, high-throughput screening (HTS) and various toxicogenomic technologies to predict potential for toxicity and prioritize limited testing resources towards chemicals that likely represent the greatest hazard to human ...

Dynamic Pathfinders: Leveraging Your OPAC to Create Resource Guides

ERIC Educational Resources Information Center

Hunter, Ben

2008-01-01

Library pathfinders are a time-tested method of leading library users to important resources. However, paper-based pathfinders suffer from space limitations, and both paper-based and Web-based pathfinders require frequent updates to keep up with new library acquisitions. This article details a step-by-step method to create an online dynamic…

Pollen limitation of reproductive effort in willows.

PubMed

Fox, John F

1992-05-01

Pollen limitation of seed set differs from resource limitation in its implications for the evolution of floral traits. Willow flowers attract insects, but also abundantly produce wind-dispersed pollen. I demonstrated pollen limitation in single branches bearing 2-4 inflorescences (catkins) in a field experiment with five species by artificially increasing or decreasing the pollen load. Because the responses by single branches might be explained by diversion of resources to better-pollinated branches within a plant, a second experiment with one species tested both pollen limitation of whole plants and the autonomy of catkins. Seed set of single willow catkins is unaffected by experimental alterations of seed set in other catkins on the same plant. Hand-pollination of single catkins and of whole plants increased seed set to the same degree, suggesting there is little or no competition for resources between catkins only 5-10 cm apart. Thus, seed set in willows appears to be pollen limited, favoring insect pollination and the evolution of entomophilous traits. The data support previous views that willows have a dual pollination system utilizing wind and insects.

Microenvironmental independence associated with tumor progression.

PubMed

Anderson, Alexander R A; Hassanein, Mohamed; Branch, Kevin M; Lu, Jenny; Lobdell, Nichole A; Maier, Julie; Basanta, David; Weidow, Brandy; Narasanna, Archana; Arteaga, Carlos L; Reynolds, Albert B; Quaranta, Vito; Estrada, Lourdes; Weaver, Alissa M

2009-11-15

Tumor-microenvironment interactions are increasingly recognized to influence tumor progression. To understand the competitive dynamics of tumor cells in diverse microenvironments, we experimentally parameterized a hybrid discrete-continuum mathematical model with phenotypic trait data from a set of related mammary cell lines with normal, transformed, or tumorigenic properties. Surprisingly, in a resource-rich microenvironment, with few limitations on proliferation or migration, transformed (but not tumorigenic) cells were most successful and outcompeted other cell types in heterogeneous tumor simulations. Conversely, constrained microenvironments with limitations on space and/or growth factors gave a selective advantage to phenotypes derived from tumorigenic cell lines. Analysis of the relative performance of each phenotype in constrained versus unconstrained microenvironments revealed that, although all cell types grew more slowly in resource-constrained microenvironments, the most aggressive cells were least affected by microenvironmental constraints. A game theory model testing the relationship between microenvironment resource availability and competitive cellular dynamics supports the concept that microenvironmental independence is an advantageous cellular trait in resource-limited microenvironments.

Participation of low-income women in genetic cancer risk assessment and BRCA 1/2 testing: the experience of a safety-net institution.

PubMed

Komenaka, Ian K; Nodora, Jesse N; Madlensky, Lisa; Winton, Lisa M; Heberer, Meredith A; Schwab, Richard B; Weitzel, Jeffrey N; Martinez, Maria Elena

2016-07-01

Some communities and populations lack access to genetic cancer risk assessment (GCRA) and testing. This is particularly evident in safety-net institutions, which serve a large segment of low-income, uninsured individuals. We describe the experience of a safety-net clinic with limited resources in providing GCRA and BRCA1/2 testing. We compared the proportion and characteristics of high-risk women who were offered and underwent GCRA and genetic testing. We also provide a description of the mutation profile for affected women. All 125 patients who were offered GCRA accepted to undergo GCRA. Of these, 72 % had a breast cancer diagnosis, 70 % were Hispanic, 52.8 % were non-English speakers, and 66 % did not have health insurance. Eighty four (67 %) were offered genetic testing and 81 (96 %) agreed. Hispanic women, those with no medical insurance, and those with a family history of breast cancer were significantly more likely to undergo testing (p > 0.01). Twelve of 81 (15 %) patients were found to have deleterious mutations, seven BRCA1, and five BRCA2. Our experience shows that it is possible to offer GCRA and genetic testing even in the setting of limited resources for these services. This is important given that a large majority of the low-income women in our study agreed to undergo counseling and testing. Our experience could serve as a model for similar low-resource safety-net health settings.

International neurocognitive normative study: neurocognitive comparison data in diverse resource-limited settings: AIDS Clinical Trials Group A5271.

PubMed

Robertson, K; Jiang, H; Evans, S R; Marra, C M; Berzins, B; Hakim, J; Sacktor, N; Silva, M Tulius; Campbell, T B; Nair, A; Schouten, J; Kumwenda, J; Supparatpinyo, K; Tripathy, S; Kumarasamy, N; la Rosa, A; Montano, S; Mwafongo, A; Firnhaber, C; Sanne, I; Naini, L; Amod, F; Walawander, A

2016-08-01

Infrastructure for conducting neurological research in resource-limited settings (RLS) is limited. The lack of neurological and neuropsychological (NP) assessment and normative data needed for clinical interpretation impedes research and clinical care. Here, we report on ACTG 5271, which provided neurological training of clinical site personnel and collected neurocognitive normative comparison data in diverse settings. At ten sites in seven RLS countries, we provided training for NP assessments. We collected normative comparison data on HIV- participants from Brazil (n = 240), India (n = 480), Malawi (n = 481), Peru (n = 239), South Africa (480), Thailand (n = 240), and Zimbabwe (n = 240). Participants had a negative HIV test within 30 days before standardized NP exams were administered at baseline and 770 at 6 months. Participants were enrolled in eight strata, gender (female and male), education (<10 and ≥10 years), and age (<35 and ≥35 years). Of 2400 enrolled, 770 completed the 6-month follow-up. As expected, significant between-country differences were evident in all the neurocognitive test scores (p < 0.0001). There was variation between the age, gender, and education strata on the neurocognitive tests. Age and education were important variables for all tests; older participants had poorer performance, and those with higher education had better performance. Women had better performance on verbal learning/memory and speed of processing tests, while men performed better on motor tests. This study provides the necessary neurocognitive normative data needed to build infrastructure for future neurological and neurocognitive studies in diverse RLS. These normative data are a much-needed resource for both clinicians and researchers.

Using a Sequence Homology-Based Predictive Strategy to Address Current Demands for Focused Toxicity Testing in Ecological Risk Assessment

EPA Science Inventory

The lack of resources available for comprehensive toxicity testing, international interest in limiting the quantity of animals used in testing, and a mounting list of anthropogenic chemicals produced world-wide have led to the exploration of innovative means for identifying chemi...

Colorectal cancer screening: An updated review of the available options.

PubMed

Issa, Iyad A; Noureddine, Malak

2017-07-28

Colorectal cancer (CRC) is a significant cause of morbidity and mortality worldwide. However, colon cancer incidence and mortality is declining over the past decade owing to adoption of effective screening programs. Nevertheless, in some parts of the world, CRC incidence and mortality remain on the rise, likely due to factors including "westernized" diet, lifestyle, and lack of health-care infrastructure and resources. Participation and adherence to different national screening programs remain obstacles limiting the achievement of screening goals. Different modalities are available ranging from stool based tests to radiology and endoscopy with varying sensitivity and specificity. However, the availability of these tests is limited to areas with high economic resources. Recently, FDA approved a blood-based test (Epi procolon ® ) for CRC screening. This blood based test may serve to increase the participation and adherence rates. Hence, leading to increase in colon cancer detection and prevention. This article will discuss various CRC screening tests with a particular focus on the data regarding the new approved blood test. Finally, we will propose an algorithm for a simple cost-effective CRC screening program.

Colorectal cancer screening: An updated review of the available options

PubMed Central

Issa, Iyad A; Noureddine, Malak

2017-01-01

Colorectal cancer (CRC) is a significant cause of morbidity and mortality worldwide. However, colon cancer incidence and mortality is declining over the past decade owing to adoption of effective screening programs. Nevertheless, in some parts of the world, CRC incidence and mortality remain on the rise, likely due to factors including “westernized” diet, lifestyle, and lack of health-care infrastructure and resources. Participation and adherence to different national screening programs remain obstacles limiting the achievement of screening goals. Different modalities are available ranging from stool based tests to radiology and endoscopy with varying sensitivity and specificity. However, the availability of these tests is limited to areas with high economic resources. Recently, FDA approved a blood-based test (Epi procolon®) for CRC screening. This blood based test may serve to increase the participation and adherence rates. Hence, leading to increase in colon cancer detection and prevention. This article will discuss various CRC screening tests with a particular focus on the data regarding the new approved blood test. Finally, we will propose an algorithm for a simple cost-effective CRC screening program. PMID:28811705

Assessment of a New Lower-Cost Real-Time PCR Assay for Detection of High-Risk Human Papillomavirus: Useful for Cervical Screening in Limited-Resource Settings?

PubMed Central

Schiffman, Mark; Wentzensen, Nicolas H.; Gage, Julia C.; Castle, Philip E.; Raine-Bennett, Tina R.; Fetterman, Barbara; Lorey, Thomas; Poitras, Nancy E.; Befano, Brian; Xie, Yi; Miachon, Lais S.; Dean, Michael

2017-01-01

ABSTRACT Inexpensive and easy-to-perform human papillomavirus (HPV) tests are needed for primary cervical cancer screening in lower-resource regions. In a convenience sample of 516 residual exfoliative cervical specimens from the Kaiser Permanente Northern California and U.S. National Cancer Institute Persistence and Progression Study, we assessed the agreement and clinical performance of a simple, inexpensive real-time PCR assay for the detection of 13 carcinogenic HPV types (the H13 assay; Hybribio, Hong Kong) that is marketed in limited-resource settings compared to previous testing by the Hybrid Capture 2 assay (HC2; Qiagen, Germantown, MD) and the Onclarity assay (BD Diagnostics, Sparks, MD). The test set was chosen to include many HPV-positive specimens. The reference standard was a combination of HC2 and Onclarity results for HPV detection and histologic diagnosis of controls (less than cervical intraepithelial neoplasia grade 2 [

Assessment of a New Lower-Cost Real-Time PCR Assay for Detection of High-Risk Human Papillomavirus: Useful for Cervical Screening in Limited-Resource Settings?

PubMed

Fokom Domgue, Joel; Schiffman, Mark; Wentzensen, Nicolas H; Gage, Julia C; Castle, Philip E; Raine-Bennett, Tina R; Fetterman, Barbara; Lorey, Thomas; Poitras, Nancy E; Befano, Brian; Xie, Yi; Miachon, Lais S; Dean, Michael

2017-08-01

Inexpensive and easy-to-perform human papillomavirus (HPV) tests are needed for primary cervical cancer screening in lower-resource regions. In a convenience sample of 516 residual exfoliative cervical specimens from the Kaiser Permanente Northern California and U.S. National Cancer Institute Persistence and Progression Study, we assessed the agreement and clinical performance of a simple, inexpensive real-time PCR assay for the detection of 13 carcinogenic HPV types (the H13 assay; Hybribio, Hong Kong) that is marketed in limited-resource settings compared to previous testing by the Hybrid Capture 2 assay (HC2; Qiagen, Germantown, MD) and the Onclarity assay (BD Diagnostics, Sparks, MD). The test set was chosen to include many HPV-positive specimens. The reference standard was a combination of HC2 and Onclarity results for HPV detection and histologic diagnosis of controls (less than cervical intraepithelial neoplasia grade 2 [

Guidance on the diagnosis and management of asthma among adults in resource limited settings.

PubMed

Kirenga, Bruce J; Schwartz, Jeremy I; de Jong, Corina; van der Molen, Thys; Okot-Nwang, Martin

2015-12-01

Optimal management of asthma in resource limited settings is hindered by lack of resources, making it difficult for health providers to adhere to international guidelines. The purpose of this review is to identify steps for asthma diagnosis and management in resource limited settings. Review of international asthma guidelines and other published studies on diagnosis and management of asthma. We establish that clinical diagnosis of asthma can be made if recurrent respiratory symptoms especially current wheeze or wheeze in the last 12 months are present. Presence of a trigger, other allergic diseases, personal or family history of asthma; clinical improvement and increase in the peak flow and forced expiratory volume in one second of ≥12% after salbutamol administration increases the likelihood of asthma. At diagnosis severity grading, patient education, removal or reduction of trigger should be done. Follow up 2-6 weeks and assessment of control during therapy is essential. Therapy should be adjusted up or down depending on control levels. Patients should be instructed to increase the frequency of their bronchodilators and/or steroids therapy when they start to experience worsening symptoms. Good quality asthma care can be achieved in resource limited settings by use of clinical data and simple tests.

The design and evaluation of a system for improved surveillance and prevention programmes in resource-limited settings using a hospital-based burn injury questionnaire.

PubMed

Peck, Michael; Falk, Henry; Meddings, David; Sugerman, David; Mehta, Sumi; Sage, Michael

2016-04-01

Limited and fragmented data collection systems exist for burn injury. A global registry may lead to better injury estimates and identify risk factors. A collaborative effort involving the WHO, the Global Alliance for Clean Cookstoves, the CDC and the International Society for Burn Injuries was undertaken to simplify and standardise inpatient burn data collection. An expert panel of epidemiologists and burn care practitioners advised on the development of a new Global Burn Registry (GBR) form and online data entry system that can be expected to be used in resource-abundant or resource-limited settings. International burn organisations, the CDC and the WHO solicited burn centre participation to pilot test the GBR system. The WHO and the CDC led a webinar tutorial for system implementation. During an 8-month period, 52 hospitals in 30 countries enrolled in the pilot and were provided the GBR instrument, guidance and a data visualisation tool. Evaluations were received from 29 hospitals (56%). Median time to upload completed forms was <10 min; physicians most commonly entered data (64%), followed by nurses (25%); layout, clarity, accuracy and relevance were all rated high; and a vast majority (85%) considered the GBR 'highly valuable' for prioritising, developing and monitoring burn prevention programmes. The GBR was shown to be simple, flexible and acceptable to users. Enhanced regional and global understanding of burn epidemiology may help prioritise the selection, development and testing of primary prevention interventions for burns in resource-limited settings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Current strategies for improving access and adherence to antiretroviral therapies in resource-limited settings

PubMed Central

Scanlon, Michael L; Vreeman, Rachel C

2013-01-01

The rollout of antiretroviral therapy (ART) significantly reduced human immunodeficiency virus (HIV)-related morbidity and mortality, but good clinical outcomes depend on access and adherence to treatment. In resource-limited settings, where over 90% of the world’s HIV-infected population resides, data on barriers to treatment are emerging that contribute to low rates of uptake in HIV testing, linkage to and retention in HIV care systems, and suboptimal adherence rates to therapy. A review of the literature reveals limited evidence to inform strategies to improve access and adherence with the majority of studies from sub-Saharan Africa. Data from observational studies and randomized controlled trials support home-based, mobile and antenatal care HIV testing, task-shifting from doctor-based to nurse-based and lower level provider care, and adherence support through education, counseling and mobile phone messaging services. Strategies with more limited evidence include targeted HIV testing for couples and family members of ART patients, decentralization of HIV care, including through home- and community-based ART programs, and adherence promotion through peer health workers, treatment supporters, and directly observed therapy. There is little evidence for improving access and adherence among vulnerable groups such as women, children and adolescents, and other high-risk populations and for addressing major barriers. Overall, studies are few in number and suffer from methodological issues. Recommendations for further research include health information technology, social-level factors like HIV stigma, and new research directions in cost-effectiveness, operations, and implementation. Findings from this review make a compelling case for more data to guide strategies to improve access and adherence to treatment in resource-limited settings. PMID:23326204

Multi Sensor Fusion Framework for Indoor-Outdoor Localization of Limited Resource Mobile Robots

PubMed Central

Marín, Leonardo; Vallés, Marina; Soriano, Ángel; Valera, Ángel; Albertos, Pedro

2013-01-01

This paper presents a sensor fusion framework that improves the localization of mobile robots with limited computational resources. It employs an event based Kalman Filter to combine the measurements of a global sensor and an inertial measurement unit (IMU) on an event based schedule, using fewer resources (execution time and bandwidth) but with similar performance when compared to the traditional methods. The event is defined to reflect the necessity of the global information, when the estimation error covariance exceeds a predefined limit. The proposed experimental platforms are based on the LEGO Mindstorm NXT, and consist of a differential wheel mobile robot navigating indoors with a zenithal camera as global sensor, and an Ackermann steering mobile robot navigating outdoors with a SBG Systems GPS accessed through an IGEP board that also serves as datalogger. The IMU in both robots is built using the NXT motor encoders along with one gyroscope, one compass and two accelerometers from Hitecnic, placed according to a particle based dynamic model of the robots. The tests performed reflect the correct performance and low execution time of the proposed framework. The robustness and stability is observed during a long walk test in both indoors and outdoors environments. PMID:24152933

Multi sensor fusion framework for indoor-outdoor localization of limited resource mobile robots.

PubMed

Marín, Leonardo; Vallés, Marina; Soriano, Ángel; Valera, Ángel; Albertos, Pedro

2013-10-21

This paper presents a sensor fusion framework that improves the localization of mobile robots with limited computational resources. It employs an event based Kalman Filter to combine the measurements of a global sensor and an inertial measurement unit (IMU) on an event based schedule, using fewer resources (execution time and bandwidth) but with similar performance when compared to the traditional methods. The event is defined to reflect the necessity of the global information, when the estimation error covariance exceeds a predefined limit. The proposed experimental platforms are based on the LEGO Mindstorm NXT, and consist of a differential wheel mobile robot navigating indoors with a zenithal camera as global sensor, and an Ackermann steering mobile robot navigating outdoors with a SBG Systems GPS accessed through an IGEP board that also serves as datalogger. The IMU in both robots is built using the NXT motor encoders along with one gyroscope, one compass and two accelerometers from Hitecnic, placed according to a particle based dynamic model of the robots. The tests performed reflect the correct performance and low execution time of the proposed framework. The robustness and stability is observed during a long walk test in both indoors and outdoors environments.

Decentralization of CD4 testing in resource-limited settings: 7 years of experience in six African countries.

PubMed

Marinucci, F; Medina-Moreno, S; Paterniti, A D; Wattleworth, M; Redfield, R R

2011-05-01

Improving access to CD4 testing in resource-limited settings can be achieved through both centralized and decentralized testing networks. Decentralized testing models are more suitable for countries where the HIV epidemic affects a large portion of rural populations. Timely access to accurate CD4 results is crucial at the primary level of the health system. For the past 7 years, the Institute of Human Virology of the University of Maryland School of Medicine has implemented a flexible and sustainable three-phase model: (1) site assessment and improvement, (2) appropriate technology selection with capacity building through practical training and laboratory mentoring, and (3) quality management system strengthening and monitoring, to support accessibility to reliable CD4 counting at the point of service. CD4 testing capacity was established in 122 of 229 (53%) laboratories supported in Nigeria, Uganda, Kenya, Zambia, Tanzania, and Rwanda. Among those in rural settings, 46% (69/151) had CD4 testing available at site level, with a functioning flow cytometer installed at 28% (8/29) and 50% (61/122) of level 1 and level 2 sites, respectively. To strengthen local capacity, a total of 1,152 laboratory technicians were trained through 188 training sessions provided both on-site and at central locations. The overall quality of CD4 total testing procedure was assessed at 76% (92/121) of the laboratories, with 25% (23/92), 34% (31/92), and 33% (30/92) of them reporting excellent, good, and satisfactory performance. Balancing country-specific factors with the location of the clinic, number of patients, and the expected workload, was crucial in adapting this flexible model for decentralizing CD4 testing. The close collaboration with local governments and private vendors was key to successfully expanding access to CD4 testing within the framework of HIV care and treatment programs and for the sustainability of medical laboratories in resource-limited settings. Copyright © 2011 International Society for Advancement of Cytometry.

Quantification of Carbon and Phosphorus Co-Limitation in Bacterioplankton: New Insights on an Old Topic

PubMed Central

Dorado-García, Irene; Medina-Sánchez, Juan Manuel; Herrera, Guillermo; Cabrerizo, Marco J.; Carrillo, Presentación

2014-01-01

Because the nature of the main resource that limits bacterioplankton (e.g. organic carbon [C] or phosphorus [P]) has biogeochemical implications concerning organic C accumulation in freshwater ecosystems, empirical knowledge is needed concerning how bacteria respond to these two resources, available alone or together. We performed field experiments of resource manipulation (2×2 factorial design, with the addition of C, P, or both combined) in two Mediterranean freshwater ecosystems with contrasting trophic states (oligotrophy vs. eutrophy) and trophic natures (autotrophy vs. heterotrophy, measured as gross primary production:respiration ratio). Overall, the two resources synergistically co-limited bacterioplankton, i.e. the magnitude of the response of bacterial production and abundance to the two resources combined was higher than the additive response in both ecosystems. However, bacteria also responded positively to single P and C additions in the eutrophic ecosystem, but not to single C in the oligotrophic one, consistent with the value of the ratio between bacterial C demand and algal C supply. Accordingly, the trophic nature rather than the trophic state of the ecosystems proves to be a key feature determining the expected types of resource co-limitation of bacteria, as summarized in a proposed theoretical framework. The actual types of co-limitation shifted over time and partially deviated (a lesser degree of synergism) from the theoretical expectations, particularly in the eutrophic ecosystem. These deviations may be explained by extrinsic ecological forces to physiological limitations of bacteria, such as predation, whose role in our experiments is supported by the relationship between the dynamics of bacteria and bacterivores tested by SEMs (structural equation models). Our study, in line with the increasingly recognized role of freshwater ecosystems in the global C cycle, suggests that further attention should be focussed on the biotic interactions that modulate resource co-limitation of bacteria. PMID:24918445

The impact of resource limitation and the phenology of parasitoid attack on the duration of insect herbivore outbreaks.

PubMed

Umbanhowar, James; Hastings, Alan

2002-11-01

Fluctuations in resource quality and quantity, and changes in mortality due to predators and parasites are thought to be of prime importance in the regular fluctuations of forest insects. We examine how food limitation and parasitoids with different phenologies of attack regulate the population cycles of insect hosts. Our analysis of the limit cycle of a model with a biologically realistic form of density dependence in the host yields two novel predictions. First, outbreaks will typically last for only 2 generations after parasitoids begin to reduce the host population below the maximum density. Second, host growth rate is important in determining cycle length only when parasitoids attack before the impacts of resource limitation affect the host. The robustness of these predictions are tested using a more general form of density dependence in the host, revealing that our predictions are valid as long as density dependence in the host is not too overcompensatory.

Diagnostics for invasive Salmonella infections: current challenges and future directions

PubMed Central

Andrews, Jason R.; Ryan, Edward T.

2015-01-01

Invasive Salmonellosis caused by Salmonella enterica serotype Typhi or Paratyphi A, B, C, or invasive non-typhoidal Salmonella serotypes, is an immensely important disease cluster for which reliable, rapid diagnostic tests are not available. Blood culture remains the gold standard but is insensitive, slow, and resource-intensive. Existing molecular diagnostics have poor sensitivity due to the low organism burden in bodily fluids. Commercially available serologic tests for typhoidal Salmonella have had limited sensitivity and specificity. In high burden, resource-limited settings, reliance on clinical diagnosis or inaccurate tests often results in frequent, unnecessary treatment, which contributes selective pressure for the emergence of antimicrobial resistance. This practice also results in inadequate therapy for other etiologies of acute febrile illnesses, including leptospirosis and rickettsial infections. A number of novel serologic, molecular, transcriptomic and metabolomic approaches to diagnostics are under development. Target product profiles that outline specific needs may focus development and investment, and establish benchmarks for accuracy, cost, speed, and portability of new diagnostics. Of note, a critical barrier to diagnostic assay rollout will be the low cost and low perceived harm of empiric therapy on behalf of providers and patients, which leaves few perceived incentives to utilize diagnostics. Approaches that align incentives with societal goals of limiting inappropriate antimicrobial use, such as subsidizing diagnostics, may be essential for stimulating development and uptake of such assays in resource-limited settings. New diagnostics for invasive Salmonellosis should be developed and deployed alongside diagnostics for alternative etiologies of acute febrile illnesses to improve targeted use of antibiotics. PMID:25937611

Diagnostics for invasive Salmonella infections: Current challenges and future directions.

PubMed

Andrews, Jason R; Ryan, Edward T

2015-06-19

Invasive Salmonellosis caused by Salmonella enterica serotype Typhi or Paratyphi A, B, C, or invasive non-typhoidal Salmonella serotypes, is an immensely important disease cluster for which reliable, rapid diagnostic tests are not available. Blood culture remains the gold standard but is insensitive, slow, and resource-intensive. Existing molecular diagnostics have poor sensitivity due to the low organism burden in bodily fluids. Commercially available serologic tests for typhoidal Salmonella have had limited sensitivity and specificity. In high burden, resource-limited settings, reliance on clinical diagnosis or inaccurate tests often results in frequent, unnecessary treatment, which contributes selective pressure for the emergence of antimicrobial resistance. This practice also results in inadequate therapy for other etiologies of acute febrile illnesses, including leptospirosis and rickettsial infections. A number of novel serologic, molecular, transcriptomic and metabolomic approaches to diagnostics are under development. Target product profiles that outline specific needs may focus development and investment, and establish benchmarks for accuracy, cost, speed, and portability of new diagnostics. Of note, a critical barrier to diagnostic assay rollout will be the low cost and low perceived harm of empiric therapy on behalf of providers and patients, which leaves few perceived incentives to utilize diagnostics. Approaches that align incentives with societal goals of limiting inappropriate antimicrobial use, such as subsidizing diagnostics, may be essential for stimulating development and uptake of such assays in resource-limited settings. New diagnostics for invasive Salmonellosis should be developed and deployed alongside diagnostics for alternative etiologies of acute febrile illnesses to improve targeted use of antibiotics. Copyright © 2015. Published by Elsevier Ltd.

Addressing Standardized Testing through a Novel Assesment Model

ERIC Educational Resources Information Center

Schifter, Catherine C.; Carey, Martha

2014-01-01

The No Child Left Behind (NCLB) legislation spawned a plethora of standardized testing services for all the high stakes testing required by the law. We argue that one-size-fits all assessments disadvantage students who are English Language Learners, in the USA, as well as students with limited economic resources, special needs, and not reading on…

Nitrogen Dioxide Sterilization in Low-Resource Environments: A Feasibility Study

PubMed Central

Avasthi, Trisha; Trilling, Ariel

2015-01-01

Access to sterilization is a critical need for global healthcare, as it is one of the prerequisites for safe surgical care. Lack of sterilization capability has driven up healthcare infection rates as well as limited access to healthcare, especially in low-resource environments. Sterilization technology has for the most part been static and none of the established sterilization methods has been so far successfully adapted for use in low-resource environments on a large scale. It is evident that healthcare facilities in low-resource settings require reliable, deployable, durable, affordable, easily operable sterilization equipment that can operate independently of scarce resources. Recently commercialized nitrogen dioxide (NO2) sterilization technology was analyzed and adapted into a form factor suitable for use in low-resource environments. Lab testing was conducted in microbiological testing facilities simulating low-resource environments and in accordance with the requirements of the international sterilization standard ANSI/AAMI/ISO 14937 to assess effectiveness of the device and process. The feasibility of a portable sterilizer based on nitrogen dioxide has been demonstrated, showing that sterilization of medical instruments can occur in a form factor suitable for use in low-resource environments. If developed and deployed, NO2 sterilization technology will have the twin benefits of reducing healthcare acquired infections and limiting a major constraint for access to surgical care on a global scale. Additional benefits are achieved in reducing costs and biohazard waste generated by current health care initiatives that rely primarily on disposable kits, increasing the effectiveness and outreach of these initiatives. PMID:26098905

CT Angiography (CTA)

MedlinePlus

... News Physician Resources Professions Site Index A-Z CT Angiography (CTA) Computed tomography angiography (CTA) uses an ... are the limitations of CT Angiography? What is CT Angiography? Angiography is a minimally invasive medical test ...

Online Learning: Experiences and Perceptions of Gifted Middle School Students, Their Parents, and Principals

ERIC Educational Resources Information Center

Buescher, Susan H.

2013-01-01

The 2001 No Child Left Behind Act's focus on raising standardized test scores for underachieving students has created a national education system where teacher time and resources are often not directed to students in the top percentiles and those identified as gifted and talented. As resources for gifted students continue to be limited,…

Microfluidic point-of-care diagnostics for resource-poor environments

NASA Astrophysics Data System (ADS)

Laksanasopin, Tassaneewan; Chin, Curtis D.; Moore, Hannah; Wang, Jennifer; Cheung, Yuk Kee; Sia, Samuel K.

2009-05-01

Point-of-care (POC) diagnostics have tremendous potential to improve human health in remote and resource-poor settings. However, the design criteria for diagnostic tests appropriate in settings with limited infrastructure are unique and challenging. Here we present a custom optical reader which quantifies silver absorbance from heterogeneous immunoassays. The reader is simple and low-cost and suited for POC diagnostics.

Measuring Socioeconomic Status in Health Research in Developing Countries: Should We Be Focusing on Households, Communities or Both?

ERIC Educational Resources Information Center

Fotso, Jean-Christophe; Kuate-Defo, Barthelemy

2005-01-01

Research on the effects of socioeconomic well-being on health is important for policy makers in developing countries, where limited resources make it crucial to use existing health care resources to the best advantage. This paper develops and tests a set of measures of socioeconomic status indicators for predicting health status in developing…

Woodworking Safety. A Guide for Teachers of Limited English Proficient Students.

ERIC Educational Resources Information Center

Umatilla Education Service District, OR.

This packet of materials was developed (1) to address the liability concerns of woodworking instructors by providing safety instruction materials and tests for limited English proficient (LEP) or Spanish-speaking students, and (2) to provide some ideas, strategies, and resources for working effectively with LEP students in the vocational…

Current perspectives on the use of alternative species in human health and ecological hazard assessments

EPA Science Inventory

Traditional animal toxicity tests can be time and resource intensive thereby limiting the number of chemicals that can be comprehensively tested for potential hazards to humans and/or to the environment. Using several examples and analyses, we demonstrate that pathway-based analy...

Dilution testing using rapid diagnostic tests in a HIV diagnostic algorithm: a novel alternative for confirmation testing in resource limited settings.

PubMed

Shanks, Leslie; Siddiqui, M Ruby; Abebe, Almaz; Piriou, Erwan; Pearce, Neil; Ariti, Cono; Masiga, Johnson; Muluneh, Libsework; Wazome, Joseph; Ritmeijer, Koert; Klarkowski, Derryck

2015-05-14

Current WHO testing guidelines for resource limited settings diagnose HIV on the basis of screening tests without a confirmation test due to cost constraints. This leads to a potential risk of false positive HIV diagnosis. In this paper, we evaluate the dilution test, a novel method for confirmation testing, which is simple, rapid, and low cost. The principle of the dilution test is to alter the sensitivity of a rapid diagnostic test (RDT) by dilution of the sample, in order to screen out the cross reacting antibodies responsible for falsely positive RDT results. Participants were recruited from two testing centres in Ethiopia where a tiebreaker algorithm using 3 different RDTs in series is used to diagnose HIV. All samples positive on the initial screening RDT and every 10th negative sample underwent testing with the gold standard and dilution test. Dilution testing was performed using Determine™ rapid diagnostic test at 6 different dilutions. Results were compared to the gold standard of Western Blot; where Western Blot was indeterminate, PCR testing determined the final result. 2895 samples were recruited to the study. 247 were positive for a prevalence of 8.5 % (247/2895). A total of 495 samples underwent dilution testing. The RDT diagnostic algorithm misclassified 18 samples as positive. Dilution at the level of 1/160 was able to correctly identify all these 18 false positives, but at a cost of a single false negative result (sensitivity 99.6 %, 95 % CI 97.8-100; specificity 100 %, 95 % CI: 98.5-100). Concordance between the gold standard and the 1/160 dilution strength was 99.8 %. This study provides proof of concept for a new, low cost method of confirming HIV diagnosis in resource-limited settings. It has potential for use as a supplementary test in a confirmatory algorithm, whereby double positive RDT results undergo dilution testing, with positive results confirming HIV infection. Negative results require nucleic acid testing to rule out false negative results due to seroconversion or misclassification by the lower sensitivity dilution test. Further research is needed to determine if these results can be replicated in other settings. ClinicalTrials.gov, NCT01716299 .

Optimizing Resource Utilization in Grid Batch Systems

NASA Astrophysics Data System (ADS)

Gellrich, Andreas

2012-12-01

On Grid sites, the requirements of the computing tasks (jobs) to computing, storage, and network resources differ widely. For instance Monte Carlo production jobs are almost purely CPU-bound, whereas physics analysis jobs demand high data rates. In order to optimize the utilization of the compute node resources, jobs must be distributed intelligently over the nodes. Although the job resource requirements cannot be deduced directly, jobs are mapped to POSIX UID/GID according to the VO, VOMS group and role information contained in the VOMS proxy. The UID/GID then allows to distinguish jobs, if users are using VOMS proxies as planned by the VO management, e.g. ‘role=production’ for Monte Carlo jobs. It is possible to setup and configure batch systems (queuing system and scheduler) at Grid sites based on these considerations although scaling limits were observed with the scheduler MAUI. In tests these limitations could be overcome with a home-made scheduler.

Laboratory challenges in the scaling up of HIV, TB, and malaria programs: The interaction of health and laboratory systems, clinical research, and service delivery.

PubMed

Birx, Deborah; de Souza, Mark; Nkengasong, John N

2009-06-01

Strengthening national health laboratory systems in resource-poor countries is critical to meeting the United Nations Millennium Development Goals. Despite strong commitment from the international community to fight major infectious diseases, weak laboratory infrastructure remains a huge rate-limiting step. Some major challenges facing laboratory systems in resource-poor settings include dilapidated infrastructure; lack of human capacity, laboratory policies, and strategic plans; and limited synergies between clinical and research laboratories. Together, these factors compromise the quality of test results and impact patient management. With increased funding, the target of laboratory strengthening efforts in resource-poor countries should be the integrating of laboratory services across major diseases to leverage resources with respect to physical infrastructure; types of assays; supply chain management of reagents and equipment; and maintenance of equipment.

Oculomotor responses and visuospatial perceptual judgments compete for common limited resources

PubMed Central

Tibber, Marc S.; Grant, Simon; Morgan, Michael J.

2010-01-01

While there is evidence for multiple spatial and attentional maps in the brain it is not clear to what extent visuoperceptual and oculomotor tasks rely on common neural representations and attentional mechanisms. Using a dual-task interference paradigm we tested the hypothesis that eye movements and perceptual judgments made to simultaneously presented visuospatial information compete for shared limited resources. Observers undertook judgments of stimulus collinearity (perceptual extrapolation) using a pointer and Gabor patch and/or performed saccades to a peripheral dot target while their eye movements were recorded. In addition, observers performed a non-spatial control task (contrast discrimination), matched for task difficulty and stimulus structure, which on the basis of previous studies was expected to represent a lesser load on putative shared resources. Greater mutual interference was indeed found between the saccade and extrapolation task pair than between the saccade and contrast discrimination task pair. These data are consistent with visuoperceptual and oculomotor responses competing for common limited resources as well as spatial tasks incurring a relatively high attentional cost. PMID:20053112

Resource Optimization Techniques and Security Levels for Wireless Sensor Networks Based on the ARSy Framework.

PubMed

Parenreng, Jumadi Mabe; Kitagawa, Akio

2018-05-17

Wireless Sensor Networks (WSNs) with limited battery, central processing units (CPUs), and memory resources are a widely implemented technology for early warning detection systems. The main advantage of WSNs is their ability to be deployed in areas that are difficult to access by humans. In such areas, regular maintenance may be impossible; therefore, WSN devices must utilize their limited resources to operate for as long as possible, but longer operations require maintenance. One method of maintenance is to apply a resource adaptation policy when a system reaches a critical threshold. This study discusses the application of a security level adaptation model, such as an ARSy Framework, for using resources more efficiently. A single node comprising a Raspberry Pi 3 Model B and a DS18B20 temperature sensor were tested in a laboratory under normal and stressful conditions. The result shows that under normal conditions, the system operates approximately three times longer than under stressful conditions. Maintaining the stability of the resources also enables the security level of a network's data output to stay at a high or medium level.

Resource Optimization Techniques and Security Levels for Wireless Sensor Networks Based on the ARSy Framework

PubMed Central

Kitagawa, Akio

2018-01-01

Wireless Sensor Networks (WSNs) with limited battery, central processing units (CPUs), and memory resources are a widely implemented technology for early warning detection systems. The main advantage of WSNs is their ability to be deployed in areas that are difficult to access by humans. In such areas, regular maintenance may be impossible; therefore, WSN devices must utilize their limited resources to operate for as long as possible, but longer operations require maintenance. One method of maintenance is to apply a resource adaptation policy when a system reaches a critical threshold. This study discusses the application of a security level adaptation model, such as an ARSy Framework, for using resources more efficiently. A single node comprising a Raspberry Pi 3 Model B and a DS18B20 temperature sensor were tested in a laboratory under normal and stressful conditions. The result shows that under normal conditions, the system operates approximately three times longer than under stressful conditions. Maintaining the stability of the resources also enables the security level of a network’s data output to stay at a high or medium level. PMID:29772773

14 CFR 142.53 - Training center instructor training and testing requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... instruction in at least— (i) The fundamental principles of the learning process; (ii) Elements of effective... limitations; (iv) Training policies and procedures; (v) Cockpit resource management and crew coordination; and...

Phenotypic plasticity in a population of odonates.

PubMed

Bowman, Randi M; Schmidt, Sharol; Weeks, Chelsea; Clark, Hunter; Brown, Christopher; Latta, Leigh C; Edgehouse, Michael

2018-05-31

The maintenance of phenotypic plasticity within a species ensures survival through environmental flux. Plastic strategies are increasingly important given the number and magnitude of modern anthropogenic threats to the environment. We tested for phenotypic plasticity in the odonate Argia vivida in response to resource limitation. By limiting food availability, effectively inducing hunger, we were able to quantify shifts in agonistic behavior during intraspecific interactions. Scoring behavior in one-on-one combat trials after 1 and 4 days without food revealed phenotypic plasticity. Three classes of genotypes were identified, genotypes exhibiting either increased aggression, decreased aggression, or no phenotypic plasticity, in response to resource limitation. The variable plastic strategies in this population of odonates likely aids in maintaining fitness in fluctuating environments.

Molecular malaria diagnostics: A systematic review and meta-analysis.

PubMed

Roth, Johanna M; Korevaar, Daniël A; Leeflang, Mariska M G; Mens, Pètra F

2016-01-01

Accurate diagnosis of malaria is essential for identification and subsequent treatment of the disease. Currently, microscopy and rapid diagnostic tests are the most commonly used diagnostics, next to treatment based on clinical signs only. These tests are easy to deploy, but have a relatively high detection limit. With declining prevalence in many areas, there is an increasing need for more sensitive diagnostics. Molecular tools may be a suitable alternative, although costs and technical requirements currently hamper their implementation in resource limited settings. A range of (near) point-of-care diagnostics is therefore under development, including simplifications in sample preparation, amplification and/or read-out of the test. Accuracy data, in combination with technical characteristics, are essential in determining which molecular test, if any, would be the most promising to be deployed. This review presents a comprehensive overview of the currently available molecular malaria diagnostics, ranging from well-known tests to platforms in early stages of evaluation, and systematically evaluates their published accuracy. No important difference in accuracy was found between the most commonly used PCR-based assays (conventional, nested and real-time PCR), with most of them having high sensitivity and specificity, implying that there are no reasons other than practical ones to choose one technique over the other. Loop-mediated isothermal amplification and other (novel) diagnostics appear to be highly accurate as well, with some offering potential to be used in resource-limited settings.

Preliminary assessment of the diagnostic performances of a new rapid diagnostic test for the serodiagnosis of human cystic echinococcosis.

PubMed

Vola, Ambra; Tamarozzi, Francesca; Noordin, Rahmah; Yunus, Muhammad Hafiznur; Khanbabaie, Sam; De Silvestri, Annalisa; Brunetti, Enrico; Mariconti, Mara

2018-04-14

Rapid diagnostic tests for cystic echinococcosis (CE) are convenient to support ultrasound diagnosis in uncertain cases, especially in resource-limited settings. We found comparable diagnostic performances of the experimental Hyd Rapid Test and the commercial VIRapid HYDATIDOSIS Test, used in our diagnostic laboratory, using samples from well-characterized hepatic CE cases. Copyright © 2018 Elsevier Inc. All rights reserved.

An Integrated In Vitro and Computational Approach to Define the Exposure-Dose-Toxicity Relationships In High-Throughput Screens

EPA Science Inventory

Research efforts by the US Environmental Protection Agency have set out to develop alternative testing programs to prioritize limited testing resources toward chemicals that likely represent the greatest hazard to human health and the environment. Efforts such as EPA’s ToxCast r...

Security Considerations and Recommendations in Computer-Based Testing

PubMed Central

Al-Saleem, Saleh M.

2014-01-01

Many organizations and institutions around the globe are moving or planning to move their paper-and-pencil based testing to computer-based testing (CBT). However, this conversion will not be the best option for all kinds of exams and it will require significant resources. These resources may include the preparation of item banks, methods for test delivery, procedures for test administration, and last but not least test security. Security aspects may include but are not limited to the identification and authentication of examinee, the risks that are associated with cheating on the exam, and the procedures related to test delivery to the examinee. This paper will mainly investigate the security considerations associated with CBT and will provide some recommendations for the security of these kinds of tests. We will also propose a palm-based biometric authentication system incorporated with basic authentication system (username/password) in order to check the identity and authenticity of the examinee. PMID:25254250

Security considerations and recommendations in computer-based testing.

PubMed

Al-Saleem, Saleh M; Ullah, Hanif

2014-01-01

Many organizations and institutions around the globe are moving or planning to move their paper-and-pencil based testing to computer-based testing (CBT). However, this conversion will not be the best option for all kinds of exams and it will require significant resources. These resources may include the preparation of item banks, methods for test delivery, procedures for test administration, and last but not least test security. Security aspects may include but are not limited to the identification and authentication of examinee, the risks that are associated with cheating on the exam, and the procedures related to test delivery to the examinee. This paper will mainly investigate the security considerations associated with CBT and will provide some recommendations for the security of these kinds of tests. We will also propose a palm-based biometric authentication system incorporated with basic authentication system (username/password) in order to check the identity and authenticity of the examinee.

Assessment of hospital surge capacity using the MACSIM simulation system: a pilot study.

PubMed

Lennquist Montán, K; Riddez, L; Lennquist, S; Olsberg, A C; Lindberg, H; Gryth, D; Örtenwall, P

2017-08-01

The aim of this study was to use a simulation model developed for the scientific evaluation of methodology in disaster medicine to test surge capacity (SC) in a major hospital responding to a simulated major incident with a scenario copied from a real incident. The tested hospital was illustrated on a system of magnetic boards, where available resources, staff, and patients treated in the hospital at the time of the test were illustrated. Casualties were illustrated with simulation cards supplying all data required to determine procedures for diagnosis and treatment, which all were connected to real consumption of time and resources. The first capacity-limiting factor was the number of resuscitation teams that could work parallel in the emergency department (ED). This made it necessary to refer severely injured to other hospitals. At this time, surgery (OR) and intensive care (ICU) had considerable remaining capacity. Thus, the reception of casualties could be restarted when the ED had been cleared. The next limiting factor was lack of ventilators in the ICU, which permanently set the limit for SC. At this time, there was still residual OR capacity. With access to more ventilators, the full surgical capacity of the hospital could have been utilized. The tested model was evaluated as an accurate tool to determine SC. The results illustrate that SC cannot be determined by testing one single function in the hospital, since all functions interact with each other and different functions can be identified as limiting factors at different times during the response.

Inkjet-printed point-of-care immunoassay on a nanoscale polymer brush enables subpicomolar detection of analytes in blood

NASA Astrophysics Data System (ADS)

Joh, Daniel Y.; Hucknall, Angus M.; Wei, Qingshan; Mason, Kelly A.; Lund, Margaret L.; Fontes, Cassio M.; Hill, Ryan T.; Blair, Rebecca; Zimmers, Zackary; Achar, Rohan K.; Tseng, Derek; Gordan, Raluca; Freemark, Michael; Ozcan, Aydogan; Chilkoti, Ashutosh

2017-08-01

The ELISA is the mainstay for sensitive and quantitative detection of protein analytes. Despite its utility, ELISA is time-consuming, resource-intensive, and infrastructure-dependent, limiting its availability in resource-limited regions. Here, we describe a self-contained immunoassay platform (the “D4 assay”) that converts the sandwich immunoassay into a point-of-care test (POCT). The D4 assay is fabricated by inkjet printing assay reagents as microarrays on nanoscale polymer brushes on glass chips, so that all reagents are “on-chip,” and these chips show durable storage stability without cold storage. The D4 assay can interrogate multiple analytes from a drop of blood, is compatible with a smartphone detector, and displays analytical figures of merit that are comparable to standard laboratory-based ELISA in whole blood. These attributes of the D4 POCT have the potential to democratize access to high-performance immunoassays in resource-limited settings without sacrificing their performance.

Information needs of mothers regarding communicating BRCA1/2 cancer genetic test results to their children.

PubMed

Tercyak, Kenneth P; Peshkin, Beth N; Demarco, Tiffani A; Patenaude, Andrea Farkas; Schneider, Katherine A; Garber, Judy E; Valdimarsdottir, Heiddis B; Schwartz, Marc D

2007-01-01

Mothers who participate in genetic testing for hereditary breast/ovarian cancer risk must decide if, when, and how to ultimately share their BRCA1 and BRCA2 (BRCA1/2) test results with their minor-age children. One of the primary aides for mothers in making this decision is cancer genetic counseling. However, counseling is limited in how well it can educate mothers about such decisions without the availability of resources that are specific to family communication and genetic testing per se. In an effort to fill this gap and identify mothers most likely to benefit from such resources, surveys were conducted with 187 mothers undergoing BRCA1/2 testing who had children 8-21 years old. Data were collected weeks after genetic testing but prior to mothers' learning of their test results; quantitative assessments of informational resource needs (i.e., speaking with previous BRCA1/2 testing participants who are parents regarding their experiences, reading educational literature about options and what to expect, speaking with a family counselor, attending a family support group, and self-nominated other resources), testing motivations, decision making vigilance, and decisional conflict regarding communicating test results to children were included. Mothers' most-to-least frequently cited information resource needs were: literature (93.4%), family counseling (85.8%), prior participants (79.0%), support groups (53.9%), and other (28.9%; e.g., pediatricians and psychologists). Seventy-eight percent of mothers were interested in accessing three or more resources. In multivariate regression analyses, testing motivations (beta = 0.35, p = 0.03), decision-making vigilance (beta = 0.16, p = 0.00), and decisional conflict (beta = 0.10, p = 0.00) were associated with mothers' need level; mothers with a greater interest in testing to learn about their children's risks, those with more vigilant decision-making styles, and those with higher decisional conflict had the greatest need. In conjunction with enhanced genetic counseling focusing on family disclosure, educational literature, and psychosocial support may promote improved outcomes.

Testing phenotypic trade-offs in the chemical defence strategy of Scots pine under growth-limiting field conditions.

PubMed

Villari, Caterina; Faccoli, Massimo; Battisti, Andrea; Bonello, Pierluigi; Marini, Lorenzo

2014-09-01

Plants protect themselves from pathogens and herbivores through fine-tuned resource allocation, including trade-offs among resource investments to support constitutive and inducible defences. However, empirical research, especially concerning conifers growing under natural conditions, is still scarce. We investigated the complexity of constitutive and induced defences in a natural Scots pine (Pinus sylvestris L.) stand under growth-limiting conditions typical of alpine environments. Phenotypic trade-offs at three hierarchical levels were tested by investigating the behaviour of phenolic compounds and terpenoids of outer bark and phloem. We tested resource-derived phenotypic correlations between (i) constitutive and inducible defences vs tree ring growth, (ii) different constitutive defence metabolites and (iii) constitutive concentration and inducible variation of individual metabolites. Tree ring growth was positively correlated only with constitutive concentration of total terpenoids, and no overall phenotypic trade-offs between different constitutive defensive metabolites were found. At the lowest hierarchical level tested, i.e., at the level of relationship between constitutive and inducible variation of individual metabolites, we found that different compounds displayed different behaviours; we identified five different defensive metabolite response types, based on direction and strength of the response, regardless of tree age and growth rate. Therefore, under growth-limiting field conditions, Scots pine appears to utilize varied and complex outer bark and phloem defence chemistry, in which only part of the constitutive specialized metabolism is influenced by tree growth, and individual components do not appear to be expressed in a mutually exclusive manner in either constitutive or inducible metabolism. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Can self-testing increase HIV testing among men who have sex with men: A systematic review and meta-analysis.

PubMed

Zhang, Ci; Li, Xianhong; Brecht, Mary-Lynn; Koniak-Griffin, Deborah

2017-01-01

Globally, four out of ten individuals living with HIV have not been tested for HIV. Testing is especially important for men who have sex with men (MSM), among whom an increasing HIV epidemic has been identified in many regions of the world. As a supplement to site-based HIV testing services, HIV self-testing (HIVST) provides a promising approach to promote HIV testing. However, evidence is scattered and not well-summarized on the effect of HIVST to improve HIV testing behaviors, especially for MSM. Seven databases (PubMed, Web of Science, Cochrane Library, PsycINFO, CINAHL Plus, WanFang, and China National Knowledge Internet) and conference abstracts from six HIV/sexually transmitted infections conferences were searched from January 2000-April 2017. Of 1,694 records retrieved, 23 studies were identified, 9 conducted in resource-limited countries and 14 in high-income countries. The pooled results showed that HIVST increased HIV test frequency for MSM by one additional test in a 6-month period (mean difference = 0.88 [95% CI 0.52-1.24]). The pooled proportion of first-time testers among those who took HIVST was 18.7% (95% CI: 9.9-32.4) globally, with a rate 3.32 times higher in resource-limited country settings (32.9% [95% CI: 21.3-47.6]) than in high-income countries (9.9% [95% CI: 7.4-13.8]). The pooled proportions included non-recent testers, 32.9% (95% CI: 28.1-38.3); ever or currently married MSM, 16.7% (95% CI: 14.5-19.4); and HIV positive men, 3.8% (95% CI: 2.0-5.7) globally; 6.5% [95% CI: 0.38-12.3] in resource-limited country settings; and 2.9% [95% CI: 2.0-5.0] in high-income countries). The rates reported for linkage to care ranged from 31.3% to 100%. HIVST could increase HIV testing frequency and potentially have capacity equivalent to that of site-based HIV testing services to reach first-time, delayed, married, and HIV-infected testers among MSM and link them to medical care. However, more rigorous study designs are needed to explore the specific self-testing approach (oral-fluid based or finger-prick based) on improving HIV testing for MSM in different social and economic settings.

The WHO/PEPFAR collaboration to prepare an operations manual for HIV prevention, care, and treatment at primary health centers in high-prevalence, resource-constrained settings: defining laboratory services.

PubMed

Spira, Thomas; Lindegren, Mary Lou; Ferris, Robert; Habiyambere, Vincent; Ellerbrock, Tedd

2009-06-01

The expansion of HIV/AIDS care and treatment in resource-constrained countries, especially in sub-Saharan Africa, has generally developed in a top-down manner. Further expansion will involve primary health centers where human and other resources are limited. This article describes the World Health Organization/President's Emergency Plan for AIDS Relief collaboration formed to help scale up HIV services in primary health centers in high-prevalence, resource-constrained settings. It reviews the contents of the Operations Manual developed, with emphasis on the Laboratory Services chapter, which discusses essential laboratory services, both at the center and the district hospital level, laboratory safety, laboratory testing, specimen transport, how to set up a laboratory, human resources, equipment maintenance, training materials, and references. The chapter provides specific information on essential tests and generic job aids for them. It also includes annexes containing a list of laboratory supplies for the health center and sample forms.

Emerging technologies in point-of-care molecular diagnostics for resource-limited settings.

PubMed

Peeling, Rosanna W; McNerney, Ruth

2014-06-01

Emerging molecular technologies to diagnose infectious diseases at the point at which care is delivered have the potential to save many lives in developing countries where access to laboratories is poor. Molecular tests are needed to improve the specificity of syndromic management, monitor progress towards disease elimination and screen for asymptomatic infections with the goal of interrupting disease transmission and preventing long-term sequelae. In simplifying laboratory-based molecular assays for use at point-of-care, there are inevitable compromises between cost, ease of use and test performance. Despite significant technological advances, many challenges remain for the development of molecular diagnostics for resource-limited settings. There needs to be more advocacy for these technologies to be applied to infectious diseases, increased efforts to lower the barriers to market entry through streamlined and harmonized regulatory approaches, faster policy development for adoption of new technologies and novel financing mechanisms to enable countries to scale up implementation.

A Nationwide Population-Based Approach to Study Health-Related and Psychosocial Aspects of Neurofibromatosis Type 1

DTIC Science & Technology

2016-07-31

the relatively narrow focus on Wechsler’s IQ test (WAIS-IV) – a test chosen primarily due to budget constraints. Thus, to meet the requests from the...consultants allows us to re-allocate financial resources to address the limitations of our study 7 raised by the reviewers. Jens Richardt Møllegaard

The Affordable Care Act and genetic testing for inheritable cancer syndromes: impact on high-risk underserved minorities.

PubMed

Walcott, Farzana L; Dunn, Barbara K; DeShields, Mary; Baquet, Claudia

2014-02-01

Genetic testing for inheritable cancer syndromes is becoming a critical part of preventive health services. The Patient Protection and Affordable Care Act (PPACA) Essential Health Benefits package addresses breast cancer susceptibility-gene testing for women who are unaffected by cancer. The absence of provisions for 1) men, 2) cancer patients, 3) other inheritable cancer syndromes, and 4) risk-reducing interventions are limitations of PPACA. We discuss provisions and limitations of PPACA pertaining to genetic testing and effects on high-risk populations, in particular minorities. The PPACA is the beginning of an ongoing process of incorporating genetic testing in the armamentarium of cancer prevention. Future efforts should focus on ensuring equitable access to genetic testing as a preventive service under PPACA to high-risk populations other than women. Consideration should also be given to provisions for risk-reducing interventions, especially in underserved minority populations, who are known to underutilize genetic testing and may have limited financial resources for medical intervention.

The effect of limited cognitive resources on communication disturbances in serious mental illness

PubMed Central

Le, Thanh P.; Najolia, Gina M.; Minor, Kyle S.; Cohen, Alex S.

2017-01-01

Semantically incoherent speech is a pernicious clinical feature of serious mental illness (SMI). The precise mechanisms underlying this deficit remain unclear. Prior studies have found that arousal of negative emotion exaggerates the severity of these communication disturbances; this has been coined “affective reactivity”. Recent research suggests that “cognitive reactivity” may also occur, namely reflecting reduced “on-line” cognitive resources in SMI. We tested the hypothesis that communication disturbances manifest as a function of limited cognitive resources in SMI above and beyond that associated with state affectivity. We also investigated individual differences in symptoms, cognitive ability, and trait affect that may be related to cognitive reactivity. We compared individuals with SMI (n=52) to nonpsychiatric controls (n=27) on a behavioral-based coding of communication disturbances during separate baseline and experimentally-manipulated high cognitive-load dual tasks. Controlling for state affective reactivity, a significant interaction was observed such that communication disturbances decreased in the SMI group under high cognitive-load. Furthermore, a reduction in communication disturbances was related to lower trait and state positive affectivity in the SMI group. Contrary to our expectations, limited cognitive resources temporarily relieved language dysfunction. Implications, particularly with respect to interventions, are discussed. PMID:28038440

Intellectual performance and ego depletion: role of the self in logical reasoning and other information processing.

PubMed

Schmeichel, Brandon J; Vohs, Kathleen D; Baumeister, Roy F

2003-07-01

Some complex thinking requires active guidance by the self, but simpler mental activities do not. Depletion of the self's regulatory resources should therefore impair the former and not the latter. Resource depletion was manipulated by having some participants initially regulate attention (Studies 1 and 3) or emotion (Study 2). As compared with no-regulation participants who did not perform such exercises, depleted participants performed worse at logic and reasoning (Study 1), cognitive extrapolation (Study 2), and a test of thoughtful reading comprehension (Study 3). The same manipulations failed to cause decrements on a test of general knowledge (Study 2) or on memorization and recall of nonsense syllables (Study 3). Successful performance at complex thinking may therefore rely on limited regulatory resources.

Potential environmental impacts of light-emitting diodes (LEDs): metallic resources, toxicity, and hazardous waste classification.

PubMed

Lim, Seong-Rin; Kang, Daniel; Ogunseitan, Oladele A; Schoenung, Julie M

2011-01-01

Light-emitting diodes (LEDs) are advertised as environmentally friendly because they are energy efficient and mercury-free. This study aimed to determine if LEDs engender other forms of environmental and human health impacts, and to characterize variation across different LEDs based on color and intensity. The objectives are as follows: (i) to use standardized leachability tests to examine whether LEDs are to be categorized as hazardous waste under existing United States federal and California state regulations; and (ii) to use material life cycle impact and hazard assessment methods to evaluate resource depletion and toxicity potentials of LEDs based on their metallic constituents. According to federal standards, LEDs are not hazardous except for low-intensity red LEDs, which leached Pb at levels exceeding regulatory limits (186 mg/L; regulatory limit: 5). However, according to California regulations, excessive levels of copper (up to 3892 mg/kg; limit: 2500), Pb (up to 8103 mg/kg; limit: 1000), nickel (up to 4797 mg/kg; limit: 2000), or silver (up to 721 mg/kg; limit: 500) render all except low-intensity yellow LEDs hazardous. The environmental burden associated with resource depletion potentials derives primarily from gold and silver, whereas the burden from toxicity potentials is associated primarily with arsenic, copper, nickel, lead, iron, and silver. Establishing benchmark levels of these substances can help manufacturers implement design for environment through informed materials substitution, can motivate recyclers and waste management teams to recognize resource value and occupational hazards, and can inform policymakers who establish waste management policies for LEDs.

The Argument-Structure Complexity Effect in Children with Specific Language Impairment: Evidence from the Use of Grammatical Morphemes in French

ERIC Educational Resources Information Center

Pizzioli, Fabrizio; Schelstraete, Marie-Anne

2008-01-01

Purpose: The hypothesis that the linguistic deficit presented by children with specific language impairment (SLI) is caused by limited cognitive resources (e.g., S. Ellis Weismer & L. Hesketh, 1996) was tested against the hypothesis of a limitation in linguistic knowledge (e.g., M. L. Rice, K. Wexler, & P. Cleave, 1995). Method: The study examined…

Attentional priority determines working memory precision.

PubMed

Klyszejko, Zuzanna; Rahmati, Masih; Curtis, Clayton E

2014-12-01

Visual working memory is a system used to hold information actively in mind for a limited time. The number of items and the precision with which we can store information has limits that define its capacity. How much control do we have over the precision with which we store information when faced with these severe capacity limitations? Here, we tested the hypothesis that rank-ordered attentional priority determines the precision of multiple working memory representations. We conducted two psychophysical experiments that manipulated the priority of multiple items in a two-alternative forced choice task (2AFC) with distance discrimination. In Experiment 1, we varied the probabilities with which memorized items were likely to be tested. To generalize the effects of priority beyond simple cueing, in Experiment 2, we manipulated priority by varying monetary incentives contingent upon successful memory for items tested. Moreover, we illustrate our hypothesis using a simple model that distributed attentional resources across items with rank-ordered priorities. Indeed, we found evidence in both experiments that priority affects the precision of working memory in a monotonic fashion. Our results demonstrate that representations of priority may provide a mechanism by which resources can be allocated to increase the precision with which we encode and briefly store information. Copyright © 2014 Elsevier Ltd. All rights reserved.

Optimization of biomass composition explains microbial growth-stoichiometry relationships

USGS Publications Warehouse

Franklin, O.; Hall, E.K.; Kaiser, C.; Battin, T.J.; Richter, A.

2011-01-01

Integrating microbial physiology and biomass stoichiometry opens far-reaching possibilities for linking microbial dynamics to ecosystem processes. For example, the growth-rate hypothesis (GRH) predicts positive correlations among growth rate, RNA content, and biomass phosphorus (P) content. Such relationships have been used to infer patterns of microbial activity, resource availability, and nutrient recycling in ecosystems. However, for microorganisms it is unclear under which resource conditions the GRH applies. We developed a model to test whether the response of microbial biomass stoichiometry to variable resource stoichiometry can be explained by a trade-off among cellular components that maximizes growth. The results show mechanistically why the GRH is valid under P limitation but not under N limitation. We also show why variability of growth rate-biomass stoichiometry relationships is lower under P limitation than under N or C limitation. These theoretical results are supported by experimental data on macromolecular composition (RNA, DNA, and protein) and biomass stoichiometry from two different bacteria. In addition, compared to a model with strictly homeostatic biomass, the optimization mechanism we suggest results in increased microbial N and P mineralization during organic-matter decomposition. Therefore, this mechanism may also have important implications for our understanding of nutrient cycling in ecosystems.

Continental diatom biodiversity in stream benthos declines as more nutrients become limiting

PubMed Central

Passy, Sophia I.

2008-01-01

Biodiversity of both terrestrial ecosystems and lacustrine phytoplankton increases with niche dimensionality, which can be determined by the number of limiting resources (NLR) in the environment. In the present continental study, I tested whether niche dimensionality and, with this species, richness scale positively with NLR in running waters. Diatom richness in 2,426 benthic and 383 planktonic communities from 760 and 127 distinct localities, respectively, was examined as a function of NLR, including basic cations, silica, iron, ammonia, nitrate, and dissolved phosphorus. The patterns found in the two communities were opposite: as more resources became limiting, diatom richness declined in the benthos but increased in the phytoplankton. The divergence of benthic from both planktonic and terrestrial communities is attributed to the complex spatial organization of the benthos, generating strong internal resource gradients. Differential stress tolerance among benthic diatoms allows substantial overgrowth, which greatly reduces nutrient transport to the biofilm base and can be supported only by high ambient resource levels. Therefore, niche dimensionality in the benthos increases with the number of resources at high supply. These findings provide a mechanistic explanation of the well documented phenomenon of increased species richness after fertilization in freshwater as opposed to terrestrial ecosystems. Clearly, however, new theoretical approaches, retaining resource availability as an environmental constraint but incorporating a trade-off between tolerance and spatial positioning, are necessary to address coexistence in one of the major producer communities in streams, the algae. PMID:18599459

How Management Information Systems Can Enhance the Air Force Drug Testing Program

DTIC Science & Technology

1989-12-01

promising processes to positively identify potential system users (46:401). Scope This study will cover issues concerning the Air Force drug testing...7 Scope....................10 Limitations of the Research . . . 10 Investigative Questions ............ 10 Expected Benefits of the Study . . . . 11...Resource Allocation. ....... 41 M1.>ethodology....................44 The Historical Research Method . . .. 44 The Historical Research Method for this Study

Limited Resources Induce Bistability in Microtubule Length Regulation

NASA Astrophysics Data System (ADS)

Rank, Matthias; Mitra, Aniruddha; Reese, Louis; Diez, Stefan; Frey, Erwin

2018-04-01

The availability of protein is an important factor for the determination of the size of the mitotic spindle. Involved in spindle-size regulation is kinesin-8, a molecular motor and microtubule (MT) depolymerase, which is known to tightly control MT length. Here, we propose and analyze a theoretical model in which kinesin-induced MT depolymerization competes with spontaneous polymerization while supplies of both tubulin and kinesin are limited. In contrast to previous studies where resources were unconstrained, we find that, for a wide range of concentrations, MT length regulation is bistable. We test our predictions by conducting in vitro experiments and find that the bistable behavior manifests in a bimodal MT length distribution.

Access and Quality of HIV-Related Point-of-Care Diagnostic Testing in Global Health Programs.

PubMed

Fonjungo, Peter N; Boeras, Debrah I; Zeh, Clement; Alexander, Heather; Parekh, Bharat S; Nkengasong, John N

2016-02-01

Access to point-of-care testing (POCT) improves patient care, especially in resource-limited settings where laboratory infrastructure is poor and the bulk of the population lives in rural settings. However, because of challenges in rolling out the technology and weak quality assurance measures, the promise of human immunodeficiency virus (HIV)-related POCT in resource-limited settings has not been fully exploited to improve patient care and impact public health. Because of these challenges, the Joint United Nations Programme on HIV/AIDS (UNAIDS), in partnership with other organizations, recently launched the Diagnostics Access Initiative. Expanding HIV programs, including the "test and treat" strategies and the newly established UNAIDS 90-90-90 targets, will require increased access to reliable and accurate POCT results. In this review, we examine various components that could improve access and uptake of quality-assured POC tests to ensure coverage and public health impact. These components include evaluation, policy, regulation, and innovative approaches to strengthen the quality of POCT. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

ToxCast: Using high throughput screening to identify profiles of biological activity

EPA Science Inventory

ToxCast, the United States Environmental Protection Agency’s chemical prioritization research program, is developing methods for utilizing computational chemistry and bioactivity profiling to predict potential for toxicity and prioritize limited testing resources (www.epa.gov/toc...

Applications of high throughput screening to identify profiles of biological activity

EPA Science Inventory

ToxCast, the United States Environmental Protection Agency’s chemical prioritization research program, is developing methods for utilizing computational chemistry and bioactivity profiling to predict potential for toxicity and prioritize limited testing resources (www.epa.gov/toc...

Predictive In Vitro Screening of Environmental Chemicals – The ToxCast Project

EPA Science Inventory

ToxCast, the United States Environmental Protection Agency’s chemical prioritization research program, is developing methods for utilizing computational chemistry and bioactivity profiling to predict potential for toxicity and prioritize limited testing resources (www.epa.gov/toc...

Development and sensitivity testing of alternative mobility standards : literature review.

DOT National Transportation Integrated Search

2010-12-01

The Oregon Department of Transportation (ODOT) manages the state highway system under the guidance of the 1999 Oregon Highway Plan (OHP) (ODOT 1999). Among other things, OHP policies and actions emphasize efficient use of limited resources. This emph...

NASA Propulsion Concept Studies and Risk Reduction Activities for Resource Prospector Lander

NASA Technical Reports Server (NTRS)

Trinh, Huu P.; Williams, Hunter; Burnside, Chris

2015-01-01

The trade study has led to the selection of propulsion concept with the lowest cost and net lowest risk -Government-owned, flight qualified components -Meet mission requirements although the configuration is not optimized. Risk reduction activities have provided an opportunity -Implement design improvements while development with the early-test approach. -Gain knowledge on the operation and identify operation limit -Data to anchor analytical models for future flight designs; The propulsion system cold flow tests series have provided valuable data for future design. -The pressure surge from the system priming and waterhammer within component operation limits. -Enable to optimize the ullage volume to reduce the propellant tank mass; RS-34 hot fire tests have successfully demonstrated of using the engines for the RP mission -No degradation of performance due to extended storage life of the hardware. -Enable to operate the engine for RP flight mission scenarios, outside of the qualification regime. -Provide extended data for the thermal and GNC designs. Significant progress has been made on NASA propulsion concept design and risk reductions for Resource Prospector lander.

The clinical and economic impact of point-of-care CD4 testing in mozambique and other resource-limited settings: a cost-effectiveness analysis.

PubMed

Hyle, Emily P; Jani, Ilesh V; Lehe, Jonathan; Su, Amanda E; Wood, Robin; Quevedo, Jorge; Losina, Elena; Bassett, Ingrid V; Pei, Pamela P; Paltiel, A David; Resch, Stephen; Freedberg, Kenneth A; Peter, Trevor; Walensky, Rochelle P

2014-09-01

Point-of-care CD4 tests at HIV diagnosis could improve linkage to care in resource-limited settings. Our objective is to evaluate the clinical and economic impact of point-of-care CD4 tests compared to laboratory-based tests in Mozambique. We use a validated model of HIV testing, linkage, and treatment (CEPAC-International) to examine two strategies of immunological staging in Mozambique: (1) laboratory-based CD4 testing (LAB-CD4) and (2) point-of-care CD4 testing (POC-CD4). Model outcomes include 5-y survival, life expectancy, lifetime costs, and incremental cost-effectiveness ratios (ICERs). Input parameters include linkage to care (LAB-CD4, 34%; POC-CD4, 61%), probability of correctly detecting antiretroviral therapy (ART) eligibility (sensitivity: LAB-CD4, 100%; POC-CD4, 90%) or ART ineligibility (specificity: LAB-CD4, 100%; POC-CD4, 85%), and test cost (LAB-CD4, US$10; POC-CD4, US$24). In sensitivity analyses, we vary POC-CD4-specific parameters, as well as cohort and setting parameters to reflect a range of scenarios in sub-Saharan Africa. We consider ICERs less than three times the per capita gross domestic product in Mozambique (US$570) to be cost-effective, and ICERs less than one times the per capita gross domestic product in Mozambique to be very cost-effective. Projected 5-y survival in HIV-infected persons with LAB-CD4 is 60.9% (95% CI, 60.9%-61.0%), increasing to 65.0% (95% CI, 64.9%-65.1%) with POC-CD4. Discounted life expectancy and per person lifetime costs with LAB-CD4 are 9.6 y (95% CI, 9.6-9.6 y) and US$2,440 (95% CI, US$2,440-US$2,450) and increase with POC-CD4 to 10.3 y (95% CI, 10.3-10.3 y) and US$2,800 (95% CI, US$2,790-US$2,800); the ICER of POC-CD4 compared to LAB-CD4 is US$500/year of life saved (YLS) (95% CI, US$480-US$520/YLS). POC-CD4 improves clinical outcomes and remains near the very cost-effective threshold in sensitivity analyses, even if point-of-care CD4 tests have lower sensitivity/specificity and higher cost than published values. In other resource-limited settings with fewer opportunities to access care, POC-CD4 has a greater impact on clinical outcomes and remains cost-effective compared to LAB-CD4. Limitations of the analysis include the uncertainty around input parameters, which is examined in sensitivity analyses. The potential added benefits due to decreased transmission are excluded; their inclusion would likely further increase the value of POC-CD4 compared to LAB-CD4. POC-CD4 at the time of HIV diagnosis could improve survival and be cost-effective compared to LAB-CD4 in Mozambique, if it improves linkage to care. POC-CD4 could have the greatest impact on mortality in settings where resources for HIV testing and linkage are most limited. Please see later in the article for the Editors' Summary.

Software for Optimizing Quality Assurance of Other Software

NASA Technical Reports Server (NTRS)

Feather, Martin; Cornford, Steven; Menzies, Tim

2004-01-01

Software assurance is the planned and systematic set of activities that ensures that software processes and products conform to requirements, standards, and procedures. Examples of such activities are the following: code inspections, unit tests, design reviews, performance analyses, construction of traceability matrices, etc. In practice, software development projects have only limited resources (e.g., schedule, budget, and availability of personnel) to cover the entire development effort, of which assurance is but a part. Projects must therefore select judiciously from among the possible assurance activities. At its heart, this can be viewed as an optimization problem; namely, to determine the allocation of limited resources (time, money, and personnel) to minimize risk or, alternatively, to minimize the resources needed to reduce risk to an acceptable level. The end result of the work reported here is a means to optimize quality-assurance processes used in developing software.

Software for Analyzing Laminar-to-Turbulent Flow Transitions

NASA Technical Reports Server (NTRS)

Chang, Chau-Lyan

2004-01-01

Software assurance is the planned and systematic set of activities that ensures that software processes and products conform to requirements, standards, and procedures. Examples of such activities are the following: code inspections, unit tests, design reviews, performance analyses, construction of traceability matrices, etc. In practice, software development projects have only limited resources (e.g., schedule, budget, and availability of personnel) to cover the entire development effort, of which assurance is but a part. Projects must therefore select judiciously from among the possible assurance activities. At its heart, this can be viewed as an optimization problem; namely, to determine the allocation of limited resources (time, money, and personnel) to minimize risk or, alternatively, to minimize the resources needed to reduce risk to an acceptable level. The end result of the work reported here is a means to optimize quality-assurance processes used in developing software. This is achieved by combining two prior programs in an innovative manner

FUNCTIONAL LIMITATION AND DEPRESSIVE SYMPTOMATOLOGY: CONSIDERING PERCEIVED STIGMA AND DISCRIMINATION WITHIN A STRESS AND COPING FRAMEWORK

PubMed Central

Brown, Robyn Lewis

2016-01-01

This study examines whether perceived stigma and discrimination moderate the associations between functional limitation, psychosocial coping resources, and depressive symptoms among people with physical disabilities. Using two waves of data from a large community study including a representative sample of persons with physical disabilities (N=417), an SEM-based moderated mediation analysis was performed. Mediation tests demonstrate that mastery significantly mediates the association between functional limitation and depressive symptoms over the study period. Moderated mediation tests reveal that the linkage between functional limitation and mastery varies as a function of perceived stigma and experiences of major discrimination and day-to-day discrimination, however. The implications of these findings are discussed in the context of the stress and coping literature. PMID:28497112

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

Geng, Guangchao; Abhyankar, Shrirang; Wang, Xiaoyu

Transient stability-constrained optimal power flow is an important emerging problem with power systems pushed to the limits for economic benefits, dense and larger interconnected systems, and reduced inertia due to expected proliferation of renewable energy resources. In this study, two more approaches: single machine equivalent and computational intelligence are presented. Also discussed are various application areas, and future directions in this research area. In conclusion, a comprehensive resource for the available literature, publicly available test systems, and relevant numerical libraries is also provided.

The Effects of Caregiving Resources on Perceived Health among Caregivers

PubMed Central

Hong, Michin; Harrington, Donna

2016-01-01

This study examined how various types of resources influence perceived health of caregivers. Guided by the conservation of resources theory, a caregiver health model was built and tested using structural equation modeling. The caregiver health model consisted of caregiving situations (functional limitations and cognitive impairments of older adults and caregiving time), resources (financial resources, mastery, social support, family harmony, and service utilization), caregiver burden, and perceived health of caregivers. The sample included 1,837 unpaid informal caregivers drawn from the 2004 National Long-Term Caregiver Survey. The model fit indices indicated that the first structural model did not fit well; however, the revised model yielded an excellent model fit. More stressful caregiving situations were associated with fewer resources and higher burden, whereas greater resources were associated with lower burden and better perceived health of caregivers. The results suggest explicit implications for social work research and practice on how to protect the health of caregivers. PMID:29206951

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

Hummon, M.; Kiliccote, S.

Demand response (DR) resources present a potentially important source of grid flexibility however, DR in grid models is limited by data availability and modeling complexity. This presentation focuses on the co-optimization of DR resources to provide energy and ancillary services in a production cost model of the Colorado "test system". We assume each DR resource can provide energy services by either shedding load or shifting its use between different times, as well as operating reserves: frequency regulation, contingency reserve, and flexibility (or ramping) reserve. There are significant variations in the availabilities of different types of DR resources, which affect bothmore » the operational savings as well as the revenue for each DR resource. The results presented include the system-wide avoided fuel and generator start-up costs as well as the composite revenue for each DR resource by energy and operating reserves.« less

Dangerous nutrients: evolution of phytoplankton resource uptake subject to virus attack.

PubMed

Menge, Duncan N L; Weitz, Joshua S

2009-03-07

Phytoplankton need multiple resources to grow and reproduce (such as nitrogen, phosphorus, and iron), but the receptors through which they acquire resources are, in many cases, the same channels through which viruses attack. Therefore, phytoplankton can face a bottom-up vs. top-down tradeoff in receptor allocation: Optimize resource uptake or minimize virus attack? We investigate this top-down vs. bottom-up tradeoff using an evolutionary ecology model of multiple essential resources, specialist viruses that attack through the resource receptors, and a phytoplankton population that can evolve to alter the fraction of receptors used for each resource/virus type. Without viruses present the singular continuously stable strategy is to allocate receptors such that resources are co-limiting, which also minimizes the equilibrium concentrations of both resources. Only one virus type can be present at equilibrium (because phytoplankton, in this model, are a single resource for viruses), and when a virus type is present, it controls the equilibrium phytoplankton population size. Despite this top-down control on equilibrium densities, bottom-up control determines the evolutionary outcome. Regardless of which virus type is present, the allocation strategy that yields co-limitation between the two resources is continuously stable. This is true even when the virus type attacking through the limiting resource channel is present, even though selection for co-limitation in this case decreases the equilibrium phytoplankton population and does not decrease the equilibrium concentration of the limiting resource. Therefore, although moving toward co-limitation and decreasing the equilibrium concentration of the limiting resource often co-occur in models, it is co-limitation, and not necessarily the lowest equilibrium concentration of the limiting resource, that is the result of selection. This result adds to the growing body of literature suggesting that co-limitation at equilibrium is a winning strategy.

TOXCAST: A PROGRAM FOR PRIORTITIZING TOXICITY TESTING OF ENVIRONMENTAL CHEMICALS

EPA Science Inventory

Evaluating the potential of tens of thousands of chemicals for risk to human health and the environment is beyond the resource limits of the Environmental Protection Agency. The EPA's ToxCast program will explore alternative methods comprising computational chemistry, high-throug...

Applications of high throughput screening to identify profiles of biological activity relevant to carcinogenesis

EPA Science Inventory

ToxCast, the United States Environmental Protection Agency’s chemical prioritization research program, is developing methods for utilizing computational chemistry and bioactivity profiling to predict potential for toxicity and prioritize limited testing resources (www.epa.gov/toc...

A survey of Ethiopian physicians' experiences of bedside rationing: extensive resource scarcity, tough decisions and adverse consequences.

PubMed

Defaye, Frehiwot Berhane; Desalegn, Dawit; Danis, Marion; Hurst, Samia; Berhane, Yemane; Norheim, Ole Frithjof; Miljeteig, Ingrid

2015-10-14

Resource scarcity in health care is a universal challenge. In high-income settings, bedside rationing is commonly discussed and debated as a means to addressing scarcity. However, little is known about physicians' experiences in resource-limited contexts in low- income countries. Here we describe physicians' experiences regarding scarcity of resources, bedside rationing, use of various strategies to save resources, and perceptions of the consequences of rationing in Ethiopia. A national survey was conducted amongst physicians from 49 public hospitals using stratified, multi-stage sampling in six regions. All physicians in the selected hospitals were invited to respond to a self-administered questionnaire. Data were weighted and analyzed using descriptive statistics. In total, 587 physicians responded (91% response rate). The majority had experienced system-wide shortages of various types of medical services. The services most frequently reported to be in short supply, either daily or weekly, were access to surgery, specialist and intensive care units, drug prescriptions and admission to hospital (52, 49, 46, 47 and 46% respectively). The most common rationing strategies used daily or weekly were limiting laboratory tests, hospital drugs, radiological investigations and providing second best treatment (47, 47, 47 and 39% respectively). Availability of institutional or national guidelines for whom to see and treat first was lacking. Almost all respondents had witnessed different adverse consequences of resource scarcity; 54% reported seeing patients who, in their estimation, had died due to resource scarcity. Almost 9 out of 10 physicians were so troubled by limited resources that they often regretted their choice of profession. This study provides the first glimpses of the untold story of resource shortage and bedside rationing in Ethiopia. Physicians encounter numerous dilemmas due to resource scarcity, and they report they lack adequate guidance for how to handle them. The consequences for patients and the professionals are substantial.

Xpert MTB/RIF testing in a low tuberculosis incidence, high-resource setting: limitations in accuracy and clinical impact.

PubMed

Sohn, Hojoon; Aero, Abebech D; Menzies, Dick; Behr, Marcel; Schwartzman, Kevin; Alvarez, Gonzalo G; Dan, Andrei; McIntosh, Fiona; Pai, Madhukar; Denkinger, Claudia M

2014-04-01

Xpert MTB/RIF, the first automated molecular test for tuberculosis, is transforming the diagnostic landscape in low-income countries. However, little information is available on its performance in low-incidence, high-resource countries. We evaluated the accuracy of Xpert in a university hospital tuberculosis clinic in Montreal, Canada, for the detection of pulmonary tuberculosis on induced sputum samples, using mycobacterial cultures as the reference standard. We also assessed the potential reduction in time to diagnosis and treatment initiation. We enrolled 502 consecutive patients who presented for evaluation of possible active tuberculosis (most with abnormal chest radiographs, only 18% symptomatic). Twenty-five subjects were identified to have active tuberculosis by culture. Xpert had a sensitivity of 46% (95% confidence interval [CI], 26%-67%) and specificity of 100% (95% CI, 99%-100%) for detection of Mycobacterium tuberculosis. Sensitivity was 86% (95% CI, 42%-100%) in the 7 subjects with smear-positive results, and 28% (95% CI, 10%-56%) in the remaining subjects with smear-negative, culture-positive results; in this latter group, positive Xpert results were obtained a median 12 days before culture results. Subjects with positive cultures but negative Xpert results had minimal disease: 11 of 13 had no symptoms on presentation, and mean time to positive liquid culture results was 28 days (95% CI, 25-47 days) compared with 14 days (95% CI, 8-21 days) in Xpert/culture-positive cases. Our findings suggest limited potential impact of Xpert testing in high-resource, low-incidence ambulatory settings due to lower sensitivity in the context of less extensive disease, and limited potential to expedite diagnosis beyond what is achieved with the existing, well-performing diagnostic algorithm.

The effect of limited cognitive resources on communication disturbances in serious mental illness.

PubMed

Le, Thanh P; Najolia, Gina M; Minor, Kyle S; Cohen, Alex S

2017-02-01

Semantically incoherent speech is a pernicious clinical feature of serious mental illness (SMI). The precise mechanisms underlying this deficit remain unclear. Prior studies have found that arousal of negative emotion exaggerates the severity of these communication disturbances; this has been coined "affective reactivity". Recent research suggests that "cognitive reactivity" may also occur, namely reflecting reduced "on-line" cognitive resources in SMI. We tested the hypothesis that communication disturbances manifest as a function of limited cognitive resources in SMI above and beyond that associated with state affectivity. We also investigated individual differences in symptoms, cognitive ability, and trait affect that may be related to cognitive reactivity. We compared individuals with SMI (n=52) to nonpsychiatric controls (n=27) on a behavioral-based coding of communication disturbances during separate baseline and experimentally-manipulated high cognitive-load dual tasks. Controlling for state affective reactivity, a significant interaction was observed such that communication disturbances decreased in the SMI group under high cognitive-load. Furthermore, a reduction in communication disturbances was related to lower trait and state positive affectivity in the SMI group. Contrary to our expectations, limited cognitive resources temporarily relieved language dysfunction. Implications, particularly with respect to interventions, are discussed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Towards a cognitive resource limitations model of diminished expression in schizotypy.

PubMed

Cohen, Alex S; Morrison, Sean C; Brown, Laura A; Minor, Kyle S

2012-02-01

Diminished expression of speech is a pernicious feature of both schizophrenia and schizotypy--defined as the personality organization reflecting a putative genetic schizophrenia liability. As yet, the mechanism underlying diminished expression is unclear. We tested the hypothesis that diminished expression reflects a cognitive resource issue--that is, as cognitive resources are depleted, expression becomes diminished in individuals with psychometrically defined schizotypy. Acoustic analysis of natural speech was procured during experimentally manipulated baseline and high cognitive-load dual tasks and examined in 38 individuals with psychometrically defined schizotypy and 34 controls. For both groups, expression significantly decreased as a function of increased task demands, although there were no group differences in expression or magnitude of change across baseline to high cognitive-load conditions. Participants with self-reported constricted affect showed significant reductions in expression under high-load versus baseline speaking conditions relative to other schizotypal and control participants. Moreover, psychometrically defined schizotypal participants with poor cognitive performance on the high-load task, suggestive of depleted cognitive resources, also showed expressivity reductions compared with other participants. These findings suggest that diminished expression occurs as a function of limited cognitive resources in psychometrically defined schizotypy. PsycINFO Database Record (c) 2012 APA, all rights reserved.

The use of Minilabs to improve the testing capacity of regulatory authorities in resource limited settings: Tanzanian experience.

PubMed

Risha, Peter Gasper; Msuya, Zera; Clark, Malcolm; Johnson, Keith; Ndomondo-Sigonda, Margareth; Layloff, Thomas

2008-08-01

The Tanzania Food and Drugs Authority piloted the use of Minilab kits, a thin-layer-chromatographic based drug quality testing technique, in a two-tier quality assurance program. The program is intended to improve testing capacity with timely screening of the quality of medicines as they enter the market. After 1 week training of inspectors on Minilab screening techniques, they were stationed at key Ports-of-Entry (POE) to screen the quality of imported medicines. In addition, three non-Ports-of-Entry centres were established to screen samples collected during Post-Marketing-Surveillance. Standard operating procedures (SOPs) were developed to structure and standardize the implementation process. Over 1200 samples were tested using the Minilab outside the central quality control laboratory (QCL), almost doubling the previous testing capacity. The program contributed to increased regulatory reach and visibility of the Authority throughout the country, serving as a deterrent against entry of substandard medicines into market. The use of Minilab for quality screening was inexpensive and provided a high sample throughput. However, it suffers from the limitation that it can reliably detect only grossly substandard or wrong drug samples and therefore, it should not be used as an independent testing resource but in conjunction with a full-service quality control laboratory capable of auditing reported substandard results.

The introduction of syphilis point of care tests in resource limited settings.

PubMed

Marks, Michael; Mabey, David Cw

2017-04-01

Syphilis remains an important and preventable cause of stillbirth and neonatal mortality. About 1 million women with active syphilis become pregnant each year. Without treatment, 25% of them will deliver a stillborn baby and 33% a low birth weight baby with an increased chance of dying in the first month of life. Adverse pregnancy outcomes due to syphilis can be prevented by screening pregnant women, and treating those who test positive with a single dose of penicillin before 28 weeks' gestation. Areas covered: This manuscript covers the impact of syphilis on pregnancy outcome, the diagnosis of syphilis, with a special focus on point of care (POC) tests, and challenges to the introduction of POC tests, and their potential impact on the control and prevention of syphilis in resource limited settings. Expert commentary: POC tests for syphilis are available which meet the ASSURED criteria, and could make syphilis screening accessible to all women anywhere in the world who attend an antenatal clinic. High quality dual POC tests for HIV and syphilis could ensure that well-funded programmes for the prevention of mother to child transmission of HIV can contribute towards increased coverage of antenatal syphilis screening, and prevent more than 300,000 adverse pregnancy outcomes due to syphilis annually. Alongside investment to increase availability of syphilis POC tests, operational research is needed to understand how best to improve screening of pregnant women and to translate test availability into improved pregnancy outcomes.

A Summary Catalogue of Microbial Drinking Water Tests for Low and Medium Resource Settings

PubMed Central

Bain, Robert; Bartram, Jamie; Elliott, Mark; Matthews, Robert; McMahan, Lanakila; Tung, Rosalind; Chuang, Patty; Gundry, Stephen

2012-01-01

Microbial drinking-water quality testing plays an essential role in measures to protect public health. However, such testing remains a significant challenge where resources are limited. With a wide variety of tests available, researchers and practitioners have expressed difficulties in selecting the most appropriate test(s) for a particular budget, application and setting. To assist the selection process we identified the characteristics associated with low and medium resource settings and we specified the basic information that is needed for different forms of water quality monitoring. We then searched for available faecal indicator bacteria tests and collated this information. In total 44 tests have been identified, 18 of which yield a presence/absence result and 26 of which provide enumeration of bacterial concentration. The suitability of each test is assessed for use in the three settings. The cost per test was found to vary from $0.60 to $5.00 for a presence/absence test and from $0.50 to $7.50 for a quantitative format, though it is likely to be only a small component of the overall costs of testing. This article presents the first comprehensive catalogue of the characteristics of available and emerging low-cost tests for faecal indicator bacteria. It will be of value to organizations responsible for monitoring national water quality, water service providers, researchers and policy makers in selecting water quality tests appropriate for a given setting and application. PMID:22754460

A summary catalogue of microbial drinking water tests for low and medium resource settings.

PubMed

Bain, Robert; Bartram, Jamie; Elliott, Mark; Matthews, Robert; McMahan, Lanakila; Tung, Rosalind; Chuang, Patty; Gundry, Stephen

2012-05-01

Microbial drinking-water quality testing plays an essential role in measures to protect public health. However, such testing remains a significant challenge where resources are limited. With a wide variety of tests available, researchers and practitioners have expressed difficulties in selecting the most appropriate test(s) for a particular budget, application and setting. To assist the selection process we identified the characteristics associated with low and medium resource settings and we specified the basic information that is needed for different forms of water quality monitoring. We then searched for available faecal indicator bacteria tests and collated this information. In total 44 tests have been identified, 18 of which yield a presence/absence result and 26 of which provide enumeration of bacterial concentration. The suitability of each test is assessed for use in the three settings. The cost per test was found to vary from $0.60 to $5.00 for a presence/absence test and from $0.50 to $7.50 for a quantitative format, though it is likely to be only a small component of the overall costs of testing. This article presents the first comprehensive catalogue of the characteristics of available and emerging low-cost tests for faecal indicator bacteria. It will be of value to organizations responsible for monitoring national water quality, water service providers, researchers and policy makers in selecting water quality tests appropriate for a given setting and application.

Safety in the skies : personnel and parties in NTSB aviation accident investigations : master volume

DOT National Transportation Integrated Search

2001-01-01

Recent high-profile commercial aviation mishaps have stretched the National Transportation Safety Board's (NTSB) resources to the limit and are testing the agency's ability to unravel the sorts of complex failures that lead to tragic accidents. In re...

A scheme for the uniform mapping and monitoring of earth resources and environmental complexes using ERTS-1 imagery

NASA Technical Reports Server (NTRS)

Poulton, C. E. (Principal Investigator); Welch, R. I.

1973-01-01

There are no author-identified significant results in this report. Progress on plans for the development and testing of a practical procedure and system for the uniform mapping and monitoring of natural ecosystems and environmental complexes from space-acquired imagery is discussed. With primary emphasis on ERTS-1 imagery, but supported by appropriate aircraft photography as necessary, the objectives are to accomplish the following: (1) Develop and test in a few selected sites and areas of the western United States a standard format for an ecological and land use legend for making natural resource inventories on a simulated global basis. (2) Based on these same limited geographic areas, identify the potentialities and limitations of the legend concept for the recognition and annotation of ecological analogs and environmental complexes. An additional objective is to determine the optimum combination of space photography, aerial photography, ground data, human data analysis, and automatic data analysis for estimating crop yield in the rice growing areas of California and Louisiana.

HIV genotype resistance testing in antiretroviral (ART) exposed Indian children--a need of the hour.

PubMed

Shah, Ira; Parikh, Shefali

2013-04-01

Development of drug resistance in HIV infected children with treatment failure is a major impediment to selection of appropriate therapy. HIV genotype resistance assays predict drug resistance on the basis of mutations in the viral genome. However, their clinical utility, especially in a resource limited setting is still a subject of debate. The authors report two cases in which both the children suffered from treatment failure of various antiretroviral therapy regimes. In both the cases, Genotype Resistance Testing (GRT) prompted a radical change from proposed failure therapy as per existing guidelines. GRT was specifically important for the selection of a new dual Nucleoside reverse transcriptase inhibitors (NRTI) component of failure regimen by identifying TAMS and M184V mutations in the HIV genome. These case reports highlight the importance of GRT in children failing multiple antiretroviral regimes; and emphasizes the need to recognize situations where GRT is absolutely essential to guide appropriate therapy, even in a resource limited setting.

Predictive Software Cost Model Study. Volume II. Software Package Detailed Data.

DTIC Science & Technology

1980-06-01

will not be limited to: a. ASN-91 NWDS Computer b. Armament System Control Unit ( ASCU ) c. AN/ASN-90 IMS 6. CONFIGURATION CONTROL. OFP/OTP...planned approach. 3. Detailed analysis and study; impacts on hardware, manuals, data, AGE , etc; alternatives with pros and cons; cost estimates; ECP...WAIT UNTIL RESOURCE REQUEST FOR * : HAG TAPE HAS BEEN FULFILLED )MTS 0 RI * Ae* NESDIIRCE MAG TAPE (SHORT FORM)I:TST IN I" . TEST " AG TAPE RESOURCE

Diagnostics in Ebola Virus Disease in Resource-Rich and Resource-Limited Settings

PubMed Central

Shorten, Robert J; Brown, Colin S; Jacobs, Michael; Rattenbury, Simon; Simpson, Andrew J.; Mepham, Stephen

2016-01-01

The Ebola virus disease (EVD) outbreak in West Africa was unprecedented in scale and location. Limited access to both diagnostic and supportive pathology assays in both resource-rich and resource-limited settings had a detrimental effect on the identification and isolation of cases as well as individual patient management. Limited access to such assays in resource-rich settings resulted in delays in differentiating EVD from other illnesses in returning travellers, in turn utilising valuable resources until a diagnosis could be made. This had a much greater impact in West Africa, where it contributed to the initial failure to contain the outbreak. This review explores diagnostic assays of use in EVD in both resource-rich and resource-limited settings, including their respective limitations, and some novel assays and approaches that may be of use in future outbreaks. PMID:27788135

Effect of water availability on tolerance of leaf damage in tall morning glory, Ipomoea purpurea

NASA Astrophysics Data System (ADS)

Atala, Cristian; Gianoli, Ernesto

2009-03-01

Resource availability may limit plant tolerance of herbivory. To predict the effect of differential resource availability on plant tolerance, the limiting resource model (LRM) considers which resource limits plant fitness and which resource is mostly affected by herbivore damage. We tested the effect of experimental drought on tolerance of leaf damage in Ipomoea purpurea, which is naturally exposed to both leaf damage and summer drought. To seek mechanistic explanations, we also measured several morphological, allocation and gas exchange traits. In this case, LRM predicts that tolerance would be the same in both water treatments. Plants were assigned to a combination of two water treatments (control and low water) and two damage treatments (50% defoliation and undamaged). Plants showed tolerance of leaf damage, i.e., a similar number of fruits were produced by damaged and undamaged plants, only in control water. Whereas experimental drought affected all plant traits, leaf damage caused plants to show a greater leaf trichome density and reduced shoot biomass, but only in low water. It is suggested that the reduced fitness (number of fruits) of damaged plants in low water was mediated by the differential reduction of shoot biomass, because the number of fruits per shoot biomass was similar in damaged and undamaged plants. Alternative but less likely explanations include the opposing direction of functional responses to drought and defoliation, and resource costs of the damage-induced leaf trichome density. Our results somewhat challenge the LRM predictions, but further research including field experiments is needed to validate some of the preliminary conclusions drawn.

Microclimate and propagule availability are equally important for rehabilitation of dryland N-fixing lichens

USGS Publications Warehouse

Bowker, M.A.; Belnap, J.; Davidson, D.W.

2010-01-01

In some arid regions, rehabilitation of whole system N-fixation may be strongly facilitated by the recovery of populations of the lichen genus Collema. Identification of the limits to recovery of Collema in apparently suitable habitat should inform selection of rehabilitation techniques. We simultaneously tested the relative importance of three hypothetical limits to Collema recovery: active erosion, resource limitation, and propagule scarcity. We found that in our experimental system, active erosion had no effect on short-term establishment of Collema, whereas propagule addition did enhance recovery and microhabitat (a resource availability gradient) also exerted a strong influence. It is possible that attempts to improve N cycling via re-establishment of Collema might be best served by developing economical means of simulating moister, cooler microhabitats, e.g., sloping soil or creating partial shade, which would favor the establishment of naturally dispersed propagules, rather than introducing propagules. ?? 2009 Society for Ecological Restoration International.

A new semantic vigilance task: vigilance decrement, workload, and sensitivity to dual-task costs.

PubMed

Epling, Samantha L; Russell, Paul N; Helton, William S

2016-01-01

Cognitive resource theory is a common explanation for both the performance decline in vigilance tasks, known as the vigilance decrement, and the limited ability to perform multiple tasks simultaneously. The limited supply of cognitive resources may be utilized faster than they are replenished resulting in a performance decrement, or may need to be allocated among multiple tasks with some performance cost. Researchers have proposed both domain-specific, for example spatial versus verbal processing resources, and domain general cognitive resources. One challenge in testing the domain specificity of cognitive resources in vigilance is the current lack of difficult semantic vigilance tasks which reliably produce a decrement. In the present research, we investigated whether the vigilance decrement was found in a new abbreviated semantic discrimination vigilance task, and whether there was a performance decrement in said vigilance task when paired with a word recall task, as opposed to performed individually. As hypothesized, a vigilance decrement in the semantic vigilance task was found in both the single-task and dual-task conditions, along with reduced vigilance performance in the dual-task condition and reduced word recall in the dual-task condition. This is consistent with cognitive resource theory. The abbreviated semantic vigilance task will be a useful tool for researchers interested in determining the specificity of cognitive resources utilized in vigilance tasks.

Outcomes and Disability After Massive Proximal Upper Extremity Reconstruction in a Resource-Limited Setting.

PubMed

Giladi, Aviram M; Shanmugakrishnan, R Raja; Venkatramani, Hari; Raja Sekaran, S; Chung, Kevin C; Sabapathy, S Raja

2017-06-01

At Ganga Hospital in Coimbatore, India, a unique approach is applied to treat massive upper limb injuries. However, long-term outcomes of complex reconstruction performed in the resource-limited setting are not known. This hinders understanding of outcomes and disability from these injuries and prevents systematically addressing care delivery around upper extremity trauma in the developing world. This project aims to analyze the details of the unique Ganga Hospital reconstruction experience and use patient-reported outcome measures for the first time in this patient population to evaluate post-injury recovery and disability . Forty-six patients were evaluated 6 months or more after massive proximal upper extremity reconstruction at Ganga Hospital. Patients completed functional tests, Jebsen-Taylor test (JTT), and patient-reported outcomes (PROs)-Michigan Hand Questionnaire (MHQ), Disability of Arm, Shoulder, and Hand questionnaire (DASH), and Short-Form 36 (SF-36). Correlations between metrics were assessed with Pearson's correlation coefficients. Linear regression modeling evaluated associations between severity, reconstruction, and outcomes. MHQ and DASH results correlated with functional test performance, JTT performance, and SF-36 scores (Pearson's coefficients all ≥0.33, p ≤ 0.05). In this cohort, mean MHQ score was 79 ± 15 and mean DASH score was 13 ± 15, which are not significantly different than scores for long-term outcomes after other complex upper extremity procedures. The following factors predicted PROs and functional performance after reconstruction: extent of soft tissue reconstruction, multi-segmental ulna fractures, median nerve injury, and ability for patients to return to work and maintain their job after injury. Complex proximal upper extremity salvage can be performed in the resource-limited setting with excellent long-term functional and patient-reported outcomes. PRO questionnaires are useful for reporting outcomes that correlate to functional and sensory testing and may be used to assess post-traumatic disability.

Approach motivation and cognitive resources combine to influence memory for positive emotional stimuli.

PubMed

Crowell, Adrienne; Schmeichel, Brandon J

2016-01-01

Inspired by the elaborated intrusion theory of desire, the current research tested the hypothesis that persons higher in trait approach motivation process positive stimuli deeply, which enhances memory for them. Ninety-four undergraduates completed a measure of trait approach motivation, viewed positive or negative image slideshows in the presence or absence of a cognitive load, and one week later completed an image memory test. Higher trait approach motivation predicted better memory for the positive slideshow, but this memory boost disappeared under cognitive load. Approach motivation did not influence memory for the negative slideshow. The current findings support the idea that individuals higher in approach motivation spontaneously devote limited resources to processing positive stimuli.

Testing hypotheses for excess flower production and low fruit-to-flower ratios in a pollinating seed-consuming mutualism

USGS Publications Warehouse

Holland, J. Nathaniel; Bronstein, Judith L.; DeAngelis, Donald L.

2004-01-01

Pollinator attraction, pollen limitation, resource limitation, pollen donation and selective fruit abortion have all been proposed as processes explaining why hermaphroditic plants commonly produce many more flowers than mature fruit. We conducted a series of experiments in Arizona to investigate low fruit-to-flower ratios in senita cacti, which rely exclusively on pollinating seed-consumers. Selective abortion of fruit based on seed predators is of particular interest in this case because plants relying on pollinating seed-consumers are predicted to have such a mechanism to minimize seed loss. Pollinator attraction and pollen dispersal increased with flower number, but fruit set did not, refuting the hypothesis that excess flowers increase fruit set by attracting more pollinators. Fruit set of natural- and hand-pollinated flowers were not different, supporting the resource, rather than pollen, limitation hypothesis. Senita did abort fruit, but not selectively based on pollen quantity, pollen donors, or seed predators. Collectively, these results are consistent with sex allocation theory in that resource allocation to excess flower production can increase pollen dispersal and the male fitness function of flowers, but consequently results in reduced resources available for fruit set. Inconsistent with sex allocation theory, however, fruit production and the female fitness function of flowers may actually increase with flower production. This is because excess flower production lowers pollinator-to-flower ratios and results in fruit abortion, both of which limit the abundance and hence oviposition rates, of pre-dispersal seed predators.

Principles of Point of Care Culture, the Spatial Care Path™, and Enabling Community and Global Resilience: Enabling Community and Global Resilience.

PubMed

Gerald, J Kost; William, J Ferguson; Laurie, E Kost

2014-09-01

This article a) defines point of care (POC) culture; b) presents seven underlying fundamental principles; c) describes the importance of needs assessment; d) introduces a new innovation, the spatial care path™; and e) illustrates how POC testing that properly fulfills needs and spatial care paths™ enable community and global resilience. Often, POC testing supplants the conventional clinical laboratory, which may be too distant, prohibitively expensive, or simply not available in limited-resource settings. New POC technologies "fit" future medical problem solving. Screening and testing directly in the home or primary care facilitate rapid diagnosis, monitoring, and treatment. In contrast to the past where attention has been placed on emergency departments, hospitals, and referral centers, the spatial care path™ starts with the patient and guides him or her through an efficient strategy of care in small-world networks (SWNs) defined by local geography and topology, long-standing customs, public health jurisdictions, and geographic information systems (GIS). POC testing needs in limited-resource settings are striking. Fulfillment is best guided by thorough understanding of POC culture. Quick feedback and fast decision-making by patients and physicians alike yield significant value that motivates changes in patient lifestyles and physician interactions. Culturally sensitive technology assimilation addresses leadership challenges in nations adapting to increasing populations of young and old, despite scarcity of resources. The spatial care path™ facilitates an essential balance of prevention and intervention in public health and shifts future focus to the patient, empowerment, and primary care within the context of POC culture.

New nucleic acid testing devices to diagnose infectious diseases in resource-limited settings.

PubMed

Maffert, P; Reverchon, S; Nasser, W; Rozand, C; Abaibou, H

2017-10-01

Point-of-care diagnosis based on nucleic acid testing aims to incorporate all the analytical steps, from sample preparation to nucleic acid amplification and detection, in a single device. This device needs to provide a low-cost, robust, sensitive, specific, and easily readable analysis. Microfluidics has great potential for handling small volumes of fluids on a single platform. Microfluidic technology has recently been applied to paper, which is already used in low-cost lateral flow tests. Nucleic acid extraction from a biological specimen usually requires cell filtration and lysis on specific membranes, while affinity matrices, such as chitosan or polydiacetylene, are well suited to concentrating nucleic acids for subsequent amplification. Access to electricity is often difficult in resource-limited areas, so the amplification step needs to be equipment-free. Consequently, the reaction has to be isothermal to alleviate the need for a thermocycler. LAMP, NASBA, HDA, and RPA are examples of the technologies available. Nucleic acid detection techniques are currently based on fluorescence, colorimetry, or chemiluminescence. For point-of-care diagnostics, the results should be readable with the naked eye. Nowadays, interpretation and communication of results to health professionals could rely on a smartphone, used as a telemedicine device. The major challenge of creating an "all-in-one" diagnostic test involves the design of an optimal solution and a sequence for each analytical step, as well as combining the execution of all these steps on a single device. This review provides an overview of available materials and technologies which seem to be adapted to point-of-care nucleic acid-based diagnosis, in low-resource areas.

A simple and inexpensive point-of-care test for hepatitis B surface antigen detection: serological and molecular evaluation.

PubMed

Gish, R G; Gutierrez, J A; Navarro-Cazarez, N; Giang, K; Adler, D; Tran, B; Locarnini, S; Hammond, R; Bowden, S

2014-12-01

Early identification of chronic hepatitis B is important for optimal disease management and prevention of transmission. Cost and lack of access to commercial hepatitis B surface antigen (HBsAg) immunoassays can compromise the effectiveness of HBV screening in resource-limited settings and among marginalized populations. High-quality point-of-care (POC) testing may improve HBV diagnosis in these situations. Currently available POC HBsAg assays are often limited in sensitivity. We evaluated the NanoSign(®) HBs POC chromatographic immunoassay for its ability to detect HBsAg of different genotypes and with substitutions in the 'a' determinant. Thirty-seven serum samples from patients with HBV infection, covering HBV genotypes A-G, were assessed for HBsAg titre with the Roche Elecsys HBsAg II quantification assay and with the POC assay. The POC assay reliably detected HBsAg at a concentration of at least 50 IU/mL for all genotypes, and at lower concentrations for some genotypes. Eight samples with substitutions in the HBV 'a' determinant were reliably detected after a 1/100 dilution. The POC strips were used to screen serum samples from 297 individuals at risk for HBV in local clinical settings (health fairs and outreach events) in parallel with commercial laboratory HBsAg testing (Quest Diagnostics EIA). POC testing was 73.7% sensitive and 97.8% specific for detection of HBsAg. Although the POC test demonstrated high sensitivity over a range of genotypes, false negatives were frequent in a clinical setting. Nevertheless, the POC assay offers advantages for testing in both developed and resource-limited countries due to its low cost (0.50$) and immediately available results. © 2014 John Wiley & Sons Ltd.

External quality assurance for HIV point-of-care testing in Africa: A collaborative country-partner approach to strengthen diagnostic services

PubMed Central

2016-01-01

It is important to consider the role of diagnostics and the critical need for quality diagnostics services in resource-limited settings. Accurate diagnostic tests play a key role in patient management and the prevention and control of most infectious diseases. As countries plan for implementation of HIV early infant diagnosis and viral load point-of-care testing, the London School of Hygiene & Tropical Medicine has worked with countries and partners with an interest in external quality assurance to support quality point-of-care testing on the continent. Through a series of collaborative consultations and workshops, the London School of Hygiene & Tropical Medicine has gathered lessons learned, tools, and resources and developed quality assurance models that will support point-of-care testing. The London School of Hygiene & Tropical Medicine is committed to the continued advancement of laboratory diagnostics in Africa and quality laboratory services and point-of-care testing. PMID:28879132

Getting Personal: Head and Neck Cancer Management in the Era of Genomic Medicine

PubMed Central

Birkeland, Andrew C.; Uhlmann, Wendy R.; Brenner, J. Chad; Shuman, Andrew G.

2015-01-01

Background Genetic testing is rapidly becoming an important tool in the management of patients with head and neck cancer. As we enter the era of genomics and personalized medicine, providers should be aware of testing options, counseling resources, and the benefits, limitations and future of personalized therapy. Methods This manuscript offers a primer to assist clinicians treating patients in anticipating and managing the inherent practical and ethical challenges of cancer care in the genomic era. Results Clinical applications of genomics for head and neck cancer are emerging. We discuss the indications for genetic testing, types of testing available, implications for care, privacy/disclosure concerns and ethical considerations. Hereditary genetic syndromes associated with head and neck neoplasms are reviewed, and online genetics resources are provided. Conclusions This article summarizes and contextualizes the evolving diagnostic and therapeutic options that impact the care of patients with head and neck cancer in the genomic era. PMID:25995036

Frustrated Fertility: Infertility and Psychological Distress among Women.

ERIC Educational Resources Information Center

McQuillan, Julia; Greil, Arthur L.; White, Lynn; Jacob, Mary Casey

2003-01-01

Tests the hypothesis that women who have experienced infertility report higher psychological distress. Examines whether roles or resources condition the effects of infertility or whether its effects are limited to childless women. Infertility combined with involuntary childlessness is associated with significantly greater distress. For women in…

Paving the Way for Predictive Ecotoxicology in the 21st Century

EPA Science Inventory

The ability to conduct traditional whole organism toxicity tests for increasingly wide inventories of chemicals of concern is limited by the resource-intensity of the approach in terms of cost, person-hours, and animal use. In a 2007 report, a National Research Council Committee ...

The Analysis of Genomic Dose-Response Data in the EPA ToxCast™ Program

EPA Science Inventory

The U.S. EPA must assess the potential adverse effects of thousands of chemicals, often with limited toxicity information. Accurate toxicity predictions will help prioritize chemicals for further testing, focusing resources on the greater potential hazards or risks. In vitro geno...

Comparison between performances of three types of manual wheelchairs often distributed in low-resource settings.

PubMed

Rispin, Karen; Wee, Joy

2015-07-01

This study was conducted to compare the performance of three types of chairs in a low-resource setting. The larger goal was to provide information which will enable more effective use of limited funds by wheelchair manufacturers and suppliers in low-resource settings. The Motivation Rough Terrain and Whirlwind Rough Rider were compared in six skills tests which participants completed in one wheelchair type and then a day later in the other. A hospital-style folding transport wheelchair was also included in one test. For all skills, participants rated the ease or difficulty on a visual analogue scale. For all tracks, distance traveled and the physiological cost index were recorded. Data were analyzed using repeated measures analysis of variance. The Motivation wheelchair outperformed Whirlwind wheelchair on rough and smooth tracks, and in some metrics on the tight spaces track. Motivation and Whirlwind wheelchairs significantly outperformed the hospital transport wheelchair in all metrics on the rough track skills test. This comparative study provides data that are valuable for manufacturers and for those who provide wheelchairs to users. The comparison with the hospital-style transport chair confirms the cost to users of inappropriate wheelchair provision. Implications for Rehabilitation For those with compromised lower limb function, wheelchairs are essential to enable full participation and improved quality of life. Therefore, provision of wheelchairs which effectively enable mobility in the cultures and environments in which people with disabilities live is crucial. This includes low-resource settings where the need for appropriate seating is especially urgent. A repeated measures study to measure wheelchair performances in everyday skills in the setting where wheelchairs are used gives information on the quality of mobility provided by those wheelchairs. This study highlights differences in the performance of three types of wheelchairs often distributed in low-resource settings. This information can improve mobility for wheelchair users in those settings by enabling wheelchair manufacturers to optimize wheelchair design and providers to optimize the use of limited funds.

The HIV self-testing debate: where do we stand?

PubMed

Gagnon, Marilou; French, Martin; Hébert, Yamilee

2018-01-18

Emphasis on HIV testing as a gateway to prevention, treatment and care has grown tremendously over the past decade. In turn, this emphasis on testing has created a demand for new policies, programs, and technologies that can potentially increase access to and uptake of HIV testing. HIV self-testing (HST) technologies have gained important momentum following the approval of the over-the-counter self-tests in the United States, the UK, and France. While the renewed interest in HST has given rise to a number of high quality reviews of empirical studies conducted on this topic, we have yet to find an article that captures the extent of the debate on HST. A critical review of the literature on HST was conducted and organized into three categories based on the focus of the article: 1) Empirical research, 2) Arguments, and 3) Context. We focused exclusively on the second category which included ethical analyses, policy analyses, editorials, opinion pieces, commentaries, letters to the editor and so forth. 10 lines of argument on HST were identified in the literature: 1) Individual - Public Health, 2) Strengths - Limits, 3) Benefits - Harms, 4) Screening - Testing, 5) Target - Market, 6) Health Care - Industry, 7) Regulation - Restriction, 8) Resource-Rich Settings - Resource-Limited Settings, 9) Ethical - Unethical, and 10) Exceptionalism - Normalization. Each line of argument is presented and discussed in the paper. We conclude by providing examples of critical questions that should be raised in order to take the debate to another level and generate new ways of thinking about HST.

Performance comparison of CareStart™ HRP2/pLDH combo rapid malaria test with light microscopy in north-western Tigray, Ethiopia: a cross-sectional study.

PubMed

Feleke, Daniel Getacher; Tarko, Shambel; Hadush, Haftom

2017-06-06

Rapid diagnostic tests (RDTs) are alternative methods for microscopy in the diagnosis of malaria in resource limited settings. Among commercially available RDTs, CareStart™ Malaria test was found to show reliable results. This study evaluated the performance of CareStart™ Malaria Combo test kit in Northwestern Tigray in Ethiopia. Blood samples were collected from 320 malaria-suspected patients at Mayani Hospital in Northwestern Tigray from December 2015 to March 2016. All blood samples were examined using both light microscopy and CareStart™ Malaria HRP2/pLDH Combo Test kit. Statistical analyses were performed using SPSS version 20. The overall parasite positivity using light microscopy and CareStart™ RDT was 41 (12.8%) and 43 (13.4%), respectively. The sensitivity and specificity of CareStart™ RDT, regardless of species, were found to be 95.4 and 99.3%, respectively. Furthermore, the sensitivity of CareStart™ RDT for Plasmodium falciparum or mixed infection and non-falciparum malaria parasites was 94.4 and 85.0%, respectively while the specificity was found to be 98.9 and 99.7%, respectively. The agreement between the two test methods was "excellent" with a kappa value of 0.92. CareStart™ RDT has very good sensitivity and specificity for malaria diagnosis. The test kit also has an excellent agreement with light microscopy. It is therefore useful in resource-limited areas where microscopy is not available.

Use of a Commercially Available Flight Simulator during Aircrew Performance Testing.

DTIC Science & Technology

1991-11-01

Automiated Battery of Performance-based Tests, NAMRL 1354, Naval Aerospace Medical Research Laboratory, Pensacola, FL, 1990. 13. Human Performance...ability of an aircraft to remain airborne well beyond the limits of its human operator. This capacity for longer flights, coupled with a tendency for short...Measurement, Final Report, Air Force Human Resources Laboratory, Brooks AFB, TX, 1983. 5. Stein, E.S., Measurement of Pilot Performance: A Master Journeyman

Influence of supplementary lighting during artificial scab inoculation tests in an apple breeding programm focused on partial resistance.

PubMed

Lefrancq, B; Lateur, M

2006-01-01

In 1988, the Department of Biological Control and Plant Genetic Resources at the Walloon Agricultural Research Centre started an apple-breeding programme using local genetic resources and modern varieties. Our objective is to create high quality commercial cultivars with durable resistance to scab (Venturia inaequalis), powdery mildew (Podosphaera leucotricha) and canker (Nectria galligena). The breeding strategy is based on crossing old apple cultivars and landraces selected as parents for low disease susceptibility and possessing other desirable horticultural characteristics. The programme aims to develop an early and efficient selection methodology adapted to partial disease resistance. One of the objectives is to define the optimal screening limit for discarding individuals after artificial scab inoculation tests. Working with large populations of seedlings entails spacing the seedling scab tests throughout the year. In order to work during winter, seedlings were grown in controlled cabinet conditions and in a glasshouse with supplementary lighting. To assess the bias introduced by these conditions, two trials were conducted: the first one to compare the influence of both environments on the results of scab inoculation tests, and the second one to assess the influence of the duration of supplementary lighting. The results enabled us to evaluate the limits of artificial cultural systems.

Gas-Centered Swirl Coaxial Liquid Injector Evaluations

NASA Technical Reports Server (NTRS)

Cohn, A. K.; Strakey, P. A.; Talley, D. G.

2005-01-01

Development of Liquid Rocket Engines is expensive. Extensive testing at large scales usually required. In order to verify engine lifetime, large number of tests required. Limited Resources available for development. Sub-scale cold-flow and hot-fire testing is extremely cost effective. Could be a necessary (but not sufficient) condition for long engine lifetime. Reduces overall costs and risk of large scale testing. Goal: Determine knowledge that can be gained from sub-scale cold-flow and hot-fire evaluations of LRE injectors. Determine relationships between cold-flow and hot-fire data.

Effectiveness of a computerized alert system based on re-testing intervals for limiting the inappropriateness of laboratory test requests.

PubMed

Lippi, Giuseppe; Brambilla, Marco; Bonelli, Patrizia; Aloe, Rosalia; Balestrino, Antonio; Nardelli, Anna; Ceda, Gian Paolo; Fabi, Massimo

2015-11-01

There is consolidated evidence that the burden of inappropriate laboratory test requests is very high, up to 70%. We describe here the function of a computerized alert system linked to the order entry, designed to limit the number of potentially inappropriate laboratory test requests. A computerized alert system based on re-testing intervals and entailing the generation of pop-up alerts when preset criteria of appropriateness for 15 laboratory tests were violated was implemented in two clinical wards of the University Hospital of Parma. The effectiveness of the system for limiting potentially inappropriate tests was monitored for 6months. Overall, 765/3539 (22%) test requests violated the preset criteria of appropriateness and generated the appearance of electronic alert. After alert appearance, 591 requests were annulled (17% of total tests requested and 77% of tests alerted, respectively). The total number of test requests violating the preset criteria of inappropriateness constantly decreased over time (26% in the first three months of implementation versus 17% in the following period; p<0.001). The total financial saving of test withdrawn was 3387 Euros (12.8% of the total test cost) throughout the study period. The results of this study suggest that a computerized alert system may be effective to limit the inappropriateness of laboratory test requests, generating significant economic saving and educating physicians to a more efficient use of laboratory resources. Copyright © 2015 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Pooled nucleic acid testing to identify antiretroviral treatment failure during HIV infection.

PubMed

May, Susanne; Gamst, Anthony; Haubrich, Richard; Benson, Constance; Smith, Davey M

2010-02-01

Pooling strategies have been used to reduce the costs of polymerase chain reaction-based screening for acute HIV infection in populations in which the prevalence of acute infection is low (less than 1%). Only limited research has been done for conditions in which the prevalence of screening positivity is higher (greater than 1%). We present data on a variety of pooling strategies that incorporate the use of polymerase chain reaction-based quantitative measures to monitor for virologic failure among HIV-infected patients receiving antiretroviral therapy. For a prevalence of virologic failure between 1% and 25%, we demonstrate relative efficiency and accuracy of various strategies. These results could be used to choose the best strategy based on the requirements of individual laboratory and clinical settings such as required turnaround time of results and availability of resources. Virologic monitoring during antiretroviral therapy is not currently being performed in many resource-constrained settings largely because of costs. The presented pooling strategies may be used to significantly reduce the cost compared with individual testing, make such monitoring feasible, and limit the development and transmission of HIV drug resistance in resource-constrained settings. They may also be used to design efficient pooling strategies for other settings with quantitative screening measures.

The influence of working memory capacity on experimental heat pain.

PubMed

Nakae, Aya; Endo, Kaori; Adachi, Tomonori; Ikeda, Takashi; Hagihira, Satoshi; Mashimo, Takashi; Osaka, Mariko

2013-10-01

Pain processing and attention have a bidirectional interaction that depends upon one's relative ability to use limited-capacity resources. However, correlations between the size of limited-capacity resources and pain have not been evaluated. Working memory capacity, which is a cognitive resource, can be measured using the reading span task (RST). In this study, we hypothesized that an individual's potential working memory capacity and subjective pain intensity are related. To test this hypothesis, we evaluated 31 healthy participants' potential working memory capacity using the RST, and then applied continuous experimental heat stimulation using the listening span test (LST), which is a modified version of the RST. Subjective pain intensities were significantly lower during the challenging parts of the RST. The pain intensity under conditions where memorizing tasks were performed was compared with that under the control condition, and it showed a correlation with potential working memory capacity. These results indicate that working memory capacity reflects the ability to process information, including precise evaluations of changes in pain perception. In this work, we present data suggesting that changes in subjective pain intensity are related, depending upon individual potential working memory capacities. Individual working memory capacity may be a phenotype that reflects sensitivity to changes in pain perception. Copyright © 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.

Improving a Counselor Education Web Site through Usability Testing: The Bibliotherapy Education Project

ERIC Educational Resources Information Center

McMillen, Paula S.; Pehrsson, Dale-Elizabeth

2009-01-01

Technology proficiency expectations have proliferated in counselor education; however, limited information in the counseling literature details how to effectively evaluate or refine online resources from a design/utility standpoint. This description of a small-scale usability study demonstrates a cost-effective strategy for improving counselor…

IMPROVING PARTICULATE MATTER SOURCE APPORTIONMENT FOR HEALTH STUDIES: A TRAINED RECEPTOR MODELING APPROACH WITH SENSITIVITY, UNCERTAINTY AND SPATIAL ANALYSES

EPA Science Inventory

An approach for conducting PM source apportionment will be developed, tested, and applied that directly addresses limitations in current SA methods, in particular variability, biases, and intensive resource requirements. Uncertainties in SA results and sensitivities to SA inpu...

Complementing in vitro hazard assessment with exposure and pharmacokinetics considerations for chemical prioritization

EPA Science Inventory

Traditional toxicity testing involves a large investment in resources, often using low-throughput in vivo animal studies for limited numbers of chemicals. An alternative strategy is the emergence of high-throughput (HT) in vitro assays as a rapid, cost-efficient means to screen t...

Methods for Instructional Diagnosis with Limited Available Resources.

ERIC Educational Resources Information Center

Gillmore, Gerald M.; Clark, D. Joseph

College teaching should be approached with the same careful delineation of problems and systematic attempts to find solutions which characterize research. Specific methods for the diagnosis of instructional problems include audio-video taping, use of teaching assistants, colleague assistance, classroom tests, student projects in and out of class,…

The Effects of Caregiving Resources on Perceived Health among Caregivers.

PubMed

Hong, Michin; Harrington, Donna

2016-08-01

This study examined how various types of resources influence perceived health of caregivers. Guided by the conservation of resources theory, a caregiver health model was built and tested using structural equation modeling. The caregiver health model consisted of caregiving situations (functional limitations and cognitive impairments of older adults and caregiving time), resources (financial resources, mastery, social support, family harmony, and service utilization), caregiver burden, and perceived health of caregivers. The sample included 1,837 unpaid informal caregivers drawn from the 2004 National Long-Term Caregiver Survey. The model fit indices indicated that the first structural model did not fit well; however, the revised model yielded an excellent model fit. More stressful caregiving situations were associated with fewer resources and higher burden, whereas greater resources were associated with lower burden and better perceived health of caregivers. The results suggest explicit implications for social work research and practice on how to protect the health of caregivers. © 2016 National Association of Social Workers.

Paper-based analytical devices for clinical diagnosis: recent advances in the fabrication techniques and sensing mechanisms

PubMed Central

Sher, Mazhar; Zhuang, Rachel; Demirci, Utkan; Asghar, Waseem

2017-01-01

Introduction There is a significant interest in developing inexpensive portable biosensing platforms for various applications including disease diagnostics, environmental monitoring, food safety, and water testing at the point-of-care (POC) settings. Current diagnostic assays available in the developed world require sophisticated laboratory infrastructure and expensive reagents. Hence, they are not suitable for resource-constrained settings with limited financial resources, basic health infrastructure, and few trained technicians. Cellulose and flexible transparency paper-based analytical devices have demonstrated enormous potential for developing robust, inexpensive and portable devices for disease diagnostics. These devices offer promising solutions to disease management in resource-constrained settings where the vast majority of the population cannot afford expensive and highly sophisticated treatment options. Areas covered In this review, the authors describe currently developed cellulose and flexible transparency paper-based microfluidic devices, device fabrication techniques, and sensing technologies that are integrated with these devices. The authors also discuss the limitations and challenges associated with these devices and their potential in clinical settings. Expert commentary In recent years, cellulose and flexible transparency paper-based microfluidic devices have demonstrated the potential to become future healthcare options despite a few limitations such as low sensitivity and reproducibility. PMID:28103450

Paper-based analytical devices for clinical diagnosis: recent advances in the fabrication techniques and sensing mechanisms.

PubMed

Sher, Mazhar; Zhuang, Rachel; Demirci, Utkan; Asghar, Waseem

2017-04-01

There is a significant interest in developing inexpensive portable biosensing platforms for various applications including disease diagnostics, environmental monitoring, food safety, and water testing at the point-of-care (POC) settings. Current diagnostic assays available in the developed world require sophisticated laboratory infrastructure and expensive reagents. Hence, they are not suitable for resource-constrained settings with limited financial resources, basic health infrastructure, and few trained technicians. Cellulose and flexible transparency paper-based analytical devices have demonstrated enormous potential for developing robust, inexpensive and portable devices for disease diagnostics. These devices offer promising solutions to disease management in resource-constrained settings where the vast majority of the population cannot afford expensive and highly sophisticated treatment options. Areas covered: In this review, the authors describe currently developed cellulose and flexible transparency paper-based microfluidic devices, device fabrication techniques, and sensing technologies that are integrated with these devices. The authors also discuss the limitations and challenges associated with these devices and their potential in clinical settings. Expert commentary: In recent years, cellulose and flexible transparency paper-based microfluidic devices have demonstrated the potential to become future healthcare options despite a few limitations such as low sensitivity and reproducibility.

Audiology in Latin America: hearing impairment, resources and services.

PubMed

Madriz, J J

2001-01-01

Evidence is presented about the limitation of information available on prevalence/incidence of deafness and hearing impairment in the developing world; particularly in Latin America. Two questionnaires on audiological resources and services were mailed to Latin American and Caribbean countries in general and to Central American nations in particular. The information returned by Argentina, Chile, Colombia, Costa Rica, Cuba, Belize, El Salvador, Grenada, Guatemala, Honduras, Mexico, Nicaragua, Panama, Puerto Rico and Uruguay was analysed. Data was gathered about epidemiological studies on hearing impairment, about specific programmes, such as early identification of hearing impairment, national registers on deafness and programmes on hearing screening. Training programmes and availability of professionals in the field of hearing and deafness is also shown. Hearing services, hearing aids provision, hearing testing equipment, professional organization and legislation in audiology is also documented. It is our conclusion that hearing impairment is a low priority for health systems in the developing world, technology continues to be excessively costly and material and human resources are limited, and services are poor and restricted.

Point-of-Care Diagnostics in Low Resource Settings: Present Status and Future Role of Microfluidics

PubMed Central

Sharma, Shikha; Zapatero-Rodríguez, Julia; Estrela, Pedro; O’Kennedy, Richard

2015-01-01

The inability to diagnose numerous diseases rapidly is a significant cause of the disparity of deaths resulting from both communicable and non-communicable diseases in the developing world in comparison to the developed world. Existing diagnostic instrumentation usually requires sophisticated infrastructure, stable electrical power, expensive reagents, long assay times, and highly trained personnel which is not often available in limited resource settings. This review will critically survey and analyse the current lateral flow-based point-of-care (POC) technologies, which have made a major impact on diagnostic testing in developing countries over the last 50 years. The future of POC technologies including the applications of microfluidics, which allows miniaturisation and integration of complex functions that facilitate their usage in limited resource settings, is discussed The advantages offered by such systems, including low cost, ruggedness and the capacity to generate accurate and reliable results rapidly, are well suited to the clinical and social settings of the developing world. PMID:26287254

Failure of self-consistency in the discrete resource model of visual working memory.

PubMed

Bays, Paul M

2018-06-03

The discrete resource model of working memory proposes that each individual has a fixed upper limit on the number of items they can store at one time, due to division of memory into a few independent "slots". According to this model, responses on short-term memory tasks consist of a mixture of noisy recall (when the tested item is in memory) and random guessing (when the item is not in memory). This provides two opportunities to estimate capacity for each observer: first, based on their frequency of random guesses, and second, based on the set size at which the variability of stored items reaches a plateau. The discrete resource model makes the simple prediction that these two estimates will coincide. Data from eight published visual working memory experiments provide strong evidence against such a correspondence. These results present a challenge for discrete models of working memory that impose a fixed capacity limit. Copyright © 2018 The Author. Published by Elsevier Inc. All rights reserved.

Operational challenges in delivering CD4 diagnostics in sub-Saharan Africa.

PubMed

Thairu, L; Katzenstein, D; Israelski, D

2011-07-01

Access to reliable and low cost CD4 T-cell enumeration to stage illness and monitor anti-retroviral therapy remains elusive in resource-limited settings. We report challenges in delivering CD4 testing using the microcapillary Fluorescence-Activated Cell Sorter (FACS) methodology (Guava EasyCD4 instrument Guava Technologies, Hayward) in Burkina Faso and Zimbabwe. Resources, instruments, reagents, and training were provided to local laboratories within the existing infrastructure and data on CD4 were collected from routine laboratory testing. Challenges encountered included frequent instrument breakdown; poor manufacturer maintenance; difficulties in managing reagent stocks; high technician turnover; reliance on antiquated data management systems; redundant service provision; and lack of repeat testing in male HIV+ patients and in patients with higher CD4 counts after initial staging. While adopting newer, less expensive technologies such as fluorescent platforms and point of care tests can facilitate access to lower cost CD4 testing, our experience suggests that supply chain, corporate commitment to implementation, and community factors also require consideration.

Replacement of HCFC-225 Solvent for Cleaning NASA Propulsion Oxygen Systems

NASA Technical Reports Server (NTRS)

Lowrey, Nikki M.; Mitchell, Mark A.

2015-01-01

Since the 1990's, when the Class I Ozone Depleting Substance (ODS) chlorofluorocarbon-113 (CFC-113) was banned, NASA's propulsion test facilities at Marshall Space Flight Center (MSFC) and Stennis Space Center (SSC) have relied upon hydrochlorofluorocarbon-225 (HCFC-225) to safely clean and verify the cleanliness of large scale propulsion oxygen systems. Effective January 1, 2015, the production, import, export, and new use of HCFC-225, a Class II ODS, was prohibited by the Clean Air Act. In 2012 through 2014, leveraging resources from both NASA and the Defense Logistics Agency - Aviation Hazardous Minimization and Green Products Branch, test labs at MSFC, SSC, and Johnson Space Center's White Sands Test Facility (WSTF) collaborated to seek out, test, and qualify a replacement for HCFC-225 that is both an effective cleaner and safe for use with oxygen systems. This presentation summarizes the tests performed, results, and lessons learned. It also demonstrates the benefits of cross-agency collaboration in a time of limited resources.

Influence of prey dispersion on territory and group size of African lions: a test of the resource dispersion hypothesis.

PubMed

Valeix, Marion; Loveridge, Andrew J; MacDonald, David W

2012-11-01

Empirical tests of the resource dispersion hypothesis (RDH), a theory to explain group living based on resource heterogeneity, have been complicated by the fact that resource patch dispersion and richness have proved difficult to define and measure in natural systems. Here, we studied the ecology of African lions Panthera leo in Hwange National Park, Zimbabwe, where waterholes are prey hotspots, and where dispersion of water sources and abundance of prey at these water sources are quantifiable. We combined a 10-year data set from GPS-collared lions for which information of group composition was available concurrently with data for herbivore abundance at waterholes. The distance between two neighboring waterholes was a strong determinant of lion home range size, which provides strong support for the RDH prediction that territory size increases as resource patches are more dispersed in the landscape. The mean number of herbivore herds using a waterhole, a good proxy of patch richness, determined the maximum lion group biomass an area can support. This finding suggests that patch richness sets a maximum ceiling on lion group size. This study demonstrates that landscape ecology is a major driver of ranging behavior and suggests that aspects of resource dispersion limit group sizes.

Prey resources before spawning influence gonadal investment of female, but not male, white crappie

USGS Publications Warehouse

Bunnell, D.B.; Thomas, S.E.; Stein, R.A.

2007-01-01

In this study, an outdoor pool experiment was used to evaluate the effect of prey resources during 4 months before spawning on the gonadal investments of male and female white crappie Pomoxis annularis, a popular freshwater sportfish that exhibits erratic recruitment. Fish were assigned one of three feeding treatments: starved, fed once every 5 days (intermediate) or fed daily (high). All measurements of male testes (i.e. wet mass, energy density and spermatocrit) were similar across treatments. Conversely, high-fed females produced larger ovaries than those of intermediate-fed and starved fish, and invested more energy in their ovaries than starved fish. Compared to pre-experiment fish, starved and intermediate-fed females appeared to increase their ovary size by relying on liver energy stores (‘capital’ spawning). Conversely, high-fed females increased liver and gonad mass, implying an ‘income’-spawning strategy (where gonads are built from recently acquired energy). Fecundity did not differ among treatments, but high-fed fish built larger eggs than those starved. Females rarely ‘skipped’ spawning opportunities when prey resources were low, as only 8% of starved females and 8% of intermediate-fed females lacked vitellogenic eggs. These results suggest that limited prey resources during the months before spawning can limit ovary production, which, in turn, can limit reproductive success of white crappies.

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

Saikkonen, K.; Koivunen, S.; Vuorisalo, T.

The authors studied resource allocation between sexual reproduction and clonal propagation in a perennial stoloniferous clonal plant, Potentilla anserina, an obligate outcrosser. They manipulated reproductive effort of Potentilla anserina either by hand-pollinating all flowers or by preventing pollination. To test the effect of resource-limiting conditions on resource allocation and reproductive output, the authors used a control and two levels of heavy metals (copper and nickel) to limit plant growth. The experiment was conducted as a 2 {times} 3 factorial design to reveal possible interactions between reproductive manipulation and resource limitation. Heavy metals decreased the total biomass of the plants andmore » number of flowers and ramets produced. Only 50% of the plants grown with the higher level of heavy metals produced flowers. Pollination treatment interacted significantly with the heavy-metal treatment. In the metal control and lower heavy-metal treatment, there were no significant differences in total vegetative biomass between the two pollination treatments. Costs of reproduction in terms of subsequent flowering in the later season appeared to be clear, because the number of flowers per whole plant was lower if the plants were hand-pollinated and because the proportion of flowering ramets decreased due to hand-pollination. However, flowering may also be partly hormonally controlled. In contrast, hand-pollinated plants exposed to high concentrations of heavy metals tended to have greater biomass of vegetative plant structures and higher number of flowers compared to nonpollinated plants.« less

Atypical resource allocation may contribute to many aspects of autism

PubMed Central

Goldknopf, Emily J.

2013-01-01

Based on a review of the literature and on reports by people with autism, this paper suggests that atypical resource allocation is a factor that contributes to many aspects of autism spectrum conditions, including difficulties with language and social cognition, atypical sensory and attentional experiences, executive and motor challenges, and perceptual and conceptual strengths and weaknesses. Drawing upon resource theoretical approaches that suggest that perception, cognition, and action draw upon multiple pools of resources, the approach hypothesizes that compared with resources in typical cognition, resources in autism are narrowed or reduced, especially in people with strong sensory symptoms. In narrowed attention, resources are restricted to smaller areas and to fewer modalities, stages of processing, and cognitive processes than in typical cognition; narrowed resources may be more intense than in typical cognition. In reduced attentional capacity, overall resources are reduced; resources may be restricted to fewer modalities, stages of processing, and cognitive processes than in typical cognition, or the amount of resources allocated to each area or process may be reduced. Possible neural bases of the hypothesized atypical resource allocation, relations to other approaches, limitations, and tests of the hypotheses are discussed. PMID:24421760

Diagnostic accuracy of two multiplex real-time polymerase chain reaction assays for the diagnosis of meningitis in children in a resource-limited setting.

PubMed

Khumalo, Jermaine; Nicol, Mark; Hardie, Diana; Muloiwa, Rudzani; Mteshana, Phindile; Bamford, Colleen

2017-01-01

Accurate etiological diagnosis of meningitis is important, but difficult in resource-limited settings due to prior administration of antibiotics and lack of viral diagnostics. We aimed to develop and validate 2 real-time multiplex PCR (RT-PCR) assays for the detection of common causes of community-acquired bacterial and viral meningitis in South African children. We developed 2 multiplex RT- PCRs for detection of S. pneumoniae, N. meningitidis, H. influenzae, enteroviruses, mumps virus and herpes simplex virus. We tested residual CSF samples from children presenting to a local paediatric hospital over a one-year period, whose CSF showed an abnormal cell count. Results were compared with routine diagnostic tests and the final discharge diagnosis. We calculated accuracy of the bacterial RT-PCR assay compared to CSF culture and using World Health Organisation definitions of laboratory-confirmed bacterial meningitis. From 292 samples, bacterial DNA was detected in 12 (4.1%) and viral nucleic acids in 94 (32%). Compared to CSF culture, the sensitivity and specificity of the bacterial RT-PCR was 100% and 97.2% with complete agreement in organism identification. None of the cases positive by viral RT-PCR had a bacterial cause confirmed on CSF culture. Only 9/90 (10%) of patients diagnosed clinically as bacterial meningitis or partially treated bacterial meningitis tested positive with the bacterial RT-PCR. In this population the use of 2 multiplex RT-PCRs targeting 6 common pathogens gave promising results. If introduced into routine diagnostic testing, these multiplex RT-PCR assays would supplement other diagnostic tests, and have the potential to limit unnecessary antibiotic therapy and hospitalisation.

Diagnostic accuracy of two multiplex real-time polymerase chain reaction assays for the diagnosis of meningitis in children in a resource-limited setting

PubMed Central

Khumalo, Jermaine; Nicol, Mark; Hardie, Diana; Muloiwa, Rudzani; Mteshana, Phindile

2017-01-01

Introduction Accurate etiological diagnosis of meningitis is important, but difficult in resource-limited settings due to prior administration of antibiotics and lack of viral diagnostics. We aimed to develop and validate 2 real-time multiplex PCR (RT-PCR) assays for the detection of common causes of community-acquired bacterial and viral meningitis in South African children. Methods We developed 2 multiplex RT- PCRs for detection of S. pneumoniae, N. meningitidis, H. influenzae, enteroviruses, mumps virus and herpes simplex virus. We tested residual CSF samples from children presenting to a local paediatric hospital over a one-year period, whose CSF showed an abnormal cell count. Results were compared with routine diagnostic tests and the final discharge diagnosis. We calculated accuracy of the bacterial RT-PCR assay compared to CSF culture and using World Health Organisation definitions of laboratory-confirmed bacterial meningitis. Results From 292 samples, bacterial DNA was detected in 12 (4.1%) and viral nucleic acids in 94 (32%). Compared to CSF culture, the sensitivity and specificity of the bacterial RT-PCR was 100% and 97.2% with complete agreement in organism identification. None of the cases positive by viral RT-PCR had a bacterial cause confirmed on CSF culture. Only 9/90 (10%) of patients diagnosed clinically as bacterial meningitis or partially treated bacterial meningitis tested positive with the bacterial RT-PCR. Discussion In this population the use of 2 multiplex RT-PCRs targeting 6 common pathogens gave promising results. If introduced into routine diagnostic testing, these multiplex RT-PCR assays would supplement other diagnostic tests, and have the potential to limit unnecessary antibiotic therapy and hospitalisation. PMID:28346504

Towards the Fundamental Quantum Limit of Linear Measurements of Classical Signals

NASA Astrophysics Data System (ADS)

Miao, Haixing; Adhikari, Rana X.; Ma, Yiqiu; Pang, Belinda; Chen, Yanbei

2017-08-01

The quantum Cramér-Rao bound (QCRB) sets a fundamental limit for the measurement of classical signals with detectors operating in the quantum regime. Using linear-response theory and the Heisenberg uncertainty relation, we derive a general condition for achieving such a fundamental limit. When applied to classical displacement measurements with a test mass, this condition leads to an explicit connection between the QCRB and the standard quantum limit that arises from a tradeoff between the measurement imprecision and quantum backaction; the QCRB can be viewed as an outcome of a quantum nondemolition measurement with the backaction evaded. Additionally, we show that the test mass is more a resource for improving measurement sensitivity than a victim of the quantum backaction, which suggests a new approach to enhancing the sensitivity of a broad class of sensors. We illustrate these points with laser interferometric gravitational-wave detectors.

Mobile device for disease diagnosis and data tracking in resource-limited settings.

PubMed

Chin, Curtis D; Cheung, Yuk Kee; Laksanasopin, Tassaneewan; Modena, Mario M; Chin, Sau Yin; Sridhara, Archana A; Steinmiller, David; Linder, Vincent; Mushingantahe, Jules; Umviligihozo, Gisele; Karita, Etienne; Mwambarangwe, Lambert; Braunstein, Sarah L; van de Wijgert, Janneke; Sahabo, Ruben; Justman, Jessica E; El-Sadr, Wafaa; Sia, Samuel K

2013-04-01

Collection of epidemiological data and care of patients are hampered by lack of access to laboratory diagnostic equipment and patients' health records in resource-limited settings. We engineered a low-cost mobile device that combines cell-phone and satellite communication technologies with fluid miniaturization techniques for performing all essential ELISA functions. We assessed the device's ability to perform HIV serodiagnostic testing in Rwanda and synchronize results in real time with electronic health records. We tested serum, plasma, and whole blood samples collected in Rwanda and on a commercially available sample panel made of mixed antibody titers. HIV testing on 167 Rwandan patients evaluated for HIV, viral hepatitis, and sexually transmitted infections yielded diagnostic sensitivity and specificity of 100% and 99%, respectively. Testing on 40 Rwandan whole-blood samples-using 1 μL of sample per patient-resulted in diagnostic sensitivity and specificity of 100% and 100%. The mobile device also successfully transmitted all whole-blood test results from a Rwandan clinic to a medical records database stored on the cloud. For all samples in the commercial panel, the device produced results in agreement with a leading ELISA test, including detection of weakly positive samples that were missed by existing rapid tests. The device operated autonomously with minimal user input, produced each result 10 times faster than benchtop ELISA, and consumed as little power as a mobile phone. A low-cost mobile device can perform a blood-based HIV serodiagnostic test with laboratory-level accuracy and real-time synchronization of patient health record data. © 2012 American Association for Clinical Chemistry

Improving Molecular Genetic Test Utilization through Order Restriction, Test Review, and Guidance.

PubMed

Riley, Jacquelyn D; Procop, Gary W; Kottke-Marchant, Kandice; Wyllie, Robert; Lacbawan, Felicitas L

2015-05-01

The ordering of molecular genetic tests by health providers not well trained in genetics may have a variety of untoward effects. These include the selection of inappropriate tests, the ordering of panels when the assessment of individual or fewer genes would be more appropriate, inaccurate result interpretation and inappropriate patient guidance, and significant unwarranted cost expenditure. We sought to improve the utilization of molecular genetic tests by requiring providers without specialty training in genetics to use genetic counselors and molecular genetic pathologists to assist in test selection. We used a genetic and genomic test review process wherein the laboratory-based genetic counselor performed the preanalytic assessment of test orders and test triage. Test indication and clinical findings were evaluated against the test panel composition, methods, and test limitations under the supervision of the molecular genetic pathologist. These test utilization management efforts resulted in a decrease in genetic test ordering and a gross cost savings of $1,531,913 since the inception of these programs in September 2011 through December 2013. The combination of limiting the availability of complex genetic tests and providing guidance regarding appropriate test strategies is an effective way to improve genetic tests, contributing to judicious use of limited health care resources. Copyright © 2015 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.

A quality management systems approach for CD4 testing in resource-poor settings.

PubMed

Westerman, Larry E; Kohatsu, Luciana; Ortiz, Astrid; McClain, Bernice; Kaplan, Jonathan; Spira, Thomas; Marston, Barbara; Jani, Ilesh V; Nkengasong, John; Parsons, Linda M

2010-10-01

Quality assurance (QA) is a systematic process to monitor and improve clinical laboratory practices. The fundamental components of a laboratory QA program include providing a functional and safe laboratory environment, trained and competent personnel, maintained equipment, adequate supplies and reagents, testing of appropriate specimens, internal monitoring of quality, accurate reporting, and external quality assessments. These components are necessary to provide accurate and precise CD4 T-cell counts, an essential test to evaluate start of and monitor effectiveness of antiretroviral therapy for HIV-infected patients. In recent years, CD4 testing has expanded dramatically in resource-limited settings. Information on a CD4 QA program as described in this article will provide guidelines not only for clinical laboratory staff but also for managers of programs responsible for supporting CD4 testing. All agencies involved in implementing CD4 testing must understand the needs of the laboratory and provide advocacy, guidance, and financial support to established CD4 testing sites and programs. This article describes and explains the procedures that must be put in place to provide reliable CD4 determinations in a variety of settings.

Sustainable funding for biocuration: The Arabidopsis Information Resource (TAIR) as a case study of a subscription-based funding model.

PubMed

Reiser, Leonore; Berardini, Tanya Z; Li, Donghui; Muller, Robert; Strait, Emily M; Li, Qian; Mezheritsky, Yarik; Vetushko, Andrey; Huala, Eva

2016-01-01

Databases and data repositories provide essential functions for the research community by integrating, curating, archiving and otherwise packaging data to facilitate discovery and reuse. Despite their importance, funding for maintenance of these resources is increasingly hard to obtain. Fueled by a desire to find long term, sustainable solutions to database funding, staff from the Arabidopsis Information Resource (TAIR), founded the nonprofit organization, Phoenix Bioinformatics, using TAIR as a test case for user-based funding. Subscription-based funding has been proposed as an alternative to grant funding but its application has been very limited within the nonprofit sector. Our testing of this model indicates that it is a viable option, at least for some databases, and that it is possible to strike a balance that maximizes access while still incentivizing subscriptions. One year after transitioning to subscription support, TAIR is self-sustaining and Phoenix is poised to expand and support additional resources that wish to incorporate user-based funding strategies. Database URL: www.arabidopsis.org. © The Author(s) 2016. Published by Oxford University Press.

Sustainable funding for biocuration: The Arabidopsis Information Resource (TAIR) as a case study of a subscription-based funding model

PubMed Central

Berardini, Tanya Z.; Li, Donghui; Muller, Robert; Strait, Emily M.; Li, Qian; Mezheritsky, Yarik; Vetushko, Andrey; Huala, Eva

2016-01-01

Databases and data repositories provide essential functions for the research community by integrating, curating, archiving and otherwise packaging data to facilitate discovery and reuse. Despite their importance, funding for maintenance of these resources is increasingly hard to obtain. Fueled by a desire to find long term, sustainable solutions to database funding, staff from the Arabidopsis Information Resource (TAIR), founded the nonprofit organization, Phoenix Bioinformatics, using TAIR as a test case for user-based funding. Subscription-based funding has been proposed as an alternative to grant funding but its application has been very limited within the nonprofit sector. Our testing of this model indicates that it is a viable option, at least for some databases, and that it is possible to strike a balance that maximizes access while still incentivizing subscriptions. One year after transitioning to subscription support, TAIR is self-sustaining and Phoenix is poised to expand and support additional resources that wish to incorporate user-based funding strategies. Database URL: www.arabidopsis.org PMID:26989150

The Use of EEG as a Workload Assessment Tool in Flight Test

DTIC Science & Technology

1993-10-01

resource, single pool, mental model (Wickens) 9 which postulates that the human has a limited source of mental potential and when tasked with multiple...psychological spectrum presents an interesting challenge for future research. 10 EP Amplitude Microvolts) I-J ---- Single Task ......... Difficult...example, they obtained a p value of .000025 for a single test and then applied a Bonferroni correction to yield a conservatively corrected value of p

Solution techniques for transient stability-constrained optimal power flow – Part II

DOE PAGES

Geng, Guangchao; Abhyankar, Shrirang; Wang, Xiaoyu; ...

2017-06-28

Transient stability-constrained optimal power flow is an important emerging problem with power systems pushed to the limits for economic benefits, dense and larger interconnected systems, and reduced inertia due to expected proliferation of renewable energy resources. In this study, two more approaches: single machine equivalent and computational intelligence are presented. Also discussed are various application areas, and future directions in this research area. In conclusion, a comprehensive resource for the available literature, publicly available test systems, and relevant numerical libraries is also provided.

NASA Standard Measures Overview

NASA Technical Reports Server (NTRS)

Meck, Janice V.

2008-01-01

Due to the limited in-flight resources available for human physiological research in the foreseeable future, NASA has increased its reliance on head-down bed rest. NASA has created the Bed Rest Project at the Johnson Space Center, which is implemented on the 6th floor of the Children's Hospital at UTMB. It has been conducted for three years. The overall objective of the Project is to use bed rest to develop and evaluate countermeasures for the ill effects of space flight before flight resources are requested for refinement and final testing.

Solution techniques for transient stability-constrained optimal power flow – Part II

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

Geng, Guangchao; Abhyankar, Shrirang; Wang, Xiaoyu

Transient stability-constrained optimal power flow is an important emerging problem with power systems pushed to the limits for economic benefits, dense and larger interconnected systems, and reduced inertia due to expected proliferation of renewable energy resources. In this study, two more approaches: single machine equivalent and computational intelligence are presented. Also discussed are various application areas, and future directions in this research area. In conclusion, a comprehensive resource for the available literature, publicly available test systems, and relevant numerical libraries is also provided.

Differences in Medical and Life-style Risk Factors for Malnutrition in Limited-Resource Older Adults in a Rural U.S. State: A Descriptive Study.

PubMed

Getty, M D; Mueller, M; Amella, E J; Fraser, A M

2016-02-01

Medical and life-style factors are associated with malnutrition in older adults. This study assessed the presence of these risk factors in limited-resource, community-dwelling older adults to inform the development of a nutrition education interventions. Quantitative descriptive study. A total of 24 randomly selected congregate nutrition sites (where limited-resource older adults can receive one hot meal/day, five days/week) in the rural state of South Carolina, USA. Data were collected from 477 older adults (of the 407 who reported race, 219 were African American and 171 were White). Extension Educators who work for the Cooperative Extension Service (a formalized educational outreach system associated with some U.S. universities) read aloud a 27-item instrument designed to assess risk factors for malnutrition. Response frequencies were tabulated and chi-square tests were performed using SAS 9.3. More African Americans reported having a chronic illness or condition (81.2 vs. 68.3%; p=0.003), eating alone (66.2 vs. 53.6%; p=0.012), having a refrigerator that sometimes did not keep food cold (31.8 vs. 8.4%; p<0.0001), and sometimes not having enough money to buy food (38.9 vs. 18.5%; p<0.0001) compared to White older adults. Rural older adults who attend congregate nutrition sites, especially African Americans, could be at risk for malnutrition due to health status and food preparation-related factors. Evidence-based, tailored programs are needed to minimize malnutrition among limited-resource older adults living in rural areas in the U.S.

C-reactive protein point-of-care testing and antibiotic prescribing for acute respiratory tract infections in rural primary health centres of North Ethiopia: a cross-sectional study.

PubMed

Yebyo, Henock; Medhanyie, Araya Abrha; Spigt, Mark; Hopstaken, Rogier

2016-01-14

Unjustified antibiotic prescribing for acute upper respiratory infections (URTIs) is probably more common in poor-resource settings where physicians are scarce. Introducing C-reactive protein (CRP) point-of-care testing in such settings could reduce the misuse of antibiotics, which could avert antibiotic resistance. However, information useful for the applicability of CRP test in resource-limited settings is lacking. This study aimed to elicit the frequency of antibiotic prescribing and distribution of CRP levels in remote, rural settings in Ethiopia. We included 414 patients with acute URTIs from four health centres. Health professionals recorded the clinical features of the patients, but the laboratory professionals measured the CRP levels of all patients at the point of care. The most prominent respiratory causes for consultation were acute URTIs combined (44.4%), and lower respiratory tract infections-pneumonia (29.71%) and acute bronchitis (25.84%). The CRP distribution was <20 mg/l, 20-99 mg/l and 100 mg/l or more in 66.6%, 27.9% and 5.5% of the patients, respectively. The CRP levels were significantly different among these clinical diagnoses (X(2)=114.3, P<0.001, d.f.=4). A wide range of antibiotics was administered for 87.8% of the patients, regardless of the diagnostic or prognostic nature of their diseases. Antibiotic prescribing for acute URTIs in the rural areas of Ethiopia is unduly high, with high proportions of mild, self-limiting illness, mostly URTIs. Implementation of CRP point-of-care testing in such resource-constrained settings, with low- or middle-grade healthcare professionals, could help reconcile the inappropriate use of antibiotics by withholding from patients who do not benefit from antibiotic treatment.

C-reactive protein point-of-care testing and antibiotic prescribing for acute respiratory tract infections in rural primary health centres of North Ethiopia: a cross-sectional study

PubMed Central

Yebyo, Henock; Medhanyie, Araya Abrha; Spigt, Mark; Hopstaken, Rogier

2016-01-01

Unjustified antibiotic prescribing for acute upper respiratory infections (URTIs) is probably more common in poor-resource settings where physicians are scarce. Introducing C-reactive protein (CRP) point-of-care testing in such settings could reduce the misuse of antibiotics, which could avert antibiotic resistance. However, information useful for the applicability of CRP test in resource-limited settings is lacking. This study aimed to elicit the frequency of antibiotic prescribing and distribution of CRP levels in remote, rural settings in Ethiopia. We included 414 patients with acute URTIs from four health centres. Health professionals recorded the clinical features of the patients, but the laboratory professionals measured the CRP levels of all patients at the point of care. The most prominent respiratory causes for consultation were acute URTIs combined (44.4%), and lower respiratory tract infections—pneumonia (29.71%) and acute bronchitis (25.84%). The CRP distribution was <20 mg/l, 20–99 mg/l and 100 mg/l or more in 66.6%, 27.9% and 5.5% of the patients, respectively. The CRP levels were significantly different among these clinical diagnoses (X2=114.3, P<0.001, d.f.=4). A wide range of antibiotics was administered for 87.8% of the patients, regardless of the diagnostic or prognostic nature of their diseases. Antibiotic prescribing for acute URTIs in the rural areas of Ethiopia is unduly high, with high proportions of mild, self-limiting illness, mostly URTIs. Implementation of CRP point-of-care testing in such resource-constrained settings, with low- or middle-grade healthcare professionals, could help reconcile the inappropriate use of antibiotics by withholding from patients who do not benefit from antibiotic treatment. PMID:26769226

Point-of-Care Testing for Anaemia in Children Using Portable Haematocrit Meter: A Pilot Study from Southwest Nigeria and Implications for Developing Countries.

PubMed

Olatunya, Oladele; Ogundare, Olatunde; Olaleye, Abiola; Agaja, Oyinkansola; Omoniyi, Evelyn; Adeyefa, Babajide; Oluwadiya, Kehinde; Oyelami, Oyeku

2016-05-01

Prompt and accurate diagnosis is needed to prevent the untoward effects of anaemia on children. Although haematology analyzers are the gold standard for accurate measurement of haemoglobin or haematocrit for anaemia diagnosis, they are often out of the reach of most health facilities in resource-poor settings thus creating a care gap. We conducted this study to examine the agreement between a point-of-care device and haematology analyzer in determining the haematocrit levels in children and to determine its usefulness in diagnosing anaemia in resource-poor settings. EDTA blood samples collected from participants were processed to estimate their haematocrits using the two devices (Mindray BC-3600 haematology analyzer and Portable Mission Hb/Haemotocrit testing system). A pairwise t-test was used to compare the haematocrit (PCV) results from the automated haematology analyzer and the portable haematocrit meter. The agreement between the two sets of measurements was assessed using the Bland and Altman method where the mean, standard deviation and limit of agreement of paired results were calculated. The intraclass and concordance correlation coefficients were 0.966 and 0.936. Sensitivity and specificity were 97.85% and 94.51% respectively while the positive predictive and negative predictive values were 94.79% and 97.73%. The Bland and Altman`s limit of agreement was -5.5-5.1 with the mean difference being -0.20 and a non-ignificant variability between the two measurements (p = 0.506). Haematocrit determined by the portable testing system is comparable to that determined by the haematology analyzer. We therefore recommend its use as a point-of-care device for determining haematocrit in resource-poor settings where haematology analyzers are not available.

Prioritizing CD4 Count Monitoring in Response to ART in Resource-Constrained Settings: A Retrospective Application of Prediction-Based Classification

PubMed Central

Liu, Yan; Li, Xiaohong; Johnson, Margaret; Smith, Collette; Kamarulzaman, Adeeba bte; Montaner, Julio; Mounzer, Karam; Saag, Michael; Cahn, Pedro; Cesar, Carina; Krolewiecki, Alejandro; Sanne, Ian; Montaner, Luis J.

2012-01-01

Background Global programs of anti-HIV treatment depend on sustained laboratory capacity to assess treatment initiation thresholds and treatment response over time. Currently, there is no valid alternative to CD4 count testing for monitoring immunologic responses to treatment, but laboratory cost and capacity limit access to CD4 testing in resource-constrained settings. Thus, methods to prioritize patients for CD4 count testing could improve treatment monitoring by optimizing resource allocation. Methods and Findings Using a prospective cohort of HIV-infected patients (n = 1,956) monitored upon antiretroviral therapy initiation in seven clinical sites with distinct geographical and socio-economic settings, we retrospectively apply a novel prediction-based classification (PBC) modeling method. The model uses repeatedly measured biomarkers (white blood cell count and lymphocyte percent) to predict CD4+ T cell outcome through first-stage modeling and subsequent classification based on clinically relevant thresholds (CD4+ T cell count of 200 or 350 cells/µl). The algorithm correctly classified 90% (cross-validation estimate = 91.5%, standard deviation [SD] = 4.5%) of CD4 count measurements <200 cells/µl in the first year of follow-up; if laboratory testing is applied only to patients predicted to be below the 200-cells/µl threshold, we estimate a potential savings of 54.3% (SD = 4.2%) in CD4 testing capacity. A capacity savings of 34% (SD = 3.9%) is predicted using a CD4 threshold of 350 cells/µl. Similar results were obtained over the 3 y of follow-up available (n = 619). Limitations include a need for future economic healthcare outcome analysis, a need for assessment of extensibility beyond the 3-y observation time, and the need to assign a false positive threshold. Conclusions Our results support the use of PBC modeling as a triage point at the laboratory, lessening the need for laboratory-based CD4+ T cell count testing; implementation of this tool could help optimize the use of laboratory resources, directing CD4 testing towards higher-risk patients. However, further prospective studies and economic analyses are needed to demonstrate that the PBC model can be effectively applied in clinical settings. Please see later in the article for the Editors' Summary PMID:22529752

Global Health: Pediatric Neurology.

PubMed

Bearden, David R; Ciccone, Ornella; Patel, Archana A

2018-04-01

Neurologic disorders contribute significantly to both morbidity and mortality among children in resource-limited settings, but there are a few succinct studies summarizing the epidemiology of neurologic disorders in these settings. A review of available literature was performed to identify data on the prevalence, etiology, outcomes, and treatment of neurologic disorders in children in resource-limited settings. The burden of neurologic disorders in children is high in resource-limited settings. Barriers to optimal care include lack of trained personnel, limited access to diagnostic technology, and limited availability of drugs used to treat common conditions. Several solutions have been suggested to deal with these challenges including increased collaborations to train neurologists willing to practice in resource-limited settings and increased training of physician extenders or community health workers. Further studies are necessary to improve our understanding of the epidemiology of neurologic disorders in resource-limited settings. Future epidemiologic studies should incorporate multiple countries in resource-limited settings and utilize standardized definitions and methodologies to enable comparison across regions. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Buffering Effect of Workplace Resources on the Relationship between the Areas of Worklife and Burnout

PubMed Central

Jimenez, Paul; Dunkl, Anita

2017-01-01

Background: Workplace resources are found to play a major role in the stress–strain relationship. However, usually different types of resources are investigated, whereas investigating different facets of stress (“stressors”) receive less attention in research about the relationship between stress, strain and resources. Based upon recent research, we expected that workplace resources moderate the relationship between stressors (operationalized with the areas of worklife) and long-term strain (operationalized with three dimensions of burnout) in the sense that workplace resources buffer the negative effects of stressors on strain. Method: Hypotheses were tested in a longitudinal sample of 141 Austrian workers, who participated two times in an online study over a period of 6 months. Hierarchical multiple regression analysis was used to test the proposed relationships. Results: The results imply that workload and reward seem to be the most important predictors for burnout. Workload is important for emotional exhaustion, whereas reward is important for cynicism. Value-fit at the workplace plays a significant role for cynicism, but only if resources at the workplace are high. Further moderating effects of resources were found for the outcome personal accomplishment. More specifically, results indicate that having high resources in a high workload environment increases personal accomplishment after a time interval of 6 months. In addition, employees experiencing high levels of control but low workplace resources show less personal accomplishment. Conclusion: Despite the limiting aspects of the relatively short period of time we can see that resources can buffer workload effects. This should be taken into consideration when doing risk assessments in practice as work design should focus on resources even more when high workload can be found. PMID:28144227

A low-cost touchscreen operant chamber using a Raspberry Pi™.

PubMed

O'Leary, James D; O'Leary, Olivia F; Cryan, John F; Nolan, Yvonne M

2018-03-08

The development of a touchscreen platform for rodent testing has allowed new methods for cognitive testing that have been back-translated from clinical assessment tools to preclinical animal models. This platform for cognitive assessment in animals is comparable to human neuropsychological tests such as those employed by the Cambridge Neuropsychological Test Automated Battery, and thus has several advantages compared to the standard maze apparatuses typically employed in rodent behavioral testing, such as the Morris water maze. These include improved translation of preclinical models, as well as high throughput and the automation of animal testing. However, these systems are relatively expensive, which can impede progress for researchers with limited resources. Here we describe a low-cost touchscreen operant chamber based on the single-board computer, Raspberry Pi TM , which is capable of performing tasks similar to those supported by current state-of-the-art systems. This system provides an affordable alternative for cognitive testing in a touchscreen operant paradigm for researchers with limited funding.

Optimizing Infant HIV Diagnosis in Resource-Limited Settings: Modeling the Impact of HIV DNA PCR Testing at Birth.

PubMed

Chiu, Alexander; Modi, Surbhi; Rivadeneira, Emilia D; Koumans, Emilia H

2016-12-01

Early antiretroviral therapy (ART) initiation in HIV-infected infants significantly improves survival but is often delayed in resource-limited settings. Adding HIV testing of infants at birth to the current recommendation of testing at age 4-6 weeks may improve testing rates and decrease time to ART initiation. We modeled the benefit of adding HIV testing at birth to the current 6-week testing algorithm. Microsoft Excel was used to create a decision-tree model of the care continuum for the estimated 1,400,000 HIV-infected women and their infants in sub-Saharan Africa in 2012. The model assumed average published rates for facility births (42.9%), prevention of mother-to-child HIV transmission utilization (63%), mother-to-child-transmission rates based on prevention of mother-to-child HIV transmission regimen (5%-40%), return of test results (41%), enrollment in HIV care (52%), and ART initiation (54%). We conducted sensitivity analyses to model the impact of key variables and applied the model to specific country examples. Adding HIV testing at birth would increase the number of infants on ART by 204% by age 18 months. The greatest increase is seen in early ART initiations (543% by age 3 months). The increase would lead to a corresponding increase in survival at 12 months of age, with 5108 fewer infant deaths (44,550, versus 49,658). Adding HIV testing at birth has the potential to improve the number and timing of ART initiation of HIV-infected infants, leading to a decrease in infant mortality. Using this model, countries should investigate a combination of HIV testing at birth and during the early infant period.

Challenges with implementing malaria rapid diagnostic tests at primary care facilities in a Ghanaian district: a qualitative study.

PubMed

Boadu, Nana Yaa; Amuasi, John; Ansong, Daniel; Einsiedel, Edna; Menon, Devidas; Yanow, Stephanie K

2016-02-27

Rapid diagnostic Tests (RDTs) for malaria enable diagnostic testing at primary care facilities in resource-limited settings, where weak infrastructure limits the use of microscopy. In 2010, Ghana adopted a test-before-treat guideline for malaria, with RDT use promoted to facilitate diagnosis. Yet healthcare practitioners still treat febrile patients without testing, or despite negative malaria test results. Few studies have explored RDT implementation beyond the notions of provider or patient acceptability. The aim of this study was to identify the factors directly influencing malaria RDT implementation at primary care facilities in a Ghanaian district. Qualitative interviews, focus groups and direct observations were conducted with 50 providers at six purposively selected primary care facilities in the Atwima-Nwabiagya district. Data were analysed thematically. RDT implementation was hampered by: (1) healthcare delivery constraints (weak supply chain, limited quality assurance and control, inadequate guideline emphasis, staffing limitations); (2) provider perceptions (entrenched case-management paradigms, limited preparedness for change); (3) social dynamics of care delivery (expected norms of provider-patient interaction, test affordability); and (4) limited provider engagement in policy processes leading to fragmented implementation of health sector reform. Limited health system capacity, socio-economic, political, and historical factors hampered malaria RDT implementation at primary care facilities in the study district. For effective RDT implementation providers must be: (1) adequately enabled through efficient allocation and management of essential healthcare commodities; (2) appropriately empowered with the requisite knowledge and skill through ongoing, effective professional development; and (3) actively engaged in policy dialogue to demystify socio-political misconceptions that hinder health sector reform policies from improving care delivery. Clear, consistent guideline emphasis, with complementary action to address deep-rooted provider concerns will build their confidence in, and promote uptake of recommended policies, practices, and technology for diagnosing malaria.

Detection of Entamoeba histolytica by Recombinase Polymerase Amplification

PubMed Central

Nair, Gayatri; Rebolledo, Mauricio; White, A. Clinton; Crannell, Zachary; Richards-Kortum, R. Rebecca; Pinilla, A. Elizabeth; Ramírez, Juan David; López, M. Consuelo; Castellanos-Gonzalez, Alejandro

2015-01-01

Amebiasis is an important cause of diarrheal disease worldwide and has been associated with childhood malnutrition. Traditional microscopy approaches are neither sensitive nor specific for Entamoeba histolytica. Antigen assays are more specific, but many cases are missed unless tested by molecular methods. Although polymerase chain reaction (PCR) is effective, the need for sophisticated, expensive equipment, infrastructure, and trained personnel limits its usefulness, especially in the resource-limited, endemic areas. Here, we report development of a recombinase polymerase amplification (RPA) method to detect E. histolytica specifically. Using visual detection by lateral flow (LF), the test was highly sensitive and specific and could be performed without additional equipment. The availability of this inexpensive, sensitive, and field-applicable diagnostic test could facilitate rapid diagnosis and treatment of amebiasis in endemic regions. PMID:26123960

Natural resource collection and desired family size: a longitudinal test of environment-population theories.

PubMed

Brauner-Otto, Sarah R; Axinn, William G

2017-06-01

Theories relating the changing environment to human fertility predict declining natural resources may actually increase the demand for children. Unfortunately most previous empirical studies have been limited to cross-sectional designs that limit our ability to understand links between processes that change over time. We take advantage of longitudinal measurement spanning more than a decade of change in the natural environment, household agricultural behaviors, and individual fertility preferences to reexamine this question. Using fixed-effects models, we find that women experiencing increasing time required to collect firewood to heat and cook or fodder to feed animals (the dominant needs for natural resources in this setting) increased their desired family size, even as many other macro-level changes have reduced desired family size. In contrast to previous, cross-sectional studies we find no evidence of such a relationship for men. Our findings regarding time spent collecting firewood are also new. These results support the "vicious circle" perspective and economic theories of fertility pointing to the value of children for household labor. This feedback from natural resource constraint to increased fertility is an important mechanism for understanding long term environmental change.

State-of-the-Art Resources (SOAR) for Software Vulnerability Detection, Test, and Evaluation

DTIC Science & Technology

2014-07-01

preclude in-depth analysis, and widespread use of a Software -as-a- Service ( SaaS ) model that limits data availability and application to DoD systems...provide mobile application analysis using a Software - as-a- Service ( SaaS ) model. In this case, any software to be analyzed must be sent to the...tools are only available through a SaaS model. The widespread use of a Software -as-a- Service ( SaaS ) model as a sole evaluation model limits data

Update on diagnostics for Phytophthora ramorum

Treesearch

Philip Berger

2006-01-01

Diagnostics used by the U.S. Department of Agriculture (USDA), to determine absence or presence of Phytophthora ramorum in plant samples, are based on a combination of tests and depend on collaboration with external laboratories. The system currently in place attempts to maximize limited resources and at the same time provide the most scientifically...

Curriculum: Big Decisions--Making Healthy, Informed Choices about Sex

ERIC Educational Resources Information Center

Davis, Melanie

2009-01-01

Big Decisions is a 10-lesson abstinence-plus curriculum for ages 12-18 that emphasizes sex as a big decision, abstinence as the healthiest choice, and the mandate that sexually active teens use condoms and be tested for sexually transmitted diseases. This program can be implemented with limited resources and facilitator training when abstinence…

Competition as a mechanism structuring mutualisms

Treesearch

Robert J. Warren; Itamar Giladi; Mark A. Bradford

2014-01-01

Summary 1. Hutchinsonian niche theory posits that organisms have fundamental abiotic resource requirements from which they are limited by competition. Organisms also have fundamental biotic requirements, such as mutualists, for which they also might compete. 2. We test this idea with a widespread ant–plant mutualism. Ant-mediated seed dispersal (myrmecochory) in...

Integration and Test of Shuttle Small Payloads

NASA Technical Reports Server (NTRS)

Wright, Michael R.

2003-01-01

Recommended approaches for space shuttle small payload integration and test (I&T) are presented. The paper is intended for consideration by developers of shuttle small payloads, including I&T managers, project managers, and system engineers. Examples and lessons learned are presented based on the extensive history of NASA's Hitchhiker project. All aspects of I&T are presented, including: (1) I&T team responsibilities, coordination, and communication; (2) Flight hardware handling practices; (3) Documentation and configuration management; (4) I&T considerations for payload development; (5) I&T at the development facility; (6) Prelaunch operations, transfer, orbiter integration and interface testing; (7) Postflight operations. This paper is of special interest to those payload projects that have small budgets and few resources: that is, the truly faster, cheaper, better projects. All shuttle small payload developers are strongly encouraged to apply these guidelines during I&T planning and ground operations to take full advantage of today's limited resources and to help ensure mission success.

Psychometric properties of the newly translated creole multidimensional scale of perceived social support (MSPSS) and perceived adequacy of resource scale (PARS) and the relationship between perceived social support and resources in Haitian mothers in the US.

PubMed

Hannan, Jean; Alce, Marise; Astros, Adrian

2016-02-09

Low income postpartum mothers with little to no social support have increased maternal and infant morbidity and mortality, especially those with limited English proficiency and limited accesses to resources. Haitians, a growing minority in the US are an understudied population excluded from most studies due to the lack of instruments in Creole. The most widely used instruments for measuring social support, the Multidimensional Scale of Perceived Social Support (MSPSS) and Perceived Adequacy of Resource Scale (PARS), are not available in Creole. Currently, there are no published studies on the psychometric properties of the MSPSS or the PARS in Creole. Data from Haitian mothers are needed to identify potential postpartum mothers and infants most at risk of developing adverse maternal and infant outcomes from a lack of social support and perceived resources. The purpose of this study is to test the psychometrics of the newly-translated Creole instruments of the MSPSS and PARS with a sample of bilingual (Creole/English) mothers. The MSPSS and PARS were translated and back translated from English to Creole. The adapted Creole versions of the instruments were tested using a convenience sample. A total of 85 Haitian mothers' completed both instruments in Creole and English 2 weeks apart. Internal consistency reliability and stability were strong for both the MSPSS and PARS (.91-.99). The two instruments had strong reliability and validity for the translated Creole versions and similar to the English versions. The MSPSS and PARS are a valid measure of perceived social support and resources. Psychometric findings suggest that the newly translated Creole versions are good representations of the English versions indicating the translation process was successful. The newly translated instruments available in Creole provide non-English speaking Haitian mothers the opportunity to participate in studies.

ReSTART: A Novel Framework for Resource-Based Triage in Mass-Casualty Events.

PubMed

Mills, Alex F; Argon, Nilay T; Ziya, Serhan; Hiestand, Brian; Winslow, James

2014-01-01

Current guidelines for mass-casualty triage do not explicitly use information about resource availability. Even though this limitation has been widely recognized, how it should be addressed remains largely unexplored. The authors present a novel framework developed using operations research methods to account for resource limitations when determining priorities for transportation of critically injured patients. To illustrate how this framework can be used, they also develop two specific example methods, named ReSTART and Simple-ReSTART, both of which extend the widely adopted triage protocol Simple Triage and Rapid Treatment (START) by using a simple calculation to determine priorities based on the relative scarcity of transportation resources. The framework is supported by three techniques from operations research: mathematical analysis, optimization, and discrete-event simulation. The authors? algorithms were developed using mathematical analysis and optimization and then extensively tested using 9,000 discrete-event simulations on three distributions of patient severity (representing low, random, and high acuity). For each incident, the expected number of survivors was calculated under START, ReSTART, and Simple-ReSTART. A web-based decision support tool was constructed to help providers make prioritization decisions in the aftermath of mass-casualty incidents based on ReSTART. In simulations, ReSTART resulted in significantly lower mortality than START regardless of which severity distribution was used (paired t test, p<.01). Mean decrease in critical mortality, the percentage of immediate and delayed patients who die, was 8.5% for low-acuity distribution (range ?2.2% to 21.1%), 9.3% for random distribution (range ?0.2% to 21.2%), and 9.1% for high-acuity distribution (range ?0.7% to 21.1%). Although the critical mortality improvement due to ReSTART was different for each of the three severity distributions, the variation was less than 1 percentage point, indicating that the ReSTART policy is relatively robust to different severity distributions. Taking resource limitations into account in mass-casualty situations, triage has the potential to increase the expected number of survivors. Further validation is required before field implementation; however, the framework proposed in here can serve as the foundation for future work in this area. 2014.

Predicting FLDs Using a Multiscale Modeling Scheme

NASA Astrophysics Data System (ADS)

Wu, Z.; Loy, C.; Wang, E.; Hegadekatte, V.

2017-09-01

The measurement of a single forming limit diagram (FLD) requires significant resources and is time consuming. We have developed a multiscale modeling scheme to predict FLDs using a combination of limited laboratory testing, crystal plasticity (VPSC) modeling, and dual sequential-stage finite element (ABAQUS/Explicit) modeling with the Marciniak-Kuczynski (M-K) criterion to determine the limit strain. We have established a means to work around existing limitations in ABAQUS/Explicit by using an anisotropic yield locus (e.g., BBC2008) in combination with the M-K criterion. We further apply a VPSC model to reduce the number of laboratory tests required to characterize the anisotropic yield locus. In the present work, we show that the predicted FLD is in excellent agreement with the measured FLD for AA5182 in the O temper. Instead of 13 different tests as for a traditional FLD determination within Novelis, our technique uses just four measurements: tensile properties in three orientations; plane strain tension; biaxial bulge; and the sheet crystallographic texture. The turnaround time is consequently far less than for the traditional laboratory measurement of the FLD.

Discovery of cryptophycin-1 and BCN-183577: examples of strategies and problems in the detection of antitumor activity in mice.

PubMed

Corbett, T H; Valeriote, F A; Demchik, L; Lowichik, N; Polin, L; Panchapor, C; Pugh, S; White, K; Kushner, J; Rake, J; Wentland, M; Golakoti, T; Hetzel, C; Ogino, J; Patterson, G; Moore, R

1997-01-01

Historically, many new anticancer agents were first detected in a prescreen; usually consisting of a molecular/biochemical target or a cellular cytotoxicity assay. The agent then progressed to in vivo evaluation against transplanted human or mouse tumors. If the investigator had a large drug supply and ample resources, multiple tests were possible, with variations in tumor models, tumor and drug routes, dose-decrements, dose-schedules, number of groups, etc. However, in most large programs involving several hundred in vivo tests yearly, resource limitations and drug supply limitations have usually dictated a single trial. Under such restrictive conditions, we have implemented a flexible in vivo testing protocol. With this strategy, the tumor model is dictated by in vitro cellular sensitivity; drug route by water solubility (with water soluble agents injected intravenously); dosage decrement by drug supply, dose-schedule by toxicities encountered, etc. In this flexible design, many treatment parameters can be changed during the course of treatment (e.g., dose and schedule). The discovery of two active agents are presented (Cryptophycin-1, and Thioxanthone BCN 183577). Both were discovered by the intravenous route of administration. Both would have been missed if they were tested intraperitoneally, the usual drug route used in discovery protocols. It is also likely that they would have been missed with an easy to execute fixed protocol design, even if injected i.v.

Rapid tests for diagnosis of leptospirosis: current tools and emerging technologies.

PubMed

Picardeau, Mathieu; Bertherat, Eric; Jancloes, Michel; Skouloudis, Andreas N; Durski, Kara; Hartskeerl, Rudy A

2014-01-01

Leptospirosis is an emerging zoonosis with a worldwide distribution but is more commonly found in impoverished populations in developing countries and tropical regions with frequent flooding. The rapid detection of leptospirosis is a critical step to effectively manage the disease and to control outbreaks in both human and animal populations. Therefore, there is a need for accurate and rapid diagnostic tests and appropriate surveillance and alert systems to identify outbreaks. This review describes current in-house methods and commercialized tests for the rapid diagnosis of acute leptospirosis. It focuses on diagnostic tests that can be performed with minimal training and limited equipment in less-developed and newly industrialized countries, particularly in resource-limited settings and with results in minutes to less than 4 hours. We also describe recent technological advances in the field of diagnostic tests that could allow for the development of innovative rapid tests in the near future. © 2013 Elsevier Inc. All rights reserved.

The effects of density dependent resource limitation on size of wild reindeer.

PubMed

Skogland, Terje

1983-11-01

A density-dependent decrement in size for wild reindeer from 12 different Norwegian herds at 16 different densities was shown using lower jawbone-length as the criterion of size. This criterion was tested and found to adequately predict body size of both bucks and does. Lactation in does did not affect jaw length but significantly affected dressed weights.A decrement in the size of does as a result of gross density was found. This size decrement was further analysed in relation to the habitat densities in winter (R 2 =0.85) and in summer (R 2 =0.75) separately, in order to estimate the relative effects of each factor. For herds with adequate food in winter (no signs of overgrazing of lichens) density in relation to summer habitat and mires yielded the highest predictive power in a multiple regression. For herds with adequate summer pastures, densities per winter habitat and lichen volumes showed likewise a highly significant correlation. The inclusion of the lichen volume data in the regression increased its predictive power. The major effect of resource limitation was to delay the time of calving because a maternal carry-over effect allowed the calf a shorter period of growth to be completed during its first summer. Neonate size at birth was highly correlated with maternal size regardless of the mean calving date although the latter was significantly delayed for small-sized does in food resource-limited herds. Likewise the postnatal growth rate of all calves were not significantly different during 50 days postpartum regardless of maternal conditions in winter feeding. The summer growth rates of bucks ≧1 year did not vary significantly between herds. The age of maturity of food resource-limited does was delayed by one year and growth ceased after the initiation of reproduction. This shows that under conditions of limited resources the does with delayed births of calves allocated less energy to body growth simply because they had less time to replenish body reserves once they were freed of the energetic demands of lactation. The overriding effects of such limitation of food resources is thus to produce a time-lag for the completition of all the important life-history events, such as growth, maintenance and reproduction. From a theoretical point of view, i.e. according to the reproductive effort model their only option is to try to overcome this time limitation to reproductive success.

A high order approach to flight software development and testing

NASA Technical Reports Server (NTRS)

Steinbacher, J.

1981-01-01

The use of a software development facility is discussed as a means of producing a reliable and maintainable ECS software system, and as a means of providing efficient use of the ECS hardware test facility. Principles applied to software design are given, including modularity, abstraction, hiding, and uniformity. The general objectives of each phase of the software life cycle are also given, including testing, maintenance, code development, and requirement specifications. Software development facility tools are summarized, and tool deficiencies recognized in the code development and testing phases are considered. Due to limited lab resources, the functional simulation capabilities may be indispensable in the testing phase.

Current limitations and recommendations to improve testing ...

EPA Pesticide Factsheets

In this paper existing regulatory frameworks and test systems for assessing potential endocrine-active chemicals are described, and associated challenges discussed, along with proposed approaches to address these challenges. Regulatory frameworks vary somewhat across organizations, but all basically evaluate whether a chemical possesses endocrine activity and whether this activity can result in adverse outcomes either to humans or the environment. Current test systems include in silico, in vitro and in vivo techniques focused on detecting potential endocrine activity, and in vivo tests that collect apical data to detect possible adverse effects. These test systems are currently designed to robustly assess endocrine activity and/or adverse effects in the estrogen, androgen, and thyroid hormonal pathways; however, there are some limitations of current test systems for evaluating endocrine hazard and risk. These limitations include a lack of certainty regarding: 1)adequately sensitive species and life-stages, 2) mechanistic endpoints that are diagnostic for endocrine pathways of concern, and 3) the linkage between mechanistic responses and apical, adverse outcomes. Furthermore, some existing test methods are resource intensive in regard to time, cost, and use of animals. However, based on recent experiences, there are opportunities to improve approaches to, and guidance for existing test methods, and to reduce uncertainty. For example, in vitro high throughput

Discriminatory validity of the Aspects of Wheelchair Mobility Test as demonstrated by a comparison of four wheelchair types designed for use in low-resource areas

PubMed Central

Hamm, Elisa; Wee, Joy

2017-01-01

Background Comparative effectiveness research on wheelchairs available in low-resource areas is needed to enable effective use of limited funds. Mobility on commonly encountered rolling environments is a key aspect of function. High variation in capacity among wheelchair users can mask changes in mobility because of wheelchair design. A repeated measures protocol in which the participants use one type of wheelchair and then another minimises the impact of individual variation. Objectives The Aspects of Wheelchair Mobility Test (AWMT) was designed to be used in repeated measures studies in low-resource areas. It measures the impact of different wheelchair types on physical performance in commonly encountered rolling environments and provides an opportunity for qualitative and quantitative participant response. This study sought to confirm the ability of the AWMT to discern differences in mobility because of wheelchair design. Method Participants were wheelchair users at a boarding school for students with disabilities in a low-resource area. Each participant completed timed tests on measured tracks on rough and smooth surfaces, in tight spaces and over curbs. Four types of wheelchairs designed for use in low-resource areas were included. Results The protocol demonstrated the ability to discriminate changes in mobility of individuals because of wheelchair type. Conclusion Comparative effectiveness studies with this protocol can enable beneficial change. This is illustrated by design alterations by wheelchair manufacturers in response to results. PMID:28936413

Using Spare Logic Resources To Create Dynamic Test Points

NASA Technical Reports Server (NTRS)

Katz, Richard; Kleyner, Igor

2011-01-01

A technique has been devised to enable creation of a dynamic set of test points in an embedded digital electronic system. As a result, electronics contained in an application specific circuit [e.g., gate array, field programmable gate array (FPGA)] can be internally probed, even when contained in a closed housing during all phases of test. In the present technique, the test points are not fixed and limited to a small number; the number of test points can vastly exceed the number of buffers or pins, resulting in a compact footprint. Test points are selected by means of spare logic resources within the ASIC(s) and/or FPGA(s). A register is programmed with a command, which is used to select the signals that are sent off-chip and out of the housing for monitoring by test engineers and external test equipment. The register can be commanded by any suitable means: for example, it could be commanded through a command port that would normally be used in the operation of the system. In the original application of the technique, commanding of the register is performed via a MIL-STD-1553B communication subsystem.

Hidden Costs: the ethics of cost-effectiveness analyses for health interventions in resource-limited settings

PubMed Central

Rutstein, Sarah E.; Price, Joan T.; Rosenberg, Nora E.; Rennie, Stuart M.; Biddle, Andrea K.; Miller, William C.

2017-01-01

Cost-effectiveness analysis (CEA) is an increasingly appealing tool for evaluating and comparing health-related interventions in resource-limited settings. The goal is to inform decision-makers regarding the health benefits and associated costs of alternative interventions, helping guide allocation of limited resources by prioritizing interventions that offer the most health for the least money. Although only one component of a more complex decision-making process, CEAs influence the distribution of healthcare resources, directly influencing morbidity and mortality for the world’s most vulnerable populations. However, CEA-associated measures are frequently setting-specific valuations, and CEA outcomes may violate ethical principles of equity and distributive justice. We examine the assumptions and analytical tools used in CEAs that may conflict with societal values. We then evaluate contextual features unique to resource-limited settings, including the source of health-state utilities and disability weights; implications of CEA thresholds in light of economic uncertainty; and the role of external donors. Finally, we explore opportunities to help align interpretation of CEA outcomes with values and budgetary constraints in resource-limited settings. The ethical implications of CEAs in resource-limited settings are vast. It is imperative that CEA outcome summary measures and implementation thresholds adequately reflect societal values and ethical priorities in resource-limited settings. PMID:27141969

Hidden costs: The ethics of cost-effectiveness analyses for health interventions in resource-limited settings.

PubMed

Rutstein, Sarah E; Price, Joan T; Rosenberg, Nora E; Rennie, Stuart M; Biddle, Andrea K; Miller, William C

2017-10-01

Cost-effectiveness analysis (CEA) is an increasingly appealing tool for evaluating and comparing health-related interventions in resource-limited settings. The goal is to inform decision-makers regarding the health benefits and associated costs of alternative interventions, helping guide allocation of limited resources by prioritising interventions that offer the most health for the least money. Although only one component of a more complex decision-making process, CEAs influence the distribution of health-care resources, directly influencing morbidity and mortality for the world's most vulnerable populations. However, CEA-associated measures are frequently setting-specific valuations, and CEA outcomes may violate ethical principles of equity and distributive justice. We examine the assumptions and analytical tools used in CEAs that may conflict with societal values. We then evaluate contextual features unique to resource-limited settings, including the source of health-state utilities and disability weights, implications of CEA thresholds in light of economic uncertainty, and the role of external donors. Finally, we explore opportunities to help align interpretation of CEA outcomes with values and budgetary constraints in resource-limited settings. The ethical implications of CEAs in resource-limited settings are vast. It is imperative that CEA outcome summary measures and implementation thresholds adequately reflect societal values and ethical priorities in resource-limited settings.

An efficient approach to improve the usability of e-learning resources: the role of heuristic evaluation.

PubMed

Davids, Mogamat Razeen; Chikte, Usuf M E; Halperin, Mitchell L

2013-09-01

Optimizing the usability of e-learning materials is necessary to maximize their potential educational impact, but this is often neglected when time and other resources are limited, leading to the release of materials that cannot deliver the desired learning outcomes. As clinician-teachers in a resource-constrained environment, we investigated whether heuristic evaluation of our multimedia e-learning resource by a panel of experts would be an effective and efficient alternative to testing with end users. We engaged six inspectors, whose expertise included usability, e-learning, instructional design, medical informatics, and the content area of nephrology. They applied a set of commonly used heuristics to identify usability problems, assigning severity scores to each problem. The identification of serious problems was compared with problems previously found by user testing. The panel completed their evaluations within 1 wk and identified a total of 22 distinct usability problems, 11 of which were considered serious. The problems violated the heuristics of visibility of system status, user control and freedom, match with the real world, intuitive visual layout, consistency and conformity to standards, aesthetic and minimalist design, error prevention and tolerance, and help and documentation. Compared with user testing, heuristic evaluation found most, but not all, of the serious problems. Combining heuristic evaluation and user testing, with each involving a small number of participants, may be an effective and efficient way of improving the usability of e-learning materials. Heuristic evaluation should ideally be used first to identify the most obvious problems and, once these are fixed, should be followed by testing with typical end users.

Evaluation and Acceptability of a Simplified Test of Visual Function at Birth in a Limited-Resource Setting.

PubMed

Carrara, Verena I; Darakomon, Mue Chae; Thin, Nant War War; Paw, Naw Ta Kaw; Wah, Naw; Wah, Hser Gay; Helen, Naw; Keereecharoen, Suporn; Paw, Naw Ta Mlar; Jittamala, Podjanee; Nosten, François H; Ricci, Daniela; McGready, Rose

2016-01-01

Neurological examination, including visual fixation and tracking of a target, is routinely performed in the Shoklo Malaria Research Unit postnatal care units on the Thailand-Myanmar border. We aimed to evaluate a simple visual newborn test developed in Italy and performed by non-specialized personnel working in neonatal care units. An intensive training of local health staff in Thailand was conducted prior to performing assessments at 24, 48 and 72 hours of life in healthy, low-risk term singletons. The 48 and 72 hours results were then compared to values obtained to those from Italy. Parents and staff administering the test reported on acceptability. One hundred and seventy nine newborns, between June 2011 and October 2012, participated in the study. The test was rapidly completed if the infant remained in an optimal behavioral stage (7 ± 2 minutes) but the test duration increased significantly (12 ± 4 minutes, p < 0.001) if its behavior changed. Infants were able to fix a target and to discriminate a colored face at 24 hours of life. Horizontal tracking of a target was achieved by 96% (152/159) of the infants at 48 hours. Circular tracking, stripe discrimination and attention to distance significantly improved between each 24-hour test period. The test was easily performed by non-specialized local staff and well accepted by the parents. Healthy term singletons in this limited-resource setting have a visual response similar to that obtained to gestational age matched newborns in Italy. It is possible to use these results as a reference set of values for the visual assessment in Karen and Burmese infants in the first 72 hours of life. The utility of the 24 hours test should be pursued.

How Resource Dynamics Explain Accumulating Developmental and Health Disparities for Teen Parents’ Children

PubMed Central

Mollborn, Stefanie; Lawrence, Elizabeth; James-Hawkins, Laurie; Fomby, Paula

2014-01-01

This study examines the puzzle of disparities experienced by U.S. teen parents’ young children, whose health and development increasingly lag behind those of peers while their parents are simultaneously experiencing socioeconomic improvements. Using the nationally representative Early Childhood Longitudinal Study-Birth Cohort (2001–2007; N ≈ 8,600), we assess four dynamic patterns in socioeconomic resources that might account for these growing developmental and health disparities throughout early childhood and then test them in multilevel growth curve models. Persistently low socioeconomic resources constituted the strongest explanation, given that consistently low income, maternal education, and assets fully or partially account for growth in cognitive, behavioral, and health disparities experienced by teen parents’ children from infancy through kindergarten. That is, although teen parents gained socioeconomic resources over time, those resources remained relatively low, and the duration of exposure to limited resources explains observed growing disparities. Results suggest that policy interventions addressing the time dynamics of low socioeconomic resources in a household, in terms of both duration and developmental timing, are promising for reducing disparities experienced by teen parents’ children. PMID:24802282

Resources alter the structure and increase stochasticity in bromeliad microfauna communities.

PubMed

Petermann, Jana S; Kratina, Pavel; Marino, Nicholas A C; MacDonald, A Andrew M; Srivastava, Diane S

2015-01-01

Although stochastic and deterministic processes have been found to jointly shape structure of natural communities, the relative importance of both forces may vary across different environmental conditions and across levels of biological organization. We tested the effects of abiotic environmental conditions, altered trophic interactions and dispersal limitation on the structure of aquatic microfauna communities in Costa Rican tank bromeliads. Our approach combined natural gradients in environmental conditions with experimental manipulations of bottom-up interactions (resources), top-down interactions (predators) and dispersal at two spatial scales in the field. We found that resource addition strongly increased the abundance and reduced the richness of microfauna communities. Community composition shifted in a predictable way towards assemblages dominated by flagellates and ciliates but with lower abundance and richness of algae and amoebae. While all functional groups responded strongly and predictably to resource addition, similarity among communities at the species level decreased, suggesting a role of stochasticity in species-level assembly processes. Dispersal limitation did not affect the communities. Since our design excluded potential priority effects we can attribute the differences in community similarity to increased demographic stochasticity of resource-enriched communities related to erratic changes in population sizes of some species. In contrast to resources, predators and environmental conditions had negligible effects on community structure. Our results demonstrate that bromeliad microfauna communities are strongly controlled by bottom-up forces. They further suggest that the relative importance of stochasticity may change with productivity and with the organizational level at which communities are examined.

Resources Alter the Structure and Increase Stochasticity in Bromeliad Microfauna Communities

PubMed Central

Petermann, Jana S.; Kratina, Pavel; Marino, Nicholas A. C.; MacDonald, A. Andrew M.; Srivastava, Diane S.

2015-01-01

Although stochastic and deterministic processes have been found to jointly shape structure of natural communities, the relative importance of both forces may vary across different environmental conditions and across levels of biological organization. We tested the effects of abiotic environmental conditions, altered trophic interactions and dispersal limitation on the structure of aquatic microfauna communities in Costa Rican tank bromeliads. Our approach combined natural gradients in environmental conditions with experimental manipulations of bottom-up interactions (resources), top-down interactions (predators) and dispersal at two spatial scales in the field. We found that resource addition strongly increased the abundance and reduced the richness of microfauna communities. Community composition shifted in a predictable way towards assemblages dominated by flagellates and ciliates but with lower abundance and richness of algae and amoebae. While all functional groups responded strongly and predictably to resource addition, similarity among communities at the species level decreased, suggesting a role of stochasticity in species-level assembly processes. Dispersal limitation did not affect the communities. Since our design excluded potential priority effects we can attribute the differences in community similarity to increased demographic stochasticity of resource-enriched communities related to erratic changes in population sizes of some species. In contrast to resources, predators and environmental conditions had negligible effects on community structure. Our results demonstrate that bromeliad microfauna communities are strongly controlled by bottom-up forces. They further suggest that the relative importance of stochasticity may change with productivity and with the organizational level at which communities are examined. PMID:25775464

Evaluation of a manual DNA extraction protocol and an isothermal amplification assay for detecting HIV-1 DNA from dried blood spots for use in resource-limited settings.

PubMed

Jordan, Jeanne A; Ibe, Christine O; Moore, Miranda S; Host, Christel; Simon, Gary L

2012-05-01

In resource-limited settings (RLS) dried blood spots (DBS) are collected on infants and transported through provincial laboratories to a central facility where HIV-1 DNA PCR testing is performed using specialized equipment. Implementing a simpler approach not requiring such equipment or skilled personnel could allow the more numerous provincial laboratories to offer testing, improving turn-around-time to identify and treat infected infants sooner. Assess performances of a manual DNA extraction method and helicase-dependent amplification (HDA) assay for detecting HIV-1 DNA from DBS. 60 HIV-1 infected adults were enrolled, blood samples taken and DBS made. DBS extracts were assessed for DNA concentration and beta globin amplification using PCR and melt-curve analysis. These same extracts were then tested for HIV-1 DNA using HDA and compared to results generated by PCR and pyrosequencing. Finally, HDA limit of detection (LOD) studies were performed using DBS extracts prepared with known numbers of 8E5 cells. The manual extraction protocol consistently yielded high concentrations of amplifiable DNA from DBS. LOD assessment demonstrated HDA detected ∼470 copies/ml of HIV-1 DNA extracts in 4/4 replicates. No statistical difference was found using the McNemar's test when comparing HDA to PCR for detecting HIV-1 DNA from DBS. Using just a magnet, heat block and pipettes, the manual extraction protocol and HDA assay detected HIV-1 DNA from DBS at levels that would be useful for early infant diagnosis. Next steps will include assessing HDA for non-B HIV-1 subtypes recognition and comparison to Roche HIV-1 DNA v1.5 PCR assay. Copyright © 2012 Elsevier B.V. All rights reserved.

Nursing intensive care skills training: a nurse led, short, structured, and practical training program, developed and tested in a resource-limited setting.

PubMed

De Silva, A Pubudu; Stephens, Tim; Welch, John; Sigera, Chathurani; De Alwis, Sunil; Athapattu, Priyantha; Dharmagunawardene, Dilantha; Olupeliyawa, Asela; de Abrew, Ashwini; Peiris, Lalitha; Siriwardana, Somalatha; Karunathilake, Indika; Dondorp, Arjen; Haniffa, Rashan

2015-04-01

To assess the impact of a nurse-led, short, structured training program for intensive care unit (ICU) nurses in a resource-limited setting. A training program using a structured approach to patient assessment and management for ICU nurses was designed and delivered by local nurse tutors in partnership with overseas nurse trainers. The impact of the course was assessed using the following: pre-course and post-course self-assessment, a pre-course and post-course Multiple Choice Questionnaire (MCQ), a post-course Objective Structured Clinical Assessment station, 2 post-course Short Oral Exam (SOE) stations, and post-course feedback questionnaires. In total, 117 ICU nurses were trained. Post-MCQ scores were significantly higher when compared with pre-MCQ (P < .0001). More than 95% passed the post-course Objective Structured Clinical Assessment (patient assessment) and SOE 1 (arterial blood gas analysis), whereas 76.9% passed SOE 2 (3-lead electrocardiogram analysis). The course was highly rated by participants, with 98% believing that this was a useful experience. Nursing Intensive Care Skills Training was highly rated by participants and was effective in improving the knowledge of the participants. This sustainable short course model may be adaptable to other resource-limited settings. Copyright © 2014 Elsevier Inc. All rights reserved.

Drought survival and reproduction impose contrasting selection pressures on maximum body size and sexual size dimorphism in a snake, Seminatrix pygaea.

PubMed

Winne, Christopher T; Willson, John D; Whitfield Gibbons, J

2010-04-01

The causes and consequences of body size and sexual size dimorphism (SSD) have been central questions in evolutionary ecology. Two, often opposing selective forces are suspected to act on body size in animals: survival selection and reproductive (fecundity and sexual) selection. We have recently identified a system where a small aquatic snake species (Seminatrix pygaea) is capable of surviving severe droughts by aestivating within dried, isolated wetlands. We tested the hypothesis that the lack of aquatic prey during severe droughts would impose significant survivorship pressures on S. pygaea, and that the largest individuals, particularly females, would be most adversely affected by resource limitation. Our findings suggest that both sexes experience selection against large body size during severe drought when prey resources are limited, as nearly all S. pygaea are absent from the largest size classes and maximum body size and SSD are dramatically reduced following drought. Conversely, strong positive correlations between maternal body size and reproductive success in S. pygaea suggest that females experience fecundity selection for large size during non-drought years. Collectively, our study emphasizes the dynamic interplay between selection pressures that act on body size and supports theoretical predictions about the relationship between body size and survivorship in ectotherms under conditions of resource limitation.

Substituting Sodium Hydrosulfite with Sodium Metabisulfite Improves Long-Term Stability of a Distributable Paper-Based Test Kit for Point-of-Care Screening for Sickle Cell Anemia.

PubMed

Torabian, Kian; Lezzar, Dalia; Piety, Nathaniel Z; George, Alex; Shevkoplyas, Sergey S

2017-09-20

Sickle cell anemia (SCA) is a genetic blood disorder that is particularly lethal in early childhood. Universal newborn screening programs and subsequent early treatment are known to drastically reduce under-five SCA mortality. However, in resource-limited settings, cost and infrastructure constraints limit the effectiveness of laboratory-based SCA screening programs. To address this limitation our laboratory previously developed a low-cost, equipment-free, point-of-care, paper-based SCA test. Here, we improved the stability and performance of the test by replacing sodium hydrosulfite (HS), a key reducing agent in the hemoglobin solubility buffer which is not stable in aqueous solutions, with sodium metabisulfite (MS). The MS formulation of the test was compared to the HS formulation in a laboratory setting by inexperienced users ( n = 3), to determine visual limit of detection (LOD), readout time, diagnostic accuracy, intra- and inter-observer agreement, and shelf life. The MS test was found to have a 10% sickle hemoglobin LOD, 21-min readout time, 97.3% sensitivity and 99.5% specificity for SCA, almost perfect intra- and inter-observer agreement, at least 24 weeks of shelf stability at room temperature, and could be packaged into a self-contained, distributable test kits comprised of off-the-shelf disposable components and food-grade reagents with a total cost of only $0.21 (USD).

Development of enhancing agglutination reaction using gold nanoparticle for pre-transfusion testing.

PubMed

Choktaweesak, N; Krasathong, P; Ammaranond, P

2016-10-01

To explore an alternative way for antibody detection testing, the examination of gold nanoparticle solution for enhancing unexpected antibodies for pre-transfusion testing was investigated. Exposure of foreign antigens on red blood cells from transfusion can trigger the immune system to produce unexpected antibodies. This immunological response may cause the complication to future transfusion. For detection of unexpected antibodies, the antibody screening test is performed approximately 30-60 min. To reduce turnaround time, enhancing reagent, low-ionic strength solution (LISS), is widely used. However, cost of enhancing reagent is an issue which has concerned in resource limited countries. Gold nanoparticle solution can increase red blood cells agglutination reaction. To solve this issue, study of gold nanoparticle solution was investigated. Samples were performed comparing between LISS and gold nanoparticle solution at antiglobulin phase. After reading the agglutination reaction, supernatants were collected and measured at the optical density at 760 nm by spectrophotometer. The optical density in the tube of gold nanoparticle solution was higher than in the tube of 2-5% cell suspension and monoclonal antibody. It has been observed that gold nanoparticle solution enhanced the reaction of agglutination 98% while LISS enhanced the agglutination only 60·8%. Employing a commercially available enhancing reagent, parallel samples confirmed results providing validation of the assay. It approximately costs $1 US dollars compared to $30 for a commercially available reagent. The low cost and yet effective time-consuming test for antibody screening is a practical and viable solution alternative way for performing in antibody screening test in resource limited countries. © 2016 British Blood Transfusion Society.

Addition of multiple limiting resources reduces grassland diversity

USDA-ARS?s Scientific Manuscript database

Niche dimensionality is the most general theoretical explanation for biodiversity: more niches allow for more ecological tradeoffs between species and thus greater opportunities for coexistence. Resource competition theory predicts that removing resource limitations, by increasing resource availabil...

78 FR 28626 - Oshkosh Defense, a Subsidiary of Oshkosh Corporation, Including On-Site Leased Workers From...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-15

...., Larsen and Toubro Limited, MRI Network/Manta Resources, Inc., Omni Resources, Premier Temporary Staffing...., Larsen and Toubro Limited, MRI Network/Manta Resources, Inc., Omni Resources, Premier Temporary Staffing...

The Relationship Between Sports Participation and Managerial Behavior: An Exploratory Study

DTIC Science & Technology

1986-09-01

Response ...... .......................... 44 Analysis ........................................ 45 T-Test Decision Criteria ................. 45...magnitude and the limited availability of Air Force resources managed by its officer corp. Air Force officers are charged with the responsibility and S...successful organization, the SPO requires careful definition of authority and responsibility as well as strenuous efforts toward coordination, teamwork and

Decentralization of storm runoff via engagement of social and cultural capitals - implications for the management of flood risk at the municipal scale

EPA Science Inventory

This research tests a novel method that focuses limited community resources on a decentralized approach to storm water management. A reverse auction was used to relieve legal constraints on management implementation on private land. Residents voluntarily bid on rain gardens and r...

Field efficiency and bias of snag inventory methods

Treesearch

Robert S. Kenning; Mark J. Ducey; John C. Brissette; Jeffery H. Gove

2005-01-01

Snags and cavity trees are important components of forests, but can be difficult to inventory precisely and are not always included in inventories because of limited resources. We tested the application of N-tree distance sampling as a time-saving snag sampling method and compared N-tree distance sampling to fixed-area sampling and modified horizontal line sampling in...

Socioeconomic Status, Smoking, and Health: A Test of Competing Theories of Cumulative Advantage

ERIC Educational Resources Information Center

Pampel, Fred C.; Rogers, Richard G.

2004-01-01

Although both low socioeconomic status and cigarette smoking increase health problems and mortality, their possible combined or interactive influence is less clear. On one hand, the health of low status groups may be harmed least by unhealthy behavior such as smoking because, given the substantial health risks produced by limited resources, they…

Wintering Yellow-rumped Warblers (Dendroica coronata) track manipulated abundance of Myrica cerifera fruits

Treesearch

Kathi L. Borgmann; Scott F. Pearson; Douglas J. Levey; Cathryn H. Greenberg

2004-01-01

Food availability during winter may determine habitat use and limit populations of overwintering birds, yet its importance is difficult to judge because few studies have experimentally tested the response of nonbreedlng birds to changes in resource abundance. We expenmentally examined the link between fruit availability and habitat use by manipulating winter abundance...

Prioritizing Threats to Patient Safety in Rural Primary Care

ERIC Educational Resources Information Center

Singh, Ranjit; Singh, Ashok; Servoss, Timothy J.; Singh, Gurdev

2007-01-01

Context: Rural primary care is a complex environment in which multiple patient safety challenges can arise. To make progress in improving safety with limited resources, each practice needs to identify those safety problems that pose the greatest threat to patients and focus efforts on these. Purpose: To describe and field-test a novel approach to…

Detection of Entamoeba histolytica by Recombinase Polymerase Amplification.

PubMed

Nair, Gayatri; Rebolledo, Mauricio; White, A Clinton; Crannell, Zachary; Richards-Kortum, R Rebecca; Pinilla, A Elizabeth; Ramírez, Juan David; López, M Consuelo; Castellanos-Gonzalez, Alejandro

2015-09-01

Amebiasis is an important cause of diarrheal disease worldwide and has been associated with childhood malnutrition. Traditional microscopy approaches are neither sensitive nor specific for Entamoeba histolytica. Antigen assays are more specific, but many cases are missed unless tested by molecular methods. Although polymerase chain reaction (PCR) is effective, the need for sophisticated, expensive equipment, infrastructure, and trained personnel limits its usefulness, especially in the resource-limited, endemic areas. Here, we report development of a recombinase polymerase amplification (RPA) method to detect E. histolytica specifically. Using visual detection by lateral flow (LF), the test was highly sensitive and specific and could be performed without additional equipment. The availability of this inexpensive, sensitive, and field-applicable diagnostic test could facilitate rapid diagnosis and treatment of amebiasis in endemic regions. © The American Society of Tropical Medicine and Hygiene.

Making choices impairs subsequent self-control: a limited-resource account of decision making, self-regulation, and active initiative.

PubMed

Vohs, Kathleen D; Baumeister, Roy F; Schmeichel, Brandon J; Twenge, Jean M; Nelson, Noelle M; Tice, Dianne M

2008-05-01

The current research tested the hypothesis that making many choices impairs subsequent self-control. Drawing from a limited-resource model of self-regulation and executive function, the authors hypothesized that decision making depletes the same resource used for self-control and active responding. In 4 laboratory studies, some participants made choices among consumer goods or college course options, whereas others thought about the same options without making choices. Making choices led to reduced self-control (i.e., less physical stamina, reduced persistence in the face of failure, more procrastination, and less quality and quantity of arithmetic calculations). A field study then found that reduced self-control was predicted by shoppers' self-reported degree of previous active decision making. Further studies suggested that choosing is more depleting than merely deliberating and forming preferences about options and more depleting than implementing choices made by someone else and that anticipating the choice task as enjoyable can reduce the depleting effect for the first choices but not for many choices. (c) 2008 APA, all rights reserved

Interoperating Cloud-based Virtual Farms

NASA Astrophysics Data System (ADS)

Bagnasco, S.; Colamaria, F.; Colella, D.; Casula, E.; Elia, D.; Franco, A.; Lusso, S.; Luparello, G.; Masera, M.; Miniello, G.; Mura, D.; Piano, S.; Vallero, S.; Venaruzzo, M.; Vino, G.

2015-12-01

The present work aims at optimizing the use of computing resources available at the grid Italian Tier-2 sites of the ALICE experiment at CERN LHC by making them accessible to interactive distributed analysis, thanks to modern solutions based on cloud computing. The scalability and elasticity of the computing resources via dynamic (“on-demand”) provisioning is essentially limited by the size of the computing site, reaching the theoretical optimum only in the asymptotic case of infinite resources. The main challenge of the project is to overcome this limitation by federating different sites through a distributed cloud facility. Storage capacities of the participating sites are seen as a single federated storage area, preventing the need of mirroring data across them: high data access efficiency is guaranteed by location-aware analysis software and storage interfaces, in a transparent way from an end-user perspective. Moreover, the interactive analysis on the federated cloud reduces the execution time with respect to grid batch jobs. The tests of the investigated solutions for both cloud computing and distributed storage on wide area network will be presented.

Distributed storage and cloud computing: a test case

NASA Astrophysics Data System (ADS)

Piano, S.; Delia Ricca, G.

2014-06-01

Since 2003 the computing farm hosted by the INFN Tier3 facility in Trieste supports the activities of many scientific communities. Hundreds of jobs from 45 different VOs, including those of the LHC experiments, are processed simultaneously. Given that normally the requirements of the different computational communities are not synchronized, the probability that at any given time the resources owned by one of the participants are not fully utilized is quite high. A balanced compensation should in principle allocate the free resources to other users, but there are limits to this mechanism. In fact, the Trieste site may not hold the amount of data needed to attract enough analysis jobs, and even in that case there could be a lack of bandwidth for their access. The Trieste ALICE and CMS computing groups, in collaboration with other Italian groups, aim to overcome the limitations of existing solutions using two approaches: sharing the data among all the participants taking full advantage of GARR-X wide area networks (10 GB/s) and integrating the resources dedicated to batch analysis with the ones reserved for dynamic interactive analysis, through modern solutions as cloud computing.

Empirical evidence for resource-rational anchoring and adjustment.

PubMed

Lieder, Falk; Griffiths, Thomas L; M Huys, Quentin J; Goodman, Noah D

2018-04-01

People's estimates of numerical quantities are systematically biased towards their initial guess. This anchoring bias is usually interpreted as sign of human irrationality, but it has recently been suggested that the anchoring bias instead results from people's rational use of their finite time and limited cognitive resources. If this were true, then adjustment should decrease with the relative cost of time. To test this hypothesis, we designed a new numerical estimation paradigm that controls people's knowledge and varies the cost of time and error independently while allowing people to invest as much or as little time and effort into refining their estimate as they wish. Two experiments confirmed the prediction that adjustment decreases with time cost but increases with error cost regardless of whether the anchor was self-generated or provided. These results support the hypothesis that people rationally adapt their number of adjustments to achieve a near-optimal speed-accuracy tradeoff. This suggests that the anchoring bias might be a signature of the rational use of finite time and limited cognitive resources rather than a sign of human irrationality.

Perceived Barriers to Information Access Among Medical Residents in Iran: Obstacles to Answering Clinical Queries in Settings with Limited Internet Accessibility

PubMed Central

Mazloomdoost, Danesh; Mehregan, Shervineh; Mahmoudi, Hilda; Soltani, Akbar; Embi, Peter J.

2007-01-01

Studies performed in the US and other Western countries have documented that physicians generate many clinical questions during a typical day and rely on various information sources for answers. Little is known about the information seeking behaviors of physicians practicing in other countries, particularly those with limited Internet connectivity. We conducted this study to document the perceived barriers to information resources used by medical residents in Iran. Our findings reveal that different perceived barriers exist for electronic versus paper-based resources. Notably, paper-based resources are perceived to be limited by resident time-constraints and availability of resources, whereas electronic resources are limited by cost decentralized resources (such as PDAs) and accessibility of centralized, Internet access. These findings add to the limited literature regarding health information-seeking activities in international healthcare settings, particularly those with limited Internet connectivity, and will supplement future studies of and interventions in such settings. PMID:18693891

Perceived barriers to information access among medical residents in Iran: obstacles to answering clinical queries in settings with limited Internet accessibility.

PubMed

Mazloomdoost, Danesh; Mehregan, Shervineh; Mahmoudi, Hilda; Soltani, Akbar; Embi, Peter J

2007-10-11

Studies performed in the US and other Western countries have documented that physicians generate many clinical questions during a typical day and rely on various information sources for answers. Little is known about the information seeking behaviors of physicians practicing in other countries, particularly those with limited Internet connectivity. We conducted this study to document the perceived barriers to information resources used by medical residents in Iran. Our findings reveal that different perceived barriers exist for electronic versus paper-based resources. Notably, paper-based resources are perceived to be limited by resident time-constraints and availability of resources, whereas electronic resources are limited by cost decentralized resources (such as PDAs) and accessibility of centralized, Internet access. These findings add to the limited literature regarding health information-seeking activities in international healthcare settings, particularly those with limited Internet connectivity, and will supplement future studies of and interventions in such settings.

Physiological strategies of co-occurring oaks in a water- and nutrient-limited ecosystem

Treesearch

Heidi Renninger; Nicholas Carlo; Kenneth L. Clark; Karina V.R. Schafer

2014-01-01

Oak species are well suited to water-limited conditions by either avoiding water stress through deep rooting or tolerating water stress through tight stomatal control. In co-occurring species where resources are limited, species may either partition resources in space and/or time or exhibit differing efficiencies in the use of limited resources. Therefore, this study...

Optimization of Water Resources and Agricultural Activities for Economic Benefit in Colorado

NASA Astrophysics Data System (ADS)

LIM, J.; Lall, U.

2017-12-01

The limited water resources available for irrigation are a key constraint for the important agricultural sector of Colorado's economy. As climate change and groundwater depletion reshape these resources, it is essential to understand the economic potential of water resources under different agricultural production practices. This study uses a linear programming optimization at the county spatial scale and annual temporal scales to study the optimal allocation of water withdrawal and crop choices. The model, AWASH, reflects streamflow constraints between different extraction points, six field crops, and a distinct irrigation decision for maize and wheat. The optimized decision variables, under different environmental, social, economic, and physical constraints, provide long-term solutions for ground and surface water distribution and for land use decisions so that the state can generate the maximum net revenue. Colorado, one of the largest agricultural producers, is tested as a case study and the sensitivity on water price and on climate variability is explored.

Profit-based conventional resource scheduling with renewable energy penetration

NASA Astrophysics Data System (ADS)

Reddy, K. Srikanth; Panwar, Lokesh Kumar; Kumar, Rajesh; Panigrahi, B. K.

2017-08-01

Technological breakthroughs in renewable energy technologies (RETs) enabled them to attain grid parity thereby making them potential contenders for existing conventional resources. To examine the market participation of RETs, this paper formulates a scheduling problem accommodating energy market participation of wind- and solar-independent power producers (IPPs) treating both conventional and RETs as identical entities. Furthermore, constraints pertaining to penetration and curtailments of RETs are restructured. Additionally, an appropriate objective function for profit incurred by conventional resource IPPs through reserve market participation as a function of renewable energy curtailment is also proposed. The proposed concept is simulated with a test system comprising 10 conventional generation units in conjunction with solar photovoltaic (SPV) and wind energy generators (WEG). The simulation results indicate that renewable energy integration and its curtailment limits influence the market participation or scheduling strategies of conventional resources in both energy and reserve markets. Furthermore, load and reliability parameters are also affected.

Comparison of one commercial and two in-house TaqMan multiplex real-time PCR assays for detection of enteropathogenic, enterotoxigenic and enteroaggregative Escherichia coli.

PubMed

Hahn, Andreas; Luetgehetmann, Marc; Landt, Olfert; Schwarz, Norbert Georg; Frickmann, Hagen

2017-11-01

Enteropathogenic, enterotoxigenic and enteroaggregative Escherichia coli (EPEC, ETEC, EAEC) are among the most frequent causes of diarrhoea during travel or on military deployments. Cost-efficient and reliable real-time multiplex PCR (mPCR) assays are desirable for surveillance or point prevalence studies in remote and resource-limited tropical settings. We compared one commercial PCR kit and two in-house assays without using a gold standard to estimate sensitivity and specificity of each assay. Residual materials from nucleic acid extractions of stool samples from two groups with presumably different prevalences and increased likelihood of being infected or colonised by diarrhoeagenic E. coli were included in the assessment. One group comprised samples from returnees from tropical deployments, the second group was of migrants and study participants from high-endemicity settings. Each sample was assessed with all of the PCR assays. Cycle threshold (Ct) values were descriptively compared. The calculated sensitivities for the commercial test vs. the in-house tests were for EPEC 0.84 vs. 0.89 and 0.96, for ETEC 0.83 vs. 0.76 and 0.61, and for EAEC 0.69 vs. 0.54 and 0.69. False positive results were rare - specificity was 0.94 and 0.97 for two EPEC tests and 1.0 for all other tests. Most positive samples had late Ct values corresponding to low quantities of pathogens. Discordant test results were associated with late Ct values. As commercial and in-house assays showed comparable results, in-house tests can be assumed to be safe while affording considerable savings, making them a valuable alternative for surveillance testing in resource-limited tropical areas. © 2017 John Wiley & Sons Ltd.

Common neural substrates for visual working memory and attention.

PubMed

Mayer, Jutta S; Bittner, Robert A; Nikolić, Danko; Bledowski, Christoph; Goebel, Rainer; Linden, David E J

2007-06-01

Humans are severely limited in their ability to memorize visual information over short periods of time. Selective attention has been implicated as a limiting factor. Here we used functional magnetic resonance imaging to test the hypothesis that this limitation is due to common neural resources shared by visual working memory (WM) and selective attention. We combined visual search and delayed discrimination of complex objects and independently modulated the demands on selective attention and WM encoding. Participants were presented with a search array and performed easy or difficult visual search in order to encode one or three complex objects into visual WM. Overlapping activation for attention-demanding visual search and WM encoding was observed in distributed posterior and frontal regions. In the right prefrontal cortex and bilateral insula blood oxygen-level-dependent activation additively increased with increased WM load and attentional demand. Conversely, several visual, parietal and premotor areas showed overlapping activation for the two task components and were severely reduced in their WM load response under the condition with high attentional demand. Regions in the left prefrontal cortex were selectively responsive to WM load. Areas selectively responsive to high attentional demand were found within the right prefrontal and bilateral occipital cortex. These results indicate that encoding into visual WM and visual selective attention require to a high degree access to common neural resources. We propose that competition for resources shared by visual attention and WM encoding can limit processing capabilities in distributed posterior brain regions.

Non-Interfering Effects of Active Post-Encoding Tasks on Episodic Memory Consolidation in Humans

PubMed Central

Varma, Samarth; Takashima, Atsuko; Krewinkel, Sander; van Kooten, Maaike; Fu, Lily; Medendorp, W. Pieter; Kessels, Roy P. C.; Daselaar, Sander M.

2017-01-01

So far, studies that investigated interference effects of post-learning processes on episodic memory consolidation in humans have used tasks involving only complex and meaningful information. Such tasks require reallocation of general or encoding-specific resources away from consolidation-relevant activities. The possibility that interference can be elicited using a task that heavily taxes our limited brain resources, but has low semantic and hippocampal related long-term memory processing demands, has never been tested. We address this question by investigating whether consolidation could persist in parallel with an active, encoding-irrelevant, minimally semantic task, regardless of its high resource demands for cognitive processing. We distinguish the impact of such a task on consolidation based on whether it engages resources that are: (1) general/executive, or (2) specific/overlapping with the encoding modality. Our experiments compared subsequent memory performance across two post-encoding consolidation periods: quiet wakeful rest and a cognitively demanding n-Back task. Across six different experiments (total N = 176), we carefully manipulated the design of the n-Back task to target general or specific resources engaged in the ongoing consolidation process. In contrast to previous studies that employed interference tasks involving conceptual stimuli and complex processing demands, we did not find any differences between n-Back and rest conditions on memory performance at delayed test, using both recall and recognition tests. Our results indicate that: (1) quiet, wakeful rest is not a necessary prerequisite for episodic memory consolidation; and (2) post-encoding cognitive engagement does not interfere with memory consolidation when task-performance has minimal semantic and hippocampally-based episodic memory processing demands. We discuss our findings with reference to resource and reactivation-led interference theories. PMID:28424596

Non-Interfering Effects of Active Post-Encoding Tasks on Episodic Memory Consolidation in Humans.

PubMed

Varma, Samarth; Takashima, Atsuko; Krewinkel, Sander; van Kooten, Maaike; Fu, Lily; Medendorp, W Pieter; Kessels, Roy P C; Daselaar, Sander M

2017-01-01

So far, studies that investigated interference effects of post-learning processes on episodic memory consolidation in humans have used tasks involving only complex and meaningful information. Such tasks require reallocation of general or encoding-specific resources away from consolidation-relevant activities. The possibility that interference can be elicited using a task that heavily taxes our limited brain resources, but has low semantic and hippocampal related long-term memory processing demands, has never been tested. We address this question by investigating whether consolidation could persist in parallel with an active, encoding-irrelevant, minimally semantic task, regardless of its high resource demands for cognitive processing. We distinguish the impact of such a task on consolidation based on whether it engages resources that are: (1) general/executive, or (2) specific/overlapping with the encoding modality. Our experiments compared subsequent memory performance across two post-encoding consolidation periods: quiet wakeful rest and a cognitively demanding n-Back task. Across six different experiments (total N = 176), we carefully manipulated the design of the n-Back task to target general or specific resources engaged in the ongoing consolidation process. In contrast to previous studies that employed interference tasks involving conceptual stimuli and complex processing demands, we did not find any differences between n-Back and rest conditions on memory performance at delayed test, using both recall and recognition tests. Our results indicate that: (1) quiet, wakeful rest is not a necessary prerequisite for episodic memory consolidation; and (2) post-encoding cognitive engagement does not interfere with memory consolidation when task-performance has minimal semantic and hippocampally-based episodic memory processing demands. We discuss our findings with reference to resource and reactivation-led interference theories.

The Technology Acceptance Model for Resource-Limited Settings (TAM-RLS): A Novel Framework for Mobile Health Interventions Targeted to Low-Literacy End-Users in Resource-Limited Settings.

PubMed

Campbell, Jeffrey I; Aturinda, Isaac; Mwesigwa, Evans; Burns, Bridget; Santorino, Data; Haberer, Jessica E; Bangsberg, David R; Holden, Richard J; Ware, Norma C; Siedner, Mark J

2017-11-01

Although mobile health (mHealth) technologies have shown promise in improving clinical care in resource-limited settings (RLS), they are infrequently brought to scale. One limitation to the success of many mHealth interventions is inattention to end-user acceptability, which is an important predictor of technology adoption. We conducted in-depth interviews with 43 people living with HIV in rural Uganda who had participated in a clinical trial of a short messaging system (SMS)-based intervention designed to prompt return to clinic after an abnormal laboratory test. Interviews focused on established features of technology acceptance models, including perceived ease of use and perceived usefulness, and included open-ended questions to gain insight into unexplored issues related to the intervention's acceptability. We used conventional (inductive) and direct content analysis to derive categories describing use behaviors and acceptability. Interviews guided development of a proposed conceptual framework, the technology acceptance model for resource-limited settings (TAM-RLS). This framework incorporates both classic technology acceptance model categories as well as novel factors affecting use in this setting. Participants described how SMS message language, phone characteristics, and experience with similar technologies contributed to the system's ease of use. Perceived usefulness was shaped by the perception that the system led to augmented HIV care services and improved access to social support from family and colleagues. Emergent themes specifically related to mHealth acceptance among PLWH in Uganda included (1) the importance of confidentiality, disclosure, and stigma, and (2) the barriers and facilitators downstream from the intervention that impacted achievement of the system's target outcome. The TAM-RLS is a proposed model of mHealth technology acceptance based upon end-user experiences in rural Uganda. Although the proposed model requires validation, the TAM-RLS may serve as a useful tool to guide design and implementation of mHealth interventions.

Stochastic Averaging for Constrained Optimization With Application to Online Resource Allocation

NASA Astrophysics Data System (ADS)

Chen, Tianyi; Mokhtari, Aryan; Wang, Xin; Ribeiro, Alejandro; Giannakis, Georgios B.

2017-06-01

Existing approaches to resource allocation for nowadays stochastic networks are challenged to meet fast convergence and tolerable delay requirements. The present paper leverages online learning advances to facilitate stochastic resource allocation tasks. By recognizing the central role of Lagrange multipliers, the underlying constrained optimization problem is formulated as a machine learning task involving both training and operational modes, with the goal of learning the sought multipliers in a fast and efficient manner. To this end, an order-optimal offline learning approach is developed first for batch training, and it is then generalized to the online setting with a procedure termed learn-and-adapt. The novel resource allocation protocol permeates benefits of stochastic approximation and statistical learning to obtain low-complexity online updates with learning errors close to the statistical accuracy limits, while still preserving adaptation performance, which in the stochastic network optimization context guarantees queue stability. Analysis and simulated tests demonstrate that the proposed data-driven approach improves the delay and convergence performance of existing resource allocation schemes.

The Effects of Job Demands and Organizational Resources through Psychological Need Satisfaction and Thwarting.

PubMed

Gillet, Nicolas; Fouquereau, Evelyne; Huyghebaert, Tiphaine; Colombat, Philippe

2015-05-20

In Study 1, we tested a model in which two job demands (i.e., changes in tasks and ambiguities about work) and organizational resources (i.e., interpersonal and informational justice) influence work engagement through the satisfaction of individuals' psychological needs for autonomy, competence, and relatedness. In Study 2, we examined the indirect effects of the same job demands and organizational resources on burnout through need thwarting. We also examined the mediating role of organizational resources in the relationships of changes in tasks and ambiguities about work to need satisfaction (Study 1) and need thwarting (Study 2). Structural equation modeling performed on cross-sectional data collected from 461 workers in Study 1 and 708 employees in Study 2 provided support for the hypothesized models. Specifically, results revealed that changes in tasks and ambiguities about work have direct and indirect effects (via organizational resources) on psychological need satisfaction and need thwarting, which in turn positively predicted work engagement and burnout, respectively (p < .05). Research implications and study limitations are discussed.

20 CFR 416.1242 - Time limits for disposing of resources.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Time limits for disposing of resources. 416.1242 Section 416.1242 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Resources and Exclusions § 416.1242 Time limits for disposing of...

Cranial biomechanics underpins high sauropod diversity in resource-poor environments

PubMed Central

Button, David J.; Rayfield, Emily J.; Barrett, Paul M.

2014-01-01

High megaherbivore species richness is documented in both fossil and contemporary ecosystems despite their high individual energy requirements. An extreme example of this is the Late Jurassic Morrison Formation, which was dominated by sauropod dinosaurs, the largest known terrestrial vertebrates. High sauropod diversity within the resource-limited Morrison is paradoxical, but might be explicable through sophisticated resource partitioning. This hypothesis was tested through finite-element analysis of the crania of the Morrison taxa Camarasaurus and Diplodocus. Results demonstrate divergent specialization, with Camarasaurus capable of exerting and accommodating greater bite forces than Diplodocus, permitting consumption of harder food items. Analysis of craniodental biomechanical characters taken from 35 sauropod taxa demonstrates a functional dichotomy in terms of bite force, cranial robustness and occlusal relationships yielding two polyphyletic functional ‘grades’. Morrison taxa are widely distributed within and between these two morphotypes, reflecting distinctive foraging specializations that formed a biomechanical basis for niche partitioning between them. This partitioning, coupled with benefits associated with large body size, would have enabled the high sauropod diversities present in the Morrison Formation. Further, this provides insight into the mechanisms responsible for supporting the high diversities of large megaherbivores observed in other Mesozoic and Cenozoic communities, particularly those occurring in resource-limited environments. PMID:25297869

Preliminary testing of a prototype portable X-ray fluorescence spectrometer

NASA Technical Reports Server (NTRS)

Patten, L. L.; Anderson, N. B.; Stevenson, J. J.

1982-01-01

A portable X-ray fluorescence spectrometer for use as an analyzer in mineral resource investigative work was built and tested. The prototype battery powered spectrometer, measuring 11 by 12 by 5 inches and weighing only about 15 pounds, was designed specifically for field use. The spectrometer has two gas proportional counters and two radioactive sources, Cd (10a) and Fe (55). Preliminary field and laboratory tests on rock specimens and rock pulps have demonstrated the capability of the spectrometer to detect 33 elements to date. Characteristics of the system present some limitations, however, and further improvements are recommended.

Rats do not eat alone in public: Food-deprived rats socialize rather than competing for baits

PubMed Central

Ram, Tamar; Zadicario, Pazit; Eilam, David

2017-01-01

Limited resources result in competition among social animals. Nevertheless, social animals also have innate preferences for cooperative behavior. In the present study, 12 dyads of food-deprived rats were tested in four successive trials, and then re-tested as eight triads of food-deprived rats that were unfamiliar to each other. We found that the food-deprived dyads or triads of rats did not compete for the food available to them at regular spatially-marked locations that they had previously learnt. Rather, these rats traveled together to collect the baits. One rat, or two rats in some triads, lead (ran ahead) to collect most of the baits, but "leaders" differed across trials so that, on average, each rat ultimately collected similar amounts of baits. Regardless of which rat collected the baits, the rats traveled together with no substantial difference among them in terms of their total activity. We suggest that rats, which are a social species that has been found to display reciprocity, have evolved to travel and forage together and to share limited resources. Consequently, they displayed a sort of 'peace economy' that on average resulted in equal access to the baits across trials. For social animals, this type of dynamics is more relaxed, tolerant, and effective in the management of conflicts. Rather than competing for the limited available food, the food-deprived rats socialized and coexisted peacefully. PMID:28278246

Challenges in diagnosis and management of Cryptococcal immune reconstitution inflammatory syndrome (IRIS) in resource limited settings.

PubMed

Musubire, A K; Meya, B D; Mayanja-Kizza, H; Lukande, R; Wiesner, L D; Bohjanen, P; R Boulware, R D

2012-06-01

In many resource-limited settings, cryptococcal meningitis (CM) contributes up to 20% of all deaths with further complications due to Immune Reconstitution Inflammatory Syndrome (IRIS). We present a case report on a patient who developed CM-IRIS and then subsequent CM-relapse with a fluconazole-resistant organism and then later CM-IRIS once again, manifesting as cystic cryptococcomas, hydrocephalus, and sterile CSF. In this case we, demonstrate that CM-IRIS and persistent low level cryptococcal infection are not mutually exclusive phenomena. The management of IRIS with corticosteroids may increase the risk of culture positive CM-relapse which may further increase the risk of recurrent IRIS and resulting complications including death. We also highlight the role of imaging and fluconazole resistance testing in patients with recurrent meningitis and the importance of CSF cultures in guiding treatment decisions.

Primary Care Clinicians' Perspectives on Reducing Low-Value Care in an Integrated Delivery System.

PubMed

Buist, Diana S M; Chang, Eva; Handley, Matt; Pardee, Roy; Gundersen, Gabrielle; Cheadle, Allen; Reid, Robert J

2016-01-01

Perceptions about low-value care (eg, medical tests and procedures that may be unnecessary and/or harmful) among clinicians with capitated salaries are unknown. Explore clinicians' perceived use of and responsibility for reducing low-value care by focusing on barriers to use, awareness of the Choosing Wisely campaign, and response to reports of peer-comparison resource use and practice patterns. Electronic, cross-sectional survey, distributed in 2013, to 304 salaried primary care physicians and physician assistants at Group Health Cooperative. Attitudes, awareness, and barriers of low-value care strategies and initiatives. A total of 189 clinicians responded (62% response rate). More than 90% believe cost is important to various stakeholders and believe it is fair to ask clinicians to be cost-conscious. Most found peer-comparison resource-use reports useful for understanding practice patterns and prompting peer discussions. Two-thirds of clinicians were aware of the Choosing Wisely campaign; among them, 97% considered it a legitimate information source. Although 88% reported being comfortable discussing low-value care with patients, 80% reported they would order tests or procedures when a patient insisted. As key barriers in reducing low-value care, clinicians identified time constraints (45%), overcoming patient preferences/values (44%), community standards (43%), fear of patients' dissatisfaction (41%), patients' knowledge about the harms of low-value care (38%), and availability of tools to support shared decision making (37%). Salaried clinicians are aware of rising health care costs and want to be stewards of limited health care resources. Evidence-based initiatives such as the Choosing Wisely campaign may help motivate clinicians to be conscientious stewards of limited health care resources.

Toxicity testing of chemical mixtures: some general aspects and need of international guidelines.

PubMed

Kappus, H; Yang, R S

1996-01-01

The topics discussed by the Working Group on Toxicity Testing of Chemical Mixtures included the following (1) the study designs and results from two real-life exposure scenarios as additional information to the various investigations reported at the conference; (2) the need to take into consideration low-level, long-term exposure (i.e. mimicking human exposure conditions) as well as the issue of limited resources in experimental toxicology studies; (3) the importance of exploring alternative and predictive toxicology methodologies to minimize animal use and to conserve resources; (4) the realization that interactive toxicity should include the consideration of physical and biological agents in addition to chemicals. Two specific studies reported at the conference were also discussed. A number of recommendations were made concerning the planning and implementation of toxicology studies on chemical mixtures.

Using discrete event computer simulation to improve patient flow in a Ghanaian acute care hospital.

PubMed

Best, Allyson M; Dixon, Cinnamon A; Kelton, W David; Lindsell, Christopher J; Ward, Michael J

2014-08-01

Crowding and limited resources have increased the strain on acute care facilities and emergency departments worldwide. These problems are particularly prevalent in developing countries. Discrete event simulation is a computer-based tool that can be used to estimate how changes to complex health care delivery systems such as emergency departments will affect operational performance. Using this modality, our objective was to identify operational interventions that could potentially improve patient throughput of one acute care setting in a developing country. We developed a simulation model of acute care at a district level hospital in Ghana to test the effects of resource-neutral (eg, modified staff start times and roles) and resource-additional (eg, increased staff) operational interventions on patient throughput. Previously captured deidentified time-and-motion data from 487 acute care patients were used to develop and test the model. The primary outcome was the modeled effect of interventions on patient length of stay (LOS). The base-case (no change) scenario had a mean LOS of 292 minutes (95% confidence interval [CI], 291-293). In isolation, adding staffing, changing staff roles, and varying shift times did not affect overall patient LOS. Specifically, adding 2 registration workers, history takers, and physicians resulted in a 23.8-minute (95% CI, 22.3-25.3) LOS decrease. However, when shift start times were coordinated with patient arrival patterns, potential mean LOS was decreased by 96 minutes (95% CI, 94-98), and with the simultaneous combination of staff roles (registration and history taking), there was an overall mean LOS reduction of 152 minutes (95% CI, 150-154). Resource-neutral interventions identified through discrete event simulation modeling have the potential to improve acute care throughput in this Ghanaian municipal hospital. Discrete event simulation offers another approach to identifying potentially effective interventions to improve patient flow in emergency and acute care in resource-limited settings. Copyright © 2014 Elsevier Inc. All rights reserved.

Role-Playing Games for Capacity Building in Water and Land Management: Some Brazilian Experiences

ERIC Educational Resources Information Center

Camargo, Maria Eugenia; Jacobi, Pedro Roberto; Ducrot, Raphaele

2007-01-01

Role-playing games in natural resource management are currently being tested as research, training, and intervention tools all over the world. Various studies point out their potential to deal with complex issues and to contribute to training processes. The objective of this contribution is to analyze the limits and potentialities of this tool for…

Redesigning Design: Field Testing a Revised Design Rubric Based on iNACOL Quality Course Standards

ERIC Educational Resources Information Center

Adelstein, David; Barbour, Michael K.

2016-01-01

Designers have a limited selection of K-12 online course creation standards to choose from that are not blocked behind proprietary or pay walls. For numerous institutions and states, the use of the iNACOL "National Standards for Quality Online Courses" is becoming a widely used resource. This article presents the final phase in a…

Computer-Based Instruction within Transportation Mobility Training

DTIC Science & Technology

1990-09-01

APT Lesson Plan .... 191 Appendix C: APT Workbook .... .............. . 209 Appendix D: Experiment Pretest and Posttest ..... .. 222 Appendix E : Test...Questions The following investigative questions are set forth to determine if CBI is an effective alternative to classroom training in the area of...Submotorpool covered too limited an area , focusing mainly on the dispatching and driving of vehicles. The Transportation Resources Control Center/Transportation

Limitations and mechanisms influencing the migratory performance of soaring birds

Treesearch

Tricia A. Miller; Brooks Robert P.; Michael J. Lanzone; David Brandes; Jeff Cooper; Junior A. Tremblay; Jay Wilhelm; Adam Duerr; Todd E. Katzner

2016-01-01

Migration is costly in terms of time, energy and safety. Optimal migration theory suggests that individual migratory birds will choose between these three costs depending on their motivation and available resources. To test hypotheses about use of migratory strategies by large soaring birds, we used GPS telemetry to track 18 adult, 13 sub-adult and 15 juvenile Golden...

Effectiveness of a Mobile Short-Message-Service–Based Disease Outbreak Alert System in Kenya

PubMed Central

Njeru, Ian; Zurovac, Dejan; Tipo, Shikanga O; Kareko, David; Mwau, Matilu; Morita, Kouichi

2016-01-01

We conducted a randomized, controlled trial to test the effectiveness of a text-messaging system used for notification of disease outbreaks in Kenya. Health facilities that used the system had more timely notifications than those that did not (19.2% vs. 2.6%), indicating that technology can enhance disease surveillance in resource-limited settings. PMID:26981628

Adopting a Blended Learning Approach: Challenges Encountered and Lessons Learned in an Action Research Study

ERIC Educational Resources Information Center

Kenney, Jane; Newcombe, Ellen

2011-01-01

Adopting a new teaching approach is often a daunting task especially if one is an early adopter in a limited-resource environment. This article describes the challenges encountered and the strategies used in pilot testing a blended instructional method in a large size class within the college of education at a medium-sized university. The main…

A Low-Pressure Oxygen Storage System for Oxygen Supply in Low-Resource Settings.

PubMed

Rassool, Roger P; Sobott, Bryn A; Peake, David J; Mutetire, Bagayana S; Moschovis, Peter P; Black, Jim Fp

2017-12-01

Widespread access to medical oxygen would reduce global pneumonia mortality. Oxygen concentrators are one proposed solution, but they have limitations, in particular vulnerability to electricity fluctuations and failure during blackouts. The low-pressure oxygen storage system addresses these limitations in low-resource settings. This study reports testing of the system in Melbourne, Australia, and nonclinical field testing in Mbarara, Uganda. The system included a power-conditioning unit, a standard oxygen concentrator, and an oxygen store. In Melbourne, pressure and flows were monitored during cycles of filling/emptying, with forced voltage fluctuations. The bladders were tested by increasing pressure until they ruptured. In Mbarara, the system was tested by accelerated cycles of filling/emptying and then run on grid power for 30 d. The low-pressure oxygen storage system performed well, including sustaining a pressure approximately twice the standard working pressure before rupture of the outer bag. Flow of 1.2 L/min was continuously maintained to a simulated patient during 30 d on grid power, despite power failures totaling 2.9% of the total time, with durations of 1-176 min (mean 36.2, median 18.5). The low-pressure oxygen storage system was robust and durable, with accelerated testing equivalent to at least 2 y of operation revealing no visible signs of imminent failure. Despite power cuts, the system continuously provided oxygen, equivalent to the treatment of one child, for 30 d under typical power conditions for sub-Saharan Africa. The low-pressure oxygen storage system is ready for clinical field trials. Copyright © 2017 by Daedalus Enterprises.

[Human resource capacity building on TB laboratory work for TB control program--through the experience of international TB laboratory training course for TB control at the Research Institute of Tuberculosis, JATA, Japan].

PubMed

Fujiki, Akiko; Kato, Seiya

2008-06-01

The international training course on TB laboratory work for national tuberculosis program (NTP) has been conducted at the Research Institute of Tuberculosis since 1975 funded by Japan International Cooperation Agency in collaboration with WHO Western Pacific Regional Office. The aim of the course is to train key personnel in TB laboratory field for NTP in resource-limited countries. The course has trained 265 national key personnel in TB laboratory service from 57 resource-limited countries in the last 33 years. The number of participants trained may sound too small in the fight against the large TB problem in resource-limited countries. However, every participant is playing an important role as a core and catalyst for the TB control program in his/her own country when they were back home. The curriculum is composed of technical aspects on TB examination, mainly sputum microscopy in addition since microscopy service is provided at many centers that are deployed in a widely spread area, the managerial aspect of maintaining quality TB laboratory work at the field laboratory is another component of the curriculum. Effective teaching methods using materials such as artificial sputum, which is useful for panel slide preparation, and technical manuals with illustrations and pictures of training procedure have been developed through the experience of the course. These manuals are highly appreciated and widely used by the front line TB workers. The course has also contributed to the expansion of EQA (External Quality Assessment) system on AFB microscopy for the improvement of the quality of TB laboratory service of NTP. The course is well-known for not only having a long history, but also for its unique learning method emphasizing "Participatory Training", particularly for practicum sessions to master the skills on AFB microscopy. The method in learning AFB microscopy, which was developed by the course, was published as a training manual by IUATLD, RIT and USAID. As it is mentioned, the course has been contributing to human resource capacity building including management of laboratory service to improve NTP in the resource-limited countries. Currently, expansion of technology transfer on culture examination for drug susceptibility test has been attempted to the resource-limited countries due to the occurrence of MDR-TB (Multi drug-resistant tuberculosis) and XDR-TB (Extensively drug-resistant tuberculosis) cases. However, since sputum smear examination is most effective method of detection of infectious TB, the writers believe it is still a core component of TB control, unless a new diagnostic tool that is practicable and effective in the resource-limited countries is developed. Therefore the course will keep focused on the smear examination as the basic curriculum. The course is highly appreciated by international experts and it is our responsibility to answer the expectation from them.

Parallel Application Performance on Two Generations of Intel Xeon HPC Platforms

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

Chang, Christopher H.; Long, Hai; Sides, Scott

2015-10-15

Two next-generation node configurations hosting the Haswell microarchitecture were tested with a suite of microbenchmarks and application examples, and compared with a current Ivy Bridge production node on NREL" tm s Peregrine high-performance computing cluster. A primary conclusion from this study is that the additional cores are of little value to individual task performance--limitations to application parallelism, or resource contention among concurrently running but independent tasks, limits effective utilization of these added cores. Hyperthreading generally impacts throughput negatively, but can improve performance in the absence of detailed attention to runtime workflow configuration. The observations offer some guidance to procurement ofmore » future HPC systems at NREL. First, raw core count must be balanced with available resources, particularly memory bandwidth. Balance-of-system will determine value more than processor capability alone. Second, hyperthreading continues to be largely irrelevant to the workloads that are commonly seen, and were tested here, at NREL. Finally, perhaps the most impactful enhancement to productivity might occur through enabling multiple concurrent jobs per node. Given the right type and size of workload, more may be achieved by doing many slow things at once, than fast things in order.« less

Safety of stavudine in the treatment of HIV infection with a special focus on resource-limited settings.

PubMed

Makinson, Alain; Moing, Vincent Le; Kouanfack, Charles; Laurent, Christian; Delaporte, Eric

2008-05-01

Western randomized trials and prospective cohorts in resource-limited settings have proven virological success with stavudine-based highly active antiretroviral therapy. However, stavudine is no longer recommended in first-line treatments in these two settings due to its intrinsic toxicities and side effects. Yet it remains a cornerstone of treatment in resource-limited settings, due to lack of alternatives and its availability in generic fixed-dose combinations. To review the toxic effects of stavudine and their prevention and management strategies, especially in resource-limited settings. Data from clinical and pharmacological trials in Western countries, as well as prospective cohorts in resource-limited settings, were reviewed. Initiating or switching to less toxic nucleoside analogues whenever possible, or lowering stavudine doses to 30 mg b.i.d., is strongly recommended.

Effects of Motion in the Far Peripheral Visual Field on Cognitive Test Performance and Cognitive Load.

PubMed

Bevilacqua, Andy; Paas, Fred; Krigbaum, Genomary

2016-04-01

Cognitive load theory posits that limited attention is in actuality a limitation in working memory resources. The load theory of selective attention and cognitive control sees the interplay between attention and awareness as separate modifying functions that act on working memory. Reconciling the theoretical differences in these two theories has important implications for learning. Thirty-nine adult participants performed a cognitively demanding test, with and without movement in the far peripheral field. Although the results for movement effects on cognitive load in this experiment were not statistically significant, men spent less time on the cognitive test in the peripheral movement condition than in the conditions without peripheral movement. No such difference was found for women. The implications of these results and recommendations for future research that extends the present study are presented. © The Author(s) 2016.

Provision of genetics services on Guam.

PubMed

McWalter, Kirsty; Hasegawa, Lianne; Au, Sylvia Mann

2013-12-01

Guam's geographic isolation and lack of community resources have resulted in unique healthcare needs. In 2006, the Western States Genetic Services Collaborative (WSGSC) conducted a genetics needs assessment and found that professional development is limited, families lack access to genetic services, and improved coverage of genetic testing is needed. With funding from the WSGSC, a Guam genetics outreach clinic was established and staffed by genetic counselors and a medical geneticist from Hawaii. Four clinics have been held to date. Although several challenges have been encountered, including minimal coverage of genetic testing by Guam insurance companies, limited referrals for families with private insurance, and inappropriate referral indications, the outreach clinic has been successful at increasing access to genetic services and improving professional development. With more collaborative work by staff from Guam, Hawaii, and the WSGSC, provision and reimbursement of genetic services and testing will continue to improve.

How to get the most bang for your buck: the evolution and physiology of nutrition-dependent resource allocation strategies.

PubMed

Ng'oma, Enoch; Perinchery, Anna M; King, Elizabeth G

2017-06-28

All organisms use resources to grow, survive and reproduce. The supply of these resources varies widely across landscapes and time, imposing ultimate constraints on the maximal trait values for allocation-related traits. In this review, we address three key questions fundamental to our understanding of the evolution of allocation strategies and their underlying mechanisms. First, we ask: how diverse are flexible resource allocation strategies among different organisms? We find there are many, varied, examples of flexible strategies that depend on nutrition. However, this diversity is often ignored in some of the best-known cases of resource allocation shifts, such as the commonly observed pattern of lifespan extension under nutrient limitation. A greater appreciation of the wide variety of flexible allocation strategies leads directly to our second major question: what conditions select for different plastic allocation strategies? Here, we highlight the need for additional models that explicitly consider the evolution of phenotypically plastic allocation strategies and empirical tests of the predictions of those models in natural populations. Finally, we consider the question: what are the underlying mechanisms determining resource allocation strategies? Although evolutionary biologists assume differential allocation of resources is a major factor limiting trait evolution, few proximate mechanisms are known that specifically support the model. We argue that an integrated framework can reconcile evolutionary models with proximate mechanisms that appear at first glance to be in conflict with these models. Overall, we encourage future studies to: (i) mimic ecological conditions in which those patterns evolve, and (ii) take advantage of the 'omic' opportunities to produce multi-level data and analytical models that effectively integrate across physiological and evolutionary theory. © 2017 The Author(s).

National Assessment of Oil and Gas Project: geologic assessment of undiscovered gas hydrate resources on the North Slope, Alaska

USGS Publications Warehouse

USGS AK Gas Hydrate Assessment Team: Collett, Timothy S.; Agena, Warren F.; Lee, Myung Woong; Lewis, Kristen A.; Zyrianova, Margarita V.; Bird, Kenneth J.; Charpentier, Ronald R.; Cook, Troy A.; Houseknecht, David W.; Klett, Timothy R.; Pollastro, Richard M.

2014-01-01

Scientists with the U.S. Geological Survey have completed the first assessment of the undiscovered, technically recoverable gas hydrate resources beneath the North Slope of Alaska. This assessment indicates the existence of technically recoverable gas hydrate resources—that is, resources that can be discovered, developed, and produced using current technology. The approach used in this assessment followed standard geology-based USGS methodologies developed to assess conventional oil and gas resources. In order to use the USGS conventional assessment approach on gas hydrate resources, three-dimensional industry-acquired seismic data were analyzed. The analyses indicated that the gas hydrates on the North Slope occupy limited, discrete volumes of rock bounded by faults and downdip water contacts. This assessment approach also assumes that the resource can be produced by existing conventional technology, on the basis of limited field testing and numerical production models of gas hydrate-bearing reservoirs. The area assessed in northern Alaska extends from the National Petroleum Reserve in Alaska on the west through the Arctic National Wildlife Refuge on the east and from the Brooks Range northward to the State-Federal offshore boundary (located 3 miles north of the coastline). This area consists mostly of Federal, State, and Native lands covering 55,894 square miles. Using the standard geology-based assessment methodology, the USGS estimated that the total undiscovered technically recoverable natural-gas resources in gas hydrates in northern Alaska range between 25.2 and 157.8 trillion cubic feet, representing 95 percent and 5 percent probabilities of greater than these amounts, respectively, with a mean estimate of 85.4 trillion cubic feet.

How to get the most bang for your buck: the evolution and physiology of nutrition-dependent resource allocation strategies

PubMed Central

2017-01-01

All organisms use resources to grow, survive and reproduce. The supply of these resources varies widely across landscapes and time, imposing ultimate constraints on the maximal trait values for allocation-related traits. In this review, we address three key questions fundamental to our understanding of the evolution of allocation strategies and their underlying mechanisms. First, we ask: how diverse are flexible resource allocation strategies among different organisms? We find there are many, varied, examples of flexible strategies that depend on nutrition. However, this diversity is often ignored in some of the best-known cases of resource allocation shifts, such as the commonly observed pattern of lifespan extension under nutrient limitation. A greater appreciation of the wide variety of flexible allocation strategies leads directly to our second major question: what conditions select for different plastic allocation strategies? Here, we highlight the need for additional models that explicitly consider the evolution of phenotypically plastic allocation strategies and empirical tests of the predictions of those models in natural populations. Finally, we consider the question: what are the underlying mechanisms determining resource allocation strategies? Although evolutionary biologists assume differential allocation of resources is a major factor limiting trait evolution, few proximate mechanisms are known that specifically support the model. We argue that an integrated framework can reconcile evolutionary models with proximate mechanisms that appear at first glance to be in conflict with these models. Overall, we encourage future studies to: (i) mimic ecological conditions in which those patterns evolve, and (ii) take advantage of the ‘omic’ opportunities to produce multi-level data and analytical models that effectively integrate across physiological and evolutionary theory. PMID:28637856

Evaluation of a Music Therapy Social Skills Development Program for Youth with Limited Resources.

PubMed

Pasiali, Varvara; Clark, Cherie

2018-05-21

Children living in low-resource communities are at risk for poorer socio-emotional development and academic performance. Emerging evidence supports use of group music therapy experiences to support social development through community afterschool programming. To examine the potential benefit of a music therapy social skills development program to improve social skills and academic performance of school-aged children with limited resources in an afterschool program. We used a single-group pre/post-test design, and recruited 20 students (11 females, 9 males), ages 5 to 11 years, from an afterschool program. The music therapy social skills program consisted of eight 50-minute sessions, and we measured social competence and antisocial behavior using the Home & Community Social Behavioral Scale (HCSBS; Merrell & Caldarella, 2008), and social skills, problem behaviors, and academic competence using the Social Skills Improvement System (SSIS; Gresham & Elliot, 2008a, 2008b). Only students who attended a minimum of six sessions (N = 14) were included in data analysis. Results showed no significant change in individual HBSC subscale scores; however, the total number of low-performance/high-risk skills significantly decreased. SSIS teacher results indicated significant improvement in communication, significant decrease of hyperactivity, autistic behavioral tendencies and overall problem behaviors, and marginal decreases in internalization. Parent ratings mirrored, in part, those of the teacher. Results indicated that music therapy has the potential of being an effective intervention for promoting social competence of school-aged children with limited resources, particularly in the areas of communication and low-performance/high-risk behaviors. Teaching skills through song lyrics and improvisation emerged as salient interventions.

Integration and Test for Small Shuttle Payloads

NASA Technical Reports Server (NTRS)

Wright, Michael R.; Day, John H. (Technical Monitor)

2001-01-01

Recommended approaches for shuttle small payload integration and test (I&T) are presented. The paper is intended for consideration by developers of small shuttle payloads, including I&T managers, project managers, and system engineers. Examples and lessons learned are presented based on the extensive history of the NASA's Hitchhiker project. All aspects of I&T are presented, including: (1) I&T team responsibilities, coordination, and communication; (2) Flight hardware handling practices; (3) Documentation and configuration management; (4) I&T considerations for payload development; (5) I&T at the development facility; (6) Prelaunch operations, transfer, orbiter integration, and interface testing; and (7) Postflight operations. This paper is of special interest to those payload projects which have small budgets and few resources: That is, the truly 'faster, cheaper, better' projects. All shuttle small payload developers are strongly encouraged to apply these guidelines during I&T planning and ground operations to take full advantage of today's limited resources and to help ensure mission success.

18 CFR 701.205 - Time limit for requester to appeal an initial adverse determination.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true Time limit for requester to appeal an initial adverse determination. 701.205 Section 701.205 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Availability of Information § 701.205 Time limit for...

Multispectral Resource Sampler Workshop

NASA Technical Reports Server (NTRS)

1979-01-01

The utility of the multispectral resource sampler (MRS) was examined by users in the following disciplines: agriculture, atmospheric studies, engineering, forestry, geology, hydrology/oceanography, land use, and rangelands/soils. Modifications to the sensor design were recommended and the desired types of products and number of scenes required per month were indicated. The history, design, capabilities, and limitations of the MRS are discussed as well as the multilinear spectral array technology which it uses. Designed for small area inventory, the MRS can provide increased temporal, spectral, and spatial resolution, facilitate polarization measurement and atmospheric correction, and test onboard data compression techniques. The advantages of using it along with the thematic mapper are considered.

Distribution, behavior, and condition of herbivorous fishes on coral reefs track algal resources.

PubMed

Tootell, Jesse S; Steele, Mark A

2016-05-01

Herbivore distribution can impact community structure and ecosystem function. On coral reefs, herbivores are thought to play an important role in promoting coral dominance, but how they are distributed relative to algae is not well known. Here, we evaluated whether the distribution, behavior, and condition of herbivorous fishes correlated with algal resource availability at six sites in the back reef environment of Moorea, French Polynesia. Specifically, we tested the hypotheses that increased algal turf availability would coincide with (1) increased biomass, (2) altered foraging behavior, and (3) increased energy reserves of herbivorous fishes. Fish biomass and algal cover were visually estimated along underwater transects; behavior of herbivorous fishes was quantified by observations of focal individuals; fish were collected to assess their condition; and algal turf production rates were measured on standardized tiles. The best predictor of herbivorous fish biomass was algal turf production, with fish biomass increasing with algal production. Biomass of herbivorous fishes was also negatively related to sea urchin density, suggesting competition for limited resources. Regression models including both algal turf production and urchin density explained 94 % of the variation in herbivorous fish biomass among sites spread over ~20 km. Behavioral observations of the parrotfish Chlorurus sordidus revealed that foraging area increased as algal turf cover decreased. Additionally, energy reserves increased with algal turf production, but declined with herbivorous fish density, implying that algal turf is a limited resource for this species. Our findings support the hypothesis that herbivorous fishes can spatially track algal resources on coral reefs.

An improved resource management model based on MDS

NASA Astrophysics Data System (ADS)

Yuan, Man; Sun, Changying; Li, Pengfei; Sun, Yongdong; He, Rui

2005-11-01

GRID technology provides a kind of convenient method for managing GRID resources. This service is so-called monitoring, discovering service. This method is proposed by Globus Alliance, in this GRID environment, all kinds of resources, such as computational resources, storage resources and other resources can be organized by MDS specifications. However, this MDS is a theory framework, particularly, in a small world intranet, in the case of limit of resources, the MDS has its own limitation. Based on MDS, an improved light method for managing corporation computational resources and storage resources is proposed in intranet(IMDS). Firstly, in MDS, all kinds of resource description information is stored in LDAP, it is well known although LDAP is a light directory access protocol, in practice, programmers rarely master how to access and store resource information into LDAP store, in such way, it limits MDS to be used. So, in intranet, these resources' description information can be stored in RDBMS, programmers and users can access this information by standard SQL. Secondly, in MDS, how to monitor all kinds of resources in GRID is not transparent for programmers and users. In such way, it limits its application scope, in general, resource monitoring method base on SNMP is widely employed in intranet, therefore, a kind of resource monitoring method based on SNMP is integrated into MDS. Finally, all kinds of resources in the intranet can be described by XML, and all kinds of resources' description information is stored in RDBMS, such as MySql, and retrieved by standard SQL, dynamic information for all kinds of resources can be sent to resource storage by SNMP, A prototype resource description, monitoring is designed and implemented in intranet.

From waste to resource: a systems-based approach to sustainable community development through equitable enterprise and agriculturally-derived polymeric composites

NASA Astrophysics Data System (ADS)

Teipel, Elisa

Rural communities in developing countries are most vulnerable to the plight of requiring repeated infusions of charitable aid over time. Micro-business opportunities that effectively break the cycle of poverty in resource-rich countries in the developing world are limited. However, a strong model for global commerce can break the cycle of donor-based economic supplements and limited local economic growth. Sustainable economic development can materialize when a robust framework combines engineering with the generous investment of profits back into the community. This research presents a novel, systems-based approach to sustainable community development in which a waste-to-resource methodology catalyzes the disruption of rural poverty. The framework developed in this thesis was applied to the rural communities of Cagmanaba and Badian, Philippines. An initial assessment of these communities showed that community members are extremely poor, but they possess an abundant natural resource: coconuts. The various parts of the coconut offer excellent potential value in global commerce. Today the sale of coconut water is on the rise, and coconut oil is an established $3 billion market annually that is also growing rapidly. Since these current industries harvest only two parts of the coconut (meat and water), the 50 billion coconuts that grow annually leave behind approximately 100 billion pounds of coconut shell and husk as agricultural waste. Coconuts thus provide an opportunity to create and test a waste-to-resource model. Intensive materials analysis, research, development, and optimization proved that coconut shell, currently burned as a fuel or discarded as agricultural waste, can be manufactured into high-grade coconut shell powder (CSP), which can be a viable filler in polymeric composites. This framework was modeled and tested as a case study in a manufacturing facility known as a Community Transformation Plant (CTP) in Cagmanaba, Philippines. The CTP enables local creation of globally viable products from agricultural waste. This researcher seeks to encourage the propagation of CTPs throughout developing communities worldwide, each profiting from its own waste-to-resource value.

Eye-tracking-based assessment of cognitive function in low-resource settings.

PubMed

Forssman, Linda; Ashorn, Per; Ashorn, Ulla; Maleta, Kenneth; Matchado, Andrew; Kortekangas, Emma; Leppänen, Jukka M

2017-04-01

Early development of neurocognitive functions in infants can be compromised by poverty, malnutrition and lack of adequate stimulation. Optimal management of neurodevelopmental problems in infants requires assessment tools that can be used early in life, and are objective and applicable across economic, cultural and educational settings. The present study examined the feasibility of infrared eye tracking as a novel and highly automated technique for assessing visual-orienting and sequence-learning abilities as well as attention to facial expressions in young (9-month-old) infants. Techniques piloted in a high-resource laboratory setting in Finland (N=39) were subsequently field-tested in a community health centre in rural Malawi (N=40). Parents' perception of the acceptability of the method (Finland 95%, Malawi 92%) and percentages of infants completing the whole eye-tracking test (Finland 95%, Malawi 90%) were high, and percentages of valid test trials (Finland 69-85%, Malawi 68-73%) satisfactory at both sites. Test completion rates were slightly higher for eye tracking (90%) than traditional observational tests (87%) in Malawi. The predicted response pattern indicative of specific cognitive function was replicated in Malawi, but Malawian infants exhibited lower response rates and slower processing speed across tasks. High test completion rates and the replication of the predicted test patterns in a novel environment in Malawi support the feasibility of eye tracking as a technique for assessing infant development in low-resource setting. Further research is needed to the test-retest stability and predictive validity of the eye-tracking scores in low-income settings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Impact of organizational factors on adherence to laboratory testing protocols in adult HIV care in Lusaka, Zambia.

PubMed

Deo, Sarang; Topp, Stephanie M; Westfall, Andrew O; Chiko, Matimbo M; Wamulume, Chibesa S; Morris, Mary; Reid, Stewart

2012-05-02

Previous operational research studies have demonstrated the feasibility of large-scale public sector ART programs in resource-limited settings. However, organizational and structural determinants of quality of care have not been studied. We estimate multivariate regression models using data from 13 urban HIV treatment facilities in Zambia to assess the impact of structural determinants on health workers' adherence to national guidelines for conducting laboratory tests such as CD4, hemoglobin and liver function and WHO staging during initial and follow-up visits as part of Zambian HIV care and treatment program. CD4 tests were more routinely ordered during initial history and physical (IHP) than follow-up (FUP) visits (93.0 % vs. 85.5 %; p < 0.01). More physical space, higher staff turnover and greater facility experience with ART was associated with greater odds of conducting tests. Higher staff experience decreased the odds of conducting CD4 tests in FUP (OR 0.93; p < 0.05) and WHO staging in IHP visit (OR 0.90; p < 0.05) but increased the odds of conducting hemoglobin test in IHP visit (OR 1.05; p < 0.05). Higher staff burnout increased the odds of conducting CD4 test during FUP (OR 1.14; p < 0.05) but decreased the odds of conducting hemoglobin test in IHP visit (0.77; p < 0.05) and CD4 test in IHP visit (OR 0.78; p < 0.05). Physical space plays an important role in ensuring high quality care in resource-limited setting. In the context of protocolized care, new staff members are likely to be more diligent in following the protocol verbatim rather than relying on memory and experience thereby improving adherence. Future studies should use prospective data to confirm the findings reported here.

Testing the efficiency of rover science protocols for robotic sample selection: A GeoHeuristic Operational Strategies Test

NASA Astrophysics Data System (ADS)

Yingst, R. A.; Bartley, J. K.; Chidsey, T. C.; Cohen, B. A.; Gilleaudeau, G. J.; Hynek, B. M.; Kah, L. C.; Minitti, M. E.; Williams, R. M. E.; Black, S.; Gemperline, J.; Schaufler, R.; Thomas, R. J.

2018-05-01

The GHOST field tests are designed to isolate and test science-driven rover operations protocols, to determine best practices. During a recent field test at a potential Mars 2020 landing site analog, we tested two Mars Science Laboratory data-acquisition and decision-making methods to assess resulting science return and sample quality: a linear method, where sites of interest are studied in the order encountered, and a "walkabout-first" method, where sites of interest are examined remotely before down-selecting to a subset of sites that are interrogated with more resource-intensive instruments. The walkabout method cost less time and fewer resources, while increasing confidence in interpretations. Contextual data critical to evaluating site geology was acquired earlier than for the linear method, and given a higher priority, which resulted in development of more mature hypotheses earlier in the analysis process. Combined, this saved time and energy in the collection of data with more limited spatial coverage. Based on these results, we suggest that the walkabout method be used where doing so would provide early context and time for the science team to develop hypotheses-critical tests; and that in gathering context, coverage may be more important than higher resolution.

The Tanzania experience: clinical laboratory testing harmonization and equipment standardization at different levels of a tiered health laboratory system.

PubMed

Massambu, Charles; Mwangi, Christina

2009-06-01

The rapid scale-up of the care and treatment programs in Tanzania during the preceding 4 years has greatly increased the demand for quality laboratory services for diagnosis of HIV and monitoring patients during antiretroviral therapy. Laboratory services were not in a position to cope with this demand owing to poor infrastructure, lack of human resources, erratic and/or lack of reagent supply and commodities, and slow manual technologies. With the limited human resources in the laboratory and the need for scaling up the care and treatment program, it became necessary to install automated equipment and train personnel for the increased volume of testing and new tests across all laboratory levels. With the numerous partners procuring equipment, the possibility of a multitude of equipment platforms with attendant challenges for procurement of reagents, maintenance of equipment, and quality assurance arose. Tanzania, therefore, had to harmonize laboratory tests and standardize laboratory equipment at different levels of the laboratory network. The process of harmonization of tests and standardization of equipment included assessment of laboratories, review of guidelines, development of a national laboratory operational plan, and stakeholder advocacy. This document outlines this process.

Microbial limitation in a changing world: A stoichiometric approach for predicting microbial resource limitation and fluxes

NASA Astrophysics Data System (ADS)

Midgley, M.; Phillips, R.

2014-12-01

Microbes mediate fluxes of carbon (C), nitrogen (N), and phosphorus (P) in soils depending on ratios of available C, N, and P relative to microbial demand. Hence, characterizing microbial C and nutrient limitation in soils is critical for predicting how ecosystems will respond to human alterations of climate and nutrient availability. Here, we take a stoichiometric approach to assessing microbial C, N, and P limitation by using threshold element ratios (TERs). TERs enable shifting resource limitation to be assessed by matching C, N and P ratios from microbial biomass, extracellular enzyme activities, and soil nutrient concentrations. We assessed microbial nutrient limitation in temperate forests dominated by trees that associate with one of two mycorrhizal symbionts: arbsucular mycorrhizal (AM) or ectomycorrhizal (ECM) fungi. We found that both ECM and AM microbial communities were co-limited by C and N, supporting conventional wisdom that microbes are C-limited and temperate forests are N-limited. However, AM microbial communities were relatively more C-limited than ECM communities (P=0.001). In response to chronic field N fertilization, both AM and ECM communities became relatively more P-limited (P=0.011), but they remained N- and C-limited overall. Thus, realistic levels of N deposition may not dampen microbial N limitation. Reflecting differences in relative limitation, N mineralization rates were higher in AM soils than in ECM soils (P=0.004) while C mineralization rates were higher in ECM soils than in AM soils (P=0.023). There were no significant differences in P flux between AM and ECM soils or detectable mineralization responses to N addition, indicating that mineralization rates are closely tied to C and nutrient limitation. Overall, we found that 1) microbial resource limitation can be detected without resource addition; and 2) TERs and ratios of labile resources are viable tools for predicting mineralization responses to resource additions.

Consumer interaction strength may limit the diversifying effect of intraspecific competition: a test in alewife (Alosa pseudoharengus).

PubMed

Jones, Andrew W; Post, David M

2013-06-01

Intraspecific competition is considered a principal driver of dietary variation, but empirical studies provide mixed support for this mechanism. Here we link comparative and experimental work testing the effects of competition and resource availability on the dietary variation of the alewife (Alosa pseudoharengus). The alewife, a consumer with extreme effects on its resources, was specifically utilized to additionally test the idea that strong interactions between a consumer and its resources can diminish the diversifying effect of competition. First, we compared the short- and long-term diet measures of wild populations across a wide range of densities. Second, in a pair of large-scale field mesocosm experiments, we explored the influence of competition and interaction strength on alewife dietary variation. Results from a whole-lake comparison and field experiments indicated that increasing competition was negatively correlated with population dietary variation. Further, altering the strength of the interaction between the alewife and its prey via prey supplementation eliminated this negative relationship. Collectively, our results suggest that competitive interactions may not drive dietary diversification in the alewife and, potentially, in other highly effective consumers. Our results also indicate that further consideration of the strength of species interactions (and the consumer traits that underlie them) would improve our understanding of the link between intraspecific competition and variation.

A multi-trait test of the leaf-height-seed plant strategy scheme with 133 species from a pine forest flora

Treesearch

Daniel C. Laughlin; Jessica J. Leppert; Margaret M. Moore; Carolyn Hull Sieg

2010-01-01

Plants are multifaceted organisms that have evolved ecological strategies for sustaining populations in resource-limited environments (Grime 1979; Craine 2009). Plant strategies can be quantified by measuring functional traits (Grime et al. 1997; Reich et al. 2003), which are the properties of plants that impact plant fitness (Violle et al. 2008) and ecosystem...

Development and Dematerialization: An International Study

PubMed Central

Steinberger, Julia K.; Krausmann, Fridolin; Getzner, Michael; Schandl, Heinz; West, Jim

2013-01-01

Economic development and growth depend on growing levels of resource use, and result in environmental impacts from large scale resource extraction and emissions of waste. In this study, we examine the resource dependency of economic activities over the past several decades for a set of countries comprising developing, emerging and mature industrialized economies. Rather than a single universal industrial development pathway, we find a diversity of economic dependencies on material use, made evident through cluster analysis. We conduct tests for relative and absolute decoupling of the economy from material use, and compare these with similar tests for decoupling from carbon emissions, both for single countries and country groupings using panel analysis. We show that, over the longer term, emerging and developing countries tend to have significantly larger material-economic coupling than mature industrialized economies (although this effect may be enhanced by trade patterns), but that the contrary is true for short-term coupling. Moreover, we demonstrate that absolute dematerialization limits economic growth rates, while the successful industrialization of developing countries inevitably requires a strong material component. Alternative development priorities are thus urgently needed both for mature and emerging economies: reducing absolute consumption levels for the former, and avoiding the trap of resource-intensive economic and human development for the latter. PMID:24204555

Role of co-occurring competition and facilitation in plant spacing hydrodynamics in water-limited environments

PubMed Central

2017-01-01

Plant performance (i.e., fecundity, growth, survival) depends on an individual’s access to space and resources. At the community level, plant performance is reflected in observable vegetation patterning (i.e., spacing distance, density) often controlled by limiting resources. Resource availability is, in turn, strongly dependent on plant patterning mediated by competitive and facilitative plant–plant interactions. Co-occurring competition and facilitation has never been specifically investigated from a hydrodynamic perspective. To address this knowledge gap, and to overcome limitations of field studies, three intermediate-scale laboratory experiments were conducted using a climate-controlled wind tunnel–porous media test facility to simulate the soil–plant–atmosphere continuum. The spacing between two synthetic plants, a design consideration introduced by the authors in a recent publication, was varied between experiments; edaphic and mean atmospheric conditions were held constant. The strength of the above- and belowground plant–plant interactions changed with spacing distance, allowing the creation of a hydrodynamic conceptual model based on established ecological theories. Greatest soil water loss was observed for the experiment with the smallest spacing where competition dominated. Facilitation dominated at the intermediate spacing; little to no interactions were observed for the largest plant spacing. Results suggest that there exists an optimal spacing distance range that lowers plant environmental stress, thus improving plant performance through reduced atmospheric demand and conservation of available soil water. These findings may provide a foundation for improving our understanding of many climatological, ecohydrological, and hydrological problems pertaining to the hydrodynamics of water-limited environments where plant–plant interactions and community self-organization are important. PMID:28807999

Role of co-occurring competition and facilitation in plant spacing hydrodynamics in water-limited environments.

PubMed

Trautz, Andrew C; Illangasekare, Tissa H; Rodriguez-Iturbe, Ignacio

2017-08-29

Plant performance (i.e., fecundity, growth, survival) depends on an individual's access to space and resources. At the community level, plant performance is reflected in observable vegetation patterning (i.e., spacing distance, density) often controlled by limiting resources. Resource availability is, in turn, strongly dependent on plant patterning mediated by competitive and facilitative plant-plant interactions. Co-occurring competition and facilitation has never been specifically investigated from a hydrodynamic perspective. To address this knowledge gap, and to overcome limitations of field studies, three intermediate-scale laboratory experiments were conducted using a climate-controlled wind tunnel-porous media test facility to simulate the soil-plant-atmosphere continuum. The spacing between two synthetic plants, a design consideration introduced by the authors in a recent publication, was varied between experiments; edaphic and mean atmospheric conditions were held constant. The strength of the above- and belowground plant-plant interactions changed with spacing distance, allowing the creation of a hydrodynamic conceptual model based on established ecological theories. Greatest soil water loss was observed for the experiment with the smallest spacing where competition dominated. Facilitation dominated at the intermediate spacing; little to no interactions were observed for the largest plant spacing. Results suggest that there exists an optimal spacing distance range that lowers plant environmental stress, thus improving plant performance through reduced atmospheric demand and conservation of available soil water. These findings may provide a foundation for improving our understanding of many climatological, ecohydrological, and hydrological problems pertaining to the hydrodynamics of water-limited environments where plant-plant interactions and community self-organization are important.

Cyber Foraging for Improving Survivability of Mobile Systems

DTIC Science & Technology

2016-02-10

environments—such as dynamic context, limited computing resources, disconnected- intermittent - limited (DIL) network connectivity, and high levels of stress...environments, such as dynamic context, limited computing resources, disconnected- intermittent -limited (DIL) network connectivity, and high levels of...Table 1: Mapping of Cloudlet Features to Survivability Requirements Threats Intermittent Cloudlet- Enterprise Connectivity Mobility Limited

The investigation and implementation of real-time face pose and direction estimation on mobile computing devices

NASA Astrophysics Data System (ADS)

Fu, Deqian; Gao, Lisheng; Jhang, Seong Tae

2012-04-01

The mobile computing device has many limitations, such as relative small user interface and slow computing speed. Usually, augmented reality requires face pose estimation can be used as a HCI and entertainment tool. As far as the realtime implementation of head pose estimation on relatively resource limited mobile platforms is concerned, it is required to face different constraints while leaving enough face pose estimation accuracy. The proposed face pose estimation method met this objective. Experimental results running on a testing Android mobile device delivered satisfactory performing results in the real-time and accurately.

Implementation of data node in spatial information grid based on WS resource framework and WS notification

NASA Astrophysics Data System (ADS)

Zhang, Dengrong; Yu, Le

2006-10-01

Abstract-An approach of constructing a data node in spatial information grid (SIG) based on Web Service Resource Framework (WSRF) and Web Service Notification (WSN) is described in this paper. Attentions are paid to construct and implement SIG's resource layer, which is the most important part. A study on this layer find out, it is impossible to require persistent interaction with the clients of the services in common SIG architecture because of inheriting "stateless" and "not persistent" limitations of Web Service. A WSRF/WSN-based data node is designed to hurdle this short comes. Three different access modes are employed to test the availability of this node. Experimental results demonstrate this service node can successfully respond to standard OGC requests and returns specific spatial data in different network environment, also is stateful, dynamic and persistent.

The (non-)replicability of regulatory resource depletion: A field report employing non-invasive brain stimulation

PubMed Central

Martijn, Carolien; Alberts, Hugo J. E. M.; Thomson, Alix C.; David, Bastian; Kessler, Daniel

2017-01-01

Cognitive effort and self-control are exhausting. Although evidence is ambiguous, behavioural studies have repeatedly suggested that control-demanding tasks seem to deplete a limited cache of self-regulatory resources leading to performance degradations and fatigue. While resource depletion has indirectly been associated with a decline in right prefrontal cortex capacity, its precise neural underpinnings have not yet been revealed. This study consisted of two independent experiments, which set out to investigate the causal role of the right dorsolateral prefrontal cortex (DLPFC) in a classic dual phase depletion paradigm employing non-invasive brain stimulation. In Experiment 1 we demonstrated a general depletion effect, which was significantly eliminated by anodal transcranial Direct Current Stimulation to the right DLPFC. In Experiment 2, however, we failed to replicate the basic psychological depletion effect within a second independent sample. The dissimilar results are discussed in the context of the current ‘replication crisis’ and suggestions for future studies are offered. While our current results do not allow us to firmly argue for or against the existence of resource depletion, we outline why it is crucial to further clarify which specific external and internal circumstances lead to limited replicability of the described effect. We showcase and discuss the current inter-lab replication problem based on two independent samples tested within one research group (intra-lab). PMID:28362843

Characterization and application of shape-changing panels with embedded rubber muscle actuators

NASA Astrophysics Data System (ADS)

Peel, Larry D.; Molina, Enrique, Jr.; Baur, Jeffery W.; Justice, Ryan S.

2013-09-01

Cylindrical soft actuators efficiently convert fluid pressure into mechanical energy and thus offer excellent force-to-weight ratios while behaving similar to biological muscle. McKibben-like rubber muscle actuators (RMAs) were embedded into neat elastomer and act as shape-changing panels. The effect of actuator spacing and modeling methods on the performance of these panels was investigated. Simulations from nonlinear finite element models were compared with results from test panels containing four RMAs that were spaced 0, 1/2, 1, and 1.3 RMA diameters apart. Nonlinear ‘laminated plate’ and ‘rod & plate’ finite element (FE) models of individual (non-embedded) RMAs and panels with embedded RMAs were developed. Due to model complexity and resource limitations, several simplified 2D and 3D FE model types, including a 3D ‘Unit Cell’ were created. After subtracting the ‘activation pressure’ needed to initiate contraction, all the models for the individual actuators produced forces consistent with experimental values, but only the more resource-intensive rod & plate models replicated fiber/braid re-orientation and produced more realistic values for actuator contraction. For panel models, the Full 3D rod & plate model appeared to be the most accurate for panel contraction and force, but was not completed for all configurations due to resource limitations. Most embedded panel FE models produced maximum panel actuator force and maximum contraction when the embedded actuators are spaced between 1/2 and 1 diameter apart. Seven panels with embedded RMAs were experimentally fabricated and tested. Panel tests confirmed that maximum or optimal performance occurs when the RMAs are spaced between 1/2 and 1 diameter apart. The tested actuator force was fairly constant in this range, suggesting that minor design or manufacturing differences may not significantly affect panel performance. However, the amount of axial force and contraction decreases significantly at greater than optimal spacing. This multi-faceted work provides useful design, simulation fabrication, and test characteristics for shape-adaptive panels. Bending panels were demonstrated but not modeled. Developers of future shape-adaptive air vehicles have been provided with additional simulation and design tools.

An analysis of factors affecting participation behavior of limited resource farmers in agricultural cost-share programs in Alabama

Treesearch

Okwudili Onianwa; Gerald Wheelock; Buddhi Gyawali; Jianbang Gan; Mark Dubois; John Schelhas

2004-01-01

This study examines factors that affect the participation behavior of limited resource farmers in agricultural cost-share programs in Alabama. The data were generated from a survey administered to a sample of limited resource farm operators. A binary logit model was employed to analyze the data. Results indicate that college education, age, gross sales, ratio of owned...

Reaching Families and Youth Who Have Limited Resources. Proceedings of a Conference for Educators and Practitioners in Family, Youth and Community Development (Columbus, Ohio, September 16-17, 1992).

ERIC Educational Resources Information Center

Spiegel, Marilyn R., Ed.; Safrit, R. Dale, Ed.

These conference proceedings contain abstracts of papers or complete papers that were submitted for presentation, along with descriptions of all workshops from a conference on reaching families and youths who have limited resources. The following are included: "Volunteerism and Limited Resource Audiences" (Safrit, Smith); "Cultural Do's and…

Cue-induced smoking urges deplete cigarette smokers' self-control resources.

PubMed

Hagger, Martin S; Leaver, Eamonn; Esser, Kerstin; Leung, Chung-Ming; Te Pas, Nina; Keatley, David A; Chan, Derwin K-C; Chatzisarantis, Nikos L D

2013-12-01

Exposure to smoking-related cues leads to increased urge to smoke in regular cigarette smokers and resisting these urges requires considerable self-control. Adopting a resource depletion model, two studies tested the hypothesis that resisting smoking urges depletes self-control resources. Adopting a within-participants randomized cross-over design, participants (study 1, N = 19; study 2, N = 32) were exposed to smoking-related (study 1: smoking images; study 2: cigarette cue-exposure task) and neutral (study 1: neutral images; study 2: drinking-straw task) cues with presentation order randomized. After each cue set, participants completed self-control tasks (study 1: handgrip task; study 2: handgrip and Stroop tasks), performance on which constituted dependent measures of self-control. Self-control task performance was significantly impaired when exposed to smoking-related cues compared to neutral cues. No significant presentation-order effects, or interaction effects between stimulus and presentation order, were found. Findings corroborate our hypothesis that resisting smoking urges depletes cigarette smokers' self-control resources and suggests that self-control capacity is governed by a limited resource.

Competition explains limited attention and perceptual resources: implications for perceptual load and dilution theories.

PubMed

Scalf, Paige E; Torralbo, Ana; Tapia, Evelina; Beck, Diane M

2013-01-01

Both perceptual load theory and dilution theory purport to explain when and why task-irrelevant information, or so-called distractors are processed. Central to both explanations is the notion of limited resources, although the theories differ in the precise way in which those limitations affect distractor processing. We have recently proposed a neurally plausible explanation of limited resources in which neural competition among stimuli hinders their representation in the brain. This view of limited capacity can also explain distractor processing, whereby the competitive interactions and bias imposed to resolve the competition determine the extent to which a distractor is processed. This idea is compatible with aspects of both perceptual load and dilution models of distractor processing, but also serves to highlight their differences. Here we review the evidence in favor of a biased competition view of limited resources and relate these ideas to both classic perceptual load theory and dilution theory.

Resource Management in Constrained Dynamic Situations

NASA Astrophysics Data System (ADS)

Seok, Jinwoo

Resource management is considered in this dissertation for systems with limited resources, possibly combined with other system constraints, in unpredictably dynamic environments. Resources may represent fuel, power, capabilities, energy, and so on. Resource management is important for many practical systems; usually, resources are limited, and their use must be optimized. Furthermore, systems are often constrained, and constraints must be satisfied for safe operation. Simplistic resource management can result in poor use of resources and failure of the system. Furthermore, many real-world situations involve dynamic environments. Many traditional problems are formulated based on the assumptions of given probabilities or perfect knowledge of future events. However, in many cases, the future is completely unknown, and information on or probabilities about future events are not available. In other words, we operate in unpredictably dynamic situations. Thus, a method is needed to handle dynamic situations without knowledge of the future, but few formal methods have been developed to address them. Thus, the goal is to design resource management methods for constrained systems, with limited resources, in unpredictably dynamic environments. To this end, resource management is organized hierarchically into two levels: 1) planning, and 2) control. In the planning level, the set of tasks to be performed is scheduled based on limited resources to maximize resource usage in unpredictably dynamic environments. In the control level, the system controller is designed to follow the schedule by considering all the system constraints for safe and efficient operation. Consequently, this dissertation is mainly divided into two parts: 1) planning level design, based on finite state machines, and 2) control level methods, based on model predictive control. We define a recomposable restricted finite state machine to handle limited resource situations and unpredictably dynamic environments for the planning level. To obtain a policy, dynamic programing is applied, and to obtain a solution, limited breadth-first search is applied to the recomposable restricted finite state machine. A multi-function phased array radar resource management problem and an unmanned aerial vehicle patrolling problem are treated using recomposable restricted finite state machines. Then, we use model predictive control for the control level, because it allows constraint handling and setpoint tracking for the schedule. An aircraft power system management problem is treated that aims to develop an integrated control system for an aircraft gas turbine engine and electrical power system using rate-based model predictive control. Our results indicate that at the planning level, limited breadth-first search for recomposable restricted finite state machines generates good scheduling solutions in limited resource situations and unpredictably dynamic environments. The importance of cooperation in the planning level is also verified. At the control level, a rate-based model predictive controller allows good schedule tracking and safe operations. The importance of considering the system constraints and interactions between the subsystems is indicated. For the best resource management in constrained dynamic situations, the planning level and the control level need to be considered together.

Travel-associated acquisition of hepatitis C virus infection in patients receiving haemodialysis.

PubMed

Ghafur, Abdul; Raza, Muhammad; Labbett, Wendy; Chawla, Anuradha; Smith, Colette; Ngui, Siew Lin; Davenport, Andrew; Geretti, Anna Maria

2007-09-01

It has been proposed that hepatitis C virus (HCV)-infected patients with end-stage renal disease undergoing maintenance haemodialysis may lack HCV antibody (anti-HCV) despite chronic HCV viraemia. This carries important implications for the design of surveillance policies. To characterize the prevalence of antibody-negative/RNA-positive HCV infection, patients attending seven haemodialysis units underwent anti-HCV testing using a third-generation assay and HCV RNA testing using real-time PCR. At screening, anti-HCV prevalence was 12/360 (3.3%; 95% CI 1.7-5.8%); 7/12 (58.3%) anti-HCV positive samples were HCV RNA positive. Among anti-HCV-negative samples, 2/348 (0.6%; 95% CI 0.2-2.1%) tested HCV RNA positive (genotype 1a). Retrospective testing of stored sera dated the infections to a period of holiday in the Indian subcontinent. The two infections were unrelated by HCV-NS5B sequencing. Only one of the two newly infected persons showed raised transaminases. Both developed anti-HCV within 8-13 weeks of follow-up. Prospective surveillance of travellers to resource-limited countries returning to the units showed a HCV incidence of 4/153 travel episodes (2.6%; 95% CI 0.7-6.6%) among 131 persons (3.1%; 95% CI 0.8-7.6%). Among haemodialysis patients in the United Kingdom, antibody-negative/RNA-positive HCV status is associated with newly acquired infection, rather than lack of antibody responses in chronic HCV infection. There is a significant risk of HCV infection associated with travel to resource-limited countries. Given that transaminase levels may be normal, HCV RNA testing is recommended in patients re-entering a dialysis unit following haemodialysis in settings where suboptimal infection control policies pose a risk of exposure to blood-borne viruses.

Evaluation of a Newly Developed Lateral Flow Immunoassay for the Diagnosis of Cryptococcosis

PubMed Central

Lindsley, Mark D.; Mekha, Nanthawan; Baggett, Henry C.; Surinthong, Yupha; Autthateinchai, Rinrapas; Sawatwong, Pongpun; Harris, Julie R.; Park, Benjamin J.; Chiller, Tom; Poonwan, Natteewan

2011-01-01

Background. Cryptococcosis is a common opportunistic infection of human immunodeficiency virus (HIV)–infected individuals mostly occurring in resource-limited countries. This study compares the performance of a recently developed lateral flow immunoassay (LFA) to blood culture and enzyme immunoassay (EIA) for the diagnosis of cryptococcosis. Methods. Archived sera from 704 HIV-infected patients hospitalized for acute respiratory illness in Thailand were tested for cryptococcal antigenemia using EIA. All EIA-positive and a subset of EIA-negative sera were tested by LFA, with results recorded after 5 and 15 minutes incubation. Urine from patients with LFA- and EIA-positive sera was tested by LFA. Antigen results from patients with positive cryptococcal blood cultures were compared. Results. Of 704 sera, 92 (13%) were positive by EIA; among the 91 EIA-positive sera tested by LFA, 82 (90%) and 87 (96%) were LFA positive when read after 5 and 15 minutes, respectively. Kappa agreement of EIA and LFA for sera was 0.923 after 5 minutes and 0.959 after 15 minutes, respectively. Two of 373 EIA-negative sera were LFA positive at both time points. Of 74 urine specimens from EIA-positive patients, 52 (70.3%) were LFA positive. EIA was positive in 16 of 17 sera from blood culture–positive patients (94% sensitivity), and all sera were positive by LFA (100% sensitivity). Conclusions. A high level of agreement was shown between LFA and EIA testing of serum. The LFA is a rapid, easy-to-perform assay that does not require refrigeration, demonstrating its potential usefulness as a point-of-care assay for diagnosis of cryptococcosis in resource-limited countries. PMID:21810743

Cyanobacteria dominance influences resource use efficiency and community turnover in phytoplankton and zooplankton communities.

PubMed

Filstrup, Christopher T; Hillebrand, Helmut; Heathcote, Adam J; Harpole, W Stanley; Downing, John A

2014-04-01

Freshwater biodiversity loss potentially disrupts ecosystem services related to water quality and may negatively impact ecosystem functioning and temporal community turnover. We analysed a data set containing phytoplankton and zooplankton community data from 131 lakes through 9 years in an agricultural region to test predictions that plankton communities with low biodiversity are less efficient in their use of limiting resources and display greater community turnover (measured as community dissimilarity). Phytoplankton resource use efficiency (RUE = biomass per unit resource) was negatively related to phytoplankton evenness (measured as Pielou's evenness), whereas zooplankton RUE was positively related to phytoplankton evenness. Phytoplankton and zooplankton RUE were high and low, respectively, when Cyanobacteria, especially Microcystis sp., dominated. Phytoplankton communities displayed slower community turnover rates when dominated by few genera. Our findings, which counter findings of many terrestrial studies, suggest that Cyanobacteria dominance may play important roles in ecosystem functioning and community turnover in nutrient-enriched lakes. © 2014 John Wiley & Sons Ltd/CNRS.

Depressive symptoms, stress and resources among adult immigrants living with HIV.

PubMed

Noh, Marianne S; Rueda, Sergio; Bekele, Tsegaye; Fenta, Haile; Gardner, Sandra; Hamilton, Hayley; Hart, Trevor A; Li, Alan; Noh, Samuel; Rourke, Sean B

2012-06-01

Investigation on the mental health of HIV-positive immigrants is severely limited. We examine the independent and combined effects of HIV symptom and coping resources on depressive symptoms among HIV-positive immigrants (n = 259). Ordinary Least Squares regression models were estimated with data from a survey of clinical and social-psychological outcomes in people receiving treatment for HIV infection. We tested for the impact of two HIV-related stressors, one life events stressor and three buffering resources on depressive symptoms, controlling for thirteen demographic, clinical and acculturative factors. HIV-related stressors were found to be positively related to depressive symptom severity. Coping resources, namely self-mastery, mediate the relationships between HIV-related stressors and depressive symptoms. Results from this study provide the first empirical assessment of stress processes for immigrants living with HIV. Although more research is needed to understand mental health among HIV-positive immigrants, the study results suggest that health care providers focus on self-mastery enhancement among HIV-positive immigrants.

Energy Management of the Multi-Mission Space Exploration Vehicle Using a Goal-Oriented Control System

NASA Technical Reports Server (NTRS)

Braman, Julia M. B.; Wagner, David A.

2010-01-01

Safe human exploration in space missions requires careful management of limited resources such as breathable air and stored electrical energy. Daily activities for astronauts must be carefully planned with respect to such resources, and usage must be monitored as activities proceed to ensure that they can be completed while maintaining safe resource margins. Such planning and monitoring can be complex because they depend on models of resource usage, the activities being planned, and uncertainties. This paper describes a system - and the technology behind it - for energy management of the NASA-Johnson Space Center's Multi-Mission Space Exploration Vehicles (SEV), that provides, in an onboard advisory mode, situational awareness to astronauts and real-time guidance to mission operators. This new capability was evaluated during this year's Desert RATS (Research and Technology Studies) planetary exploration analog test in Arizona. This software aided ground operators and crew members in modifying the day s activities based on the real-time execution of the plan and on energy data received from the rovers.

High levels of time contraction in young children in dual tasks are related to their limited attention capacities.

PubMed

Hallez, Quentin; Droit-Volet, Sylvie

2017-09-01

Numerous studies have shown that durations are judged shorter in a dual-task condition than in a simple-task condition. The resource-based theory of time perception suggests that this is due to the processing of temporal information, which is a demanding cognitive task that consumes limited attention resources. Our study investigated whether this time contraction in a dual-task condition is greater in younger children and, if so, whether this is specifically related to their limited attention capacities. Children aged 5-7years were given a temporal reproduction task in a simple-task condition and a dual-task condition. In addition, different neuropsychological tests were used to assess not only their attention capacities but also their capacities in terms of working memory and information processing speed. The results showed a shortening of perceived time in the dual task compared with the simple task, and this increased as age decreased. The extent of this shortening effect was directly linked to younger children's limited attentional capacities; the lower their attentional capacities, the greater the time contraction. This study demonstrated that children's errors in time judgments are linked to their cognitive capacities rather than to capacities that are specific to time. Copyright © 2017 Elsevier Inc. All rights reserved.

A multi-site reconstruction algorithm for bottom-up vulnerability assessment of water resource systems to changing streamflow conditions

NASA Astrophysics Data System (ADS)

Nazemi, A.; Zaerpour, M.

2016-12-01

Current paradigm for assessing the vulnerability of water resource systems to changing streamflow conditions often involves a cascade application of climate and hydrological models to project the future states of streamflow regime, entering to a given water resource system. It is widely warned, however, that the overall uncertainty in this "top-down" modeling enterprise can be large due to the limitations in representing natural and anthropogenic processes that affect future streamflow variability and change. To address this, various types of stress-tests are suggested to assess the vulnerability of water resources systems under a wide range of possible changes in streamflow conditions. The scope of such "bottom-up" assessments can go well beyond top-down projections and therefore provide a basis for monitoring different response modes, under which water resource systems become vulnerable. Despite methodological differences, all bottom-up assessments are equipped with a systematic sampling procedure, with which different possibilities for future climate and/or streamflow conditions can be realized. Regardless of recent developments, currently available streamflow sampling algorithms are still limited, particularly in regional contexts, for which accurate representation of spatiotemporal dependencies in streamflow regime are of major importance. In this presentation, we introduce a new development that enables handling temporal and spatial dependencies in regional streamflow regimes through a unified stochastic reconstruction algorithm. We demonstrate the application of this algorithm accross various Canadian regions. By considering a real-world regional water resources system, we show how the new multi-site reconstruction algorithm can extend the practical utility of bottom-up vulnerability assessment and improve quantifying the associated risk in natural and anthropogenic water systems under unknown future conditions.

Electrical safety Q&A. A reference guide for the clinical engineer.

PubMed

2005-02-01

This guide, which ECRI developed to answer the electrical safety questions most frequently asked by member hospitals, features practical advice for addressing electrical safety concerns in the healthcare environment. Questions addressed include: STANDARDS AND APPROVALS: What electrical safety standards apply? How do NFPA 99 and IEC 60601-1 differ? What organizations approve medical devices? LEAKAGE CURRENT LIMITS AND TESTING: How are leakage current limits established? What limits apply to equipment used in the hospital? And how should the limits be applied in special cases, such as the use of PCs in the patient care area or equipment used in the clinical laboratory? ISOLATED POWER: What are its advantages and disadvantages, and is isolated power needed in the operating room? Other topics addressed include double insulation, ground-fault circuit interrupters (GFCIs), and requirements for medical devices used in the home. Supplementary articles discuss acceptable alternatives to UL listing, the use of Hospital Grade plugs, the limitations of leakage current testing of devices connected to isolated power systems, and the debate about whether to designate ORs as wet locations. Experienced clinical engineers should find this guide to be a handy reference, while those new to the field should find it to be a helpful educational resource.

Evaluation of a Rapid One-step Real-time PCR Method as a High-throughput Screening for Quantification of Hepatitis B Virus DNA in a Resource-limited Setting.

PubMed

Rashed-Ul Islam, S M; Jahan, Munira; Tabassum, Shahina

2015-01-01

Virological monitoring is the best predictor for the management of chronic hepatitis B virus (HBV) infections. Consequently, it is important to use the most efficient, rapid and cost-effective testing systems for HBV DNA quantification. The present study compared the performance characteristics of a one-step HBV polymerase chain reaction (PCR) vs the two-step HBV PCR method for quantification of HBV DNA from clinical samples. A total of 100 samples consisting of 85 randomly selected samples from patients with chronic hepatitis B (CHB) and 15 samples from apparently healthy individuals were enrolled in this study. Of the 85 CHB clinical samples tested, HBV DNA was detected from 81% samples by one-step PCR method with median HBV DNA viral load (VL) of 7.50 × 10 3 lU/ml. In contrast, 72% samples were detected by the two-step PCR system with median HBV DNA of 3.71 × 10 3 lU/ml. The one-step method showed strong linear correlation with two-step PCR method (r = 0.89; p < 0.0001). Both methods showed good agreement at Bland-Altman plot, with a mean difference of 0.61 log 10 IU/ml and limits of agreement of -1.82 to 3.03 log 10 IU/ml. The intra-assay and interassay coefficients of variation (CV%) of plasma samples (4-7 log 10 IU/ml) for the one-step PCR method ranged between 0.33 to 0.59 and 0.28 to 0.48 respectively, thus demonstrating a high level of concordance between the two methods. Moreover, elimination of the DNA extraction step in the one-step PCR kit allowed time-efficient and significant labor and cost savings for the quantification of HBV DNA in a resource limited setting. Rashed-Ul Islam SM, Jahan M, Tabassum S. Evaluation of a Rapid One-step Real-time PCR Method as a High-throughput Screening for Quantification of Hepatitis B Virus DNA in a Resource-limited Setting. Euroasian J Hepato-Gastroenterol 2015;5(1):11-15.

Evaluation of a Rapid One-step Real-time PCR Method as a High-throughput Screening for Quantification of Hepatitis B Virus DNA in a Resource-limited Setting

PubMed Central

Jahan, Munira; Tabassum, Shahina

2015-01-01

Virological monitoring is the best predictor for the management of chronic hepatitis B virus (HBV) infections. Consequently, it is important to use the most efficient, rapid and cost-effective testing systems for HBV DNA quantification. The present study compared the performance characteristics of a one-step HBV polymerase chain reaction (PCR) vs the two-step HBV PCR method for quantification of HBV DNA from clinical samples. A total of 100 samples consisting of 85 randomly selected samples from patients with chronic hepatitis B (CHB) and 15 samples from apparently healthy individuals were enrolled in this study. Of the 85 CHB clinical samples tested, HBV DNA was detected from 81% samples by one-step PCR method with median HBV DNA viral load (VL) of 7.50 × 103 lU/ml. In contrast, 72% samples were detected by the two-step PCR system with median HBV DNA of 3.71 × 103 lU/ml. The one-step method showed strong linear correlation with two-step PCR method (r = 0.89; p < 0.0001). Both methods showed good agreement at Bland-Altman plot, with a mean difference of 0.61 log10 IU/ml and limits of agreement of -1.82 to 3.03 log10 IU/ml. The intra-assay and interassay coefficients of variation (CV%) of plasma samples (4-7 log10 IU/ml) for the one-step PCR method ranged between 0.33 to 0.59 and 0.28 to 0.48 respectively, thus demonstrating a high level of concordance between the two methods. Moreover, elimination of the DNA extraction step in the one-step PCR kit allowed time-efficient and significant labor and cost savings for the quantification of HBV DNA in a resource limited setting. How to cite this article Rashed-Ul Islam SM, Jahan M, Tabassum S. Evaluation of a Rapid One-step Real-time PCR Method as a High-throughput Screening for Quantification of Hepatitis B Virus DNA in a Resource-limited Setting. Euroasian J Hepato-Gastroenterol 2015;5(1):11-15. PMID:29201678

Applying Adverse Outcome Pathways (AOPs) to support Integrated Approaches to Testing and Assessment (IATA).

PubMed

Tollefsen, Knut Erik; Scholz, Stefan; Cronin, Mark T; Edwards, Stephen W; de Knecht, Joop; Crofton, Kevin; Garcia-Reyero, Natalia; Hartung, Thomas; Worth, Andrew; Patlewicz, Grace

2014-12-01

Chemical regulation is challenged by the large number of chemicals requiring assessment for potential human health and environmental impacts. Current approaches are too resource intensive in terms of time, money and animal use to evaluate all chemicals under development or already on the market. The need for timely and robust decision making demands that regulatory toxicity testing becomes more cost-effective and efficient. One way to realize this goal is by being more strategic in directing testing resources; focusing on chemicals of highest concern, limiting testing to the most probable hazards, or targeting the most vulnerable species. Hypothesis driven Integrated Approaches to Testing and Assessment (IATA) have been proposed as practical solutions to such strategic testing. In parallel, the development of the Adverse Outcome Pathway (AOP) framework, which provides information on the causal links between a molecular initiating event (MIE), intermediate key events (KEs) and an adverse outcome (AO) of regulatory concern, offers the biological context to facilitate development of IATA for regulatory decision making. This manuscript summarizes discussions at the Workshop entitled "Advancing AOPs for Integrated Toxicology and Regulatory Applications" with particular focus on the role AOPs play in informing the development of IATA for different regulatory purposes. Copyright © 2014 Elsevier Inc. All rights reserved.

Biogenic disturbance determines invasion success in a subtidal soft-sediment system.

PubMed

Lohrer, Andrew M; Chiaroni, Luca D; Hewitt, Judi E; Thrush, Simon F

2008-05-01

Theoretically, disturbance and diversity can influence the success of invasive colonists if (1) resource limitation is a prime determinant of invasion success and (2) disturbance and diversity affect the availability of required resources. However, resource limitation is not of overriding importance in all systems, as exemplified by marine soft sediments, one of Earth's most widespread habitat types. Here, we tested the disturbance-invasion hypothesis in a marine soft-sediment system by altering rates of biogenic disturbance and tracking the natural colonization of plots by invasive species. Levels of sediment disturbance were controlled by manipulating densities of burrowing spatangoid urchins, the dominant biogenic sediment mixers in the system. Colonization success by two invasive species (a gobiid fish and a semelid bivalve) was greatest in plots with sediment disturbance rates < 500 cm(3) x m(-2) x d(-1), at the low end of the experimental disturbance gradient (0 to > 9000 cm(3) x m(-2) x d(-1)). Invasive colonization declined with increasing levels of sediment disturbance, counter to the disturbance-invasion hypothesis. Increased sediment disturbance by the urchins also reduced the richness and diversity of native macrofauna (particularly small, sedentary, surface feeders), though there was no evidence of increased availability of resources with increased disturbance that would have facilitated invasive colonization: sediment food resources (chlorophyll a and organic matter content) did not increase, and space and access to overlying water were not limited (low invertebrate abundance). Thus, our study revealed the importance of biogenic disturbance in promoting invasion resistance in a marine soft-sediment community, providing further evidence of the valuable role of bioturbation in soft-sediment systems (bioturbation also affects carbon processing, nutrient recycling, oxygen dynamics, benthic community structure, and so on.). Bioturbation rates are influenced by the presence and abundance of large burrowing species (like spatangoid urchins). Therefore, mass mortalities of large bioturbators could inflate invasion risk and alter other aspects of ecosystem performance in marine soft-sediment habitats.

Addressing historic environmental exposures along the Alaska Highway

PubMed Central

Godduhn, Anna; Duffy, Lawrence

2013-01-01

Background A World War II defense site at Northway, Alaska, was remediated in the 1990s, leaving complex questions regarding historic exposures to toxic waste. This article describes the context, methods, limitations and findings of the Northway Wild Food and Health Project (NWFHP). Objective The NWFHP comprised 2 pilot studies: the Northway Wild Food Study (NWFS), which investigated contaminants in locally prioritized traditional foods over time, and the Northway Health Study (NHS), which investigated locally suspected links between resource uses and health problems. Design This research employed mixed methods. The NWFS reviewed remedial documents and existing data. The NHS collected household information regarding resource uses and health conditions by questionnaire and interview. NHS data represent general (yes or no) personal knowledge that was often second hand. Retrospective cohort comparisons were made of the reported prevalence of 7 general health problems between groups based on their reported (yes or no) consumption of particular resources, for 3 data sets (existing, historic and combined) with a two-tailed Fisher's Exact Test in SAS (n=325 individuals in 83 households, 24 of which no longer exist). Results The NWFS identified historic pathways of exposure to petroleum, pesticides, herbicides, chlorinated byproducts of disinfection and lead from resources that were consumed more frequently decades ago and are not retrospectively quantifiable. The NHS found complex patterns of association between reported resource uses and cancer and thyroid-, reproductive-, metabolic- and cardiac problems. Conclusion Lack of detail regarding medical conditions, undocumented histories of exposure, time lapsed since the release of pollution and changes to health and health care over the same period make this exploratory research. Rather than demonstrate causation, these results document the legitimacy of local suspicions and warrant additional investigation. This article presents our findings, with discussion of limitations related to study design and limitations that are inherent to such research. PMID:23984298

Use and limitations of malaria rapid diagnostic testing by community health workers in war-torn Democratic Republic of Congo.

PubMed

Hawkes, Michael; Katsuva, Jean Paul; Masumbuko, Claude K

2009-12-23

Accurate and practical malaria diagnostics, such as immunochromatographic rapid diagnostic tests (RDTs), have the potential to avert unnecessary treatments and save lives. Volunteer community health workers (CHWs) represent a potentially valuable human resource for expanding this technology to where it is most needed, remote rural communities in sub-Saharan Africa with limited health facilities and personnel. This study reports on a training programme for CHWs to incorporate RDTs into their management strategy for febrile children in the Democratic Republic of Congo, a tropical African setting ravaged by human conflict. Prospective cohort study, satisfaction questionnaire and decision analysis. Twelve CHWs were trained to safely and accurately perform and interpret RDTs, then successfully implemented rapid diagnostic testing in their remote community in a cohort of 357 febrile children. CHWs were uniformly positive in evaluating RDTs for their utility and ease of use. However, high malaria prevalence in this cohort (93% by RDTs, 88% by light microscopy) limited the cost-effectiveness of RDTs compared to presumptive treatment of all febrile children, as evidenced by findings from a simplified decision analysis. CHWs can safely and effectively use RDTs in their management of febrile children; however, cost-effectiveness of RDTs is limited in zones of high malaria prevalence.

Use and limitations of malaria rapid diagnostic testing by community health workers in war-torn Democratic Republic of Congo

PubMed Central

2009-01-01

Background Accurate and practical malaria diagnostics, such as immunochromatographic rapid diagnostic tests (RDTs), have the potential to avert unnecessary treatments and save lives. Volunteer community health workers (CHWs) represent a potentially valuable human resource for expanding this technology to where it is most needed, remote rural communities in sub-Saharan Africa with limited health facilities and personnel. This study reports on a training programme for CHWs to incorporate RDTs into their management strategy for febrile children in the Democratic Republic of Congo, a tropical African setting ravaged by human conflict. Methods Prospective cohort study, satisfaction questionnaire and decision analysis. Results Twelve CHWs were trained to safely and accurately perform and interpret RDTs, then successfully implemented rapid diagnostic testing in their remote community in a cohort of 357 febrile children. CHWs were uniformly positive in evaluating RDTs for their utility and ease of use. However, high malaria prevalence in this cohort (93% by RDTs, 88% by light microscopy) limited the cost-effectiveness of RDTs compared to presumptive treatment of all febrile children, as evidenced by findings from a simplified decision analysis. Conclusions CHWs can safely and effectively use RDTs in their management of febrile children; however, cost-effectiveness of RDTs is limited in zones of high malaria prevalence. PMID:20028563

Age-related changes in selective attention and perceptual load during visual search.

PubMed

Madden, David J; Langley, Linda K

2003-03-01

Three visual search experiments were conducted to test the hypothesis that age differences in selective attention vary as a function of perceptual load (E. A. Maylor & N. Lavie, 1998). Under resource-limited conditions (Experiments 1 and 2), the distraction from irrelevant display items generally decreased as display size (perceptual load) increased. This perceptual load effect was similar for younger and older adults, contrary to the findings of Maylor and Lavie. Distraction at low perceptual loads appeared to reflect both general and specific inhibitory mechanisms. Under more data-limited conditions (Experiment 3), an age-related decline in selective attention was evident, but the age difference was not attributable to capacity limitations as predicted by the perceptual load theory.

A Delphi study assessing the utility of quality improvement tools and resources in Australian primary care.

PubMed

Upham, Susan J; Janamian, Tina; Crossland, Lisa; Jackson, Claire L

2016-04-18

To determine the relevance and utility of online tools and resources to support organisational performance development in primary care and to complement the Primary Care Practice Improvement Tool (PC-PIT). A purposively recruited Expert Advisory Panel of 12 end users used a modified Delphi technique to evaluate 53 tools and resources identified through a previously conducted systematic review. The panel comprised six practice managers and six general practitioners who had participated in the PC-PIT pilot study in 2013-2014. Tools and resources were reviewed in three rounds using a standard pre-tested assessment form. Recommendations, scores and reasons for recommending or rejecting each tool or resource were analysed to determine the final suite of tools and resources. The evaluation was conducted from November 2014 to August 2015. Recommended tools and resources scored highly (mean score, 16/20) in Rounds 1 and 2 of review (n = 25). These tools and resources were perceived to be easily used, useful to the practice and supportive of the PC-PIT. Rejected resources scored considerably lower (mean score, 5/20) and were noted to have limitations such as having no value to the practice and poor utility (n = 6). A final review (Round 3) of 28 resources resulted in a suite of 21 to support the elements of the PC-PIT. This suite of tools and resources offers one approach to supporting the quality improvement initiatives currently in development in primary care reform.

Evaluating the Auto-MODS Assay, a Novel Tool for Tuberculosis Diagnosis for Use in Resource-Limited Settings

PubMed Central

Wang, Linwei; Mohammad, Sohaib H.; Li, Qiaozhi; Rienthong, Somsak; Rienthong, Dhanida; Nedsuwan, Supalert; Mahasirimongkol, Surakameth; Yasui, Yutaka

2014-01-01

There is an urgent need for simple, rapid, and affordable diagnostic tests for tuberculosis (TB) to combat the great burden of the disease in developing countries. The microscopic observation drug susceptibility assay (MODS) is a promising tool to fill this need, but it is not widely used due to concerns regarding its biosafety and efficiency. This study evaluated the automated MODS (Auto-MODS), which operates on principles similar to those of MODS but with several key modifications, making it an appealing alternative to MODS in resource-limited settings. In the operational setting of Chiang Rai, Thailand, we compared the performance of Auto-MODS with the gold standard liquid culture method in Thailand, mycobacterial growth indicator tube (MGIT) 960 plus the SD Bioline TB Ag MPT64 test, in terms of accuracy and efficiency in differentiating TB and non-TB samples as well as distinguishing TB and multidrug-resistant (MDR) TB samples. Sputum samples from clinically diagnosed TB and non-TB subjects across 17 hospitals in Chiang Rai were consecutively collected from May 2011 to September 2012. A total of 360 samples were available for evaluation, of which 221 (61.4%) were positive and 139 (38.6%) were negative for mycobacterial cultures according to MGIT 960. Of the 221 true-positive samples, Auto-MODS identified 212 as positive and 9 as negative (sensitivity, 95.9%; 95% confidence interval [CI], 92.4% to 98.1%). Of the 139 true-negative samples, Auto-MODS identified 135 as negative and 4 as positive (specificity, 97.1%; 95% CI, 92.8% to 99.2%). The median time to culture positivity was 10 days, with an interquartile range of 8 to 13 days for Auto-MODS. Auto-MODS is an effective and cost-sensitive alternative diagnostic tool for TB diagnosis in resource-limited settings. PMID:25378569

Improved Neuropsychological and Neurological Functioning Across Three Antiretroviral Regimens in Diverse Resource-Limited Settings: AIDS Clinical Trials Group Study A5199, the International Neurological Study

PubMed Central

Robertson, K.; Jiang, H.; Kumwenda, J.; Supparatpinyo, K.; Evans, S.; Campbell, T. B.; Price, R.; Tripathy, S.; Kumarasamy, N.; La Rosa, A.; Santos, B.; Silva, M. T.; Montano, S.; Kanyama, C.; Faesen, S.; Murphy, R.; Hall, C.; Marra, C. M.; Marcus, C.; Berzins, B.; Allen, R.; Housseinipour, M.; Amod, F.; Sanne, I.; Hakim, J.; Walawander, A.; Nair, A.

2012-01-01

Background. AIDS Clinical Trials Group (ACTG) A5199 compared the neurological and neuropsychological (NP) effects of 3 antiretroviral regimens in participants infected with human immunodeficiency virus type 1 (HIV-1) in resource-limited settings. Methods. Participants from Brazil, India, Malawi, Peru, South Africa, Thailand, and Zimbabwe were randomized to 3 antiretroviral treatment arms: A (lamivudine-zidovudine plus efavirenz, n = 289), B (atazanavir, emtricitabine, and didanosine-EC, n = 293), and C (emtricitabine-tenofovir-disoproxil fumarate plus efavirenz, n = 278) as part of the ACTG PEARLS study (A5175). Standardized neurological and neuropsychological (NP) screening examinations (grooved pegboard, timed gait, semantic verbal fluency, and finger tapping) were administered every 24 weeks from February 2006 to May 2010. Associations with neurological and neuropsychological function were estimated from linear and logistic regression models using generalized estimating equations. Results. The median weeks on study was 168 (Q1 = 96, Q3 = 192) for the 860 participants. NP test scores improved (P < .05) with the exception of semantic verbal fluency. No differences in neurological and neuropsychological functioning between treatment regimens were detected (P > .10). Significant country effects were noted on all NP tests and neurological outcomes (P < .01). Conclusions. The study detected no significant differences in neuropsychological and neurological outcomes between randomized ART regimens. Significant improvement occurred in neurocognitive and neurological functioning over time after initiation of ARTs. The etiology of these improvements is likely multifactorial, reflecting reduced central nervous system HIV infection, better general health, and practice effects. This study suggests that treatment with either of the World Health Organization –recommended first-line antiretroviral regimens in resource-limited settings will improve neuropsychological functioning and reduce neurological dysfunction. Clinical trials registration.  NCT00096824. PMID:22661489

Virtual pools for interactive analysis and software development through an integrated Cloud environment

NASA Astrophysics Data System (ADS)

Grandi, C.; Italiano, A.; Salomoni, D.; Calabrese Melcarne, A. K.

2011-12-01

WNoDeS, an acronym for Worker Nodes on Demand Service, is software developed at CNAF-Tier1, the National Computing Centre of the Italian Institute for Nuclear Physics (INFN) located in Bologna. WNoDeS provides on demand, integrated access to both Grid and Cloud resources through virtualization technologies. Besides the traditional use of computing resources in batch mode, users need to have interactive and local access to a number of systems. WNoDeS can dynamically select these computers instantiating Virtual Machines, according to the requirements (computing, storage and network resources) of users through either the Open Cloud Computing Interface API, or through a web console. An interactive use is usually limited to activities in user space, i.e. where the machine configuration is not modified. In some other instances the activity concerns development and testing of services and thus implies the modification of the system configuration (and, therefore, root-access to the resource). The former use case is a simple extension of the WNoDeS approach, where the resource is provided in interactive mode. The latter implies saving the virtual image at the end of each user session so that it can be presented to the user at subsequent requests. This work describes how the LHC experiments at INFN-Bologna are testing and making use of these dynamically created ad-hoc machines via WNoDeS to support flexible, interactive analysis and software development at the INFN Tier-1 Computing Centre.

A Framework for Analyzing and Testing the Performance of Software Services

NASA Astrophysics Data System (ADS)

Bertolino, Antonia; de Angelis, Guglielmo; di Marco, Antinisca; Inverardi, Paola; Sabetta, Antonino; Tivoli, Massimo

Networks "Beyond the 3rd Generation" (B3G) are characterized by mobile and resource-limited devices that communicate through different kinds of network interfaces. Software services deployed in such networks shall adapt themselves according to possible execution contexts and requirement changes. At the same time, software services have to be competitive in terms of the Quality of Service (QoS) provided, or perceived by the end user.

Dopamine and the Management of Attentional Resources: Genetic Markers of Striatal D2 Dopamine Predict Individual Differences in the Attentional Blink

ERIC Educational Resources Information Center

Colzato, Lorenza S.; Slagter, Heleen A.; de Rover, Mischa; Hommel, Bernhard

2011-01-01

The attentional blink (AB)--a deficit in reporting the second of two target stimuli presented in close succession in a rapid sequence of distracters--has been related to processing limitations in working memory. Given that dopamine (DA) plays a crucial role working memory, the present study tested whether individual differences in the size of the…

Gibbon travel paths are goal oriented.

PubMed

Asensio, Norberto; Brockelman, Warren Y; Malaivijitnond, Suchinda; Reichard, Ulrich H

2011-05-01

Remembering locations of food resources is critical for animal survival. Gibbons are territorial primates which regularly travel through small and stable home ranges in search of preferred, limited and patchily distributed resources (primarily ripe fruit). They are predicted to profit from an ability to memorize the spatial characteristics of their home range and may increase their foraging efficiency by using a 'cognitive map' either with Euclidean or with topological properties. We collected ranging and feeding data from 11 gibbon groups (Hylobates lar) to test their navigation skills and to better understand gibbons' 'spatial intelligence'. We calculated the locations at which significant travel direction changes occurred using the change-point direction test and found that these locations primarily coincided with preferred fruit sources. Within the limits of biologically realistic visibility distances observed, gibbon travel paths were more efficient in detecting known preferred food sources than a heuristic travel model based on straight travel paths in random directions. Because consecutive travel change-points were far from the gibbons' sight, planned movement between preferred food sources was the most parsimonious explanation for the observed travel patterns. Gibbon travel appears to connect preferred food sources as expected under the assumption of a good mental representation of the most relevant sources in a large-scale space.

The detection of malingered post-traumatic stress disorder.

PubMed

Knoll, James; Resnick, Phillip J

2006-09-01

The detection of malingered PTSD is made particularly challenging by the subjective nature of PTSD criteria and requires a thorough, systematic approach. The psychiatrist must gather and analyze evidence from the evaluation, clinical records, psychologic testing, third parties, and other sources. Although some individuals may malinger PTSD to avoid criminal sanctions, the most common motivation for malingering PTSD is financial gain. Clinical nuances may help distinguish genuine from malingered PTSD. The psychiatrist should be aware of the differences observed between civilian and combat-related PTSD. Although special effort is required, the psychiatrist bears considerable responsibility to assist society in differentiating true PTSD from malingering.Undetected malingering is not limited simply to fraudulent monetary awards, but can involve misuse of limited mental health resources, leading to negative consequences for the mental health system. As Burkett aptly notes, malingered combat PTSD cases "take time, energy, and financial resources away from treating true combat veterans with PTSD. And real combat vets who truly need help end up in group therapy with phonies, get disgusted, and quit treatment".

Advances in Developing HIV-1 Viral Load Assays for Resource-Limited Settings

PubMed Central

Wang, ShuQi; Xu, Feng; Demirci, Utkan

2010-01-01

Commercial HIV-1 RNA viral load assays have been routinely used in developed countries to monitor antiretroviral treatment (ART). However, these assays require expensive equipment and reagents, well-trained operators, and established laboratory infrastructure. These requirements restrict their use in resource-limited settings where people are most afflicted with the HIV-1 epidemic. Inexpensive alternatives such as the Ultrasensitive p24 assay, the Reverse Transcriptase (RT) assay and in-house reverse transcription quantitative polymerase chain reaction (RT-qPCR) have been developed. However, they are still time-consuming, technologically complex and inappropriate for decentralized laboratories as point-of-care (POC) tests. Recent advances in microfluidics and nanotechnology offer new strategies to develop low-cost, rapid, robust and simple HIV-1 viral load monitoring systems. We review state-of-the-art technologies used for HIV-1 viral load monitoring in both developed and developing settings. Emerging approaches based on microfluidics and nanotechnology, which have potential to be integrated into POC HIV-1 viral load assays, are also discussed. PMID:20600784

Local extinction of a coral reef fish explained by inflexible prey choice

NASA Astrophysics Data System (ADS)

Brooker, R. M.; Munday, P. L.; Brandl, S. J.; Jones, G. P.

2014-12-01

While global extinctions of marine species are infrequent, local extinctions are becoming common. However, the role of habitat degradation and resource specialisation in explaining local extinction is unknown. On coral reefs, coral bleaching is an increasingly frequent cause of coral mortality that can result in dramatic changes to coral community composition. Coral-associated fishes are often specialised on a limited suite of coral species and are therefore sensitive to these changes. This study documents the local extinction of a corallivorous reef fish, Oxymonacanthus longirostris, following a mass bleaching event that altered the species composition of associated coral communities. Local extinction only occurred on reefs that also completely lost a key prey species, Acropora millepora, even though coral cover remained high. In an experimental test, fish continued to select bleached A. millepora over the healthy, but less-preferred prey species that resisted bleaching. These results suggest that behavioural inflexibility may limit the ability of specialists to cope with even subtle changes to resource availability.

A lightweight distributed framework for computational offloading in mobile cloud computing.

PubMed

Shiraz, Muhammad; Gani, Abdullah; Ahmad, Raja Wasim; Adeel Ali Shah, Syed; Karim, Ahmad; Rahman, Zulkanain Abdul

2014-01-01

The latest developments in mobile computing technology have enabled intensive applications on the modern Smartphones. However, such applications are still constrained by limitations in processing potentials, storage capacity and battery lifetime of the Smart Mobile Devices (SMDs). Therefore, Mobile Cloud Computing (MCC) leverages the application processing services of computational clouds for mitigating resources limitations in SMDs. Currently, a number of computational offloading frameworks are proposed for MCC wherein the intensive components of the application are outsourced to computational clouds. Nevertheless, such frameworks focus on runtime partitioning of the application for computational offloading, which is time consuming and resources intensive. The resource constraint nature of SMDs require lightweight procedures for leveraging computational clouds. Therefore, this paper presents a lightweight framework which focuses on minimizing additional resources utilization in computational offloading for MCC. The framework employs features of centralized monitoring, high availability and on demand access services of computational clouds for computational offloading. As a result, the turnaround time and execution cost of the application are reduced. The framework is evaluated by testing prototype application in the real MCC environment. The lightweight nature of the proposed framework is validated by employing computational offloading for the proposed framework and the latest existing frameworks. Analysis shows that by employing the proposed framework for computational offloading, the size of data transmission is reduced by 91%, energy consumption cost is minimized by 81% and turnaround time of the application is decreased by 83.5% as compared to the existing offloading frameworks. Hence, the proposed framework minimizes additional resources utilization and therefore offers lightweight solution for computational offloading in MCC.

A Lightweight Distributed Framework for Computational Offloading in Mobile Cloud Computing

PubMed Central

Shiraz, Muhammad; Gani, Abdullah; Ahmad, Raja Wasim; Adeel Ali Shah, Syed; Karim, Ahmad; Rahman, Zulkanain Abdul

2014-01-01

The latest developments in mobile computing technology have enabled intensive applications on the modern Smartphones. However, such applications are still constrained by limitations in processing potentials, storage capacity and battery lifetime of the Smart Mobile Devices (SMDs). Therefore, Mobile Cloud Computing (MCC) leverages the application processing services of computational clouds for mitigating resources limitations in SMDs. Currently, a number of computational offloading frameworks are proposed for MCC wherein the intensive components of the application are outsourced to computational clouds. Nevertheless, such frameworks focus on runtime partitioning of the application for computational offloading, which is time consuming and resources intensive. The resource constraint nature of SMDs require lightweight procedures for leveraging computational clouds. Therefore, this paper presents a lightweight framework which focuses on minimizing additional resources utilization in computational offloading for MCC. The framework employs features of centralized monitoring, high availability and on demand access services of computational clouds for computational offloading. As a result, the turnaround time and execution cost of the application are reduced. The framework is evaluated by testing prototype application in the real MCC environment. The lightweight nature of the proposed framework is validated by employing computational offloading for the proposed framework and the latest existing frameworks. Analysis shows that by employing the proposed framework for computational offloading, the size of data transmission is reduced by 91%, energy consumption cost is minimized by 81% and turnaround time of the application is decreased by 83.5% as compared to the existing offloading frameworks. Hence, the proposed framework minimizes additional resources utilization and therefore offers lightweight solution for computational offloading in MCC. PMID:25127245

Better to Be in Bad Company than to Be Alone? Aedes Vectors Respond Differently to Breeding Site Quality in the Presence of Others

PubMed Central

Pereira, Renato N.; Godoy, Wesley A. C.

2015-01-01

This study focuses on two competing species, Aedes aegypti and Aedes albopictus (Diptera: Culicidae), both invasive mosquitoes of the New World. Context-specific competition between immature forms inside containers seems to be an important determinant of the coexistence or displacement of each species in different regions of the world. Here, competition experiments developed at low density (one, two or three larvae) and receiving four different resource food concentration, were designed to test whether Ae. albopictus and Ae. aegypti respond differently to competition, and whether competition can be attributed to a simple division of resources. Three phenotypic traits - larval development, adult survival under starvation and wing length - were used as indicators of performance. Larvae of neither species were limited by resource concentration when they were alone, unlike when they developed with competitors. The presence of conspecifics affected Ae. aegypti and Ae. albopictus, inducing slower development, reduced survival and wing length. The response to resource limitation was different when developing with heterospecifics: Ae. aegypti developing with one heterospecific showed faster development, producing smaller adults with shorter lives, while in the presence of two competitors, development increased and adults lived longer. Aedes albopictus demonstrated a better performance when developing with heterospecifics, with no loss in their development period and improved adult survival. Overall, our results suggest that response to competition can not simply be attributed to the division of resources, and that larvae of both species presented large phenotypic plasticity in their response to the presence or absence of heterospecifics and conspecifics. PMID:26244511

44 CFR 352.25 - Limitation on committing Federal facilities and resources for emergency preparedness.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Federal facilities and resources for emergency preparedness. 352.25 Section 352.25 Emergency Management... COMMERCIAL NUCLEAR POWER PLANTS: EMERGENCY PREPAREDNESS PLANNING Federal Participation § 352.25 Limitation on committing Federal facilities and resources for emergency preparedness. (a) The commitment of Federal...

The oncology pharmacy in cancer care delivery in a resource-constrained setting in western Kenya.

PubMed

Strother, R Matthew; Rao, Kamakshi V; Gregory, Kelly M; Jakait, Beatrice; Busakhala, Naftali; Schellhase, Ellen; Pastakia, Sonak; Krzyzanowska, Monika; Loehrer, Patrick J

2012-12-01

The movement to deliver cancer care in resource-limited settings is gaining momentum, with particular emphasis on the creation of cost-effective, rational algorithms utilizing affordable chemotherapeutics to treat curable disease. The delivery of cancer care in resource-replete settings is a concerted effort by a team of multidisciplinary care providers. The oncology pharmacy, which is now considered integral to cancer care in resourced medical practice, developed over the last several decades in an effort to limit healthcare provider exposure to workplace hazards and to limit risk to patients. In developing cancer care services in resource-constrained settings, creation of oncology pharmacies can help to both mitigate the risks to practitioners and patients, and also limit the costs of cancer care and the environmental impact of chemotherapeutics. This article describes the experience and lessons learned in establishing a chemotherapy pharmacy in western Kenya.

Crossing the quality chasm in resource-limited settings.

PubMed

Maru, Duncan Smith-Rohrberg; Andrews, Jason; Schwarz, Dan; Schwarz, Ryan; Acharya, Bibhav; Ramaiya, Astha; Karelas, Gregory; Rajbhandari, Ruma; Mate, Kedar; Shilpakar, Sona

2012-11-30

Over the last decade, extensive scientific and policy innovations have begun to reduce the "quality chasm"--the gulf between best practices and actual implementation that exists in resource-rich medical settings. While limited data exist, this chasm is likely to be equally acute and deadly in resource-limited areas. While health systems have begun to be scaled up in impoverished areas, scale-up is just the foundation necessary to deliver effective healthcare to the poor. This perspective piece describes a vision for a global quality improvement movement in resource-limited areas. The following action items are a first step toward achieving this vision: 1) revise global health investment mechanisms to value quality; 2) enhance human resources for improving health systems quality; 3) scale up data capacity; 4) deepen community accountability and engagement initiatives; 5) implement evidence-based quality improvement programs; 6) develop an implementation science research agenda.

Cuticular colour reflects underlying architecture and is affected by a limiting resource.

PubMed

Evison, Sophie E F; Gallagher, Joe D; Thompson, John J W; Siva-Jothy, Michael T; Armitage, Sophie A O

2017-04-01

Central to the basis of ecological immunology are the ideas of costs and trade-offs between immunity and life history traits. As a physical barrier, the insect cuticle provides a key resistance trait, and Tenebrio molitor shows phenotypic variation in cuticular colour that correlates with resistance to the entomopathogenic fungus Metarhizium anisopliae. Here we first examined whether there is a relationship between cuticular colour variation and two aspects of cuticular architecture that we hypothesised may influence resistance to fungal invasion through the cuticle: its thickness and its porosity. Second, we tested the hypothesis that tyrosine, a semi-essential amino acid required for immune defence and cuticular melanisation and sclerotisation, can act as a limiting resource by supplementing the larval diet and subsequently examining adult cuticular colouration and thickness. We found that stock beetles and beetles artificially selected for extremes of cuticular colour had thicker less porous cuticles when they were darker, and thinner more porous cuticles when they were lighter, showing that colour co-varies with two architectural cuticular features. Experimental supplementation of the larval diet with tyrosine led to the development of darker adult cuticle and affected thickness in a sex-specific manner. However, it did not affect two immune traits. The results of this study provide a mechanism for maintenance of cuticular colour variation in this species of beetle; darker cuticles are thicker, but their production is potentially limited by resource constraints and differential investments in resistance mechanisms between the sexes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Computer-generated reminders and quality of pediatric HIV care in a resource-limited setting.

PubMed

Were, Martin C; Nyandiko, Winstone M; Huang, Kristin T L; Slaven, James E; Shen, Changyu; Tierney, William M; Vreeman, Rachel C

2013-03-01

To evaluate the impact of clinician-targeted computer-generated reminders on compliance with HIV care guidelines in a resource-limited setting. We conducted this randomized, controlled trial in an HIV referral clinic in Kenya caring for HIV-infected and HIV-exposed children (<14 years of age). For children randomly assigned to the intervention group, printed patient summaries containing computer-generated patient-specific reminders for overdue care recommendations were provided to the clinician at the time of the child's clinic visit. For children in the control group, clinicians received the summaries, but no computer-generated reminders. We compared differences between the intervention and control groups in completion of overdue tasks, including HIV testing, laboratory monitoring, initiating antiretroviral therapy, and making referrals. During the 5-month study period, 1611 patients (49% female, 70% HIV-infected) were eligible to receive at least 1 computer-generated reminder (ie, had an overdue clinical task). We observed a fourfold increase in the completion of overdue clinical tasks when reminders were availed to providers over the course of the study (68% intervention vs 18% control, P < .001). Orders also occurred earlier for the intervention group (77 days, SD 2.4 days) compared with the control group (104 days, SD 1.2 days) (P < .001). Response rates to reminders varied significantly by type of reminder and between clinicians. Clinician-targeted, computer-generated clinical reminders are associated with a significant increase in completion of overdue clinical tasks for HIV-infected and exposed children in a resource-limited setting.

The influence of schizotypal traits on attention under high perceptual load.

PubMed

Stotesbury, Hanne; Gaigg, Sebastian B; Kirhan, Saim; Haenschel, Corinna

2018-03-01

Schizophrenia Spectrum Disorders (SSD) are known to be characterised by abnormalities in attentional processes, but there are inconsistencies in the literature that remain unresolved. This article considers whether perceptual resource limitations play a role in moderating attentional abnormalities in SSD. According to perceptual load theory, perceptual resource limitations can lead to attenuated or superior performance on dual-task paradigms depending on whether participants are required to process, or attempt to ignore, secondary stimuli. If SSD is associated with perceptual resource limitations, and if it represents the extreme end of an otherwise normally distributed neuropsychological phenotype, schizotypal traits in the general population should lead to disproportionate performance costs on dual-task paradigms as a function of the perceptual task demands. To test this prediction, schizotypal traits were quantified via the Schizotypal Personality Questionnaire (SPQ) in 74 healthy volunteers, who also completed a dual-task signal detection paradigm that required participants to detect central and peripheral stimuli across conditions that varied in the overall number of stimuli presented. The results confirmed decreasing performance as the perceptual load of the task increased. More importantly, significant correlations between SPQ scores and task performance confirmed that increased schizotypal traits, particularly in the cognitive-perceptual domain, are associated with greater performance decrements under increasing perceptual load. These results confirm that attentional difficulties associated with SSD extend sub-clinically into the general population and suggest that cognitive-perceptual schizotypal traits may represent a risk factor for difficulties in the regulation of attention under increasing perceptual load.

Development of Next Generation Memory Test Experiment for Deployment on a Small Satellite

NASA Technical Reports Server (NTRS)

MacLeod, Todd; Ho, Fat D.

2012-01-01

The original Memory Test Experiment successfully flew on the FASTSAT satellite launched in November 2010. It contained a single Ramtron 512K ferroelectric memory. The memory device went through many thousands of read/write cycles and recorded any errors that were encountered. The original mission length was schedule to last 6 months but was extended to 18 months. New opportunities exist to launch a similar satellite and considerations for a new memory test experiment should be examined. The original experiment had to be designed and integrated in less than two months, so the experiment was a simple design using readily available parts. The follow-on experiment needs to be more sophisticated and encompass more technologies. This paper lays out the considerations for the design and development of this follow-on flight memory experiment. It also details the results from the original Memory Test Experiment that flew on board FASTSAT. Some of the design considerations for the new experiment include the number and type of memory devices to be used, the kinds of tests that will be performed, other data needed to analyze the results, and best use of limited resources on a small satellite. The memory technologies that are considered are FRAM, FLASH, SONOS, Resistive Memory, Phase Change Memory, Nano-wire Memory, Magneto-resistive Memory, Standard DRAM, and Standard SRAM. The kinds of tests that could be performed are read/write operations, non-volatile memory retention, write cycle endurance, power measurements, and testing Error Detection and Correction schemes. Other data that may help analyze the results are GPS location of recorded errors, time stamp of all data recorded, radiation measurements, temperature, and other activities being perform by the satellite. The resources of power, volume, mass, temperature, processing power, and telemetry bandwidth are extremely limited on a small satellite. Design considerations must be made to allow the experiment to not interfere with the satellite s primary mission.

Monitoring the quality of HIV-1 viral load testing through a proficiency testing program using dried tube specimens in resource-limited settings.

PubMed

Nguyen, Shon; Ramos, Artur; Chang, Joy; Li, Bin; Shanmugam, Vedapuri; Boeras, Debrah; Nkengasong, John N; Yang, Chunfu; Ellenberger, Dennis

2015-04-01

HIV-1 viral load (VL) levels are used for monitoring disease progression and antiretroviral therapy outcomes in HIV-infected patients. To assess the performance of laboratories conducting HIV-1 VL testing in resource-limited settings, the U.S. Centers for Disease Control and Prevention implemented a voluntary, free-of-charge, external quality assurance program using dried tube specimens (DTSs). Between 2010 and 2012, DTS proficiency testing (PT) panels consisting of 5 specimens were distributed at ambient temperature to participants. The results from the participants (n≥6) using the same assay were grouped, analyzed, and graded as acceptable within a group mean±3 standard deviations. Mean proficiency scores were calculated by dividing the combined PT scores by the number of testing cycles using a linear regression model. Between 2010 and 2012, the number of participants enrolled increased from 32 in 16 countries to 114 in 44 countries. A total of 78.2% of the participants reported results using 10 different VL assays. The rates of reporting of acceptable results by the participants were 96.6% for the Abbott assay, 96.3% for the Roche Cobas assay, 94.5% for the Roche Amplicor assay, 93.0% for the Biocentric assay, and 89.3% for the NucliSens assay. The overall mean proficiency scores improved over time (P=0.024). DTSs are a good alternative specimen type to plasma specimens for VL PT programs, as they do not require cold chain transportation and can be used on PCR-based assays. Our data suggest that the CDC HIV-1 VL PT program using DTSs positively impacts the testing performance of the participants, which might translate into better and more accurate VL testing services for patients. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Performance test results of noninvasive characterization of Resource Conservation and Recovery Act surrogate waste by prompt gamma neutron activation analysis

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

Gehrke, R.J.; Streier, G.G.

1997-03-01

During FY-96, a performance test was carried out with funding from the Mixed Waste Focus Area (MWFA) of the Department of Energy (DOE) to determine the noninvasive elemental assay capabilities of commercial companies for Resource Conservation and Recovery Act (RCRA) metals present in 8-gal drums containing surrogate waste. Commercial companies were required to be experienced in the use of prompt gamma neutron activation analysis (PGNAA) techniques and to have a prototype assay system with which to conduct the test assays. Potential participants were identified through responses to a call for proposals advertised in the Commerce Business Daily and through personalmore » contacts. Six companies were originally identified. Two of these six were willing and able to participate in the performance test, as described in the test plan, with some subsidizing from the DOE MWFA. The tests were conducted with surrogate sludge waste because (1) a large volume of this type of waste awaits final disposition and (2) sludge tends to be somewhat homogeneous. The surrogate concentrations of the above RCRA metals ranged from {approximately} 300 ppm to {approximately} 20,000 ppm. The lower limit was chosen as an estimate of the expected sensitivity of detection required by noninvasive, pretreatment elemental assay systems to be of value for operational and compliance purposes and to still be achievable with state-of-the-art methods of analysis. The upper limit of {approximately} 20,000 ppm was chosen because it is the opinion of the author that assay above this concentration level is within current state-of-the-art methods for most RCRA constituents. This report is organized into three parts: Part 1, Test Plan to Evaluate the Technical Status of Noninvasive Elemental Assay Techniques for Hazardous Waste; Part 2, Participants` Results; and Part 3, Evaluation of and Comments on Participants` Results.« less

A Cultural Resources Inventory and Historical Evaluation of the Smoky Atmospheric Nuclear Test, Areas 8, 9, and 10, Nevada National Security Site, Nye County, Nevada

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

Jones, Robert C.; King, Maureen L.; Beck, Colleen M.

This report presents the results of a National Historic Preservation Act Section 106 cultural resources inventory and historical evaluation of the 1957 Smoky atmospheric test location on the Nevada National Security Site (NNSS). The Desert Research Institute (DRI) was tasked to conduct a cultural resources study of the Smoky test area as a result of a proposed undertaking by the Department of Energy Environmental Management. This undertaking involves investigating Corrective Action Unit (CAU) 550 for potential contaminants of concern as delineated in a Corrective Action Investigation Plan. CAU 550 is an area that spatially overlaps portions of the Smoky testmore » location. Smoky, T-2c, was a 44 kt atmospheric nuclear test detonated at 5:30 am on August 31, 1957, on top of a 213.4 m (700 ft) 200 ton tower (T-2c) in Area 8 of the NNSS. Smoky was a weapons related test of the Plumbbob series (number 19) and part of the Department of Defense Exercise Desert Rock VII and VIII. The cultural resources effort involved the development of a historic context based on archival documents and engineering records, the inventory of the cultural resources in the Smoky test area and an associated military trench location in Areas 9 and 10, and an evaluation of the National Register eligibility of the cultural resources. The inventory of the Smoky test area resulted in the identification of structures, features, and artifacts related to the physical development of the test location and the post-test remains. The Smoky test area was designated historic district D104 and coincides with a historic archaeological site recorded as 26NY14794 and the military trenches designed for troop observation, site 26NY14795. Sites 26NY14794 and 26NY14795 are spatially discrete with the trenches located 4.3 km (2.7 mi) southeast of the Smoky ground zero. As a result, historic district D104 is discontiguous and in total it covers 151.4 hectares (374 acres). The Smoky test location, recorded as historic district D104 and historic sites 26NY14794 and 26NY14795, is the best preserved post-shot atmospheric nuclear tower test at the NNSS and possibly in the world. It is of local, national, and international importance due to nuclear testing’s pivotal role in the Cold War between the United States and the former Soviet Union. The district and sites are linked to the historic theme of atmospheric nuclear testing. D104 retains aspects of the engineering plan and design for the Smoky tower, instrument stations used to measure test effects, German and French personnel shelters, and military trenches. A total of 33 structures contribute to the significance of D104. Artifacts and features provide significant post-test information. Historic district D104 (discontiguous) and historic site 26NY14794 (the Smoky test area) are eligible for listing on the NRHP under Criteria A, B, C, and D. The historic site 26NY14795 (the Smoky military trenches) is eligible for listing under Criteria A, C, and D. Several items have been identified for removal by the CAU 550 investigation. However, none of them is associated with the Smoky atmospheric test, but with later activities in the area. The military trenches are not part of CAU 550 and no actions are planned there. A proposed closure of the Smoky test area with restrictions will limit access and contribute to the preservation of the cultural resources. It is recommended that the Smoky historic district and sites be included in the NNSS cultural resources monitoring program.« less

Summary of 1971 pattern recognition program development

NASA Technical Reports Server (NTRS)

Whitley, S. L.

1972-01-01

Eight areas related to pattern recognition analysis at the Earth Resources Laboratory are discussed: (1) background; (2) Earth Resources Laboratory goals; (3) software problems/limitations; (4) operational problems/limitations; (5) immediate future capabilities; (6) Earth Resources Laboratory data analysis system; (7) general program needs and recommendations; and (8) schedule and milestones.

42 CFR 435.4 - Definitions and use of terms.

Code of Federal Regulations, 2011 CFR

2011-10-01

... this part because their income and resources are within limits set by the State under its Medicaid plan (including persons whose income and resources fall within these limits after their incurred expenses for... who, generally, meet the categorical requirements or income or resource requirements that are the same...

Leaf Angle, Light Interception, and Water Relations.

ERIC Educational Resources Information Center

Knapp, Alan K.; Smith, Dixie L.

1997-01-01

Presents an exercise that demonstrates how plants cope with multiple resource limitations in the field. Stimulates students to think about interactions among multiple limited resources and the challenges plants as immobile organisms face when characteristics that increase the capture of one resource negatively impact the availability of another.…

How community action, science and common sense can work together to develop an alternative way to combat desertification.

PubMed

Bethune, Shirley; Schachtschneider, Klaudia

2004-12-01

The Spitzkoppe Community Campsite in western Namibia lies in an area with very limited water resources. Water scarcity places a constraint on community income generation and development opportunities. The existing water resources are overexploited and to ensure future water security, the community must take sustainable water management into consideration in their daily lives and business ventures, including tourism. This has been successfully achieved at the Spitzkoppe Community Campsite through a combination of high community motivation, organisation and action, the involvement of researchers and trainers in water resource management and support from developers. The most appropriate water management solutions were found through ongoing practical testing of different strategies and technologies over two years. This paper presents a case study of a community-based tourist camp at Spitzkoppe and traces the community's progress towards developing an alternative way to combat desertification and a potentially lucrative tourist business.

Workplace Bullying Among Teachers: An Analysis From the Job Demands-Resources (JD-R) Model Perspective.

PubMed

Ariza-Montes, Antonio; Muniz R, Noel M; Leal-Rodríguez, Antonio L; Leal-Millán, Antonio G

2016-08-01

This paper adopts the Job Demands-Resources (JD-R) model to analyze workplace bullying among teachers. The data used for this research are obtained from the 5th European Working Conditions Survey. Given the objective of this work, a subsample of 261 education employees is collected: 48.7% of these teachers report having experienced workplace bullying (N = 127), while 51.3% indicate not considering themselves as bullied at work (N = 134). In order to test the research model and hypotheses, this study relies on the use of partial least squares (PLS-SEM), a variance-based structural equation modeling method. The study describes a workplace bullying prevalence rate of 4.4% among education employees. This work summarizes an array of outcomes with the aim of proposing, in general, that workplace bullying may be reduced by limiting job demands and increasing job resources.

Resource allocation. The cost of care: two troublesome cases in health care ethics.

PubMed

Armstrong, C R; Whitlock, R

1998-01-01

With the cost of health care rising rapidly, both physicians and administrators regularly face resource allocation decisions. Under these conditions of relative scarcity, the equitable and appropriate distribution of limited resources becomes an ethical as well as a financial issue. Through ethical analysis, physician executives can assist their physician colleagues and fellow administrators to find rationally defensible answers to questions regarding the distribution of limited resources. Six criteria are frequently "weighted in the balance" by ethicists when analyzing whether justice is served in the distribution of a limited resource: need, equality, contribution, ability to pay, effort, and merit. The authors argue that, from an ethical standpoint, the best single criterion upon which one can base an allocation decision is that of merit, defined as the potential to benefit from the investment of additional resources.

How Much Higher Can HTCondor Fly?

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

Fajardo, E. M.; Dost, J. M.; Holzman, B.

The HTCondor high throughput computing system is heavily used in the high energy physics (HEP) community as the batch system for several Worldwide LHC Computing Grid (WLCG) resources. Moreover, it is the backbone of GlidelnWMS, the pilot system used by the computing organization of the Compact Muon Solenoid (CMS) experiment. To prepare for LHC Run 2, we probed the scalability limits of new versions and configurations of HTCondor with a goal of reaching 200,000 simultaneous running jobs in a single internationally distributed dynamic pool.In this paper, we first describe how we created an opportunistic distributed testbed capable of exercising runsmore » with 200,000 simultaneous jobs without impacting production. This testbed methodology is appropriate not only for scale testing HTCondor, but potentially for many other services. In addition to the test conditions and the testbed topology, we include the suggested configuration options used to obtain the scaling results, and describe some of the changes to HTCondor inspired by our testing that enabled sustained operations at scales well beyond previous limits.« less

Memory for a single object has differently variable precisions for relevant and irrelevant features.

PubMed

Swan, Garrett; Collins, John; Wyble, Brad

2016-01-01

Working memory is a limited resource. To further characterize its limitations, it is vital to understand exactly what is encoded about a visual object beyond the "relevant" features probed in a particular task. We measured the memory quality of a task-irrelevant feature of an attended object by coupling a delayed estimation task with a surprise test. Participants were presented with a single colored arrow and were asked to retrieve just its color for the first half of the experiment before unexpectedly being asked to report its direction. Mixture modeling of the data revealed that participants had highly variable precision on the surprise test, indicating a coarse-grained memory for the irrelevant feature. Following the surprise test, all participants could precisely recall the arrow's direction; however, this improvement in direction memory came at a cost in precision for color memory even though only a single object was being remembered. We attribute these findings to varying levels of attention to different features during memory encoding.

Investigations using data from Earth Resources Technology Satellite in the fields of agriculture/geography. Timber inventory (land use) in the Province of Huelva, Spain

NASA Technical Reports Server (NTRS)

Debenito, E.; Lopez-Cuervo, S.; Rodriguez, J.

1973-01-01

A test site was chosen for the purpose of elaborating the patterns for the future total use of the satellite photographs. The election of the test site was made with the following criteria in mind: (1) a flat terrain for eliminating the dangers of shadows produced by a difficult topography; and (2) searching of well defined natural limits for the test site. Due to the lack of satellite photographs from the study area, a number of photos from the northern area of Spain have been studied from the point of view of obtaining answers from the spectra of the vegetation masses.

Arsenic in private drinking water wells: an assessment of jurisdictional regulations and guidelines for risk remediation in North America.

PubMed

Chappells, Heather; Parker, Louise; Fernandez, Conrad V; Conrad, Cathy; Drage, John; O'Toole, Gary; Campbell, Norma; Dummer, Trevor J B

2014-09-01

Arsenic is a known carcinogen found globally in groundwater supplies due to natural geological occurrence. Levels exceeding the internationally recognized safe drinking water standard of 10 μg/L have been found in private drinking water supplies in many parts of Canada and the United States. Emerging epidemiological evidence confirms groundwater arsenic to be a significant health concern, even at the low to moderate levels typically found in this region. These findings, coupled with survey data reporting limited public adherence to testing and treatment guidelines, have prompted calls for improved protective measures for private well users. The purpose of this review is to assess current jurisdictional provisions for private well water protection in areas where arsenic is known to naturally occur in groundwater at elevated levels. Significant limitations in risk management approaches are identified, including inconsistent and uncoordinated risk communication approaches, lack of support mechanisms for routine water testing and limited government resources to check that testing and treatment guidelines are followed. Key action areas are discussed that can help to build regulatory, community and individual capacity for improved protection of private well water supplies and enhancement of public health.

Improved Linear Algebra Methods for Redshift Computation from Limited Spectrum Data - II

NASA Technical Reports Server (NTRS)

Foster, Leslie; Waagen, Alex; Aijaz, Nabella; Hurley, Michael; Luis, Apolo; Rinsky, Joel; Satyavolu, Chandrika; Gazis, Paul; Srivastava, Ashok; Way, Michael

2008-01-01

Given photometric broadband measurements of a galaxy, Gaussian processes may be used with a training set to solve the regression problem of approximating the redshift of this galaxy. However, in practice solving the traditional Gaussian processes equation is too slow and requires too much memory. We employed several methods to avoid this difficulty using algebraic manipulation and low-rank approximation, and were able to quickly approximate the redshifts in our testing data within 17 percent of the known true values using limited computational resources. The accuracy of one method, the V Formulation, is comparable to the accuracy of the best methods currently used for this problem.

Direction information in multiple object tracking is limited by a graded resource.

PubMed

Horowitz, Todd S; Cohen, Michael A

2010-10-01

Is multiple object tracking (MOT) limited by a fixed set of structures (slots), a limited but divisible resource, or both? Here, we answer this question by measuring the precision of the direction representation for tracked targets. The signature of a limited resource is a decrease in precision as the square root of the tracking load. The signature of fixed slots is a fixed precision. Hybrid models predict a rapid decrease to asymptotic precision. In two experiments, observers tracked moving disks and reported target motion direction by adjusting a probe arrow. We derived the precision of representation of correctly tracked targets using a mixture distribution analysis. Precision declined with target load according to the square-root law up to six targets. This finding is inconsistent with both pure and hybrid slot models. Instead, directional information in MOT appears to be limited by a continuously divisible resource.

Use of a Rapid Test for Diagnosis of Dengue during Suspected Dengue Outbreaks in Resource-Limited Regions

PubMed Central

Sharp, Tyler M.; Lalita, Paul; Tikomaidraubuta, Kini; Cardoso, Yolanda Rebello; Naivalu, Taina; Khan, Aalisha Sahu; Marfel, Maria; Hancock, W. Thane; Tomashek, Kay M.; Margolis, Harold S.

2016-01-01

Dengue is major public health problem, globally. Timely verification of suspected dengue outbreaks allows for public health response, leading to the initiation of appropriate clinical care. Because the clinical presentation of dengue is nonspecific, dengue diagnosis would benefit from a sensitive rapid diagnostic test (RDT). We evaluated the diagnostic performance of an RDT that detects dengue virus (DENV) nonstructural protein 1 (NS1) and anti-DENV IgM during suspected acute febrile illness (AFI) outbreaks in four countries. Real-time reverse transcription-PCR and anti-DENV IgM enzyme-linked immunosorbent assay were used to verify RDT results. Anti-DENV IgM RDT sensitivity and specificity ranged from 55.3 to 91.7% and 85.3 to 98.5%, respectively, and NS1 sensitivity and specificity ranged from 49.7 to 92.9% and 22.2 to 89.0%, respectively. Sensitivity varied by timing of specimen collection and DENV serotype. Combined test results moderately improved the sensitivity. The use of RDTs identified dengue as the cause of AFI outbreaks where reference diagnostic testing was limited or unavailable. PMID:27225409

What resources are used in emergency departments in rural sub-Saharan Africa? A retrospective analysis of patient care in a district-level hospital in Uganda.

PubMed

Bitter, Cindy Carol; Rice, Brian; Periyanayagam, Usha; Dreifuss, Bradley; Hammerstedt, Heather; Nelson, Sara W; Bisanzo, Mark; Maling, Samuel; Chamberlain, Stacey

2018-02-24

To determine the most commonly used resources (provider procedural skills, medications, laboratory studies and imaging) needed to care for patients. A single emergency department (ED) of a district-level hospital in rural Uganda. 26 710 patient visits. Procedures were performed for 65.6% of patients, predominantly intravenous cannulation, wound care, bladder catheterisation and orthopaedic procedures. Medications were administered to 87.6% of patients, most often pain medications, antibiotics, intravenous fluids, antimalarials, nutritional supplements and vaccinations. Laboratory testing was used for 85% of patients, predominantly malaria smears, rapid glucose testing, HIV assays, blood counts, urinalyses and blood type. Radiology testing was performed for 17.3% of patients, including X-rays, point-of-care ultrasound and formal ultrasound. This study describes the skills and resources needed to care for a large prospective cohort of patients seen in a district hospital ED in rural sub-Saharan Africa. It demonstrates that the vast majority of patients were treated with a small formulary of critical medications and limited access to laboratories and imaging, but providers require a broad set of decision-making and procedural skills. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Towards biomarker-based tests that can facilitate decisions about prevention and management of preeclampsia in low-resource settings.

PubMed

Acestor, Nathalie; Goett, Jane; Lee, Arthur; Herrick, Tara M; Engelbrecht, Susheela M; Harner-Jay, Claudia M; Howell, Bonnie J; Weigl, Bernhard H

2016-01-01

In recent years, an increasing amount of literature is emerging on candidate urine and blood-based biomarkers associated with incidence and severity of preeclampsia (PE) in pregnant women. While enthusiasm on the usefulness of several of these markers in predicting PE is evolving, essentially all work so far has focused on the needs of high-resource settings and high-income countries, resulting primarily in multi-parameter laboratory assays based on proteomic and metabolomics analysis techniques. These highly complex methods, however, require laboratory capabilities that are rarely available or affordable in low-resource settings (LRS). The importance of quantifying maternal and perinatal risks and identifying which pregnancies can be safely prolonged is also much greater in LRS, where intensive care facilities that can rapidly respond to PE-related health threats for women and infants are limited. For these reasons, simple, low cost, sensitive, and specific point-of-care (POC) tests are needed that can be performed by antenatal health care providers in LRS and that can facilitate decisions about detection and management of PE. Our study aims to provide a comprehensive systematic review of current and emerging blood and urine biomarkers for PE, not only on the basis of their clinical performance, but also of their suitability to be used in LRS-compatible test formats, such as lateral flow and other variants of POC rapid assays.

Launching a Laboratory Testing Process Quality Improvement Toolkit: From the Shared Networks of Colorado Ambulatory Practices and Partners (SNOCAP).

PubMed

Fernald, Douglas; Hamer, Mika; James, Kathy; Tutt, Brandon; West, David

2015-01-01

Family medicine and internal medicine physicians order diagnostic laboratory tests for nearly one-third of patient encounters in an average week, yet among medical errors in primary care, an estimated 15% to 54% are attributed to laboratory testing processes. From a practice improvement perspective, we (1) describe the need for laboratory testing process quality improvements from the perspective of primary care practices, and (2) describe the approaches and resources needed to implement laboratory testing process quality improvements in practice. We applied practice observations, process mapping, and interviews with primary care practices in the Shared Networks of Colorado Ambulatory Practices and Partners (SNOCAP)-affiliated practice-based research networks that field-tested in 2013 a laboratory testing process improvement toolkit. From the data collected in each of the 22 participating practices, common testing quality issues included, but were not limited to, 3 main testing process steps: laboratory test preparation, test tracking, and patient notification. Three overarching qualitative themes emerged: practices readily acknowledge multiple laboratory testing process problems; practices know that they need help addressing the issues; and practices face challenges with finding patient-centered solutions compatible with practice priorities and available resources. While practices were able to get started with guidance and a toolkit to improve laboratory testing processes, most did not seem able to achieve their quality improvement aims unassisted. Providing specific guidance tools with practice facilitation or other rapid-cycle quality improvement support may be an effective approach to improve common laboratory testing issues in primary care. © Copyright 2015 by the American Board of Family Medicine.

Cost-effectiveness of point-of-care viral load monitoring of antiretroviral therapy in resource-limited settings: mathematical modelling study.

PubMed

Estill, Janne; Egger, Matthias; Blaser, Nello; Vizcaya, Luisa Salazar; Garone, Daniela; Wood, Robin; Campbell, Jennifer; Hallett, Timothy B; Keiser, Olivia

2013-06-01

Monitoring of HIV viral load in patients on combination antiretroviral therapy (ART) is not generally available in resource-limited settings. We examined the cost-effectiveness of qualitative point-of-care viral load tests (POC-VL) in sub-Saharan Africa. Mathematical model based on longitudinal data from the Gugulethu and Khayelitsha township ART programmes in Cape Town, South Africa. Cohorts of patients on ART monitored by POC-VL, CD4 cell count or clinically were simulated. Scenario A considered the more accurate detection of treatment failure with POC-VL only, and scenario B also considered the effect on HIV transmission. Scenario C further assumed that the risk of virologic failure is halved with POC-VL due to improved adherence. We estimated the change in costs per quality-adjusted life-year gained (incremental cost-effectiveness ratios, ICERs) of POC-VL compared with CD4 and clinical monitoring. POC-VL tests with detection limits less than 1000 copies/ml increased costs due to unnecessary switches to second-line ART, without improving survival. Assuming POC-VL unit costs between US$5 and US$20 and detection limits between 1000 and 10,000 copies/ml, the ICER of POC-VL was US$4010-US$9230 compared with clinical and US$5960-US$25540 compared with CD4 cell count monitoring. In Scenario B, the corresponding ICERs were US$2450-US$5830 and US$2230-US$10380. In Scenario C, the ICER ranged between US$960 and US$2500 compared with clinical monitoring and between cost-saving and US$2460 compared with CD4 monitoring. The cost-effectiveness of POC-VL for monitoring ART is improved by a higher detection limit, by taking the reduction in new HIV infections into account and assuming that failure of first-line ART is reduced due to targeted adherence counselling.

Potential environmental and human health impacts of rechargeable lithium batteries in electronic waste.

PubMed

Kang, Daniel Hsing Po; Chen, Mengjun; Ogunseitan, Oladele A

2013-05-21

Rechargeable lithium-ion (Li-ion) and lithium-polymer (Li-poly) batteries have recently become dominant in consumer electronic products because of advantages associated with energy density and product longevity. However, the small size of these batteries, the high rate of disposal of consumer products in which they are used, and the lack of uniform regulatory policy on their disposal means that lithium batteries may contribute substantially to environmental pollution and adverse human health impacts due to potentially toxic materials. In this research, we used standardized leaching tests, life-cycle impact assessment (LCIA), and hazard assessment models to evaluate hazardous waste classification, resource depletion potential, and toxicity potentials of lithium batteries used in cellphones. Our results demonstrate that according to U.S. federal regulations, defunct Li-ion batteries are classified hazardous due to their lead (Pb) content (average 6.29 mg/L; σ = 11.1; limit 5). However, according to California regulations, all lithium batteries tested are classified hazardous due to excessive levels of cobalt (average 163,544 mg/kg; σ = 62,897; limit 8000), copper (average 98,694 mg/kg; σ = 28,734; limit 2500), and nickel (average 9525 mg/kg; σ = 11,438; limit 2000). In some of the Li-ion batteries, the leached concentrations of chromium, lead, and thallium exceeded the California regulation limits. The environmental impact associated with resource depletion and human toxicity is mainly associated with cobalt, copper, nickel, thallium, and silver, whereas the ecotoxicity potential is primarily associated with cobalt, copper, nickel, thallium, and silver. However, the relative contribution of aluminum and lithium to human toxicity and ecotoxicity could not be estimated due to insufficient toxicity data in the models. These findings support the need for stronger government policy at the local, national, and international levels to encourage recovery, recycling, and reuse of lithium battery materials.

Potential Environmental and Human Health Impacts of Rechargeable Lithium Batteries in Electronic Waste

PubMed Central

Kang, Daniel Hsing Po; Chen, Mengjun; Ogunseitan, Oladele A.

2013-01-01

Rechargeable lithium-ion (Li-ion) and lithium-polymer (Li-poly) batteries have recently become dominant in consumer electronic products because of advantages associated with energy density and product longevity. However, the small size of these batteries, the high rate of disposal of consumer products in which they are used, and the lack of uniform regulatory policy on their disposal means that lithium batteries may contribute substantially to environmental pollution and adverse human health impacts due to potentially toxic materials. In this research, we used standardized leaching tests, life-cycle impact assessment (LCIA), and hazard assessment models to evaluate hazardous waste classification, resource depletion potential, and toxicity potentials of lithium batteries used in cellphones. Our results demonstrate that according to U.S. federal regulations, defunct Li-ion batteries are classified hazardous due to their lead (Pb) content (average 6.29 mg/L; σ = 11.1; limit 5). However, according to California regulations, all lithium batteries tested are classified hazardous due to excessive levels of cobalt (average 163 544 mg/kg; σ = 62 897; limit 8000), copper (average 98 694 mg/kg; σ = 28 734; limit 2500), and nickel (average 9525 mg/kg; σ = 11 438; limit 2000). In some of the Li-ion batteries, the leached concentrations of chromium, lead, and thallium exceeded the California regulation limits. The environmental impact associated with resource depletion and human toxicity is mainly associated with cobalt, copper, nickel, thallium, and silver, whereas the ecotoxicity potential is primarily associated with cobalt, copper, nickel, thallium, and silver. However, the relative contribution of aluminum and lithium to human toxicity and ecotoxicity could not be estimated due to insufficient toxicity data in the models. These findings support the need for stronger government policy at the local, national, and international levels to encourage recovery, recycling, and reuse of lithium battery materials. PMID:23638841

Automated Item Generation with Recurrent Neural Networks.

PubMed

von Davier, Matthias

2018-03-12

Utilizing technology for automated item generation is not a new idea. However, test items used in commercial testing programs or in research are still predominantly written by humans, in most cases by content experts or professional item writers. Human experts are a limited resource and testing agencies incur high costs in the process of continuous renewal of item banks to sustain testing programs. Using algorithms instead holds the promise of providing unlimited resources for this crucial part of assessment development. The approach presented here deviates in several ways from previous attempts to solve this problem. In the past, automatic item generation relied either on generating clones of narrowly defined item types such as those found in language free intelligence tests (e.g., Raven's progressive matrices) or on an extensive analysis of task components and derivation of schemata to produce items with pre-specified variability that are hoped to have predictable levels of difficulty. It is somewhat unlikely that researchers utilizing these previous approaches would look at the proposed approach with favor; however, recent applications of machine learning show success in solving tasks that seemed impossible for machines not too long ago. The proposed approach uses deep learning to implement probabilistic language models, not unlike what Google brain and Amazon Alexa use for language processing and generation.

Cost analysis of centralized viral load testing for antiretroviral therapy monitoring in Nicaragua, a low-HIV prevalence, low-resource setting.

PubMed

Gerlach, Jay; Sequeira, Magda; Alvarado, Vivian; Cerpas, Christian; Balmaseda, Angel; Gonzalez, Alcides; de Los Santos, Tala; Levin, Carol E; Amador, Juan Jose; Domingo, Gonzalo J

2010-11-05

HIV viral load testing as a component of antiretroviral therapy monitoring is costly. Understanding the full costs and the major sources of inefficiency associated with viral load testing is critical for optimizing the systems and technologies that support the testing process. The objective of our study was to estimate the costs associated with viral load testing performed for antiretroviral therapy monitoring to both patients and the public healthcare system in a low-HIV prevalence, low-resource country. A detailed cost analysis was performed to understand the costs involved in each step of performing a viral load test in Nicaragua, from initial specimen collection to communication of the test results to each patient's healthcare provider. Data were compiled and cross referenced from multiple information sources: laboratory records, regional surveillance centre records, and scheduled interviews with the key healthcare providers responsible for HIV patient care in five regions of the country. The total average cost of performing a viral load test in Nicaragua varied by region, ranging from US$99.01 to US$124.58, the majority of which was at the laboratory level: $88.73 to $97.15 per specimen, depending on batch size. The average cost to clinics at which specimens were collected ranged from $3.31 to $20.92, depending on the region. The average cost per patient for transportation, food, lodging and lost income ranged from $3.70 to $14.93. The quantitative viral load test remains the single most expensive component of the process. For the patient, the distance of his or her residence from the specimen collection site is a large determinant of cost. Importantly, the efficiency of results reporting has a large impact on the cost per result delivered to the clinician and utility of the result for patient monitoring. Detailed cost analysis can identify opportunities for removing barriers to effective antiretroviral therapy monitoring programmes in limited-resource countries with low HIV prevalence.

28 CFR 16.92 - Exemption of Environment and Natural Resources Division Systems-limited access.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Environment and Natural Resources Division Case and Related Files System, JUSTICE/ENRD-003. (ii) [Reserved] (2... Resources Division Systems-limited access. 16.92 Section 16.92 Judicial Administration DEPARTMENT OF JUSTICE PRODUCTION OR DISCLOSURE OF MATERIAL OR INFORMATION Exemption of Records Systems Under the Privacy Act § 16...

28 CFR 16.92 - Exemption of Environment and Natural Resources Division Systems-limited access.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Environment and Natural Resources Division Case and Related Files System, JUSTICE/ENRD-003. (ii) [Reserved] (2... Resources Division Systems-limited access. 16.92 Section 16.92 Judicial Administration DEPARTMENT OF JUSTICE PRODUCTION OR DISCLOSURE OF MATERIAL OR INFORMATION Exemption of Records Systems Under the Privacy Act § 16...

28 CFR 16.92 - Exemption of Environment and Natural Resources Division Systems-limited access.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Environment and Natural Resources Division Case and Related Files System, JUSTICE/ENRD-003. (ii) [Reserved] (2... Resources Division Systems-limited access. 16.92 Section 16.92 Judicial Administration DEPARTMENT OF JUSTICE PRODUCTION OR DISCLOSURE OF MATERIAL OR INFORMATION Exemption of Records Systems Under the Privacy Act § 16...

18 CFR 701.207 - Extension of time limits for WRC initial and final determinations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 2 2012-04-01 2012-04-01 false Extension of time limits for WRC initial and final determinations. 701.207 Section 701.207 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Availability of Information § 701.207 Extension of...

18 CFR 701.205 - Time limit for requester to appeal an initial adverse determination.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Time limit for requester to appeal an initial adverse determination. 701.205 Section 701.205 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Availability of Information § 701.205 Time...

18 CFR 701.204 - Time limits for WRC initial determinations regarding requests for information.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Time limits for WRC initial determinations regarding requests for information. 701.204 Section 701.204 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Availability of Information § 701.204...

18 CFR 701.207 - Extension of time limits for WRC initial and final determinations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 2 2011-04-01 2011-04-01 false Extension of time limits for WRC initial and final determinations. 701.207 Section 701.207 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Availability of Information § 701.207 Extension of...

18 CFR 701.207 - Extension of time limits for WRC initial and final determinations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true Extension of time limits for WRC initial and final determinations. 701.207 Section 701.207 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Availability of Information § 701.207 Extension of...

18 CFR 701.207 - Extension of time limits for WRC initial and final determinations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Extension of time limits for WRC initial and final determinations. 701.207 Section 701.207 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Availability of Information § 701.207 Extension of...

18 CFR 701.204 - Time limits for WRC initial determinations regarding requests for information.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 2 2012-04-01 2012-04-01 false Time limits for WRC initial determinations regarding requests for information. 701.204 Section 701.204 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Availability of Information § 701.204...

18 CFR 701.205 - Time limit for requester to appeal an initial adverse determination.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 2 2014-04-01 2014-04-01 false Time limit for requester to appeal an initial adverse determination. 701.205 Section 701.205 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Availability of Information § 701.205 Time...

18 CFR 701.204 - Time limits for WRC initial determinations regarding requests for information.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 2 2014-04-01 2014-04-01 false Time limits for WRC initial determinations regarding requests for information. 701.204 Section 701.204 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Availability of Information § 701.204...

18 CFR 701.204 - Time limits for WRC initial determinations regarding requests for information.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 2 2011-04-01 2011-04-01 false Time limits for WRC initial determinations regarding requests for information. 701.204 Section 701.204 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Availability of Information § 701.204...

18 CFR 701.204 - Time limits for WRC initial determinations regarding requests for information.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true Time limits for WRC initial determinations regarding requests for information. 701.204 Section 701.204 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Availability of Information § 701.204...

18 CFR 701.207 - Extension of time limits for WRC initial and final determinations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 2 2014-04-01 2014-04-01 false Extension of time limits for WRC initial and final determinations. 701.207 Section 701.207 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Availability of Information § 701.207 Extension of...

18 CFR 701.205 - Time limit for requester to appeal an initial adverse determination.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 2 2012-04-01 2012-04-01 false Time limit for requester to appeal an initial adverse determination. 701.205 Section 701.205 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Availability of Information § 701.205 Time...

18 CFR 701.205 - Time limit for requester to appeal an initial adverse determination.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 2 2011-04-01 2011-04-01 false Time limit for requester to appeal an initial adverse determination. 701.205 Section 701.205 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL ORGANIZATION Availability of Information § 701.205 Time...

28 CFR 16.92 - Exemption of Environment and Natural Resources Division Systems-limited access.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Exemption of Environment and Natural....92 Exemption of Environment and Natural Resources Division Systems—limited access. (a)(1) The...) Environment and Natural Resources Division Case and Related Files System, JUSTICE/ENRD-003. (ii) [Reserved] (2...

28 CFR 16.92 - Exemption of Environment and Natural Resources Division Systems-limited access.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Exemption of Environment and Natural....92 Exemption of Environment and Natural Resources Division Systems—limited access. (a)(1) The...) Environment and Natural Resources Division Case and Related Files System, JUSTICE/ENRD-003. (ii) [Reserved] (2...

7 CFR 624.9 - Time limits.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 6 2014-01-01 2014-01-01 false Time limits. 624.9 Section 624.9 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE WATER RESOURCES EMERGENCY WATERSHED PROTECTION § 624.9 Time limits. Funds must be obligated by the...

7 CFR 624.9 - Time limits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 6 2010-01-01 2010-01-01 false Time limits. 624.9 Section 624.9 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE WATER RESOURCES EMERGENCY WATERSHED PROTECTION § 624.9 Time limits. Funds must be obligated by the...

18 CFR 807.2 - Time limits.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Time limits. 807.2 Section 807.2 Conservation of Power and Water Resources SUSQUEHANNA RIVER BASIN COMMISSION WATER WITHDRAWAL REGISTRATION § 807.2 Time limits. (a) Except for agricultural water use projects, all registration...

18 CFR 807.2 - Time limits.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 2 2012-04-01 2012-04-01 false Time limits. 807.2 Section 807.2 Conservation of Power and Water Resources SUSQUEHANNA RIVER BASIN COMMISSION WATER WITHDRAWAL REGISTRATION § 807.2 Time limits. (a) Except for agricultural water use projects, all registration...

7 CFR 624.9 - Time limits.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 6 2013-01-01 2013-01-01 false Time limits. 624.9 Section 624.9 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE WATER RESOURCES EMERGENCY WATERSHED PROTECTION § 624.9 Time limits. Funds must be obligated by the...

18 CFR 807.2 - Time limits.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true Time limits. 807.2 Section 807.2 Conservation of Power and Water Resources SUSQUEHANNA RIVER BASIN COMMISSION WATER WITHDRAWAL REGISTRATION § 807.2 Time limits. (a) Except for agricultural water use projects, all registration...

7 CFR 624.9 - Time limits.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 6 2011-01-01 2011-01-01 false Time limits. 624.9 Section 624.9 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE WATER RESOURCES EMERGENCY WATERSHED PROTECTION § 624.9 Time limits. Funds must be obligated by the...

18 CFR 807.2 - Time limits.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 2 2011-04-01 2011-04-01 false Time limits. 807.2 Section 807.2 Conservation of Power and Water Resources SUSQUEHANNA RIVER BASIN COMMISSION WATER WITHDRAWAL REGISTRATION § 807.2 Time limits. (a) Except for agricultural water use projects, all registration...

18 CFR 807.2 - Time limits.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 2 2014-04-01 2014-04-01 false Time limits. 807.2 Section 807.2 Conservation of Power and Water Resources SUSQUEHANNA RIVER BASIN COMMISSION WATER WITHDRAWAL REGISTRATION § 807.2 Time limits. (a) Except for agricultural water use projects, all registration...

7 CFR 624.9 - Time limits.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 6 2012-01-01 2012-01-01 false Time limits. 624.9 Section 624.9 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE WATER RESOURCES EMERGENCY WATERSHED PROTECTION § 624.9 Time limits. Funds must be obligated by the...

Testing the Limits of the Price Elasticity of Potential Students at Colleges and Universities: Has the Increased Direct Cost to the Student Begun to Drive down Higher Education Enrolment?

ERIC Educational Resources Information Center

Fincher, Mark; Katsinas, Stephen

2017-01-01

Higher education enrolment has long been known to rise and fall counter to the current economic situation. This counter-cyclical enrolment response represents an economic principle where a price-elastic consumer is more likely make a consumption choice when another valuable use of resources is not available. Higher unemployment has historically…

How to allocate limited healthcare resources: Lessons from the introduction of antiretroviral therapy in rural Mozambique

PubMed Central

Dodson, Zan M.; Agadjanian, Victor; Driessen, Julia

2016-01-01

Proper allocation of limited healthcare resources is a challenging task for policymakers in developing countries. Allocation of and access to these resources typically varies based on how need is defined, thus determining how individuals access and acquire healthcare. Using the introduction of antiretroviral therapy in southern Mozambique as an example, we examine alternative definitions of need for rural populations and how they might impact the allocation of this vital health service. Our results show that how need is defined matters when allocating limited healthcare resources and the use of need-based metrics can help ensure more optimal distribution of services. PMID:28596630

Replacement of Hydrochlorofluorocarbon (HCFC) -225 Solvent for Cleaning and Verification Sampling of NASA Propulsion Oxygen Systems Hardware, Ground Support Equipment, and Associated Test Systems

NASA Technical Reports Server (NTRS)

Mitchell, Mark A.; Lowrey, Nikki M.

2015-01-01

Since the 1990's, when the Class I Ozone Depleting Substance (ODS) chlorofluorocarbon-113 (CFC-113) was banned, NASA's rocket propulsion test facilities at Marshall Space Flight Center (MSFC) and Stennis Space Center (SSC) have relied upon hydrochlorofluorocarbon-225 (HCFC-225) to safely clean and verify the cleanliness of large scale propulsion oxygen systems. Effective January 1, 2015, the production, import, export, and new use of HCFC-225, a Class II ODS, was prohibited by the Clean Air Act. In 2012 through 2014, leveraging resources from both the NASA Rocket Propulsion Test Program and the Defense Logistics Agency - Aviation Hazardous Minimization and Green Products Branch, test labs at MSFC, SSC, and Johnson Space Center's White Sands Test Facility (WSTF) collaborated to seek out, test, and qualify a replacement for HCFC-225 that is both an effective cleaner and safe for use with oxygen systems. Candidate solvents were selected and a test plan was developed following the guidelines of ASTM G127, Standard Guide for the Selection of Cleaning Agents for Oxygen Systems. Solvents were evaluated for materials compatibility, oxygen compatibility, cleaning effectiveness, and suitability for use in cleanliness verification and field cleaning operations. Two solvents were determined to be acceptable for cleaning oxygen systems and one was chosen for implementation at NASA's rocket propulsion test facilities. The test program and results are summarized. This project also demonstrated the benefits of cross-agency collaboration in a time of limited resources.

Addition of multiple limiting resources reduces grassland diversity.

PubMed

Harpole, W Stanley; Sullivan, Lauren L; Lind, Eric M; Firn, Jennifer; Adler, Peter B; Borer, Elizabeth T; Chase, Jonathan; Fay, Philip A; Hautier, Yann; Hillebrand, Helmut; MacDougall, Andrew S; Seabloom, Eric W; Williams, Ryan; Bakker, Jonathan D; Cadotte, Marc W; Chaneton, Enrique J; Chu, Chengjin; Cleland, Elsa E; D'Antonio, Carla; Davies, Kendi F; Gruner, Daniel S; Hagenah, Nicole; Kirkman, Kevin; Knops, Johannes M H; La Pierre, Kimberly J; McCulley, Rebecca L; Moore, Joslin L; Morgan, John W; Prober, Suzanne M; Risch, Anita C; Schuetz, Martin; Stevens, Carly J; Wragg, Peter D

2016-09-01

Niche dimensionality provides a general theoretical explanation for biodiversity-more niches, defined by more limiting factors, allow for more ways that species can coexist. Because plant species compete for the same set of limiting resources, theory predicts that addition of a limiting resource eliminates potential trade-offs, reducing the number of species that can coexist. Multiple nutrient limitation of plant production is common and therefore fertilization may reduce diversity by reducing the number or dimensionality of belowground limiting factors. At the same time, nutrient addition, by increasing biomass, should ultimately shift competition from belowground nutrients towards a one-dimensional competitive trade-off for light. Here we show that plant species diversity decreased when a greater number of limiting nutrients were added across 45 grassland sites from a multi-continent experimental network. The number of added nutrients predicted diversity loss, even after controlling for effects of plant biomass, and even where biomass production was not nutrient-limited. We found that elevated resource supply reduced niche dimensionality and diversity and increased both productivity and compositional turnover. Our results point to the importance of understanding dimensionality in ecological systems that are undergoing diversity loss in response to multiple global change factors.

Resource Allocation and Seed Size Selection in Perennial Plants under Pollen Limitation.

PubMed

Huang, Qiaoqiao; Burd, Martin; Fan, Zhiwei

2017-09-01

Pollen limitation may affect resource allocation patterns in plants, but its role in the selection of seed size is not known. Using an evolutionarily stable strategy model of resource allocation in perennial iteroparous plants, we show that under density-independent population growth, pollen limitation (i.e., a reduction in ovule fertilization rate) should increase the optimal seed size. At any level of pollen limitation (including none), the optimal seed size maximizes the ratio of juvenile survival rate to the resource investment needed to produce one seed (including both ovule production and seed provisioning); that is, the optimum maximizes the fitness effect per unit cost. Seed investment may affect allocation to postbreeding adult survival. In our model, pollen limitation increases individual seed size but decreases overall reproductive allocation, so that pollen limitation should also increase the optimal allocation to postbreeding adult survival. Under density-dependent population growth, the optimal seed size is inversely proportional to ovule fertilization rate. However, pollen limitation does not affect the optimal allocation to postbreeding adult survival and ovule production. These results highlight the importance of allocation trade-offs in the effect pollen limitation has on the ecology and evolution of seed size and postbreeding adult survival in perennial plants.

Determinants of VIA (Visual Inspection of the Cervix After Acetic Acid Application) Positivity in Cervical Cancer Screening of Women in a Peri-Urban Area in Andhra Pradesh, India

PubMed Central

Vedantham, Haripriya; Silver, Michelle I.; Kalpana, B.; Rekha, C.; Karuna, B.P.; Vidyadhari, K.; Mrudula, S.; Ronnett, Brigitte M.; Vijayaraghavan, K.; Ramakrishna, Gayatri; Sowjanya, Pavani; Laxmi, Shantha; Shah, Keerti V.; Gravitt, Patti E.

2010-01-01

Objectives Visual inspection of the cervix after acetic acid application (VIA) is widely recommended as the method of choice in cervical cancer screening programs in resource-limited settings because of its simplicity and ability to link with immediate treatment. In testing the effectiveness of VIA, human papillomavirus DNA testing, and Pap cytology in a population-based study in a peri-urban area in Andhra Pradesh, India, we found the sensitivity of VIA for detection of cervical intraepithelial neoplasia grade 2 and worse (CIN2+) to be 26.3%, much lower than the 60% to 90% reported in the literature. We therefore investigated the determinants of VIA positivity in our study population. Methods We evaluated VIA positivity by demographics and reproductive history, results of clinical examination, and results from the other screening methods. Results Of the 19 women diagnosed with CIN2+, only 5 were positive by VIA (positive predictive value, 3.1%). In multivariate analysis, VIA positivity (12.74%) was associated with older age, positive Pap smear, visually apparent cervical inflammation, and interobserver variation. Cervical inflammation of unknown cause was present in 21.62% of women. In disease-negative women, cervical inflammation was associated with an increase in VIA positivity from 6.1% to 15.5% (P < 0.001). Among the six gynecologists who performed VIA, the positivity rate varied from 4% to 31%. Conclusions The interpretation of VIA is subjective and its performance cannot be readily evaluated against objective standards. Impact VIA is not a robust screening test and we caution against its use as the primary screening test in resource-limited regions. PMID:20447927

18 CFR 1b.11 - Limitation on participation.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Limitation on participation. 1b.11 Section 1b.11 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL RULES RULES RELATING TO INVESTIGATIONS § 1b.11 Limitation on...

18 CFR 1b.11 - Limitation on participation.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Limitation on participation. 1b.11 Section 1b.11 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL RULES RULES RELATING TO INVESTIGATIONS § 1b.11 Limitation on...

18 CFR 1b.11 - Limitation on participation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Limitation on participation. 1b.11 Section 1b.11 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL RULES RULES RELATING TO INVESTIGATIONS § 1b.11 Limitation on...

18 CFR 1b.11 - Limitation on participation.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Limitation on participation. 1b.11 Section 1b.11 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL RULES RULES RELATING TO INVESTIGATIONS § 1b.11 Limitation on...

Impact of a congregation-based intervention on uptake of HIV testing and linkage to care among pregnant women in Nigeria: The Baby Shower cluster randomized trial

PubMed Central

Ezeanolue, Echezona E.; Obiefune, Michael C; Ezeanolue, Chinenye O; Ehiri, John E.; Osuji, Alice; Ogidi, Amaka G.; Hunt, Aaron T.; Patel, Dina; Yang, Wei; Pharr, Jennifer; Ogedegbe, Gbenga

2016-01-01

Summary Background There is a dearth of effective community-based interventions to increase HIV testing and uptake of antiretroviral therapy (ART) among pregnant women in hard–to-reach resource-limited settings. We assessed whether a faith-based intervention, the Healthy Beginning Initiative (HBI), would increase uptake of HIV testing and ART among pregnant women as compared to health facility referral. Methods This trial was conducted in southeast Nigeria, between January 20, 2013, and August 31, 2014. Eligible churches had at least 20 annual infant baptisms. Forty churches (clusters), stratified by number of infant baptisms (<80 vs. >80) were randomized 1:1 to intervention (IG) or control (CG). Three thousand and two (3002) self-identified pregnant women aged 18 and older participated. Intervention included heath education and onsite laboratory testing implemented during baby shower in IG churches, while participants in CG churches were referred to health facilities. Primary outcome (confirmed HIV testing) and secondary outcome (receipt of ART during pregnancy) were assessed at the individual level. Findings Antenatal care attendance was similar in both groups (IG=79.4% [1309/1647] vs. CG=79.7% [1080/1355], P=0.8). The intervention was associated with higher HIV testing (CG=54.6% [740/1355] vs. IG =91.9% [1514/1647]; [AOR= 11.2; 95% CI: 8.77-14.25, P-value=<0.001]. Women in the IG were significantly more likely to be linked to care prior to delivery (P<0.01) and more likely to have received ART during pregnancy (P=0.042) compared to those in the CG. Interpretation Culturally-adapted, community-based programs such as HBI can be effective in increasing HIV screening and ART among pregnant women in resource-limited settings. Funding National Institute of Health and President's Emergency Plan for AIDS Relief PMID:26475016

Sensitivity and specificity of dried blood spots for HIV-1 viral load quantification

PubMed Central

Pannus, Pieter; Claus, Maarten; Gonzalez, Maria Mercedes Perez; Ford, Nathan; Fransen, Katrien

2016-01-01

Abstract The use of dried blood spots (DBS) instead of plasma as a specimen type for HIV-1 viral load (VL) testing facilitates the decentralization of specimen collection and can increase access to VL testing in resource-limited settings. The performance of DBS for VL testing is lower, however, when compared to the gold standard sample type plasma. In this diagnostic accuracy study, we evaluated 3 VL assays with DBS. Participants were recruited between August 2012 and April 2015. Both plasma and DBS specimens were prepared and tested for HIV-1 VL with the Roche CAP/CTM HIV-1 test v2.0, the Abbott RealTime HIV-1, and the bioMérieux NucliSENS EasyQ HIV-1 v2.0. Sensitivity and specificity to detect treatment failure at a threshold of 1000 cps/mL with DBS were determined. A total of 272 HIV-positive patients and 51 HIV-negative people were recruited in the study. The mean difference or bias between plasma and DBS VL was <0.5 log cps/mL with all 3 assays but >25% of the specimens differed by >0.5 log cps/mL. All 3 assays had comparable sensitivities around 80% and specificities around 90%. Upward misclassification rates were around 10%, but downward misclassification rates ranged from 20.3% to 23.6%. Differences in between assays were not statistically significant (P > 0.1). The 3 VL assays evaluated had suboptimal performance with DBS but still performed better than immunological or clinical monitoring. Even after the introduction of the much-anticipated point-of-care VL devices, it is expected that DBS will remain important as a complementary option for supporting access to VL monitoring, particularly in rural, resource-limited settings. Manufacturers should accelerate efforts to develop more reliable, sensitive and specific methods to test VL on DBS specimens. PMID:27902602

Sensitivity and specificity of dried blood spots for HIV-1 viral load quantification: A laboratory assessment of 3 commercial assays.

PubMed

Pannus, Pieter; Claus, Maarten; Gonzalez, Maria Mercedes Perez; Ford, Nathan; Fransen, Katrien

2016-11-01

The use of dried blood spots (DBS) instead of plasma as a specimen type for HIV-1 viral load (VL) testing facilitates the decentralization of specimen collection and can increase access to VL testing in resource-limited settings. The performance of DBS for VL testing is lower, however, when compared to the gold standard sample type plasma. In this diagnostic accuracy study, we evaluated 3 VL assays with DBS.Participants were recruited between August 2012 and April 2015. Both plasma and DBS specimens were prepared and tested for HIV-1 VL with the Roche CAP/CTM HIV-1 test v2.0, the Abbott RealTime HIV-1, and the bioMérieux NucliSENS EasyQ HIV-1 v2.0. Sensitivity and specificity to detect treatment failure at a threshold of 1000 cps/mL with DBS were determined.A total of 272 HIV-positive patients and 51 HIV-negative people were recruited in the study. The mean difference or bias between plasma and DBS VL was <0.5 log cps/mL with all 3 assays but >25% of the specimens differed by >0.5 log cps/mL.All 3 assays had comparable sensitivities around 80% and specificities around 90%. Upward misclassification rates were around 10%, but downward misclassification rates ranged from 20.3% to 23.6%. Differences in between assays were not statistically significant (P > 0.1).The 3 VL assays evaluated had suboptimal performance with DBS but still performed better than immunological or clinical monitoring. Even after the introduction of the much-anticipated point-of-care VL devices, it is expected that DBS will remain important as a complementary option for supporting access to VL monitoring, particularly in rural, resource-limited settings. Manufacturers should accelerate efforts to develop more reliable, sensitive and specific methods to test VL on DBS specimens.

Idaho National Laboratory Cultural Resource Monitoring Report for 2013

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

Williams, Julie B.

2013-10-01

This report describes the cultural resource monitoring activities of the Idaho National Laboratory’s (INL) Cultural Resource Management (CRM) Office during 2013. Throughout the year, thirty-eight cultural resource localities were revisited including: two locations with Native American human remains, one of which is also a cave; fourteen additional caves; seven prehistoric archaeological sites ; four historic archaeological sites; one historic trail; one nuclear resource (Experimental Breeder Reactor-I, a designated National Historic Landmark); and nine historic structures located at the Central Facilities Area. Of the monitored resources, thirty-three were routinely monitored, and five were monitored to assess project compliance with cultural resourcemore » recommendations along with the effects of ongoing project activities. On six occasions, ground disturbing activities within the boundaries of the Power Burst Facility/Critical Infrastructure Test Range Complex (PBF/CITRC) were observed by INL CRM staff prepared to respond to any additional finds of Native American human remains. In addition, two resources were visited more than once as part of the routine monitoring schedule or to monitor for additional damage. Throughout the year, most of the cultural resources monitored had no visual adverse changes resulting in Type 1determinations. However, Type 2 impacts were noted at eight sites, indicating that although impacts were noted or that a project was operating outside of culturally cleared limitations, cultural resources retained integrity and noted impacts did not threaten National Register eligibility. No new Type 3 or any Type 4 impacts that adversely impacted cultural resources and threatened National Register eligibility were observed at cultural resources monitored in 2013.« less

Identifying users of traditional and Internet-based resources for meal ideas: An association rule learning approach.

PubMed

Doub, Allison E; Small, Meg L; Levin, Aron; LeVangie, Kristie; Brick, Timothy R

2016-08-01

Increasing home cooking while decreasing the consumption of food prepared away from home is a commonly recommended weight management strategy, however research on where individuals obtain ideas about meals to cook at home is limited. This study examined the characteristics of individuals who reported using traditional and Internet-based resources for meal ideas. 583 participants who were ≥50% responsible for household meal planning were recruited to approximate the 2014 United States Census distribution on sex, age, race/ethnicity, and household income. Participants reported demographic characteristics, home cooking frequency, and their use of 4 traditional resources for meal ideas (e.g., cookbooks), and 7 Internet-based resources for meal ideas (e.g., Pinterest) in an online survey. Independent samples t-tests compared home cooking frequency by resource use. Association rule learning identified those demographic characteristics that were significantly associated with resource use. Family and friends (71%), food community websites (45%), and cookbooks (41%) were the most common resources reported. Cookbook users reported preparing more meals at home per week (M = 9.65, SD = 5.28) compared to non-cookbook users (M = 8.11, SD = 4.93; t = -3.55, p < 0.001). Resource use was generally higher among parents and varied systematically with demographic characteristics. Findings suggest that home cooking interventions may benefit by modifying resources used by their target population. Copyright © 2016 Elsevier Ltd. All rights reserved.

Direct-to-consumer online genetic testing and the four principles: an analysis of the ethical issues.

PubMed

Wasson, Katherine; Cook, E David; Helzlsouer, Kathy

2006-01-01

The development of genetic tests marketed and sold direct-to-consumers (DTC) via the internet raises moral concerns and debate about their appropriateness and ethical and clinical significance. These tests are offered for a wide range of diseases and conditions, and the mutations have variable penetrance and associated risk. A number of these tests lack data on their accuracy and reliability, making interpretation of results difficult. DTC genetic testing is undertaken outside the context of the physician-patient relationship and may lack appropriate individual and family genetic counseling, leaving the consumer vulnerable to potential harms, such as misinterpretation of results, including false positive or false reassurance, with limited or no benefits. Beauchamp and Childress's four principles of biomedical ethics provide a framework for analyzing the ethical issues raised by DTC genetic testing. We argue that the potential harms outweigh the potential benefits of such tests, that respect for autonomy should be limited in light of potential harm from DTC testing, and that the availability of genetic testing over the internet may be considered unfair and unjust and affect resource allocation by placing an unfair burden on primary care physicians. In light of the moral issues posed by these tests, practical responses are suggested in the areas of consumer education, medical education, and interaction with commercial companies.

Current limitations and recommendations to improve testing for the environmental assessment of endocrine active substances

USGS Publications Warehouse

Coady, Katherine K.; Biever, Ronald C.; Denslow, Nancy D.; Gross, Melanie; Guiney, Patrick D.; Holbech, Henrik; Karouna-Renier, Natalie K.; Katsiadaki, Ioanna; Krueger, Hank; Levine, Steven L.; Maack, Gerd; Williams, Mike; Wolf, Jeffrey C.; Ankley, Gerald T.

2017-01-01

In the present study, existing regulatory frameworks and test systems for assessing potential endocrine active chemicals are described, and associated challenges are discussed, along with proposed approaches to address these challenges. Regulatory frameworks vary somewhat across geographies, but all basically evaluate whether a chemical possesses endocrine activity and whether this activity can result in adverse outcomes either to humans or to the environment. Current test systems include in silico, in vitro, and in vivo techniques focused on detecting potential endocrine activity, and in vivo tests that collect apical data to detect possible adverse effects. These test systems are currently designed to robustly assess endocrine activity and/or adverse effects in the estrogen, androgen, and thyroid hormone signaling pathways; however, there are some limitations of current test systems for evaluating endocrine hazard and risk. These limitations include a lack of certainty regarding: 1) adequately sensitive species and life stages; 2) mechanistic endpoints that are diagnostic for endocrine pathways of concern; and 3) the linkage between mechanistic responses and apical, adverse outcomes. Furthermore, some existing test methods are resource intensive with regard to time, cost, and use of animals. However, based on recent experiences, there are opportunities to improve approaches to and guidance for existing test methods and to reduce uncertainty. For example, in vitro high-throughput screening could be used to prioritize chemicals for testing and provide insights as to the most appropriate assays for characterizing hazard and risk. Other recommendations include adding endpoints for elucidating connections between mechanistic effects and adverse outcomes, identifying potentially sensitive taxa for which test methods currently do not exist, and addressing key endocrine pathways of possible concern in addition to those associated with estrogen, androgen, and thyroid signaling. 

Growing Rocks: Implications of Lithification for Microbial Communities and Nutrient Cycling

NASA Astrophysics Data System (ADS)

Corman, J. R.; Poret-Peterson, A. T.; Elser, J. J.

2014-12-01

Lithifying microbial communities ("microbialites") have left their signature on Earth's rock record for over 3.4 billion years and are regarded as important players in paleo-biogeochemical cycles. In this project, we study extant microbialites to understand the interactions between lithification and resource availability. All microbes need nutrients and energy for growth; indeed, nutrients are often a factor limiting microbial growth. We hypothesize that calcium carbonate deposition can sequester bioavailable phosphorus (P) and expect the growth of microbialites to be P-limited. To test our hypothesis, we first compared nutrient limitation in lithifying and non-lithifying microbial communities in Río Mesquites, Cuatro Ciénegas. Then, we experimentally manipulated calcification rates in the Río Mesquites microbialites. Our results suggest that lithifying microbialites are indeed P-limited, while non-lithifying, benthic microbial communities tend towards co-limitation by nitrogen (N) and P. Indeed, in microbialites, photosynthesis and aerobic respiration responded positively to P additions (P<0.05). Organic carbon (OC) additions caused shifts in bacterial community composition based on analysis of 16S rRNA genes. Unexpectedly, calcification rates increased with OC additions (P<0.05), but not with P additions, suggesting that sulfate reduction may be an important pathway for calcification. Experimental reductions in calcification rates caused changes to microbial biomass OC and P concentrations (P<0.01 and P<0.001, respectively), although shifts depended on whether calcification was decreased abiotically or biotically. These results show that resource availability does influence microbialite formation and that lithification may promote phosphorus limitation; however, further investigation is required to understand the mechanism by which the later occurs.

SAGES: A Suite of Freely-Available Software Tools for Electronic Disease Surveillance in Resource-Limited Settings

PubMed Central

Lewis, Sheri L.; Feighner, Brian H.; Loschen, Wayne A.; Wojcik, Richard A.; Skora, Joseph F.; Coberly, Jacqueline S.; Blazes, David L.

2011-01-01

Public health surveillance is undergoing a revolution driven by advances in the field of information technology. Many countries have experienced vast improvements in the collection, ingestion, analysis, visualization, and dissemination of public health data. Resource-limited countries have lagged behind due to challenges in information technology infrastructure, public health resources, and the costs of proprietary software. The Suite for Automated Global Electronic bioSurveillance (SAGES) is a collection of modular, flexible, freely-available software tools for electronic disease surveillance in resource-limited settings. One or more SAGES tools may be used in concert with existing surveillance applications or the SAGES tools may be used en masse for an end-to-end biosurveillance capability. This flexibility allows for the development of an inexpensive, customized, and sustainable disease surveillance system. The ability to rapidly assess anomalous disease activity may lead to more efficient use of limited resources and better compliance with World Health Organization International Health Regulations. PMID:21572957

Influencing factors for household water quality improvement in reducing diarrhoea in resource-limited areas.

PubMed

Zin, Thant; Mudin, Kamarudin D; Myint, Than; Naing, Daw K S; Sein, Tracy; Shamsul, B S

2013-01-01

Water and sanitation are major public health issues exacerbated by rapid population growth, limited resources, disasters and environmental depletion. This study was undertaken to study the influencing factors for household water quality improvement for reducing diarrhoea in resource-limited areas. Data were collected from articles and reviews from relevant randomized controlled trials, new articles, systematic reviews and meta-analyses from PubMed, World Health Organization (WHO), United Nations Children's Fund (UNICEF) and WELL Resource Centre For Water, Sanitation And Environmental Health. Water quality on diarrhoea prevention could be affected by contamination during storage, collection and even at point-of-use. Point-of-use water treatment (household-based) is the most cost-effective method for prevention of diarrhoea. Chemical disinfection, filtration, thermal disinfection, solar disinfection and flocculation and disinfection are five most promising household water treatment methodologies for resource-limited areas. Promoting household water treatment is most essential for preventing diarrhoeal disease. In addition, the water should be of acceptable taste, appropriate for emergency and non-emergency use.

10 best resources on ... mixed methods research in health systems.

PubMed

Ozawa, Sachiko; Pongpirul, Krit

2014-05-01

Mixed methods research has become increasingly popular in health systems. Qualitative approaches are often used to explain quantitative results and help to develop interventions or survey instruments. Mixed methods research is especially important in low- and middle-income country (LMIC) settings, where understanding social, economic and cultural contexts are essential to assess health systems performance. To provide researchers and programme managers with a guide to mixed methods research in health systems, we review the best resources with a focus on LMICs. We selected 10 best resources (eight peer-reviewed articles and two textbooks) based on their importance and frequency of use (number of citations), comprehensiveness of content, usefulness to readers and relevance to health systems research in resource-limited contexts. We start with an overview on mixed methods research and discuss resources that are useful for a better understanding of the design and conduct of mixed methods research. To illustrate its practical applications, we provide examples from various countries (China, Vietnam, Kenya, Tanzania, Zambia and India) across different health topics (tuberculosis, malaria, HIV testing and healthcare costs). We conclude with some toolkits which suggest what to do when mixed methods findings conflict and provide guidelines for evaluating the quality of mixed methods research.

Demands and resources: parents of school-age children with asthma.

PubMed

Lee, E Juanita; Parker, Veronica; DuBose, Lisa; Gwinn, Jane; Logan, Barbara N

2006-12-01

Asthma is one of the most common chronic diseases in children and is frequently noted as the reason for school absences. The purpose of this pilot study was to determine the differences in demands and resources reported by African American (AA) and European American (EA) parents of school-age children with asthma. A convenience sample of 37 parents participated in the study. Data were collected from 19 AA and 18 EA parents. Family stress theory provided the framework for this study. All subjects completed a demographic questionnaire, the Care of My Child With Asthma Scale, and the Family Inventory of Resources for Management (FIRM). Descriptive statistics were used to analyze the data. The most time-consuming caregiving demand reported by EA parents was providing emotional support for the child. For AA parents, the most time-consuming caregiving demand was managing work or school outside the home and organizing asthma treatments at the same time. AA parents had limited resources in the area of extended family social support. The Mann-Whitney U test found no statistically significant differences between AA and EA parents in relation to demands and resources. Nursing implications are presented.

Central Limit Theorem: New SOCR Applet and Demonstration Activity

PubMed Central

Dinov, Ivo D.; Christou, Nicolas; Sanchez, Juana

2011-01-01

Modern approaches for information technology based blended education utilize a variety of novel instructional, computational and network resources. Such attempts employ technology to deliver integrated, dynamically linked, interactive content and multifaceted learning environments, which may facilitate student comprehension and information retention. In this manuscript, we describe one such innovative effort of using technological tools for improving student motivation and learning of the theory, practice and usability of the Central Limit Theorem (CLT) in probability and statistics courses. Our approach is based on harnessing the computational libraries developed by the Statistics Online Computational Resource (SOCR) to design a new interactive Java applet and a corresponding demonstration activity that illustrate the meaning and the power of the CLT. The CLT applet and activity have clear common goals; to provide graphical representation of the CLT, to improve student intuition, and to empirically validate and establish the limits of the CLT. The SOCR CLT activity consists of four experiments that demonstrate the assumptions, meaning and implications of the CLT and ties these to specific hands-on simulations. We include a number of examples illustrating the theory and applications of the CLT. Both the SOCR CLT applet and activity are freely available online to the community to test, validate and extend (Applet: http://www.socr.ucla.edu/htmls/SOCR_Experiments.html and Activity: http://wiki.stat.ucla.edu/socr/index.php/SOCR_EduMaterials_Activities_GeneralCentralLimitTheorem). PMID:21833159

Central Limit Theorem: New SOCR Applet and Demonstration Activity.

PubMed

Dinov, Ivo D; Christou, Nicolas; Sanchez, Juana

2008-07-01

Modern approaches for information technology based blended education utilize a variety of novel instructional, computational and network resources. Such attempts employ technology to deliver integrated, dynamically linked, interactive content and multifaceted learning environments, which may facilitate student comprehension and information retention. In this manuscript, we describe one such innovative effort of using technological tools for improving student motivation and learning of the theory, practice and usability of the Central Limit Theorem (CLT) in probability and statistics courses. Our approach is based on harnessing the computational libraries developed by the Statistics Online Computational Resource (SOCR) to design a new interactive Java applet and a corresponding demonstration activity that illustrate the meaning and the power of the CLT. The CLT applet and activity have clear common goals; to provide graphical representation of the CLT, to improve student intuition, and to empirically validate and establish the limits of the CLT. The SOCR CLT activity consists of four experiments that demonstrate the assumptions, meaning and implications of the CLT and ties these to specific hands-on simulations. We include a number of examples illustrating the theory and applications of the CLT. Both the SOCR CLT applet and activity are freely available online to the community to test, validate and extend (Applet: http://www.socr.ucla.edu/htmls/SOCR_Experiments.html and Activity: http://wiki.stat.ucla.edu/socr/index.php/SOCR_EduMaterials_Activities_GeneralCentralLimitTheorem).

18 CFR 701.206 - Time limit for WRC final determinations regarding requests for information appealed by the...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Time limit for WRC final determinations regarding requests for information appealed by the requester from an initial adverse determination. 701.206 Section 701.206 Conservation of Power and Water Resources WATER RESOURCES...

18 CFR 701.206 - Time limit for WRC final determinations regarding requests for information appealed by the...

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 2 2012-04-01 2012-04-01 false Time limit for WRC final determinations regarding requests for information appealed by the requester from an initial adverse determination. 701.206 Section 701.206 Conservation of Power and Water Resources WATER RESOURCES...

18 CFR 701.206 - Time limit for WRC final determinations regarding requests for information appealed by the...

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true Time limit for WRC final determinations regarding requests for information appealed by the requester from an initial adverse determination. 701.206 Section 701.206 Conservation of Power and Water Resources WATER RESOURCES COUNCIL COUNCIL...

18 CFR 701.206 - Time limit for WRC final determinations regarding requests for information appealed by the...

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 2 2011-04-01 2011-04-01 false Time limit for WRC final determinations regarding requests for information appealed by the requester from an initial adverse determination. 701.206 Section 701.206 Conservation of Power and Water Resources WATER RESOURCES...

18 CFR 701.206 - Time limit for WRC final determinations regarding requests for information appealed by the...

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 2 2014-04-01 2014-04-01 false Time limit for WRC final determinations regarding requests for information appealed by the requester from an initial adverse determination. 701.206 Section 701.206 Conservation of Power and Water Resources WATER RESOURCES...

Experimental scarcity increases the relative reinforcing value of food in food insecure adults.

PubMed

Crandall, Amanda K; Temple, Jennifer L

2018-05-29

People with fewer financial resources are at greater risk for obesity, but the mechanisms of this relationship are not fully understood. One factor that is related, both cross-sectionally and prospectively, to obesity is the relative reinforcing value of food. It is possible that the experience of scarcity increases this reinforcing value. To date, no studies have examined this potential relationship experimentally in humans. The purpose of the studies presented here was to test the hypothesis that experimental manipulations of perceived scarcity would impact the relative reinforcing value of food. A secondary hypothesis was that individuals who report experiencing food insecurity would be more sensitive to these experimental manipulations. In order to test these hypotheses, we investigated the effects of experimentally manipulated scarcity on the relative reinforcing value of food in a laboratory setting. Study 1 had a within-subjects design and included 25 adults. Scarcity was manipulated by placing time and resource limits on the relative reinforcing value task and examining responding for a high calorie snack food versus that of an alternative reinforcer. Study 1 showed a tendency for food insecure participants to respond more for all reinforcers across conditions and have a higher proportional response for food when resources were limited. Study 2 also made use of a within-subjects design with 30 adults and primed scarcity by creating financial gains and losses on the Iowa Gambling Task. We observed higher relative reinforcing values of food among food insecure participants in the control condition, which decreased in the financial gain condition. When taken together, these two studies suggest that individuals who report experiencing food insecurity respond to acute manipulations of scarcity by increasing their reinforcing value of snack food. Copyright © 2018 Elsevier Ltd. All rights reserved.

Pathogen reduction and blood transfusion safety in Africa: strengths, limitations and challenges of implementation in low-resource settings.

PubMed

Ware, A D; Jacquot, C; Tobian, A A R; Gehrie, E A; Ness, P M; Bloch, E M

2018-01-01

Transfusion-transmitted infection risk remains an enduring challenge to blood safety in Africa. A high background incidence and prevalence of the major transfusion-transmitted infections (TTIs), dependence on high-risk donors to meet demand, suboptimal testing and quality assurance collectively contribute to the increased risk. With few exceptions, donor testing is confined to serological evaluation of human immunodeficiency virus (HIV), hepatitis B and C (HBV and HCV) and syphilis. Barriers to implementation of broader molecular methods include cost, limited infrastructure and lack of technical expertise. Pathogen reduction (PR), a term used to describe a variety of methods (e.g. solvent detergent treatment or photochemical activation) that may be applied to blood following collection, offers the means to diminish the infectious potential of multiple pathogens simultaneously. This is effective against different classes of pathogen, including the major TTIs where laboratory screening is already implemented (e.g. HIV, HBV and HCV) as well pathogens that are widely endemic yet remain unaddressed (e.g. malaria, bacterial contamination). We sought to review the available and emerging PR techniques and their potential application to resource-constrained parts of Africa, focusing on the advantages and disadvantages of such technologies. PR has been slow to be adopted even in high-income countries, primarily given the high costs of use. Logistical considerations, particularly in low-resourced parts of Africa, also raise concerns about practicality. Nonetheless, PR offers a rational, innovative strategy to contend with TTIs; technologies in development may well present a viable complement or even alternative to targeted screening in the future. © 2017 International Society of Blood Transfusion.

Outreach to the Public on Earthquake and Tsunami Safety with Limited Human Resources: Train the Trainers Pilot Program in Puerto Rico

NASA Astrophysics Data System (ADS)

Gonzalez Ruiz, W.; Vanacore, E. A.; Gomez, G.; Martinez Colon, J. F.; Perez, F.; Baez-Sanchez, G.; Flores Hots, V. E.; Lopez, A. M.; Huerfano, V.; Figueroa, J. M.

2017-12-01

Given the limited human resources available to interact directly with the public and disseminate information on earthquake and tsunami safety, the Puerto Rico Seismic Network has developed the Train the Trainers course, designed exclusively for emergency management officers (EMOs). This three-day training course provides a complete package of educational tools that will allow EMOs to present standard conferences, and lectures, with the appropriate and accurate information for different audiences on earthquake and tsunami hazard and safety. Here we present preliminary observations and lessons learned from the pilot program that was offered in July 2017 to 20 EMOs from the twelve Puerto Rico Emergency Management Agency (PREMA) zones and two students from the University of Puerto Rico Mayaguez. To ensure sufficient preparation, the training course provided evaluation tools including written and practical exams that participants were required to score 80% or more to complete the training successfully. Of the 20 EMO participants, 18 EMOs passed the final exam. Preliminary analysis of the pre-test scores and the post-test scores, show a score improvement between 8% to 46% amongst the participants. These 18 participants will receive a certificate as well as tools and resources to offer earthquakes and tsunamis conferences for up to two years across Puerto Rico and its outlying islands. To ensure that the pilot participants will provide conferences to the public PRSN required a signed commitment to give at least 5 conferences in one year from each participant and PRSN will monitor the participants for the next two years to evaluate the efficacy of the program. However, based on the preliminary data this program appears to be an effective method to increase the amount of outreach professionals on the Island.

Do positive interactions increase with abiotic stress? A test from a semi-arid steppe.

PubMed Central

Maestre, Fernando T; Cortina, Jordi

2004-01-01

Theoretical models predict that the relative importance of facilitation and competition may vary inversely across gradients of abiotic stress. However, these predictions have not been thoroughly tested in the field, especially in semi-arid environments. In this study, we evaluated how the net effect of the tussock grass Stipa tenacissima on the shrub Pistacia lentiscus varied across a gradient of abiotic stress in semi-arid Mediterranean steppes. We fitted the relationship between accumulated rainfall and the relative neighbour index (our measures of abiotic stress and of the net effect of S. tenacissima on P. lentiscus, respectively), which varied across this gradient, to a quadratic model. Competitive interactions dominated at both extremes of the gradient. Our results do not support established theory. Instead, they suggest that a shift from facilitation to competition under high abiotic stress conditions is likely to occur when the levels of the most limiting resource are so low that the benefits provided by the facilitator cannot overcome its own resource uptake. PMID:15504009

Combining infobuttons and semantic web rules for identifying patterns and delivering highly-personalized education materials.

PubMed

Hulse, Nathan C; Long, Jie; Tao, Cui

2013-01-01

Infobuttons have been established to be an effective resource for addressing information needs at the point of care, as evidenced by recent research and their inclusion in government-based electronic health record incentive programs in the United States. Yet their utility has been limited to wide success for only a specific set of domains (lab data, medication orders, and problem lists) and only for discrete, singular concepts that are already documented in the electronic medical record. In this manuscript, we present an effort to broaden their utility by connecting a semantic web-based phenotyping engine with an infobutton framework in order to identify and address broader issues in patient data, derived from multiple data sources. We have tested these patterns by defining and testing semantic definitions of pre-diabetes and metabolic syndrome. We intend to carry forward relevant information to the infobutton framework to present timely, relevant education resources to patients and providers.

Simulation analysis of resource flexibility on healthcare processes

PubMed Central

Simwita, Yusta W; Helgheim, Berit I

2016-01-01

Purpose This paper uses discrete event simulation to explore the best resource flexibility scenario and examine the effect of implementing resource flexibility on different stages of patient treatment process. Specifically we investigate the effect of resource flexibility on patient waiting time and throughput in an orthopedic care process. We further seek to explore on how implementation of resource flexibility on patient treatment processes affects patient access to healthcare services. We focus on two resources, namely, orthopedic surgeon and operating room. Methods The observational approach was used to collect process data. The developed model was validated by comparing the simulation output with actual patient data collected from the studied orthopedic care process. We developed different scenarios to identify the best resource flexibility scenario and explore the effect of resource flexibility on patient waiting time, throughput, and future changes in demand. The developed scenarios focused on creating flexibility on service capacity of this care process by altering the amount of additional human resource capacity at different stages of patient care process and extending the use of operating room capacity. Results The study found that resource flexibility can improve responsiveness to patient demand in the treatment process. Testing different scenarios showed that the introduction of resource flexibility reduces patient waiting time and improves throughput. The simulation results show that patient access to health services can be improved by implementing resource flexibility at different stages of the patient treatment process. Conclusion This study contributes to the current health care literature by explaining how implementing resource flexibility at different stages of patient care processes can improve ability to respond to increasing patients demands. This study was limited to a single patient process; studies focusing on additional processes are recommended. PMID:27785046

Simulation analysis of resource flexibility on healthcare processes.

PubMed

Simwita, Yusta W; Helgheim, Berit I

2016-01-01

This paper uses discrete event simulation to explore the best resource flexibility scenario and examine the effect of implementing resource flexibility on different stages of patient treatment process. Specifically we investigate the effect of resource flexibility on patient waiting time and throughput in an orthopedic care process. We further seek to explore on how implementation of resource flexibility on patient treatment processes affects patient access to healthcare services. We focus on two resources, namely, orthopedic surgeon and operating room. The observational approach was used to collect process data. The developed model was validated by comparing the simulation output with actual patient data collected from the studied orthopedic care process. We developed different scenarios to identify the best resource flexibility scenario and explore the effect of resource flexibility on patient waiting time, throughput, and future changes in demand. The developed scenarios focused on creating flexibility on service capacity of this care process by altering the amount of additional human resource capacity at different stages of patient care process and extending the use of operating room capacity. The study found that resource flexibility can improve responsiveness to patient demand in the treatment process. Testing different scenarios showed that the introduction of resource flexibility reduces patient waiting time and improves throughput. The simulation results show that patient access to health services can be improved by implementing resource flexibility at different stages of the patient treatment process. This study contributes to the current health care literature by explaining how implementing resource flexibility at different stages of patient care processes can improve ability to respond to increasing patients demands. This study was limited to a single patient process; studies focusing on additional processes are recommended.

Evaluation of third generation anti-HCV enzyme immunoassays.

PubMed

Panigrahi, A K; Nayak, B; Dixit, R; Acharya, S K; Panda, S K

1998-01-01

The Hepatitis C Virus (HCV) is a major cause of post transfusion hepatitis. The introduction of HCV antibody screening has reduced the risk of post transfusion hepatitis significantly. However, the test is yet to be used routinely in blood banks of several developing countries with limited resources. We have developed an Enzyme immunoassay using synthetic peptides. The test was compared to seven commercial tests available in the Indian market. The test was evaluated using a panel of 90 sera which were chosen from an earlier panel based on detection of HCV RNA by Reverse Transcription Polymerase Chain Reaction RT-PCR. In case of any discrepancy the sera were further analysed by Line immunoassay (LIA). The sensitivity of the in house EIA was 90%. The specificity of the commercial EIAs varied.

Conservation success as a function of good alignment of social and ecological structures and processes.

PubMed

Bodin, Orjan; Crona, Beatrice; Thyresson, Matilda; Golz, Anna-Lea; Tengö, Maria

2014-10-01

How to create and adjust governing institutions so that they align (fit) with complex ecosystem processes and structures across scales is an issue of increasing concern in conservation. It is argued that lack of such social-ecological fit makes governance and conservation difficult, yet progress in explicitly defining and rigorously testing what constitutes a good fit has been limited. We used a novel modeling approach and data from case studies of fishery and forest conservation to empirically test presumed relationships between conservation outcomes and certain patterns of alignment of social-ecological interdependences. Our approach made it possible to analyze conservation outcome on a systems level while also providing information on how individual actors are positioned in the complex web of social-ecological interdependencies. We found that when actors who shared resources were also socially linked, conservation at the level of the whole social-ecological system was positively affected. When the scales at which individual actors used resources and the scale at which ecological resources were interconnected to other ecological resources were aligned through tightened feedback loops, conservation outcome was better than when they were not aligned. The analysis of individual actors' positions in the web of social-ecological interdependencies was helpful in understanding why a system has a certain level of social-ecological fit. Results of analysis of positions showed that different actors contributed in very different ways to achieve a certain fit and revealed some underlying difference between the actors, for example in terms of actors' varying rights to access and use different ecological resources. © 2014 Society for Conservation Biology.

Creating Online Training for Procedures in Global Health with PEARLS (Procedural Education for Adaptation to Resource-Limited Settings).

PubMed

Bensman, Rachel S; Slusher, Tina M; Butteris, Sabrina M; Pitt, Michael B; On Behalf Of The Sugar Pearls Investigators; Becker, Amanda; Desai, Brinda; George, Alisha; Hagen, Scott; Kiragu, Andrew; Johannsen, Ron; Miller, Kathleen; Rule, Amy; Webber, Sarah

2017-11-01

The authors describe a multiinstitutional collaborative project to address a gap in global health training by creating a free online platform to share a curriculum for performing procedures in resource-limited settings. This curriculum called PEARLS (Procedural Education for Adaptation to Resource-Limited Settings) consists of peer-reviewed instructional and demonstration videos describing modifications for performing common pediatric procedures in resource-limited settings. Adaptations range from the creation of a low-cost spacer for inhaled medications to a suction chamber for continued evacuation of a chest tube. By describing the collaborative process, we provide a model for educators in other fields to collate and disseminate procedural modifications adapted for their own specialty and location, ideally expanding this crowd-sourced curriculum to reach a wide audience of trainees and providers in global health.

Replacement of HCFC-225 Solvent for Cleaning NASA Propulsion Oxygen Systems

NASA Technical Reports Server (NTRS)

Mitchell, Mark A.; Lowrey, Nikki M.

2015-01-01

Since the 1990's, when the Class I Ozone Depleting Substance (ODS) chlorofluorocarbon-113 (CFC-113) was banned, NASA's rocket propulsion test facilities at Marshall Space Flight Center (MSFC) and Stennis Space Center (SSC) have relied upon hydrochlorofluorocarbon-225 (HCFC-225) to safely clean and verify the cleanliness of large scale propulsion oxygen systems. Effective January 1, 2015, the production, import, export, and new use of HCFC-225, a Class II ODS, was prohibited by the Clean Air Act. In 2012 through 2014, leveraging resources from both the NASA Rocket Propulsion Test Program and the Defense Logistics Agency - Aviation Hazardous Minimization and Green Products Branch, test labs at MSFC, SSC, and Johnson Space Center's White Sands Test Facility (WSTF) collaborated to seek out, test, and qualify a replacement for HCFC-225 that is both an effective cleaner and safe for use with oxygen systems. Candidate solvents were selected and a test plan was developed following the guidelines of ASTM G127, Standard Guide for the Selection of Cleaning Agents for Oxygen Systems. Solvents were evaluated for materials compatibility, oxygen compatibility, cleaning effectiveness, and suitability for use in cleanliness verification and field cleaning operations. Two solvents were determined to be acceptable for cleaning oxygen systems and one was chosen for implementation at NASA's rocket propulsion test facilities. The test program and results are summarized. This project also demonstrated the benefits of cross-agency collaboration in a time of limited resources.

Correlation between serological and immunofluorescence results in the investigation of brucellosis in veterinary surgeons.

PubMed Central

Henderson, R J; Hill, D M; Vickers, A A; Edwards, J M; Tillett, H

1976-01-01

Four serological tests and three immunofluorescence tests for IgG, IgM, and IgA were compared for value in the investigation of brucellosis in veterinary surgeons. No one serological test stood out over the others, and the immunofluorescence tests did not appear to have advantages over the serological tests. If a laboratory is limited in time and resources then the saline agglutination or the complement fixation test would be reasonably satisfactory. The 2-mercaptoethanol test and the antihuman globulin (Coombs' test) have no advantages over the other two and could be dropped. Immunofluorescence tests are not recommended for routine testing of brucellosis sera. The results and these recommendations apply to the 'vet' sera tested; it is reasonable to suppose that what applies to 'vet' sera will also apply to sera of those who work with or are in repeated contact with cattle and who will have had previous experience of brucella antigen, that is, dairy farmers, herdsmen, or slaughter house employees. PMID:765361

Resource utilization and outcome among patients with selective versus nonselective troponin testing.

PubMed

Campbell, Alex R; Rodriguez, Alexander J; Larson, David M; Strauss, Craig E; Garberich, Ross F; Partridge, Matthew F; Henry, Timothy D; Sharkey, Scott W

2018-05-01

In patients with suspected acute coronary syndrome (ACS), troponin testing is effective for diagnosis and prognosis. Troponin testing has now expanded to include patients without suspected ACS. This nonselective troponin testing has unknown consequences for resource utilization and outcome. Therefore, we examined selective versus nonselective troponin testing with respect to patient characteristics, resource utilization, and outcome. This retrospective 1-year study included all patients with troponin testing at a U.S. emergency department. Testing was classified as selective (ACS) or nonselective (non-ACS) based on admission ICD-9 codes. Troponin upper reference limit (URL) was ≥99th percentile. Among 47,053 patients, troponin was measured in 9109 (19%) of whom 5764 were hospitalized. Admission diagnosis was non-ACS in 4427 (77%) and ACS in 1337 (23%). Non-ACS patients were older, 71±17 versus 65±16 years, with longer hospital stay, 77 versus 32 h, and greater 1-year mortality 22% versus 6.7%; P<.001. In patients with troponin ≥URL, revascularization was performed in 64 (4.7%) of non-ACS versus 213 (48%) of ACS; P<.001. In patients with troponin 80% of the non-ACS population CONCLUSIONS: Contemporary troponin testing is frequently nonselective. The non-ACS and ACS populations differ significantly regarding clinical characteristics, revascularization rates, and outcomes. Troponin elevation is a powerful predictor of 1-year mortality in non-ACS, this association reveals an opportunity for risk stratification and targeted therapy. In patients with suspected acute coronary syndrome (ACS), troponin testing is effective for diagnosis and prognosis. However, troponin testing has now expanded to include patients without suspected ACS. This nonselective troponin testing has unknown consequences for hospital resource utilization and patient outcome. Our findings demonstrate contemporary troponin testing is largely nonselective (77% of testing was performed in patients without acute coronary syndrome). In comparison to patients with acute coronary syndrome, those with non-acute coronary syndrome are older, with longer hospital stay, lower revascularization rates, and greater 1-year mortality. Troponin elevation identifies a high-risk population in both acute coronary syndrome and non-acute coronary syndrome populations, yet effective treatment for the latter is lacking. Copyright © 2018. Published by Elsevier Inc.

On the Water-Food Nexus: an Optimization Approach for Water and Food Security

NASA Astrophysics Data System (ADS)

Mortada, Sarah; Abou Najm, Majdi; Yassine, Ali; Alameddine, Ibrahim; El-Fadel, Mutasem

2016-04-01

Water and food security is facing increased challenges with population increase, climate and land use change, as well as resource depletion coupled with pollution and unsustainable practices. Coordinated and effective management of limited natural resources have become an imperative to meet these challenges by optimizing the usage of resources under various constraints. In this study, an optimization model is developed for optimal resource allocation towards sustainable water and food security under nutritional, socio-economic, agricultural, environmental, and natural resources constraints. The core objective of this model is to maximize the composite water-food security status by recommending an optimal water and agricultural strategy. The model balances between the healthy nutritional demand side and the constrained supply side while considering the supply chain in between. It equally ensures that the population achieves recommended nutritional guidelines and population food-preferences by quantifying an optimum agricultural and water policy through transforming optimum food demands into optimum cropping policy given the water and land footprints of each crop or agricultural product. Through this process, water and food security are optimized considering factors that include crop-food transformation (food processing), water footprints, crop yields, climate, blue and green water resources, irrigation efficiency, arable land resources, soil texture, and economic policies. The model performance regarding agricultural practices and sustainable food and water security was successfully tested and verified both at a hypothetical and pilot scale levels.

Pollen source and resource limitation to fruit production in the rare species Eremosparton songoricum (Fabaceae)

USDA-ARS?s Scientific Manuscript database

Eremosparton songoricum (Litv.) Vass. is a rare, central Asian desert species which shows lower fruit set and seed set (<16%) than most hermaphroditic species. We hypothesized that fruit production was limited by pollen and resources. To evaluate potential fruit abortion due to pollen limitation, su...

HIV drug resistance surveillance for prioritizing treatment in resource-limited settings

PubMed Central

Walensky, Rochelle P.; Weinstein, Milton C.; Yazdanpanah, Yazdan; Losina, Elena; Mercincavage, Lauren M.; Touré, Siaka; Divi, Nomita; Anglaret, Xavier; Goldie, Sue J.; Freedberg, Kenneth A.

2008-01-01

Background Sentinel testing programs for HIV drug resistance in resource-limited settings can inform policy on antiretroviral therapy (ART) and drug sequencing. Objective To examine the value of resistance surveillance in influencing recommendations toward effective and cost-effective sequencing of ART regimens. Methods A state-transition model of HIV infection was adapted to simulate clinical care in Côte d’Ivoire and evaluate the incremental cost-effectiveness of (1) no ART; (2) ART beginning with a non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimen followed by a boosted protease inhibitor (PI)-based regimen; and (3) ART beginning with a boosted PI-based regimen followed by an NNRTI-based regimen. Results At a 5% prevalence of NNRTI resistance, a strategy that started with a PI-based regimen had a smaller health benefit and higher cost-effectiveness ratio than a strategy that started with an NNRTI-based regimen (cost-effectiveness ratio $910/year of life saved). Results consistently favored initiation with an NNRTI-based regimen, regardless of the population prevalence of NNRTI resistance (up to 76%) and the efficacy of an NNRTI-based regimen in the setting of resistance. The most influential parameters on the cost-effectiveness of sequencing strategies were boosted PI-based regimen costs and the efficacy of this regimen when used as second-line therapy. Conclusions Drug costs and treatment efficacies, but not NNRTI resistance levels, were most influential in determining optimal HIV drug sequencing in Côte d’Ivoire. Results of surveillance for NNRTI resistance should not be used as a major guide to treatment policy in resource-limited settings. PMID:17457091

Ethical considerations in HIV prevention and vaccine research in resource-limited settings.

PubMed

Garner, Samual A; Anude, Chuka J; Adams, Elizabeth; Dawson, Liza

2014-09-01

HIV prevention research has been facing increasing ethical and operational challenges. Factors influencing the design and conduct of HIV prevention trials include a rapidly changing evidence base, new biomedical prevention methods and modalities being tested, a large diversity of countries, sites and populations affected by HIV and participating in trials, and challenges of developing and making available products that will be feasible and affordable for at-risk populations. To discuss these challenges, a meeting, Ethical considerations around novel combination prevention modalities in HIV prevention and vaccine trials in resource-limited settings, was convened by NIH/NIAID/Division of AIDS on April 22-23, 2013. Several themes emerged from the meeting: (1) because of both trial design and ethical complexities, choosing prevention packages and designing combination prevention research trials will need to be evaluated on a case by case basis in different clinical trials, countries, and health systems; (2) multilevel stakeholder engagement from the beginning is vital to a fair and transparent process and also to designing ethical and relevant trials; (3) research should generally be responsive to a host country's needs, and sponsors and stakeholders should work together to address potential barriers to future access; and finally, (4) another meeting including a broader group of stakeholders is needed to address many of the outstanding ethical issues raised by this meeting. We offer an overview of the meeting and the key discussion points and recommendations to help guide the design and conduct of future HIV prevention and vaccine research in resource-limited settings.

Building laboratory capacity to support HIV care in Nigeria: Harvard/APIN PEPFAR, 2004-2012.

PubMed

Hamel, Donald J; Sankalé, Jean-Louis; Samuels, Jay Osi; Sarr, Abdoulaye D; Chaplin, Beth; Ofuche, Eke; Meloni, Seema T; Okonkwo, Prosper; Kanki, Phyllis J

From 2004-2012, the Harvard/AIDS Prevention Initiative in Nigeria, funded through the US President's Emergency Plan for AIDS Relief programme, scaled up HIV care and treatment services in Nigeria. We describe the methodologies and collaborative processes developed to improve laboratory capacity significantly in a resource-limited setting. These methods were implemented at 35 clinic and laboratory locations. Systems were established and modified to optimise numerous laboratory processes. These included strategies for clinic selection and management, equipment and reagent procurement, supply chains, laboratory renovations, equipment maintenance, electronic data management, quality development programmes and trainings. Over the eight-year programme, laboratories supported 160 000 patients receiving HIV care in Nigeria, delivering over 2.5 million test results, including regular viral load quantitation. External quality assurance systems were established for CD4+ cell count enumeration, blood chemistries and viral load monitoring. Laboratory equipment platforms were improved and standardised and use of point-of-care analysers was expanded. Laboratory training workshops supported laboratories toward increasing staff skills and improving overall quality. Participation in a World Health Organisation-led African laboratory quality improvement system resulted in significant gains in quality measures at five laboratories. Targeted implementation of laboratory development processes, during simultaneous scale-up of HIV treatment programmes in a resource-limited setting, can elicit meaningful gains in laboratory quality and capacity. Systems to improve the physical laboratory environment, develop laboratory staff, create improvements to reduce costs and increase quality are available for future health and laboratory strengthening programmes. We hope that the strategies employed may inform and encourage the development of other laboratories in resource-limited settings.

Justification of Filter Selection for Robot Balancing in Conditions of Limited Computational Resources

NASA Astrophysics Data System (ADS)

Momot, M. V.; Politsinskaia, E. V.; Sushko, A. V.; Semerenko, I. A.

2016-08-01

The paper considers the problem of mathematical filter selection, used for balancing of wheeled robot in conditions of limited computational resources. The solution based on complementary filter is proposed.

Wilderness First Aid Training as a Tool for Improving Basic Medical Knowledge in South Sudan.

PubMed

Katona, Lindsay B; Douglas, William S; Lena, Sean R; Ratner, Kyle G; Crothers, Daniel; Zondervan, Robert L; Radis, Charles D

2015-12-01

The challenges presented by traumatic injuries in low-resource communities are especially relevant in South Sudan. This study was conducted to assess whether a 3-day wilderness first aid (WFA) training course taught in South Sudan improved first aid knowledge. Stonehearth Open Learning Opportunities (SOLO) Schools designed the course to teach people with limited medical knowledge to use materials from their environment to provide life-saving care in the event of an emergency. A pre-test/post-test study design was used to assess first aid knowledge of 46 community members in Kit, South Sudan, according to a protocol approved by the University of New England Institutional Review Board. The course and assessments were administered in English and translated in real-time to Acholi and Arabic, the two primary languages spoken in the Kit region. Descriptive statistics, t-test, ANOVA, and correlation analyses were conducted. Results included a statistically significant improvement in first aid knowledge after the 3-day training course: t(38)=3.94; P<.001. Although men started with more health care knowledge: (t(37)=2.79; P=.008), men and women demonstrated equal levels of knowledge upon course completion: t(37)=1.56; P=.88. This research, which may be the first of its kind in South Sudan, provides evidence that a WFA training course in South Sudan is efficacious. These findings suggest that similar training opportunities could be used in other parts of the world to improve basic medical knowledge in communities with limited access to medical resources and varying levels of education and professional experiences.

Evaluation of blood collection filter papers for HIV-1 DNA PCR.

PubMed

Masciotra, Silvina; Khamadi, Samoel; Bilé, Ebi; Puren, Adrian; Fonjungo, Peter; Nguyen, Shon; Girma, Mulu; Downing, Robert; Ramos, Artur; Subbarao, Shambavi; Ellenberger, Dennis

2012-10-01

The collection of dried blood spots (DBS) on Whatman 903 cards has facilitated for years the detection of HIV-1 in infants by DNA PCR as early as 4-6 weeks after birth in resource-limited settings (RLS), but alternate blood collection devices are proving to be necessary. The qualitative detection of HIV-1 DNA by PCR from DBS prepared on three commercially available blood collection cards was evaluated at the Centers for Disease Control and Prevention (CDC) and in four laboratories in Africa. DBS were prepared on Ahlstrom grade 226, Munktell TFN and Whatman 903, and stored under a variety of conditions. DBS were stored at ambient temperature (RT), 37°C with high humidity, and -20°C for varying lengths of time. The presence of HIV-1 DNA was tested using Roche Amplicor HIV-1 DNA (v 1.5) weekly for 4 weeks and at weeks 8 and 12 (RT and 37°C), at weeks 4, 8, and 18 (-20°C) of storage. DBS specimens were also tested after international shipment at RT. In addition, after nearly 3 years storage at -20°C, DBS were also evaluated independently using the COBAS Ampliprep/TaqMan HIV-1 Qual and Abbott RealTime HIV-1 Qualitative tests. HIV-1 DNA was detected equally well on the three blood collection cards regardless of storage conditions and PCR assay. Ahlstrom 226 and Munktell TFN papers were comparable to Whatman 903 for HIV-1 DNA detection and may be considered as optional blood collection devices in resource-limited countries. Published by Elsevier B.V.

A cluster randomized trial of routine HIV-1 viral load monitoring in Zambia: study design, implementation, and baseline cohort characteristics.

PubMed

Koethe, John R; Westfall, Andrew O; Luhanga, Dora K; Clark, Gina M; Goldman, Jason D; Mulenga, Priscilla L; Cantrell, Ronald A; Chi, Benjamin H; Zulu, Isaac; Saag, Michael S; Stringer, Jeffrey S A

2010-03-12

The benefit of routine HIV-1 viral load (VL) monitoring of patients on antiretroviral therapy (ART) in resource-constrained settings is uncertain because of the high costs associated with the test and the limited treatment options. We designed a cluster randomized controlled trial to compare the use of routine VL testing at ART-initiation and at 3, 6, 12, and 18 months, versus our local standard of care (which uses immunological and clinical criteria to diagnose treatment failure, with discretionary VL testing when the two do not agree). Dedicated study personnel were integrated into public-sector ART clinics. We collected participant information in a dedicated research database. Twelve ART clinics in Lusaka, Zambia constituted the units of randomization. Study clinics were stratified into pairs according to matching criteria (historical mortality rate, size, and duration of operation) to limit the effect of clustering, and independently randomized to the intervention and control arms. The study was powered to detect a 36% reduction in mortality at 18 months. From December 2006 to May 2008, we completed enrollment of 1973 participants. Measured baseline characteristics did not differ significantly between the study arms. Enrollment was staggered by clinic pair and truncated at two matched sites. A large clinical trial of routing VL monitoring was successfully implemented in a dynamic and rapidly growing national ART program. Close collaboration with local health authorities and adequate reserve staff were critical to success. Randomized controlled trials such as this will likely prove valuable in determining long-term outcomes in resource-constrained settings. Clinicaltrials.gov NCT00929604.

The Use of Tailored Testing with Instructional Programs.

DTIC Science & Technology

1986-03-01

AVAILABILITY OF REPORT Approved for public release: distribution un- t~X DWNCADNGSCHiEDULE li-mited. Reproduction in whole or in part is...of Education ,-’ Washington, DC 20V 0 Chicago, IL r06𔄁 Air Force Human Resources Lab Cdt. Arnold Bohrer . AFHRL/MPD Sectie Psychologisch Cnderzoek...University of Texas-Austin Univ-ir-tat Puss-ldorf Measurement and Evalu-,tion Er zi, gswi ssensch;ftl iches Cpnter Un ivf rsit ’tsst r. 1 Austin, TX 787

Expansionary Adaptive Transformations of Socio-Hydrological Systems (SHSs): The Case of Drought in Messara Plain, Crete, Greece.

PubMed

Sapountzaki, Kalliopi; Daskalakis, Ioannis

2018-05-01

The paper attempts to document the ontology of socio-hydrological systems (SHSs), propose approaches of delimitation of SHSs' (territorial) boundaries, and investigate operational aspects of their adaptation to drought including repercussions on sustainability. To this end, a series of hypotheses are tested: (a) SHSs contain social subsystems with different expectations regarding water resources, different adaptive capacities, adaptation limits and prospects of sustainability, (b) SHSs do not adapt homogenously; some of their subsystems manage optimum adaptation, others fail to adapt and (c) territorial transformation of SHSs (e.g., through expansion of SHSs) may be the result of differential adaptation and sustainability potential within the SHS owing to power relations. After testing above hypotheses in the SHS of Messara Plain, Crete, the authors found out that powerful and dynamic sub-SHSs expand or break the boundaries of the initial SHS by establishing new relationships with other SHSs for the sake of resilience resources. Conversely, powerless sub-SHSs incapable to adapt descend and disappear. Therefore, territorial transformation of SHSs comes about from a combination of successful and failed adaptations, or in other words from different adaptation limits within SHSs. Consequently, water management and local development planning to guarantee adaptability to drought for all should be based on SHSs' analysis and management, not on jurisdictional areas or hydrological basins.

Escherichia coli counting using lens-free imaging for sepsis diagnosis

NASA Astrophysics Data System (ADS)

Moon, Sangjun; Manzur, Fahim; Manzur, Tariq; Klapperich, Catherine; Demirci, Utkan

2009-09-01

Sepsis causes 9.3% of overall deaths in United States. To diagnose sepsis, cell/bacteria capture and culturing methods have been widely investigated in the medical field. Escherichia Coli (E. Coli) is used as a model organism for sepsis in blood stream since wide variety of antibodies are established and the genetic modification process is well documented for fluorescent tagging. In point-of-care testing applications, the sepsis diagnostics require fast monitoring, inexpensive testing, and reliable results at resource limited settings, i.e. battle field, home care for dialysis. However, the cell/E.coli are hard to directly capture and see at the POCT because of the small size, 2 μm long and 0.5 μm in diameter, and the bacteria are rare in the blood stream in sepsis. Here, we propose a novel POCT platform to image and enumerate cell/E.coli on a microfluidic surface to diagnose sepsis at resource limited conditions. We demonstrate that target cells are captured from 5 μl of whole blood using specific antibodies and E.coli are imaged using a lens-free imaging platform, 2.2 μm pixel CMOS based imaging sensor. This POCT cell/bacteria capture and enumeration approach can further be used for medical diagnostics of sepsis. We also show approaches to rapidly quantify white blood cell counts from blood which can be used to monitor immune response.

Introduction to the fathead minnow genome browser and ...

EPA Pesticide Factsheets

Ab initio gene prediction and evidence alignment were used to produce the first annotations for the fathead minnow SOAPdenovo genome assembly. Additionally, a genome browser hosted at genome.setac.org provides simplified access to the annotation data in context with fathead minnow genomic sequence. This work is meant to extend the utility of fathead minnow genome as a resource and enable the continued development of this species as a model organism. The fathead minnow (Pimephales promelas) is a laboratory model organism widely used in regulatory toxicity testing and ecotoxicology research. Despite, the wealth of toxicological data for this organism, until recently genome scale information was lacking for the species, which limited the utility of the species for pathway-based toxicity testing and research. As part of a EPA Pathfinder Innovation Project, next generation sequencing was applied to generate a draft genome assembly, which was published in 2016. However, application of those genome-scale sequencing resources was still limited by the lack of available gene annotations for fathead minnow. Here we report on development of a first generation genome annotation for fathead minnow and the dissemination of that information through a web-based browser that makes it easy to search for genes of interest, extract the corresponding sequence, identify intron and exon boundaries and regulatory regions, and align the computationally predicted genes with other supporti

Coupling of a distributed stakeholder-built system dynamics socio-economic model with SAHYSMOD for sustainable soil salinity management - Part 1: Model development

NASA Astrophysics Data System (ADS)

Inam, Azhar; Adamowski, Jan; Prasher, Shiv; Halbe, Johannes; Malard, Julien; Albano, Raffaele

2017-08-01

Effective policies, leading to sustainable management solutions for land and water resources, require a full understanding of interactions between socio-economic and physical processes. However, the complex nature of these interactions, combined with limited stakeholder engagement, hinders the incorporation of socio-economic components into physical models. The present study addresses this challenge by integrating the physical Spatial Agro Hydro Salinity Model (SAHYSMOD) with a participatory group-built system dynamics model (GBSDM) that includes socio-economic factors. A stepwise process to quantify the GBSDM is presented, along with governing equations and model assumptions. Sub-modules of the GBSDM, describing agricultural, economic, water and farm management factors, are linked together with feedbacks and finally coupled with the physically based SAHYSMOD model through commonly used tools (i.e., MS Excel and a Python script). The overall integrated model (GBSDM-SAHYSMOD) can be used to help facilitate the role of stakeholders with limited expertise and resources in model and policy development and implementation. Following the development of the integrated model, a testing methodology was used to validate the structure and behavior of the integrated model. Model robustness under different operating conditions was also assessed. The model structure was able to produce anticipated real behaviours under the tested scenarios, from which it can be concluded that the formulated structures generate the right behaviour for the right reasons.

The Potential for Increasing Net Incomes on Limited-Resource Farms in Eastern Kentucky. Research Report 24.

ERIC Educational Resources Information Center

Stewart, Fred J.; And Others

The study identified possibilities for improving farm incomes on limited-resource farms in eastern Kentucky. Objectives were to describe farm operations of full-time Appalachian farmers who had gross sales of less than $5,000 in 1972, estimate potential increases in net farm incomes from given resources, and identify nonresource constraints on…

Typhoid fever: misuse of Widal test in Libya.

PubMed

Zorgani, Abdulaziz; Ziglam, Hisham

2014-06-11

The worldwide gold standard of diagnosing of enteric fever depends on the isolation of Salmonella enterica serovar Typhi from a patient's bone marrow and/or blood culture. In Libya clinicians are heavily dependent on the Widal test for diagnosis of enteric fever which has been used without determining the locally appropriate threshold titer, because the laboratories lack the skilled, experienced personnel and appropriate facilities to detect and serotype Salmonella isolates. To improve the diagnosis process, clinical management and reliability of public health measures, there is an urgent need for the effective training of laboratory technicians and to provide resources to culture Salmonella species according to published guidelines. Clinicians should understand the limitations of Widal test and recognize that it cannot be expected to give a reliable diagnosis.

Drilling Automation Tests At A Lunar/Mars Analog Site

NASA Technical Reports Server (NTRS)

Glass, B.; Cannon, H.; Hanagud, S.; Lee, P.; Paulsen, G.

2006-01-01

Future in-situ lunar/martian resource utilization and characterization, as well as the scientific search for life on Mars, will require access to the subsurface and hence drilling. Drilling on Earth is hard - an art form more than an engineering discipline. The limited mass, energy and manpower in planetary drilling situations makes application of terrestrial drilling techniques problematic. The Drilling Automation for Mars Exploration (DAME) project is developing drilling automation and robotics for projected use in missions to the Moon and Mars in the 2011-15 period. This has been tested recently, drilling in permafrost at a lunar/martian analog site (Haughton Crater, Devon Island, Canada).

7 CFR 2.20 - Under Secretary for Natural Resources and Environment.

Code of Federal Regulations, 2012 CFR

2012-01-01

... cooperated in shall include, but not be limited to: renewable resource management research, renewable resource environmental research; renewable resource protection research; renewable resource utilization research, and renewable resource assessment research (16 U.S.C. 1641-1647). (x) Use authorities and means...

7 CFR 2.20 - Under Secretary for Natural Resources and Environment.

Code of Federal Regulations, 2011 CFR

2011-01-01

... cooperated in shall include, but not be limited to: renewable resource management research, renewable resource environmental research; renewable resource protection research; renewable resource utilization research, and renewable resource assessment research (16 U.S.C. 1641-1647). (x) Use authorities and means...

HIV-1 viral load measurement in venous blood and fingerprick blood using Abbott RealTime HIV-1 DBS assay.

PubMed

Tang, Ning; Pahalawatta, Vihanga; Frank, Andrea; Bagley, Zowie; Viana, Raquel; Lampinen, John; Leckie, Gregor; Huang, Shihai; Abravaya, Klara; Wallis, Carole L

2017-07-01

HIV RNA suppression is a key indicator for monitoring success of antiretroviral therapy. From a logistical perspective, viral load (VL) testing using Dried Blood Spots (DBS) is a promising alternative to plasma based VL testing in resource-limited settings. To evaluate the analytical and clinical performance of the Abbott RealTime HIV-1 assay using a fully automated one-spot DBS sample protocol. Limit of detection (LOD), linearity, lower limit of quantitation (LLQ), upper limit of quantitation (ULQ), and precision were determined using serial dilutions of HIV-1 Virology Quality Assurance stock (VQA Rush University), or HIV-1-containing armored RNA, made in venous blood. To evaluate correlation, bias, and agreement, 497 HIV-1 positive adult clinical samples were collected from Ivory Coast, Uganda and South Africa. For each HIV-1 participant, DBS-fingerprick, DBS-venous and plasma sample results were compared. Correlation and bias values were obtained. The sensitivity and specificity were analyzed at a threshold of 1000 HIV-1 copies/mL generated using the standard plasma protocol. The Abbott HIV-1 DBS protocol had an LOD of 839 copies/mL, a linear range from 500 to 1×10 7 copies/mL, an LLQ of 839 copies/mL, a ULQ of 1×10 7 copies/mL, and an inter-assay SD of ≤0.30 log copies/mL for all tested levels within this range. With clinical samples, the correlation coefficient (r value) was 0.896 between DBS-fingerprick and plasma and 0.901 between DBS-venous and plasma, and the bias was -0.07 log copies/mL between DBS-fingerprick and plasma and -0.02 log copies/mL between DBS-venous and plasma. The sensitivity of DBS-fingerprick and DBS-venous was 93%, while the specificity of both DBS methods was 95%. The results demonstrated that the Abbott RealTime HIV-1 assay with DBS sample protocol is highly sensitive, specific and precise across a wide dynamic range and correlates well with plasma values. The Abbott RealTime HIV-1 assay with DBS sample protocol provides an alternative sample collection and transfer option in resource-limited settings and expands the utility of a viral load test to monitor HIV-1 ART treatment for infected patients. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Maxillofacial prostheses challenges in resource constrained regions.

PubMed

Tetteh, Sophia; Bibb, Richard J; Martin, Simon J

2017-10-24

This study reviewed the current state of maxillofacial rehabilitation in resource-limited nations. A rigorous literature review was undertaken using several technical and clinical databases using a variety of key words pertinent to maxillofacial prosthetic rehabilitation and resource-limited areas. In addition, interviews were conducted with researchers, clinicians and prosthetists that had direct experience of volunteering or working in resource-limited countries. Results from the review and interviews suggest rehabilitating patients in resource-limited countries remains challenging and efforts to improve the situation requires a multifactorial approach. In conclusion, public health awareness programmes to reduce the causation of injuries and bespoke maxillofacial prosthetics training programmes to suit these countries, as opposed to attempting to replicate Western training programmes. It is also possible that usage of locally sourced and cheaper materials and the use of low-cost technologies could greatly improve maxillofacial rehabilitation efforts in these localities. Implications for Rehabilitation More information and support needs to be provided to maxillofacial defect/injuries patients and to their families or guardians in a culturally sensitive manner by governments. The health needs, economic and psychological needs of the patients need to be taken into account during the rehabilitation process by clinicians and healthcare organizations. The possibility of developing training programs to suit these resource limited countries and not necessarily follow conventional fabrication methods must be looked into further by educational entities.

Analysis of Energy Efficiency in WSN by Considering SHM Application

NASA Astrophysics Data System (ADS)

Kumar, Pawan; Naresh Babu, Merugu; Raju, Kota Solomon, Dr; Sharma, Sudhir Kumar, Dr; Jain, Vaibhav

2017-08-01

The Wireless Sensor Network is composed of a significant number of autonomous nodes deployed in an extensive or remote area. In WSN, the sensor nodes have a limited transmission range, processing speed and storage capabilities as well as their energy resources are also limited. In WSN all nodes are not directly connected. The primary objective for all kind of WSN is to enhance and optimize the network lifetime i.e. to minimize the energy consumption in the WSN. There are lots of applications of WSN out of which this research paper focuses upon the Structural Health Monitoring application in which 50 Meter bridge has been taken as a test application for the simulation purpose.

Equity of access to reproductive health services among youths in resource-limited suburban communities of Mandalay City, Myanmar

PubMed Central

2012-01-01

Background Inequity of accessibility to and utilization of reproductive health (RH) services among youths is a global concern, especially in resource-limited areas. The level of inequity also varies by cultural and socio-economic contexts. To tailor RH services to the needs of youths, relevant solutions are required. This study aimed to assess baseline information on access to and utilization of RH services and unmet needs among youths living in resource-limited, suburban communities of Mandalay City, Myanmar. Methods A community-based, cross-sectional study was conducted in all resource-limited, suburban communities of Mandalay City, Myanmar. A total of 444 randomly selected youths aged between 15 and 24 years were interviewed for three main outcomes, namely accessibility to and utilization of RH services and youth's unmet needs for these services. Factors associated with these outcomes were determined using multivariate logistic regression. Results Although geographical accessibility was high (79.3%), financial accessibility was low (19.1%) resulting in a low overall accessibility (34.5%) to RH services. Two-thirds of youths used some kind of RH services at least once in the past. Levels of unmet needs for sexual RH information, family planning, maternal care and HIV testing were 62.6%, 31.9%, 38.7% and 56.2%, respectively. Youths living in the south or south-western suburbs, having a deceased parent, never being married or never exposed to mass media were less likely to access RH services. Being a young adult, current student, working as a waste recycler, having ever experienced a sexual relationship, ever being married, ever exposed to mass media, having a high knowledge of RH services and providers or a high level of accessibility to RH services significantly increased the likelihood of utilization of those services. In addition to youths’ socio-demographic characteristics, exposure to mass media, norm of peer exposure and knowledge on types of providers and services significantly influenced the unmet needs of youths towards RH services. Conclusion Despite the availability of RH services, youth’s accessibility to and utilization of those services were unsatisfactory. The levels of youths’ unmet RH needs were alarmingly high. PMID:23241510

Feasibility intervention trial of two types of improved cookstoves in three resource-limited settings: study protocol for a randomized controlled trial

PubMed Central

2013-01-01

Background Exposure to biomass fuel smoke is one of the leading risk factors for disease burden worldwide. International campaigns are currently promoting the widespread adoption of improved cookstoves in resource-limited settings, yet little is known about the cultural and social barriers to successful improved cookstove adoption and how these barriers affect environmental exposures and health outcomes. Design We plan to conduct a one-year crossover, feasibility intervention trial in three resource-limited settings (Kenya, Nepal and Peru). We will enroll 40 to 46 female primary cooks aged 20 to 49 years in each site (total 120 to 138). Methods At baseline, we will collect information on sociodemographic characteristics and cooking practices, and measure respiratory health and blood pressure for all participating women. An initial observational period of four months while households use their traditional, open-fire design cookstoves will take place prior to randomization. All participants will then be randomized to receive one of two types of improved, ventilated cookstoves with a chimney: a commercially-constructed cookstove (Envirofit G3300/G3355) or a locally-constructed cookstove. After four months of observation, participants will crossover and receive the other improved cookstove design and be followed for another four months. During each of the three four-month study periods, we will collect monthly information on self-reported respiratory symptoms, cooking practices, compliance with cookstove use (intervention periods only), and measure peak expiratory flow, forced expiratory volume at 1 second, exhaled carbon monoxide and blood pressure. We will also measure pulmonary function testing in the women participants and 24-hour kitchen particulate matter and carbon monoxide levels at least once per period. Discussion Findings from this study will help us better understand the behavioral, biological, and environmental changes that occur with a cookstove intervention. If this trial indicates that reducing indoor air pollution is feasible and effective in resource-limited settings like Peru, Kenya and Nepal, trials and programs to modify the open burning of biomass fuels by installation of low-cost ventilated cookstoves could significantly reduce the burden of illness and death worldwide. Trial registration ClinicalTrials.gov NCT01686867 PMID:24112419

Feasibility intervention trial of two types of improved cookstoves in three resource-limited settings: study protocol for a randomized controlled trial.

PubMed

Klasen, Elizabeth; Miranda, J Jaime; Khatry, Subarna; Menya, Diana; Gilman, Robert H; Tielsch, James M; Kennedy, Caitlin; Dreibelbis, Robert; Naithani, Neha; Kimaiyo, Sylvester; Chiang, Marilu; Carter, E Jane; Sherman, Charles B; Breysse, Patrick N; Checkley, William

2013-10-10

Exposure to biomass fuel smoke is one of the leading risk factors for disease burden worldwide. International campaigns are currently promoting the widespread adoption of improved cookstoves in resource-limited settings, yet little is known about the cultural and social barriers to successful improved cookstove adoption and how these barriers affect environmental exposures and health outcomes. We plan to conduct a one-year crossover, feasibility intervention trial in three resource-limited settings (Kenya, Nepal and Peru). We will enroll 40 to 46 female primary cooks aged 20 to 49 years in each site (total 120 to 138). At baseline, we will collect information on sociodemographic characteristics and cooking practices, and measure respiratory health and blood pressure for all participating women. An initial observational period of four months while households use their traditional, open-fire design cookstoves will take place prior to randomization. All participants will then be randomized to receive one of two types of improved, ventilated cookstoves with a chimney: a commercially-constructed cookstove (Envirofit G3300/G3355) or a locally-constructed cookstove. After four months of observation, participants will crossover and receive the other improved cookstove design and be followed for another four months. During each of the three four-month study periods, we will collect monthly information on self-reported respiratory symptoms, cooking practices, compliance with cookstove use (intervention periods only), and measure peak expiratory flow, forced expiratory volume at 1 second, exhaled carbon monoxide and blood pressure. We will also measure pulmonary function testing in the women participants and 24-hour kitchen particulate matter and carbon monoxide levels at least once per period. Findings from this study will help us better understand the behavioral, biological, and environmental changes that occur with a cookstove intervention. If this trial indicates that reducing indoor air pollution is feasible and effective in resource-limited settings like Peru, Kenya and Nepal, trials and programs to modify the open burning of biomass fuels by installation of low-cost ventilated cookstoves could significantly reduce the burden of illness and death worldwide. ClinicalTrials.gov NCT01686867.

Between a rock and a hard place: Learning to teach science-for-all in an urban district

NASA Astrophysics Data System (ADS)

Galosy, Jodie A.

2005-07-01

Science-for-all, a contemporary science education reform initiative, envisions science classrooms where all students have opportunities to deepen their understanding of scientific concepts and practices. However, national science achievement tests indicate the reality of science-for-all is still very much a work-in-progress. Science-for-all demands much of teachers, especially those working with student populations typically underserved by science education---students of color, students with limited English proficiency, and those from families with limited economic means. A large proportion of those students attend urban districts where they are likely to encounter novice science teachers. This qualitative study investigated learning to teach science-for-all in an urban school district. Seven early career middle and high school science teachers participated in the study. Data collection took place over a period of fourteen months, through interviews and observations with teacher participants, their schools, and in their professional development activities (including new teacher support induction programs). The study examines how new teachers' use of their personal, social, and conventional resources influenced their beliefs and practices relative to science-for-all. Three reform ideals serve as the study's focal points: content goals that emphasize understanding scientific concepts and practices, hands-on activities that support students' intellectual engagement, and literacy strategies that provide access for all students to scientific content. Few novices developed beliefs and practices that supported science-for-all. Those who did brought several key personal resources to their teaching. While these personal resources were important for teacher development, they were not sufficient; novices needed additional resources. Some teachers had access to reform-based conventional resources others did not have. However, personal and social resources shaped how novices used those resources and, in turn, their beliefs about students and teaching practices. Context-specific assistance was a particularly important social resource that was in short supply for most novices. The study provides evidence that progress towards science-for-all will require substantial attention to, and investment in, teacher learning across all dimensions of the professional continuum---pre-service, induction, and in-service. The study also provides insights in two critical areas: strengthening the resources available to early career urban science teachers and shaping resource use towards the goals envisioned in science-for all.

Enhanced processing of threat stimuli under limited attentional resources.

PubMed

De Martino, Benedetto; Kalisch, Raffael; Rees, Geraint; Dolan, Raymond J

2009-01-01

The ability to process stimuli that convey potential threat, under conditions of limited attentional resources, confers adaptive advantages. This study examined the neurobiology underpinnings of this capacity. Employing an attentional blink paradigm, in conjunction with functional magnetic resonance imaging, we manipulated the salience of the second of 2 face target stimuli (T2), by varying emotionality. Behaviorally, fearful T2 faces were identified significantly more than neutral faces. Activity in fusiform face area increased with correct identification of T2 faces. Enhanced activity in rostral anterior cingulate cortex (rACC) accounted for the benefit in detection of fearful stimuli reflected in a significant interaction between target valence and correct identification. Thus, under conditions of limited attention resources activation in rACC correlated with enhanced processing of emotional stimuli. We suggest that these data support a model in which a prefrontal "gate" mechanism controls conscious access of emotional information under conditions of limited attentional resources.

Orthogonal fitness benefits of nitrogen and ants for nitrogen-limited plants in the presence of herbivores.

PubMed

Pringle, Elizabeth G; Ableson, Ian; Kerber, Jennifer; Vannette, Rachel L; Tao, Leiling

2017-12-01

Predictable effects of resource availability on plant growth-defense strategies provide a unifying theme in theories of direct anti-herbivore defense, but it is less clear how resource availability modulates plant indirect defense. Ant-plant-hemipteran interactions produce mutualistic trophic cascades when hemipteran-tending ants reduce total herbivory, and these interactions are a key component of plant indirect defense in most terrestrial ecosystems. Here we conducted an experiment to test how ant-plant-hemipteran interactions depend on nitrogen (N) availability by manipulating the presence of ants and aphids under different N fertilization treatments. Ants increased plant flowering success by decreasing the densities of herbivores, and the effects of ants on folivores were positively related to the density of aphids. Unexpectedly, N fertilization produced no changes in plant N concentrations. Plants grown in higher N grew and flowered more, but aphid honeydew chemistry stayed the same, and neither the density of aphids nor the rate of ant attraction per aphid changed with N addition. The positive effects of ants and N addition on plant fitness were thus independent of one another. We conclude that N was the plant's limiting nutrient and propose that addition of the limiting nutrient is unlikely to alter the strength of mutualistic trophic cascades. © 2017 by the Ecological Society of America.

Community Engaged Cumulative Risk Assessment of Exposure to Inorganic Well Water Contaminants, Crow Reservation, Montana

PubMed Central

Doyle, John T.; Lefthand, Myra J.; Young, Sara L.; Kindness, Larry; Other Medicine, Roberta; Ford, Timothy E.; Dietrich, Eric; Parker, Albert E.; Hoover, Joseph H.; Camper, Anne K.

2018-01-01

An estimated 11 million people in the US have home wells with unsafe levels of hazardous metals and nitrate. The national scope of the health risk from consuming this water has not been assessed as home wells are largely unregulated and data on well water treatment and consumption are lacking. Here, we assessed health risks from consumption of contaminated well water on the Crow Reservation by conducting a community-engaged, cumulative risk assessment. Well water testing, surveys and interviews were used to collect data on contaminant concentrations, water treatment methods, well water consumption, and well and septic system protection and maintenance practices. Additive Hazard Index calculations show that the water in more than 39% of wells is unsafe due to uranium, manganese, nitrate, zinc and/or arsenic. Most families’ financial resources are limited, and 95% of participants do not employ water treatment technologies. Despite widespread high total dissolved solids, poor taste and odor, 80% of families consume their well water. Lack of environmental health literacy about well water safety, pre-existing health conditions and limited environmental enforcement also contribute to vulnerability. Ensuring access to safe drinking water and providing accompanying education are urgent public health priorities for Crow and other rural US families with low environmental health literacy and limited financial resources. PMID:29304032

Many to flower, few to fruit: the reproductive biology of Hamamelis virginiana (Hamamelidaceae).

PubMed

Anderson, Gregory J; Hill, James D

2002-01-01

Hamamelis virginiana flowers from late September to late November. In 1977, we began studying the reproductive biology of this eastern North American arborescent shrub by examining floral phenology and rewards, pollen-ovule ratios, breeding system, pollination, pollinator and resource limitation, and seed dispersal. The homogamous, self-incompatible flowers emit a faint odor, bear nectar with sucrose ratios typical of bee- and fly-pollinated flowers, and produce abundant sticky pollen. Flowers were visited infrequently by insects representing six orders. Flies were the most common floral visitors, specifically members of the genus Bradysia, but small bees also carried high percentages of Hamamelis pollen. Despite high pollen/ovule ratios (11 445 grains/ovule), bees and flies are likely pollinators, as experiments indicate wind pollination is less likely. Pollen quantity and resource availability did not appear to limit reproductive output, but pollen quality did. Tests of >40 000 flowers showed natural fruit set to be <1%. The flowering time, breeding system, and clumped distribution of plants, likely due in part to limited seed dispersal, combine to yield this remarkably low fruit set. Because all other species of Hamamelis flower from late winter to early summer, it may be that H. virginiana evolved a fall flowering phenology to avoid competition for pollinators with the closely related H. vernalis.

Challenges and priorities in the management of HIV/HBV and HIV/HCV coinfection in resource-limited settings.

PubMed

Easterbrook, Philippa; Sands, Anita; Harmanci, Hande

2012-05-01

Liver disease due to chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection is now emerging as an increasing cause of morbidity and mortality in human immunodeficiency virus- (HIV-) infected persons in resource-limited settings (RLS). Existing management guidelines have generally focused on care in tertiary level facilities in developed countries. Less than half of low-income countries have guidance, and in those that do, there are important omissions or disparities in recommendations. There are multiple challenges to delivery of effective hepatitis care in RLS, but the most important remains the limited access to antiviral drugs and diagnostic tests. In 2010, the World Health Assembly adopted a resolution calling for a comprehensive approach for the prevention, control, and management of viral hepatitis. We describe activities at the World Health Organization (WHO) in three key areas: the establishment of a global hepatitis Program and interim strategy; steps toward the development of global guidance on management of coinfection for RLS; and the WHO prequalification program of HBV and HCV diagnostic assays. We highlight key research gaps and the importance of applying the lessons learned from the public health scale-up of ART to hepatitis care. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A modified culture-based study of bacterial community composition in a tannery wastewater treatment plant.

PubMed

Desta, Adey F; Dalhammer, Gunnel; Kittuva, Gunatrana R

2010-01-01

Though culture-independent methods have been used in preference to traditional isolation techniques for characterization of microbial community of wastewater treatment plants, it is difficult to widely apply this approach in resource-poor countries. The present study aimed to develop a test to identify the culturable portion of bacterial community in a high-strength wastewater. Wastewater samples were collected from nitrification-denitrification and settling tanks of the treatment plant of Elmo Leather AB tannery located in Borås, Sweden. After cultivating on nutrient agar with the optimal dilution (10⁻²), phenotypic and biochemical identification of the bacteria were done with colony morphology, Gram reaction, growth on MacConkey, phenylethanol media, triple sugar Iron agar slants, catalase and oxidase tests. Biochemical grouping of the isolates was done based on their test results for MacConkey, phenylethanol media, triple sugar Iron agar and oxidase test reaction. From the biochemical groups, isolates were randomly selected for API test and 16SrRNA gene sequencing. The isolates from the denitrification, nitrification tank were identified to be Paracoccus denitrificans (67%), Azoarcus spp (3%) and Spingomonas wittichii (1%). From the settling tank, Paracoccus denitrificans (22%), Corynebacterium freneyi (20%) and Bacillus cereus (1%) were identified. The grouping based on biochemical test results as well as the identification based on sequencing has shown coherence except for discrepancies with the API test. The preliminary implications of the grouping based on culture-based characteristics and its potential application for resource-limited environmental microbial studies is discussed.

Optimal test selection for prediction uncertainty reduction

DOE PAGES

Mullins, Joshua; Mahadevan, Sankaran; Urbina, Angel

2016-12-02

Economic factors and experimental limitations often lead to sparse and/or imprecise data used for the calibration and validation of computational models. This paper addresses resource allocation for calibration and validation experiments, in order to maximize their effectiveness within given resource constraints. When observation data are used for model calibration, the quality of the inferred parameter descriptions is directly affected by the quality and quantity of the data. This paper characterizes parameter uncertainty within a probabilistic framework, which enables the uncertainty to be systematically reduced with additional data. The validation assessment is also uncertain in the presence of sparse and imprecisemore » data; therefore, this paper proposes an approach for quantifying the resulting validation uncertainty. Since calibration and validation uncertainty affect the prediction of interest, the proposed framework explores the decision of cost versus importance of data in terms of the impact on the prediction uncertainty. Often, calibration and validation tests may be performed for different input scenarios, and this paper shows how the calibration and validation results from different conditions may be integrated into the prediction. Then, a constrained discrete optimization formulation that selects the number of tests of each type (calibration or validation at given input conditions) is proposed. Furthermore, the proposed test selection methodology is demonstrated on a microelectromechanical system (MEMS) example.« less

Cell Phone-Based and Adherence Device Technologies for HIV Care and Treatment in Resource-Limited Settings: Recent Advances.

PubMed

Campbell, Jeffrey I; Haberer, Jessica E

2015-12-01

Numerous cell phone-based and adherence monitoring technologies have been developed to address barriers to effective HIV prevention, testing, and treatment. Because most people living with HIV and AIDS reside in resource-limited settings (RLS), it is important to understand the development and use of these technologies in RLS. Recent research on cell phone-based technologies has focused on HIV education, linkage to and retention in care, disease tracking, and antiretroviral therapy adherence reminders. Advances in adherence devices have focused on real-time adherence monitors, which have been used for both antiretroviral therapy and pre-exposure prophylaxis. Real-time monitoring has recently been combined with cell phone-based technologies to create real-time adherence interventions using short message service (SMS). New developments in adherence technologies are exploring ingestion monitoring and metabolite detection to confirm adherence. This article provides an overview of recent advances in these two families of technologies and includes research on their acceptability and cost-effectiveness when available. It additionally outlines key challenges and needed research as use of these technologies continues to expand and evolve.

Data on microbiological quality assessment of rural drinking water supplies in Tiran County, Isfahan province, Iran.

PubMed

Jafari, Khadijeh; Mohammadi, Ali Akbar; Heidari, Zahra; Asghari, Farzaneh Baghal; Radfard, Majid; Yousefi, Mahmood; Shams, Mahmoud

2018-06-01

A lack of access to safe drinking water can lead to adverse health effects such as infection, disease, and undesirable aesthetic problems. The current study focused on the investigation of groundwater quality in Tiran's villages (Isfahan province, Iran). To determine essential microbiological quality, water samples were collected from 46 randomly-selected water wells during a one-year period. The parameters of pH and chlorine were measured on-site. Turbidity was measured at 420 nm using a DR5000 spectrophotometer. Microbiological tests including general thermoforms, Escherichia coli , and thermophiles were carried out according to the National Iranian Standard Method 3759. Data showed that 1.8% of the villages under study had contaminated water resources. The turbidity values for 94.5% of the resources were within recommended limits (<5NTU). In 20.6% of the samples, the residual free chlorine was in the range of 0 to 0.2 mg/L, 8.79% of samples had values greater than the recommended limits, and18.5% had no free residual chlorine.

Reasoning about Resources and Hierarchical Tasks Using OWL and SWRL

NASA Astrophysics Data System (ADS)

Elenius, Daniel; Martin, David; Ford, Reginald; Denker, Grit

Military training and testing events are highly complex affairs, potentially involving dozens of legacy systems that need to interoperate in a meaningful way. There are superficial interoperability concerns (such as two systems not sharing the same messaging formats), but also substantive problems such as different systems not sharing the same understanding of the terrain, positions of entities, and so forth. We describe our approach to facilitating such events: describe the systems and requirements in great detail using ontologies, and use automated reasoning to automatically find and help resolve problems. The complexity of our problem took us to the limits of what one can do with OWL, and we needed to introduce some innovative techniques of using and extending it. We describe our novel ways of using SWRL and discuss its limitations as well as extensions to it that we found necessary or desirable. Another innovation is our representation of hierarchical tasks in OWL, and an engine that reasons about them. Our task ontology has proved to be a very flexible and expressive framework to describe requirements on resources and their capabilities in order to achieve some purpose.

The spatial and metabolic basis of colony size variation.

PubMed

Chacón, Jeremy M; Möbius, Wolfram; Harcombe, William R

2018-03-01

Spatial structure impacts microbial growth and interactions, with ecological and evolutionary consequences. It is therefore important to quantitatively understand how spatial proximity affects interactions in different environments. We tested how proximity influences colony size when either Escherichia coli or Salmonella enterica are grown on various carbon sources. The importance of colony location changed with species and carbon source. Spatially explicit, genome-scale metabolic modeling recapitulated observed colony size variation. Competitors that determine territory size, according to Voronoi diagrams, were the most important drivers of variation in colony size. However, the relative importance of different competitors changed through time. Further, the effect of location increased when colonies took up resources quickly relative to the diffusion of limiting resources. These analyses made it apparent that the importance of location was smaller than expected for experiments with S. enterica growing on glucose. The accumulation of toxic byproducts appeared to limit the growth of large colonies and reduced variation in colony size. Our work provides an experimentally and theoretically grounded understanding of how location interacts with metabolism and diffusion to influence microbial interactions.

Gas hydrate formation rates from dissolved-phase methane in porous laboratory specimens

USGS Publications Warehouse

Waite, William F.; Spangenberg, E.K.

2013-01-01

Marine sands highly saturated with gas hydrates are potential energy resources, likely forming from methane dissolved in pore water. Laboratory fabrication of gas hydrate-bearing sands formed from dissolved-phase methane usually requires 1–2 months to attain the high hydrate saturations characteristic of naturally occurring energy resource targets. A series of gas hydrate formation tests, in which methane-supersaturated water circulates through 100, 240, and 200,000 cm3 vessels containing glass beads or unconsolidated sand, show that the rate-limiting step is dissolving gaseous-phase methane into the circulating water to form methane-supersaturated fluid. This implies that laboratory and natural hydrate formation rates are primarily limited by methane availability. Developing effective techniques for dissolving gaseous methane into water will increase formation rates above our observed (1 ± 0.5) × 10−7 mol of methane consumed for hydrate formation per minute per cubic centimeter of pore space, which corresponds to a hydrate saturation increase of 2 ± 1% per day, regardless of specimen size.

Effects of three pesticides on the avoidance behavior of earthworms in laboratory tests performed under temperate and tropical conditions.

PubMed

Garcia, Marcos; Römbke, Jörg; de Brito, Marcus Torres; Scheffczyk, Adam

2008-05-01

Little research has been performed on the impact of pesticides on earthworms under tropical conditions. Taking into consideration the often-limited resources in tropical countries, simple screening tests are needed. Therefore, it was investigated whether three pesticides relevant for the Brazilian Amazon (benomyl, carbendazim, lambda-cyhalothrin) affect the avoidance behavior of the earthworm Eisenia fetida. The tests were performed for two days according to ISO guideline 17512 but were adapted to tropical conditions (i.e. test substrate, test organism and temperature). The results indicate that this test gives reproducible and reliable results. Toxicity values (NOEC, EC50) are lower than those determined in 14 day-acute mortality tests and are approximately in the same range such as those found in 56 day-chronic reproduction tests with the same earthworm species, which were performed in parallel. Therefore, the use of the earthworm avoidance tests is recommended as a screening tool for the risk assessment of pesticides.

Pruning and Prioritising: A Case Study of a Pragmatic Method for Managing a Rapid Systematic Review with Limited Resources

ERIC Educational Resources Information Center

Harnan, Sue Elizabeth; Cooper, Katy; Jones, Sarah Lynne; Jones, Elaine

2015-01-01

Full systematic reviews are time and resource heavy. We describe a method successfully used to produce a rapid review of yoga for health and wellbeing, with limited resources, using mapping methods. Inclusion and exclusion criteria were developed a priori and refined "post hoc," with the review team blind to the study results to minimise…

Pediatric Early Warning Systems aid in triage to intermediate versus intensive care for pediatric oncology patients in resource-limited hospitals.

PubMed

Agulnik, Asya; Nadkarni, Anisha; Mora Robles, Lupe Nataly; Soberanis Vasquez, Dora Judith; Mack, Ricardo; Antillon-Klussmann, Federico; Rodriguez-Galindo, Carlos

2018-04-10

Pediatric oncology patients hospitalized in resource-limited settings are at high risk for clinical deterioration resulting in mortality. Intermediate care units (IMCUs) provide a cost-effective alternative to pediatric intensive care units (PICUs). Inappropriate IMCU triage, however, can lead to poor outcomes and suboptimal resource utilization. In this study, we sought to characterize patients with clinical deterioration requiring unplanned transfer to the IMCU in a resource-limited pediatric oncology hospital. Patients requiring subsequent early PICU transfer had longer PICU length of stay. PEWS results prior to IMCU transfer were higher in patients requiring early PICU transfer, suggesting PEWS can aid in triage between IMCU and PICU care. © 2018 Wiley Periodicals, Inc.

Bridging the gap between financial distress and available resources for patients with cancer: a qualitative study.

PubMed

Smith, Sophia K; Nicolla, Jonathan; Zafar, S Yousuf

2014-09-01

Cancer treatment-related out-of-pocket costs create substantial financial distress for many patients. However, little work has been done to describe available financial resources and barriers to connecting those resources to patients. This was a single-center, qualitative study that used semistructured interviews and focus groups with social workers and financial care counselors. Interview guides were used to elicit feedback from study participants pertaining to the types of financial problems that their patients were experiencing, the process for addressing these issues, patient assistance resources, and access barriers. Four interviews and two focus group sessions (n = 15) were conducted in which four themes emerged among the social work and financial care counselor samples. Participants cited (1) frustration over the lack of financial resources and increasingly stringent eligibility criteria, (2) barriers to providing assistance such as process inefficiencies, (3) limited resources to identify at- risk patients and refer them for services, and (4) inadequate insurance coverage and availability. To bridge the gap between increasing patient need and limited resources, participants suggested development of interventions designed to aid in patient screening and resource identification. Oncology social workers and financial care counselors reported inadequate financial resources and faced barriers to matching appropriate resources with patients in need. Limited social work resources hindered early screening for financial distress. Interventions that focus on screening for early identification of financial distress and identification of resources are needed. Copyright © 2014 by American Society of Clinical Oncology.

Discrete-Slots Models of Visual Working-Memory Response Times

PubMed Central

Donkin, Christopher; Nosofsky, Robert M.; Gold, Jason M.; Shiffrin, Richard M.

2014-01-01

Much recent research has aimed to establish whether visual working memory (WM) is better characterized by a limited number of discrete all-or-none slots or by a continuous sharing of memory resources. To date, however, researchers have not considered the response-time (RT) predictions of discrete-slots versus shared-resources models. To complement the past research in this field, we formalize a family of mixed-state, discrete-slots models for explaining choice and RTs in tasks of visual WM change detection. In the tasks under investigation, a small set of visual items is presented, followed by a test item in 1 of the studied positions for which a change judgment must be made. According to the models, if the studied item in that position is retained in 1 of the discrete slots, then a memory-based evidence-accumulation process determines the choice and the RT; if the studied item in that position is missing, then a guessing-based accumulation process operates. Observed RT distributions are therefore theorized to arise as probabilistic mixtures of the memory-based and guessing distributions. We formalize an analogous set of continuous shared-resources models. The model classes are tested on individual subjects with both qualitative contrasts and quantitative fits to RT-distribution data. The discrete-slots models provide much better qualitative and quantitative accounts of the RT and choice data than do the shared-resources models, although there is some evidence for “slots plus resources” when memory set size is very small. PMID:24015956

Evolution of CMS workload management towards multicore job support

NASA Astrophysics Data System (ADS)

Pérez-Calero Yzquierdo, A.; Hernández, J. M.; Khan, F. A.; Letts, J.; Majewski, K.; Rodrigues, A. M.; McCrea, A.; Vaandering, E.

2015-12-01

The successful exploitation of multicore processor architectures is a key element of the LHC distributed computing system in the coming era of the LHC Run 2. High-pileup complex-collision events represent a challenge for the traditional sequential programming in terms of memory and processing time budget. The CMS data production and processing framework is introducing the parallel execution of the reconstruction and simulation algorithms to overcome these limitations. CMS plans to execute multicore jobs while still supporting singlecore processing for other tasks difficult to parallelize, such as user analysis. The CMS strategy for job management thus aims at integrating single and multicore job scheduling across the Grid. This is accomplished by employing multicore pilots with internal dynamic partitioning of the allocated resources, capable of running payloads of various core counts simultaneously. An extensive test programme has been conducted to enable multicore scheduling with the various local batch systems available at CMS sites, with the focus on the Tier-0 and Tier-1s, responsible during 2015 of the prompt data reconstruction. Scale tests have been run to analyse the performance of this scheduling strategy and ensure an efficient use of the distributed resources. This paper presents the evolution of the CMS job management and resource provisioning systems in order to support this hybrid scheduling model, as well as its deployment and performance tests, which will enable CMS to transition to a multicore production model for the second LHC run.

Evolution of CMS Workload Management Towards Multicore Job Support

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

Perez-Calero Yzquierdo, A.; Hernández, J. M.; Khan, F. A.

The successful exploitation of multicore processor architectures is a key element of the LHC distributed computing system in the coming era of the LHC Run 2. High-pileup complex-collision events represent a challenge for the traditional sequential programming in terms of memory and processing time budget. The CMS data production and processing framework is introducing the parallel execution of the reconstruction and simulation algorithms to overcome these limitations. CMS plans to execute multicore jobs while still supporting singlecore processing for other tasks difficult to parallelize, such as user analysis. The CMS strategy for job management thus aims at integrating single andmore » multicore job scheduling across the Grid. This is accomplished by employing multicore pilots with internal dynamic partitioning of the allocated resources, capable of running payloads of various core counts simultaneously. An extensive test programme has been conducted to enable multicore scheduling with the various local batch systems available at CMS sites, with the focus on the Tier-0 and Tier-1s, responsible during 2015 of the prompt data reconstruction. Scale tests have been run to analyse the performance of this scheduling strategy and ensure an efficient use of the distributed resources. This paper presents the evolution of the CMS job management and resource provisioning systems in order to support this hybrid scheduling model, as well as its deployment and performance tests, which will enable CMS to transition to a multicore production model for the second LHC run.« less

Flexible services for the support of research.

PubMed

Turilli, Matteo; Wallom, David; Williams, Chris; Gough, Steve; Curran, Neal; Tarrant, Richard; Bretherton, Dan; Powell, Andy; Johnson, Matt; Harmer, Terry; Wright, Peter; Gordon, John

2013-01-28

Cloud computing has been increasingly adopted by users and providers to promote a flexible, scalable and tailored access to computing resources. Nonetheless, the consolidation of this paradigm has uncovered some of its limitations. Initially devised by corporations with direct control over large amounts of computational resources, cloud computing is now being endorsed by organizations with limited resources or with a more articulated, less direct control over these resources. The challenge for these organizations is to leverage the benefits of cloud computing while dealing with limited and often widely distributed computing resources. This study focuses on the adoption of cloud computing by higher education institutions and addresses two main issues: flexible and on-demand access to a large amount of storage resources, and scalability across a heterogeneous set of cloud infrastructures. The proposed solutions leverage a federated approach to cloud resources in which users access multiple and largely independent cloud infrastructures through a highly customizable broker layer. This approach allows for a uniform authentication and authorization infrastructure, a fine-grained policy specification and the aggregation of accounting and monitoring. Within a loosely coupled federation of cloud infrastructures, users can access vast amount of data without copying them across cloud infrastructures and can scale their resource provisions when the local cloud resources become insufficient.

77 FR 55222 - Notice of Availability of the Draft Resource Management Plan Amendment and the Draft...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-07

... development (e.g., year-round drilling instead of timing limitations if development does not exceed a particular threshold) and emphasizes conservation and protection of other resources by limiting the duration...

Concept dictionary creation and maintenance under resource constraints: lessons from the AMPATH Medical Record System.

PubMed

Were, Martin C; Mamlin, Burke W; Tierney, William M; Wolfe, Ben; Biondich, Paul G

2007-10-11

The challenges of creating and maintaining concept dictionaries are compounded in resource-limited settings. Approaches to alleviate this burden need to be based on information derived in these settings. We created a concept dictionary and evaluated new concept proposals for an open source EMR in a resource-limited setting. Overall, 87% of the concepts in the initial dictionary were used. There were 5137 new concepts proposed, with 77% of these proposed only once. Further characterization of new concept proposals revealed that 41% were due to deficiency in the existing dictionary, and 19% were synonyms to existing concepts. 25% of the requests contained misspellings, 41% were complex terms, and 17% were ambiguous. Given the resource-intensive nature of dictionary creation and maintenance, there should be considerations for centralizing the concept dictionary service, using standards, prioritizing concept proposals, and redesigning the user-interface to reduce this burden in settings with limited resources.

Concept Dictionary Creation and Maintenance Under Resource Constraints: Lessons from the AMPATH Medical Record System

PubMed Central

Were, Martin C.; Mamlin, Burke W.; Tierney, William M.; Wolfe, Ben; Biondich, Paul G.

2007-01-01

The challenges of creating and maintaining concept dictionaries are compounded in resource-limited settings. Approaches to alleviate this burden need to be based on information derived in these settings. We created a concept dictionary and evaluated new concept proposals for an open source EMR in a resource-limited setting. Overall, 87% of the concepts in the initial dictionary were used. There were 5137 new concepts proposed, with 77% of these proposed only once. Further characterization of new concept proposals revealed that 41% were due to deficiency in the existing dictionary, and 19% were synonyms to existing concepts. 25% of the requests contained misspellings, 41% were complex terms, and 17% were ambiguous. Given the resource-intensive nature of dictionary creation and maintenance, there should be considerations for centralizing the concept dictionary service, using standards, prioritizing concept proposals, and redesigning the user-interface to reduce this burden in settings with limited resources. PMID:18693945

Improving district facility readiness: a 12-month evaluation of a data-driven health systems strengthening intervention in rural Rwanda.

PubMed

Iyer, Hari S; Kamanzi, Emmanuel; Mugunga, Jean Claude; Finnegan, Karen; Uwingabiye, Alice; Shyaka, Edward; Niyonzima, Saleh; Hirschhorn, Lisa R; Drobac, Peter C

2015-01-01

While health systems strengthening (HSS) interventions are recommended by global health policy experts to improve population health in resource-limited settings, few examples exist of evaluations of HSS interventions conducted at the district level. In 2009, a partnership between Partners In Health (PIH), a non-governmental organization, and the Rwandan Ministry of Health (RMOH) was provided funds to implement and evaluate a district-level HSS intervention in two rural districts of Rwanda. The partnership provided limited funds to 14 health centers for targeted systems support in 2010; six others received support prior to the intervention (reference). RMOH health systems norms were mapped across the WHO HSS framework, scored from 0 to 10 and incorporated into a rapid survey assessing 11 domains of facility readiness. Stakeholder meetings allowed partnership leaders to review results, set priorities, and allocate resources. Investments included salary support, infrastructure improvements, medical equipment, and social support for patients. We compared facility domain scores from the start of the intervention to 12 months and tested for correlation between change in score and change in funding allocation to assess equity in our approach. We found significant improvements among intervention facilities from baseline to 12 months across several domains [infrastructure (+4, p=0.0001), clinical services (+1.2, p=0.03), infection and sanitation control (+0.6, p=0.03), medical equipment (+1.0, p=0.02), information use (+2, p=0.002)]. Composite score across domains improved from 6.2 at baseline to 7.4 at 12 months (p=0.002). Across facilities, 50% had composite scores greater than the average score among reference facilities (7.4) at 12 months compared to none at baseline. Rapid facility surveys, stakeholder engagement, and information feedback can be used for gap analysis and resource allocation. This approach can achieve effective use of limited resources, improve facility readiness, and ensure consistency of facility capacity to provide quality care at the district level.

Improving district facility readiness: a 12-month evaluation of a data-driven health systems strengthening intervention in rural Rwanda

PubMed Central

Iyer, Hari S.; Kamanzi, Emmanuel; Mugunga, Jean Claude; Finnegan, Karen; Uwingabiye, Alice; Shyaka, Edward; Niyonzima, Saleh; Hirschhorn, Lisa R.; Drobac, Peter C.

2015-01-01

Background While health systems strengthening (HSS) interventions are recommended by global health policy experts to improve population health in resource-limited settings, few examples exist of evaluations of HSS interventions conducted at the district level. In 2009, a partnership between Partners In Health (PIH), a non-governmental organization, and the Rwandan Ministry of Health (RMOH) was provided funds to implement and evaluate a district-level HSS intervention in two rural districts of Rwanda. Design The partnership provided limited funds to 14 health centers for targeted systems support in 2010; six others received support prior to the intervention (reference). RMOH health systems norms were mapped across the WHO HSS framework, scored from 0 to 10 and incorporated into a rapid survey assessing 11 domains of facility readiness. Stakeholder meetings allowed partnership leaders to review results, set priorities, and allocate resources. Investments included salary support, infrastructure improvements, medical equipment, and social support for patients. We compared facility domain scores from the start of the intervention to 12 months and tested for correlation between change in score and change in funding allocation to assess equity in our approach. Results We found significant improvements among intervention facilities from baseline to 12 months across several domains [infrastructure (+4, p=0.0001), clinical services (+1.2, p=0.03), infection and sanitation control (+0.6, p=0.03), medical equipment (+1.0, p=0.02), information use (+2, p=0.002)]. Composite score across domains improved from 6.2 at baseline to 7.4 at 12 months (p=0.002). Across facilities, 50% had composite scores greater than the average score among reference facilities (7.4) at 12 months compared to none at baseline. Conclusions Rapid facility surveys, stakeholder engagement, and information feedback can be used for gap analysis and resource allocation. This approach can achieve effective use of limited resources, improve facility readiness, and ensure consistency of facility capacity to provide quality care at the district level. PMID:26140729

Effects of Resource Availability on Children's Behavior and Conflict Management.

ERIC Educational Resources Information Center

Brown, Enora R.

1996-01-01

Examined the effect of resource availability on dyadic interaction of African American three- to five-year olds in a painting activity conducted under two resource conditions. Limited resources promoted more resource and task conflict, while plentiful resources promoted more nonconflictive social and task interactions. Results underscored the role…

Moving toward rapid and low-cost point-of-care molecular diagnostics with a repurposed 3D printer and RPA.

PubMed

Chan, Kamfai; Wong, Pui-Yan; Parikh, Chaitanya; Wong, Season

2018-03-15

Traditionally, the majority of nucleic acid amplification-based molecular diagnostic tests are done in centralized settings. In recent years, point-of-care tests have been developed for use in low-resource settings away from central laboratories. While most experts agree that point-of-care molecular tests are greatly needed, their availability as cost-effective and easy-to-operate tests remains an unmet goal. In this article, we discuss our efforts to develop a recombinase polymerase amplification reaction-based test that will meet these criteria. First, we describe our efforts in repurposing a low-cost 3D printer as a platform that can carry out medium-throughput, rapid, and high-performing nucleic acid extraction. Next, we address how these purified templates can be rapidly amplified and analyzed using the 3D printer's heated bed or the deconstructed, low-cost thermal cycler we have developed. In both approaches, real-time isothermal amplification and detection of template DNA or RNA can be accomplished using a low-cost portable detector or smartphone camera. Last, we demonstrate the capability of our technologies using foodborne pathogens and the Zika virus. Our low-cost approach does not employ complicated and high-cost components, making it suitable for resource-limited settings. When integrated and commercialized, it will offer simple sample-to-answer molecular diagnostics. Copyright © 2018 Elsevier Inc. All rights reserved.

Temporary camps at drill hole U19aq on Pahute Mesa, Nye County, Nevada

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

Pippin, L.C.; Reno, R.L.; Henton, G.H.

1992-01-01

The US Department of Energy, Nevada Field Office, has proposed a nuclear test at drill hole U19aq (902100N/585000E, Nevada Coordinate System, Central Zone) on Pahute Mesa, Nevada Test Site, Nevada. In compliance with Section 106 of the National Historic Preservation Act, the DOE/NV had the Quatenary Sciences Center, Desert Research Institute, identify and evaluate the potential effects of this activity on cultural resources. To determine the nature of cultural resources in the area, DRI conducted a Class III intensive archaeological survey of an approximately 1-km[sup 2] area around the drill hole. That survey, conducted in June 1985, located and recordedmore » 20 archaeological sites. Two of those sites, interpreted as temporary camps of ancient hunters and gatherers, covered an extensive portion of the area proposed for nuclear testing. Half the sites were small concentrations of artifacts or isolated artifacts and were collected at the time of their discovery and 10 sites were left in place. Those sites were in danger of being adversely affected by the land-disturbing activities proposed at the drill hole. In August and September 1985, DRI conducted limited test excavations (15 test units) at those sites to further evaluate their scientific significance and to provide information that could be used in designing a plan for data recovery.« less

Temporary camps at drill hole U19aq on Pahute Mesa, Nye County, Nevada

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

Pippin, L.C.; Reno, R.L.; Henton, G.H.

1992-12-31

The US Department of Energy, Nevada Field Office, has proposed a nuclear test at drill hole U19aq (902100N/585000E, Nevada Coordinate System, Central Zone) on Pahute Mesa, Nevada Test Site, Nevada. In compliance with Section 106 of the National Historic Preservation Act, the DOE/NV had the Quatenary Sciences Center, Desert Research Institute, identify and evaluate the potential effects of this activity on cultural resources. To determine the nature of cultural resources in the area, DRI conducted a Class III intensive archaeological survey of an approximately 1-km{sup 2} area around the drill hole. That survey, conducted in June 1985, located and recordedmore » 20 archaeological sites. Two of those sites, interpreted as temporary camps of ancient hunters and gatherers, covered an extensive portion of the area proposed for nuclear testing. Half the sites were small concentrations of artifacts or isolated artifacts and were collected at the time of their discovery and 10 sites were left in place. Those sites were in danger of being adversely affected by the land-disturbing activities proposed at the drill hole. In August and September 1985, DRI conducted limited test excavations (15 test units) at those sites to further evaluate their scientific significance and to provide information that could be used in designing a plan for data recovery.« less

Accuracy of dengue clinical diagnosis with and without NS1 antigen rapid test: Comparison between human and Bayesian network model decision.

PubMed

Sa-Ngamuang, Chaitawat; Haddawy, Peter; Luvira, Viravarn; Piyaphanee, Watcharapong; Iamsirithaworn, Sopon; Lawpoolsri, Saranath

2018-06-18

Differentiating dengue patients from other acute febrile illness patients is a great challenge among physicians. Several dengue diagnosis methods are recommended by WHO. The application of specific laboratory tests is still limited due to high cost, lack of equipment, and uncertain validity. Therefore, clinical diagnosis remains a common practice especially in resource limited settings. Bayesian networks have been shown to be a useful tool for diagnostic decision support. This study aimed to construct Bayesian network models using basic demographic, clinical, and laboratory profiles of acute febrile illness patients to diagnose dengue. Data of 397 acute undifferentiated febrile illness patients who visited the fever clinic of the Bangkok Hospital for Tropical Diseases, Thailand, were used for model construction and validation. The two best final models were selected: one with and one without NS1 rapid test result. The diagnostic accuracy of the models was compared with that of physicians on the same set of patients. The Bayesian network models provided good diagnostic accuracy of dengue infection, with ROC AUC of 0.80 and 0.75 for models with and without NS1 rapid test result, respectively. The models had approximately 80% specificity and 70% sensitivity, similar to the diagnostic accuracy of the hospital's fellows in infectious disease. Including information on NS1 rapid test improved the specificity, but reduced the sensitivity, both in model and physician diagnoses. The Bayesian network model developed in this study could be useful to assist physicians in diagnosing dengue, particularly in regions where experienced physicians and laboratory confirmation tests are limited.

Working memory resources are shared across sensory modalities.

PubMed

Salmela, V R; Moisala, M; Alho, K

2014-10-01

A common assumption in the working memory literature is that the visual and auditory modalities have separate and independent memory stores. Recent evidence on visual working memory has suggested that resources are shared between representations, and that the precision of representations sets the limit for memory performance. We tested whether memory resources are also shared across sensory modalities. Memory precision for two visual (spatial frequency and orientation) and two auditory (pitch and tone duration) features was measured separately for each feature and for all possible feature combinations. Thus, only the memory load was varied, from one to four features, while keeping the stimuli similar. In Experiment 1, two gratings and two tones-both containing two varying features-were presented simultaneously. In Experiment 2, two gratings and two tones-each containing only one varying feature-were presented sequentially. The memory precision (delayed discrimination threshold) for a single feature was close to the perceptual threshold. However, as the number of features to be remembered was increased, the discrimination thresholds increased more than twofold. Importantly, the decrease in memory precision did not depend on the modality of the other feature(s), or on whether the features were in the same or in separate objects. Hence, simultaneously storing one visual and one auditory feature had an effect on memory precision equal to those of simultaneously storing two visual or two auditory features. The results show that working memory is limited by the precision of the stored representations, and that working memory can be described as a resource pool that is shared across modalities.

Use of a Rapid Test for Diagnosis of Dengue during Suspected Dengue Outbreaks in Resource-Limited Regions.

PubMed

Hunsperger, Elizabeth A; Sharp, Tyler M; Lalita, Paul; Tikomaidraubuta, Kini; Cardoso, Yolanda Rebello; Naivalu, Taina; Khan, Aalisha Sahu; Marfel, Maria; Hancock, W Thane; Tomashek, Kay M; Margolis, Harold S

2016-08-01

Dengue is major public health problem, globally. Timely verification of suspected dengue outbreaks allows for public health response, leading to the initiation of appropriate clinical care. Because the clinical presentation of dengue is nonspecific, dengue diagnosis would benefit from a sensitive rapid diagnostic test (RDT). We evaluated the diagnostic performance of an RDT that detects dengue virus (DENV) nonstructural protein 1 (NS1) and anti-DENV IgM during suspected acute febrile illness (AFI) outbreaks in four countries. Real-time reverse transcription-PCR and anti-DENV IgM enzyme-linked immunosorbent assay were used to verify RDT results. Anti-DENV IgM RDT sensitivity and specificity ranged from 55.3 to 91.7% and 85.3 to 98.5%, respectively, and NS1 sensitivity and specificity ranged from 49.7 to 92.9% and 22.2 to 89.0%, respectively. Sensitivity varied by timing of specimen collection and DENV serotype. Combined test results moderately improved the sensitivity. The use of RDTs identified dengue as the cause of AFI outbreaks where reference diagnostic testing was limited or unavailable. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Software for Planning Scientific Activities on Mars

NASA Technical Reports Server (NTRS)

Ai-Chang, Mitchell; Bresina, John; Jonsson, Ari; Hsu, Jennifer; Kanefsky, Bob; Morris, Paul; Rajan, Kanna; Yglesias, Jeffrey; Charest, Len; Maldague, Pierre

2003-01-01

Mixed-Initiative Activity Plan Generator (MAPGEN) is a ground-based computer program for planning and scheduling the scientific activities of instrumented exploratory robotic vehicles, within the limitations of available resources onboard the vehicle. MAPGEN is a combination of two prior software systems: (1) an activity-planning program, APGEN, developed at NASA s Jet Propulsion Laboratory and (2) the Europa planner/scheduler from NASA Ames Research Center. MAPGEN performs all of the following functions: Automatic generation of plans and schedules for scientific and engineering activities; Testing of hypotheses (or what-if analyses of various scenarios); Editing of plans; Computation and analysis of resources; and Enforcement and maintenance of constraints, including resolution of temporal and resource conflicts among planned activities. MAPGEN can be used in either of two modes: one in which the planner/scheduler is turned off and only the basic APGEN functionality is utilized, or one in which both component programs are used to obtain the full planning, scheduling, and constraint-maintenance functionality.

Resource availability as a proxy for terminal investment in a beetle.

PubMed

Krams, Indrikis A; Krama, Tatjana; Moore, Fhionna R; Rantala, Markus J; Mänd, Raivo; Mierauskas, Pranas; Mänd, Marika

2015-06-01

Terminal investment hypothesis is a longstanding theoretical idea that organisms should increase their reproductive effort as their prospects for survival and reproduction decline. However, numerous attempts to test the terminal investment in reproduction have yielded contradictory results. This study reports an experimental confirmation of the terminal investment hypothesis. It was predicted that immune-challenged yellow mealworm beetles (Tenebrio molitor) are more likely to follow terminal investment strategy when their food resources are limited. Our results suggest the key role of food resources while making decisions to follow a terminal investment strategy. We found that male individuals invested in their sexual attractiveness at the expense of immune response and survival when food was not available. In contrast, the beetles did not decrease their lifespan and did not invest in the attractiveness of their sex odours under conditions of food ad libitum. Our results show the importance of food availability and quality in understanding the evolution of reproductive strategies.