Fraternity at the Crossroads

ERIC Educational Resources Information Center

Dowiak, Shawn M.

2016-01-01

Are fraternities still relevant to the college student experience? By examining the moral, student, and leadership development of IFC fraternity men, while controlling for institutional and student characteristics, the current study analyzed the roots of the purported value-added nature of fraternities using data from the Multi-Institutional Study…

Identical, Fraternal, or Separated at Birth: A Case Study of Educator Teams within American-Israeli School Twinning

ERIC Educational Resources Information Center

Chertok, Fern; Mittelberg, David; Laron, Dinah; Koren, Annette

2013-01-01

School-to-school collaboration has emerged as a key paradigm for fostering personal and institutional connections between Israeli and Diaspora youth, educators, and schools. Using the findings of a multi-year case study of a high school level twinning initiative, this article describes the challenges to this form of transnational collaboration and…

Importance of multi-modal approaches to effectively identify cataract cases from electronic health records.

PubMed

Peissig, Peggy L; Rasmussen, Luke V; Berg, Richard L; Linneman, James G; McCarty, Catherine A; Waudby, Carol; Chen, Lin; Denny, Joshua C; Wilke, Russell A; Pathak, Jyotishman; Carrell, David; Kho, Abel N; Starren, Justin B

2012-01-01

There is increasing interest in using electronic health records (EHRs) to identify subjects for genomic association studies, due in part to the availability of large amounts of clinical data and the expected cost efficiencies of subject identification. We describe the construction and validation of an EHR-based algorithm to identify subjects with age-related cataracts. We used a multi-modal strategy consisting of structured database querying, natural language processing on free-text documents, and optical character recognition on scanned clinical images to identify cataract subjects and related cataract attributes. Extensive validation on 3657 subjects compared the multi-modal results to manual chart review. The algorithm was also implemented at participating electronic MEdical Records and GEnomics (eMERGE) institutions. An EHR-based cataract phenotyping algorithm was successfully developed and validated, resulting in positive predictive values (PPVs) >95%. The multi-modal approach increased the identification of cataract subject attributes by a factor of three compared to single-mode approaches while maintaining high PPV. Components of the cataract algorithm were successfully deployed at three other institutions with similar accuracy. A multi-modal strategy incorporating optical character recognition and natural language processing may increase the number of cases identified while maintaining similar PPVs. Such algorithms, however, require that the needed information be embedded within clinical documents. We have demonstrated that algorithms to identify and characterize cataracts can be developed utilizing data collected via the EHR. These algorithms provide a high level of accuracy even when implemented across multiple EHRs and institutional boundaries.

Multi-institutional Comparison of Intensity Modulated Radiation Therapy (IMRT) Planning Strategies and Planning Results for Nasopharyngeal Cancer

PubMed Central

Park, Sung Ho; Park, Suk Won; Oh, Do Hoon; Choi, Youngmin; Kim, Jeung Kee; Ahn, Yong Chan; Park, Won; Suh, Hyun Sook; Lee, Rena; Bae, Hoonsik

2009-01-01

The intensity-modulated radiation therapy (IMRT) planning strategies for nasopharyngeal cancer among Korean radiation oncology facilities were investigated. Five institutions with IMRT planning capacity using the same planning system were invited to participate in this study. The institutions were requested to produce the best plan possible for 2 cases that would deliver 70 Gy to the planning target volume of gross tumor (PTV1), 59.4 Gy to the PTV2, and 51.5 Gy to the PTV3 in which elective irradiation was required. The advised fractionation number was 33. The planning parameters, resultant dose distributions, and biological indices were compared. We found 2-3-fold variations in the volume of treatment targets. Similar degree of variation was found in the delineation of normal tissue. The physician-related factors in IMRT planning had more influence on the plan quality. The inhomogeneity index of PTV dose ranged from 4 to 49% in Case 1, and from 5 to 46% in Case 2. Variation in tumor control probabilities for the primary lesion and involved LNs was less marked. Normal tissue complication probabilities for parotid glands and skin showed marked variation. Results from this study suggest that greater efforts in providing training and continuing education in terms of IMRT planning parameters usually set by physician are necessary for the successful implementation of IMRT. PMID:19399266

Exact semiclassical expansions for one-dimensional quantum oscillators

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

Delabaere, E.; Dillinger, H.; Pham, F.

1997-12-01

A set of rules is given for dealing with WKB expansions in the one-dimensional analytic case, whereby such expansions are not considered as approximations but as exact encodings of wave functions, thus allowing for analytic continuation with respect to whichever parameters the potential function depends on, with an exact control of small exponential effects. These rules, which include also the case when there are double turning points, are illustrated on various examples, and applied to the study of bound state or resonance spectra. In the case of simple oscillators, it is thus shown that the Rayleigh{endash}Schr{umlt o}dinger series is Borelmore » resummable, yielding the exact energy levels. In the case of the symmetrical anharmonic oscillator, one gets a simple and rigorous justification of the Zinn-Justin quantization condition, and of its solution in terms of {open_quotes}multi-instanton expansions.{close_quotes} {copyright} {ital 1997 American Institute of Physics.}« less

The Role of Multi-Institutional Partnerships in Supply Chain Management Course Design and Improvement

ERIC Educational Resources Information Center

Long, Suzanna; Moos, J. Chris; Radic, Anne Bartel

2012-01-01

The authors examined the skills achieved through a multicultural, virtual student project environment among 3 supply chain management courses. The partnership included 2 universities in the United States and 1 in France and created virtual teams of students across university lines and is presented as a case study. The case includes detailed…

Navigating Local Smoke-Free Multi-Unit Housing Policy Adoption

ERIC Educational Resources Information Center

Satterlund, Travis D.; Treiber, Jeanette; Cassady, Diana

2013-01-01

California state-funded local tobacco control projects have instituted smoke-free multi-unit housing (MUH) policy adoption campaigns in order to secure voluntary policy throughout the state. While landlords can legally prohibit smoking at MUH complexes in California, they often oppose such measures. The objective of this study was to analyze…

Translating Strategy, Values and Identities in Higher Education: The Case of Multi-Campus Systems

ERIC Educational Resources Information Center

Pinheiro, Rómulo; Charles, David; Jones, Glen

2017-01-01

Multi-campus university systems are not a new phenomenon. In their foundational analysis of multi-campus universities in the United States published in 1971, Lee and Bowen noted that almost 40% of American students were enroled in institutions that were part of multi-campus systems. The role of these complex multi-campus systems has continued to…

[The actual approaches to the economic analysis of effectiveness of functioning of multi-profile curative preventive medical institution].

PubMed

Gaĭdarov, G M; Alekseeva, N Iu; Latysheva, E A

2010-01-01

The article deals with the technique of economic analysis of effectiveness of functioning of multi-profile curative preventive medical institution in the conditions of transition to the payment according the completed case of treatment. The necessity of the measures targeted to prevent the financial losses under the new form of payment for hospital care is proved.

The Multiplier Effect: The Case for Multi-School, Global Education Programs

ERIC Educational Resources Information Center

Dugan, Rik; Nink, Matt

2010-01-01

Multi-school and multi-country programs greatly enhance leadership development and global awareness in students and teachers, while creating better problem solvers, stronger relationships, and wider community impact than any single-school program. That's why Global Youth Leadership Institute (GYLI) and National Association of Independent Schools…

Importance of multi-modal approaches to effectively identify cataract cases from electronic health records

PubMed Central

Rasmussen, Luke V; Berg, Richard L; Linneman, James G; McCarty, Catherine A; Waudby, Carol; Chen, Lin; Denny, Joshua C; Wilke, Russell A; Pathak, Jyotishman; Carrell, David; Kho, Abel N; Starren, Justin B

2012-01-01

Objective There is increasing interest in using electronic health records (EHRs) to identify subjects for genomic association studies, due in part to the availability of large amounts of clinical data and the expected cost efficiencies of subject identification. We describe the construction and validation of an EHR-based algorithm to identify subjects with age-related cataracts. Materials and methods We used a multi-modal strategy consisting of structured database querying, natural language processing on free-text documents, and optical character recognition on scanned clinical images to identify cataract subjects and related cataract attributes. Extensive validation on 3657 subjects compared the multi-modal results to manual chart review. The algorithm was also implemented at participating electronic MEdical Records and GEnomics (eMERGE) institutions. Results An EHR-based cataract phenotyping algorithm was successfully developed and validated, resulting in positive predictive values (PPVs) >95%. The multi-modal approach increased the identification of cataract subject attributes by a factor of three compared to single-mode approaches while maintaining high PPV. Components of the cataract algorithm were successfully deployed at three other institutions with similar accuracy. Discussion A multi-modal strategy incorporating optical character recognition and natural language processing may increase the number of cases identified while maintaining similar PPVs. Such algorithms, however, require that the needed information be embedded within clinical documents. Conclusion We have demonstrated that algorithms to identify and characterize cataracts can be developed utilizing data collected via the EHR. These algorithms provide a high level of accuracy even when implemented across multiple EHRs and institutional boundaries. PMID:22319176

Safety of open ventral hernia repair in high-risk patients with metabolic syndrome: a multi-institutional analysis of 39,118 cases.

PubMed

Zavlin, Dmitry; Jubbal, Kevin T; Van Eps, Jeffrey L; Bass, Barbara L; Ellsworth, Warren A; Echo, Anthony; Friedman, Jeffrey D; Dunkin, Brian J

2018-02-01

Metabolic syndrome (MetS) entails the simultaneous presence of a constellation of dangerous risk factors including obesity, diabetes, hypertension, and dyslipidemia. The prevalence of MetS in Western society continues to rise and implies an elevated risk for surgical complications and/or poor surgical outcomes within the affected population. To assess the risks and outcomes of multi-morbid patients with MetS undergoing open ventral hernia repair. Multi-institutional case-control study in the United States. The American College of Surgeons National Surgical Quality Improvement Program database was sampled for patients undergoing initial open ventral hernia repair from 2012 through 2014 and then stratified into 2 cohorts based on the presence or absence of MetS. Statistical analyses were performed to evaluate preoperative co-morbidities, intraoperative details, and postoperative morbidity and mortality to identify risk factors for adverse outcomes. Mean age (61.0 versus 56.0 yr, P<.001), body mass index (39.2 versus 31.1, P<.001), and prevalence of co-morbidities of multiple organ systems were significantly higher (P<.001) in the MetS cohort compared to control. Patients with MetS received higher American Society of Anesthesiologists classifications (81.0% versus 43.1% class 3 or higher, P<.001), were more likely to require operation as emergency cases (11.4% versus 7.2%, P<.001), required longer operative times (103 versus 87 min, P<.001), had longer hospitalizations (3.5 versus 2.4 d, P<.001), and had more contaminated wounds (15.9% versus 12.0% class 2 or higher, P<.001). Overall, they had more medical (7.5% versus 4.2%, P<.001), and surgical complications (9.7% versus 5.4%, P<.001), experienced more readmissions (8.3% versus 5.7%, P<.001) and reoperations (3.4% versus 2.5%, P<.001), and were at higher risk for eventual death (.8% versus .5%, P=.008). The presence of MetS is related to a multitude of unfavorable outcomes and increased mortality after open ventral hernia repair compared with a non-MetS control group. MetS is a useful marker for high operative risk in a population that is generally prone to obesity and its associated diseases. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Cyberinfrastructure for Open Science at the Montreal Neurological Institute

PubMed Central

Das, Samir; Glatard, Tristan; Rogers, Christine; Saigle, John; Paiva, Santiago; MacIntyre, Leigh; Safi-Harab, Mouna; Rousseau, Marc-Etienne; Stirling, Jordan; Khalili-Mahani, Najmeh; MacFarlane, David; Kostopoulos, Penelope; Rioux, Pierre; Madjar, Cecile; Lecours-Boucher, Xavier; Vanamala, Sandeep; Adalat, Reza; Mohaddes, Zia; Fonov, Vladimir S.; Milot, Sylvain; Leppert, Ilana; Degroot, Clotilde; Durcan, Thomas M.; Campbell, Tara; Moreau, Jeremy; Dagher, Alain; Collins, D. Louis; Karamchandani, Jason; Bar-Or, Amit; Fon, Edward A.; Hoge, Rick; Baillet, Sylvain; Rouleau, Guy; Evans, Alan C.

2017-01-01

Data sharing is becoming more of a requirement as technologies mature and as global research and communications diversify. As a result, researchers are looking for practical solutions, not only to enhance scientific collaborations, but also to acquire larger amounts of data, and to access specialized datasets. In many cases, the realities of data acquisition present a significant burden, therefore gaining access to public datasets allows for more robust analyses and broadly enriched data exploration. To answer this demand, the Montreal Neurological Institute has announced its commitment to Open Science, harnessing the power of making both clinical and research data available to the world (Owens, 2016a,b). As such, the LORIS and CBRAIN (Das et al., 2016) platforms have been tasked with the technical challenges specific to the institutional-level implementation of open data sharing, including: Comprehensive linking of multimodal data (phenotypic, clinical, neuroimaging, biobanking, and genomics, etc.)Secure database encryption, specifically designed for institutional and multi-project data sharing, ensuring subject confidentiality (using multi-tiered identifiers).Querying capabilities with multiple levels of single study and institutional permissions, allowing public data sharing for all consented and de-identified subject data.Configurable pipelines and flags to facilitate acquisition and analysis, as well as access to High Performance Computing clusters for rapid data processing and sharing of software tools.Robust Workflows and Quality Control mechanisms ensuring transparency and consistency in best practices.Long term storage (and web access) of data, reducing loss of institutional data assets.Enhanced web-based visualization of imaging, genomic, and phenotypic data, allowing for real-time viewing and manipulation of data from anywhere in the world.Numerous modules for data filtering, summary statistics, and personalized and configurable dashboards. Implementing the vision of Open Science at the Montreal Neurological Institute will be a concerted undertaking that seeks to facilitate data sharing for the global research community. Our goal is to utilize the years of experience in multi-site collaborative research infrastructure to implement the technical requirements to achieve this level of public data sharing in a practical yet robust manner, in support of accelerating scientific discovery. PMID:28111547

Cyberinfrastructure for Open Science at the Montreal Neurological Institute.

PubMed

Das, Samir; Glatard, Tristan; Rogers, Christine; Saigle, John; Paiva, Santiago; MacIntyre, Leigh; Safi-Harab, Mouna; Rousseau, Marc-Etienne; Stirling, Jordan; Khalili-Mahani, Najmeh; MacFarlane, David; Kostopoulos, Penelope; Rioux, Pierre; Madjar, Cecile; Lecours-Boucher, Xavier; Vanamala, Sandeep; Adalat, Reza; Mohaddes, Zia; Fonov, Vladimir S; Milot, Sylvain; Leppert, Ilana; Degroot, Clotilde; Durcan, Thomas M; Campbell, Tara; Moreau, Jeremy; Dagher, Alain; Collins, D Louis; Karamchandani, Jason; Bar-Or, Amit; Fon, Edward A; Hoge, Rick; Baillet, Sylvain; Rouleau, Guy; Evans, Alan C

2016-01-01

Data sharing is becoming more of a requirement as technologies mature and as global research and communications diversify. As a result, researchers are looking for practical solutions, not only to enhance scientific collaborations, but also to acquire larger amounts of data, and to access specialized datasets. In many cases, the realities of data acquisition present a significant burden, therefore gaining access to public datasets allows for more robust analyses and broadly enriched data exploration. To answer this demand, the Montreal Neurological Institute has announced its commitment to Open Science, harnessing the power of making both clinical and research data available to the world (Owens, 2016a,b). As such, the LORIS and CBRAIN (Das et al., 2016) platforms have been tasked with the technical challenges specific to the institutional-level implementation of open data sharing, including: Comprehensive linking of multimodal data (phenotypic, clinical, neuroimaging, biobanking, and genomics, etc.)Secure database encryption, specifically designed for institutional and multi-project data sharing, ensuring subject confidentiality (using multi-tiered identifiers).Querying capabilities with multiple levels of single study and institutional permissions, allowing public data sharing for all consented and de-identified subject data.Configurable pipelines and flags to facilitate acquisition and analysis, as well as access to High Performance Computing clusters for rapid data processing and sharing of software tools.Robust Workflows and Quality Control mechanisms ensuring transparency and consistency in best practices.Long term storage (and web access) of data, reducing loss of institutional data assets.Enhanced web-based visualization of imaging, genomic, and phenotypic data, allowing for real-time viewing and manipulation of data from anywhere in the world.Numerous modules for data filtering, summary statistics, and personalized and configurable dashboards. Implementing the vision of Open Science at the Montreal Neurological Institute will be a concerted undertaking that seeks to facilitate data sharing for the global research community. Our goal is to utilize the years of experience in multi-site collaborative research infrastructure to implement the technical requirements to achieve this level of public data sharing in a practical yet robust manner, in support of accelerating scientific discovery.

Expectation-Based Efficiency and Quality Improvements in Research Administration: Multi-Institutional Case Studies

ERIC Educational Resources Information Center

Saha, Dhanonjoy C.; Ahmed, Abrar; Hanumandla, Shailaja

2011-01-01

Conventional wisdom may support the presumed notion that higher expectations increase efficiency and improve quality. However, this claim may only be validated when workers are equipped with appropriate tools, training, and a conducive work environment. This study implements various interventions, observes outcomes, and analyzes data collected in…

Learning from Online Modules in Diverse Instructional Contexts

ERIC Educational Resources Information Center

Nugent, Gwen; Kohmetscher, Amy; Namuth-Covert, Deana; Guretzky, John; Murphy, Patrick; Lee, DoKyoung

2016-01-01

Learning objects originally developed for use in online learning environments can also be used to enhance face-to-face instruction. This study examined the learning impacts of online learning objects packaged into modules and used in different contexts for undergraduate education offered on campus at three institutions. A multi-case study approach…

A computable phenotype for asthma case identification in adult and pediatric patients: External validation in the Chicago Area Patient-Outcomes Research Network (CAPriCORN).

PubMed

Afshar, Majid; Press, Valerie G; Robison, Rachel G; Kho, Abel N; Bandi, Sindhura; Biswas, Ashvini; Avila, Pedro C; Kumar, Harsha Vardhan Madan; Yu, Byung; Naureckas, Edward T; Nyenhuis, Sharmilee M; Codispoti, Christopher D

2017-10-13

Comprehensive, rapid, and accurate identification of patients with asthma for clinical care and engagement in research efforts is needed. The original development and validation of a computable phenotype for asthma case identification occurred at a single institution in Chicago and demonstrated excellent test characteristics. However, its application in a diverse payer mix, across different health systems and multiple electronic health record vendors, and in both children and adults was not examined. The objective of this study is to externally validate the computable phenotype across diverse Chicago institutions to accurately identify pediatric and adult patients with asthma. A cohort of 900 asthma and control patients was identified from the electronic health record between January 1, 2012 and November 30, 2014. Two physicians at each site independently reviewed the patient chart to annotate cases. The inter-observer reliability between the physician reviewers had a κ-coefficient of 0.95 (95% CI 0.93-0.97). The accuracy, sensitivity, specificity, negative predictive value, and positive predictive value of the computable phenotype were all above 94% in the full cohort. The excellent positive and negative predictive values in this multi-center external validation study establish a useful tool to identify asthma cases in in the electronic health record for research and care. This computable phenotype could be used in large-scale comparative-effectiveness trials.

Governing Universities. Changing the Culture?

ERIC Educational Resources Information Center

Bargh, Catherine; Scott, Peter; Smith, David

This book reports on a British research project involving a questionnaire survey of 494 university governors and a multi-site case study analysis to examine how different types of higher education institutions (especially "old" and "new" universities and colleges) converge and/or diverge in their governance styles. Chapter 1…

Association between previous splenectomy and gastric dilatation-volvulus in dogs: 453 cases (2004-2009).

PubMed

Sartor, Angela J; Bentley, Adrienne M; Brown, Dorothy C

2013-05-15

To evaluate the association between previous splenectomy and gastric dilatation-volvulus (GDV) in dogs. Multi-institutional retrospective case-control study. Animals-151 dogs treated surgically for GDV and 302 control dogs with no history of GDV. Computerized records of dogs evaluated via exploratory laparotomy or abdominal ultrasonography were searched, and dogs with GDV and dogs without GDV (control dogs) were identified. Two control dogs were matched with respect to age, body weight, sex, neuter status, and breed to each dog with GDV. Data were collected on the presence or absence of the spleen for both dogs with GDV and control dogs. Conditional logistic regression analysis was used to investigate the association of previous splenectomy with GDV. 6 (4%) dogs in the GDV group and 3 (1%) dogs in the control group had a history of previous splenectomy. The odds of GDV in dogs with a history of previous splenectomy in this population of dogs were 5.3 times those of dogs without a history of previous splenectomy (95% confidence interval, 1.1 to 26.8). For the patients in the present study, there was an increased odds of GDV in dogs with a history of splenectomy. Prophylactic gastropexy may be considered in dogs undergoing a splenectomy, particularly if other risk factors for GDV are present.

Toward greater inclusion: lessons from Peru in confronting challenges of multi-sector collaboration.

PubMed

Buffardi, Anne L; Cabello, Robinson; Garcia, Patricia J

2012-09-01

Despite widespread enthusiasm for broader participation in health policy and programming, little is known about the ways in which multi-sector groups address the challenges that arise in pursuing this goal. Based on the experience of Peru's National Multi-sector Health Coordinating Body (CONAMUSA), this article characterizes these challenges and identifies organizational strategies the group has adopted to overcome them. Comprising nine government ministries, nongovernmental organizations, academia, religious institutions, and international cooperation agencies, CONAMUSA has faced three principal challenges: 1) selecting representatives, 2) balancing membership and leadership across sectors, and 3) negotiating role transition and conflict. In response, the group has instituted a rotation system for formal leadership responsibiliti es, and professionalized management functions; created electoral systems for civil society; and developed conflict of interest guidelines. This case study offers lessons for other countries trying to configure multi-sector groups, and for donors who mandate their creation, tempering unbridled idealism toward inclusive participation with a dose of healthy realism and practical adaptation.

A Data Management System for Multi-Phase Case-Control Studies

PubMed Central

Gibeau, Joanne M.; Steinfeldt, Lois C.; Stine, Mark J.; Tullis, Katherine V.; Lynch, H. Keith

1983-01-01

The design of a computerized system for the management of data in multi-phase epidemiologic case-control studies is described. Typical study phases include case-control selection, abstracting of data from medical records, and interview of study subjects or next of kin. In consultation with project personnel, requirements for the system were established: integration of data from all study phases into one data base, accurate follow-up of subjects through the study, sophisticated data editing capabilities, ready accessibility of specified programs to project personnel, and generation of current status and exception reports for project managment. SIR (Scientific Information Retrieval), a commercially available data base management system, was selected as the foundation of this system. The system forms a comprehensive data management system applicable to many types of public health research studies.

From State-controlled to Polycentric Governance in Forest Landscape Restoration: The Case of the Ecological Forest Purchase Program in Yong'an Municipality of China.

PubMed

Long, Hexing; Liu, Jinlong; Tu, Chengyue; Fu, Yimin

2018-07-01

Forest landscape restoration is emerging as an effective approach to restore degraded forests for the provision of ecosystem services and to minimize trade-offs between conservation and rural livelihoods. Policy and institutional innovations in China illustrate the governance transformation of forest landscape restoration from state-controlled to polycentric governance. Based on a case study of the Ecological Forest Purchase Program in Yong'an municipality, China's Fujian Province, this paper explores how such forest governance transformation has evolved and how it has shaped the outcomes of forest landscape restoration in terms of multi-dimensionality and actor configurations. Our analysis indicates that accommodating the participation of multiple actors and market-based instruments facilitate a smoother transition from state-centered to polycentric governance in forest landscape restoration. Governance transitions for forest landscape restoration must overcome a number of challenges including ensurance of a formal participation forum, fair participation, and a sustainable legislative and financial system to enhance long-term effectiveness.

Balancing the Values of Ethnic Studies and Academe: Exploring Efforts to Advance the Organizational Stability of American Indian and Asian American Studies

ERIC Educational Resources Information Center

Kimura-Walsh, Erin Fukiko

2009-01-01

This study examines Ethnic Studies' efforts to gain institutional stability at the university. The issue is explored through a qualitative, multi-case study of Ethnic Studies units, specifically American Indian and Asian American Studies at San Francisco State University and University of California, Los Angeles. To gain insight into their…

Strategies for Institutional Transformation: A Multi-Case Study of the Chief Diversity Officer Position

ERIC Educational Resources Information Center

Leon, Raul Alejandro

2010-01-01

This study is concerned with the fact that many colleges and universities have adopted strategic diversity plans, but many still fall short of reaping the benefits that diversity brings to the college environment (Milem, Chang, & Antonio, 2005). Today, several colleges and universities have developed a chief diversity officer (CDO) position to…

Ubiquitous Writing, Technologies, and the Social Practice of Literacies of Coordination

ERIC Educational Resources Information Center

Pigg, Stacey; Grabill, Jeffrey T.; Brunk-Chavez, Beth; Moore, Jessie L.; Rosinski, Paula; Curran, Paul G.

2014-01-01

This article shares results from a multi-institutional study of the role of writing in college students' lives. Using case studies built from a larger population survey along with interviews, diaries, and a daily SMS texting protocol, we found that students report SMS texting, lecture notes, and emails to be the most frequent writing…

The Impact of Institutional Culture on Student Activism: A Multi-Case Study in Christian Higher Education

ERIC Educational Resources Information Center

Cole, Brian E.

2013-01-01

This study contributes to the description and meaning of student activism within the context of Christian college environments and cultures, and is interpreted through the sociological concept of symbolic interactionism. The purpose of this study is to help fill the void in the literature on student activism at Christian colleges and universities,…

Perioperative Outcomes of Robotic and Laparoscopic Simple Prostatectomy: A European-American Multi-institutional Analysis.

PubMed

Autorino, Riccardo; Zargar, Homayoun; Mariano, Mirandolino B; Sanchez-Salas, Rafael; Sotelo, René J; Chlosta, Piotr L; Castillo, Octavio; Matei, Deliu V; Celia, Antonio; Koc, Gokhan; Vora, Anup; Aron, Monish; Parsons, J Kellogg; Pini, Giovannalberto; Jensen, James C; Sutherland, Douglas; Cathelineau, Xavier; Nuñez Bragayrac, Luciano A; Varkarakis, Ioannis M; Amparore, Daniele; Ferro, Matteo; Gallo, Gaetano; Volpe, Alessandro; Vuruskan, Hakan; Bandi, Gaurav; Hwang, Jonathan; Nething, Josh; Muruve, Nic; Chopra, Sameer; Patel, Nishant D; Derweesh, Ithaar; Champ Weeks, David; Spier, Ryan; Kowalczyk, Keith; Lynch, John; Harbin, Andrew; Verghese, Mohan; Samavedi, Srinivas; Molina, Wilson R; Dias, Emanuel; Ahallal, Youness; Laydner, Humberto; Cherullo, Edward; De Cobelli, Ottavio; Thiel, David D; Lagerkvist, Mikael; Haber, Georges-Pascal; Kaouk, Jihad; Kim, Fernando J; Lima, Estevao; Patel, Vipul; White, Wesley; Mottrie, Alexander; Porpiglia, Francesco

2015-07-01

Laparoscopic and robotic simple prostatectomy (SP) have been introduced with the aim of reducing the morbidity of the standard open technique. To report a large multi-institutional series of minimally invasive SP (MISP). Consecutive cases of MISP done for the treatment of bladder outlet obstruction (BOO) due to benign prostatic enlargement (BPE) between 2000 and 2014 at 23 participating institutions in the Americas and Europe were included in this retrospective analysis. Laparoscopic or robotic SP. Demographic data and main perioperative outcomes were gathered and analyzed. A multivariable analysis was conducted to identify factors associated with a favorable trifecta outcome, arbitrarily defined as a combination of the following postoperative events: International Prostate Symptom Score <8, maximum flow rate >15ml/s, and no perioperative complications. Overall, 1330 consecutive cases were analyzed, including 487 robotic (36.6%) and 843 laparoscopic (63.4%) SP cases. Median overall prostate volume was 100ml (range: 89-128). Median estimated blood loss was 200ml (range: 150-300). An intraoperative transfusion was required in 3.5% of cases, an intraoperative complication was recorded in 2.2% of cases, and the conversion rate was 3%. Median length of stay was 4 d (range: 3-5). On pathology, prostate cancer was found in 4% of cases. Overall postoperative complication rate was 10.6%, mostly of low grade. At a median follow-up of 12 mo, a significant improvement was observed for subjective and objective indicators of BOO. Trifecta outcome was not significantly influenced by the type of procedure (robotic vs laparoscopic; p=0.136; odds ratio [OR]: 1.6; 95% confidence interval [CI], 0.8-2.9), whereas operative time (p=0.01; OR: 0.9; 95% CI, 0.9-1.0) and estimated blood loss (p=0.03; OR: 0.9; 95% CI, 0.9-1.0) were the only two significant factors. Retrospective study design, lack of a control arm, and limited follow-up represent major limitations of the present analysis. This study provides the largest outcome analysis reported for MISP for BOO/BPE. These findings confirm that SP can be safely and effectively performed in a minimally invasive fashion in a variety of healthcare settings in which specific surgical expertise and technology is available. MISP can be considered a viable surgical treatment in cases of large prostatic adenomas. The use of robotic technology for this indication can be considered in centers that have a robotic program in place for other urologic indications. Analysis of a large data set from multiple institutions shows that surgical removal of symptomatic large prostatic adenomas can be carried out with good outcomes by using robot-assisted laparoscopy. Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Overall survival and clinical characteristics of BRCA mutation carriers with stage I/II pancreatic cancer.

PubMed

Golan, Talia; Sella, Tal; O'Reilly, Eileen M; Katz, Matthew H G; Epelbaum, Ron; Kelsen, David P; Borgida, Ayelet; Maynard, Hannah; Kindler, Hedy; Friedmen, Eitan; Javle, Milind; Gallinger, Steven

2017-03-14

BRCA1/BRCA2 germ line (GL) mutation carriers with pancreatic adenocarcinoma (PDAC) may have distinct outcomes. We recently described an apparent more favourable prognosis of surgically resected BRCA-associated PDAC patients in a single-arm, uncontrolled, retrospective study. However, the prognostic impact of GL BRCA1/2 mutations in surgically resected PDAC has not been compared with a matched control population. A larger multi-centre, case-control retrospective analysis was performed. Cases were patients with surgically resected, BRCA1/2-associated PDAC from 2004 to 2013. Controls included surgically resected PDAC cases treated during the same time period that were either BRCA non-carriers, or had no family history of breast, ovarian or pancreatic cancers. Cases and controls were matched by: age at diagnosis (within ±5-year period) and institution. Demographics, clinical history, overall survival (OS) and disease-free survival (DFS) were abstracted from patient records. Statistical comparisons were assessed using χ 2 - and Fisher's exact test, and median DFS/OS using Kaplan-Meier method and log-rank testing. Twenty-five patients with BRCA1-(n=4) or BRCA2 (N=21)-associated resectable PDAC were identified. Mean age was 55.7 years (range, 34-78 years), 48% (n=12) were females and 76% (n=19) were Jewish. Cases were compared (1 : 2) with 49 resectable PDAC controls, and were balanced for age, ethnicity and other relevant clinical and pathological features. BRCA-associated PDAC patients received neoadjuvant, or adjuvant platinum-based treatment more frequently than controls (7 out of 8 vs 6 out of 14) and (7 out of 21 vs 3 out of 44), respectively. No significant difference in median OS (37.06 vs 38.77 months, P=0.838) and in DFS (14.3 vs 12.0 months, P=0.303) could be demonstrated between cases and controls. A trend to increased DFS was observed among BRCA-positive cases treated with neoadjuvant/adjuvant platinum-containing regimens (n=10) compared with similarly treated controls (n=7) (39.1 vs 12.4 months, P=0.255). In this retrospective analysis, the prognosis of surgically resectable BRCA-associated PDAC is no different than that of sporadic PDAC from the same institution. The role of platinum-based adjuvant therapy in this setting requires prospective investigation.

Learning from Transitioning to New Technology That Supports Online and Blended Learning: A Case Study

ERIC Educational Resources Information Center

Lock, Jennifer; Johnson, Carol

2017-01-01

Transitioning from one technology to another within educational institutions is complex and multi-faceted, and requires time. Such a transition involves more than making the new technology available for use. It requires knowing the people involved, designing differentiated support structures, and integrating various resources to meet their…

Knowledge Production within the Innovation System: A Case Study from the United Kingdom

ERIC Educational Resources Information Center

Wilson-Medhurst, Sarah

2010-01-01

This paper focuses on a key issue for university managers, educational developers and teaching practitioners: that of producing new operational knowledge in the innovation system. More specifically, it explores the knowledge required to guide individual and institutional styles of teaching and learning in a large multi-disciplinary faculty. The…

Agroforestry adoption in the Calakmul biosphere reserve, Campeche, Mexico

Treesearch

D. Evan Mercer; Jeremy Haggar; Ann Snook; Mauricio Sosa

2005-01-01

Since farmers engage in a complex, dynamic process of learning-by-doing, evaluating economic incentives, and assessing risks in deciding whether to adopt agroforestry systems, a multi-pronged research approach is required for a complete analysis of adoption potential and to develop effective technological and institutional interventions. A case study is presented for...

Language Policy and Language Governance: A Case-Study of Irish Language Legislation

ERIC Educational Resources Information Center

Walsh, John

2012-01-01

In this paper, it is argued that the existing conceptual framework of "language policy" should be expanded to include perspectives from the emerging field of "language governance", as the latter pays attention to the multi-faceted internal and external contexts in which institutions and organisations seek to develop language…

Military-Connected Student Academic Success at 4-Year Institutions: A Multi-Institution Study

ERIC Educational Resources Information Center

Williams-Klotz, Denise N.; Gansemer-Topf, Ann M.

2017-01-01

We examined how the experiences--academic, financial, social, and personal--and relationship factors of military-connected students attending a 4-year institution are associated with their academic success. This multi-institution study highlights the demographic characteristics, experiences, and campus relationships that are associated with…

Identification of Management Information System (MIS) Strategies Barriers in Higher Education Institutions through Multi-Criteria Decision Making (MCDM) Approach: Case Study of Ferdowsi University of Mashhad

ERIC Educational Resources Information Center

Hosseini, Mirza Hasan; Karimzadegan, Davood; Sazvar, Azam

2012-01-01

Each organization or company, regardless to its restrictions, purposes, and type of the activity, in order to fulfill and manage the duties is in need of various data and pieces of information. The aforesaid cases are generated by managers and employees and used by all the staffs. The manifest issue of current days is that organizations and…

34 CFR 675.34 - Multi-Institutional job location and development programs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 34 Education 3 2014-07-01 2014-07-01 false Multi-Institutional job location and development... (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION FEDERAL WORK-STUDY PROGRAMS Job Location and Development Program § 675.34 Multi-Institutional job location and development programs. (a) An...

34 CFR 675.34 - Multi-Institutional job location and development programs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 3 2013-07-01 2013-07-01 false Multi-Institutional job location and development... (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION FEDERAL WORK-STUDY PROGRAMS Job Location and Development Program § 675.34 Multi-Institutional job location and development programs. (a) An...

34 CFR 675.34 - Multi-Institutional job location and development programs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 3 2011-07-01 2011-07-01 false Multi-Institutional job location and development... (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION FEDERAL WORK-STUDY PROGRAMS Job Location and Development Program § 675.34 Multi-Institutional job location and development programs. (a) An...

34 CFR 675.34 - Multi-Institutional job location and development programs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 3 2012-07-01 2012-07-01 false Multi-Institutional job location and development... (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION FEDERAL WORK-STUDY PROGRAMS Job Location and Development Program § 675.34 Multi-Institutional job location and development programs. (a) An...

34 CFR 675.34 - Multi-Institutional job location and development programs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 3 2010-07-01 2010-07-01 false Multi-Institutional job location and development... (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION FEDERAL WORK-STUDY PROGRAMS Job Location and Development Program § 675.34 Multi-Institutional job location and development programs. (a) An...

Gynecologic Oncology Group quality assurance audits: analysis and initiatives for improvement.

PubMed

Blessing, John A; Bialy, Sally A; Whitney, Charles W; Stonebraker, Bette L; Stehman, Frederick B

2010-08-01

The Gynecologic Oncology Group (GOG) is a multi-institution, multi-discipline Cooperative Group funded by the National Cancer Institute (NCI) to conduct clinical trials which investigate the treatment, prevention, control, quality of survivorship, and translational science of gynecologic malignancies. In 1982, the NCI initiated a program of on-site quality assurance audits of participating institutions. Each is required to be audited at least once every 3 years. In GOG, the audit mandate is the responsibility of the GOG Quality Assurance Audit Committee and it is centralized in the Statistical and Data Center (SDC). Each component (Regulatory, Investigational Drug Pharmacy, Patient Case Review) is classified as Acceptable, Acceptable, follow-up required, or Unacceptable. To determine frequently occurring deviations and develop focused innovative solutions to address them. A database was created to examine the deviations noted at the most recent audit conducted at 57 GOG parent institutions during 2004-2007. Cumulatively, this involved 687 patients and 306 protocols. The results documented commendable performance: Regulatory (39 Acceptable, 17 Acceptable, follow-up, 1 Unacceptable); Pharmacy (41 Acceptable, 3 Acceptable, follow-up, 1 Unacceptable, 12 N/A): Patient Case Review (31 Acceptable, 22 Acceptable, follow-up, 4 Unacceptable). The nature of major and lesser deviations was analyzed to create and enhance initiatives for improvement of the quality of clinical research. As a result, Group-wide proactive initiatives were undertaken, audit training sessions have emphasized recurring issues, and GOG Data Management Subcommittee agendas have provided targeted instruction and training. The analysis was based upon parent institutions only; affiliate institutions and Community Clinical Oncology Program participants were not included, although it is assumed their areas of difficulty are similar. The coordination of the GOG Quality Assurance Audit program in the SDC has improved data quality by enhancing our ability to identify frequently occurring deviations and develop innovative solutions to avoid or minimize their occurrence in the future.

Bloodstream infections caused by multi-drug resistant Proteus mirabilis: Epidemiology, risk factors and impact of multi-drug resistance.

PubMed

Korytny, Alexander; Riesenberg, Klaris; Saidel-Odes, Lisa; Schlaeffer, Fransisc; Borer, Abraham

2016-01-01

The prevalence of antimicrobial co-resistance among ESBL-producing Enterobactereaceae is extremely high in Israel. Multidrug-resistant Proteus mirabilis strains (MDR-PM), resistant to almost all antibiotic classes have been described. The aim was to determine the risk factors for bloodstream infections caused by MDR-PM and clinical outcomes. A retrospective case-control study. Adult patients with PM bacteremia during 7 years were identified retrospectively and their files reviewed for demographics, underlying diseases, Charlson Comorbidity Index, treatment and outcome. One hundred and eighty patients with PM-bloodstream infection (BSI) were included; 90 cases with MDR-PM and 90 controls with sensitive PM (S-PM). Compared to controls, cases more frequently were from nursing homes, had recurrent hospital admissions in the past year and received antibiotic therapy in the previous 3 months, were bedridden and suffered from peripheral vascular disease and peptic ulcer disease (p < 0.001). Two-thirds of the MDR-PM isolates were ESBL-producers vs 4.4% of S-PM isolates (p < 0.001, OR = 47.6, 95% CI = 15.9-142.6). In-hospital crude mortality rate of patients with MDR-PM BSI was 37.7% vs 23.3% in those with S-PM BSI (p = 0.0359, OR = 2, 95% CI = 1.4-3.81). PM bacteremia in elderly and functionally-dependent patients is likely to be caused by nearly pan-resistant PM strains in the institution; 51.8% of the patients received inappropriate empiric antibiotic treatment. The crude mortality rate of patients with MDR-PM BSI was significantly higher than that of patients with S-PM BSI.

Identifying Factors That Influence Persistence of Hawai'i Students Studying at Mainland Colleges: A Phenomenological Multi-Case Study of Higher Education

ERIC Educational Resources Information Center

Lima, Kevin M.

2015-01-01

The purpose of this study was to examine the experiences of mainland college students, graduates of a unique Hawai'i high school, to identify factors that influenced higher education persistence. Students not persisting at college, a problem for students and higher education institutions is defined for this study as a student that did not return…

Overall survival and clinical characteristics of BRCA mutation carriers with stage I/II pancreatic cancer

PubMed Central

Golan, Talia; Sella, Tal; O'Reilly, Eileen M; Katz, Matthew H G; Epelbaum, Ron; Kelsen, David P; Borgida, Ayelet; Maynard, Hannah; Kindler, Hedy; Friedmen, Eitan; Javle, Milind; Gallinger, Steven

2017-01-01

Background: BRCA1/BRCA2 germ line (GL) mutation carriers with pancreatic adenocarcinoma (PDAC) may have distinct outcomes. We recently described an apparent more favourable prognosis of surgically resected BRCA-associated PDAC patients in a single-arm, uncontrolled, retrospective study. However, the prognostic impact of GL BRCA1/2 mutations in surgically resected PDAC has not been compared with a matched control population. Methods: A larger multi-centre, case–control retrospective analysis was performed. Cases were patients with surgically resected, BRCA1/2-associated PDAC from 2004 to 2013. Controls included surgically resected PDAC cases treated during the same time period that were either BRCA non-carriers, or had no family history of breast, ovarian or pancreatic cancers. Cases and controls were matched by: age at diagnosis (within ±5-year period) and institution. Demographics, clinical history, overall survival (OS) and disease-free survival (DFS) were abstracted from patient records. Statistical comparisons were assessed using χ2- and Fisher's exact test, and median DFS/OS using Kaplan–Meier method and log-rank testing. Results: Twenty-five patients with BRCA1-(n=4) or BRCA2 (N=21)-associated resectable PDAC were identified. Mean age was 55.7 years (range, 34–78 years), 48% (n=12) were females and 76% (n=19) were Jewish. Cases were compared (1 : 2) with 49 resectable PDAC controls, and were balanced for age, ethnicity and other relevant clinical and pathological features. BRCA-associated PDAC patients received neoadjuvant, or adjuvant platinum-based treatment more frequently than controls (7 out of 8 vs 6 out of 14) and (7 out of 21 vs 3 out of 44), respectively. No significant difference in median OS (37.06 vs 38.77 months, P=0.838) and in DFS (14.3 vs 12.0 months, P=0.303) could be demonstrated between cases and controls. A trend to increased DFS was observed among BRCA-positive cases treated with neoadjuvant/adjuvant platinum-containing regimens (n=10) compared with similarly treated controls (n=7) (39.1 vs 12.4 months, P=0.255). Conclusions: In this retrospective analysis, the prognosis of surgically resectable BRCA-associated PDAC is no different than that of sporadic PDAC from the same institution. The role of platinum-based adjuvant therapy in this setting requires prospective investigation. PMID:28183138

Clarus multi-state regional demonstrations, evaluation of use case #4 : multi-state control strategy tool.

DOT National Transportation Integrated Search

2011-06-10

This report provides the results of an independent evaluation of the Clarus Use Case #4 Multi-State Control Strategy Tool (MSCST). This tool, developed for the Road Weather Management Program of the Federal Highway Administration by a private contrac...

STEAM-y Partnerships: A Case of Interdisciplinary Professional Development and Collaboration

ERIC Educational Resources Information Center

Kelton, Molly L.; Saraniero, Patti

2018-01-01

Museum partnerships can involve significant tensions, especially when these collaborations reach across institutions to blend disciplines such as art and mathematics. Rather than simply being obstacles to overcome, we suggest that tensions arising in multi-institutional, cross-disciplinary collaborations can be highly generative for collaborators,…

Obesity and Diabetes Mellitus Adversely Affect Outcomes after Cardiac Surgery in Children's Hospitals.

PubMed

Shamszad, Pirouz; Rossano, Joseph W; Marino, Bradley S; Lowry, Adam W; Knudson, Jarrod D

2016-09-01

To assess how obesity or diabetes mellitus impacts outcomes in patients undergoing cardiac surgery in pediatric hospitals. A multi-institutional, matched case-control study of the Pediatric Health Information System database was performed. Tertiary children's hospitals in the United States. All cardiac surgical cases in patients with obesity or diabetes mellitus between 2004 and 2012 were included. Cases were matched to controls by age, sex, race, and Risk Adjustment for Congenital Heart Surgery score. Mortality, surgical complications, and hospital utilization. Differences in outcome measures were assessed by chi-square and Mann-Whitney tests. P value < .05 was significant. Six hundred twenty-nine cardiac surgical cases (median age 17 years [IQR 12-32]) with obesity or diabetes mellitus were matched to 629 controls. Cases demonstrated lower median household income than those in the control group ($38,031 [IQR $31,900-$48,844] vs. ($41,896 [IQR $32,854-$56,020], P < .001). Mortality was similar between cases and controls (22% vs. 1.9%, P =.692). Surgical complications occurred similarly between cases and controls (13.5% vs. 12.4%, P = .535). Cases had longer intensive care unit length of stay than controls (3 vs. 2 days, P = .001), resulting in longer overall hospital length of stay (5 vs. 4 days, P < .001). Cases also had a higher odds of undergoing mechanical ventilation for >96 hours (OR 2.0, 95% CI 1.1-3.7) and higher rate of total parenteral nutrition use (7.2% vs. 4.5%, P = .040). Median hospital charges were higher in cases (clinical: $6,696 vs. $5,872; laboratory: $14,168 vs. $12,251; pharmacy: $12,971 vs. $10,426; imaging: $6,259 vs. $5,660; P ≤ .030 for all). The presence of obesity or diabetes mellitus was associated with increased postoperative morbidity, hospital utilization, and cost in patients undergoing cardiac surgery in pediatric hospitals. © 2016 Wiley Periodicals, Inc.

Multi-Institutional Partnerships for Higher Education in Africa: A Case Study of Assumptions of International Academic Collaboration

ERIC Educational Resources Information Center

Semali, Ladislaus M.; Baker, Rose; Freer, Rob

2013-01-01

Public and private universities in Kenya, Tanzania, Uganda, South Africa, and elsewhere in Africa, were experiencing all time high enrollments since the late 1990s. To address these demands, university administrators sought partnerships with universities of the global North to facilitate the necessary educational reform and curriculum…

Use of Online Assessment Tools by Instructional Designers-by-Assignment: Necessary Features and Functionalities

ERIC Educational Resources Information Center

Halloran, Jo-Ann

2013-01-01

Government entities set criteria for institutions that have teacher educator programs to use online assessment tools to show continuous ongoing evaluation, and use data from the tools to guide the improvement of courses. The purpose of this qualitative, multi-case study was to discover how Instructional Designers-by-Assignment (IDBA) are using…

'It'll Look Good on Your Personal Statement': Self-Marketing amongst University Applicants in the United Kingdom

ERIC Educational Resources Information Center

Shuker, Lucie

2014-01-01

"Selling yourself" through personal statements and interviews is now a standard practice for university applicants. This article draws on a multi-case-study research project to report on the self-marketing orientations of students within three 16-19 institutions in England. These orientations (active/passive; internal/external;…

The financial impact of heparin-induced thrombocytopenia.

PubMed

Smythe, Maureen A; Koerber, John M; Fitzgerald, Maureen; Mattson, Joan C

2008-09-01

Heparin-induced thrombocytopenia (HIT) is an adverse drug reaction that increases patient morbidity and mortality. The financial impact of HIT to an institution is thought to be significant. The objective of this study was to evaluate the financial impact of HIT. A case-control study was employed. Case patients were identified as newly diagnosed HIT patients. Control subjects were matched by diagnosis-related group, primary diagnosis code, primary procedure code, and hospital admission date. The financial/decision support database of the hospital was queried to identify the matched control subjects, total cost, and reimbursement. The determination of financial impact included the total profit or (total loss) and the backfill effect (ie, the lost operating margin resulting from increased length of stay). Length of stay and mortality were compared. Data from 22 case patients and 255 control subjects were analyzed. On average, HIT case patients incurred a financial loss of $14,387 per patient and an increase in length of stay of 14.5 days. When confining the analysis to only Medicare case patients (n = 17) and Medicare control subjects, case patients incurred a financial loss of $20,170 per case and an increase in length of stay of 15.8 days. Depending on the occupancy rate of the institution, additional financial loss could result from the backfill effect. Mortality was not significantly affected. For an institution that sees 50 new cases of HIT per year, the projected annual financial impact ranges from approximately $700,000 to $1 million. Institutions with high bed occupancy rates may see an additional loss from the backfill effect.

Students' well-being in nursing undergraduate education.

PubMed

Tuomi, Jouni; Aimala, Anna-Mari; Plazar, Nadja; Starčič, Andreja Istenič; Žvanut, Boštjan

2013-06-01

Although previously the Job-Demand-Control-Support model has been successfully applied in many studies in the field of health care and education, the model was never used for the evaluation of the nursing students' well-being. The aim of this study was to promote nursing students' well-being. The objective was to verify whether the Job-Demand-Control-Support model is appropriate for the evaluation of their well-being. The Job-Demand-Control-Support model was implemented and investigated in a multiple-case study, which consisted of two phases. In phase I the students' well-being along with the perceived levels of control, support, and demand for each individual student during their study were identified. These results were used in phase II, where the usefulness of the presented model was evaluated. The study was performed at the end of the academic year 2009/2010 in two institutions: Tampere University of Applied Sciences, School of Health Care, Finland (institution 1); and the University of Primorska, Faculty of Health Sciences, Slovenia (institution 2). Participants of the study were nursing graduates who finished their studies in 2009/2010 and the Vice-Deans for education of both institutions. The final sample included 83 students in institution 1 and 79 students in institution 2. The case study was combined with a survey (phase I) and an interview (phase II). Although the students' well-being in these two institutions was different, most students of both institutions perceived their studies as low strain, placid, and only some of the students in both institutions had a high risk of malaise. The Vice-Deans for education of both institutions confirmed that the application of the Job-Demand-Control-Support model provided relevant information on the nursing students' well-being, which helped in planning improved nursing study programmes. This study demonstrated that the Job-Demand-Control-Support model is appropriate for estimating undergraduate nursing students' well-being. Copyright © 2013 Elsevier Ltd. All rights reserved.

Multi-institutional oncogenic driver mutation analysis in lung adenocarcinoma: The Lung Cancer Mutation Consortium experience

PubMed Central

Dias-Santagata, Dora; Wistuba, Ignacio I.; Chen, Heidi; Fujimoto, Junya; Kugler, Kelly; Franklin, Wilbur A.; Iafrate, A. John; Ladanyi, Marc; Kris, Mark G.; Johnson, Bruce E.; Bunn, Paul A.; Minna, John D.; Kwiatkowski, David J.

2015-01-01

Introduction Molecular genetic analyses of lung adenocarcinoma have recently become standard of care for treatment selection. The Lung Cancer Mutation Consortium was formed to enable collaborative multi-institutional analyses of 10 potential oncogenic driver mutations. Technical aspects of testing, and clinicopathologic correlations are presented. Methods Mutation testing in at least one of 8 genes (EGFR, KRAS, ERBB2, AKT1, BRAF, MEK1, NRAS, PIK3CA) using SNaPshot, mass spectrometry, Sanger sequencing +/− PNA and/or sizing assays, along with ALK and/or MET FISH were performed in 6 labs on 1007 patients from 14 institutions. Results 1007 specimens had mutation analysis performed, and 733 specimens had all 10 genes analyzed. Mutation identification rates did not vary by analytic method. Biopsy and cytology specimens were inadequate for testing in 26% and 35% of cases compared to 5% of surgical specimens. Among the 1007 cases with mutation analysis performed, EGFR, KRAS, ALK, and ERBB2 alterations were detected in 22, 25, 8.5, and 2.4% of cases, respectively. EGFR mutations were highly associated with female sex, Asian race, and never smoking status; and less strongly associated with stage IV disease, presence of bone metastases, and absence of adrenal metastases. ALK rearrangements were strongly associated with never smoking status, and more weakly associated with presence of liver metastases. ERBB2 mutations were strongly associated with Asian race and never smoking status. Two mutations were seen in 2.7% of samples, all but one of which involved one or more of PIK3CA, ALK or MET. Conclusion Multi-institutional molecular analysis across multiple platforms, sample types, and institutions can yield consistent results and novel clinicopathological observations. PMID:25738220

Development and application of a Controlled Release Facility (CRF) to validate flux quantifying methodologies.

NASA Astrophysics Data System (ADS)

Helmore, Jonathan

2017-04-01

The National Physical Laboratory, the UK's National Measurement Institute, has developed a novel facility capable of replicating the gaseous emission flux characteristics of a variety of real-word scenarios as may be found in small to medium scale industry and agriculture. The Controlled Release Facility (CRF) can be used to challenge conventional remote sensing techniques, as well as validate new Unmanned Aerial Vehicle (UAV) and distributed sensor network based methods, for source identification and flux calculation. The CRF method will be described and the results from three case studies will be discussed: The replication of an operational on-shore shale gas well using emissions of natural gas to atmosphere and measurements using Differential Absorption LIDAR (DIAL); the replication of fugitive volatile organic compounds emissions from a petrochemical unit and measurements using DIAL; and the replication of methane and carbon dioxide emissions from landfill and measurements using both fixed wing and multi-rotor UAVs.

The Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) Study Protocol

PubMed Central

Woo, Daniel; Rosand, Jonathan; Kidwell, Chelsea; McCauley, Jacob L.; Osborne, Jennifer; Brown, Mark W.; West, Sandra E.; Rademacher, Eric W.; Waddy, Salina; Roberts, Jamie N.; Koch, Sebastian; Gonzales, Nicole R.; Sung, Gene; Kittner, Steven J.; Birnbaum, Lee; Frankel, Michael; Daniel Testai, Fernando; Hall, Christiana E.; Elkind, Mitchell S. V.; Flaherty, Matthew; Coull, Bruce; Chong, Ji Y.; Warwick, Tanya; Malkoff, Marc; James, Michael L.; Ali, Latisha K.; Worrall, Bradford B.; Jones, Floyd; Watson, Tiffany; Leonard, Anne; Martinez, Rebecca; Sacco, Ralph I; Langefeld, Carl D.

2013-01-01

Background and Purpose Epidemiologic studies of intracerebral hemorrhage (ICH) have consistently demonstrated variation in incidence, location, age at presentation, and outcomes among non-Hispanic white, black, and Hispanic populations. We report here the design and methods for this large, prospective, multi-center case-control study of ICH. Methods The ERICH study is a multi-center, prospective case-control study of ICH. Cases are identified by hot-pursuit and enrolled using standard phenotype and risk factor information and include neuroimaging and blood sample collection. Controls are centrally identified by random digit dialing to match cases by age (+/−5 years), race, ethnicity, gender and metropolitan region. Results As of March 22, 2013, 1,655 cases of ICH had been recruited into the study which is 101.5% of the target for that date and 851 controls had been recruited which is 67.2% of the target for that date (1,267 controls) for a total of 2,506 subjects which is 86.5% of the target for that date (2,897 subjects). Of the 1,655 cases enrolled, 1,640 cases had the case interview entered into the database of which 628 (38%) were non-Hispanic black, 458 (28%) were non-Hispanic white and 554 (34%) were Hispanic. Of the 1,197 cases with imaging submitted, 876 (73.2%) had a 24 hour follow-up CT available In addition to CT imaging, 607 cases have had MRI evaluation. Conclusion The ERICH study is a large, case-control study of ICH with particular emphasis on recruitment of minority populations for the identification of genetic and epidemiologic risk factors for ICH and outcomes after ICH. PMID:24021679

Development Impact Assessment (DIA) Case Study. South Africa

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

Cox, Sadie; Nawaz, Kathleen; Sandor, Debra

2015-05-19

This case study reviews South Africa’s experience in considering the impacts of climate change action on development goals, focusing on the South African energy sector and development impact assessments (DIAs) that have and could be used to influence energy policy or inform the selection of energy activities. It includes a review of assessments—conducted by government ministries, technical partners, and academic institutes and non-governmental organizations (NGOs)—that consider employment, health, and water implications of possible energy sector actions, as well as multi-criteria impact assessments.

Colorectal cancer and its association with the metabolic syndrome: a Malaysian multi-centric case-control study.

PubMed

Ulaganathan, V; Kandiah, M; Zalilah, M S; Faizal, J A; Fijeraid, H; Normayah, K; Gooi, B H; Othman, R

2012-01-01

Colorectal cancer (CRC) and the metabolic syndrome (MetS) are both on the rise in Malaysia. A multi-centric case-control study was conducted from December 2009 to January 2011 to determine any relationship between the two. Patients with confirmed CRC based on colonoscopy findings and cancer free controls from five local hospitals were assessed for MetS according to the International Diabetes Federation (IDF) definition. Each index case was matched for age, gender and ethnicity with two controls (140: 280). MetS among cases was highly prevalent (70.7%), especially among women (68.7%). MetS as an entity increased CRC risk by almost three fold independently (OR=2.61, 95%CI=1.53-4.47). In men MetS increased the risk of CRC by two fold (OR=2.01, 95%CI, 1.43-4.56), demonstrating an increasing trend in risk with the number of Mets components observed. This study provides evidence for a positive association between the metabolic syndrome and colorectal cancer. A prospective study on the Malaysian population is a high priority to confirm these findings.

DEMAT: A multi-institutional dosimetry audit of rotational and static intensity-modulated radiotherapy.

PubMed

Lafond, Caroline; Chiavassa, Sophie; Bertaut, Cindy; Boussion, Nicolas; Chapel, Nathalie; Chapron, Lucie; Coste, Frédéric; Crespin, Sylvain; Dy, Gilles; Faye, Papa Abdoulaye; Leleu, Cyril; Bouvier, Jeanne; Madec, Ludovic; Mesgouez, Jérôme; Palisson, Jérémy; Vela, Anthony; Delpon, Grégory

2016-05-01

Static beam intensity-modulated-radiation-therapy (IMRT) and/or Volumetric-Modulated-Arc-Therapy (VMAT) are now available in many regional radiotherapy departments. The aim of this multi-institutional audit was to design a new methodology based on radiochromic films to perform an independent quality control. A set of data were sent to all participating centres for two clinical localizations: prostate and Head and Neck (H&N) cancers. The agreement between calculations and measurements was verified in the Octavius phantom (PTW) by point measurements using ionization chambers and by 2D measurements using EBT3 radiochromic films. Due to uncertainties in the whole procedure, criteria were set to 5% and 3% in local dose and 3mm in distance excluding doses lower than 10% of the maximum doses. No normalization point or area was used for the quantitative analysis. 13 radiotherapy centres participated in this audit involving 28 plans (12 IMRT, 16 VMAT). For point measurements, mean errors were -0.18±1.54% and 0.00±1.58% for prostate and H&N cases respectively. For 2D measurements with 5%/3mm criteria, gamma map analysis showed a pixel pass rate higher than 95% for prostate and H&N. Mean gamma index was lower than 0.4 for prostate and 0.5 for H&N. Both techniques yielded similar results. This study showed the feasibility of an independent quality control by peers for conventional IMRT and VMAT. Results from all participating centres were found to be in good agreement. This regional study demonstrated the feasibility of our new methodology based on radiochromic films without dose normalization on a specific point. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Exploring Characteristics of Religious Affiliated Colleges Labeled "Diploma Mills": A Multi-Case Study of U.S. Court Decisions

ERIC Educational Resources Information Center

Callahan, Laura L.

2014-01-01

Over 600 higher education institutions have been identified as alleged diploma mills by governmental authorities based on criteria set forth in U.S. federal law. The characteristics of religious colleges exempt from State oversight varied based on each States' higher education legislation and implementing policy. The U.S. Constitution was the core…

Profiles of Pre-Service Teacher Education: An Investigation into the Nature of Selected Exemplary Programs in Jamaica and Michigan

ERIC Educational Resources Information Center

Smith-Sherwood, Heather

2018-01-01

This qualitative multi-case study investigated three exemplary pre-service teacher education programs in Jamaica and Michigan in order to provide an account of how they are structured in different contexts of tertiary institutions and, to identify how they ensure that their graduates are prepared to function effectively in today's schools. Five…

Evaluating Multi-Institutional Partnership Sustainability: A Case Study of Collaborative Workforce Development in Renewable Energy Assessment

ERIC Educational Resources Information Center

Diaz, John M.; Stallings, Kevin D.; KC, Birendra; Seekamp, Erin

2015-01-01

Partnership evaluation typically occurs during the final stages either to assess why a collaborative effort did not work or to identify the indicators of success. Partnerships are rarely evaluated at their incipient stage, which is a critical time to assess their potential for long-term sustainability. In this paper, we present an early-stage…

An Unlikely Destination: Meeting the Educational Needs of Immigrant, Migrant and Refugee Children in the Suburbs of Chicago, IL

ERIC Educational Resources Information Center

Israel, Marla; Goldberger, Nancy; Vera, Elizabeth; Heineke, Amy

2017-01-01

Purpose: The purpose of this paper is to describe a university-multi-school district partnership that positively affected the lives of P-12 immigrant, migrant and refugee students and their parents through an iterative collaboration of talent and resources among institutions. Design/methodology/approach: This is a case study describing a…

Putting Ourselves in the Big Picture: A Sustainable Approach to Project Management for e-Learning

ERIC Educational Resources Information Center

Buchan, Janet

2010-01-01

In a case study of a large Australian university the metaphor of panarchy is used as a means of describing and understanding the complex interrelationships of multi-scale institutional projects and the influences of a variety factors on the potential success of e-learning initiatives. The concept of para-analysis is introduced as a management…

Busting the Myth of Gender Bias: Views from Men and Women Primary-School Trainees and Teachers

ERIC Educational Resources Information Center

Mistry, Malini; Sood, Krishan

2016-01-01

We explore the ideology associated with gender equality that despite primary schools and initial teacher education (ITE) institutions doing all they can to recruit men into primary education, a huge gender imbalance still exists. We frame our study around the notions of gender equality and professional responsibility. Using a multi-case study…

Wheels of Change in Higher Education: A Collaborative, Multi-Stakeholder Project as a Vehicle for Sustainability Education

ERIC Educational Resources Information Center

Warr Pedersen, Kristin; Pharo, Emma; Peterson, Corey; Clark, Geoffrey Andrew

2017-01-01

Purpose: The purpose of this paper is to profile the development of a bicycle parking hub at the University of Tasmania to illustrate how the Academic Operations Sustainability Integration Program promotes real change through the engagement of stakeholders from across an institution to deliver campus sustainability. This case study outlines one…

Civil-Military Relations in European Security Institutions - Challenges of Multi-Institutionality in Peace Operations

DTIC Science & Technology

2007-03-01

term “The Short Century” was used for the first time by Eric Hobsbawn, in his book The Short Century, written 1994, in which he claims that the...military implementation of the Peace Agreement.”148 147 Richard L. Layton , Command and Control...Richard L. Layton , Command and Control Structure, in Lessons from Bosnia: The IFOR Experience, Larry Wentz ed., (Washington D.C.: Institute for National

Hydropower and sustainability: resilience and vulnerability in China's powersheds.

PubMed

McNally, Amy; Magee, Darrin; Wolf, Aaron T

2009-07-01

Large dams represent a whole complex of social, economic and ecological processes, perhaps more than any other large infrastructure project. Today, countries with rapidly developing economies are constructing new dams to provide energy and flood control to growing populations in riparian and distant urban communities. If the system is lacking institutional capacity to absorb these physical and institutional changes there is potential for conflict, thereby threatening human security. In this paper, we propose analyzing sustainability (political, socioeconomic, and ecological) in terms of resilience versus vulnerability, framed within the spatial abstraction of a powershed. The powershed framework facilitates multi-scalar and transboundary analysis while remaining focused on the questions of resilience and vulnerability relating to hydropower dams. Focusing on examples from China, this paper describes the complex nature of dams using the sustainability and powershed frameworks. We then analyze the roles of institutions in China to understand the relationships between power, human security and the socio-ecological system. To inform the study of conflicts over dams China is a particularly useful case study because we can examine what happens at the international, national and local scales. The powershed perspective allows us to examine resilience and vulnerability across political boundaries from a dynamic, process-defined analytical scale while remaining focused on a host of questions relating to hydro-development that invoke drivers and impacts on national and sub-national scales. The ability to disaggregate the affects of hydropower dam construction from political boundaries allows for a deeper analysis of resilience and vulnerability. From our analysis we find that reforms in China's hydropower sector since 1996 have been motivated by the need to create stability at the national scale rather than resilient solutions to China's growing demand for energy and water resource control at the local and international scales. Some measures that improved economic development through the market economy and a combination of dam construction and institutional reform may indeed improve hydro-political resilience at a single scale. However, if China does address large-scale hydropower construction's potential to create multi-scale geopolitical tensions, they may be vulnerable to conflict - though not necessarily violent - in domestic and international political arenas. We conclude with a look toward a resilient basin institution for the Nu/Salween River, the site of a proposed large-scale hydropower development effort in China and Myanmar.

CER Hub: An informatics platform for conducting comparative effectiveness research using multi-institutional, heterogeneous, electronic clinical data.

PubMed

Hazlehurst, Brian L; Kurtz, Stephen E; Masica, Andrew; Stevens, Victor J; McBurnie, Mary Ann; Puro, Jon E; Vijayadeva, Vinutha; Au, David H; Brannon, Elissa D; Sittig, Dean F

2015-10-01

Comparative effectiveness research (CER) requires the capture and analysis of data from disparate sources, often from a variety of institutions with diverse electronic health record (EHR) implementations. In this paper we describe the CER Hub, a web-based informatics platform for developing and conducting research studies that combine comprehensive electronic clinical data from multiple health care organizations. The CER Hub platform implements a data processing pipeline that employs informatics standards for data representation and web-based tools for developing study-specific data processing applications, providing standardized access to the patient-centric electronic health record (EHR) across organizations. The CER Hub is being used to conduct two CER studies utilizing data from six geographically distributed and demographically diverse health systems. These foundational studies address the effectiveness of medications for controlling asthma and the effectiveness of smoking cessation services delivered in primary care. The CER Hub includes four key capabilities: the ability to process and analyze both free-text and coded clinical data in the EHR; a data processing environment supported by distributed data and study governance processes; a clinical data-interchange format for facilitating standardized extraction of clinical data from EHRs; and a library of shareable clinical data processing applications. CER requires coordinated and scalable methods for extracting, aggregating, and analyzing complex, multi-institutional clinical data. By offering a range of informatics tools integrated into a framework for conducting studies using EHR data, the CER Hub provides a solution to the challenges of multi-institutional research using electronic medical record data. Copyright © 2015. Published by Elsevier Ireland Ltd.

Concordant, non-atypical breast papillomas do not require surgical excision: A 10-year multi-institution study and review of the literature.

PubMed

Grimm, Lars J; Bookhout, Christine E; Bentley, Rex C; Jordan, Sheryl G; Lawton, Thomas J

2018-05-01

Non-atypical papillomas (NAPs) diagnosed on core needle biopsy (CNB) frequently undergo surgical excision due to highly variable upstaging rates. The purpose of this study is to document our dual-institution upgrade rates of NAPs diagnosed on core needle biopsy and review the upgrade rates reported in the literature. Following IRB approval, CNB results from Duke University (7/1/2004-6/30/2014) and the University of North Carolina Chapel Hill (1/1/04-6/30/2013) were reviewed to identify non-atypical papillomas. All cases with surgical excision or 2 years of imaging follow up were included. In addition, a literature review identified 60 published studies on upgrades of NAPs diagnosed at CNB. Cases in our cohort and the published literature were reviewed for confounding factors: [1] missing radiologic-pathologic concordance and/or discordance, [2] papillomas included with high-risk lesions, [3] high risk lesions counted as upgrades, [4] review by a nonspecialized breast pathologist, and [5] cancer incidentally detected. Of the 388 CNBs in our dual-institution cohort, 136 (35%) patients underwent surgical excision and 252 (65%) patients had imaging follow up. After controlling for confounders, no cancers (0/388) were found at surgical excision or during follow up imaging. The literature review upstaging rate was 4.0% (166/4157) but 1.8% (4/227) after excluding studies with confounders. The combined upstaging rate from the literature and this study was 0.6% (4/615). The upstaging rate for CNB diagnosed NAPs was 0% in our cohort and 0.6% overall after adjusting for confounders. This low rate does not warrant reflexive surgical excision and diagnostic imaging follow up should be discretionary. Copyright © 2018 Elsevier Inc. All rights reserved.

Toward Data-Driven Radiology Education-Early Experience Building Multi-Institutional Academic Trainee Interpretation Log Database (MATILDA).

PubMed

Chen, Po-Hao; Loehfelm, Thomas W; Kamer, Aaron P; Lemmon, Andrew B; Cook, Tessa S; Kohli, Marc D

2016-12-01

The residency review committee of the Accreditation Council of Graduate Medical Education (ACGME) collects data on resident exam volume and sets minimum requirements. However, this data is not made readily available, and the ACGME does not share their tools or methodology. It is therefore difficult to assess the integrity of the data and determine if it truly reflects relevant aspects of the resident experience. This manuscript describes our experience creating a multi-institutional case log, incorporating data from three American diagnostic radiology residency programs. Each of the three sites independently established automated query pipelines from the various radiology information systems in their respective hospital groups, thereby creating a resident-specific database. Then, the three institutional resident case log databases were aggregated into a single centralized database schema. Three hundred thirty residents and 2,905,923 radiologic examinations over a 4-year span were catalogued using 11 ACGME categories. Our experience highlights big data challenges including internal data heterogeneity and external data discrepancies faced by informatics researchers.

Multi-objective Optimization on Helium Liquefier Using Genetic Algorithm

NASA Astrophysics Data System (ADS)

Wang, H. R.; Xiong, L. Y.; Peng, N.; Meng, Y. R.; Liu, L. Q.

2017-02-01

Research on optimization of helium liquefier is limited at home and abroad, and most of the optimization is single-objective based on Collins cycle. In this paper, a multi-objective optimization is conducted using genetic algorithm (GA) on the 40 L/h helium liquefier developed by Technical Institute of Physics and Chemistry of the Chinese Academy of Science (TIPC, CAS), steady solutions are obtained in the end. In addition, the exergy loss of the optimized system is studied in the case of with and without liquid nitrogen pre-cooling. The results have guiding significance for the future design of large helium liquefier.

Outbreak of haemolytic uraemic syndrome in Norway caused by stx2-positive Escherichia coli O103:H25 traced to cured mutton sausages

PubMed Central

Schimmer, Barbara; Nygard, Karin; Eriksen, Hanne-Merete; Lassen, Jørgen; Lindstedt, Bjørn-Arne; Brandal, Lin T; Kapperud, Georg; Aavitsland, Preben

2008-01-01

Background On 20–21 February 2006, six cases of diarrhoea-associated haemolytic uraemic syndrome (HUS) were reported by paediatricians to the Norwegian Institute of Public Health. We initiated an investigation to identify the etiologic agent and determine the source of the outbreak in order to implement control measures. Methods A case was defined as a child with diarrhoea-associated HUS or any person with an infection with the outbreak strain of E. coli O103 (defined by the multi-locus variable number tandem repeats analysis (MLVA) profile) both with illness onset after January 1st 2006 in Norway. After initial hypotheses-generating interviews, we performed a case-control study with the first fifteen cases and three controls for each case matched by age, sex and municipality. Suspected food items were sampled, and any E. coli O103 strains were typed by MLVA. Results Between 20 February and 6 April 2006, 17 cases were identified, of which 10 children developed HUS, including one fatal case. After pilot interviews, a matched case-control study was performed indicating an association between a traditional cured sausage (odds ratio 19.4 (95% CI: 2.4–156)) and STEC infection. E. coli O103:H25 identical to the outbreak strain defined by MLVA profile was found in the product and traced back to contaminated mutton. Conclusion We report an outbreak caused by a rare STEC variant (O103:H25, stx2-positive). More than half of the diagnosed patients developed HUS, indicating that the causative organism is particularly virulent. Small ruminants continue to be important reservoirs for human-pathogen STEC. Improved slaughtering hygiene and good manufacturing practices for cured sausage products are needed to minimise the possibility of STEC surviving through the entire sausage production process. PMID:18387178

Australian Schizophrenia Research Bank: a database of comprehensive clinical, endophenotypic and genetic data for aetiological studies of schizophrenia.

PubMed

Loughland, Carmel; Draganic, Daren; McCabe, Kathryn; Richards, Jacqueline; Nasir, Aslam; Allen, Joanne; Catts, Stanley; Jablensky, Assen; Henskens, Frans; Michie, Patricia; Mowry, Bryan; Pantelis, Christos; Schall, Ulrich; Scott, Rodney; Tooney, Paul; Carr, Vaughan

2010-11-01

This article describes the establishment of the Australian Schizophrenia Research Bank (ASRB), which operates to collect, store and distribute linked clinical, cognitive, neuroimaging and genetic data from a large sample of people with schizophrenia and healthy controls. Recruitment sources for the schizophrenia sample include a multi-media national advertising campaign, inpatient and community treatment services and non-government support agencies. Healthy controls have been recruited primarily through multi-media advertisements. All participants undergo an extensive diagnostic and family history assessment, neuropsychological evaluation, and blood sample donation for genetic studies. Selected individuals also complete structural MRI scans. Preliminary analyses of 493 schizophrenia cases and 293 healthy controls are reported. Mean age was 39.54 years (SD = 11.1) for the schizophrenia participants and 37.38 years (SD = 13.12) for healthy controls. Compared to the controls, features of the schizophrenia sample included a higher proportion of males (cases 65.9%; controls 46.8%), fewer living in married or de facto relationships (cases 16.1%; controls 53.6%) and fewer years of education (cases 13.05, SD = 2.84; controls 15.14, SD = 3.13), as well as lower current IQ (cases 102.68, SD = 15.51; controls 118.28, SD = 10.18). These and other sample characteristics are compared to those reported in another large Australian sample (i.e. the Low Prevalence Disorders Study), revealing some differences that reflect the different sampling methods of these two studies. The ASRB is a valuable and accessible schizophrenia research facility for use by approved scientific investigators. As recruitment continues, the approach to sampling for both cases and controls will need to be modified to ensure that the ASRB samples are as broadly representative as possible of all cases of schizophrenia and healthy controls.

Development of an International Canine Spinal Cord Injury observational registry: a collaborative data-sharing network to optimize translational studies of SCI.

PubMed

Moore, Sarah A; Zidan, Natalia; Spitzbarth, Ingo; Nout-Lomas, Yvette S; Granger, Nicolas; da Costa, Ronaldo C; Levine, Jonathan M; Jeffery, Nick D; Stein, Veronika M; Tipold, Andrea; Olby, Natasha J

2018-05-23

Prospective cross-sectional cohort study. The canine spontaneous model of spinal cord injury (SCI) is as an important pre-clinical platform as it recapitulates key facets of human injury in a naturally occurring context. The establishment of an observational canine SCI registry constitutes a key step in performing epidemiologic studies and assessing the impact of therapeutic strategies to enhance translational research. Further, accumulating information on dogs with SCI may contribute to current "big data" approaches to enhance understanding of the disease using heterogeneous multi-institutional, multi-species datasets from both pre-clinical and human studies. Multiple veterinary academic institutions across the United States and Europe. Common data elements recommended for experimental and human SCI studies were reviewed and adapted for use in a web-based registry, to which all dogs presenting to member veterinary tertiary care facilities were prospectively entered over ~1 year. Analysis of data accumulated during the first year of the registry suggests that 16% of dogs with SCI present with severe, sensorimotor-complete injury and that 15% of cases are seen by a tertiary care facility within 8 h of injury. Similar to the human SCI population, 34% were either overweight or obese. Severity of injury and timing of presentation suggests that neuroprotective studies using the canine clinical model could be conducted efficiently using a multi-institutional approach. Additionally, pet dogs with SCI experience similar comorbidities to people with SCI, in particular obesity, and could serve as an important model to evaluate the effects of this condition.

[A Multi-arm Placebo-controlled Study with Glutamic Acid Conducted in Rostock in 1953/1954].

PubMed

Häßler, Frank; Weirich, Steffen

2017-09-01

A Multi-arm Placebo-controlled Study with Glutamic Acid Conducted in Rostock in 1953/1954 Glutamic acid was commonly used in the treatment of intellectually disabled children in the 50s. Koch reported first results of an observation of 140 children treated with glutamic acid in 1952. In this line is the multi-arm placebo-controlled study reported here. The original study protocols were available. 58 children with speech problems who attending a school of special needs received glutamic acid, or vitamin B, or St.-John's-wort. The effect of glutamic acid was in few cases an improvement of attention. On the other hand restlessness and stutter increased. The majority of all reported a weight loss. The treatment with vitamin B showed a positive effect concerning concentration. The treatment with St.-John's wort was stopped caused by headache and vomiting in eight of nine cases. The results of the study reported here are unpublished. The reason may be that until the 60s the effects of glutamic acid in the treatment of intellectually disabled children were in generally overestimated.

A Process for Comprehensive Educational Change: The Experimental Schools Program in Rural America - A Case Study (1973-1978).

ERIC Educational Resources Information Center

Peters, Richard O.

One of 10 sites chosen for multi-year funding under the National Institute of Education's rural Experimental Schools Program (ES), the New Hampshire School Supervisory Union 58 ES Project was a community-based effort, serving 3 autonomous school districts and operative between July 1973-July 1978. Serving a total population of 3,816, the project…

'We Are at This Campus, There Is Nothing in This Campus …': Socio-Spatial Analysis of a University Campus

ERIC Educational Resources Information Center

Aglargöz, Ozan

2017-01-01

This article provides a socio-spatial analysis of a higher education institution operating within a multi-campus system at a location other than the flagship campus. Based on this case study of a technical school, the meanings attached to the university campus are analyzed through semi-structured interviews and official documents. The study…

On controllability of homogeneous and inhomogeneous discrete-time multi-input bilinear systems in dimension two

NASA Astrophysics Data System (ADS)

Tie, Lin

2017-08-01

In this paper, the controllability problem of two-dimensional discrete-time multi-input bilinear systems is completely solved. The homogeneous and the inhomogeneous cases are studied separately and necessary and sufficient conditions for controllability are established by using a linear algebraic method, which are easy to apply. Moreover, for the uncontrollable systems, near-controllability is considered and similar necessary and sufficient conditions are also obtained. Finally, examples are provided to demonstrate the results of this paper.

Bulky mesonephric adenocarcinoma of the uterine cervix treated with neoadjuvant chemotherapy and radical surgery: report of the first case.

PubMed

Ditto, Antonino; Martinelli, Fabio; Bogani, Giorgio; Gasparri, Maria L; Donato, Violante Di; Paolini, Biagio; Carcangiu, Maria L; Lorusso, Domenica; Raspagliesi, Francesco

2016-11-11

Malignant mesonephric adenocarcinoma of the uterine cervix is a rare occurrence with few cases described in the literature. Although surgery seems to be effective in the treatment of early-stage tumor, no cases describing outcomes of locally advanced stage are available. We report the first case of a patient with International Federation of Obstetrics and Gynecologists stage IIB mesonephric adenocarcinoma undergoing neoadjuvant chemotherapy and radical surgery. Despite the inherent limitation of a single description of a case, our experience supports the utilization of neoadjuvant chemotherapy in patients with malignant mesonephric adenocarcinoma of the uterine cervix. Further prospective multi-institutional studies are needed.

Myeloproliferative neoplasms with concurrent BCR-ABL1 translocation and JAK2 V617F mutation: a multi-institutional study from the bone marrow pathology group.

PubMed

Soderquist, Craig R; Ewalt, Mark D; Czuchlewski, David R; Geyer, Julia T; Rogers, Heesun J; Hsi, Eric D; Wang, Sa A; Bueso-Ramos, Carlos E; Orazi, Attilio; Arber, Daniel A; Hexner, Elizabeth O; Babushok, Daria V; Bagg, Adam

2018-05-01

Myeloproliferative neoplasms arise from hematopoietic stem cells with somatically altered tyrosine kinase signaling. Classification of myeloproliferative neoplasms is based on hematologic, histopathologic and molecular characteristics including the presence of the BCR-ABL1 and JAK2 V617F. Although thought to be mutually exclusive, a number of cases with co-occurring BCR-ABL1 and JAK2 V617F have been identified. To characterize the clinicopathologic features of myeloproliferative neoplasms with concomitant BCR-ABL1 and JAK2 V617F, and define the frequency of co-occurrence, we conducted a retrospective multi-institutional study. Cases were identified using a search of electronic databases over a decade at six major institutions. Of 1570 patients who were tested for both BCR-ABL1 and JAK2 V617F, six were positive for both. An additional five patients were identified via clinical records providing a total of 11 cases for detailed evaluation. For each case, clinical variables, hematologic and genetic data, and bone marrow histomorphologic features were analyzed. The sequence of identification of the genetic abnormalities varied: five patients were initially diagnosed with a JAK2 V617F+ myeloproliferative neoplasm, one patient initially had BCR-ABL1+ chronic myeloid leukemia, while both alterations were identified simultaneously in five patients. Classification of the BCR-ABL1-negative myeloproliferative neoplasms varied, and in some cases, features only became apparent following tyrosine kinase inhibitor therapy. Seven of the 11 patients showed myelofibrosis, in some cases before identification of the second genetic alteration. Our data, reflecting the largest reported study comprehensively detailing clinicopathologic features and response to therapy, show that the co-occurrence of BCR-ABL1 and JAK2 V617F is rare, with an estimated frequency of 0.4%, and most often reflects two distinct ('composite') myeloproliferative neoplasms. Although uncommon, it is important to be aware of this potentially confounding genetic combination, lest these features be misinterpreted to reflect resistance to therapy or disease progression, considerations that could lead to inappropriate management.

Governance of water resources in the phase of change: a case study of the implementation of the EU Water Framework Directive in Sweden.

PubMed

Hammer, Monica; Balfors, Berit; Mörtberg, Ulla; Petersson, Mona; Quin, Andrew

2011-03-01

In this article, focusing on the ongoing implementation of the EU Water Framework Directive, we analyze some of the opportunities and challenges for a sustainable governance of water resources from an ecosystem management perspective. In the face of uncertainty and change, the ecosystem approach as a holistic and integrated management framework is increasingly recognized. The ongoing implementation of the Water Framework Directive (WFD) could be viewed as a reorganization phase in the process of change in institutional arrangements and ecosystems. In this case study from the Northern Baltic Sea River Basin District, Sweden, we focus in particular on data and information management from a multi-level governance perspective from the local stakeholder to the River Basin level. We apply a document analysis, hydrological mapping, and GIS models to analyze some of the institutional framework created for the implementation of the WFD. The study underlines the importance of institutional arrangements that can handle variability of local situations and trade-offs between solutions and priorities on different hierarchical levels.

Preliminary evaluation of serum total cholesterol concentrations in dogs with osteosarcoma.

PubMed

Leeper, H; Viall, A; Ruaux, C; Bracha, S

2017-10-01

To determine if total serum cholesterol concentrations were altered in dogs with osteosarcoma. To evaluate association of total serum cholesterol concentration with clinical outcomes in dogs with appendicular osteosarcoma. Retrospective, multi-institutional study on 64 dogs with osteosarcoma. Control population consisted of dogs with traumatic bone fractures (n=30) and healthy patients of similar age and weight as those of the osteosarcoma cases (n=31). Survival analysis was done on 35 appendicular osteosarcoma patients that received the current standard of care. Statistical associations were assessed by univariable and multi-variable analysis. Information about age, sex, primary tumour location, total cholesterol concentration, monocytes and lymphocyte counts and alkaline phosphatase were also included. Total cholesterol was elevated above the reference interval (3·89 to 7·12 mmol/L) (150 to 275 mg/dL) in 29 of 64 (45·3%) osteosarcoma-bearing dogs, whereas similar elevations were found in only 3 of 30 (10%) fracture controls (P<0·0001) and 2 of 31 (6·5%) similar age/weight controls (P=0·0002). Elevated total cholesterol was significantly associated with a reduced hazard ratio (0·27, P=0·008) for overall mortality in dogs with osteosarcoma. These results suggest that elevated total cholesterol is associated with canine osteosarcoma and may have prognostic significance. © 2017 British Small Animal Veterinary Association.

Performance assessment of multi-frequency processing of ICU chest images for enhanced visualization of tubes and catheters

NASA Astrophysics Data System (ADS)

Wang, Xiaohui; Couwenhoven, Mary E.; Foos, David H.; Doran, James; Yankelevitz, David F.; Henschke, Claudia I.

2008-03-01

An image-processing method has been developed to improve the visibility of tube and catheter features in portable chest x-ray (CXR) images captured in the intensive care unit (ICU). The image-processing method is based on a multi-frequency approach, wherein the input image is decomposed into different spatial frequency bands, and those bands that contain the tube and catheter signals are individually enhanced by nonlinear boosting functions. Using a random sampling strategy, 50 cases were retrospectively selected for the study from a large database of portable CXR images that had been collected from multiple institutions over a two-year period. All images used in the study were captured using photo-stimulable, storage phosphor computed radiography (CR) systems. Each image was processed two ways. The images were processed with default image processing parameters such as those used in clinical settings (control). The 50 images were then separately processed using the new tube and catheter enhancement algorithm (test). Three board-certified radiologists participated in a reader study to assess differences in both detection-confidence performance and diagnostic efficiency between the control and test images. Images were evaluated on a diagnostic-quality, 3-megapixel monochrome monitor. Two scenarios were studied: the baseline scenario, representative of today's workflow (a single-control image presented with the window/level adjustments enabled) vs. the test scenario (a control/test image pair presented with a toggle enabled and the window/level settings disabled). The radiologists were asked to read the images in each scenario as they normally would for clinical diagnosis. Trend analysis indicates that the test scenario offers improved reading efficiency while providing as good or better detection capability compared to the baseline scenario.

Prospects of poisoning - a multi facet study.

PubMed

Mishra, Pradeep K; Kulkarni, Rashmi; Sane, Mandar R; Deshpande, Ajit; Kushwah, Manish

2016-01-01

Aim of the study is to find out demographic profile, clinical characteristics and analysis of poison in clinical set up. The study carried out in Sri Aurobindo Medical College and PG Institute Indore, Madhya Pradesh. Total 75 cases of poisoning were studied for demographic profile, vitals (BP, pulse, heart rate, pupils, etc.), clinical features (such as vomiting, salivation, consciousness, etc.), type of poison and its analysis. Results: Poisoning was more common in cases between 15 and 25 years of age, in males than in females and in Hindu religion. Poisoning cases were predominantly from rural areas and in married people. Majority of cases were discharged after proper treatment and counseling. Altered vitals and clinical features were found in most of the cases. Organophosphate and aluminum phosphide compound were evaluated in most of the cases. Conclusions: Preventive measures should be applied through educating people, proper counseling, promoting poison information centers, and introducing separate toxicological units in hospitals.

Identifying the Sources Contributing to PM Exceedances in Ostrava, Czech Republic, Using Passive Aerosol Sampling Coupled with Computer-Controlled Microscopy

EPA Science Inventory

The Czech Hydrometeorological Institute (CHMI) in collaboration with the U.S. Environmental Protection Agency conducted a multi-pollutant source apportionment study in 2012 to quantify the impact of regional as well as local sources on air quality in the Ostrava metropolitan area...

Coronary CT angiography using 64 detector rows: methods and design of the multi-centre trial CORE-64.

PubMed

Miller, Julie M; Dewey, Marc; Vavere, Andrea L; Rochitte, Carlos E; Niinuma, Hiroyuki; Arbab-Zadeh, Armin; Paul, Narinder; Hoe, John; de Roos, Albert; Yoshioka, Kunihiro; Lemos, Pedro A; Bush, David E; Lardo, Albert C; Texter, John; Brinker, Jeffery; Cox, Christopher; Clouse, Melvin E; Lima, João A C

2009-04-01

Multislice computed tomography (MSCT) for the noninvasive detection of coronary artery stenoses is a promising candidate for widespread clinical application because of its non-invasive nature and high sensitivity and negative predictive value as found in several previous studies using 16 to 64 simultaneous detector rows. A multi-centre study of CT coronary angiography using 16 simultaneous detector rows has shown that 16-slice CT is limited by a high number of nondiagnostic cases and a high false-positive rate. A recent meta-analysis indicated a significant interaction between the size of the study sample and the diagnostic odds ratios suggestive of small study bias, highlighting the importance of evaluating MSCT using 64 simultaneous detector rows in a multi-centre approach with a larger sample size. In this manuscript we detail the objectives and methods of the prospective "CORE-64" trial ("Coronary Evaluation Using Multidetector Spiral Computed Tomography Angiography using 64 Detectors"). This multi-centre trial was unique in that it assessed the diagnostic performance of 64-slice CT coronary angiography in nine centres worldwide in comparison to conventional coronary angiography. In conclusion, the multi-centre, multi-institutional and multi-continental trial CORE-64 has great potential to ultimately assess the per-patient diagnostic performance of coronary CT angiography using 64 simultaneous detector rows.

Multi-objective optimization of composite structures. A review

NASA Astrophysics Data System (ADS)

Teters, G. A.; Kregers, A. F.

1996-05-01

Studies performed on the optimization of composite structures by coworkers of the Institute of Polymers Mechanics of the Latvian Academy of Sciences in recent years are reviewed. The possibility of controlling the geometry and anisotropy of laminar composite structures will make it possible to design articles that best satisfy the requirements established for them. Conflicting requirements such as maximum bearing capacity, minimum weight and/or cost, prescribed thermal conductivity and thermal expansion, etc. usually exist for optimal design. This results in the multi-objective compromise optimization of structures. Numerical methods have been developed for solution of problems of multi-objective optimization of composite structures; parameters of the structure of the reinforcement and the geometry of the design are assigned as controlling parameters. Programs designed to run on personal computers have been compiled for multi-objective optimization of the properties of composite materials, plates, and shells. Solutions are obtained for both linear and nonlinear models. The programs make it possible to establish the Pareto compromise region and special multicriterial solutions. The problem of the multi-objective optimization of the elastic moduli of a spatially reinforced fiberglass with stochastic stiffness parameters has been solved. The region of permissible solutions and the Pareto region have been found for the elastic moduli. The dimensions of the scatter ellipse have been determined for a multidimensional Gaussian probability distribution where correlation between the composite's properties being optimized are accounted for. Two types of problems involving the optimization of a laminar rectangular composite plate are considered: the plate is considered elastic and anisotropic in the first case, and viscoelastic properties are accounted for in the second. The angle of reinforcement and the relative amount of fibers in the longitudinal direction are controlling parameters. The optimized properties are the critical stresses, thermal conductivity, and thermal expansion. The properties of a plate are determined by the properties of the components in the composite, eight of which are stochastic. The region of multi-objective compromise solutions is presented, and the parameters of the scatter ellipses of the properties are given.

Long-term Follow-up Results of a Multi-institutional Phase 2 Study of Concurrent Chemoradiation Therapy for Locally Advanced Cervical Cancer in East and Southeast Asia

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

Kato, Shingo, E-mail: s_kato@saitama-med.ac.jp; National Institute of Radiological Sciences of Japan, Chiba; Ohno, Tatsuya

2013-09-01

Purpose: To report the long-term survival and toxicity of a multi-institutional phase 2 study of concurrent chemoradiation therapy (CCRT) for locally advanced cervical cancer in east and southeast Asia. Methods and Materials: Ten institutions from 8 Asian countries participated in the study. Between April 2003 and March 2006, 120 patients (60 with bulky stage IIB and 60 with stage IIIB) were treated with CCRT. Radiation therapy consisted of pelvic external beam radiation therapy and either high-dose-rate or low-dose-rate intracavitary brachytherapy. Five cycles of weekly cisplatin (40 mg/m{sup 2}) were administered during the course of radiation therapy. Treatment results were evaluatedmore » by the rates of local control, overall survival, and late toxicities. Results: Median follow-up was 63.7 months, and the follow-up rate at 5 years was 98%. The 5-year local control and overall survival rates for all patients were 76.8% and 55.1%, respectively. The 5-year rates of major late toxicities of the rectum and bladder were 7.9% and 0%, respectively. Conclusions: The long-term results have suggested that CCRT is safe and effective for patients with locally advanced cervical cancer in east and southeast Asia. However, further efforts are needed to improve overall survival.« less

Is Hypospadias Associated with Prenatal Exposure to Endocrine Disruptors? A French Collaborative Controlled Study of a Cohort of 300 Consecutive Children Without Genetic Defect.

PubMed

Kalfa, Nicolas; Paris, Françoise; Philibert, Pascal; Orsini, Mattea; Broussous, Sylvie; Fauconnet-Servant, Nadège; Audran, Françoise; Gaspari, Laura; Lehors, Hélène; Haddad, Myriam; Guys, Jean-Michel; Reynaud, Rachel; Alessandrini, Pierre; Merrot, Thierry; Wagner, Kathy; Kurzenne, Jean-Yves; Bastiani, Florence; Bréaud, Jean; Valla, Jean-Stéphane; Lacombe, Gérard Morisson; Dobremez, Eric; Zahhaf, Amel; Daures, Jean-Pierre; Sultan, Charles

2015-12-01

Numerous studies have focused on the association between endocrine-disrupting chemicals (EDCs) and hypospadias. Phenotype variability, the absence of representative comparison groups and concomitant genetic testing prevent any definitive conclusions. To identify the role of occupational and environmental exposures to EDCs in nongenetic isolated hypospadias. A total of 408 consecutive children with isolated hypospadias and 302 normal boys were prospectively included (2009-2014) in a multi-institutional study in the south of France, the area of the country with the highest prevalence of hypospadias surgery. In patients without AR, SRD5A2, and MAMLD1 mutations, parental occupational and professional exposures to EDCs were evaluated based on European questionnaire QLK4-1999-01422 and a validated job-exposure matrix for EDCs. Environmental exposure was estimated using the zip code, the type of surrounding hazards, and distance from these hazards. Multivariate analysis was performed. Fetal exposure to EDCs around the window of genital differentiation was more frequent in the case of hypospadias (40.00% vs 17.55%, odds ratio 3.13, 95% confidence interval 2.11-4.65). The substances were paints/solvents/adhesives (16.0%), detergents (11.0%), pesticides (9.0%), cosmetics (5.6%), and industrial chemicals (4.0%). Jobs with exposure were more frequent in mothers of hypospadiac boys (19.73% vs 10.26%, p=0.0019), especially cleaners, hairdressers, beauticians, and laboratory workers. Paternal job exposure was more frequent in the cases of hypospadias (40.13% vs 27.48%, p=0.02). Industrial areas, incinerators, and waste areas were more frequent within a 3-km radius for mothers of hypospadiac boys (13.29% vs. 6.64%, p<0.00005). Association of occupational and environmental exposures increases this risk. This multicenter prospective controlled study with a homogeneous cohort of hypospadiac boys without genetic defects strongly suggests that EDCs are a risk factor for hypospadias through occupational and environmental exposure during fetal life. The association of various types of exposures may increase this risk. Our multi-institutional study showed that parental professional, occupational, and environmental exposures to chemical products increase the risk of hypospadias in children. Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Who pays for cooperation in global health? A comparative analysis of WHO, the World Bank, the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria, and Gavi, the Vaccine Alliance.

PubMed

Clinton, Chelsea; Sridhar, Devi

2017-07-15

In this report we assess who pays for cooperation in global health through an analysis of the financial flows of WHO, the World Bank, the Global Fund to Fight HIV/AIDS, TB and Malaria, and Gavi, the Vaccine Alliance. The past few decades have seen the consolidation of influence in the disproportionate roles the USA, UK, and the Bill & Melinda Gates Foundation have had in financing three of these four institutions. Current financing flows in all four case study institutions allow donors to finance and deliver assistance in ways that they can more closely control and monitor at every stage. We highlight three major trends in global health governance more broadly that relate to this development: towards more discretionary funding and away from core or longer-term funding; towards defined multi-stakeholder governance and away from traditional government-centred representation and decision-making; and towards narrower mandates or problem-focused vertical initiatives and away from broader systemic goals. Copyright © 2017 Elsevier Ltd. All rights reserved.

Overcoming Barriers to Public Engagement through a Multi-Institution Consortium

NASA Astrophysics Data System (ADS)

Lambert, K. F.; Weiss, M.; Garlick, S.

2016-12-01

A growing body of evidence suggests that public engagement with science (PES) can enhance the relevance and impact of science on society. At the same time, advances in our understanding of public engagement suggest that greater skills, resources, and time horizons are often required to create effective programs. Consequently, despite a proliferation of training programs, many scientists still face the challenge of balancing the demands of public engagement with the requirements of their disciplinary research. Novel institutions are emerging that bring together interdisciplinary networks of principle investigators with PES practitioners to overcome barriers to effective and sustained public engagement in the environmental sciences. We will use the Science Policy Exchange (SPE), a consortium housed at the Harvard Forest, Harvard University, to illustrate how PIs and PES practitioners can collaborate to design public engagement processes, conduct policy-relevant scientific syntheses, and implement science communication strategies. Results from two SPE case studies demonstrate how multi-institutional consortia can help scientists overcome barriers such as lack of knowledge of evidence-based PES approaches, limits on time and funding to implement PES projects, and the need to integrate PES activities with research. The case studies also show how SPE strives to achieve credibility, saliency, and legitimacy in different public policy contexts: (1) engagement between scientists and local stakeholders to develop scenarios of landscape change; and (2) engagement between scientists and policy makers to understand the relationship between power plant emission standards, and air quality, human health and ecosystem function. The presentation will conclude with examples of how SPE programs have led to institutional change (staffing and budget), cultural change (attitudes and expectations of senior leaders), and research change (development of research questions, funding proposals, and research design).

Multi-Institutional Evaluation of Digital Tomosynthesis, Dual-Energy Radiography, and Conventional Chest Radiography for the Detection and Management of Pulmonary Nodules.

PubMed

Dobbins, James T; McAdams, H Page; Sabol, John M; Chakraborty, Dev P; Kazerooni, Ella A; Reddy, Gautham P; Vikgren, Jenny; Båth, Magnus

2017-01-01

Purpose To conduct a multi-institutional, multireader study to compare the performance of digital tomosynthesis, dual-energy (DE) imaging, and conventional chest radiography for pulmonary nodule detection and management. Materials and Methods In this binational, institutional review board-approved, HIPAA-compliant prospective study, 158 subjects (43 subjects with normal findings) were enrolled at four institutions. Informed consent was obtained prior to enrollment. Subjects underwent chest computed tomography (CT) and imaging with conventional chest radiography (posteroanterior and lateral), DE imaging, and tomosynthesis with a flat-panel imaging device. Three experienced thoracic radiologists identified true locations of nodules (n = 516, 3-20-mm diameters) with CT and recommended case management by using Fleischner Society guidelines. Five other radiologists marked nodules and indicated case management by using images from conventional chest radiography, conventional chest radiography plus DE imaging, tomosynthesis, and tomosynthesis plus DE imaging. Sensitivity, specificity, and overall accuracy were measured by using the free-response receiver operating characteristic method and the receiver operating characteristic method for nodule detection and case management, respectively. Results were further analyzed according to nodule diameter categories (3-4 mm, >4 mm to 6 mm, >6 mm to 8 mm, and >8 mm to 20 mm). Results Maximum lesion localization fraction was higher for tomosynthesis than for conventional chest radiography in all nodule size categories (3.55-fold for all nodules, P < .001; 95% confidence interval [CI]: 2.96, 4.15). Case-level sensitivity was higher with tomosynthesis than with conventional chest radiography for all nodules (1.49-fold, P < .001; 95% CI: 1.25, 1.73). Case management decisions showed better overall accuracy with tomosynthesis than with conventional chest radiography, as given by the area under the receiver operating characteristic curve (1.23-fold, P < .001; 95% CI: 1.15, 1.32). There were no differences in any specificity measures. DE imaging did not significantly affect nodule detection when paired with either conventional chest radiography or tomosynthesis. Conclusion Tomosynthesis outperformed conventional chest radiography for lung nodule detection and determination of case management; DE imaging did not show significant differences over conventional chest radiography or tomosynthesis alone. These findings indicate performance likely achievable with a range of reader expertise. © RSNA, 2016 Online supplemental material is available for this article.

Multi-Institutional Evaluation of Digital Tomosynthesis, Dual-Energy Radiography, and Conventional Chest Radiography for the Detection and Management of Pulmonary Nodules

PubMed Central

McAdams, H. Page; Sabol, John M.; Chakraborty, Dev P.; Kazerooni, Ella A.; Reddy, Gautham P.; Vikgren, Jenny; Båth, Magnus

2017-01-01

Purpose To conduct a multi-institutional, multireader study to compare the performance of digital tomosynthesis, dual-energy (DE) imaging, and conventional chest radiography for pulmonary nodule detection and management. Materials and Methods In this binational, institutional review board–approved, HIPAA-compliant prospective study, 158 subjects (43 subjects with normal findings) were enrolled at four institutions. Informed consent was obtained prior to enrollment. Subjects underwent chest computed tomography (CT) and imaging with conventional chest radiography (posteroanterior and lateral), DE imaging, and tomosynthesis with a flat-panel imaging device. Three experienced thoracic radiologists identified true locations of nodules (n = 516, 3–20-mm diameters) with CT and recommended case management by using Fleischner Society guidelines. Five other radiologists marked nodules and indicated case management by using images from conventional chest radiography, conventional chest radiography plus DE imaging, tomosynthesis, and tomosynthesis plus DE imaging. Sensitivity, specificity, and overall accuracy were measured by using the free-response receiver operating characteristic method and the receiver operating characteristic method for nodule detection and case management, respectively. Results were further analyzed according to nodule diameter categories (3–4 mm, >4 mm to 6 mm, >6 mm to 8 mm, and >8 mm to 20 mm). Results Maximum lesion localization fraction was higher for tomosynthesis than for conventional chest radiography in all nodule size categories (3.55-fold for all nodules, P < .001; 95% confidence interval [CI]: 2.96, 4.15). Case-level sensitivity was higher with tomosynthesis than with conventional chest radiography for all nodules (1.49-fold, P < .001; 95% CI: 1.25, 1.73). Case management decisions showed better overall accuracy with tomosynthesis than with conventional chest radiography, as given by the area under the receiver operating characteristic curve (1.23-fold, P < .001; 95% CI: 1.15, 1.32). There were no differences in any specificity measures. DE imaging did not significantly affect nodule detection when paired with either conventional chest radiography or tomosynthesis. Conclusion Tomosynthesis outperformed conventional chest radiography for lung nodule detection and determination of case management; DE imaging did not show significant differences over conventional chest radiography or tomosynthesis alone. These findings indicate performance likely achievable with a range of reader expertise. © RSNA, 2016 Online supplemental material is available for this article. PMID:27439324

Perceptions about the Role of Race in the Job Acquisition Process: At the Nexus of Attributional Ambiguity and Aversive Racism in Technology and Engineering Education

ERIC Educational Resources Information Center

Niemann, Yolanda Flores; Sánchez, Nydia C.

2015-01-01

This study explored the role of race in the negative job acquisition outcomes of African American graduates of a federally funded multi-institution doctoral training program. Because the credentials of African American graduates were similar, equal to, and/or, in some cases, exceeded those of their white peers, qualifications were ruled out as…

An outbreak of vancomycin-resistant Enterococcus faecium in an acute care pediatric hospital: Lessons from environmental screening and a case-control study

PubMed Central

Drews, Steven J; Richardson, Susan E; Wray, Rick; Freeman, Renee; Goldman, Carol; Streitenberger, Laurie; Stevens, Derek; Goia, Cristina; Kovach, Danuta; Brophy, Jason; Matlow, Anne G

2008-01-01

BACKGROUND The present study describes a vancomycin-resistant enterococci (VRE) outbreak investigation and a case-control study to identify risk factors for VRE acquisition in a tertiary care pediatric hospital. OBJECTIVE To report an outbreak investigation and a case-control study to identify risk factors for VRE colonization or infection in hospitalized children. METHODS Screening for VRE cases was performed by culture or polymerase chain reaction. A case-control study of VRE-colonized patients was undertaken. Environmental screening was performed using standard culture and susceptibility methods, with pulsed-field gel electrophoresis to determine relationships between VRE isolates. Statistical analysis was performed using SAS version 9.0 (SAS Institute Inc, USA). RESULTS Thirty-four VRE-positive cases were identified on 10 wards between February 28, 2005, and May 27, 2005. Pulsed-field gel electrophoresis analysis confirmed a single outbreak strain that was also isolated from a video game found on one affected ward. Multivariate analysis identified cephalosporin use as the major risk factor for VRE colonization. CONCLUSIONS In the present study outbreak, VRE colonization was significantly associated with cephalosporin use. Because shared recreational items and environmental surfaces may be colonized by VRE, they warrant particular attention in housekeeping protocols, particularly in pediatric institutions. PMID:19412380

Optimizing the construction of devices to control inaccesible surfaces - case study

NASA Astrophysics Data System (ADS)

Niţu, E. L.; Costea, A.; Iordache, M. D.; Rizea, A. D.; Babă, Al

2017-10-01

The modern concept for the evolution of manufacturing systems requires multi-criteria optimization of technological processes and equipments, prioritizing associated criteria according to their importance. Technological preparation of the manufacturing can be developed, depending on the volume of production, to the limit of favourable economical effects related to the recovery of the costs for the design and execution of the technological equipment. Devices, as subsystems of the technological system, in the general context of modernization and diversification of machines, tools, semi-finished products and drives, are made in a multitude of constructive variants, which in many cases do not allow their identification, study and improvement. This paper presents a case study in which the multi-criteria analysis of some structures, based on a general optimization method, of novelty character, is used in order to determine the optimal construction variant of a control device. The rational construction of the control device confirms that the optimization method and the proposed calculation methods are correct and determine a different system configuration, new features and functions, and a specific method of working to control inaccessible surfaces.

Using a multi-scale approach to identify and quantify oil and gas emissions: a case study for GHG emissions verification

NASA Astrophysics Data System (ADS)

Sweeney, C.; Kort, E. A.; Rella, C.; Conley, S. A.; Karion, A.; Lauvaux, T.; Frankenberg, C.

2015-12-01

Along with a boom in oil and natural gas production in the US, there has been a substantial effort to understand the true environmental impact of these operations on air and water quality, as well asnet radiation balance. This multi-institution effort funded by both governmental and non-governmental agencies has provided a case study for identification and verification of emissions using a multi-scale, top-down approach. This approach leverages a combination of remote sensing to identify areas that need specific focus and airborne in-situ measurements to quantify both regional and large- to mid-size single-point emitters. Ground-based networks of mobile and stationary measurements provide the bottom tier of measurements from which process-level information can be gathered to better understand the specific sources and temporal distribution of the emitters. The motivation for this type of approach is largely driven by recent work in the Barnett Shale region in Texas as well as the San Juan Basin in New Mexico and Colorado; these studies suggest that relatively few single-point emitters dominate the regional emissions of CH4.

Analysis of airframe/engine interactions in integrated flight and propulsion control

NASA Technical Reports Server (NTRS)

Schierman, John D.; Schmidt, David K.

1991-01-01

An analysis framework for the assessment of dynamic cross-coupling between airframe and engine systems from the perspective of integrated flight/propulsion control is presented. This analysis involves to determining the significance of the interactions with respect to deterioration in stability robustness and performance, as well as critical frequency ranges where problems may occur due to these interactions. The analysis illustrated here investigates both the airframe's effects on the engine control loops and the engine's effects on the airframe control loops in two case studies. The second case study involves a multi-input/multi-output analysis of the airframe. Sensitivity studies are performed on critical interactions to examine the degradations in the system's stability robustness and performance. Magnitudes of the interactions required to cause instabilities, as well as the frequencies at which the instabilities occur are recorded. Finally, the analysis framework is expanded to include control laws which contain cross-feeds between the airframe and engine systems.

Nature's Medicines: Traditional Knowledge and Intellectual Property Management. Case Studies from the National Institutes of Health (NIH), USA

PubMed Central

Gupta, Ranjan; Gabrielsen, Bjarne; Ferguson, Steven M.

2009-01-01

With the emergence and re-emergence of infectious diseases and development of multi-drug resistance, there is a dire need to find newer cures and to produce more drugs and vaccines in the pipeline. To meet these increasing demands biomedical researchers and pharmaceutical companies are combining advanced methods of drug discovery, such as combinatorial chemistry, high-throughput screening and genomics, with conventional approaches using natural products and traditional knowledge. However, such approaches require much international cooperation and understanding of international laws and conventions as well as local customs and traditions. This article reviews the forty years of cumulative experience at the National Institutes of Health (initiated by the National Cancer Institute) in natural products drug discovery. It presents (1) three major cooperative programs (2) the legal mechanisms for cooperation and (3) illustrative case studies from these programs. We hope that these discussions and our lessons learned would be helpful to others seeking to develop their own models of cooperation for the benefit of global health. PMID:16475917

A survey of contemporary opinions and practices of surgical and intensive care specialists towards peri-operative venous thromboembolism prophylaxis in Asia.

PubMed

Lee, L; Liew, N C; Gee, T

2012-12-01

This survey was conducted to determine the opinions and practices of peri-operative venous thromboembolism (VTE) prophylaxis among surgical and intensive care specialists in Asia. A set of questionnaire was distributed to surgeons and intensivists from different countries in Asia. The specialties included were general surgery and its sub-specialties, orthopaedic surgery, gynaecological surgery and intensive care unit. This survey involved teaching institutions, general hospitals and private hospitals. To gauge if the respondents were from hospitals that would likely encounter VTE cases, the hospital's bed-strength, intensive care facility and sub-specialty services were recorded. Over a period of six months, questionnaires and feedbacks were collected and analyzed. One hundred and ninety-one responses were received from 8 countries throughout Asia. Fifty-six percent of these were from large hospitals (800 bedded or more) and 62% of these hospitals have large intensive care facility (20 or more beds). Only half of the respondents practice routine thromboprophylaxis in moderate and high risk surgeries. Thirty six percent of them practices selective thromboprophylaxis and only 3% do not believe in any thromboprophylaxis. A third prescribed thromboprophylaxis for 3 to 5 days; another third extended it until patient is mobile. About 48.6% of the respondents do not have VTE guidelines in their institutions. Majority of the respondents agreed that more evidence is needed in the form of multi-centre randomized controlled trials to influence their decision on thromboprophylaxis. Despite the availability of strong epidemiological data, randomized controlled trials and multicentre case-controlled studies, perioperative VTE prophylactic practices are still suboptimal in Asia.

Techniques for High-contrast Imaging in Multi-star Systems. II. Multi-star Wavefront Control

NASA Astrophysics Data System (ADS)

Sirbu, D.; Thomas, S.; Belikov, R.; Bendek, E.

2017-11-01

Direct imaging of exoplanets represents a challenge for astronomical instrumentation due to the high-contrast ratio and small angular separation between the host star and the faint planet. Multi-star systems pose additional challenges for coronagraphic instruments due to the diffraction and aberration leakage caused by companion stars. Consequently, many scientifically valuable multi-star systems are excluded from direct imaging target lists for exoplanet surveys and characterization missions. Multi-star Wavefront Control (MSWC) is a technique that uses a coronagraphic instrument’s deformable mirror (DM) to create high-contrast regions in the focal plane in the presence of multiple stars. MSWC uses “non-redundant” modes on the DM to independently control speckles from each star in the dark zone. Our previous paper also introduced the Super-Nyquist wavefront control technique, which uses a diffraction grating to generate high-contrast regions beyond the Nyquist limit (nominal region correctable by the DM). These two techniques can be combined as MSWC-s to generate high-contrast regions for multi-star systems at wide (Super-Nyquist) angular separations, while MSWC-0 refers to close (Sub-Nyquist) angular separations. As a case study, a high-contrast wavefront control simulation that applies these techniques shows that the habitable region of the Alpha Centauri system can be imaged with a small aperture at 8× {10}-9 mean raw contrast in 10% broadband light in one-sided dark holes from 1.6-5.5 λ/D. Another case study using a larger 2.4 m aperture telescope such as the Wide-Field Infrared Survey Telescope uses these techniques to image the habitable zone of Alpha Centauri at 3.2× {10}-9 mean raw contrast in monochromatic light.

The association of contact lens solution use and Acanthamoeba keratitis

PubMed Central

Joslin, Charlotte E.; Tu, Elmer Y.; Shoff, Megan E.; Booton, Gregory C.; Fuerst, Paul A.; McMahon, Timothy T.; Anderson, Robert J.; Dworkin, Mark S.; Sugar, Joel; Davis, Faith G.; Stayner, Leslie T.

2009-01-01

Purpose Diagnosis of Acanthamoeba keratitis, a rare but serious corneal infection, has recently increased significantly at the University of Illinois at Chicago (UIC) Cornea Service. The purpose is to investigate Acanthamoeba keratitis risk factors. Design Retrospective case-control study. Methods Setting University, tertiary care hospital. Patients Fifty-five Acanthamoeba keratitis cases with contact lens use were diagnosed between May 1, 2003 and September 15, 2006. Clinic-matched controls with contact lens use were recruited. Subjects completed surveys targeting lens hygiene, contact lens solution use, and water exposure. Main Outcome Measure Acanthamoeba keratitis. Results Thirty-nine (73.6%) cases and 113 (65.3%) controls participated; 38 cases had complete contact lens data. Thirty-five of 38 cases (92.1%) and 47 of 100 controls (47.0%) used soft lenses. Analysis was performed on 30 cases and 39 controls with matched pairs with soft lens use. Exclusive use of AMO Complete MoisturePlus Multi-Purpose Solution was independently associated with Acanthamoeba keratitis in multivariable analysis (55.2% vs. 10.5%; OR, 16.67; 95% CI, 2.11–162.63; p = 0.008). However, 38.8% of cases reported no use of AMO Complete MoisturePlus Multi-Purpose Solution or used it in combination with other solutions. Although not statistically significant, additional hygiene-related variables (solution ‘reuse’, lack of ‘rubbing’, and showering with lenses) suggest a pattern of risk,. Conclusions AMO Complete MoisturePlus Multi-Purpose Solution use is independently associated with Acanthamoeba keratitis among soft contact lens users. However, it does not explain all cases, suggesting additional factors. Further research into environmental risk factors and hygiene practices is warranted, especially considering this is the second outbreak of an atypical, contact lens-related infection. PMID:17588524

The association of contact lens solution use and Acanthamoeba keratitis.

PubMed

Joslin, Charlotte E; Tu, Elmer Y; Shoff, Megan E; Booton, Gregory C; Fuerst, Paul A; McMahon, Timothy T; Anderson, Robert J; Dworkin, Mark S; Sugar, Joel; Davis, Faith G; Stayner, Leslie T

2007-08-01

To investigate Acanthamoeba keratitis (AK) risk factors. Diagnosis of AK, a rare but serious corneal infection, has recently increased significantly at the University of Illinois at Chicago (UIC) Cornea Service. Retrospective case-control study. settings: University, tertiary care hospital. patients: Fifty-five AK cases with contact lens use were diagnosed between May 1, 2003 and September 15, 2006. Clinic-matched controls with contact lens use were recruited. Subjects completed surveys targeting lens hygiene, contact lens solution use, and water exposure. main outcome measure: Acanthamoeba keratitis. Thirty-nine (73.6%) cases and 113 (65.3%) controls participated; 38 cases had complete contact lens data. Thirty-five of 38 cases (92.1%) and 47 of 100 controls (47.0%) used soft lenses. Analysis was performed on 30 cases and 39 controls with matched pairs with soft lens use. Exclusive use of Advance Medical Optics (AMO) Complete MoisturePlus Multi-Purpose Solution was independently associated with AK in multivariable analysis (55.2% vs 10.5%; odds ratio [OR], 16.67; 95% confidence interval [CI] 2.11 to 162.63; P = .008). However, 38.8% of cases reported no use of AMO Complete MoisturePlus Multi-Purpose Solution either alone or in combination with other solutions. Although not statistically significant, additional hygiene-related variables (solution "reuse," lack of "rubbing," and showering with lenses) suggest a pattern of risk. AMO Complete MoisturePlus Multi-Purpose Solution use is independently associated with AK among soft contact lens users. However, it does not explain all cases, suggesting additional factors. Further research into environmental risk factors and hygiene practices is warranted, especially considering this is the second outbreak of an atypical, contact lens-related infection.

OUTCOME OF DOGS WITH INTRANASAL LYMPHOMA TREATED WITH VARIOUS RADIATION AND CHEMOTHERAPY PROTOCOLS: 24 CASES.

PubMed

George, Rebecca; Smith, Annette; Schleis, Stephanie; Brawner, William; Almond, Gregory; Kent, Michael; Wypij, Jackie; Borrego, Juan; Moore, Antony; Keyerleber, Michele; Kraiza, Sarah

2016-05-01

Tumors of the nasal cavity comprise approximately 1% of all neoplasms in dogs. Canine intranasal lymphoma is rare and reports evaluating the outcome of treatment are lacking. The goal of this observational, descriptive, multi-institutional study was to evaluate the overall median survival times (MSTs) in a group of dogs with intranasal lymphoma that were treated with irradiation and/or chemotherapy. Dogs meeting these inclusion criteria were retrospectively recruited from medical archives at multiple institutions. Eighteen cases of intermediate to high grade intranasal lymphoma and six cases of low-grade intranasal lymphoma were identified. The date of diagnosis, method of diagnosis, treatment received (radiation and/or chemotherapy protocols), and date of death were recorded. Kaplan-Meier survival analysis was performed on the intermediate to high grade group to calculate overall MST. Log-rank tests were performed to compare effects of treatment with radiation therapy ± chemotherapy and chemotherapy alone. Kaplan-Meier survival analysis was performed separately on the low-grade group. The overall MST was 375 days for the intermediate to high grade group. Cases treated with radiation ± chemotherapy had an MST of 455 days (n = 12) and those treated with chemotherapy alone (n = 6) had an MST of 157 days in the intermediate to high grade group. The MST was 823 days for the low-grade group. Results support the use of radiation therapy for treatment of canine intranasal lymphoma, however a randomized, controlled, clinical trial would be needed for more definitive recommendations. The role of adjunctive chemotherapy also may require further investigation. © 2016 American College of Veterinary Radiology.

A Case Study of Collaboration with Multi-Robots and Its Effect on Children's Interaction

ERIC Educational Resources Information Center

Hwang, Wu-Yuin; Wu, Sheng-Yi

2014-01-01

Learning how to carry out collaborative tasks is critical to the development of a student's capacity for social interaction. In this study, a multi-robot system was designed for students. In three different scenarios, students controlled robots in order to move dice; we then examined their collaborative strategies and their behavioral…

Providing Health Sciences Services in a Joint-Use Distributed Learning Library System: An Organizational Case Study.

PubMed

Enslow, Electra; Fricke, Suzanne; Vela, Kathryn

2017-01-01

The purpose of this organizational case study is to describe the complexities librarians face when serving a multi-campus institution that supports both a joint-use library and expanding health sciences academic partnerships. In a system without a centralized health science library administration, liaison librarians are identifying dispersed programs and user groups and collaborating to define their unique service and outreach needs within a larger land-grant university. Using a team-based approach, health sciences librarians are communicating to integrate research and teaching support, systems differences across dispersed campuses, and future needs of a new community-based medical program.

Local knowledge, science, and institutional change: the case of desertification control in Northern China.

PubMed

Yang, Lihua

2015-03-01

This article studies the influence of local knowledge on the impact of science on institutional change in ecological and environmental management. Based on an empirical study on desertification control in 12 counties in north China, the study found the following major results: (1) although there was a cubic relationship between the extent and effect of local knowledge, local knowledge significantly influenced the impact of science on institutional change; (2) local knowledge took effect mainly through affecting formal laws and regulations, major actors, and methods of desertification control in institutional change but had no significant impact on the types of property rights; and (3) local knowledge enhanced the impact of science on the results of desertification control through affecting the impact of science on institutional change. These findings provide a reference for researchers, policy makers, and practitioners, both in China and in other regions of the world, to further explore the influence of local knowledge on the impact of science on institutional change and the roles of local knowledge or knowledge in institutional change and governance.

Challenges in Credentialing Institutions and Participants in Advanced Technology Multi-institutional Clinical Trials

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

Ibbott, Geoffrey S.; Followill, David S.; Molineu, H. Andrea

The Radiological Physics Center (RPC) has functioned continuously for 38 years to assure the National Cancer Institute and the cooperative groups that institutions participating in multi-institutional trials can be expected to deliver radiation treatments that are clinically comparable to those delivered by other institutions in the cooperative groups. To accomplish this, the RPC monitors the machine output, the dosimetry data used by the institutions, the calculation algorithms used for treatment planning, and the institutions' quality control procedures. The methods of monitoring include on-site dosimetry review by an RPC physicist and a variety of remote audit tools. The introduction of advancedmore » technology clinical trials has prompted several study groups to require participating institutions and personnel to become credentialed, to ensure their familiarity and capability with techniques such as three-dimensional conformal radiotherapy, intensity-modulated radiotherapy, stereotactic body radiotherapy, and brachytherapy. The RPC conducts a variety of credentialing activities, beginning with questionnaires to evaluate an institution's understanding of the protocol and their capabilities. Treatment-planning benchmarks are used to allow the institution to demonstrate their planning ability and to facilitate a review of the accuracy of treatment-planning systems under relevant conditions. The RPC also provides mailable anthropomorphic phantoms to verify tumor dose delivery for special treatment techniques. While conducting these reviews, the RPC has amassed a large amount of data describing the dosimetry at participating institutions. Representative data from the monitoring programs are discussed, and examples are presented of specific instances in which the RPC contributed to the discovery and resolution of dosimetry errors.« less

An Approach to Find out Students' Motives and Influences on Their Selection of Studies and University: Results from Six Years of Continuous Institutional Research in a Multi-Campus System in Spain

ERIC Educational Resources Information Center

Gallifa, Josep

2009-01-01

This paper presents an institutional research on service quality conducted to analyze the students' motives and influences on their selection of studies and university. The research was carried out by collecting data from first-year students in a multi-campus system where institutions are independent in their recruitment strategies. Results from…

Education Unit Transformation for Maintain Its Existence in Islamic Boarding School (Multi-Case Study on Tebuireng Islamic Boarding School, Gading Islamic Boarding School Malang, and Sidogiri Islamic Boarding School Pasuruan)

ERIC Educational Resources Information Center

Busyairi AS, M.

2017-01-01

Islamic Boarding School which serves as native Islamic education institution is a continuation of education tradition grown strongly in Islamization history in unitary nation Republic of Indonesia. The education of Islamic Boarding School is also a sub-system of National Education with the purpose to make intelligent national life, to make…

Mild asthma and chronic bronchitis seem to influence functional exercise capacity: a multi-case control study.

PubMed

Marcon, Alessandro; Girardi, Paolo; Ferrari, Marcello; Olivieri, Mario; Accordini, Simone; Bombieri, Cristina; Bortolami, Oscar; Braggion, Marco; Cappa, Veronica; Cazzoletti, Lucia; Locatelli, Francesca; Nicolis, Morena; Perbellini, Luigi; Sembeni, Silvia; Verlato, Giuseppe; Zanolin, Maria Elisabetta; de Marco, Roberto

2013-01-01

In the Genes Environment Interaction in Respiratory Diseases population-based multi-case control study, we investigated whether asthma, chronic bronchitis (CB) and rhinitis were associated with a reduced 6-minute walk distance (6MWD), and whether the 6MWD determinants were similar for subjects with/without respiratory diseases. Cases of asthma (n = 360), CB (n = 120), rhinitis (n = 203) and controls (no respiratory diseases: n = 302) were recruited. The variation in the 6MWD across the groups was analyzed by ANCOVA, adjusting for gender, age, height, weight and comorbidity. The 6MWD determinants were studied by linear regression, and heterogeneity across the cases and controls was investigated. The 6MWD differed across cases and controls (p = 0.01). It was shorter for cases of asthma (-17.1, 95% CI -28.3 to -5.8 m) and CB (-20.7, 95% CI: -36.6 to -4.8 m) than for controls (604 ± 68 m on average), but not for cases of rhinitis. The negative association between age and the 6MWD was significant for cases of CB, but not for the other groups (p = 0.001). Even at the level of severity found in the general population, asthma and CB could influence the 6MWD, which seems to reflect the functional exercise level for daily physical activities. The negative association between ageing and the 6MWD was particularly strong in subjects with CB. Our report adds to the mounting evidence that CB is not a trivial condition, especially in the ageing adult population, and it supports the importance of monitoring functional capacity and of physical reconditioning in mild asthma. Copyright © 2013 S. Karger AG, Basel.

Enrolling the Tide: A Case Study of Purposeful Campus Enrollment Increases

ERIC Educational Resources Information Center

Hutt, Chris D.; Bray, Nathaniel J.; Jones, Jennifer L.; Leach, Kelly; Ward, Jerome

2010-01-01

Enrollment management is an institutional function that has enjoyed burgeoning attention since the 1970s. The primary function of enrollment management is to control the size and composition of students within an institution. As the number of higher education institutions increased and as the number of high school graduates stagnated--particularly…

Retention Strategies for Health Disparities Preventive Trials: Findings from the Early Childhood Caries Collaborating Centers

PubMed Central

Garcia, Raul I.; Tiwari, Tamanna; Ramos-Gomez, Francisco; Heaton, Brenda; Orozco, Mario; Rasmussen, Margaret; Braun, Patricia; Henshaw, Michelle; Borrelli, Belinda; Albino, Judith; Vargas, Clemencia; Diamond, Courtney; Gebel, Christina; Batliner, Terrence S.; Barker, Judith; Gregorich, Steven; Gansky, Stuart A.

2017-01-01

Objectives To identify successful strategies for retention of participants in multi-year, community-based randomized controlled trials (RCTs) aiming to reduce early childhood caries in health disparities populations from diverse racial/ethnic backgrounds and across diverse geographic settings. Methods Four RCTs conducted by the Early Childhood Caries Collaborating Centers (EC4), an initiative of the National Institute of Dental and Craniofacial Research, systematically collected information on the success of various strategies implemented to promote participant retention in each RCT. The observational findings from this case series of four RCTs were tabulated and the strategies rated by study staff. Results Participant retention at 12 months of follow-up ranged from 52.8% to 91.7%, and at 24 months ranged from 53.6% to 85.9, across the four RCT. For the three RCT that had a 36 month follow-up, retention ranged from 53.6% to 85.1%. Effectiveness of different participant retention strategies varied widely across the RCT. Conclusions Findings from this case series study may help to guide the design of future RCTs to maximize retention of study participants and yield needed data on effective interventions to reduce oral health disparities. PMID:27759164

A tuning algorithm for model predictive controllers based on genetic algorithms and fuzzy decision making.

PubMed

van der Lee, J H; Svrcek, W Y; Young, B R

2008-01-01

Model Predictive Control is a valuable tool for the process control engineer in a wide variety of applications. Because of this the structure of an MPC can vary dramatically from application to application. There have been a number of works dedicated to MPC tuning for specific cases. Since MPCs can differ significantly, this means that these tuning methods become inapplicable and a trial and error tuning approach must be used. This can be quite time consuming and can result in non-optimum tuning. In an attempt to resolve this, a generalized automated tuning algorithm for MPCs was developed. This approach is numerically based and combines a genetic algorithm with multi-objective fuzzy decision-making. The key advantages to this approach are that genetic algorithms are not problem specific and only need to be adapted to account for the number and ranges of tuning parameters for a given MPC. As well, multi-objective fuzzy decision-making can handle qualitative statements of what optimum control is, in addition to being able to use multiple inputs to determine tuning parameters that best match the desired results. This is particularly useful for multi-input, multi-output (MIMO) cases where the definition of "optimum" control is subject to the opinion of the control engineer tuning the system. A case study will be presented in order to illustrate the use of the tuning algorithm. This will include how different definitions of "optimum" control can arise, and how they are accounted for in the multi-objective decision making algorithm. The resulting tuning parameters from each of the definition sets will be compared, and in doing so show that the tuning parameters vary in order to meet each definition of optimum control, thus showing the generalized automated tuning algorithm approach for tuning MPCs is feasible.

Does low to moderate environmental exposure to noise and air pollution influence preterm delivery in medium-sized cities?

PubMed

Barba-Vasseur, Marie; Bernard, Nadine; Pujol, Sophie; Sagot, Paul; Riethmuller, Didier; Thiriez, Gérard; Houot, Hélène; Defrance, Jérôme; Mariet, Anne-Sophie; Luu, Vinh-Phuc; Barbier, Alice; Benzenine, Eric; Quantin, Catherine; Mauny, Frédéric

2017-12-01

Preterm birth (PB) is an important predictor of childhood morbidity and educational performance. Beyond the known risk factors, environmental factors, such as air pollution and noise, have been implicated in PB. In urban areas, these pollutants coexist. Very few studies have examined the effects of multi-exposure on the pregnancy duration. The objective of this study was to analyse the relationship between PB and environmental chronic multi-exposure to noise and air pollution in medium-sized cities. A case-control study was conducted among women living in the city of Besançon (121 671 inhabitants) or in the urban unit of Dijon (243 936 inhabitants) and who delivered in a university hospital between 2005 and 2009. Only singleton pregnancies without associated pathologies were considered. Four controls were matched to each case in terms of the mother's age and delivery location. Residential noise and nitrogen dioxide (NO2) exposures were calculated at the mother's address. Conditional logistic regression models were applied, and sensitivity analyses were performed. This study included 302 cases and 1204 controls. The correlation between noise and NO2 indices ranged from 0.41 to 0.59. No significant differences were found in pollutant exposure levels between cases and controls. The adjusted odds ratios ranged between 0.96 and 1.08. Sensitivity analysis conducted using different temporal and spatial exposure windows demonstrated the same results. The results are in favour of a lack of connection between preterm delivery and multi-exposure to noise and air pollution in medium-sized cities for pregnant women without underlying disease. © The Author 2017; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association

Studying fire mitigation strategies in multi-ownership landscapes: balancing the management of fire-dependent ecosystems and fire risk

Treesearch

Brian R. Sturtevant; Brian R. Miranda; Jian Yang; Hong S. He; Eric J. Gustafson; Robert M. Scheller

2009-01-01

Public forests are surrounded by land over which agency managers have no control, and whose owners expect the public forest to be a "good neighbor." Fire risk abatement on multi-owner landscapes containing flammable but fire-dependent ecosystems epitomizes the complexities of managing public lands. We report a case study that applies a landscape disturbance...

Benefits for Women and Men of Inquiry-Based Learning in College Mathematics: A Multi-Institution Study

ERIC Educational Resources Information Center

Laursen, Sandra L.; Hassi, Marja-Liisa; Kogan, Marina; Weston, Timothy J.

2014-01-01

Slow faculty uptake of research-based, student-centered teaching and learning approaches limits the advancement of U.S. undergraduate mathematics education. A study of inquiry-based learning (IBL) as implemented in over 100 course sections at 4 universities provides an example of such multicourse, multi-institution uptake. Despite variation in how…

Does cataract surgery alleviate poverty? Evidence from a multi-centre intervention study conducted in Kenya, the Philippines and Bangladesh.

PubMed

Kuper, Hannah; Polack, Sarah; Mathenge, Wanjiku; Eusebio, Cristina; Wadud, Zakia; Rashid, Mamunur; Foster, Allen

2010-11-09

Poverty and blindness are believed to be intimately linked, but empirical data supporting this purported relationship are sparse. The objective of this study is to assess whether there is a reduction in poverty after cataract surgery among visually impaired cases. A multi-centre intervention study was conducted in three countries (Kenya, Philippines, Bangladesh). Poverty data (household per capita expenditure--PCE, asset ownership and self-rated wealth) were collected from cases aged ≥50 years who were visually impaired due to cataract (visual acuity<6/24 in the better eye) and age-sex matched controls with normal vision. Cases were offered free/subsidised cataract surgery. Approximately one year later participants were re-interviewed about poverty. 466 cases and 436 controls were examined at both baseline and follow-up (Follow up rate: 78% for cases, 81% for controls), of which 263 cases had undergone cataract surgery ("operated cases"). At baseline, operated cases were poorer compared to controls in terms of PCE (Kenya: $22 versus £35 p = 0.02, Bangladesh: $16 vs $24 p = 0.004, Philippines: $24 vs 32 p = 0.0007), assets and self-rated wealth. By follow-up PCE had increased significantly among operated cases in each of the three settings to the level of controls (Kenya: $30 versus £36 p = 0.49, Bangladesh: $23 vs $23 p = 0.20, Philippines: $45 vs $36 p = 0.68). There were smaller increases in self-rated wealth and no changes in assets. Changes in PCE were apparent in different socio-demographic and ocular groups. The largest PCE increases were apparent among the cases that were poorest at baseline. This study showed that cataract surgery can contribute to poverty alleviation, particularly among the most vulnerable members of society. This study highlights the need for increased provision of cataract surgery to poor people and shows that a focus on blindness may help to alleviate poverty and achieve the Millennium Development Goals.

A case study in nonlinear dynamics and control of articulated spacecraft: The Space Station Freedom with a mobile remote manipulator system

NASA Technical Reports Server (NTRS)

Bennett, William H.; Kwatny, Harry G.; Lavigna, Chris; Blankenship, Gilmer

1994-01-01

The following topics are discussed: (1) modeling of articulated spacecraft as multi-flex-body systems; (2) nonlinear attitude control by adaptive partial feedback linearizing (PFL) control; (3) attitude dynamics and control for SSF/MRMS; and (4) performance analysis results for attitude control of SSF/MRMS.

Multi-phase post-mortem CT-angiography: a pathologic correlation study on cardiovascular sudden death

PubMed Central

Turillazzi, Emanuela; Frati, Paola; Pascale, Natascha; Pomara, Cristoforo; Grilli, Giampaolo; Viola, Rocco Valerio; Fineschi, Vittorio

2016-01-01

Multi-phase post-mortem CT-angiography (MPMCTA) has the great potential to increase the quality of the post-mortem investigation, especially in the area of sudden death; however, its role as routine complement to the pathology toolbox is still questioned as it needs to be further standardized. The aim of this study is to investigate the contribution of MPMCTA in cases of sudden unexplained death in adults and in particular in sudden cardiovascular death. Sixty-eight sudden unexpected deaths of adults were investigated at our institution between 2012 and 2013. Ten cases underwent MPMCTA and autopsy and were included in the study. Before the angiographic step by complete filling of the vascular system, prior to any manipulation of the body, a non-contrast CT-scan was carried out. Image reconstructions were performed on a CT workstation (Vitrea) and two radiologists experienced with post mortem imaging interpreted the MPMCTA findings. In all 10 cases, we could state a good correlation between combination of post-mortem CT and MPMCTA and autopsy procedures, confirming a high diagnostic sensitivity. With this case series we want to illustrate the advantages offered by performing MPMCTA when facing a sudden death, regardless of specific suspicion for acute coronary syndrome or other vascular or ischemic disease. PMID:27928228

Double KRAS and BRAF Mutations in Surgically Treated Colorectal Cancer Liver Metastases: An International, Multi-institutional Case Series.

PubMed

Deshwar, Amar; Margonis, Georgios Antonios; Andreatos, Nikolaos; Barbon, Carlotta; Wang, Jaeyun; Buettner, Stefan; Wagner, Doris; Sasaki, Kazunari; Beer, Andrea; Løes, Inger Marie; Pikoulis, Emmanouil; Damaskos, Christos; Garmpis, Nikolaos; Kamphues, Karsten; He, Jin; Kaczirek, Klaus; Poultsides, George; Lønning, Per Eystein; Mischinger, Hans Joerg; Aucejo, Federico N; Kreis, Martin E; Wolfgang, Christopher L; Weiss, Matthew J

2018-05-01

While previously believed to be mutually exclusive, concomitant mutation of Kirsten rat sarcoma viral oncogene homolog (KRAS)- and V-raf murine sarcoma b-viral oncogene homolog B1 (BRAF)-mutated colorectal carcinoma (CRC), has been described in rare instances and been associated with advanced-stage disease. The present case series is the first to report on the implications of concurrent KRAS/BRAF mutations among surgically treated patients, and the largest set of patients with surgically treated colorectal liver metastasis (CRLM) and data on KRAS/BRAF mutational status thus far described. We present cases from an international, multi-institutional cohort of patients that underwent hepatic resection for CRLM between 2000-2015 at seven tertiary centers. The incidence of KRAS/BRAF mutation in patients with CRLM was 0.5% (4/820). Of these cases, patient 1 (T2N1 primary, G13D/V600E), patient 2 (T3N1 primary, G12V/V600E) and patient 3 (T4N2 primary, G13D/D594N) succumbed to their disease within 485, 236 and 79 days respectively, post-hepatic resection. Patient 4 (T4 primary, G12S/G469S) was alive 416 days after hepatic resection. The present case series suggests that the incidence of concomitant KRAS/BRAF mutations in surgical cohorts may be higher than previously hypothesized, and associated with more variable survival outcomes than expected. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Backend Control Processor for a Multi-Processor Relational Database Computer System.

DTIC Science & Technology

1984-12-01

SCHOOL OF ENGI. UNCRSIFID MPONTIFF DEC 84 AFXT/GCS/ENG/84D-22 F/O 9/2 L ommhhhhmhhml mhhhommhhhhhm i-2 8 -- U0. 11111= Q. 2 111.8IIII- 1111111..6...THESIS Presented to the Faculty of the School of Engineering of the Air Force Institute of Technology Air University In Partial Fulfillment of the...development of a Backend Multi-Processor Relational Database Computer System. This thesis addresses a single component of this system, the Backend Control

25-hydroxyvitamin D and breast cancer, colorectal cancer, and colorectal adenomas: case-control versus nested case-control studies.

PubMed

Grant, William B

2015-02-01

Existing literature includes concerns regarding reliability of case-control studies of breast cancer incidence with respect to 25-hydroxyvitamin D (25(OH)D) concentrations. For breast cancer, only case-control studies consistently find inverse correlations between 25(OH)D and breast cancer. However, for colorectal cancer, nested case-control studies find significant inverse correlations with respect to 25(OH)D concentrations at baseline for mean follow-up times of 7 years. This is a review of results currently existing in literature. I provide evidence that 25(OH)D concentration values are only useful for short follow-up times for breast cancer since it develops rapidly. To support the robust nature of breast cancer case-control studies, I show that results from 11 studies from seven countries align in a robust power-law fit to the odds ratio versus mean 25(OH)D concentrations. Case-control studies of breast cancer incidence rates provide reliable results. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Climate change induced risk analysis of Dar es Salaam city (Tanzania)

NASA Astrophysics Data System (ADS)

Topa, Maria Elena; Herslund, Lise; Cavan, Gina; Printz, Andreas; Simonis, Ingo; Bucchignani, Edoardo; Jean-Baptiste, Nathalie; Hellevik, Siri; Johns, Regina; Kibassa, Deusdedit; Kweka, Clara; Magina, Fredrick; Mangula, Alpha; Mbuya, Elinorata; Uhinga, Guido; Kassenga, Gabriel; Kyessi, Alphonce; Shemdoe, Riziki; Kombe, Wilbard

2013-04-01

CLUVA (CLimate change and Urban Vulnerability in Africa; http://www.cluva.eu/) is a 3 years project, funded by the European Commission in 2010. The main objective of CLUVA is to develop context-centered methods and knowledge to be applied to African cities to assess vulnerabilities and increase knowledge on managing climate related risks. The project estimates the impacts of climate changes in the next 40 years at urban scale and downscales IPCC climate projections to evaluate specific threats to selected African test cities. These are mainly from floods, sea-level rise, droughts, heat waves, and desertification. The project evaluates and links: social vulnerability; urban green structures and ecosystem services; urban-rural interfaces; vulnerability of urban built environment and lifelines; and related institutional and governance dimensions of adaptation. The multi-scale and multi-disciplinary qualitative, quantitative and probabilistic approach of CLUVA is currently being applied to selected African test cities (Addis Ababa - Ethiopia; Dar es Salaam - Tanzania; Douala - Cameroun; Ouagadougou - Burkina Faso; St. Louis - Senegal). In particular, the poster will present preliminary findings for the Dar es Salaam case study. Dar es Salaam, which is Tanzania's largest coastal city, is exposed to floods, coastal erosion, droughts and heat waves, and highly vulnerable to impacts as a result of ineffective urban planning (about 70% unplanned settlements), poverty and lack of basic infrastructure (e.g. lack of or poor quality storm water drainage systems). Climate change could exacerbate the current situation increasing hazard-exposure alongside the impacts of development pressures which act to increase urban vulnerability for example because of informal (unregulated) urbanization. The CLUVA research team - composed of climate and environmental scientists, risk management experts, urban planners and social scientists from both European and African institutions - has started to produce research outputs suitable for use in evidence-based planning activities in the case study cities through interdisciplinary methods and analysis. Climate change projections at 8 km resolution are ready for regions containing each of the case study cities; a preliminary hazard assessment for floods, droughts and heat waves has been performed, based on historical data; urban morphology and related green structures have been characterized; preliminary findings in social vulnerability provide insights how communities and households can resist and cope with, as well as recover from climate induced hazards; vulnerability of informal settlements to floods has been assessed for a case study area (Suna sub ward) and a GIS based identification of urban residential hotspots to flooding is completed. Furthermore, a set of indicators has been identified and the most relevant for Dar es Salaam has been selected by local stakeholders to identify particular vulnerable high risk areas and communities. An investigation of the existing urban planning and governance system and its interface with climate risks and vulnerability has inter-alia suggested severe institutional deficits including over-centralized institutions for disaster risk management and climate change adaptation. A multi-risk framework considering climate-related hazards, and physical and social fragilities has been set up.

A manual-based individual therapy to improve metacognition in schizophrenia: protocol of a multi-center RCT

PubMed Central

2014-01-01

Background Metacognitive dysfunction has been widely recognized as a feature of schizophrenia. As it is linked with deficits in several aspects of daily life functioning, improvement of metacognition may lead to improvement in functioning. Individual psychotherapy might be a useful form of treatment to improve metacognition in patients with schizophrenia; multiple case reports and a pilot study show promising results. The present study aims to measure the effectiveness of an individual, manual-based therapy (Metacognitive Reflection and Insight Therapy, MERIT) in improving metacognition in patients with schizophrenia. We also want to examine if improvement in metacognitive abilities is correlated with improvements in aspects of daily life functioning namely social functioning, experience of symptoms, quality of life, depression, work readiness, insight and experience of stigma. Methods/Design MERIT is currently evaluated in a multicenter randomized controlled trial. Thirteen therapists in six mental health institutions in the Netherlands participate in this study. Patients are randomly assigned to either MERIT or the control condition: treatment as usual (TAU). Discussion If proven effective, MERIT can be a useful addition to the care for schizophrenia patients. The design brings along some methodological difficulties, these issues are addressed in the discussion of this paper. Trial registration Current Controlled Trials: ISRCTN16659871. PMID:24490942

Raising standards while watching the bottom line: making a business case for infection control.

PubMed

Perencevich, Eli N; Stone, Patricia W; Wright, Sharon B; Carmeli, Yehuda; Fisman, David N; Cosgrove, Sara E

2007-10-01

While society would benefit from a reduced incidence of nosocomial infections, there is currently no direct reimbursement to hospitals for the purpose of infection control, which forces healthcare institutions to make economic decisions about funding infection control activities. Demonstrating value to administrators is an increasingly important function of the hospital epidemiologist because healthcare executives are faced with many demands and shrinking budgets. Aware of the difficulties that face local infection control programs, the Society for Healthcare Epidemiology of America (SHEA) Board of Directors appointed a task force to draft this evidence-based guideline to assist hospital epidemiologists in justifying and expanding their programs. In Part 1, we describe the basic steps needed to complete a business-case analysis for an individual institution. A case study based on a representative infection control intervention is provided. In Part 2, we review important basic economic concepts and describe approaches that can be used to assess the financial impact of infection prevention, surveillance, and control interventions, as well as the attributable costs of specific healthcare-associated infections. Both parts of the guideline aim to provide the hospital epidemiologist, infection control professional, administrator, and researcher with the tools necessary to complete a thorough business-case analysis and to undertake an outcome study of a nosocomial infection or an infection control intervention.

Natural disaster management: experience of an academic institution after a 7.8 magnitude earthquake in Ecuador.

PubMed

Cordero-Reyes, A M; Palacios, I; Ramia, D; West, R; Valencia, M; Ramia, N; Egas, D; Rodas, P; Bahamonde, M; Grunauer, M

2017-03-01

This case study describes the implementation of an academic institution's disaster management plan. Case study. USFQ's Medical School developed a six-phase disaster relief plan consisting of: induction, establishing a base camp, crisis management and mental health aid, creation of multidisciplinary teams and multi-agency teams, and reconstruction. Each phase uses a community-oriented approach to foster survivor autonomy and recovery. Our methodology facilitated the successful implementation of multidisciplinary interventions to manage the earthquake's aftermath on the personal, community and regional levels, treated and prevented psychological and physical morbidity among survivors and promoted healthy living conditions and independence. A multidisciplinary response team that addresses medical needs, mental health, education, food, nutrition and sanitation is highly effective in contributing to timely, effective relief efforts. The short- and long-term solutions we describe could be applicable to other academic centres' interventions in future disaster scenarios around the world. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

A Successful Model of Collaborative Undergraduate Research: A Multi-Faculty, Multi-Project, Multi-Institution Team Approach

ERIC Educational Resources Information Center

Woodzicka, Julie A.; Ford, Thomas E.; Caudill, Abbie; Ohanmamooreni, Alyna

2015-01-01

A collaborative research grant from the National Science Foundation allowed the first two authors to provide students at primarily undergraduate institutions with a multi-faculty, multi-institution team research experience. Teams of undergraduate students at Western Carolina University and Washington and Lee University collaborated with one…

Pathways to Undergraduate Research Experiences: A Multi-Institutional Study

ERIC Educational Resources Information Center

Mahatmya, Duhita; Morrison, Janet; Jones, Rebecca M.; Garner, Pamela W.; Davis, Shannon N.; Manske, Jill; Berner, Nancy; Johnson, Ann; Ditty, Jayna

2017-01-01

The positive impact of undergraduate research experiences on students' post-secondary success is well-documented. However, these conclusions are drawn from undergraduate students who already participate; very little research has explored the pathways by which students enter these experiences. Using data from a multi-institutional survey, we…

34 CFR 675.47 - Multi-institutional work-colleges arrangements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 3 2010-07-01 2010-07-01 false Multi-institutional work-colleges arrangements. 675.47 Section 675.47 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION FEDERAL WORK-STUDY PROGRAMS Work-Colleges Program § 675.47...

Real-Time PCR Typing of Escherichia coli Based on Multiple Single Nucleotide Polymorphisms--a Convenient and Rapid Method.

PubMed

Lager, Malin; Mernelius, Sara; Löfgren, Sture; Söderman, Jan

2016-01-01

Healthcare-associated infections caused by Escherichia coli and antibiotic resistance due to extended-spectrum beta-lactamase (ESBL) production constitute a threat against patient safety. To identify, track, and control outbreaks and to detect emerging virulent clones, typing tools of sufficient discriminatory power that generate reproducible and unambiguous data are needed. A probe based real-time PCR method targeting multiple single nucleotide polymorphisms (SNP) was developed. The method was based on the multi locus sequence typing scheme of Institute Pasteur and by adaptation of previously described typing assays. An 8 SNP-panel that reached a Simpson's diversity index of 0.95 was established, based on analysis of sporadic E. coli cases (ESBL n = 27 and non-ESBL n = 53). This multi-SNP assay was used to identify the sequence type 131 (ST131) complex according to the Achtman's multi locus sequence typing scheme. However, it did not fully discriminate within the complex but provided a diagnostic signature that outperformed a previously described detection assay. Pulsed-field gel electrophoresis typing of isolates from a presumed outbreak (n = 22) identified two outbreaks (ST127 and ST131) and three different non-outbreak-related isolates. Multi-SNP typing generated congruent data except for one non-outbreak-related ST131 isolate. We consider multi-SNP real-time PCR typing an accessible primary generic E. coli typing tool for rapid and uniform type identification.

External Accountability of Collaborative Arrangements; A Case Study of a Multi Academy Trust in England

ERIC Educational Resources Information Center

Ehren, Melanie C. M.; Godfrey, David

2017-01-01

This paper explores the impact of external accountability on four mechanisms of network-internal quality control and the properties of (mandated) inter-organizational networks. An explorative case study approach examines the external accountability of a newly established educational network (MAT) and how schools and the Trust are held accountable…

The clinical features and prognosis of mumps-associated hearing loss: a retrospective, multi-institutional investigation in Japan.

PubMed

Morita, Shinya; Fujiwara, Keishi; Fukuda, Atsushi; Fukuda, Satoshi; Nishio, Shin-Ya; Kitoh, Ryosuke; Hato, Naohito; Ikezono, Tetsuo; Ishikawa, Kotaro; Kaga, Kimitaka; Matsubara, Atsushi; Matsunaga, Tatsuo; Murata, Takaaki; Naito, Yasushi; Nishizaki, Kazunori; Ogawa, Kaoru; Sano, Hajime; Sato, Hiroaki; Sone, Michihiko; Suzuki, Mikio; Takahashi, Haruo; Tono, Tetsuya; Yamashita, Hiroshi; Yamasoba, Tatsuya; Usami, Shin-Ichi

2017-01-01

The majority of hearing loss due to mumps presents as unilateral profound sensorineural hearing loss, which is refractory to treatment. In rare cases of bilateral total deafness, cochlear implants were beneficial for speech perception. Vaccination against mumps is recommended to prevent mumps-associated hearing loss. The objective of this study is to investigate the clinical characteristics of hearing loss due to mumps and to evaluate hearing outcomes. The clinical parameters were analyzed under a retrospective multi-institutional study design in patients diagnosed with hearing loss due to mumps at the Otolaryngology departments of 19 hospitals between 1987 and 2016. Sixty-seven patients with hearing loss due to mumps were enrolled. The study population consisted of 35 males and 32 females, ranging in age from 1 to 54, with a median age of 9.5 years. Sixty-three patients presented with unilateral, and 4 with bilateral hearing loss. Profound hearing loss was observed in 65 ears. Only one ear with severe hearing loss showed complete recovery. Four patients with bilateral hearing loss received cochlear implant surgery. Most of the patients with hearing loss due to mumps had no history of vaccination.

The Hazard of Graduation: Analysis of Three Multivariate Statistics Used to Study Multi-Institutional Attendance

ERIC Educational Resources Information Center

Muehlberg, Jessica Marie

2013-01-01

Adelman (2006) observed that a large quantity of research on retention is "institution-specific or use institutional characteristics as independent variables" (p. 81). However, he observed that over 60% of the students he studied attended multiple institutions making the calculation of institutional effects highly problematic. He argued…

Multiple-function multi-input/multi-output digital control and on-line analysis

NASA Technical Reports Server (NTRS)

Hoadley, Sherwood T.; Wieseman, Carol D.; Mcgraw, Sandra M.

1992-01-01

The design and capabilities of two digital controller systems for aeroelastic wind-tunnel models are described. The first allowed control of flutter while performing roll maneuvers with wing load control as well as coordinating the acquisition, storage, and transfer of data for on-line analysis. This system, which employs several digital signal multi-processor (DSP) boards programmed in high-level software languages, is housed in a SUN Workstation environment. A second DCS provides a measure of wind-tunnel safety by functioning as a trip system during testing in the case of high model dynamic response or in case the first DCS fails. The second DCS uses National Instruments LabVIEW Software and Hardware within a Macintosh environment.

Different approaches for centralized and decentralized water system management in multiple decision makers' problems

NASA Astrophysics Data System (ADS)

Anghileri, D.; Giuliani, M.; Castelletti, A.

2012-04-01

There is a general agreement that one of the most challenging issues related to water system management is the presence of many and often conflicting interests as well as the presence of several and independent decision makers. The traditional approach to multi-objective water systems management is a centralized management, in which an ideal central regulator coordinates the operation of the whole system, exploiting all the available information and balancing all the operating objectives. Although this approach allows to obtain Pareto-optimal solutions representing the maximum achievable benefit, it is based on assumptions which strongly limits its application in real world contexts: 1) top-down management, 2) existence of a central regulation institution, 3) complete information exchange within the system, 4) perfect economic efficiency. A bottom-up decentralized approach seems therefore to be more suitable for real case applications since different reservoir operators may maintain their independence. In this work we tested the consequences of a change in the water management approach moving from a centralized toward a decentralized one. In particular we compared three different cases: the centralized management approach, the independent management approach where each reservoir operator takes the daily release decision maximizing (or minimizing) his operating objective independently from each other, and an intermediate approach, leading to the Nash equilibrium of the associated game, where different reservoir operators try to model the behaviours of the other operators. The three approaches are demonstrated using a test case-study composed of two reservoirs regulated for the minimization of flooding in different locations. The operating policies are computed by solving one single multi-objective optimal control problem, in the centralized management approach; multiple single-objective optimization problems, i.e. one for each operator, in the independent case; using techniques related to game theory for the description of the interaction between the two operators, in the last approach. Computational results shows that the Pareto-optimal control policies obtained in the centralized approach dominate the control policies of both the two cases of decentralized management and that the so called price of anarchy increases moving toward the independent management approach. However, the Nash equilibrium solution seems to be the most promising alternative because it represents a good compromise in maximizing management efficiency without limiting the behaviours of the reservoir operators.

Genomic Diversity and the Microenvironment as Drivers of Progression in DCIS

DTIC Science & Technology

2015-10-01

integration of team members over the past year via frequent conferencing , face to face meetings, and constant communication. This multi-disciplinary...several searches into our electronic medical records to identify qualifying DCIS cases from our institution. From over 1300 initial candidates, we have

Mexican American Male Masquerades in the Institution as Bully

ERIC Educational Resources Information Center

Oesterreich, Heather A.; Sosa-Provencio, Mia A.; Anatska, Tamara

2017-01-01

This Black and Chicana Feminist case study challenges national discourse surrounding school bullying as individualistic, student-centered. We explore the warrior lens of Mexican/Mexican-American males. While masquerading institutional compliance, they simultaneously unmask policies, practices as the means to control mind/bodies/spirit. This…

Genetic Basis of Autoantibody Positive and Negative Rheumatoid Arthritis Risk in a Multi-ethnic Cohort Derived from Electronic Health Records

PubMed Central

Kurreeman, Fina; Liao, Katherine; Chibnik, Lori; Hickey, Brendan; Stahl, Eli; Gainer, Vivian; Li, Gang; Bry, Lynn; Mahan, Scott; Ardlie, Kristin; Thomson, Brian; Szolovits, Peter; Churchill, Susanne; Murphy, Shawn N.; Cai, Tianxi; Raychaudhuri, Soumya; Kohane, Isaac; Karlson, Elizabeth; Plenge, Robert M.

2011-01-01

Discovering and following up on genetic associations with complex phenotypes require large patient cohorts. This is particularly true for patient cohorts of diverse ancestry and clinically relevant subsets of disease. The ability to mine the electronic health records (EHRs) of patients followed as part of routine clinical care provides a potential opportunity to efficiently identify affected cases and unaffected controls for appropriate-sized genetic studies. Here, we demonstrate proof-of-concept that it is possible to use EHR data linked with biospecimens to establish a multi-ethnic case-control cohort for genetic research of a complex disease, rheumatoid arthritis (RA). In 1,515 EHR-derived RA cases and 1,480 controls matched for both genetic ancestry and disease-specific autoantibodies (anti-citrullinated protein antibodies [ACPA]), we demonstrate that the odds ratios and aggregate genetic risk score (GRS) of known RA risk alleles measured in individuals of European ancestry within our EHR cohort are nearly identical to those derived from a genome-wide association study (GWAS) of 5,539 autoantibody-positive RA cases and 20,169 controls. We extend this approach to other ethnic groups and identify a large overlap in the GRS among individuals of European, African, East Asian, and Hispanic ancestry. We also demonstrate that the distribution of a GRS based on 28 non-HLA risk alleles in ACPA+ cases partially overlaps with ACPA- subgroup of RA cases. Our study demonstrates that the genetic basis of rheumatoid arthritis risk is similar among cases of diverse ancestry divided into subsets based on ACPA status and emphasizes the utility of linking EHR clinical data with biospecimens for genetic studies. PMID:21211616

Violent youth groups in Indonesia: the cases of Yogyakarta and Nusa Tenggara Barat.

PubMed

Kristiansen, Stein

2003-01-01

Problems of violent youth groups have escalated in Indonesia, following economic recession, unemployment, and weakened state institutions. Young people have been hit by the lack of income and broken expectations. In consequence, youth groups emerge and arrange for members' economic revenue as well as identity creation and confidence. Religion in some cases is used to legitimize violence and to strengthen the boldness of group members. The paper offers a brief overview of gangster (preman) traditions in Indonesia. Empirical findings on violent youth groups in the two selected provinces are presented within a multi-factor analytical framework, where the need for income and identity strengthening, political élite interests, and the lack of law enforcement contribute to explaining criminal and vigilante violence. Interviews with leaders and members of movements engaged in violent actions offer insights into a problem that threatens national security and control.

A Multi-Level Examination of College and Its Influence on Ecumenical Worldview Development

ERIC Educational Resources Information Center

Mayhew, Matthew J.

2012-01-01

This multi-level, longitudinal study investigated the ecumenical worldview development of 13,932 students enrolled in one of 126 institutions. Results indicated that the final hierarchical linear model, consisting of institution-and-student-level predictors as well as slopes explaining the relationships among some of these predictors, explained…

Multi-Institution Research Centers: Planning and Management Challenges

ERIC Educational Resources Information Center

Spooner, Catherine; Lavey, Lisa; Mukuka, Chilandu; Eames-Brown, Rosslyn

2016-01-01

Funding multi-institution centers of research excellence (CREs) has become a common means of supporting collaborative partnerships to address specific research topics. However, there is little guidance for those planning or managing a multi-institution CRE, which faces specific challenges not faced by single-institution research centers. We…

Enabling multi-faceted measures of success for protected area management in Trinidad and Tobago.

PubMed

Granderson, Ainka A

2011-08-01

A key challenge has been to define and measure "success" in managing protected areas. A case study was conducted of efforts to evaluate the new protected area management system in Trinidad and Tobago using a participatory approach. The aim of the case study was to (1) examine whether stakeholder involvement better captures the multi-faceted nature of success and (2) identify the role and influence of various stakeholder groups in this process. An holistic and systematic framework was developed with stakeholder input that facilitated the integration of expert and lay knowledge, a broad emphasis on ecological, socio-economic, and institutional aspects, and the use of both quantitative and qualitative data allowing the evaluation to capture the multi-faceted nature and impacts of protected area management. Input from primary stakeholders, such as local communities, was critical as they have a high stake in protected area outcomes. Secondary and external stakeholders, including government agencies, non-governmental organizations, academia and the private sector, were also important in providing valuable technical assistance and serving as mediators. However, a lack of consensus over priorities, politics, and limited stakeholder capacity and data access pose significant barriers to engaging stakeholders to effectively measure the management success of protected areas. Copyright © 2011 Elsevier Ltd. All rights reserved.

Optimizing RNA Extraction of Renal Papilla Biopsy Tissue in Kidney Stone Formers: A New Methodology for Genomic Study.

PubMed

Taguchi, Kazumi; Usawachintachit, Manint; Hamamoto, Shuzo; Unno, Rei; Tzou, David T; Sherer, Benjamin A; Wang, Yongmei; Okada, Atsushi; Stoller, Marshall L; Yasui, Takahiro; Chi, Thomas

2017-09-01

Endoscopic tools have provided versatile examination and treatment for kidney stone procedures. Despite endourologists researching urinary stone disease using endoscopes to collect tissue, this tissue collection method is limited. Endoscopically removed tissues are small in size, restricting the types of genome-based examination possible. We investigated a new method of renal papilla biopsy and RNA extraction to establish a genomic research methodology for kidney stone disease. We conducted a prospective multi-institutional study and collected renal papilla specimens from consecutive percutaneous nephrolithotomy and ureteroscopy (URS) cases performed for removal of upper urinary tract stones. Renal papilla tissue was extracted using ureteroscopic biopsy forceps after stone removal. RNA was extracted using two different extraction kits, and their quantity and quality were examined. Additionally, the impact of biopsy on surgical complications was compared between cases performed with and without biopsy by matched case-control analysis adjusted for age, gender, body mass index, bilaterality, and stone burden. A total of 90 biopsies from 49 patients were performed, and the median duration between specimen collection and RNA extraction was 61 days. Both univariate and multivariate analyses showed BIGopsy ® forceps usage significantly increased the total yield (p = 0.004) and quality (p = 0.001 for A260/280, p = 0.004 for A260/A230) of extracted RNA. Extraction using the RNeasy Micro Kit ® also improved A260/A230, whereas reduced RNA integrity number of extracted RNA by univariate and multivariate analyses (p = 0.002 and p < 0.001, respectively). Moreover, matched case-control study demonstrated that endoscopic renal papilla biopsy caused no significant surgical complications, including bleeding, decreased stone clearance and hematocrit, and renal dysfunction. Biopsies during URS imparted an average of 20 minutes of procedure time over nonbiopsy cases. We demonstrate a safe methodology for optimal RNA extraction of renal papilla tissue. This technique will accelerate advanced genomic studies for kidney stone formers by facilitating larger tissue yields.

[Multi-central controlled study on three-part massage therapy for treatment of insomnia of deficiency of both the heart and spleen].

PubMed

Zhou, Yun-feng; Wei, Yu-long; Zhang, Pu-lin; Gao, Shan; Ning, Guo-li; Zhang, Zhen-qiang; Hu, Bin; Wang, Dan-yi; Yan, Mei-rong; Liu, Wen-jun

2006-06-01

To make multi-central clinical evaluation for three-part massage therapy for treatment of insomnia of deficiency of both the heart and spleen. One hundred and sixty-six cases were randomly divided into a test group (n = 84) and a control group (n = 82). Multi-central, randomized and controlled methods were adopted. The test group were treated by the three-part massage therapy, i. e. acupoints at the head, abdomen and back were massaged, once each day; and the control group by oral administration of Guipi Pills [symbol: see text], 8 pills each time, thrice daily. The treatment was given for 15 consecutive days and then the therapeutic effects were observed. Sixty-seven cases were cured, 11 markedly effective, 3 effective, and 3 ineffective in the test group, and the corresponding figures were 10, 21, 29 and 22 in the control group with a very significant difference between the two groups (P< 0.001). The test group was superior to the control group in improvement for Pittsburgh Sleep Quality Index (PSQI), Sleepless Anxiety Scale (SAS) and Sleepless Depression Scale (SDS) (P < 0.001). The three-part massage therapy has definite therapeutic effect on insomnia of deficiency of both the heart and spleen with safety.

Calculation of controllability and observability matrices for special case of continuous-time multi-order fractional systems.

PubMed

Hassanzadeh, Iman; Tabatabaei, Mohammad

2017-03-28

In this paper, controllability and observability matrices for pseudo upper or lower triangular multi-order fractional systems are derived. It is demonstrated that these systems are controllable and observable if and only if their controllability and observability matrices are full rank. In other words, the rank of these matrices should be equal to the inner dimension of their corresponding state space realizations. To reduce the computational complexities, these matrices are converted to simplified matrices with smaller dimensions. Numerical examples are provided to show the usefulness of the mentioned matrices for controllability and observability analysis of this case of multi-order fractional systems. These examples clarify that the duality concept is not necessarily true for these special systems. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

Overview of Research Activities on Time and Frequency at the National Institute of Information and Communications Technology

DTIC Science & Technology

2004-12-01

FREQUENCY TRANSFER ( TWSTFT ) TWSTFT network in the Asia-Pacific region has developed by the collaboration of NICT and major T&F institutes in the...region [7]. A multi-channel TWSTFT modem has been developed by NICT. The performance evaluation shows that it is capable of sub-nanosecond time...intercomparison of NICT modem TWSTFT , ATLANTIS modem TWSTFT , and GPS common view (CV) in the case of the NICT-TL link is shown in Figure 4, and the stability

Techniques for High Contrast Imaging in Multi-Star Systems II: Multi-Star Wavefront Control

NASA Technical Reports Server (NTRS)

Sirbu, D.; Thomas, S.; Belikov, R.

2017-01-01

Direct imaging of exoplanets represents a challenge for astronomical instrumentation due to the high-contrast ratio and small angular separation between the host star and the faint planet. Multi-star systems pose additional challenges for coronagraphic instruments because of the diffraction and aberration leakage introduced by the additional stars, and as a result are not planned to be on direct imaging target lists. Multi-star wavefront control (MSWC) is a technique that uses a coronagraphic instrument's deformable mirror (DM) to create high-contrast regions in the focal plane in the presence of multiple stars. Our previous paper introduced the Super-Nyquist Wavefront Control (SNWC) technique that uses a diffraction grating to enable the DM to generate high-contrast regions beyond the nominal controllable region. These two techniques can be combined to generate high-contrast regions for multi-star systems at any angular separations. As a case study, a high-contrast wavefront control (WC) simulation that applies these techniques shows that the habitable region of the Alpha Centauri system can be imaged reaching 8 times 10(exp -9) mean contrast in 10 percent broadband light in one-sided dark holes from 1.6-5.5 lambda (wavelength) divided by D (distance).

The Effectiveness of Off Campus Multi-Institutional Teaching Centers as Perceived by Students

ERIC Educational Resources Information Center

Flores-Mejorado, Dina; Edmonson, Stacey; Fisher, Alice

2008-01-01

The purpose of this study was to examine and compare the perceptions of undergraduate and graduate students of a selected state university in Texas attending the Multi Institutional Teaching Center (MITC)/The University Center (TUC) or the main campus regarding the effectiveness of student services. As universities face limited resources and…

A Multi-Institution Study of Student Demographics and Outcomes in Chemical Engineering

ERIC Educational Resources Information Center

Lord, Susan M.; Layton, Richard A.; Ohland, Matthew W.; Brawner, Catherine E.; Long, Russell A.

2014-01-01

Using a large multi-institutional dataset, we describe demographics and outcomes for students starting in and transferring into chemical engineering (ChE). In this dataset, men outnumber women in ChE except among black students. While ChE starters graduate in ChE at rates comparable to or above their racial/ethnic population average for…

Risk assessment in infrastructure in educational institution: A study in Malaysia

NASA Astrophysics Data System (ADS)

Rasdan Ismail, Ahmad; Adilah Hamzah, Noor; Kamilah Makhtar, Nor; Azhar Mat Daud, Khairul; Zulkarnaen Khidzir, Nik; Husna Che Hassan, Nurul; Arifpin Mansor, Muhamad

2017-10-01

This particular study was conducted to assess the hazard exposure in education institution and to highlight the possible risk level available. The assessment utilised is Hazard Identification, Risk Assessment and Risk Control (HIRARC). There was a 2008’s form in order to determine the risk level of the hazard. There were over 111 of education institutions were selected around Malaysia to perform this assessment. Area chosen for each institution was office, playing field, canteen, classroom, toilet and drainage. By referring HIRARC Guideline 2008, the determination of risk rank is measure based on the formula likelihood multiply severity and the rank need to refer from risk matrix standard. There are several hazard have be found and shows the high, medium and low of risk level. The higher level of risk was discussed in the study which is hazard found in playing field and hazard in office. There several hazard that need to be control by education management to avoid increase of case accident in Education Sector, Malaysia. As conclusion, the exposure hazard among the staff and educators is high and further action and control are needed. Further study need to explore the best recommendation for control measure of the hazard exposed by education institution.

Illustrating and analyzing the processes of multi-institutional collaboration: Lessons learnt at Howard University Hospital.

PubMed

Malik, Mansoor; Kumari, Suneeta; Manalai, Partam; Hipolito, Maria

2017-05-01

Multi-institutional collaboration offers a promising approach to the dissemination of resources for capacity building and the improvement of the training of new investigators and residents, especially in areas of novel curricular content. Physicians should keep pace with the rapid growth of curricular content in an era of restricted resources. Such collaborations, in which educational entities work together and share resources and infrastructure, have been employed in health care to improve quality of care, capacity building, disparity reduction, and resident training. This paper examines a federally funded multi-institutional collaboration for the project STRIDE (Seek, Treat, Reach to Identify Pretrial Defendants Enhancement) between Yale University, George Mason University (GMU), and Howard University, a Historically Black University. The STRIDE study collaboration focused on mental health, opioid addiction, and infectious disease/HIV among Africans Americans involved in CJS (Criminal Justice System). We discuss some of the challenges and benefits of collaborative research projects conducted at Historically Black Colleges and University (HBCUs) and highlight the educational opportunities created by such collaborations for residents and other trainees, leading to the development of independent investigators through multi-institutional, structured collaborative research. We identify some unique challenges such as substance use, race, stigma, incarceration among participants, and the cultural and power difference between participating institutions, and thereby address these issues and how it impacted the course of the multi-institutional collaborative effort.

Illustrating and analyzing the processes of multi-institutional collaboration: Lessons learnt at Howard University Hospital

PubMed Central

Malik, Mansoor; Kumari, Suneeta; Manalai, Partam; Hipolito, Maria

2017-01-01

Multi-institutional collaboration offers a promising approach to the dissemination of resources for capacity building and the improvement of the training of new investigators and residents, especially in areas of novel curricular content. Physicians should keep pace with the rapid growth of curricular content in an era of restricted resources. Such collaborations, in which educational entities work together and share resources and infrastructure, have been employed in health care to improve quality of care, capacity building, disparity reduction, and resident training. This paper examines a federally funded multi-institutional collaboration for the project STRIDE (Seek, Treat, Reach to Identify Pretrial Defendants Enhancement) between Yale University, George Mason University (GMU), and Howard University, a Historically Black University. The STRIDE study collaboration focused on mental health, opioid addiction, and infectious disease/HIV among Africans Americans involved in CJS (Criminal Justice System). We discuss some of the challenges and benefits of collaborative research projects conducted at Historically Black Colleges and University (HBCUs) and highlight the educational opportunities created by such collaborations for residents and other trainees, leading to the development of independent investigators through multi-institutional, structured collaborative research. We identify some unique challenges such as substance use, race, stigma, incarceration among participants, and the cultural and power difference between participating institutions, and thereby address these issues and how it impacted the course of the multi-institutional collaborative effort. PMID:28966991

Globally linearized control on diabatic continuous stirred tank reactor: a case study.

PubMed

Jana, Amiya Kumar; Samanta, Amar Nath; Ganguly, Saibal

2005-07-01

This paper focuses on the promise of globally linearized control (GLC) structure in the realm of strongly nonlinear reactor system control. The proposed nonlinear control strategy is comprised of: (i) an input-output linearizing state feedback law (transformer), (ii) a state observer, and (iii) an external linear controller. The synthesis of discrete-time GLC controller for single-input single-output diabatic continuous stirred tank reactor (DCSTR) has been studied first, followed by the synthesis of feedforward/feedback controller for the same reactor having dead time in process as well as in disturbance. Subsequently, the multivariable GLC structure has been designed and then applied on multi-input multi-output DCSTR system. The simulation study shows high quality performance of the derived nonlinear controllers. The better-performed GLC in conjunction with reduced-order observer has been compared with the conventional proportional integral controller on the example reactor and superior performance has been achieved by the proposed GLC control scheme.

Climate change collaboration among natural resource management agencies: lessons learned from two US regions

USGS Publications Warehouse

Lemieux, Christopher J.; Thompson, Jessica; Slocombe, D. Scott; Schuster, Rudy

2015-01-01

It has been argued that regional collaboration can facilitate adaptation to climate change impacts through integrated planning and management. In an attempt to understand the underlying institutional factors that either support or contest this assumption, this paper explores the institutional factors influencing adaptation to climate change at the regional scale, where multiple public land and natural resource management jurisdictions are involved. Insights from two mid-western US case studies reveal that several challenges to collaboration persist and prevent fully integrative multi-jurisdictional adaptation planning at a regional scale. We propose that some of these challenges, such as lack of adequate time, funding and communication channels, be reframed as opportunities to build interdependence, identify issue-linkages and collaboratively explore the nature and extent of organisational trade-offs with respect to regional climate change adaptation efforts. Such a reframing can better facilitate multi-jurisdictional adaptation planning and management of shared biophysical resources generally while simultaneously enhancing organisational capacity to mitigate negative effects and take advantage of potentially favourable future conditions in an era characterised by rapid climate change.

Impact of case type, length of stay, institution type, and comorbidities on Medicare diagnosis-related group reimbursement for adult spinal deformity surgery.

PubMed

Nunley, Pierce D; Mundis, Gregory M; Fessler, Richard G; Park, Paul; Zavatsky, Joseph M; Uribe, Juan S; Eastlack, Robert K; Chou, Dean; Wang, Michael Y; Anand, Neel; Frank, Kelly A; Stone, Marcus B; Kanter, Adam S; Shaffrey, Christopher I; Mummaneni, Praveen V

2017-12-01

OBJECTIVE The aim of this study was to educate medical professionals about potential financial impacts of improper diagnosis-related group (DRG) coding in adult spinal deformity (ASD) surgery. METHODS Medicare's Inpatient Prospective Payment System PC Pricer database was used to collect 2015 reimbursement data for ASD procedures from 12 hospitals. Case type, hospital type/location, number of operative levels, proper coding, length of stay, and complications/comorbidities (CCs) were analyzed for effects on reimbursement. DRGs were used to categorize cases into 3 types: 1) anterior or posterior only fusion, 2) anterior fusion with posterior percutaneous fixation with no dorsal fusion, and 3) combined anterior and posterior fixation and fusion. RESULTS Pooling institutions, cases were reimbursed the same for single-level and multilevel ASD surgery. Longer stay, from 3 to 8 days, resulted in an additional $1400 per stay. Posterior fusion was an additional $6588, while CCs increased reimbursement by approximately $13,000. Academic institutions received higher reimbursement than private institutions, i.e., approximately $14,000 (Case Types 1 and 2) and approximately $16,000 (Case Type 3). Urban institutions received higher reimbursement than suburban institutions, i.e., approximately $3000 (Case Types 1 and 2) and approximately $3500 (Case Type 3). Longer stay, from 3 to 8 days, increased reimbursement between $208 and $494 for private institutions and between $1397 and $1879 for academic institutions per stay. CONCLUSIONS Reimbursement is based on many factors not controlled by surgeons or hospitals, but proper DRG coding can significantly impact the financial health of hospitals and availability of quality patient care.

Colon injury after blunt abdominal trauma: results of the EAST Multi-Institutional Hollow Viscus Injury Study.

PubMed

Williams, Michael D; Watts, Dorraine; Fakhry, Samir

2003-11-01

Blunt injury to the colon is rare. Few studies of adequate size and design exist to allow clinically useful conclusions. The Eastern Association for the Surgery of Trauma Multi-institutional Hollow Viscus Injury (HVI) Study presents a unique opportunity to definitively study these injuries. Patients with blunt HVI were identified from the registries of 95 trauma centers over 2 years (1998-1999). Patients with colon injuries (cases) were compared with blunt trauma patient undergoing a negative laparotomy (controls). Data were abstracted by chart review. Of the 227,972 patients represented, 2,632 (1.0%) had an HVI and 798 had a colonic/rectal injury (0.3%). Of patients diagnosed with HVI, 30.2% had a colon injury. No physical findings or imaging modalities were able to discriminate colonic injury. Logistic regression modeling yielded no clinically useful combination of findings that would reliably predict colonic injury. In patients undergoing laparotomy, presence of colon injury was associated with a higher risk of some complications but not mortality. Colon injury was associated with increased hospital (17.4 vs. 13.1, p < 0.001) and intensive care unit (9.7 vs. 6.9, p = 0.003) length of stay. Almost all colon patients (92.0%) underwent laparotomy within 24 hours of injury. Colonic injury after blunt trauma is rare and difficult to diagnose. No diagnostic test or combination of findings reliably excluded blunt colonic injury. Despite the inadequacy of current diagnostic tests, almost all patients with colonic injury were taken to the operating room within 24 hours. Even with relatively prompt surgery, patients with colon injury were at significantly higher risk for serious complications and increased length of stay. In contrast to small bowel perforation, delay in operative intervention appears to be less common but is still associated with serious morbidity.

A large multi-pathogen gastroenteritis outbreak caused by drinking contaminated water from antique neighbourhood fountains, Erzurum city, Turkey, December 2012.

PubMed

Sezen, F; Aval, E; Ağkurt, T; Yilmaz, Ş; Temel, F; Güleşen, R; Korukluoğlu, G; Sucakli, M B; Torunoğlu, M A; Zhu, B-P

2015-03-01

We investigated a gastroenteritis outbreak in Erzurum city, Turkey in December 2012 to identify its cause and mode of transmission. We defined a probable case as onset of diarrhoea (⩾3 episodes/day) or vomiting, plus fever or nausea or abdominal pain during 19-27 December, 2012 in an Erzurum city resident. In a case-control study we compared exposures of 95 randomly selected probable cases and 95 neighbourhood-matched controls. We conducted bacterial culture and real-time multiplex PCR for identification of pathogens. During the week before illness onset, 72% of cases and 15% of controls only drank water from antique neighbourhood fountains; conversely, 16% of cases and 65% of controls only drank bottled or tap water (adjusted odds ratio 20, 95% confidence interval 4·6-84, after controlling for age and sex using conditional logistic regression). Of eight stool specimens collected, two were positive for Shigella sonnei, one for astrovirus, one for astrovirus and norovirus, and one for astrovirus and rotavirus. Water samples from the fountains had elevated total coliform (38-300/100 ml) and Escherichia coli (22-198/100 ml) counts. In conclusion, drinking contaminated fountain water caused this multi-pathogen outbreak. Residents should stop drinking water from these fountains, and clean water from the water treatment plant should be connected to the fountains.

Cloudwave: distributed processing of "big data" from electrophysiological recordings for epilepsy clinical research using Hadoop.

PubMed

Jayapandian, Catherine P; Chen, Chien-Hung; Bozorgi, Alireza; Lhatoo, Samden D; Zhang, Guo-Qiang; Sahoo, Satya S

2013-01-01

Epilepsy is the most common serious neurological disorder affecting 50-60 million persons worldwide. Multi-modal electrophysiological data, such as electroencephalography (EEG) and electrocardiography (EKG), are central to effective patient care and clinical research in epilepsy. Electrophysiological data is an example of clinical "big data" consisting of more than 100 multi-channel signals with recordings from each patient generating 5-10GB of data. Current approaches to store and analyze signal data using standalone tools, such as Nihon Kohden neurology software, are inadequate to meet the growing volume of data and the need for supporting multi-center collaborative studies with real time and interactive access. We introduce the Cloudwave platform in this paper that features a Web-based intuitive signal analysis interface integrated with a Hadoop-based data processing module implemented on clinical data stored in a "private cloud". Cloudwave has been developed as part of the National Institute of Neurological Disorders and Strokes (NINDS) funded multi-center Prevention and Risk Identification of SUDEP Mortality (PRISM) project. The Cloudwave visualization interface provides real-time rendering of multi-modal signals with "montages" for EEG feature characterization over 2TB of patient data generated at the Case University Hospital Epilepsy Monitoring Unit. Results from performance evaluation of the Cloudwave Hadoop data processing module demonstrate one order of magnitude improvement in performance over 77GB of patient data. (Cloudwave project: http://prism.case.edu/prism/index.php/Cloudwave).

Cloudwave: Distributed Processing of “Big Data” from Electrophysiological Recordings for Epilepsy Clinical Research Using Hadoop

PubMed Central

Jayapandian, Catherine P.; Chen, Chien-Hung; Bozorgi, Alireza; Lhatoo, Samden D.; Zhang, Guo-Qiang; Sahoo, Satya S.

2013-01-01

Epilepsy is the most common serious neurological disorder affecting 50–60 million persons worldwide. Multi-modal electrophysiological data, such as electroencephalography (EEG) and electrocardiography (EKG), are central to effective patient care and clinical research in epilepsy. Electrophysiological data is an example of clinical “big data” consisting of more than 100 multi-channel signals with recordings from each patient generating 5–10GB of data. Current approaches to store and analyze signal data using standalone tools, such as Nihon Kohden neurology software, are inadequate to meet the growing volume of data and the need for supporting multi-center collaborative studies with real time and interactive access. We introduce the Cloudwave platform in this paper that features a Web-based intuitive signal analysis interface integrated with a Hadoop-based data processing module implemented on clinical data stored in a “private cloud”. Cloudwave has been developed as part of the National Institute of Neurological Disorders and Strokes (NINDS) funded multi-center Prevention and Risk Identification of SUDEP Mortality (PRISM) project. The Cloudwave visualization interface provides real-time rendering of multi-modal signals with “montages” for EEG feature characterization over 2TB of patient data generated at the Case University Hospital Epilepsy Monitoring Unit. Results from performance evaluation of the Cloudwave Hadoop data processing module demonstrate one order of magnitude improvement in performance over 77GB of patient data. (Cloudwave project: http://prism.case.edu/prism/index.php/Cloudwave) PMID:24551370

Variable cycle control model for intersection based on multi-source information

NASA Astrophysics Data System (ADS)

Sun, Zhi-Yuan; Li, Yue; Qu, Wen-Cong; Chen, Yan-Yan

2018-05-01

In order to improve the efficiency of traffic control system in the era of big data, a new variable cycle control model based on multi-source information is presented for intersection in this paper. Firstly, with consideration of multi-source information, a unified framework based on cyber-physical system is proposed. Secondly, taking into account the variable length of cell, hysteresis phenomenon of traffic flow and the characteristics of lane group, a Lane group-based Cell Transmission Model is established to describe the physical properties of traffic flow under different traffic signal control schemes. Thirdly, the variable cycle control problem is abstracted into a bi-level programming model. The upper level model is put forward for cycle length optimization considering traffic capacity and delay. The lower level model is a dynamic signal control decision model based on fairness analysis. Then, a Hybrid Intelligent Optimization Algorithm is raised to solve the proposed model. Finally, a case study shows the efficiency and applicability of the proposed model and algorithm.

Control, Control, Complete Control!!! Neurotic Control Relationships and the Development of Dysfunctional Organizational Structures.

ERIC Educational Resources Information Center

Kersten, Astrid

A case study illustrates the concept of the neurotic organization by describing the development of "Central Control College" over a period of 11 years. In this period of time, the college moved from a small, informal organization to a highly developed compulsive institution. The image of neurosis has been applied in the organizational…

Information security concepts and practices: the case of a provincial multi-specialty hospital.

PubMed

Cavalli, Enrico; Mattasoglio, Andrea; Pinciroli, Francesco; Spaggiari, Piergiorgio

2004-03-31

In recent years, major and widely accepted information security understandings and achievements confirm that the problem is complex. They clarify that technologies are fundamental tools, but management processes have even bigger relevance, as also prestigious international magazines dossier clearly explained recently. Such a magazine attention outlines the wide impact that the subject has on watchful decision makers. ISO17799 is an emerging standard in information security. In principle there are no reasons for considering it not applicable to the health care sector. In practice, because of both the just conceptual level of the standard and the peculiarities of the health care data and institutions, a lot of analysis and design work need to be invested any time a health care institution decides to deal with the subject. CEN/ENV 12924 is another emerging standard certainly more on the spot of the health care. Nevertheless, it also asks for evident further investigation. The practical case of information security design, implementation, management, and auditing inside a multi-specialty provincial Italian hospital will be described.

[The problem of abortions and enhancement of analysis of reproductive behavior of women].

PubMed

Maksimova, T M; Belov, V B; Lushkina, N P; Nikitina, S Iu; Redina, M A

2012-01-01

The article deals with the study of actual rate of abortions in Russia. It is established that multi-aspect statistical information is needed to compare with the data of international organizations. The regular monitoring is important to control the different characteristics of population reproductive behavior abortion prevalence and the all-inclusive participation in the reporting activity of all medical institutions involved independently of property forms and sectorial membership.

Inattentive/overactive children with histories of profound institutional deprivation compared with standard ADHD cases: a brief report.

PubMed

Sonuga-Barke, E J S; Rubia, K

2008-09-01

The Inattention/Overactivity/Impulsiveness (I/OA) behavioural cluster diagnostic of ADHD is recognized as a characteristic outcome of early institutional care. We compared the symptom and neuropsychological profiles of children with a history of I/OA and early severe deprivation (D-I/OA: n=13) with standard clinical ADHD cases (S-ADHD; N=20) and children who had experienced deprivation but were not pervasively I/OA (ERA-controls; n=22). The mean age of testing was around 13 years. D-I/OA and ERA-controls were selected from the English and Romanian Adoptees (ERA) study and had spent their early lives in the extremely depriving Romanian institutions of the Ceausescu regime and were later adopted into UK families. ADHD symptoms for male D-I/OA and S-ADHD cases showed marked similarities across symptom domains. In contrast, girls with D-I/OA were more similar to ERA controls than to ADHD cases. Longitudinal data suggested that this was due to a remission of symptoms in D-I/OA girls. Neuropsychological profiles of males and females with D-I/OA, however, were similar: both were more impaired than S-ADHD and ERA controls. Children with D-I/OA were more neuropsychologically impaired than S-ADHD despite the fact that only boys showed a persistent pattern of ADHD symptoms. These results need replication in a larger sample with groups matched for gender.

Multi-centric universal pseudonymisation for secondary use of the EHR.

PubMed

Lo Iacono, Luigi

2007-01-01

This paper discusses the importance of protecting the privacy of patient data kept in an Electronic Health Record (EHR) in the case, where it leaves the control- and protection-sphere of the health care realm for secondary uses such as clinical or epidemiological research projects, health care research, assessment of treatment quality or economic assessments. The paper focuses on multi-centric studies, where various data sources are linked together using Grid technologies. It introduces a pseudonymisation system which enables a multi-centric universal pseudonymisation, meaning that a patient's identity will result in the same pseudonym, regardless of which participating study center the patient data is collected.

Epidemiology, surgical management and early postoperative outcome in a cohort of gastric cancer patients of a tertiary referral center in relation to multi-center quality assurance studies.

PubMed

Garlipp, Benjamin; Schwalenberg, Jens; Adolf, Daniela; Lippert, Hans; Meyer, Frank

2011-03-01

The aim of the study was to analyze epidemiologic parameters, treatment-related data and prognostic factors in the management of gastric cancer patients of a university surgical center under conditions of routine clinical care before the onset of the era of multimodal therapies. By analyzing our data in relation with multi-center quality assurance trials [German Gastric Cancer Study - GGCS (1992) and East German Gastric Cancer Study - EGGCS (2004)] we aimed at providing an instrument of internal quality control at our institution as well as a base for comparison with future analyses taking into account the implementation of evolving (multimodal) therapies and their influence on treatment results. Retrospective analysis of prospectively gathered data of gastric cancer patients treated at a single institution during a defined 10-year time period with multivariate analysis of risk factors for early postoperative outcome. From 04/01/1993 through 03/31/2003, a total of 328 gastric cancer patients were treated. In comparison with the EGGCS cohort there was a larger proportion of patients with locally advanced and proximally located tumors. 272 patients (82.9%) underwent surgery with curative intent; in 88.4% of these an R0 resection was achieved (EGGCS/GGCS: 82.5%/71.5%). 68.2% of patients underwent preoperative endoluminal ultrasound (EUS) (EGGCS: 27.4%); the proportion of patients undergoing EUS increased over the study period. Diagnostic accuracy of EUS for T stage was 50.6% (EGGCS: 42.6%). 77.2% of operated patients with curative intent underwent gastrectomy (EGGCS/GGCS: 79.8%/71.1%). Anastomotic leaks at the esophagojejunostomy occurred slightly more frequently (8.8%) than in the EGGCS (5.9%) and GGCS (7.2%); however, postoperative morbidity (36.1%) and early postoperative mortality (5.3%) were not increased compared to the multi-center quality assurance study results (EGGCS morbidity, 45%); EGGCS/GGCS mortality, 8%/8.9%). D2 lymphadenectomy was performed in 72.6% of cases (EGGCS: 70.9%). Multivariate analysis revealed splenectomy as an independent risk factor for postoperative morbidity and ASA status 3 or 4 as an independent risk factor for early postoperative mortality. The rate of splenectomies performed during gastric cancer surgery decreased substantially during the study period. Preoperative diagnostics were able to accurately predict resectability in almost 90% of patients which is substantially more than the corresponding results of both the EGGCS and the GGCS. In the future, more wide-spread use of EUS will play an increasing role as stage-dependent differentiation of therapeutic concepts gains acceptance. However, diagnostic accuracy of EUS needs to be improved. Our early postoperative outcome data demonstrate that the quality standard of gastric cancer care established by the EGGCS is being fulfilled at our institution in spite of distinct characteristics placing our patients at higher surgical risk. Besides being a valuable instrument of internal quality control, our study provides a good base for comparison with ongoing analyses on future developments in gastric cancer therapy.

Techniques and potential capabilities of multi-resolutional information (knowledge) processing

NASA Technical Reports Server (NTRS)

Meystel, A.

1989-01-01

A concept of nested hierarchical (multi-resolutional, pyramidal) information (knowledge) processing is introduced for a variety of systems including data and/or knowledge bases, vision, control, and manufacturing systems, industrial automated robots, and (self-programmed) autonomous intelligent machines. A set of practical recommendations is presented using a case study of a multiresolutional object representation. It is demonstrated here that any intelligent module transforms (sometimes, irreversibly) the knowledge it deals with, and this tranformation affects the subsequent computation processes, e.g., those of decision and control. Several types of knowledge transformation are reviewed. Definite conditions are analyzed, satisfaction of which is required for organization and processing of redundant information (knowledge) in the multi-resolutional systems. Providing a definite degree of redundancy is one of these conditions.

Multi-agent systems and their applications

DOE PAGES

Xie, Jing; Liu, Chen-Ching

2017-07-14

The number of distributed energy components and devices continues to increase globally. As a result, distributed control schemes are desirable for managing and utilizing these devices, together with the large amount of data. In recent years, agent-based technology becomes a powerful tool for engineering applications. As a computational paradigm, multi agent systems (MASs) provide a good solution for distributed control. Here in this paper, MASs and applications are discussed. A state-of-the-art literature survey is conducted on the system architecture, consensus algorithm, and multi-agent platform, framework, and simulator. In addition, a distributed under-frequency load shedding (UFLS) scheme is proposed using themore » MAS. Simulation results for a case study are presented. The future of MASs is discussed in the conclusion.« less

Multi-agent systems and their applications

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

Xie, Jing; Liu, Chen-Ching

The number of distributed energy components and devices continues to increase globally. As a result, distributed control schemes are desirable for managing and utilizing these devices, together with the large amount of data. In recent years, agent-based technology becomes a powerful tool for engineering applications. As a computational paradigm, multi agent systems (MASs) provide a good solution for distributed control. Here in this paper, MASs and applications are discussed. A state-of-the-art literature survey is conducted on the system architecture, consensus algorithm, and multi-agent platform, framework, and simulator. In addition, a distributed under-frequency load shedding (UFLS) scheme is proposed using themore » MAS. Simulation results for a case study are presented. The future of MASs is discussed in the conclusion.« less

Studying a Rare Disease Using Multi-Institutional Research Collaborations vs Big Data: Where Lies the Truth?

PubMed

Johnson, Aileen C; Ethun, Cecilia G; Liu, Yuan; Lopez-Aguiar, Alexandra G; Tran, Thuy B; Poultsides, George; Grignol, Valerie; Howard, J Harrison; Bedi, Meena; Gamblin, T Clark; Tseng, Jennifer; Roggin, Kevin K; Chouliaras, Konstantinos; Votanopoulos, Konstantinos; Cullinan, Darren; Fields, Ryan C; Delman, Keith A; Wood, William C; Cardona, Kenneth; Maithel, Shishir K

2018-06-12

Multi-institutional collaborations provide granularity lacking in epidemiologic datasets to enable in-depth study of rare diseases. For pts with superficial, high-grade soft tissue sarcomas (STS) of the trunk/extremity, the value of radiation therapy (RT) is not clear. We aimed to utilize the 7-institution US-Sarcoma-Collaborative (USSC) and the National Cancer Database (NCDB) to investigate this issue. All adult pts with superficial truncal/extremity high-grade STS who underwent primary curative-intent resection from 2000-2016 at USSC institutions or were included in the NCDB from 2004-2013 were analyzed. Propensity-score matching was performed. Endpoints were locoregional recurrence-free survival(LRFS), overall-survival(OS), and disease-specific survival(DSS). Of 4,153pts in the USSC, 169pts with superficial high-grade tumors underwent primary curative-intent resection, of whom 38% received RT. On multivariable Cox-regression analysis, RT was not associated with improved LRFS(p=0.56), OS(p=0.31), or DSS(p=0.20). On analysis of 51 propensity-score matched-pairs, RT was still not associated with increased LRFS, OS, or DSS. Analysis of 631 propensity-score matched-pairs in the NCDB demonstrated improved 5-yr OS associated with RT (80%vs70%;p=0.02). LRFS and DSS were not evaluable. Granular data afforded by collaborative research enables in-depth analysis of patient outcomes. The NCDB, although powered with large numbers, cannot assess many relevant outcomes (recurrence, DSS, or complications). In this study, the approaches yielded conflicting results. USSC data suggested no value of radiation while the NCDB demonstrated improved overall survival, contradicting all randomized-controlled trials in sarcoma. The pros/cons of either approach must be considered when applying results to clinical practice, and underscore the importance of randomized-controlled trials. Copyright © 2018. Published by Elsevier Inc.

Agents Control in Intelligent Learning Systems: The Case of Reactive Characteristics

ERIC Educational Resources Information Center

Laureano-Cruces, Ana Lilia; Ramirez-Rodriguez, Javier; de Arriaga, Fernando; Escarela-Perez, Rafael

2006-01-01

Intelligent learning systems (ILSs) have evolved in the last few years basically because of influences received from multi-agent architectures (MAs). Conflict resolution among agents has been a very important problem for multi-agent systems, with specific features in the case of ILSs. The literature shows that ILSs with cognitive or pedagogical…

Risk factors associated with sporadic salmonellosis in adults: a case-control study.

PubMed

Ziehm, D; Dreesman, J; Campe, A; Kreienbrock, L; Pulz, M

2013-02-01

In order to identify and assess recent risk factors for sporadic human infections with Salmonella enterica, we conducted a case-control study in Lower Saxony, Germany. The data collection was based on standardized telephone interviews with 1017 cases and 346 controls aged >14 years. Odds ratios were calculated in single-factor and multi-factor analyses for Salmonella cases and two different control groups, i.e. population controls and controls with rotavirus infection. Multi-factor analysis revealed associations between sporadic Salmonella infections for two exposures by both sets of controls: consumption of raw ground pork [adjusted odds ratio (aOR) 2·38, 95% confidence interval (CI) 1·27-4·44] and foreign travel (aOR 2·12, 95% CI 1·00-4·52). Other exposures included consumption of food items containing eggs (aOR 1·43, 95% CI 0·80-2·54), consumption of chicken meat (aOR 1·77, 95% CI 1·26-2·50), outdoor meals/barbecues (aOR 3·96, 95% CI 1·41-11·12) and taking gastric acidity inhibitors (aOR 2·42, 95% CI 1·19-4·92), all were significantly associated with respect to one of the two control groups. The impact of consuming food items containing eggs or chicken meat was lower than expected from the literature. This might be a consequence of Salmonella control programmes as well as increased public awareness of eggs and chicken products being a risk factor for salmonellosis. Efforts to reduce Salmonella infections due to raw pork products should be intensified.

Undergraduate Music Program Alumni's Career Path, Retrospective Institutional Satisfaction, and Financial Status

ERIC Educational Resources Information Center

Miksza, Peter; Hime, Lauren

2015-01-01

The purpose of this study was to examine undergraduate music education and performance alumni's career path, retrospective institutional satisfaction, and financial status. Data for this study were drawn from respondents from the 2010 administration of the nationwide, multi-institutional survey conducted by the Strategic National Arts Alumni…

BigMouth: a multi-institutional dental data repository

PubMed Central

Walji, Muhammad F; Kalenderian, Elsbeth; Stark, Paul C; White, Joel M; Kookal, Krishna K; Phan, Dat; Tran, Duong; Bernstam, Elmer V; Ramoni, Rachel

2014-01-01

Few oral health databases are available for research and the advancement of evidence-based dentistry. In this work we developed a centralized data repository derived from electronic health records (EHRs) at four dental schools participating in the Consortium of Oral Health Research and Informatics. A multi-stakeholder committee developed a data governance framework that encouraged data sharing while allowing control of contributed data. We adopted the i2b2 data warehousing platform and mapped data from each institution to a common reference terminology. We realized that dental EHRs urgently need to adopt common terminologies. While all used the same treatment code set, only three of the four sites used a common diagnostic terminology, and there were wide discrepancies in how medical and dental histories were documented. BigMouth was successfully launched in August 2012 with data on 1.1 million patients, and made available to users at the contributing institutions. PMID:24993547

Coordination of networked systems on digraphs with multiple leaders via pinning control

NASA Astrophysics Data System (ADS)

Chen, Gang; Lewis, Frank L.

2012-02-01

It is well known that achieving consensus among a group of multi-vehicle systems by local distributed control is feasible if and only if all nodes in the communication digraph are reachable from a single (root) node. In this article, we take into account a more general case that the communication digraph of the networked multi-vehicle systems is weakly connected and has two or more zero-in-degree and strongly connected subgraphs, i.e. there are two or more leader groups. Based on the pinning control strategy, the feasibility problem of achieving second-order controlled consensus is studied. At first, a necessary and sufficient condition is given when the topology is fixed. Then the method to design the controller and the rule to choose the pinned vehicles are discussed. The proposed approach allows us to extend several existing results for undirected graphs to directed balanced graphs. A sufficient condition is proposed in the case where the coupling topology is variable. As an illustrative example, a second-order controlled consensus scheme is applied to coordinate the movement of networked multiple mobile robots.

Decreased bed rest post-percutaneous coronary intervention with a 7-French arterial sheath and its effects on vascular complications.

PubMed

Wentworth, Laura J; Bechtum, Elizabeth L; Hoffman, Jessica G; Kramer, Robert R; Bartel, David C; Slusser, Joshua P; Tilbury, Ralph Thomas

2018-01-01

To compare the incidence of femoral access puncture site complications in the control group, who underwent 6 hr of bed rest, with patients in the case group, who underwent 4 hr of bed rest. The ideal bed rest length after percutaneous coronary intervention with a 7-French arterial sheath has been investigated by nursing practice. However, in this larger-sheath-size group, best practices have not been determined, and bed rest time continues to vary markedly among institutions. Retrospective study. Data were retrieved from the National Cardiovascular Data Registry and electronic health records in this retrospective study. Sample size was 401 patients: 152 case patients with 4-hr bed rest and 249 controls with 6-hr bed rest. Case group data were obtained from 20 May 2013-31 December 2014; and control group data, 15 June 2011-20 May 2013. National Cardiovascular Data Registry event rates were generally low in both groups: Only three patients in each group had a bleeding event within 72 hr (2% vs. 1%) and no patient and only two controls had arteriovenous fistula (0% vs. 1%). Complications documented in the electronic health records with institutional femoral access puncture site complication definitions identified bleeding at the access site in eight case patients (5%) and nine controls (4%). Haematoma at the access site occurred in 21 case patients (14%) and 25 controls (10%). The practice change of decreasing bed rest from 6-4 hr for patients with 7-French arterial sheaths post-percutaneous coronary intervention was associated with no significant change in femoral access puncture site complications in either National Cardiovascular Data Registry data or institutional electronic health records data. This introduces expanded evidence of safety in decreasing bed rest length in larger (7-French) arterial sheaths post-percutaneous coronary intervention. © 2017 John Wiley & Sons Ltd.

Global multi-sensor satellite monitoring of volcanic SO2 and ash emissions in support to aviation control

NASA Astrophysics Data System (ADS)

Brenot, H.; Theys, N.; van Gent, J.; Van Roozendael, M.; van der A, R.; Clarisse, L.; Hurtmans, D.; Ngadi, Y.; Coheur, P.-F.; Clerbaux, C.

2012-04-01

The "Support to Aviation Control Service" (SACS; http://sacs.aeronomie.be) is an ESA-funded project hosted by the Belgian Institute for Space Aeronomy. The service provides near real-time (NRT) global SO2 and volcanic ash data, as well as alerts in case of volcanic eruptions. The SACS service is primarily designed to support the Volcanic Ash Advisory Centers (VAACs) in their mandate to gather information on volcanic clouds and give advice to airline and air traffic control organisations. SACS also serves other users that subscribe to the service, in particular local volcano observatories and research scientists. SACS is based on the combined use of UV-visible (SCIAMACHY, OMI, GOME-2) and infrared (AIRS, IASI) satellite instruments. When a volcanic eruption is detected, SACS issues an alert that takes the form of a notification sent by e-mail to users. This notification points to a dedicated web page where all relevant information is available and can be visualized with user-friendly tools. The strength of a multi-sensor approach relies in the use of satellite data with different overpasses times, minimizing the time-lag for detection and enhancing the reliability of such alerts. This paper will give a general presentation of the SACS service, different techniques used to detect volcanic plumes. It will also highlight the strengths and limitations of the service and measurements.

Development of efficiency indicators of operating room management for multi-institutional comparisons.

PubMed

Tanaka, Masayuki; Lee, Jason; Ikai, Hiroshi; Imanaka, Yuichi

2013-04-01

The efficiency of a hospital's operating room (OR) management can affect its overall profitability. However, existing indicators that assess OR management efficiency do not take into account differences in hospital size, manpower and functional characteristics, thereby rendering them unsuitable for multi-institutional comparisons. The aim of this study was to develop indicators of OR management efficiency that would take into account differences in hospital size and manpower, which may then be applied to multi-institutional comparisons. Using administrative data from 224 hospitals in Japan from 2008 to 2010, we performed four multiple linear regression analyses at the hospital level, in which the dependent variables were the number of operations per OR per month, procedural fees per OR per month, total utilization times per OR per month and total fees per OR per month for each of the models. The expected values of these four indicators were produced using multiple regression analysis results, adjusting for differences in hospital size and manpower, which are beyond the control of process owners' management. However, more than half of the variations in three of these four indicators were shown to be explained by differences in hospital size and manpower. Using the ratio of observed to expected values (OE ratio), as well as the difference between the two values (OE difference) allows hospitals to identify weaknesses in efficiency with more validity when compared to unadjusted indicators. The new indicators may support the improvement and sustainment of a high-quality health care system. © 2012 Blackwell Publishing Ltd.

[Construction and operation status of management system of laboratories of schistosomiasis control institutions in Hubei Province].

PubMed

Zhao-Hui, Zheng; Jun, Qin; Li, Chen; Hong, Zhu; Li, Tang; Zu-Wu, Tu; Ming-Xing, Zeng; Qian, Sun; Shun-Xiang, Cai

2016-10-09

To analyze the construction and operation status of management system of laboratories of schistosomiasis control institutions in Hubei Province, so as to provide the reference for the standardized detection and management of schistosomiasis laboratories. According to the laboratory standard of schistosomiasis at provincial, municipal and county levels, the management system construction and operation status of 60 schistosomiasis control institutions was assessed by the acceptance examination method from 2013 to 2015. The management system was already occupied over all the laboratories of schistosomiasis control institutions and was officially running. There were 588 non-conformities and the inconsistency rate was 19.60%. The non-conformity rate of the management system of laboratory quality control was 38.10% (224 cases) and the non-conformity rate of requirements of instrument and equipment was 23.81% (140 cases). The management system has played an important role in the standardized management of schistosomiasis laboratories.

Pigs on the plains: Institutional analysis of a Colorado water quality initiative

USGS Publications Warehouse

King, D.; Burkardt, N.; Lee, Lamb B.

2006-01-01

We used the Legal-Institutional Analysis Model (LIAM) and Advocacy Coalition Framework (ACF) to analyze the campaign over passage of the Colorado Hogs Rule, an initiative passed by the voters in 1998 to require regulation of swine production facilities in Colorado. Used in tandem, LIAM and ACF provided an opportunity to develop a robust understanding of the obstacles and opportunities that face water quality managers in a state-centered multi-organizational decision process. We found that combining the LIAM with the ACF enhanced the understanding that could be achieved by using either model in isolation. The predictive capacity of the LIAM would have been reduced without information from the ACF, and the ACF by itself would have missed the importance of a single-case study.

Multi-parameter optimization of piezoelectric actuators for multi-mode active vibration control of cylindrical shells

NASA Astrophysics Data System (ADS)

Hu, K. M.; Li, Hua

2018-07-01

A novel technique for the multi-parameter optimization of distributed piezoelectric actuators is presented in this paper. The proposed method is designed to improve the performance of multi-mode vibration control in cylindrical shells. The optimization parameters of actuator patch configuration include position, size, and tilt angle. The modal control force of tilted orthotropic piezoelectric actuators is derived and the multi-parameter cylindrical shell optimization model is established. The linear quadratic energy index is employed as the optimization criterion. A geometric constraint is proposed to prevent overlap between tilted actuators, which is plugged into a genetic algorithm to search the optimal configuration parameters. A simply-supported closed cylindrical shell with two actuators serves as a case study. The vibration control efficiencies of various parameter sets are evaluated via frequency response and transient response simulations. The results show that the linear quadratic energy indexes of position and size optimization decreased by 14.0% compared to position optimization; those of position and tilt angle optimization decreased by 16.8%; and those of position, size, and tilt angle optimization decreased by 25.9%. It indicates that, adding configuration optimization parameters is an efficient approach to improving the vibration control performance of piezoelectric actuators on shells.

Research priorities for multi-institutional collaborative research in surgical education.

PubMed

Stefanidis, Dimitrios; Cochran, Amalia; Sevdalis, Nick; Mellinger, John; Phitayakorn, Roy; Sullivan, Maura; Barney, Linda

2015-01-01

Research in surgical education has seen unprecedented growth but originates from single institutions and remains uncoordinated; this study aimed to generate a list of research priorities in surgical educational topics. The membership of the Association for Surgical Education was asked to submit up to 5 research questions concerned with multi-institutional collaborative surgical education research and to identify challenges faced by surgical education researchers. A modified Delphi methodology was used to create the research agenda based on these responses. Surgical educators responded to 3 survey rounds. Categories of submitted questions included teaching methods and curriculum development; assessment and competency; simulation; medical student preparation and selection; impact of work hour restrictions; and faculty development. Participants cited institutional culture and practice variability and lack of institutional review board coordination as common barriers to collaborative research, while identifying extensive planning, frequent communication, and availability of dedicated research coordinators as the most important facilitators. Using a Delphi methodology, a prioritized agenda for multi-institutional surgical education research was developed that may help advance surgeon education. Copyright © 2015 Elsevier Inc. All rights reserved.

Multi-faceted case management: reducing compensation costs of musculoskeletal work injuries in Australia.

PubMed

Iles, Ross Anthony; Wyatt, M; Pransky, G

2012-12-01

This study aimed to determine whether a multi-faceted model of management of work related musculoskeletal disorders reduced compensation claim costs and days of compensation for injured workers. An intervention including early reporting, employee centred case management and removal of barriers to return to work was instituted in 16 selected companies with a combined remuneration over $337 million. Outcomes were evaluated by an administrative dataset from the Victorian WorkCover Authority database. A 'quasi experimental' pre-post design was employed with 492 matched companies without the intervention used as a control group and an average of 21 months of post-intervention follow-up. Primary outcomes were average number of days of compensation and average cost of claims. Secondary outcomes were total medical costs and weekly benefits paid. Information on 3,312 claims was analysed. In companies where the intervention was introduced the average cost of claims was reduced from $6,019 to $3,913 (estimated difference $2,329, 95 % CI $1,318-$3,340) and the number of days of compensation decreased from 33.5 to 14.1 (HR 0.77, 95 % CI 0.67-0.88). Medical costs and weekly benefits costs were also lower after the intervention (p < 0.05). Reduction in claims costs were noted across industry types, injury location and most employer sizes. The model of claims management investigated was effective in reducing the number of days of compensation, total claim costs, total medical costs and the amount paid in weekly benefits. Further research should investigate whether the intervention improves non-financial outcomes in the return to work process.

Formal Leadership of Department Chairpersons with a Broadening Span of Control in Restructured Community Colleges: A Multi-Case Study

ERIC Educational Resources Information Center

Fattig, Teri L.

2013-01-01

Community college department chairpersons have experienced a broadening span of control due to the restructuring tactics of community colleges and the approaches utilized in order to cope with decreased budgets and increased enrollments. Many community colleges used strategies which involved flattening the middle management section of the…

Wearable Wireless Sensor for Multi-Scale Physiological Monitoring

DTIC Science & Technology

2014-10-01

respectively from healthy subjects recruited from the student community of Worcester Polytechnic Institute (WPI). This study was approved by WPI’s IRB and...subjects recruited from the student community of Worcester Polytechnic Institute (WPI). This study was approved by WPI’s institutional review board and all...consisted of students and staff members from Worcester Polytechnic Institute, MA, USA. All volunteers were invited to participate in the study and each

Automatic indexing in a drug information portal.

PubMed

Sakji, Saoussen; Letord, Catherine; Dahamna, Badisse; Kergourlay, Ivan; Pereira, Suzanne; Joubert, Michel; Darmoni, Stéfan

2009-01-01

The objective of this work is to create a bilingual (French/English) Drug Information Portal (DIP), in a multi-terminological context and to emphasize its exploitation by an ATC automatic indexing allowing having more pertinent information about substances, organs or systems on which drugs act and their therapeutic and chemical characteristics. The development of the DIP was based on the CISMeF portal, which catalogues and indexes the most important and quality-controlled sources of institutional health information in French. DIP has created specific functionalities and uses specific drugs terminologies such as the ATC classification which used to automatic index the DIP resources. DIP is the result of collaboration between the CISMeF team and the VIDAL Company, specialized in drug information. DIP is conceived to facilitate the user information retrieval. The ATC automatic indexing provided relevant results in 76% of cases. Using multi-terminological context and in the framework of the drug field, indexing drugs with the appropriate codes or/and terms revealed to be very important to have the appropriate information storage and retrieval. The main challenge in the coming year is to increase the accuracy of the approach.

Teachers' Experiences in Educational Multi-Media Content Development: The Case of Tanzania's Institute of Adult Education

ERIC Educational Resources Information Center

Mariki, Belingtone Eliringia

2014-01-01

This paper is an academic observation of an Educational Multimedia Content development-training programme funded by the Commonwealth of Learning (COL) in Tanzania. This project focused on skills development in script writing and in radio and video programme development, aimed at transforming selected subjects from text to multimedia content. The…

Parents Psychopathology of Children with Attention Deficit Hyperactivity Disorder

ERIC Educational Resources Information Center

Margari, Francesco; Craig, Francesco; Petruzzelli, Maria Giuseppina; Lamanna, Annalinda; Matera, Emilia; Margari, Lucia

2013-01-01

Attention Deficit Hyperactivity Disorder (ADHD) is a disorder with extremely complex etiology, not yet well defined but certainly multi-factorial. This study investigated the possible etiopathogenetic role of ADHD symptoms and psychopathology disorders in parents of children with ADHD. We present a case-control study of parents of 50 children…

Joint Services Electronics Program. Electronics Research at the University of Texas at Austin.

DTIC Science & Technology

1986-09-30

L.S. Davis and J.K. Aggarwal, "Region Correspondence in Multi-Resolution Images Taken from Dynamic Scenes." Mexican Polytechnic Institute Mexico...Estimation and Control of Stochastic Systems ,", ’ Dept. of Mathematics Mexican Polytechnic Institute ,,, 1 Mexico City, Mexico March 27, 1985 * S.I...surface with well known stoichiometry. We have observed interesting new phenomena asociated with the 0__ local surface crystal field (splitting of the

Laterality defects in the national birth defects prevention study 1998-2007 birth prevalence and descriptive epidemiology

USDA-ARS?s Scientific Manuscript database

Little is known epidemiologically about laterality defects. Using data from the National Birth Defects Prevention Study (NBDPS), a large multi-site case-control study of birth defects, we analyzed prevalence and selected characteristics in children born with laterality defects born from 1998 to 2007...

A custom correlation coefficient (CCC) approach for fast identification of multi-SNP association patterns in genome-wide SNPs data.

PubMed

Climer, Sharlee; Yang, Wei; de las Fuentes, Lisa; Dávila-Román, Victor G; Gu, C Charles

2014-11-01

Complex diseases are often associated with sets of multiple interacting genetic factors and possibly with unique sets of the genetic factors in different groups of individuals (genetic heterogeneity). We introduce a novel concept of custom correlation coefficient (CCC) between single nucleotide polymorphisms (SNPs) that address genetic heterogeneity by measuring subset correlations autonomously. It is used to develop a 3-step process to identify candidate multi-SNP patterns: (1) pairwise (SNP-SNP) correlations are computed using CCC; (2) clusters of so-correlated SNPs identified; and (3) frequencies of these clusters in disease cases and controls compared to identify disease-associated multi-SNP patterns. This method identified 42 candidate multi-SNP associations with hypertensive heart disease (HHD), among which one cluster of 22 SNPs (six genes) included 13 in SLC8A1 (aka NCX1, an essential component of cardiac excitation-contraction coupling) and another of 32 SNPs had 29 from a different segment of SLC8A1. While allele frequencies show little difference between cases and controls, the cluster of 22 associated alleles were found in 20% of controls but no cases and the other in 3% of controls but 20% of cases. These suggest that both protective and risk effects on HHD could be exerted by combinations of variants in different regions of SLC8A1, modified by variants from other genes. The results demonstrate that this new correlation metric identifies disease-associated multi-SNP patterns overlooked by commonly used correlation measures. Furthermore, computation time using CCC is a small fraction of that required by other methods, thereby enabling the analyses of large GWAS datasets. © 2014 WILEY PERIODICALS, INC.

A custom correlation coefficient (CCC) approach for fast identification of multi-SNP association patterns in genome-wide SNPs data

PubMed Central

Climer, Sharlee; Yang, Wei; de las Fuentes, Lisa; Dávila-Román, Victor G.; Gu, C. Charles

2014-01-01

Complex diseases are often associated with sets of multiple interacting genetic factors and possibly with unique sets of the genetic factors in different groups of individuals (genetic heterogeneity). We introduce a novel concept of Custom Correlation Coefficient (CCC) between single nucleotide polymorphisms (SNPs) that address genetic heterogeneity by measuring subset correlations autonomously. It is used to develop a 3-step process to identify candidate multi-SNP patterns: (1) pairwise (SNP-SNP) correlations are computed using CCC; (2) clusters of so-correlated SNPs identified; and (3) frequencies of these clusters in disease cases and controls compared to identify disease-associated multi-SNP patterns. This method identified 42 candidate multi-SNP associations with hypertensive heart disease (HHD), among which one cluster of 22 SNPs (6 genes) included 13 in SLC8A1 (aka NCX1, an essential component of cardiac excitation-contraction coupling) and another of 32 SNPs had 29 from a different segment of SLC8A1. While allele frequencies show little difference between cases and controls, the cluster of 22 associated alleles were found in 20% of controls but no cases and the other in 3% of controls but 20% of cases. These suggest that both protective and risk effects on HHD could be exerted by combinations of variants in different regions of SLC8A1, modified by variants from other genes. The results demonstrate that this new correlation metric identifies disease-associated multi-SNP patterns overlooked by commonly used correlation measures. Furthermore, computation time using CCC is a small fraction of that required by other methods, thereby enabling the analyses of large GWAS datasets. PMID:25168954

Outbreak of epidemic keratoconjunctivitis caused by adenovirus in medical residents.

PubMed

Melendez, Carlos Pantoja; Florentino, Margarita Matias; Martinez, Irma Lopez; Lopez, Herlinda Mejia

2009-01-01

The present work documents an outbreak of epidemic keratoconjunctivitis among ophthalmology residents, its influence in the presentation of the community cases, the use of molecular techniques for its diagnosis, and the implementation of successful control measures for its containment. Isolation of the etiologic agent was achieved using cultured African green monkey kidney epithelial cells (VERO). Through molecular tests, such as polymerase chain reaction (PCR) and DNA sequencing, the genotype of the isolated virus was identified. The sequences obtained were aligned with data reported in the NCBI GenBank. A scheme of outbreak control measures was designed to enforce correct sanitary measures in the clinic. The statistical program, Epi info 2002, and openepi were used to determine the attack rate. The Excel Microsoft program was used to elaborate the endemic channel. Nine of the ten samples studied were isolated from the culture and identified by Adenovirus-specifc PCR. Sequencing allowed identification of Ad8 as the agent responsible for the outbreak. The attack rate was 24.39 cases per 100. The epidemic curve allowed identification of a disseminated source in the Institute of Ophthalmology "Conde de Valenciana." It was not possible to calculate the incubation periods among the cases. The endemic channel showed the presence of an epidemic keratoconjunctivitis among the patients that had been cared for at the out-patient services of the institute. One outbreak of a disseminated source caused by Ad8 was detected in the institute among its medical residents, probably associated with relaxation of the habitual sanitary measures during an epidemic of hemorrhagic conjunctivitis among the patients cared for at the institute. The proposed scheme to control the outbreak allowed for its containment and controlled the epidemic of associated cases.

Treatment of lymphangiomas with OK-432 (Picibanil) sclerotherapy: a prospective multi-institutional trial.

PubMed

Giguère, Chantal M; Bauman, Nancy M; Sato, Yutaka; Burke, Diane K; Greinwald, John H; Pransky, Seth; Kelley, Peggy; Georgeson, Keith; Smith, Richard J H

2002-10-01

To describe and to determine the robustness of our study evaluating the efficacy of OK-432 (Picibanil) as a therapeutic modality for lymphangiomas. Prospective, randomized trial and parallel-case series at 13 US tertiary care referral centers. Thirty patients diagnosed as having lymphangioma. Ages in 25 ranged from 6 months to 18 years. Twenty-nine had lesions located in the head-and-neck area. Every patient received a 4-dose injection series of OK-432 scheduled 6 to 8 weeks apart unless a contraindication existed or a complete response was observed before completion of all injections. A control group was observed for 6 months. Successful outcome of therapy was defined as a complete or a substantial (>60%) reduction in lymphangioma size as determined by calculated lesion volumes on computed tomographic or magnetic resonance imaging scans. Overall, 19 (86%) of the 22 patients with predominantly macrocystic lymphangiomas had a successful outcome. OK-432 should be efficacious in the treatment of lymphangiomas. Our study design is well structured to clearly define the role of this treatment agent.

Multi-ethnic genome-wide association study of 21,000 cases and 95,000 controls identifies new risk loci for atopic dermatitis

PubMed Central

Waage, Johannes; Baurecht, Hansjörg; Hotze, Melanie; Strachan, David P; Curtin, John A; Bønnelykke, Klaus; Tian, Chao; Takahashi, Atsushi; Esparza-Gordillo, Jorge; Alves, Alexessander Couto; Thyssen, Jacob P; den Dekker, Herman T; Ferreira, Manuel A; Altmaier, Elisabeth; Sleiman, Patrick MA; Xiao, Feng Li; Gonzalez, Juan R; Marenholz, Ingo; Kalb, Birgit; Yanes, Maria Pino; Xu, Cheng-Jian; Carstensen, Lisbeth; Groen-Blokhuis, Maria M; Venturini, Cristina; Pennell, Craig E; Barton, Sheila J; Levin, Albert M; Curjuric, Ivan; Bustamante, Mariona; Kreiner-Møller, Eskil; Lockett, Gabrielle A; Bacelis, Jonas; Bunyavanich, Supinda; Myers, Rachel A; Matanovic, Anja; Kumar, Ashish; Tung, Joyce Y; Hirota, Tomomitsu; Kubo, Michiaki; McArdle, Wendy L; Henderson, A J; Kemp, John P; Zheng, Jie; Smith, George Davey; Rüschendorf, Franz; Bauerfeind, Anja; Lee-Kirsch, Min Ae; Arnold, Andreas; Homuth, Georg; Schmidt, Carsten O; Mangold, Elisabeth; Cichon, Sven; Keil, Thomas; Rodríguez, Elke; Peters, Annette; Franke, Andre; Lieb, Wolfgang; Novak, Natalija; Fölster-Holst, Regina; Horikoshi, Momoko; Pekkanen, Juha; Sebert, Sylvain; Husemoen, Lise L; Grarup, Niels; de Jongste, Johan C; Rivadeneira, Fernando; Hofman, Albert; Jaddoe, Vincent WV; Pasmans, Suzanne GMA; Elbert, Niels J; Uitterlinden, André G; Marks, Guy B; Thompson, Philip J; Matheson, Melanie C; Robertson, Colin F; Ried, Janina S; Li, Jin; Zuo, Xian Bo; Zheng, Xiao Dong; Yin, Xian Yong; Sun, Liang Dan; McAleer, Maeve A; O'Regan, Grainne M; Fahy, Caoimhe MR; Campbell, Linda E; Macek, Milan; Kurek, Michael; Hu, Donglei; Eng, Celeste; Postma, Dirkje S; Feenstra, Bjarke; Geller, Frank; Hottenga, Jouke Jan; Middeldorp, Christel M; Hysi, Pirro; Bataille, Veronique; Spector, Tim; Tiesler, Carla MT; Thiering, Elisabeth; Pahukasahasram, Badri; Yang, James J; Imboden, Medea; Huntsman, Scott; Vilor-Tejedor, Natàlia; Relton, Caroline L; Myhre, Ronny; Nystad, Wenche; Custovic, Adnan; Weiss, Scott T; Meyers, Deborah A; Söderhäll, Cilla; Melén, Erik; Ober, Carole; Raby, Benjamin A; Simpson, Angela; Jacobsson, Bo; Holloway, John W; Bisgaard, Hans; Sunyer, Jordi; Hensch, Nicole M Probst; Williams, L Keoki; Godfrey, Keith M; Wang, Carol A; Boomsma, Dorret I; Melbye, Mads; Koppelman, Gerard H; Jarvis, Deborah; McLean, WH Irwin; Irvine, Alan D; Zhang, Xue Jun; Hakonarson, Hakon; Gieger, Christian; Burchard, Esteban G; Martin, Nicholas G; Duijts, Liesbeth; Linneberg, Allan; Jarvelin, Marjo-Riitta; Noethen, Markus M; Lau, Susanne; Hübner, Norbert; Lee, Young-Ae; Tamari, Mayumi; Hinds, David A; Glass, Daniel; Brown, Sara J; Heinrich, Joachim; Evans, David M; Weidinger, Stephan

2015-01-01

Genetic association studies have identified 21 loci associated with atopic dermatitis risk predominantly in populations of European ancestry. To identify further susceptibility loci for this common complex skin disease, we performed a meta-analysis of >15 million genetic variants in 21,399 cases and 95,464 controls from populations of European, African, Japanese and Latino ancestry, followed by replication in 32,059 cases and 228,628 controls from 18 studies. We identified 10 novel risk loci, bringing the total number of known atopic dermatitis risk loci to 31 (with novel secondary signals at 4 of these). Notably, the new loci include candidate genes with roles in regulation of innate host defenses and T-cell function, underscoring the important contribution of (auto-)immune mechanisms to atopic dermatitis pathogenesis. PMID:26482879

Multi-ancestry genome-wide association study of 21,000 cases and 95,000 controls identifies new risk loci for atopic dermatitis.

PubMed

Paternoster, Lavinia; Standl, Marie; Waage, Johannes; Baurecht, Hansjörg; Hotze, Melanie; Strachan, David P; Curtin, John A; Bønnelykke, Klaus; Tian, Chao; Takahashi, Atsushi; Esparza-Gordillo, Jorge; Alves, Alexessander Couto; Thyssen, Jacob P; den Dekker, Herman T; Ferreira, Manuel A; Altmaier, Elisabeth; Sleiman, Patrick Ma; Xiao, Feng Li; Gonzalez, Juan R; Marenholz, Ingo; Kalb, Birgit; Yanes, Maria Pino; Xu, Cheng-Jian; Carstensen, Lisbeth; Groen-Blokhuis, Maria M; Venturini, Cristina; Pennell, Craig E; Barton, Sheila J; Levin, Albert M; Curjuric, Ivan; Bustamante, Mariona; Kreiner-Møller, Eskil; Lockett, Gabrielle A; Bacelis, Jonas; Bunyavanich, Supinda; Myers, Rachel A; Matanovic, Anja; Kumar, Ashish; Tung, Joyce Y; Hirota, Tomomitsu; Kubo, Michiaki; McArdle, Wendy L; Henderson, A J; Kemp, John P; Zheng, Jie; Smith, George Davey; Rüschendorf, Franz; Bauerfeind, Anja; Lee-Kirsch, Min Ae; Arnold, Andreas; Homuth, Georg; Schmidt, Carsten O; Mangold, Elisabeth; Cichon, Sven; Keil, Thomas; Rodríguez, Elke; Peters, Annette; Franke, Andre; Lieb, Wolfgang; Novak, Natalija; Fölster-Holst, Regina; Horikoshi, Momoko; Pekkanen, Juha; Sebert, Sylvain; Husemoen, Lise L; Grarup, Niels; de Jongste, Johan C; Rivadeneira, Fernando; Hofman, Albert; Jaddoe, Vincent Wv; Pasmans, Suzanne Gma; Elbert, Niels J; Uitterlinden, André G; Marks, Guy B; Thompson, Philip J; Matheson, Melanie C; Robertson, Colin F; Ried, Janina S; Li, Jin; Zuo, Xian Bo; Zheng, Xiao Dong; Yin, Xian Yong; Sun, Liang Dan; McAleer, Maeve A; O'Regan, Grainne M; Fahy, Caoimhe Mr; Campbell, Linda E; Macek, Milan; Kurek, Michael; Hu, Donglei; Eng, Celeste; Postma, Dirkje S; Feenstra, Bjarke; Geller, Frank; Hottenga, Jouke Jan; Middeldorp, Christel M; Hysi, Pirro; Bataille, Veronique; Spector, Tim; Tiesler, Carla Mt; Thiering, Elisabeth; Pahukasahasram, Badri; Yang, James J; Imboden, Medea; Huntsman, Scott; Vilor-Tejedor, Natàlia; Relton, Caroline L; Myhre, Ronny; Nystad, Wenche; Custovic, Adnan; Weiss, Scott T; Meyers, Deborah A; Söderhäll, Cilla; Melén, Erik; Ober, Carole; Raby, Benjamin A; Simpson, Angela; Jacobsson, Bo; Holloway, John W; Bisgaard, Hans; Sunyer, Jordi; Hensch, Nicole M Probst; Williams, L Keoki; Godfrey, Keith M; Wang, Carol A; Boomsma, Dorret I; Melbye, Mads; Koppelman, Gerard H; Jarvis, Deborah; McLean, Wh Irwin; Irvine, Alan D; Zhang, Xue Jun; Hakonarson, Hakon; Gieger, Christian; Burchard, Esteban G; Martin, Nicholas G; Duijts, Liesbeth; Linneberg, Allan; Jarvelin, Marjo-Riitta; Noethen, Markus M; Lau, Susanne; Hübner, Norbert; Lee, Young-Ae; Tamari, Mayumi; Hinds, David A; Glass, Daniel; Brown, Sara J; Heinrich, Joachim; Evans, David M; Weidinger, Stephan

2015-12-01

Genetic association studies have identified 21 loci associated with atopic dermatitis risk predominantly in populations of European ancestry. To identify further susceptibility loci for this common, complex skin disease, we performed a meta-analysis of >15 million genetic variants in 21,399 cases and 95,464 controls from populations of European, African, Japanese and Latino ancestry, followed by replication in 32,059 cases and 228,628 controls from 18 studies. We identified ten new risk loci, bringing the total number of known atopic dermatitis risk loci to 31 (with new secondary signals at four of these loci). Notably, the new loci include candidate genes with roles in the regulation of innate host defenses and T cell function, underscoring the important contribution of (auto)immune mechanisms to atopic dermatitis pathogenesis.

Advances in cancer epidemiology in Japan.

PubMed

Tanaka, Hideo

2014-02-15

Epidemiologists in Japan have been performing calculations to estimate nationwide cancer incidence rates as well as 5-year survival rates using population-based cancer registry data. There have been remarkable changes in cancer incidence and/or mortality in cancers of the lung, liver and stomach, which were thought to be attributed to the changing impact of exposure to cigarette smoking, chronic hepatitis C virus infection and Helicobacter pylori infection, respectively. In systematic reviews providing evidence in risk/protective factors for cancer sites using case-control and cohort studies of the Japanese population, there were associations between cancer sites (esophagus, stomach, colo-rectum, liver, pancreas, lung and breast) and various lifestyle factors. In the past 10 years, a hospital-based case-control study at Aichi Cancer Center provided valuable evidence of gene-environment interaction on the development of cancer [i.e., the effects of aldehyde dehydrogenase-2 (ALDH2) polymorphism and heavy alcohol drinking on esophageal cancer, ALDH2 polymorphism and smoking on lung cancer, methylenetetrahydrofolate reductase polymorphism and heavy alcohol drinking on pancreatic cancer]. The database with stored DNA was also used and identified seven loci containing significant but low-penetrance polymorphisms associated with the development of breast cancer. These findings together with established risk factors are likely to be useful to predict personalized breast cancer risk in East Asian women. In 2005, the Japan Multi-Institution Collaborative Cohort (J-MICC) study was launched to elucidate gene-environment interactions as well as to confirm preclinical diagnostic biomarkers of cancer. J-MICC, which has recruited 92,000 healthy individuals by the end of 2012, will follow the individuals until 2025. © 2013 UICC.

Laparoscopy for bowel obstruction--a contradiction? Results of a multi-institutional survey in Germany.

PubMed

Zimmermann, M; Hoffmann, M; Laubert, T; Bruch, H P; Keck, T; Benecke, C; Schlöricke, E

2016-05-01

The purpose of the present study was to investigate on the acceptance and frequency of laparoscopic surgery for the management of acute and chronic bowel obstruction in a general patient population in German hospitals. To receive an authoritative opinion on laparoscopic treatment of bowel obstruction in Germany, a cross-sectional online study was conducted. We designed an online-based survey, supported by the German College of Surgeons (Berufsverband der Deutschen Chirurgen, BDC) to get multi-institutional-based data from various level providers of patient care. Between January and February 2014, we received completed questionnaires from 235 individuals (16.7 %). The participating surgeons were a representative sample of German hospitals with regard to hospital size, level of center size, and localization. A total of 74.9 % (n = 176) of all responders stated to use laparoscopy as the initial step of exploration in expected bowel obstruction. This procedure was highly statistically associated with the frequency of overall laparoscopic interventions and laparoscopic experience. The overall conversion rate was reported to be 29.4 %. This survey, investigating on the use of laparoscopic exploration or interventions in bowel obstruction, was able to show that by now, a majority of the responding surgeons accept laparoscopy as an initial step for exploration of the abdomen in the case of bowel obstruction. Laparoscopy was considered to be at least comparable to open surgery in an emergency setting. Furthermore, data analysis demonstrated generally accepted advantages and disadvantages of the laparoscopic approach. Indications for or against laparoscopy are made after careful consideration in each individual case.

Statistical monitoring of data quality and consistency in the Stomach Cancer Adjuvant Multi-institutional Trial Group Trial.

PubMed

Timmermans, Catherine; Doffagne, Erik; Venet, David; Desmet, Lieven; Legrand, Catherine; Burzykowski, Tomasz; Buyse, Marc

2016-01-01

Data quality may impact the outcome of clinical trials; hence, there is a need to implement quality control strategies for the data collected. Traditional approaches to quality control have primarily used source data verification during on-site monitoring visits, but these approaches are hugely expensive as well as ineffective. There is growing interest in central statistical monitoring (CSM) as an effective way to ensure data quality and consistency in multicenter clinical trials. CSM with SMART™ uses advanced statistical tools that help identify centers with atypical data patterns which might be the sign of an underlying quality issue. This approach was used to assess the quality and consistency of the data collected in the Stomach Cancer Adjuvant Multi-institutional Trial Group Trial, involving 1495 patients across 232 centers in Japan. In the Stomach Cancer Adjuvant Multi-institutional Trial Group Trial, very few atypical data patterns were found among the participating centers, and none of these patterns were deemed to be related to a quality issue that could significantly affect the outcome of the trial. CSM can be used to provide a check of the quality of the data from completed multicenter clinical trials before analysis, publication, and submission of the results to regulatory agencies. It can also form the basis of a risk-based monitoring strategy in ongoing multicenter trials. CSM aims at improving data quality in clinical trials while also reducing monitoring costs.

Qualitative Case Study Exploring Operational Barriers Impeding Small and Private, Nonprofit Higher Education Institutions from Implementing Information Security Controls

ERIC Educational Resources Information Center

Liesen, Joseph J.

2017-01-01

The higher education industry uses the very latest technologies to effectively prepare students for their careers, but these technologies often contain vulnerabilities that can be exploited via their connection to the Internet. The complex task of securing information and computing systems is made more difficult at institutions of higher education…

Predictive Feedback and Feedforward Control for Systems with Unknown Disturbances

NASA Technical Reports Server (NTRS)

Juang, Jer-Nan; Eure, Kenneth W.

1998-01-01

Predictive feedback control has been successfully used in the regulation of plate vibrations when no reference signal is available for feedforward control. However, if a reference signal is available it may be used to enhance regulation by incorporating a feedforward path in the feedback controller. Such a controller is known as a hybrid controller. This paper presents the theory and implementation of the hybrid controller for general linear systems, in particular for structural vibration induced by acoustic noise. The generalized predictive control is extended to include a feedforward path in the multi-input multi-output case and implemented on a single-input single-output test plant to achieve plate vibration regulation. There are cases in acoustic-induce vibration where the disturbance signal is not available to be used by the hybrid controller, but a disturbance model is available. In this case the disturbance model may be used in the feedback controller to enhance performance. In practice, however, neither the disturbance signal nor the disturbance model is available. This paper presents the theory of identifying and incorporating the noise model into the feedback controller. Implementations are performed on a test plant and regulation improvements over the case where no noise model is used are demonstrated.

DEEP SPACE: High Resolution VR Platform for Multi-user Interactive Narratives

NASA Astrophysics Data System (ADS)

Kuka, Daniela; Elias, Oliver; Martins, Ronald; Lindinger, Christopher; Pramböck, Andreas; Jalsovec, Andreas; Maresch, Pascal; Hörtner, Horst; Brandl, Peter

DEEP SPACE is a large-scale platform for interactive, stereoscopic and high resolution content. The spatial and the system design of DEEP SPACE are facing constraints of CAVETM-like systems in respect to multi-user interactive storytelling. To be used as research platform and as public exhibition space for many people, DEEP SPACE is capable to process interactive, stereoscopic applications on two projection walls with a size of 16 by 9 meters and a resolution of four times 1080p (4K) each. The processed applications are ranging from Virtual Reality (VR)-environments to 3D-movies to computationally intensive 2D-productions. In this paper, we are describing DEEP SPACE as an experimental VR platform for multi-user interactive storytelling. We are focusing on the system design relevant for the platform, including the integration of the Apple iPod Touch technology as VR control, and a special case study that is demonstrating the research efforts in the field of multi-user interactive storytelling. The described case study, entitled "Papyrate's Island", provides a prototypical scenario of how physical drawings may impact on digital narratives. In this special case, DEEP SPACE helps us to explore the hypothesis that drawing, a primordial human creative skill, gives us access to entirely new creative possibilities in the domain of interactive storytelling.

[Analysis of overseas imported malaria situation and implication for control in Jiangsu Province, PR China].

PubMed

Liu, Yao-Bao; Cao, Jun; Zhou, Hua-Yun; Wang, Wei-Ming; Cao, Yuan-Yuan; Gao, Qi

2013-02-01

To analyze the epidemiological characteristics of overseas imported malaria in Jiangsu Province and explore the strategies and priorities in prevention and control, so as to provide the evidence for improving the diagnosis, treatment and management of imported malaria. The data of overseas imported malaria as well as the case epidemiological investigation in Jiangsu Province from July 18, 2011 to June 30, 2012 were collected and analyzed descriptively for the species composition, original countries, population distribution, regional distribution, onset time, diagnosis and treatment, channels to go abroad, and counterparts returned together with the patients. A total of 233 overseas imported malaria cases were reported, and 226 cases (97.0%) were imported from African countries. A total of 208 cases (89.3%) were falciparum malaria, and 224 cases (96.1%) were laboratory-confirmed. The imported malaria cases were young adults who were mainly migrant farmer and skilled male workers. There was no significant seasonal variation for onset time. Totally 145 cases (62.2%) got malaria onset in 20 days after returning home. The median time from onset to seeing doctor was two days and the median time from seeing doctor to being diagnosed was one day. The first visit health facilities by the patients were relatively scattered and the diagnostic health facilities were mainly medical institutions and CDC at the county level and above (220 cases, accounting for 94.4%). The ratio of standard treatment after malaria diagnosis was 100%. A total of 205 cases (88.0%) were workers dispatched to abroad as labor export by the company, and 142 cases (60.9%) cases had counterparts returned together. The situation of overseas imported malaria in Jiangsu Province is severe. It is necessary to further strengthen the professional training and multi-sectoral cooperation, establish the collaborative investigation mechanism for high-risk groups, and take effective prevention and control measures to reduce the risk of overseas imported malaria.

Effect of socio-cultural factors on spontaneous abortion in Burdur, Turkey: A population based case-control study.

PubMed

Catak, Binali; Oner, Can; Sutlu, Sevinc; Kilinc, Selcuk

2016-01-01

To determine the sociocultural factors that have effect on spontaneous abortion in Burdur, Turkey. Study was designed as case-control study. The case group consist of 257 women whose pregnancies ended with spontaneous abortion. The control group consisted of 514 women whose pregnancy continued since 22 weeks and more during the study. Chi-square, and backward LR logistic regression were utilized in analyses. In multifactorial-analyses it was determined that four factors (educational status of women, employment status of women, exposure to physical violence and non-receipt of ANC) created independent risk on spontaneous abortions. Pregnant women with these risk factors should be followed up more frequently and in a more qualified way in primary and secondary and tertiary health institutions.

Application of Standard Project Management Tools to Research--A Case Study from a Multi-National Clinical Trial

ERIC Educational Resources Information Center

Gist, Peter; Langley, David

2007-01-01

PRINCE2, which stands for Projects in Controlled Environments, is a project management method covering the organisation, management, and control of projects and is widely used in both government and commercial IT and building projects in the UK. This paper describes the application of PRINCE2 to the management of large clinical trials…

Collaborative simulation method with spatiotemporal synchronization process control

NASA Astrophysics Data System (ADS)

Zou, Yisheng; Ding, Guofu; Zhang, Weihua; Zhang, Jian; Qin, Shengfeng; Tan, John Kian

2016-10-01

When designing a complex mechatronics system, such as high speed trains, it is relatively difficult to effectively simulate the entire system's dynamic behaviors because it involves multi-disciplinary subsystems. Currently,a most practical approach for multi-disciplinary simulation is interface based coupling simulation method, but it faces a twofold challenge: spatial and time unsynchronizations among multi-directional coupling simulation of subsystems. A new collaborative simulation method with spatiotemporal synchronization process control is proposed for coupling simulating a given complex mechatronics system across multiple subsystems on different platforms. The method consists of 1) a coupler-based coupling mechanisms to define the interfacing and interaction mechanisms among subsystems, and 2) a simulation process control algorithm to realize the coupling simulation in a spatiotemporal synchronized manner. The test results from a case study show that the proposed method 1) can certainly be used to simulate the sub-systems interactions under different simulation conditions in an engineering system, and 2) effectively supports multi-directional coupling simulation among multi-disciplinary subsystems. This method has been successfully applied in China high speed train design and development processes, demonstrating that it can be applied in a wide range of engineering systems design and simulation with improved efficiency and effectiveness.

The influence of institutional characteristics on length of stay for psychiatric patients: a national database study in South Korea.

PubMed

Chung, Woojin; Cho, Woo Hyun; Yoon, Chung Won

2009-03-01

The institutionalization of psychiatric patients has put a tremendous burden on many societies, but few studies have examined the effects of institutional characteristics on patient length of stay (LOS). This paper investigated the association between institutional characteristics and LOS for 160,517 psychiatric patients in South Korea by applying a two-level modeling technique to administrative claims databases covering the entire patient population. Patient LOS, expressed in terms of days, was analyzed by taking account of institutional type, ownership, location, inpatient capacity, staffing, and patient demographics. The characteristics of inpatients were used as control variables and consisted of gender, age, sub-diagnosis, and the type of national health security program. The main findings of this study are: (1) patient LOS was 69% longer at psychiatric hospitals than at tertiary-care hospitals; (2) neither location nor inpatient capacity was associated with LOS; (3) larger staffs reduced LOS; and (4), LOS increased with a higher proportion of male inpatients, inpatients > or =65 years old, or inpatients diagnosed with organic or schizophrenic disorders, possibly through contextual effects. The results of this study suggest that researchers and policy makers could improve their assessment of psychiatric patient LOS and its association with health outcome by taking into account institutional characteristics and using multi-level analyses.

Autonomous Motion Learning for Intra-Vehicular Activity Space Robot

NASA Astrophysics Data System (ADS)

Watanabe, Yutaka; Yairi, Takehisa; Machida, Kazuo

Space robots will be needed in the future space missions. So far, many types of space robots have been developed, but in particular, Intra-Vehicular Activity (IVA) space robots that support human activities should be developed to reduce human-risks in space. In this paper, we study the motion learning method of an IVA space robot with the multi-link mechanism. The advantage point is that this space robot moves using reaction force of the multi-link mechanism and contact forces from the wall as space walking of an astronaut, not to use a propulsion. The control approach is determined based on a reinforcement learning with the actor-critic algorithm. We demonstrate to clear effectiveness of this approach using a 5-link space robot model by simulation. First, we simulate that a space robot learn the motion control including contact phase in two dimensional case. Next, we simulate that a space robot learn the motion control changing base attitude in three dimensional case.

Serrated adenoma of the gallbladder: a case report.

PubMed

Rubio, Carlos A

2015-06-01

A case of serrated adenomatous polyp found in a cholecystectomy specimen is reported. The adenoma was built with mucosal crypts exhibiting unlocked serrations lined with up to high-grade dysplastic cells. A desmoplastic sclerotic tissue having multiple stromal hubs with branched thin spokes replaced the subjacent lamina propia, muscularis mucosae, and submucosa. The generous serrated configurations covering a multi-branched sclerotic stroma, gave the adenoma a papillary appearance. Review of the literature indicates that this appears to be the first reported case of serrated adenoma of the gallbladder. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Hypothermia in the sepsis syndrome and clinical outcome. The Methylprednisolone Severe Sepsis Study Group.

PubMed

Clemmer, T P; Fisher, C J; Bone, R C; Slotman, G J; Metz, C A; Thomas, F O

1992-10-01

To evaluate the consequences of clinical hypothermia associated with sepsis syndrome and septic shock. Analysis of data from a multi-institutional, randomized, placebo-controlled, prospective study with predetermined end-point analysis of development of shock, recovery from shock, hospital length of stay, and death. Multi-institutional medical and surgical ICUs. Patients meeting predetermined criteria for severe sepsis syndrome. Appropriate sepsis and shock care with 50% of patients receiving methylprednisolone and 50% receiving placebo. The occurrence rate of hypothermia (< 35.5 degrees C) is 9% in this population. When compared with febrile patients, hypothermic patients had a higher frequency of central nervous system dysfunction (88% vs. 60%), increased serum bilirubin concentration (35% vs. 15%), prolonged prothrombin times (50% vs. 23%), shock (94% vs. 61%), failure to recover from shock (66% vs. 26%), and death (62% vs. 26%). The hypothermic patients were also more likely to be classified as having a rapidly or ultimately fatal disease upon study admission. This prospective study confirms that hypothermia associated with sepsis syndrome has a significant relationship to outcome manifest by increased frequency of shock and death from shock. This finding is in sharp contrast to the protective effects of induced hypothermia in septic animals and perhaps man.

Using Systems Thinking in the Design, Implementation, and Evaluation of Complex Educational Innovations, with Examples from the InTeGrate Project

ERIC Educational Resources Information Center

Kastens, Kim A.; Manduca, Cathryn A.

2017-01-01

Many geoscience education initiatives now involve cross-departmental or multi-institutional programs. However, the geoscientists who lead such programs typically have little experience or training in program design, leadership, or evaluation. In this commentary, we make the case that geoscientists taking on these ambitious leadership roles can…

Norovirus outbreak associated with a hotel in the west of Ireland, 2006.

PubMed

Michel, A; Fitzgerald, R; Whyte, D; Fitzgerald, A; Beggan, E; O'Connell, N; Greally, T

2007-07-01

An outbreak of gastrointestinal disease (nausea, vomiting or diarrhoea) occurred among a party of wedding guests, staff and other guests in a hotel in the west of Ireland, in October 2006. Upon notification, a multi-disciplinary outbreak control team was convened to investigate and control the outbreak. In all, 98 people were ascertained ill. The median duration of illness was 48 hours. The attack rate ranged between 48 and 85%. The hotel voluntarily notified health authorities and co-operated fully with investigation and control measures. Strict prevention and control measures were instituted promptly, including air ventilation, enhanced hand hygiene, isolation of cases, temporary "cooked food only", temporary alternative accommodation and specialised cleaning. Three cases of norovirus infection were laboratory-confirmed. There was no evidence of food- or water-borne transmission. Clinical and epidemiological findings indicated person-to-person transmission of norovirus. This report highlights the potential for large social gatherings to facilitate the spread of viral gastroenteritis by person-to-person transmission and via contaminated environment. Effective community management of this outbreak appears to have prevented its having an impact on local acute hospital services. The authors conclude that in addition to the existing national guidelines on the management of outbreaks of norovirus in healthcare settings, agreed guidelines for the management of norovirus outbreaks in the hotel and tourism industry are needed in Ireland.

Conducting a paediatric multi-centre RCT with an industry partner: challenges and lessons learned.

PubMed

Maskell, Jessica; Newcombe, Peter; Martin, Graham; Kimble, Roy

2012-11-01

There are many benefits of multi-centred research including large sample sizes, statistical power, timely recruitment and generalisability of results. However, there are numerous considerations when planning and implementing a multi-centred study. This article reviews the challenges and successes of planning and implementing a multi-centred prospective randomised control trial involving an industry partner. The research investigated the impact on psychosocial functioning of a cosmetic camouflage product for children and adolescents with burn scarring. Multi-centred studies commonly have many stakeholders. Within this study, six Australian and New Zealand paediatric burn units as well as an industry partner were involved. The inclusion of an industry partner added complexities as they brought different priorities and expectations to the research. Further, multifaceted ethical and institutional approval processes needed to be negotiated. The challenges, successes, lessons learned and recommendations from this study regarding Australian and New Zealand ethics and research governance approval processes, collaboration with industry partners and the management of differing expectations will be outlined. Recommendations for future multi-centred research with industry partners include provision of regular written reports for the industry partner; continual monitoring and prompt resolution of concerns; basic research practices education for industry partners; minimisation of industry partner contact with participants; clear roles and responsibilities of all stakeholders and utilisation of single ethical review if available. © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Managing an Open Access, Multi-Institutional, International Digital Library: The Digital Library of the Caribbean

ERIC Educational Resources Information Center

Wooldridge, Brooke; Taylor, Laurie; Sullivan, Mark

2009-01-01

Developing an Open Access, multi-institutional, multilingual, international digital library requires robust technological and institutional infrastructures that support both the needs of individual institutions alongside the needs of the growing partnership and ensure continuous communication and development of the shared vision for the digital…

The UNESCO biosphere reserve concept as a tool for urban sustainability: the CUBES Cape Town case study.

PubMed

Stanvliet, R; Jackson, J; Davis, G; De Swardt, C; Mokhoele, J; Thom, Q; Lane, B D

2004-06-01

The Cape Town Case Study (CTCS) was a multi-institutional collaborative project initiated by CUBES, a knowledge networking initiative of UNESCO's Ecological Sciences Division and the Earth Institute at Columbia University. Cape Town was selected as a CUBES site on the basis of its high biological and cultural significance, together with its demonstrated leadership in promoting urban sustainability. The CTCS was conducted by the Cape Town Urban Biosphere Group, a cross-disciplinary group of specialists drawn from national, provincial, municipal, and civil society institutions, mandated to examine the potential value of the UNESCO Biosphere Reserve concept as a tool for environmental management, social inclusion, and poverty alleviation in Cape Town. This article provides a contextualization of the CTCS and its collaborative process. It also reviews the biosphere reserve concept relative to urban sustainability objectives and proposes a more functional application of that concept in an urban context. A detailed analysis of key initiatives at the interface of conservation and poverty alleviation is provided in table format. Drawing on an examination of successful sustainability initiatives in Cape Town, specific recommendations are made for future application of the biosphere reserve concept in an urban context, as well as a model by which urban areas might affiliate with the UNESCO World Network of Biosphere Reserves, and criteria for such affiliation.

Knowledge-driven institutional change: an empirical study on combating desertification in northern China from 1949 to 2004.

PubMed

Yang, Lihua; Wu, Jianguo

2012-11-15

Understanding institutional changes is crucial for environmental management. Here we investigated how institutional changes influenced the process and result of desertification control in northern China between 1949 and 2004. Our analysis was based on a case study of 21 field sites and a meta-analysis of additional 29 sites reported in the literature. Our results show that imposed knowledge-driven institutional change was often perceived as a more progressive, scientific, and rational type of institutional change by entrepreneurs, scholars, experts, and technicians, while voluntary, knowledge-driven institutional change based on indigenous knowledge and experiences of local populations was discouraged. Our findings also demonstrate that eight working rules of imposed knowledge-driven institutional change can be applied to control desertification effectively. These rules address the issues of perception of potential gains, entrepreneurs' appeals and support, coordination of multiple goals, collaboration among multiple organizations, interest distribution and conflict resolution, incremental institutional change, external intervention, and coordination among the myriad institutions involved. Imposed knowledge-driven institutional change tended to be more successful when these rules were thoroughly implemented. These findings provide an outline for implementing future institutional changes and policy making to combat desertification and other types of ecological and environmental management. Copyright © 2012 Elsevier Ltd. All rights reserved.

Somatic Consequences and Symptomatic Responses to Stress: Directions for Future Research

DTIC Science & Technology

1999-07-01

endeavors, some early work in developing multi- method , multi-source assessment approaches for identifying cases of PTSD; some clinical studies ... research dealing with the entire concept of the cultural shaping of what he calls the illness narrative and the way in which this tends to control the...talk for five to ten minutes about the pattern of the research you’ve been doing and the directions it’s been going in and the directions you think it

Modeling occupancy distribution in large spaces with multi-feature classification algorithm

DOE PAGES

Wang, Wei; Chen, Jiayu; Hong, Tianzhen

2018-04-07

We present that occupancy information enables robust and flexible control of heating, ventilation, and air-conditioning (HVAC) systems in buildings. In large spaces, multiple HVAC terminals are typically installed to provide cooperative services for different thermal zones, and the occupancy information determines the cooperation among terminals. However, a person count at room-level does not adequately optimize HVAC system operation due to the movement of occupants within the room that creates uneven load distribution. Without accurate knowledge of the occupants’ spatial distribution, the uneven distribution of occupants often results in under-cooling/heating or over-cooling/heating in some thermal zones. Therefore, the lack of high-resolutionmore » occupancy distribution is often perceived as a bottleneck for future improvements to HVAC operation efficiency. To fill this gap, this study proposes a multi-feature k-Nearest-Neighbors (k-NN) classification algorithm to extract occupancy distribution through reliable, low-cost Bluetooth Low Energy (BLE) networks. An on-site experiment was conducted in a typical office of an institutional building to demonstrate the proposed methods, and the experiment outcomes of three case studies were examined to validate detection accuracy. One method based on City Block Distance (CBD) was used to measure the distance between detected occupancy distribution and ground truth and assess the results of occupancy distribution. Finally, the results show the accuracy when CBD = 1 is over 71.4% and the accuracy when CBD = 2 can reach up to 92.9%.« less

Modeling occupancy distribution in large spaces with multi-feature classification algorithm

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

Wang, Wei; Chen, Jiayu; Hong, Tianzhen

We present that occupancy information enables robust and flexible control of heating, ventilation, and air-conditioning (HVAC) systems in buildings. In large spaces, multiple HVAC terminals are typically installed to provide cooperative services for different thermal zones, and the occupancy information determines the cooperation among terminals. However, a person count at room-level does not adequately optimize HVAC system operation due to the movement of occupants within the room that creates uneven load distribution. Without accurate knowledge of the occupants’ spatial distribution, the uneven distribution of occupants often results in under-cooling/heating or over-cooling/heating in some thermal zones. Therefore, the lack of high-resolutionmore » occupancy distribution is often perceived as a bottleneck for future improvements to HVAC operation efficiency. To fill this gap, this study proposes a multi-feature k-Nearest-Neighbors (k-NN) classification algorithm to extract occupancy distribution through reliable, low-cost Bluetooth Low Energy (BLE) networks. An on-site experiment was conducted in a typical office of an institutional building to demonstrate the proposed methods, and the experiment outcomes of three case studies were examined to validate detection accuracy. One method based on City Block Distance (CBD) was used to measure the distance between detected occupancy distribution and ground truth and assess the results of occupancy distribution. Finally, the results show the accuracy when CBD = 1 is over 71.4% and the accuracy when CBD = 2 can reach up to 92.9%.« less

Inverse treatment planning for spinal robotic radiosurgery: an international multi-institutional benchmark trial.

PubMed

Blanck, Oliver; Wang, Lei; Baus, Wolfgang; Grimm, Jimm; Lacornerie, Thomas; Nilsson, Joakim; Luchkovskyi, Sergii; Cano, Isabel Palazon; Shou, Zhenyu; Ayadi, Myriam; Treuer, Harald; Viard, Romain; Siebert, Frank-Andre; Chan, Mark K H; Hildebrandt, Guido; Dunst, Jürgen; Imhoff, Detlef; Wurster, Stefan; Wolff, Robert; Romanelli, Pantaleo; Lartigau, Eric; Semrau, Robert; Soltys, Scott G; Schweikard, Achim

2016-05-08

Stereotactic radiosurgery (SRS) is the accurate, conformal delivery of high-dose radiation to well-defined targets while minimizing normal structure doses via steep dose gradients. While inverse treatment planning (ITP) with computerized optimization algorithms are routine, many aspects of the planning process remain user-dependent. We performed an international, multi-institutional benchmark trial to study planning variability and to analyze preferable ITP practice for spinal robotic radiosurgery. 10 SRS treatment plans were generated for a complex-shaped spinal metastasis with 21 Gy in 3 fractions and tight constraints for spinal cord (V14Gy < 2 cc, V18Gy < 0.1 cc) and target (coverage > 95%). The resulting plans were rated on a scale from 1 to 4 (excellent-poor) in five categories (constraint compliance, optimization goals, low-dose regions, ITP complexity, and clinical acceptability) by a blinded review panel. Additionally, the plans were mathemati-cally rated based on plan indices (critical structure and target doses, conformity, monitor units, normal tissue complication probability, and treatment time) and compared to the human rankings. The treatment plans and the reviewers' rankings varied substantially among the participating centers. The average mean overall rank was 2.4 (1.2-4.0) and 8/10 plans were rated excellent in at least one category by at least one reviewer. The mathematical rankings agreed with the mean overall human rankings in 9/10 cases pointing toward the possibility for sole mathematical plan quality comparison. The final rankings revealed that a plan with a well-balanced trade-off among all planning objectives was preferred for treatment by most par-ticipants, reviewers, and the mathematical ranking system. Furthermore, this plan was generated with simple planning techniques. Our multi-institutional planning study found wide variability in ITP approaches for spinal robotic radiosurgery. The participants', reviewers', and mathematical match on preferable treatment plans and ITP techniques indicate that agreement on treatment planning and plan quality can be reached for spinal robotic radiosurgery.

[Stewardship of public health surveillance in the health system in Colombia: a case study].

PubMed

López, Yolanda Lucía; González, Claudia; Gallego, Berta Natalia; Moreno, Ana Lida

2009-12-01

With the reform of the Colombian health system in 1993, public health surveillance continued to be a governmental responsibility under the stewardship of the Ministry of Social Protection along with state and local health authorities. The effectiveness of the development and organization of state and municipality public health surveillance programs will be studied as they have evolved under the general social security system in Colombia. Qualitative study and case-study method are applied to several institutions as they function in 5 states and 11 counties, ten years after the health system reforms. Public health authorities have reduced resources for providing advice, technical assistance, supervision and control of the process of the public health surveillance. Weaknesses in administrative control are common. Quantity and quality of human resources, as well as, staffing and financial resources are inadequate to meet the responsibilities that have been assigned to each state and county. The public health surveillance has prioritized the notification and registration of cases, and the strength of development of particular areas occasionally has been subject to the particular interests of officials in charge, particularly in the public hospitals. Little commitment or interest is shown by mayors, insurance companies, and institutions providing health services that are supposed to be involved with monitoring. A lack of cross-institutional collaboration is apparent in the development of health services surveillance. The implementation of public health surveillance at state and local levels is weak due to problems with the governmental stewardship. These weaknesses are manifested in the lack of regulation, financing and control of the health system.

Does iodine excess lead to hypothyroidism? Evidence from a case-control study in India.

PubMed

Kotwal, Atul; Kotwal, Jyoti; Prakash, Rajat; Kotwal, Narendra

2015-08-01

Iodine deficiency disorders have been known to mankind since antiquity and various researchers elucidated the role of iodine in its causation. However, recent evidence shows that the entire control program ignored multi-causality and association of increased iodine intake with hypothyroidism. This study was conducted to assess differences of iodine intake as measured by urinary iodine excretion (UIE) between cases of hypothyroidism and healthy controls. A case-control study was conducted with three groups (cases, hospital controls and community controls) in two cities of India. Patients with overt hypothyroidism were cases (n = 150) and were compared with age, sex and socioeconomic status-matched hospital (n = 154) and community (n = 488) controls. Thyroid function tests (T3, T4, TSH) were used as diagnostic and inclusion criteria. TPOAb and UIE estimation were carried out for all study participants. Mean values of TPOAb and UIE were higher in cases as compared to hospital controls as well as community controls (p <0.05). With a cut off of 34 IU/mL for TPOAb, more cases had an anti-TPO level >34 as compared to hospital controls (p <0.001) as well as community controls (p <0.001); OR, 0.06 (95% CI, 0.03, 0.12) and 0.08 (0.05, 0.12), respectively. For UIE cut-off of 300 μg/L, more cases than hospital controls (p = 0.090) and community controls (p = 0.001) had higher levels; OR, 0.671, (0.422, 1.066) and 0.509, (0.348, 0.744), respectively. The study has clearly shown that cases of hypothyroidism are associated with excess iodine intake. Cohort studies to generate further evidence and an eco-social epidemiological approach have been suggested as the way forward. Copyright © 2015 IMSS. Published by Elsevier Inc. All rights reserved.

Accelerated hyperfractionated radiotherapy for cervical cancer: multi-institutional prospective study of forum for nuclear cooperation in Asia among eight Asian countries.

PubMed

Ohno, Tatsuya; Nakano, Takashi; Kato, Shingo; Koo, Cho Chul; Chansilpa, Yaowalak; Pattaranutaporn, Pittayapoom; Calaguas, Miriam Joy C; de Los Reyes, Rey H; Zhou, Beibei; Zhou, Juying; Susworo, Raden; Supriana, Nana; Dung, To Anh; Ismail, Fuad; Sato, Sinichiro; Suto, Hisao; Kutsutani-Nakamura, Yuzuru; Tsujii, Hirohiko

2008-04-01

To evaluate the toxicity and efficacy of accelerated hyperfractionated radiotherapy (RT) for locally advanced cervical cancer. A multi-institutional prospective single-arm study was conducted among eight Asian countries. Between 1999 and 2002, 120 patients (64 with Stage IIB and 56 with Stage IIIB) with squamous cell carcinoma of the cervix were treated with accelerated hyperfractionated RT. External beam RT consisted of 30 Gy to the whole pelvis, 1.5 Gy/fraction twice daily, followed by 20 Gy of pelvic RT with central shielding at a dose of 2-Gy fractions daily. A small bowel displacement device was used with the patient in the prone position. In addition to central shielding RT, intracavitary brachytherapy was started. Acute and late morbidities were graded according to the Radiation Therapy Oncology Group and Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria. The median overall treatment time was 35 days. The median follow-up time for surviving patients was 4.7 years. The 5-year pelvic control and overall survival rate for all patients was 84% and 70%, respectively. The 5-year pelvic control and overall survival rate was 78% and 69% for tumors > or = 6 cm in diameter, respectively. No treatment-related death occurred. Grade 3-4 late toxicities of the small intestine, large intestine, and bladder were observed in 1, 1, and 2 patients, respectively. The 5-year actuarial rate of Grade 3-4 late toxicity at any site was 5%. The results of our study have shown that accelerated hyperfractionated RT achieved sufficient pelvic control and survival without increasing severe toxicity. This treatment could be feasible in those Asian countries where chemoradiotherapy is not available.

Accelerated Hyperfractionated Radiotherapy for Cervical Cancer: Multi-Institutional Prospective Study of Forum for Nuclear Cooperation in Asia Among Eight Asian Countries

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

Ohno, Tatsuya; Nakano, Takashi; Kato, Shingo

2008-04-01

Purpose: To evaluate the toxicity and efficacy of accelerated hyperfractionated radiotherapy (RT) for locally advanced cervical cancer. Methods and Materials: A multi-institutional prospective single-arm study was conducted among eight Asian countries. Between 1999 and 2002, 120 patients (64 with Stage IIB and 56 with Stage IIIB) with squamous cell carcinoma of the cervix were treated with accelerated hyperfractionated RT. External beam RT consisted of 30 Gy to the whole pelvis, 1.5 Gy/fraction twice daily, followed by 20 Gy of pelvic RT with central shielding at a dose of 2-Gy fractions daily. A small bowel displacement device was used with themore » patient in the prone position. In addition to central shielding RT, intracavitary brachytherapy was started. Acute and late morbidities were graded according to the Radiation Therapy Oncology Group and Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria. Results: The median overall treatment time was 35 days. The median follow-up time for surviving patients was 4.7 years. The 5-year pelvic control and overall survival rate for all patients was 84% and 70%, respectively. The 5-year pelvic control and overall survival rate was 78% and 69% for tumors {>=}6 cm in diameter, respectively. No treatment-related death occurred. Grade 3-4 late toxicities of the small intestine, large intestine, and bladder were observed in 1, 1, and 2 patients, respectively. The 5-year actuarial rate of Grade 3-4 late toxicity at any site was 5%. Conclusion: The results of our study have shown that accelerated hyperfractionated RT achieved sufficient pelvic control and survival without increasing severe toxicity. This treatment could be feasible in those Asian countries where chemoradiotherapy is not available.« less

Initial Technology Assessment for the Large-Aperture UV-Optical-Infrared (LUVOIR) Mission Concept Study

NASA Technical Reports Server (NTRS)

Bolcar, Matthew R.; Feinberg, Lee; France, Kevin; Rauscher, Bernard J.; Redding, David; Schiminovich, David

2016-01-01

The NASA Astrophysics Division's 30-Year Roadmap prioritized a future large-aperture space telescope operating in the ultra-violet/optical/infrared wavelength regime. The Association of Universities for Research in Astronomy envisioned a similar observatory, the High Definition Space Telescope. And a multi-institution group also studied the Advanced Technology Large Aperture Space Telescope. In all three cases, a broad science case is outlined, combining general astrophysics with the search for biosignatures via direct-imaging and spectroscopic characterization of habitable exoplanets. We present an initial technology assessment that enables such an observatory that is currently being studied for the 2020 Decadal Survey by the Large UV/Optical/Infrared (LUVOIR) surveyor Science and Technology Definition Team. We present here the technology prioritization for the 2016 technology cycle and define the required technology capabilities and current state-of-the-art performance. Current, planned, and recommended technology development efforts are also reported.

Initial Technology Assessment for the Large UV-Optical-Infrared (LUVOIR) Mission Concept Study

NASA Technical Reports Server (NTRS)

Bolcar, Matthew R.; Feinberg, Lee D.; France, Kevin; Rauscher, Bernard J.; Redding, David; Schiminovich, David

2016-01-01

The NASA Astrophysics Divisions 30-Year Roadmap prioritized a future large-aperture space telescope operating in the ultra-violet-optical-infrared wavelength regime. The Association of Universities for Research in Astronomy envisioned a similar observatory, the High Definition Space Telescope. And a multi-institution group also studied the Advanced Technology Large Aperture Space Telescope. In all three cases, a broad science case is outlined, combining general astrophysics with the search for bio-signatures via direct-imaging and spectroscopic characterization of habitable exo-planets. We present an initial technology assessment that enables such an observatory that is currently being studied for the 2020 Decadal Survey by the Large UV-Optical Infrared (LUVOIR) surveyor Science and Technology Definition Team. We present here the technology prioritization for the 2016 technology cycle and define the required technology capabilities and current state-of-the-art performance. Current, planned, and recommended technology development efforts are also reported.

A participatory approach to evaluating a national training and institutional change initiative: the BUILD longitudinal evaluation.

PubMed

Davidson, Pamela L; Maccalla, Nicole M G; Afifi, Abdelmonem A; Guerrero, Lourdes; Nakazono, Terry T; Zhong, Shujin; Wallace, Steven P

2017-01-01

The National Institutes of Health (NIH) funds training programs to increase the numbers and skills of scientists who obtain NIH research grants, but few programs have been rigorously evaluated. The sizeable recent NIH investment in developing programs to increase the diversity of the NIH-funded workforce, implemented through the Diversity Program Consortium (DPC), is unusual in that it also funds a Consortium-wide evaluation plan, which spans the activities of the 10 BUilding Infrastructure Leading to Diversity (BUILD) awardees and the National Research Mentoring Network (NRMN). The purpose of this article is to describe the evaluation design and innovations of the BUILD Program on students, faculty, and institutions of the 10 primarily undergraduate BUILD sites. Our approach to this multi-methods quasi-experimental longitudinal evaluation emphasizes stakeholder participation and collaboration. The evaluation plan specifies the major evaluation questions and key short- to long-term outcome measures (or Hallmarks of Success). The Coordination and Evaluation Center (CEC) embarked on a comprehensive evaluation strategy by developing a set of logic models that incorporate the Hallmarks of Success and other outcomes that were collaboratively identified by the DPC. Data were collected from each BUILD site through national surveys from the Higher Education Research Institute at UCLA (HERI), annual followup surveys that align with the HERI instruments, site visits and case studies, program encounter data ("tracker" data), and institutional data. The analytic approach involves comparing changes in Hallmarks (key outcomes) within institutions for biomedical students who participated versus those who did not participate in the BUILD program at each institution, as well as between institution patterns of biomedical students at the BUILD sites, and matched institutions that were not BUILD grantees. Case studies provide insights into the institutionalization of these new programs and help to explain the processes that lead to the observed outcomes. Ultimately, the results of the consortium-wide evaluation will be used to inform national policy in higher education and will provide relevant examples of institutional and educational programmatic changes required to diversify the biomedical workforce in the USA.

Complications and Short-Term Explantation Rate Following Artificial Urinary Sphincter Implantation: Results from a Large Middle European Multi-Institutional Case Series.

PubMed

Kretschmer, Alexander; Hüsch, Tanja; Thomsen, Frauke; Kronlachner, Dominik; Obaje, Alice; Anding, Ralf; Pottek, Tobias; Rose, Achim; Olianas, Roberto; Friedl, Alexander; Hübner, Wilhelm; Homberg, Roland; Pfitzenmaier, Jesco; Grein, Ulrich; Queissert, Fabian; Naumann, Carsten Maik; Schweiger, Josef; Wotzka, Carola; Nyarangi-Dix, Joanne N; Hofmann, Torben; Seiler, Roland; Haferkamp, Axel; Bauer, Ricarda M

2016-01-01

Background/Aims/Objectives: To analyze perioperative complication and short-term explantation rates after perineal or penoscrotal single-cuff and double-cuff artificial urinary sphincter (AUS) implantation in a large middle European multi-institutional patient cohort. 467 male patients with stress urinary incontinence underwent implantation of a perineal single-cuff (n = 152), penoscrotal single-cuff (n = 99), or perineal double-cuff (n = 216) AUS between 2010 and 2012. Postoperative complications and 6-month explantation rates were assessed. For statistical analysis, Fisher's exact test and Kruskal-Wallis rank sum test, and a multiple logistic regression model were used (p < 0.05). Compared to perineal single-cuff AUS, penoscrotal single-cuff implantation led to significantly increased short-term explantation rates (8.6% (perineal) vs. 19.2% (penoscrotal), p = 0.019). The postoperative infection rate was significantly higher after double-cuff compared to single-cuff implantation (6.0% (single-cuff) vs. 13.9% (double-cuff), p = 0.019). The short-term explantation rate after primary double-cuff placement was 6.5% (p = 0.543 vs. perineal single-cuff). In multivariate analysis, the penoscrotal approach (p = 0.004), intraoperative complications (p = 0.005), postoperative bleeding (p = 0.011), and perioperative infection (p < 0.001) were independent risk factors for short-term explantation. Providing data from a large contemporary multi-institutional patient cohort from high-volume and low-volume institutions, our results reflect the current standard of care in middle Europe. We indicate that the penoscrotal approach is an independent risk factor for increased short-term explantation rates. © 2016 S. Karger AG, Basel.

Orthodontic aligners and root resorption: A systematic review.

PubMed

Elhaddaoui, Rajae; Qoraich, Halima Saadia; Bahije, Loubna; Zaoui, Fatima

2017-03-01

Root resorption is one of the leading problems in orthodontic treatment. Most earlier studies have assessed the incidence and severity of root resorption following orthodontic treatment using fixed appliances as well as associated factors. However, few studies have assessed these parameters in the context of orthodontic treatment using thermoplastic splints or aligners. The aim of this systematic review was to assess the incidence and severity of root resorption following orthodontic treatment using aligners and associated factors. A comparative analysis was also made with fixed multi-bracket treatments. The data bases consulted were: Medline, Embase, EBSCO Host, Cochrane Library and Science Direct. Our search included meta-analyses, randomized and non-randomized controled trials, cohort studies and descriptive studies published before December 2015 and evidencing a connection with the incidence and severity of root resorption following orthodontic treatment using aligners alone or compared with fixed multi-bracket treatments. Among the 93 selected references, only 3 studies met our selection criteria. The incidence of root resorption ranged between 0 and 46%, of which 6% were severe cases. Relative to fixed multi-bracket non-extraction treatments to correct the same malocclusions, the incidence of resorption ranged between 2% and 50%, of which 22% were severe cases. In both techniques, the incidence of resorption was higher for the maxillary incisors and was not influenced by either age or sex. In malocclusion cases not requiring extractions, orthodontic aligner treatment is possibly associated with a lower incidence of resorption than fixed multi-bracket treatment. Further research encompassing extraction cases is needed to better assess the incidence and severity of root resorption following the use of these removable appliances. Copyright © 2016 CEO. Published by Elsevier Masson SAS. All rights reserved.

An outbreak of multi-drug resistant Escherichia coli urinary tract infection in an elderly population: a case-control study of risk factors.

PubMed

Ikram, Rosemary; Psutka, Rebecca; Carter, Alison; Priest, Patricia

2015-06-09

Prevention of infection due to multi-drug resistant organisms is particularly challenging because of the spread of resistant bacteria beyond hospitals into the community, including nursing homes. This study aimed to identify risk factors for the acquisition of a multidrug resistant (MDR) Escherichia coli in a local outbreak. Study participants were all aged over 65 years. Cases had the MDR E. coli isolated from a routine urine sample, and controls had a urine sample submitted to the laboratory in the same time period but the MDR E. coli was not isolated. Information from clinical records was used to identify risk factors both in the hospital and the community setting for acquisition of the MDR E. coli. 76 cases and 156 controls were identified and included in the study. In a multivariate analysis, risk factors statistically significantly associated with acquisition of the MDR E. coli were female gender (adjusted OR 3.2; 95 % confidence interval 1.5-6.9), level of care (high dependency OR 7.5; 2.2-25.7) compared with living independently), and in hospital prescription of antimicrobials to which the MDR E. coli was resistant (OR 5.6; 2.5-12.9). The major risk factors for the acquisition of a MDR E. coli were found to be residence in a nursing home and in-hospital prescription of antimicrobials to which the MDR E. coli was resistant. This emphasises that prevention of transmission of MDROs within a community needs to involve both hospitals and also other healthcare organizations, in this case nursing homes.

Making the business case for enhanced depression care: the National Institute of Mental Health-harvard Work Outcomes Research and Cost-effectiveness Study.

PubMed

Wang, Philip S; Simon, Gregory E; Kessler, Ronald C

2008-04-01

Explore the business case for enhanced depression care and establish a return on investment rationale for increased organizational involvement by employer-purchasers. Literature review, focused on the National Institute of Mental Health-sponsored Work Outcomes Research and Cost-effectiveness Study. This randomized controlled trial compared telephone outreach, care management, and optional psychotherapy to usual care among depressed workers in large national corporations. By 12 months, the intervention significantly improved depression outcomes, work retention, and hours worked among the employed. Results of the Work Outcomes Research and Cost-effectiveness Study trial and other studies suggest that enhanced depression care programs represent a human capital investment opportunity for employers.

Translating genomics into practice for real-time surveillance and response to carbapenemase-producing Enterobacteriaceae: evidence from a complex multi-institutional KPC outbreak.

PubMed

Kwong, Jason C; Lane, Courtney R; Romanes, Finn; Gonçalves da Silva, Anders; Easton, Marion; Cronin, Katie; Waters, Mary Jo; Tomita, Takehiro; Stevens, Kerrie; Schultz, Mark B; Baines, Sarah L; Sherry, Norelle L; Carter, Glen P; Mu, Andre; Sait, Michelle; Ballard, Susan A; Seemann, Torsten; Stinear, Timothy P; Howden, Benjamin P

2018-01-01

Until recently, Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae were rarely identified in Australia. Following an increase in the number of incident cases across the state of Victoria, we undertook a real-time combined genomic and epidemiological investigation. The scope of this study included identifying risk factors and routes of transmission, and investigating the utility of genomics to enhance traditional field epidemiology for informing management of established widespread outbreaks. All KPC-producing Enterobacteriaceae isolates referred to the state reference laboratory from 2012 onwards were included. Whole-genome sequencing was performed in parallel with a detailed descriptive epidemiological investigation of each case, using Illumina sequencing on each isolate. This was complemented with PacBio long-read sequencing on selected isolates to establish high-quality reference sequences and interrogate characteristics of KPC-encoding plasmids. Initial investigations indicated that the outbreak was widespread, with 86 KPC-producing Enterobacteriaceae isolates ( K. pneumoniae 92%) identified from 35 different locations across metropolitan and rural Victoria between 2012 and 2015. Initial combined analyses of the epidemiological and genomic data resolved the outbreak into distinct nosocomial transmission networks, and identified healthcare facilities at the epicentre of KPC transmission. New cases were assigned to transmission networks in real-time, allowing focussed infection control efforts. PacBio sequencing confirmed a secondary transmission network arising from inter-species plasmid transmission. Insights from Bayesian transmission inference and analyses of within-host diversity informed the development of state-wide public health and infection control guidelines, including interventions such as an intensive approach to screening contacts following new case detection to minimise unrecognised colonisation. A real-time combined epidemiological and genomic investigation proved critical to identifying and defining multiple transmission networks of KPC Enterobacteriaceae, while data from either investigation alone were inconclusive. The investigation was fundamental to informing infection control measures in real-time and the development of state-wide public health guidelines on carbapenemase-producing Enterobacteriaceae surveillance and management.

Entrepreneurship Education in Delta State Tertiary Institution as a Means of Achieving National Growth and Development

ERIC Educational Resources Information Center

Osakwe, Regina N.

2015-01-01

This study examined entrepreneurship education in Delta Sate tertiary institutions as a means of national growth and development. Two research questions were asked to guide the study. The population comprised all the 1,898 academic staff in eight tertiary institutions in the state. A sample of 800 lecturers was drawn through the multi stage and…

Simultaneous, proportional, multi-axis prosthesis control using multichannel surface EMG.

PubMed

Yatsenko, Dimitri; McDonnall, Daniel; Guillory, K Shane

2007-01-01

Most upper limb prosthesis controllers only allow the individual selection and control of single joints of the limb. The main limiting factor for simultaneous multi-joint control is usually the availability of reliable independent control signals that can intuitively be used. In this paper, a novel method is presented for extraction of individual muscle source signals from surface EMG array recordings, based on EMG energy orthonormalization along principle movement vectors. In cases where independently-controllable muscles are present in residual limbs, this method can be used to provide simultaneous, multi-axis, proportional control of prosthetic systems. Initial results are presented for simultaneous control of wrist rotation, wrist flexion/extension, and grip open/close for two intact subjects under both isometric and non-isometric conditions and for one subject with transradial amputation.

Faculty development to enhance humanistic teaching and role modeling: a collaborative study at eight institutions.

PubMed

Branch, William T; Chou, Calvin L; Farber, Neil J; Hatem, David; Keenan, Craig; Makoul, Gregory; Quinn, Mariah; Salazar, William; Sillman, Jane; Stuber, Margaret; Wilkerson, LuAnn; Mathew, George; Fost, Michael

2014-09-01

There is increased emphasis on practicing humanism in medicine but explicit methods for faculty development in humanism are rare. We sought to demonstrate improved faculty teaching and role modeling of humanistic and professional values by participants in a multi-institutional faculty development program as rated by their learners in clinical settings compared to contemporaneous controls. Blinded learners in clinical settings rated their clinical teachers, either participants or controls, on the previously validated 10-item Humanistic Teaching Practices Effectiveness (HTPE) questionnaire. Groups of 7-9 participants at 8 academic medical centers completed an 18-month faculty development program. Participating faculty were chosen by program facilitators at each institution on the basis of being promising teachers, willing to participate in the longitudinal faculty development program. Our 18-month curriculum combined experiential learning of teaching skills with critical reflection using appreciative inquiry narratives about their experiences as teachers and other reflective discussions. The main outcome was the aggregate score of the ten items on the questionnaire at all institutions. The aggregate score favored participants over controls (P = 0.019) independently of gender, experience on faculty, specialty area, and/or overall teaching skills. Longitudinal, intensive faculty development that employs experiential learning and critical reflection likely enhances humanistic teaching and role modeling. Almost all participants completed the program. Results are generalizable to other schools.

Design of a cluster-randomized minority recruitment trial: RECRUIT.

PubMed

Tilley, Barbara C; Mainous, Arch G; Smith, Daniel W; McKee, M Diane; Amorrortu, Rossybelle P; Alvidrez, Jennifer; Diaz, Vanessa; Ford, Marvella E; Fernandez, Maria E; Hauser, Robert A; Singer, Carlos; Landa, Veronica; Trevino, Aron; DeSantis, Stacia M; Zhang, Yefei; Daniels, Elvan; Tabor, Derrick; Vernon, Sally W

2017-06-01

Racial/ethnic minority groups remain underrepresented in clinical trials. Many strategies to increase minority recruitment focus on minority communities and emphasize common diseases such as hypertension. Scant literature focuses on minority recruitment to trials of less common conditions, often conducted in specialty clinics and dependent on physician referrals. We identified trust/mistrust of specialist physician investigators and institutions conducting medical research and consequent participant reluctance to participate in clinical trials as key-shared barriers across racial/ethnic groups. We developed a trust-based continuous quality improvement intervention to build trust between specialist physician investigators and community minority-serving physicians and ultimately potential trial participants. To avoid the inherent biases of non-randomized studies, we evaluated the intervention in the national Randomized Recruitment Intervention Trial (RECRUIT). This report presents the design of RECRUIT. Specialty clinic follow-up continues through April 2017. We hypothesized that specialist physician investigators and coordinators trained in the trust-based continuous quality improvement intervention would enroll a greater proportion of minority participants in their specialty clinics than specialist physician investigators in control specialty clinics. Specialty clinic was the unit of randomization. Using continuous quality improvement, the specialist physician investigators and coordinators tailored recruitment approaches to their specialty clinic characteristics and populations. Primary analyses were adjusted for clustering by specialty clinic within parent trial and matching covariates. RECRUIT was implemented in four multi-site clinical trials (parent trials) supported by three National Institutes of Health institutes and included 50 associated specialty clinics from these parent trials. Using current data, we have 88% power or greater to detect a 0.15 or greater difference from the currently observed control proportion adjusting for clustering. We detected no differences in baseline matching criteria between intervention and control specialty clinics (all p values > 0.17). RECRUIT was the first multi-site randomized control trial to examine the effectiveness of a trust-based continuous quality improvement intervention to increase minority recruitment into clinical trials. RECRUIT's innovations included its focus on building trust between specialist investigators and minority-serving physicians, the use of continuous quality improvement to tailor the intervention to each specialty clinic's specific racial/ethnic populations and barriers to minority recruitment, and the use of specialty clinics from more than one parent multi-site trial to increase generalizability. The effectiveness of the RECRUIT intervention will be determined after the completion of trial data collection and planned analyses.

Rationale of technical requirements for NRG-BR001: The first NCI-sponsored trial of SBRT for the treatment of multiple metastases.

PubMed

Al-Hallaq, Hania A; Chmura, Steven; Salama, Joseph K; Winter, Kathryn A; Robinson, Clifford G; Pisansky, Thomas M; Borges, Virginia; Lowenstein, Jessica R; McNulty, Susan; Galvin, James M; Followill, David S; Timmerman, Robert D; White, Julia R; Xiao, Ying; Matuszak, Martha M

In 2014, the NRG Oncology Group initiated the first National Cancer Institute-sponsored, phase 1 clinical trial of stereotactic body radiation therapy (SBRT) for the treatment of multiple metastases in multiple organ sites (BR001; NCT02206334). The primary endpoint is to test the safety of SBRT for the treatment of 2 to 4 multiple lesions in several anatomic sites in a multi-institutional setting. Because of the technical challenges inherent to treating multiple lesions as their spatial separation decreases, we present the technical requirements for NRG-BR001 and the rationale for their selection. Patients with controlled primary tumors of breast, non-small cell lung, or prostate are eligible if they have 2 to 4 metastases distributed among 7 extracranial anatomic locations throughout the body. Prescription and organ-at-risk doses were determined by expert consensus. Credentialing requirements include (1) irradiation of the Imaging and Radiation Oncology Core phantom with SBRT, (2) submitting image guided radiation therapy case studies, and (3) planning the benchmark. Guidelines for navigating challenging planning cases including assessing composite dose are discussed. Dosimetric planning to multiple lesions receiving differing doses (45-50 Gy) and fractionation (3-5) while irradiating the same organs at risk is discussed, particularly for metastases in close proximity (≤5 cm). The benchmark case was selected to demonstrate the planning tradeoffs required to satisfy protocol requirements for 2 nearby lesions. Examples of passing benchmark plans exhibited a large variability in plan conformity. NRG-BR001 was developed using expert consensus on multiple issues from the dose fractionation regimen to the minimum image guided radiation therapy guidelines. Credentialing was tied to the task rather than the anatomic site to reduce its burden. Every effort was made to include a variety of delivery methods to reflect current SBRT technology. Although some simplifications were adopted, the successful completion of this trial will inform future designs of both national and institutional trials and would allow immediate clinical adoption of SBRT trials for oligometastases. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

SO2 plume height retrieval from UV satellite measurements in support to aviation control

NASA Astrophysics Data System (ADS)

van Gent, Jeroen; Brenot, Hugues; Lerot, Christophe; Theys, Nicolas; Van Roozendael, Michel

2014-05-01

The Support to Aviation Control Service (SACS), operated at our institute, uses multi-sensor UV-visible and infrared satellite measurements to provide near real-time information on volcanic ash and SO2 concentrations. In case of enhanced SO2 concentrations, notifications are send out to subscribing organisations and individuals, with details regarding the volcanic event. This information may be used by aviation control organisations to judge the risc to air traffic and provide possible alternative routing. One of the latest additions to the system is information on the altitude of SO2 plumes, based on UV measurements of the GOME-2 sensors on the platforms METOP-A and METOP-B. Further improvement of this system is ongoing. This poster shows examples of plume height retrieval from GOME-2 (METOP-A and -B) and OMI (EOS-AURA). Results are shown for a number of recent major volcanic eruptions, each with different characteristics. The applied technique to retrieve altitude information will be discussed, as well as the applicability, quality and limitations of the method.

Moving research to practice through partnership: a case study in Asphalt Paving.

PubMed

Chang, Charlotte; Nixon, Laura; Baker, Robin

2015-08-01

Multi-stakeholder partnerships play a critical role in dissemination and implementation in health and safety. To better document and understand construction partnerships that have successfully scaled up effective interventions to protect workers, this case study focused on the collaborative processes of the Asphalt Paving Partnership. In the 1990s, this partnership developed, evaluated, disseminated, and achieved near universal, voluntary adoption of paver engineering controls to reduce exposure to asphalt fumes. We used in-depth interviews (n = 15) and document review in the case study. We describe contextual factors that both facilitated and challenged the formation of the collaboration, central themes and group processes, and research to practice (r2p) outcomes. The Asphalt Paving Partnership offers insight into how multi-stakeholder partnerships in construction can draw upon the strengths of diverse members to improve the dissemination and adoption of health and safety innovations and build a collaborative infrastructure to sustain momentum over time. © 2015 Wiley Periodicals, Inc.

Research subject privacy protection in otolaryngology.

PubMed

Noone, Michael C; Walters, K Christian; Gillespie, M Boyd

2004-03-01

Health Insurance Portability and Accountability Act regulations, which took effect on April 14, 2003, placed new constraints on the use of protected health information for research purposes. To review practices of research subject privacy protection in otolaryngology in order to determine steps necessary to achieve compliance with Health Insurance Portability and Accountability Act regulations. Literature review. Articles appearing in 2001 in 3 widely circulated otolaryngology journals were classified according to study design. The "Methods" section of each article was reviewed to determine whether the informed consent and institutional review board processes were clearly documented. Descriptive studies involving case reports and case series were more common than observational studies that include a control group (66% vs 11%). Few case series documented the consent process (18%) and institutional review board process (19%). Observational designs demonstrated better documentation of the consent process (P<.001) and the institutional review board exemption and approval process (P<.001). Methods used to protect subject privacy are not commonly documented in case series in otolaryngology. More attention needs to be given to research subject privacy concerns in the otolaryngology literature in order to comply with Health Insurance Portability and Accountability Act regulations.

Lessons from the Wabash National Study of Liberal Arts Education

ERIC Educational Resources Information Center

Pascarella, Ernest T.; Blaich, Charles

2013-01-01

Funded by the Center of Inquiry in the Liberal Arts (CILA) at Wabash College, the Wabash National Study of Liberal Arts Education (WNS) is a multi-institution, multi-year, longitudinal study designed to identify the academic and non-academic collegiate experiences that foster liberal learning. This article describes how the study was done and…

Control of a community outbreak of measles which started in a poorly immunised high school population.

PubMed

Merianos, A; Miller, N C; Patel, M S

1993-09-01

An outbreak of measles occurred in Darwin from February to March 1991. The first case was in a 13-year-old high school student who had returned from a holiday overseas. She was symptomatic on the second day of the new school term. She infected an infant while both waited in a doctor's surgery. Outbreak control measures were instituted 18 days later when the Communicable Diseases Centre was first alerted of cases through the laboratory notification scheme. Through active surveillance, we identified 76 cases of measles, of whom 92 per cent (70 cases) were under 20 years of age. Of these, 46 were students at the index high school in which the attack rate was 39.2 per 1,000. They transmitted the disease to six unvaccinated siblings aged 11 to 18 years, resulting in a secondary attack rate of 113 per 1,000 in this age group (relative risk of disease in siblings 2.8, 95 per cent confidence interval 1.2 to 6.2). The outbreak affected one other high school, a number of primary schools, one tertiary institution, and nine children under five years. Only four of the cases had a verified history of previous immunisation against measles. The outbreak was arrested within two weeks of instituting community-wide control measures. Inadequate immunisation coverage among school-aged children and delays in notification contributed to the severity of the outbreak. Improved measles surveillance systems, including telephone notification of clinical cases are needed so that control measures can be instituted immediately within the household and in the community.

Community Resistance to Survey Research and 1890 Colleges and Universities: The Case of Fort Valley State College.

ERIC Educational Resources Information Center

Walker, Melvin E., Jr.; Holik, John S.

In order to reduce community resistance to a multi-ethnic/cross-sectional survey by an 1890 institution and to identify those factors which influenced survey completion, 395 white and 335 black heads of households in 19 middle Georgia county areas were surveyed. Since a suit labeling Fort Valley a "diploma mill" had recently been filed…

Using Standardized Diagnostic Instruments to Classify Children with Autism in the Study to Explore Early Development

ERIC Educational Resources Information Center

Wiggins, Lisa D.; Reynolds, Ann; Rice, Catherine E.; Moody, Eric J.; Bernal, Pilar; Blaskey, Lisa; Rosenberg, Steven A.; Lee, Li-Ching; Levy, Susan E.

2015-01-01

The Study to Explore Early Development (SEED) is a multi-site case-control study designed to explore the relationship between autism spectrum disorder (ASD) phenotypes and etiologies. The goals of this paper are to (1) describe the SEED algorithm that uses the Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule…

Study and Application of a Multi Magnetoresistor Sensor System to Detect Corrosion in Suspension Cables

NASA Astrophysics Data System (ADS)

Torres, V.; Quek, S.; Gaydecki, P.

2010-02-01

Aging and deterioration of the main functional parts in civil structures is one of the biggest problems that private and governmental institutions, dedicated to operate and maintain such structures, are facing now days. In the case of relatively old suspension bridges, problems emerge due to corrosion and break of wires in the main cables. Decisive information and a reliable monitoring and evaluation are factors of great relevance required to prevent significant or catastrophic damages caused to the structure, and more importantly, to people. The main challenge for the NDE methods of inspection arises in dealing with the steel wrapping barrier of the suspension cable, which main function is to shield, shape and hold the bundles. The following work, presents a study of a multi-Magnetoresistive sensors system aiming to support the monitoring and evaluation of suspension cables at some of its stages. Modelling, signal acquisition, signal processing, experiments and the initial phases of implementation are presented and discussed widely.

Integration of DNA sample collection into a multi-site birth defects case-control study.

PubMed

Rasmussen, Sonja A; Lammer, Edward J; Shaw, Gary M; Finnell, Richard H; McGehee, Robert E; Gallagher, Margaret; Romitti, Paul A; Murray, Jeffrey C

2002-10-01

Advances in quantitative analysis and molecular genotyping have provided unprecedented opportunities to add biological sampling and genetic information to epidemiologic studies. The purpose of this article is to describe the incorporation of DNA sample collection into the National Birth Defects Prevention Study (NBDPS), an ongoing case-control study in an eight-state consortium with a primary goal to identify risk factors for birth defects. Babies with birth defects are identified through birth defects surveillance systems in the eight participating centers. Cases are infants with one or more of over 30 major birth defects. Controls are infants without defects from the same geographic area. Epidemiologic information is collected through an hour-long interview with mothers of both cases and controls. We added the collection of buccal cytobrush DNA samples for case-infants, control-infants, and their parents to this study. We describe here the methods by which the samples have been collected and processed, establishment of a centralized resource for DNA banking, and quality control, database management, access, informed consent, and confidentiality issues. Biological sampling and genetic analyses are important components to epidemiologic studies of birth defects aimed at identifying risk factors. The DNA specimens collected in this study can be used for detection of mutations, study of polymorphic variants that confer differential susceptibility to teratogens, and examination of interactions among genetic risk factors. Information on the methods used and issues faced by the NBDPS may be of value to others considering the addition of DNA sampling to epidemiologic studies.

Solitary Fibrous Tumors of the Head and Neck: A Multi-Institutional Clinicopathologic Study.

PubMed

Smith, Steven C; Gooding, William E; Elkins, Matthew; Patel, Rajiv M; Harms, Paul W; McDaniel, Andrew S; Palanisamy, Nallasivam; Uram-Tuculescu, Cora; Balzer, Bonnie B; Lucas, David R; Seethala, Raja R; McHugh, Jonathan B

2017-12-01

Solitary fibrous tumors (SFTs) of the head and neck are uncommon. Lesions previously diagnosed in the head and neck as hemangiopericytomas (HPCs), giant cell angiofibromas (GCAs), and orbital fibrous histiocytomas (OFHs) are now recognized as within the expanded spectrum of SFTs. To better understand the clinicopathologic profile of head and neck SFTs, we performed a multi-institutional study of 88 examples. There was no sex predilection (F:M ratio 1.2), and the median patient age was 52 years (range: 15 to above 89 y). The sinonasal tract and orbit were the most common sites involved (30% and 25%), followed by the oral cavity and salivary glands (15% and 14%). Original diagnoses included HPC (25%), SFT (67%), and OFH (6%), with 1 SFT and 1 OFH noted as showing GCA-like morphology. On review, the predominant histologic pattern was classic SFT-like in 53% and cellular (former HPC-like) in 47%; lipomatous differentiation (8%) and GCA-like pattern (7%) were less prevalent. Subsets demonstrated nuclear atypia (23%), epithelioid morphology (15%), or coagulative necrosis (6%). Infiltrative growth (49%) and osseous invasion (82%) were prevalent among evaluable cases. Of the 48 SFTs with follow-up (median: 43 mo), 19 showed recurrence (40%). Of these, 4 patients were alive with disease and 4 dead of disease. Size and mitotic rate were negative prognosticators using a joint prognostic proportional hazards regression model. Three patients experienced metastasis, to lungs, parotid, bone, and skull base, including one case showing overtly sarcomatous "dedifferentiation." As a group, SFTs present in a wide anatomic and morphologic spectrum in the head and neck. Only rare examples metastasize or cause death from disease. However, the fairly high local recurrence rate underscores their aggressive potential and highlights the importance of prospective recognition.

Modified SPC for short run test and measurement process in multi-stations

NASA Astrophysics Data System (ADS)

Koh, C. K.; Chin, J. F.; Kamaruddin, S.

2018-03-01

Due to short production runs and measurement error inherent in electronic test and measurement (T&M) processes, continuous quality monitoring through real-time statistical process control (SPC) is challenging. Industry practice allows the installation of guard band using measurement uncertainty to reduce the width of acceptance limit, as an indirect way to compensate the measurement errors. This paper presents a new SPC model combining modified guard band and control charts (\\bar{\\text{Z}} chart and W chart) for short runs in T&M process in multi-stations. The proposed model standardizes the observed value with measurement target (T) and rationed measurement uncertainty (U). S-factor (S f) is introduced to the control limits to improve the sensitivity in detecting small shifts. The model was embedded in automated quality control system and verified with a case study in real industry.

Performance Optimization Control of ECH using Fuzzy Inference Application

NASA Astrophysics Data System (ADS)

Dubey, Abhay Kumar

Electro-chemical honing (ECH) is a hybrid electrolytic precision micro-finishing technology that, by combining physico-chemical actions of electro-chemical machining and conventional honing processes, provides the controlled functional surfaces-generation and fast material removal capabilities in a single operation. Process multi-performance optimization has become vital for utilizing full potential of manufacturing processes to meet the challenging requirements being placed on the surface quality, size, tolerances and production rate of engineering components in this globally competitive scenario. This paper presents an strategy that integrates the Taguchi matrix experimental design, analysis of variances and fuzzy inference system (FIS) to formulate a robust practical multi-performance optimization methodology for complex manufacturing processes like ECH, which involve several control variables. Two methodologies one using a genetic algorithm tuning of FIS (GA-tuned FIS) and another using an adaptive network based fuzzy inference system (ANFIS) have been evaluated for a multi-performance optimization case study of ECH. The actual experimental results confirm their potential for a wide range of machining conditions employed in ECH.

Tools for quality control of fingerprint databases

NASA Astrophysics Data System (ADS)

Swann, B. Scott; Libert, John M.; Lepley, Margaret A.

2010-04-01

Integrity of fingerprint data is essential to biometric and forensic applications. Accordingly, the FBI's Criminal Justice Information Services (CJIS) Division has sponsored development of software tools to facilitate quality control functions relative to maintaining its fingerprint data assets inherent to the Integrated Automated Fingerprint Identification System (IAFIS) and Next Generation Identification (NGI). This paper provides an introduction of two such tools. The first FBI-sponsored tool was developed by the National Institute of Standards and Technology (NIST) and examines and detects the spectral signature of the ridge-flow structure characteristic of friction ridge skin. The Spectral Image Validation/Verification (SIVV) utility differentiates fingerprints from non-fingerprints, including blank frames or segmentation failures erroneously included in data; provides a "first look" at image quality; and can identify anomalies in sample rates of scanned images. The SIVV utility might detect errors in individual 10-print fingerprints inaccurately segmented from the flat, multi-finger image acquired by one of the automated collection systems increasing in availability and usage. In such cases, the lost fingerprint can be recovered by re-segmentation from the now compressed multi-finger image record. The second FBI-sponsored tool, CropCoeff was developed by MITRE and thoroughly tested via NIST. CropCoeff enables cropping of the replacement single print directly from the compressed data file, thus avoiding decompression and recompression of images that might degrade fingerprint features necessary for matching.

An investigation into the immediate effects of pelvic taping on hamstring eccentric force in an elite male sprinter - A case report.

PubMed

Macdonald, Ben

2017-11-01

Hamstring Injuries commonly cause missed training and competition time in elite sports. Injury surveillance studies have demonstrated high injury and re-injury rates, which have not improved across sports despite screening and prevention programmes being commonplace. The most commonly suggested intervention for hamstring prevention and rehabilitation is eccentric strength assessment and training. This case study describes the management of an elite sprinter with a history of hamstring injury. A multi-variate screening process based around lumbar-pelvic dysfunction and hamstring strength assessment using the Nordbord is employed. The effect of external pelvic compression using a taping technique, on eccentric hamstring strength is evaluated. A persistent eccentric strength asymmetry of 17% was recorded as well as lumbar-pelvic control deficits. Pelvic taping appears to improve load transfer capability across the pelvis, resulting in correction of eccentric strength asymmetry. Screening strategies and interventions to prevent hamstring injury have failed to consistently improve injury rates across various sports. In this case study external pelvic compression resulted in normalising eccentric strength deficits assessed using the Nordbord. The inclusion of lumbar-pelvic motor control assessment, in relation to hamstring strength and function, as part of a multi-variate screening strategy requires further research. Copyright © 2017 Elsevier Ltd. All rights reserved.

Multi-objective game-theory models for conflict analysis in reservoir watershed management.

PubMed

Lee, Chih-Sheng

2012-05-01

This study focuses on the development of a multi-objective game-theory model (MOGM) for balancing economic and environmental concerns in reservoir watershed management and for assistance in decision. Game theory is used as an alternative tool for analyzing strategic interaction between economic development (land use and development) and environmental protection (water-quality protection and eutrophication control). Geographic information system is used to concisely illustrate and calculate the areas of various land use types. The MOGM methodology is illustrated in a case study of multi-objective watershed management in the Tseng-Wen reservoir, Taiwan. The innovation and advantages of MOGM can be seen in the results, which balance economic and environmental concerns in watershed management and which can be interpreted easily by decision makers. For comparison, the decision-making process using conventional multi-objective method to produce many alternatives was found to be more difficult. Copyright © 2012 Elsevier Ltd. All rights reserved.

Assessing Factors Influencing Student Academic Success in Law School

ERIC Educational Resources Information Center

Detwiler, Robert R.

2011-01-01

The literature on student academic success of law students is limited to mostly single institution studies, and as such, a nationwide, multi-institutional empirical study of the factors that predict student academic success is greatly needed by higher education scholars, law school admission officers, faculty, and administrators. This dissertation…

Definitive salvage radiation therapy and chemoradiation therapy for lymph node oligo-recurrence of esophageal cancer: a Japanese multi-institutional study of 237 patients.

PubMed

Yamashita, Hideomi; Jingu, Keiichi; Niibe, Yuzuru; Katsui, Kuniaki; Matsumoto, Toshihiko; Nishina, Tomohiro; Terahara, Atsuro

2017-02-20

This study evaluated the treatment results of lymph node (LN) oligo-recurrence in esophageal cancer patients treated with salvage radiotherapy (RT) in a multi-institutional retrospective study. Eligibility criteria for this retrospective analysis were: the primary lesion of esophageal cancer was controlled; from one to five LN recurrences; total RT dose ≥45 Gy to exclude palliative RT; without recurrence other than LN; and salvage RT for LN recurrence was given between January 2000 and April 2015. The median follow-up time for the 93 living patients was 29.6 months. Two hundred thirty-seven patients were matched in five hospitals. The 3-year overall survival (OS) was 37%, local control was 45%, progression-free survival was 24%, and esophageal cancer-specific survival was 42%. On univariate analysis for OS, combined chemotherapy (p = 0.000055), disease-free interval (DFI) ≥12 months (p = 0.0013), LN max diameter ≤22 mm (p = 0.0052), and Karnofsky performance status ≥80% (p = 0.030) were associated with a significantly better prognosis. On multivariate analysis, significant differences were seen for combined chemotherapy (p = 0.000018), DFI (p = 0.0027), and LN max diameter (p = 0.018). LN oligo-recurrence following treatment for esophageal cancer was not a terminal-stage event. Moreover, cure may be possible by chemoradiation therapy with a long DFI (≥12 months) and small size (≤22 mm).

The CLUVA project: Climate-change scenarios and their impact on urban areas in Africa

NASA Astrophysics Data System (ADS)

Di Ruocco, Angela; Weets, Guy; Gasparini, Paolo; Jørgensen, Gertrud; Lindley, Sarah; Pauleit, Stephan; Vahed, Anwar; Schiano, Pasquale; Kabisch, Sigrun; Vedeld, Trond; Coly, Adrien; Tonye, Emmanuel; Touré, Hamidou; Kombe, Wilbard; Yeshitela, Kumelachew

2013-04-01

CLUVA (CLimate change and Urban Vulnerability in Africa; http://www.cluva.eu/) is a 3 years project, funded by the European Commission in 2010. Its main objective is the estimate of the impacts of climate changes in the next 40 years at urban scale in Africa. The mission of CLUVA is to develop methods and knowledge to assess risks cascading from climate-changes. It downscales IPCC climate projections to evaluate threats to selected African test cities; mainly floods, sea-level rise, droughts, heat waves and desertification. The project evaluates and links: social vulnerability; vulnerability of in-town ecosystems and urban-rural interfaces; vulnerability of urban built environment and lifelines; and related institutional and governance dimensions of adaptation. A multi-scale and multi-disciplinary quantitative, probabilistic, modelling is applied. CLUVA brings together climate experts, risk management experts, urban planners and social scientists with their African counterparts in an integrated research effort focusing on the improvement of the capacity of scientific institutions, local councils and civil society to cope with climate change. The CLUVA approach was set-up in the first year of the project and developed as follows: an ensemble of eight global projections of climate changes is produced for east and west Africa until 2050 considering the new IPCC (International Panel on Climate Changes; http://www.ipcc.ch/) scenarios. These are then downscaled to urban level, where territorial modeling is required to compute hazard effects on the vulnerable physical system (urban ecosystems, informal settlements, lifelines such as transportation and sewer networks) as well as on the social context, in defined time frames, and risk analysis is then employed to assess expected consequences. An investigation of the existing urban planning and governance systems and its interface with climate risks is performed. With the aid of the African partners, the developed approach is currently being applied to selected African case studies: Addis Ababa - Ethiopia; Dar es Salaam - Tanzania, Douala - Cameroun; Ouagadougou - Burkina Faso, St. Louis - Senegal. The poster will illustrate the CLUVA's framework to assess climate-change-related risks at an urban scale in Africa, and will report on the progresses of selected case studies to demonstrate feasibility of a multi-scale and multi-risk quantitative approach for risk management.

E-learning and blended learning in textile engineering education: a closed feedback loop approach

NASA Astrophysics Data System (ADS)

Charitopoulos, A.; Vassiliadis, S.; Rangoussi, M.; Koulouriotis, D.

2017-10-01

E-learning has gained a significant role in typical education and in professional training, thanks to the flexibility it offers to the time and location parameters of the education event framework. Purely e-learning scenarios are mostly limited either to Open University-type higher education institutions or to graduate level or professional degrees; blended learning scenarios are progressively becoming popular thanks to their balanced approach. The aim of the present work is to propose approaches that exploit the e-learning and the blended-learning scenarios for Textile Engineering education programmes, especially for multi-institutional ones. The “E-Team” European MSc degree programme organized by AUTEX is used as a case study. The proposed solution is based on (i) a free and open-source e-learning platform (moodle) and (ii) blended learning educational scenarios. Educational challenges addressed include student engagement, student error / failure handling, as well as collaborative learning promotion and support.

Application of dragonfly algorithm for optimal performance analysis of process parameters in turn-mill operations- A case study

NASA Astrophysics Data System (ADS)

Vikram, K. Arun; Ratnam, Ch; Lakshmi, VVK; Kumar, A. Sunny; Ramakanth, RT

2018-02-01

Meta-heuristic multi-response optimization methods are widely in use to solve multi-objective problems to obtain Pareto optimal solutions during optimization. This work focuses on optimal multi-response evaluation of process parameters in generating responses like surface roughness (Ra), surface hardness (H) and tool vibration displacement amplitude (Vib) while performing operations like tangential and orthogonal turn-mill processes on A-axis Computer Numerical Control vertical milling center. Process parameters like tool speed, feed rate and depth of cut are considered as process parameters machined over brass material under dry condition with high speed steel end milling cutters using Taguchi design of experiments (DOE). Meta-heuristic like Dragonfly algorithm is used to optimize the multi-objectives like ‘Ra’, ‘H’ and ‘Vib’ to identify the optimal multi-response process parameters combination. Later, the results thus obtained from multi-objective dragonfly algorithm (MODA) are compared with another multi-response optimization technique Viz. Grey relational analysis (GRA).

Blessed be the Children: A Case-Control Study of Sexual Abusers in the Catholic Church.

PubMed

Calkins, Cynthia; Fargo, Jamison; Jeglic, Elizabeth; Terry, Karen

2015-08-01

Individuals working in churches and other youth-serving institutions have a unique level of access to children, yet the problem of sexual abuse in institutional settings has received scant research attention. To address this gap, we analyzed data from a large sample of clergy (N = 1,121) and applied a social-ecological model of offending to identify risk factors for sexual abuse perpetration. Using a case-control study design that compared clergy sexual abusers with three control groups of clergy, this study focuses specifically on individual-, relationship-, and community-level factors associated with a higher risk of abuse in professional populations. Findings revealed that clergy sexual abusers tended to have more truncated pre-seminary dating histories, and that their dating and sexual partners were more likely to have been male than female. Self-reported sexual abuse history was associated with a greater likelihood of sexual abuse perpetration among clergy. Clergy abusers tended to be more involved with youth and adolescents in their ministries; however, they were observed to relate less well to youth and adolescents than their clergy counterparts. Given widespread changes in our cultural understanding of abuse as well as more specific changes in the organizational approach to seminary education, these differences underscore the role that youth-serving institutions and society can have in the primary prevention of child sexual abuse. Copyright © 2015 John Wiley & Sons, Ltd.

Applicability Evaluation of Simplified Cognitive Behavioral Therapy.

PubMed

Zhang, Li; Zhu, Zhipei; Fang, Fang; Shen, Yuan; Liu, Na; Li, Chunbo

2018-04-25

We have developed a structured cognitive behavioral therapy manual for anxiety disorder in China, and the present study evaluated the applicability of simplified cognitive behavioral therapy based on our previous research. To evaluate the applicability of simplified cognitive behavioral therapy (SCBT) on generalized anxiety disorder (GAD) by conducting a multi-center controlled clinical trial. A multi-center controlled clinical trial of SCBT was conducted on patients with GAD, including institutions specializing in mental health and psychiatry units in general hospitals. The participants were divided into 3 groups: SCBT group, SCBT with medication group and medication group. The drop-out rates of these three groups, the therapy satisfaction of patients who received SCBT and the evaluation of SCBT from therapists were compared. (1) There was no significant difference among the drop-out rates in the three groups. (2) Only the duration and times of therapy were significantly different between the two groups of patients who received the SCBT, and the therapy satisfaction of the SCBT group was higher than that of the SCBT with medication group. (3) Eighteen therapists who conducted the SCBT indicated that the manual was easy to comprehend and operate, and this therapy could achieve the therapy goals. The applicability of SCBT for patients with GAD is relatively high, and it is hopeful that SCBT can become a psychological treatment which can be applied in medical institutions of various levels.

Organizational Change and Conflict: A Case Study of the Bureau of Indian Affairs.

ERIC Educational Resources Information Center

Champagne, Duane

1983-01-01

Despite attempts by Congress during the 1970s to reform and reorganize the Bureau of Indian Affairs (BIA), it has maintained substantive control over reservation institutions. A key to understanding BIA resistance to change appears to lie in organizational imperative of area directors to preserve and enhance their control over bureaucratic…

Determining effective forecast horizons for multi-purpose reservoirs with short- and long-term operating objectives

NASA Astrophysics Data System (ADS)

Luchner, Jakob; Anghileri, Daniela; Castelletti, Andrea

2017-04-01

Real-time control of multi-purpose reservoirs can benefit significantly from hydro-meteorological forecast products. Because of their reliability, the most used forecasts range on time scales from hours to few days and are suitable for short-term operation targets such as flood control. In recent years, hydro-meteorological forecasts have become more accurate and reliable on longer time scales, which are more relevant to long-term reservoir operation targets such as water supply. While the forecast quality of such products has been studied extensively, the forecast value, i.e. the operational effectiveness of using forecasts to support water management, has been only relatively explored. It is comparatively easy to identify the most effective forecasting information needed to design reservoir operation rules for flood control but it is not straightforward to identify which forecast variable and lead time is needed to define effective hedging rules for operational targets with slow dynamics such as water supply. The task is even more complex when multiple targets, with diverse slow and fast dynamics, are considered at the same time. In these cases, the relative importance of different pieces of information, e.g. magnitude and timing of peak flow rate and accumulated inflow on different time lags, may vary depending on the season or the hydrological conditions. In this work, we analyze the relationship between operational forecast value and streamflow forecast horizon for different multi-purpose reservoir trade-offs. We use the Information Selection and Assessment (ISA) framework to identify the most effective forecast variables and horizons for informing multi-objective reservoir operation over short- and long-term temporal scales. The ISA framework is an automatic iterative procedure to discriminate the information with the highest potential to improve multi-objective reservoir operating performance. Forecast variables and horizons are selected using a feature selection technique. The technique determines the most informative combination in a multi-variate regression model to the optimal reservoir releases based on perfect information at a fixed objective trade-off. The improved reservoir operation is evaluated against optimal reservoir operation conditioned upon perfect information on future disturbances and basic reservoir operation using only the day of the year and the reservoir level. Different objective trade-offs are selected for analyzing resulting differences in improved reservoir operation and selected forecast variables and horizons. For comparison, the effective streamflow forecast horizon determined by the ISA framework is benchmarked against the performances obtained with a deterministic model predictive control (MPC) optimization scheme. Both the ISA framework and the MPC optimization scheme are applied to the real-world case study of Lake Como, Italy, using perfect streamflow forecast information. The principal operation targets for Lake Como are flood control and downstream water supply which makes its operation a suitable case study. Results provide critical feedback to reservoir operators on the use of long-term streamflow forecasts and to the hydro-meteorological forecasting community with respect to the forecast horizon needed from reliable streamflow forecasts.

'Away Days' in multi-centre randomised controlled trials: a questionnaire survey of their use and a case study on the effect of one Away Day on patient recruitment.

PubMed

Jefferson, Laura; Cook, Liz; Keding, Ada; Brealey, Stephen; Handoll, Helen; Rangan, Amar

2015-11-06

'Away Days' (trial promotion and training events for trial site personnel) are a well-established method used by trialists to encourage engagement of research sites in the recruitment of patients to multi-centre randomised controlled trials (RCTs). We explored the use of Away Days in multi-centre RCTs and analysed the effect on patient recruitment in a case study. Members of the United Kingdom Trial Managers' Network were surveyed in June 2013 to investigate their experiences in the design and conduct of Away Days in RCTs. We used data from a multi-centre pragmatic surgical trial to explore the effects of an Away Day on the screening and recruitment of patients. A total of 94 people responded to the survey. The majority (78%), who confirmed had organised an Away Day previously, found them to be useful. This is despite their costs.. There was no evidence, however, from the analysis of data from a surgical trial that attendance at an Away Day increased the number of patients screened or recruited at participating sites. Although those responsible for managing RCTs in the UK tend to believe that trial Away Days are beneficial, evidence from a multi-centre surgical trial shows no improvement on a key indicator of trial success. This points to the need to carefully consider the aims, design and conduct of Away Days. Further more rigorous research nested within RCTs would be valuable to evaluate the design and conduct of Away Days. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

[False positive result in mammography and its association with the presence of obesity: a case-control study].

PubMed

Castro-Ibarra, Marisela; Menchaca-Díaz, Rufino; Cabrales-Ruvalcaba, J Jesús; Luna-V Gómez, Rosa Alicia

2016-01-01

To analyze the association between a false positive result in mammography and obesity, inside the breast cancer early detection program in women affiliated to the Institute of Security and Social Services for Government and Municipality workers of the State of Baja California (ISSSTECALI). A case-control, retrospective study was done in women affiliated to ISSSTECALI to whom a mammography was performed between 2009 and 2012. Women with a false positive result in mammography were included as cases. Controls were women with a true negative result in mammography. Three controls were randomly selected for each case. Obesity was established with the body mass index (BMI) consigned in the woman's clinical file. Age and estrogen replacement therapy were included as co-variables. Seventy nine cases were identified and 237 controls were included. Obesity was observed in 54.4% of cases and in 41.3% of controls (odds ratio: 1.69; 95% confidence interval for odds ratio: 1.01-2.82; p value: 0.043). A logistic regression model including covariables maintained the observed association (p = 0.044). No association was found with analyzed co-variables. A false positive result in mammography was associated with the presence of obesity.

Multi-agent Water Resources Management

NASA Astrophysics Data System (ADS)

Castelletti, A.; Giuliani, M.

2011-12-01

Increasing environmental awareness and emerging trends such as water trading, energy market, deregulation and democratization of water-related services are challenging integrated water resources planning and management worldwide. The traditional approach to water management design based on sector-by-sector optimization has to be reshaped to account for multiple interrelated decision-makers and many stakeholders with increasing decision power. Centralized management, though interesting from a conceptual point of view, is unfeasible in most of the modern social and institutional contexts, and often economically inefficient. Coordinated management, where different actors interact within a full open trust exchange paradigm under some institutional supervision is a promising alternative to the ideal centralized solution and the actual uncoordinated practices. This is a significant issue in most of the Southern Alps regulated lakes, where upstream hydropower reservoirs maximize their benefit independently form downstream users; it becomes even more relevant in the case of transboundary systems, where water management upstream affects water availability downstream (e.g. the River Zambesi flowing through Zambia, Zimbabwe and Mozambique or the Red River flowing from South-Western China through Northern Vietnam. In this study we apply Multi-Agent Systems (MAS) theory to design an optimal management in a decentralized way, considering a set of multiple autonomous agents acting in the same environment and taking into account the pay-off of individual water users, which are inherently distributed along the river and need to coordinate to jointly reach their objectives. In this way each real-world actor, representing the decision-making entity (e.g. the operator of a reservoir or a diversion dam) can be represented one-to-one by a computer agent, defined as a computer system that is situated in some environment and that is capable of autonomous action in this environment in order to meet its design objectives. The proposed approach is numerically tested on a synthetic case study, characterized by two multi-purpose reservoirs in cascade, two diversion dams and four different conflicting water uses: hydropower energy production, drinking supply, flooding prevention along the reservoir shores and irrigation supply. The system is therefore composed by four agents: the two operators of the diversion dams, which are purely reactive agents since they simply respond directly to the environment, and the operators of the two reservoirs, which are more complex agents because they have an internal state and their decisions are taken according to a closed-loop control scheme. In particular, the set of agents can act considering only their own objectives or they can coordinate to jointly reach better compromise solutions. Different interaction scenarios between the two extreme behaviours of centralized management and completely non-cooperation are simulated and analysed.

Allergy and acute leukaemia in children with Down syndrome: a population study. Report from the Mexican inter-institutional group for the identification of the causes of childhood leukaemia.

PubMed

Núñez-Enríquez, J C; Fajardo-Gutiérrez, A; Buchán-Durán, E P; Bernáldez-Ríos, R; Medina-Sansón, A; Jiménez-Hernández, E; Amador-Sanchez, R; Peñaloza-Gonzalez, J G; Paredes-Aguilera, R; Alvarez-Rodriguez, F J; Bolea-Murga, V; de Diego Flores-Chapa, J; Flores-Lujano, J; Bekker-Mendez, V C; Rivera-Luna, R; Del Carmen Rodriguez-Zepeda, M; Rangel-López, A; Dorantes-Acosta, E M; Núñez-Villegas, N; Velazquez-Aviña, M M; Torres-Nava, J R; Reyes-Zepeda, N C; Cárdenas-Cardos, R; Flores-Villegas, L V; Martinez-Avalos, A; Salamanca-Gómez, F; Gorodezky, C; Arellano-Galindo, J; Mejía-Aranguré, J M

2013-06-11

Allergies have been described as protective factors against the development of childhood acute leukaemia (AL). Our objective was to investigate the associations between allergy history and the development of AL and acute lymphoblastic leukaemia (ALL) in children with Down syndrome (DS). A case-control study was performed in Mexico City. The cases (n=97) were diagnosed at nine public hospitals, and the controls (n=222) were recruited at institutions for children with DS. Odds ratios (OR) were calculated. Asthma was positively associated with AL development (OR=4.18; 95% confidence interval (CI): 1.47-11.87), whereas skin allergies were negatively associated (OR=0.42; 95% CI: 0.20-0.91). Our findings suggest that allergies and AL in children with DS share biological and immune mechanisms. To our knowledge, this is the first study reporting associations between allergies and AL in children with DS.

Concerns About Lung Cancer Among Prisoners.

PubMed

Renault, Luc; Perrot, Emmanuel; Pradat, Eric; Bartoli, Christophe; Greillier, Laurent; Remacle-Bonnet, Anne; Telmon, Norbert; Mazières, Julien; Molinier, Laurent; Couraud, Sébastien

2018-02-01

Few studies have looked at lung cancer in prisoners, despite this population is possibly at increased risk of malignancy. In a previous study, we found an early onset of lung cancer in prisoners. Thus, the present CARCAN study was aimed at assessing the epidemiological characteristics, management, prognosis, and incidence of lung cancer in prisoners compared to a sample of non-prisoner patients. We performed a multi-center observational case-control study. Cases were prisoners diagnosed with lung cancer from 2005 to 2013. Controls were non-prisoner lung cancer patients selected from hospital databases and randomly matched to cases (targeted case-control ratio: 1:3). Incidence rates in both groups were calculated using national statistics. Seventy-two cases and 170 controls met inclusion criteria. Cases were mainly men (99%). Mean age at diagnosis was 52.9 (± 11.0) in cases and 64.3 (± 10.1) in controls (p < 0.0001). More case patients were current smokers compared to control patients (83% vs 53%; p < 0.0001). We found no significant differences between the two groups as concerns histologic types, TNM stages at diagnosis, initially-employed treatments, times to management or survival. Incidence rates (2008-2012) in male prisoners were higher than those in the general population in all concerned age groups. There is a shift of lung cancer toward young people in prisons. However, the presentation, management, and prognosis of lung cancer are similar between prisoners and non-prisoners. These finding could justify a specific screening policy for the incarcerated populations.

[Cochlear implantation in patients with Waardenburg syndrome type II].

PubMed

Wan, Liangcai; Guo, Menghe; Chen, Shuaijun; Liu, Shuangriu; Chen, Hao; Gong, Jian

2010-05-01

To describe the multi-channel cochlear implantation in patients with Waardenburg syndrome including surgeries, pre and postoperative hearing assessments as well as outcomes of speech recognition. Multi-channel cochlear implantation surgeries have been performed in 12 cases with Waardenburg syndrome type II in our department from 2000 to 2008. All the patients received multi-channel cochlear implantation through transmastoid facial recess approach. The postoperative outcomes of 12 cases were compared with 12 cases with no inner ear malformation as a control group. The electrodes were totally inserted into the cochlear successfully, there was no facial paralysis and cerebrospinal fluid leakage occurred after operation. The hearing threshold in this series were similar to that of the normal cochlear implantation. After more than half a year of speech rehabilitation, the abilities of speech discrimination and spoken language of all the patients were improved compared with that of preoperation. Multi-channel cochlear implantation could be performed in the cases with Waardenburg syndrome, preoperative hearing and images assessments should be done.

A Tissue Systems Pathology Test Detects Abnormalities Associated with Prevalent High-Grade Dysplasia and Esophageal Cancer in Barrett's Esophagus.

PubMed

Critchley-Thorne, Rebecca J; Davison, Jon M; Prichard, Jeffrey W; Reese, Lia M; Zhang, Yi; Repa, Kathleen; Li, Jinhong; Diehl, David L; Jhala, Nirag C; Ginsberg, Gregory G; DeMarshall, Maureen; Foxwell, Tyler; Jobe, Blair A; Zaidi, Ali H; Duits, Lucas C; Bergman, Jacques J G H M; Rustgi, Anil; Falk, Gary W

2017-02-01

There is a need for improved tools to detect high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC) in patients with Barrett's esophagus. In previous work, we demonstrated that a 3-tier classifier predicted risk of incident progression in Barrett's esophagus. Our aim was to determine whether this risk classifier could detect a field effect in nondysplastic (ND), indefinite for dysplasia (IND), or low-grade dysplasia (LGD) biopsies from Barrett's esophagus patients with prevalent HGD/EAC. We performed a multi-institutional case-control study to evaluate a previously developed risk classifier that is based upon quantitative image features derived from 9 biomarkers and morphology, and predicts risk for HGD/EAC in Barrett's esophagus patients. The risk classifier was evaluated in ND, IND, and LGD biopsies from Barrett's esophagus patients diagnosed with HGD/EAC on repeat endoscopy (prevalent cases, n = 30, median time to HGD/EAC diagnosis 140.5 days) and nonprogressors (controls, n = 145, median HGD/EAC-free surveillance time 2,015 days). The risk classifier stratified prevalent cases and non-progressor patients into low-, intermediate-, and high-risk classes [OR, 46.0; 95% confidence interval, 14.86-169 (high-risk vs. low-risk); P < 0.0001]. The classifier also provided independent prognostic information that outperformed the subspecialist and generalist diagnosis. A tissue systems pathology test better predicts prevalent HGD/EAC in Barrett's esophagus patients than pathologic variables. The results indicate that molecular and cellular changes associated with malignant transformation in Barrett's esophagus may be detectable as a field effect using the test. A tissue systems pathology test may provide an objective method to facilitate earlier identification of Barrett's esophagus patients requiring therapeutic intervention. Cancer Epidemiol Biomarkers Prev; 26(2); 240-8. ©2016 AACR. ©2016 American Association for Cancer Research.

Pedagogical Practices: The Case of Multi-Class Teaching in Fiji Primary School

ERIC Educational Resources Information Center

Lingam, Govinda I.

2007-01-01

Multi-class teaching is a common phenomenon in small schools not only in Fiji, but also in many countries. The aim of the present study was to determine the teaching styles adopted by teachers in the context of multi-class teaching. A qualitative case study research design was adopted. This included a school with multi-class teaching as the norm.…

Undergraduate Psychology Students' Experiences with Creative Drama: A Multi-Case Study

ERIC Educational Resources Information Center

Wilcox, Ruth A.

2015-01-01

This qualitative multi-case study explored undergraduate psychology students' experiences participating in creative drama activities the instructor/researcher developed to teach psychological concepts. The study was conducted in three introductory and developmental courses in a mid-western community college setting. Participants (cases) included…

Institutional Disparities in the Cost Effectiveness of GCE A-Level Provision: A Multi-Level Approach.

ERIC Educational Resources Information Center

Fielding, A.

1995-01-01

Reanalyzes H. Thomas's 1980s data, which used teaching group as the unit of analysis and illuminated some institutional disparities in provision of General Certificate of Education (GCE) A-levels. Uses multilevel analysis to focus on individual students in a hierarchical framework. Among the study institutions, school sixth forms appear less…

Organization of care for persons with HIV-infection: a systematic review.

PubMed

Handford, Curtis D; Tynan, Anne-Marie; Agha, Ayda; Rzeznikiewiz, Damian; Glazier, Richard H

2017-07-01

The objective of this systematic review was to examine the effectiveness of the organization of care: case management, multidisciplinary care, multi-faceted treatment, hours of service, outreach programs and health information systems on medical, immunological, virological, psychosocial and economic outcomes for persons living with HIV/AIDS. We searched PubMed (MEDLINE) and 10 other electronic databases from 1 January 1980 to April, 2012 for both experimental and controlled observational studies. Thirty-three studies met the inclusion criteria. Eleven studies were randomized controlled trials (RCTs), three of which were conducted in low-middle income settings. Patient characteristics, study design, organization measures and outcomes data were abstracted independently by two reviewers from all studies. A risk of bias tool was applied to RCTs and a separate tool was used to assess the quality of observational studies. This review concludes that case management interventions were most consistently associated with improvements in immunological outcomes but case management demonstrates no clear association with other outcome measures. The same mixed results were also identified for multidisciplinary and multi-faceted care interventions. Eight studies with an outreach intervention were identified and demonstrated improvements or non-inferiority with respect to mortality, receipt of antiretroviral medications, immunological outcomes, improvements in healthcare utilization and lower reported healthcare costs when compared to usual care. Of the interventions examined in this review, sustained in-person case management and outreach interventions were most consistently associated with improved medical and economic outcomes, in particular antiretroviral prescribing, immunological outcomes and healthcare utilization. No firm conclusions can be reached about the impact of any one intervention on patient mortality.

Management Information Systems for Higher Education. Studies in Institutional Management in Higher Education.

ERIC Educational Resources Information Center

Hussain, K. M., Ed.

Contents include an introduction to information systems (basic concepts and life-cycle); development of an information system (design, implementation, testing, and conversion); operation (evaluation and maintenance, quality control, and economics); and case studies of such systems at the New University of Lisbon, Bath University, Laval University…

Risk Governance of Multiple Natural Hazards: Centralized versus Decentralized Approach in Europe

NASA Astrophysics Data System (ADS)

Komendantova, Nadejda; Scolobig, Anna; Vinchon, Charlotte

2014-05-01

The multi-risk approach is a relatively new field and its definition includes the need to consider multiple hazards and vulnerabilities in their interdependency (Selva, 2013) and the current multi-hazards disasters, such as the 2011 Tohoku earthquake, tsunami and nuclear catastrophe, showed the need for a multi-risk approach in hazard mitigation and management. Our knowledge about multi-risk assessment, including studies from different scientific disciplines and developed assessment tools, is constantly growing (White et al., 2001). However, the link between scientific knowledge, its implementation and the results in terms of improved governance and decision-making have gained significantly less attention (IRGC, 2005; Kappes et al., 2012), even though the interest to risk governance, in general, has increased significantly during the last years (Verweiy and Thompson, 2006). Therefore, the key research question is how risk assessment is implemented and what is the potential for the implementation of a multi-risk approach in different governance systems across Europe. More precisely, how do the characteristics of risk governance, such as the degree of centralization versus decentralization, influence the implementation of a multi-risk approach. The methodology of this research includes comparative case study analysis of top-down and bottom-up interactions in governance in the city of Naples, (Italy), where the institutional landscape is marked by significant autonomy of Italian regions in decision-making processes for assessing the majority of natural risks, excluding volcanic, and in Guadeloupe, French West Indies, an overseas department of France, where the decision-making process is marked by greater centralization in decision making associated with a well established state governance within regions, delegated to the prefect and decentralised services of central ministries. The research design included documentary analysis and extensive empirical work involving policy makers, private sector actors and practitioners in risk and emergency management. This work was informed by 36 semi-structured interviews, three workshops with over seventy participants from eleven different countries, feedback from questionnaires and focus group discussions (Scolobig et al., 2013). The results show that both governance systems have their own strengths and weaknesses (Komendantova et al., 2013). Elements of the centralized multi-risk governance system could lead to improvements in interagency communication and the creation of an inter-agency environment, where the different departments at the national level can exchange information, identify the communities that are most exposed to multiple risks and set priorities, while providing consistent information about and responses to multi-risk to the relevant stakeholders at the local level. A decentralised multi-risk governance system by contrast can instead favour the creation of local multi-risk commissions to conduct discussions between experts in meteorological, geological and technological risks and practitioners, to elaborate risk and hazard maps, and to develop local capacities which would include educational and training activities. Both governance systems suffer from common deficiencies, the most important being the frequent lack of capacities at the local level, especially financial, but sometimes also technical and institutional ones, as the responsibilities for disaster risk management are often transferred from the national to local levels without sufficient resources for implementation of programs on risk management (UNISDR, 2013). The difficulty in balancing available resources between short-term and medium-term priorities often complicates the issue. Our recommendations are that the implementation of multi-risk approach can be facilitated through knowledge exchange and dialogue between different disciplinary communities, such as geological and meteorological, and between the natural and social sciences. The implementation of a multi-risk approach can be strengthened through the creation of multi-risk platforms and multi-risk commissions, which can liaise between risk management experts and local communities and to unify numerous actions on natural hazard management. However, the multi-risk approach cannot be a subsidiary to a single risk approach, and both have to be pursued. References: IRGC. (2011). Concept note: Improving the management of emerging risks: Risks from new technologies, system interactions, and unforeseen or changing circumstances. International Risk Governance Council (IRGC), Geneva. Kappes, M. S., Keiler, M., Elverfeldt, von K., & Glade, T, (2012). Challenges of analyzing multi-hazard risk: A review. Natural Hazards, 64(2), 1925-1958. doi: 10.1007/s11069-012-0294-2. Komendantova N, Scolobig A, Vinchon C (2013). Multi-risk approach in centralized and decentralized risk governance systems: Case studies of Naples, Italy and Guadeloupe, France. International Relations and Diplomacy, 1(3):224-239 (December 2013) Scolobig, A., Vichon, C., Komendantova, N., Bengoubou-Valerius, M., & Patt, A. (2013). Social and institutional barriers to effective multi-hazard and multi-risk decision-making governance. D6.3 MATRIX project. Selva, J. (2013). Long-term multi-risk assessment: statistical treatment of interaction among risks. Natural Hazards, 67(2),701-722. UNISDR. (2013). Implementing the HYOGO framework for action in Europe: Regional synthesis report 2011-2013. Verweij, M., & Thompson, M. (Eds.). (2006). Clumsy solutions for a complex world: Governance, politics, and plural perceptions. New York: Palgrave Macmillan. White, G., Kates, R., & Burton, I. (2001). Knowing better and losing even more: the use of knowledge in hazards management. Environmental Hazards, 3, 81-92.

Assessing the Biological Safety Profession's Evaluation and Control of Risks Associated with the Field Collection of Potentially Infectious Specimens.

PubMed

Patlovich, Scott J; Emery, Robert J; Whitehead, Lawrence W; Brown, Eric L; Flores, Rene

2015-03-01

Because the origins of the biological safety profession are rooted in the control and prevention of laboratory-associated infections, the vocation focuses primarily on the safe handling of specimens within the laboratory. But in many cases, the specimens and samples handled in the lab are originally collected in the field where a broader set of possible exposure considerations may be present, each with varying degrees of controllability. The failure to adequately control the risks associated with collecting biological specimens in the field may result in illness or injury, and could have a direct impact on laboratory safety, if infectious specimens were packaged or transported inappropriately, for example. This study developed a web-based survey distributed to practicing biological safety professionals to determine the prevalence of and extent to which biological safety programs consider and evaluate field collection activities. In cases where such issues were considered, the data collected characterize the types of controls and methods of oversight at the institutional level that are employed. Sixty-one percent (61%) of the survey respondents indicated that research involving the field collection of biological specimens is conducted at their institutions. A majority (79%) of these field collection activities occur at academic institutions. Twenty-seven percent (27%) of respondents indicated that their safety committees do not consider issues related to biological specimens collected in the field, and only 25% with an oversight committee charged to review field collection protocols have generated a field research-specific risk assessment form to facilitate the assembly of pertinent information for a project risk assessment review. The results also indicated that most biosafety professionals (73% overall; 71% from institutions conducting field collection activities) have not been formally trained on the topic, but many (64% overall; 87% from institutions conducting field collection activities) indicated that training on field research safety issues would be helpful, and even more (71% overall; 93% from institutions conducting field collection activities) would consider participation in such a training course. Results obtained from this study can be used to develop a field research safety toolkit and associated training curricula specifically targeted to biological safety professionals.

Tackling health inequalities: moving theory to action

PubMed Central

Signal, Louise; Martin, Jennifer; Reid, Papaarangi; Carroll, Christopher; Howden-Chapman, Philippa; Ormsby, Vera Keefe; Richards, Ruth; Robson, Bridget; Wall, Teresa

2007-01-01

Background This paper reports on health inequalities awareness-raising workshops conducted with senior New Zealand health sector staff as part of the Government's goal of reducing inequalities in health, education, employment and housing. Methods The workshops were based on a multi-method needs assessment with senior staff in key health institutions. The workshops aimed to increase the knowledge and skills of health sector staff to act on, and advocate for, eliminating inequalities in health. They were practical, evidence-based, and action oriented and took a social approach to the causes of inequalities in health. The workshops used ethnicity as a case study and explored racism as a driver of inequalities. They focused on the role of institutionalized racism, or racism that is built into health sector institutions. Institutional theory provided a framework for participants to analyse how their institutions create and maintain inequalities and how they can act to change this. Results Participants identified a range of institutional mechanisms that promote inequalities and a range of ways to address them including: undertaking further training, using Māori (the indigenous people) models of health in policy-making, increasing Māori participation and partnership in decision making, strengthening sector relationships with iwi (tribes), funding and supporting services provided 'by Māori for Māori', ensuring a strategic approach to intersectoral work, encouraging stronger community involvement in the work of the institution, requiring all evaluations to assess impact on inequalities, and requiring the sector to report on progress in addressing health inequalities. The workshops were rated highly by participants, who indicated increased commitment to tackle inequalities as a result of the training. Discussion Government and sector leadership were critical to the success of the workshops and subsequent changes in policy and practice. The use of locally adapted equity tools, requiring participants to develop action plans, and using a case study to focus discussion were important to the success for the training. Using institutional theory was helpful in analysing how drivers of inequalities, such as racism, are built into health institutions. This New Zealand experience provides a model that may be applicable in other jurisdictions. PMID:17910778

Tackling health inequalities: moving theory to action.

PubMed

Signal, Louise; Martin, Jennifer; Reid, Papaarangi; Carroll, Christopher; Howden-Chapman, Philippa; Ormsby, Vera Keefe; Richards, Ruth; Robson, Bridget; Wall, Teresa

2007-10-03

This paper reports on health inequalities awareness-raising workshops conducted with senior New Zealand health sector staff as part of the Government's goal of reducing inequalities in health, education, employment and housing. The workshops were based on a multi-method needs assessment with senior staff in key health institutions. The workshops aimed to increase the knowledge and skills of health sector staff to act on, and advocate for, eliminating inequalities in health. They were practical, evidence-based, and action oriented and took a social approach to the causes of inequalities in health. The workshops used ethnicity as a case study and explored racism as a driver of inequalities. They focused on the role of institutionalized racism, or racism that is built into health sector institutions. Institutional theory provided a framework for participants to analyse how their institutions create and maintain inequalities and how they can act to change this. Participants identified a range of institutional mechanisms that promote inequalities and a range of ways to address them including: undertaking further training, using Māori (the indigenous people) models of health in policy-making, increasing Māori participation and partnership in decision making, strengthening sector relationships with iwi (tribes), funding and supporting services provided 'by Māori for Māori', ensuring a strategic approach to intersectoral work, encouraging stronger community involvement in the work of the institution, requiring all evaluations to assess impact on inequalities, and requiring the sector to report on progress in addressing health inequalities. The workshops were rated highly by participants, who indicated increased commitment to tackle inequalities as a result of the training. Government and sector leadership were critical to the success of the workshops and subsequent changes in policy and practice. The use of locally adapted equity tools, requiring participants to develop action plans, and using a case study to focus discussion were important to the success for the training. Using institutional theory was helpful in analysing how drivers of inequalities, such as racism, are built into health institutions. This New Zealand experience provides a model that may be applicable in other jurisdictions.

The automated multi-stage substructuring system for NASTRAN

NASA Technical Reports Server (NTRS)

Field, E. I.; Herting, D. N.; Herendeen, D. L.; Hoesly, R. L.

1975-01-01

The substructuring capability developed for eventual installation in Level 16 is now operational in a test version of NASTRAN. Its features are summarized. These include the user-oriented, Case Control type control language, the automated multi-stage matrix processing, the independent direct access data storage facilities, and the static and normal modes solution capabilities. A complete problem analysis sequence is presented with card-by-card description of the user input.

Sterilization versus segregation: control of the 'feebleminded', 1900-1938.

PubMed

Radford, J P

1991-01-01

This paper presents a model designed to contextualize studies of the specialized custodial mental handicap institutions which evolved in Britain and North America during the early decades of this century. The frame of reference adopted is the eugenics movement, and particularly the debate over sterilization vs segregation as the preferred means of controlling the breeding of the 'unfit'. The rise of farm colonies is seen as epitomizing the expression of eugenic ideologies in the social and physical landscapes. The geographical manifestation of eugenically-driven policy is illustrated in a case study of the Langdon colony, an extension of the Royal Western Counties Institution at Starcross near Exeter, as it developed between 1931 and 1938.

CONDUIT: A New Multidisciplinary Integration Environment for Flight Control Development

NASA Technical Reports Server (NTRS)

Tischler, Mark B.; Colbourne, Jason D.; Morel, Mark R.; Biezad, Daniel J.; Levine, William S.; Moldoveanu, Veronica

1997-01-01

A state-of-the-art computational facility for aircraft flight control design, evaluation, and integration called CONDUIT (Control Designer's Unified Interface) has been developed. This paper describes the CONDUIT tool and case study applications to complex rotary- and fixed-wing fly-by-wire flight control problems. Control system analysis and design optimization methods are presented, including definition of design specifications and system models within CONDUIT, and the multi-objective function optimization (CONSOL-OPTCAD) used to tune the selected design parameters. Design examples are based on flight test programs for which extensive data are available for validation. CONDUIT is used to analyze baseline control laws against pertinent military handling qualities and control system specifications. In both case studies, CONDUIT successfully exploits trade-offs between forward loop and feedback dynamics to significantly improve the expected handling, qualities and minimize the required actuator authority. The CONDUIT system provides a new environment for integrated control system analysis and design, and has potential for significantly reducing the time and cost of control system flight test optimization.

Effectiveness of interventions that assist caregivers to support people with dementia living in the community: a systematic review.

PubMed

Parker, Deborah; Mills, Sandra; Abbey, Jennifer

The objective of this review was to assess the effectiveness of interventions that assist caregivers to provide support for people living with dementia in the community. Types of participants Adult caregivers who provide support for people with dementia living in the community (non-institutional care).Types of interventions Interventions designed to support caregivers in their role such as skills training, education to assist in caring for a person living with dementia and support groups/programs. Interventions of formal approaches to care designed to support caregivers in their role, care planning, case management and specially designated members of the healthcare team - for example dementia nurse specialist or volunteers trained in caring for someone with dementia.Types of studies This review considered any meta-analyses, systematic reviews, randomised control trials, quasi-experimental studies, cohort studies, case control studies and observational studies without control groups that addressed the effectiveness of interventions that assist caregivers to provide support for people living with dementia in the community. The search sought to identify published studies from 2000 to 2005 through the use of electronic databases. Only studies in English were considered for inclusion. The initial search was conducted of the databases, CINAHL, MEDLINE and PsychINFO using search strategies adapted from the Cochrane Dementia and Cognitive Improvement Group. A second more extensive search was then conducted using the appropriate Medical Subject Headings (MeSH) and keywords for other available databases. Finally, hand searching of reference lists of articles retrieved and of core dementia, geriatric and psycho geriatric journals was undertaken. Methodological quality of each of the articles was assessed by two independent reviewers using appraisal checklist developed by the Joanna Briggs Institute and based on the work of the Cochrane Collaboration and Centre for Reviews and Dissemination. Standardised mean differences or weighted mean differences and their 95% confidence intervals were calculated for each included study reported in the meta-analysis. Results from comparable groups of studies were pooled in statistical meta-analysis using Review Manager Software from the Cochrane Collaboration. Heterogeneity between combined studies was tested using standard chi-square test. Where statistical pooling was not appropriate or possible, the findings are summarised in narrative form. A comprehensive search of relevant databases, hand searching and cross referencing found 685 articles that were assessed for relevance to the review. Eighty-five papers appeared to meet the inclusion criteria based on title and abstract, and the full paper was retrieved. Of the 85 full papers reviewed, 40 were accepted for inclusion, three were systematic reviews, three were meta-analysis, and the remaining 34 were randomised controlled trials. For the randomised controlled trials that were able to be included in a meta-analysis, standardised mean differences or weighted mean differences and their 95% confidence intervals were calculated for each. Results from comparable groups of studies were pooled in statistical meta-analysis using Review Manager Software and heterogeneity between combined studies was assessed by using the chi-square test. Where statistical pooling was not appropriate or possible, the findings are summarised in narrative form.The results are discussed in two main sections. Firstly it was possible to assess the effectiveness of different types of caregiver interventions on the outcome categories of depression, health, subjective well-being, self-efficacy and burden. Secondly, results are reported by main outcome category. For each of these sections, meta-analysis was conducted where it was possible; otherwise, a narrative summary describes the findings. Four categories of intervention were included in the review - psycho-educational, support, multi-component and other.Psycho-educational Thirteen studies used psycho-educational interventions, and all but one showed positive results across a range of outcomes. Eight studies were entered in a meta-analysis. No significant impact of psycho-educational interventions was found for the outcome categories of subjective well-being, self-efficacy or health. However, small but significant results were found for the categories of depression and burden.Support Seven studies discussed support only interventions and two of these showed significant results. These two studies were suitable for meta-analysis and demonstrated a small but significant improvement on caregiver burden.Multi-component Twelve of the studies report multi-component interventions and 10 of these report significant outcomes across a broad range of outcome measures including self-efficacy, depression, subjective well-being and burden. Unfortunately because of the heterogeneity of study designs and outcome measures, no meta-analysis was possible.Other interventions Other interventions included the use of exercise or nutrition which resulted in improvements in psychological distress and health benefits. Case management and a computer aided support intervention provided mixed results. One cognitive behavioural therapy study reported a reduction in anxiety and positive impacts on patient behaviour. In addition to analysis by type of intervention it was possible to analyse results based on some outcome categories that were used across the studies. In particular the impact of interventions on caregiver depression was available for meta-analysis from eight studies. This indicated that multi-component and psycho-educational interventions showed a small but significant positive effect on caregiver depression.Five studies using the outcome category of caregiver burden were entered into a meta-analysis and findings indicated that there were no significant effects of any of interventions. No meta-analysis was possible for the outcome categories of health, self-efficacy or subjective well-being. From this review there is evidence to support the use of well-designed psycho-educational or multi-component interventions for caregivers of people with dementia who live in the community. Factors that appear to positively contribute to effective interventions are those which:Factors which do not appear to have benefit in interventions are those which.

A Multi-Institutional Study of High School Mathematics Curricula and College Mathematics Achievement and Course Taking

ERIC Educational Resources Information Center

Harwell, Michael R.; Post, Thomas R.; Medhanie, Amanuel; Dupuis, Danielle N.; LeBeau, Brandon

2013-01-01

This study examined the relationship between high school mathematics curricula and student achievement and course-taking patterns over 4 years of college course taking for a sample of over 10,000 students from 32 postsecondary 4-year institutions. Three types of curricula were studied: National Science Foundation (NSF) funded curricula, the…

A self-scaling, distributed information architecture for public health, research, and clinical care.

PubMed

McMurry, Andrew J; Gilbert, Clint A; Reis, Ben Y; Chueh, Henry C; Kohane, Isaac S; Mandl, Kenneth D

2007-01-01

This study sought to define a scalable architecture to support the National Health Information Network (NHIN). This architecture must concurrently support a wide range of public health, research, and clinical care activities. The architecture fulfils five desiderata: (1) adopt a distributed approach to data storage to protect privacy, (2) enable strong institutional autonomy to engender participation, (3) provide oversight and transparency to ensure patient trust, (4) allow variable levels of access according to investigator needs and institutional policies, (5) define a self-scaling architecture that encourages voluntary regional collaborations that coalesce to form a nationwide network. Our model has been validated by a large-scale, multi-institution study involving seven medical centers for cancer research. It is the basis of one of four open architectures developed under funding from the Office of the National Coordinator of Health Information Technology, fulfilling the biosurveillance use case defined by the American Health Information Community. The model supports broad applicability for regional and national clinical information exchanges. This model shows the feasibility of an architecture wherein the requirements of care providers, investigators, and public health authorities are served by a distributed model that grants autonomy, protects privacy, and promotes participation.

Clinicopathological features and prognosis of mucin-producing bile duct tumor and mucinous cystic tumor of the liver: a multi-institutional study by the Japan Biliary Association.

PubMed

Kubota, Keiichi; Nakanuma, Yasuni; Kondo, Fukuo; Hachiya, Hiroyuki; Miyazaki, Masaru; Nagino, Masato; Yamamoto, Masakazu; Isayama, Hiroyuki; Tabata, Masami; Kinoshita, Hisafumi; Kamisawa, Terumi; Inui, Kazuo

2014-03-01

The aim of this study was to determine the clinicopathological features and surgical outcomes of mucinous cystic neoplasm of the liver (MCN) and mucin-producing intraductal papillary neoplasm of the intrahepatic bile duct (M-IPNB). We performed a multi-institutional, retrospective study of patients with MCN or M-IPNB pathologically defined by the presence or absence of an ovarian-like stroma. The M-IPNB and MCN were diagnosed in 119 and nine patients, respectively. MCN was observed in female patients, while M-IPNB produced symptoms of cholangitis. M-IPNBs were classed as low or intermediate grade in 53 cases, high grade in 23 and invasive carcinoma in 43. Fifty-one of the M-IPNBs were the pancreatobiliary type (PT), 33 were the intestinal type (IT), 23 were the oncocytic type (OT), and 12 were the gastric type (GT). The 1-, 5- and 10-year survival rates for the 105 patients with M-IPNB were 96%, 84% and 81%, respectively, while the 5-year survival rate for patients with MCN was 100%. OT and GT M-IPNB had better 10-year survival rates than PT and IT M-IPNB. Although MCN has different features from M-IPNB, both diseases have a good prognosis after resection. The cellular type of M-IPNB appears to predict outcome. © 2013 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

Audiovisual biofeedback breathing guidance for lung cancer patients receiving radiotherapy: a multi-institutional phase II randomised clinical trial.

PubMed

Pollock, Sean; O'Brien, Ricky; Makhija, Kuldeep; Hegi-Johnson, Fiona; Ludbrook, Jane; Rezo, Angela; Tse, Regina; Eade, Thomas; Yeghiaian-Alvandi, Roland; Gebski, Val; Keall, Paul J

2015-07-18

There is a clear link between irregular breathing and errors in medical imaging and radiation treatment. The audiovisual biofeedback system is an advanced form of respiratory guidance that has previously demonstrated to facilitate regular patient breathing. The clinical benefits of audiovisual biofeedback will be investigated in an upcoming multi-institutional, randomised, and stratified clinical trial recruiting a total of 75 lung cancer patients undergoing radiation therapy. To comprehensively perform a clinical evaluation of the audiovisual biofeedback system, a multi-institutional study will be performed. Our methodological framework will be based on the widely used Technology Acceptance Model, which gives qualitative scales for two specific variables, perceived usefulness and perceived ease of use, which are fundamental determinants for user acceptance. A total of 75 lung cancer patients will be recruited across seven radiation oncology departments across Australia. Patients will be randomised in a 2:1 ratio, with 2/3 of the patients being recruited into the intervention arm and 1/3 in the control arm. 2:1 randomisation is appropriate as within the interventional arm there is a screening procedure where only patients whose breathing is more regular with audiovisual biofeedback will continue to use this system for their imaging and treatment procedures. Patients within the intervention arm whose free breathing is more regular than audiovisual biofeedback in the screen procedure will remain in the intervention arm of the study but their imaging and treatment procedures will be performed without audiovisual biofeedback. Patients will also be stratified by treating institution and for treatment intent (palliative vs. radical) to ensure similar balance in the arms across the sites. Patients and hospital staff operating the audiovisual biofeedback system will complete questionnaires to assess their experience with audiovisual biofeedback. The objectives of this clinical trial is to assess the impact of audiovisual biofeedback on breathing motion, the patient experience and clinical confidence in the system, clinical workflow, treatment margins, and toxicity outcomes. This clinical trial marks an important milestone in breathing guidance studies as it will be the first randomised, controlled trial providing the most comprehensive evaluation of the clinical impact of breathing guidance on cancer radiation therapy to date. This study is powered to determine the impact of AV biofeedback on breathing regularity and medical image quality. Objectives such as determining the indications and contra-indications for the use of AV biofeedback, evaluation of patient experience, radiation toxicity occurrence and severity, and clinician confidence will shed light on the design of future phase III clinical trials. This trial has been registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), its trial ID is ACTRN12613001177741 .

Impact of Intercollegiate Athletic Participation on Leadership Development

ERIC Educational Resources Information Center

Huntrods, Clint S.; An, Brian P.; Pascarella, Ernest T.

2017-01-01

This study examined the effects of participation in intercollegiate athletics on leadership development using a multi-institutional, longitudinal sample of students at four-year institutions. Using Astin's (1993) Input-Environment-Outcome model, we examined whether athletic participation influenced leadership development using the Socially…

Identifying the Camouflage: Uncovering and Supporting the Transition Experiences of Military and Veteran Students

ERIC Educational Resources Information Center

Williams-Klotz, Denise N.; Gansemer-Topf, Ann M.

2017-01-01

This study summarizes the qualitative findings from a multi-institutional study about the college transition experiences of military and veteran students, specifically students' articulation of their needs. Findings reveal (a) a lack of inprocessing, (b) need for community, and (c) institutional invisibility. Using the Student Veteran Transition…

Biallelic Alteration and Dysregulation of the Hippo Pathway in Mucinous Tubular and Spindle Cell Carcinoma of the Kidney.

PubMed

Mehra, Rohit; Vats, Pankaj; Cieslik, Marcin; Cao, Xuhong; Su, Fengyun; Shukla, Sudhanshu; Udager, Aaron M; Wang, Rui; Pan, Jincheng; Kasaian, Katayoon; Lonigro, Robert; Siddiqui, Javed; Premkumar, Kumpati; Palapattu, Ganesh; Weizer, Alon; Hafez, Khaled S; Wolf, J Stuart; Sangoi, Ankur R; Trpkov, Kiril; Osunkoya, Adeboye O; Zhou, Ming; Giannico, Giovanna; McKenney, Jesse K; Dhanasekaran, Saravana M; Chinnaiyan, Arul M

2016-11-01

Mucinous tubular and spindle cell carcinoma (MTSCC) is a relatively rare subtype of renal cell carcinoma (RCC) with distinctive morphologic and cytogenetic features. Here, we carry out whole-exome and transcriptome sequencing of a multi-institutional cohort of MTSCC (n = 22). We demonstrate the presence of either biallelic loss of Hippo pathway tumor suppressor genes (TSG) and/or evidence of alteration of Hippo pathway genes in 85% of samples. PTPN14 (31%) and NF2 (22%) were the most commonly implicated Hippo pathway genes, whereas other genes such as SAV1 and HIPK2 were also involved in a mutually exclusive fashion. Mutations in the context of recurrent chromosomal losses amounted to biallelic alterations in these TSGs. As a readout of Hippo pathway inactivation, a majority of cases (90%) exhibited increased nuclear YAP1 protein expression. Taken together, nearly all cases of MTSCC exhibit some evidence of Hippo pathway dysregulation. MTSCC is a rare and relatively recently described subtype of RCC. Next-generation sequencing of a multi-institutional MTSCC cohort revealed recurrent chromosomal losses and somatic mutations in the Hippo signaling pathway genes leading to potential YAP1 activation. In virtually all cases of MTSCC, there was evidence of Hippo pathway dysregulation, suggesting a common mechanistic basis for this disease. Cancer Discov; 6(11); 1258-66. ©2016 AACR.This article is highlighted in the In This Issue feature, p. 1197. ©2016 American Association for Cancer Research.

Is diabetes mellitus a risk factor for venous thromboembolism? A systematic review and meta-analysis of case-control and cohort studies.

PubMed

Gariani, Karim; Mavrakanas, Thomas; Combescure, Christophe; Perrier, Arnaud; Marti, Christophe

2016-03-01

Diabetes mellitus is a well-established risk factor for atherosclerotic disease, but its role in the occurrence of venous thromboembolism (VTE) has not been elucidated. We conducted a meta-analysis of published cohort and case-control studies to assess whether diabetes mellitus is a risk factor for VTE. We systematically searched MEDLINE and EMBASE for case-control and prospective cohort studies assessing association between the risk of venous thromboembolism and diabetes. Odds ratios (OR) from case-control studies were combined while for prospective studies hazard ratios (HR) were combined. Models with random effects were used. Meta-analyses were conducted separately for raw and adjusted measures of association. 24 studies were identified including 10 cohort studies (274,501 patients) and 14 case-control studies (1,157,086 patients). Meta-analysis of the prospective cohort studies demonstrated a significant association between diabetes and VTE (HR 1.60; 95% CI 1.35 to 1.89). This association was no longer present after analysis of multi-adjusted HRs (HR 1.10; 95% CI 0.77 to 1.56). Meta-analysis of case-control studies showed a significant association between diabetes and VTE (OR 1.57; 95%CI 1.17 to 2.12), but this association was no longer present when adjusted ORs were used (OR 1.18; 95%CI 0.89 to 1.56). The increased risk of VTE associated with diabetes mainly results from confounders rather than an intrinsic effect of diabetes on venous thrombotic risk. Therefore, no specific recommendations should apply for the management of diabetic patients at risk for VTE. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Improving multi-objective reservoir operation optimization with sensitivity-informed dimension reduction

NASA Astrophysics Data System (ADS)

Chu, J.; Zhang, C.; Fu, G.; Li, Y.; Zhou, H.

2015-08-01

This study investigates the effectiveness of a sensitivity-informed method for multi-objective operation of reservoir systems, which uses global sensitivity analysis as a screening tool to reduce computational demands. Sobol's method is used to screen insensitive decision variables and guide the formulation of the optimization problems with a significantly reduced number of decision variables. This sensitivity-informed method dramatically reduces the computational demands required for attaining high-quality approximations of optimal trade-off relationships between conflicting design objectives. The search results obtained from the reduced complexity multi-objective reservoir operation problems are then used to pre-condition the full search of the original optimization problem. In two case studies, the Dahuofang reservoir and the inter-basin multi-reservoir system in Liaoning province, China, sensitivity analysis results show that reservoir performance is strongly controlled by a small proportion of decision variables. Sensitivity-informed dimension reduction and pre-conditioning are evaluated in their ability to improve the efficiency and effectiveness of multi-objective evolutionary optimization. Overall, this study illustrates the efficiency and effectiveness of the sensitivity-informed method and the use of global sensitivity analysis to inform dimension reduction of optimization problems when solving complex multi-objective reservoir operation problems.

Improving multi-objective reservoir operation optimization with sensitivity-informed problem decomposition

NASA Astrophysics Data System (ADS)

Chu, J. G.; Zhang, C.; Fu, G. T.; Li, Y.; Zhou, H. C.

2015-04-01

This study investigates the effectiveness of a sensitivity-informed method for multi-objective operation of reservoir systems, which uses global sensitivity analysis as a screening tool to reduce the computational demands. Sobol's method is used to screen insensitive decision variables and guide the formulation of the optimization problems with a significantly reduced number of decision variables. This sensitivity-informed problem decomposition dramatically reduces the computational demands required for attaining high quality approximations of optimal tradeoff relationships between conflicting design objectives. The search results obtained from the reduced complexity multi-objective reservoir operation problems are then used to pre-condition the full search of the original optimization problem. In two case studies, the Dahuofang reservoir and the inter-basin multi-reservoir system in Liaoning province, China, sensitivity analysis results show that reservoir performance is strongly controlled by a small proportion of decision variables. Sensitivity-informed problem decomposition and pre-conditioning are evaluated in their ability to improve the efficiency and effectiveness of multi-objective evolutionary optimization. Overall, this study illustrates the efficiency and effectiveness of the sensitivity-informed method and the use of global sensitivity analysis to inform problem decomposition when solving the complex multi-objective reservoir operation problems.

Factorial versus multi-arm multi-stage designs for clinical trials with multiple treatments.

PubMed

Jaki, Thomas; Vasileiou, Despina

2017-02-20

When several treatments are available for evaluation in a clinical trial, different design options are available. We compare multi-arm multi-stage with factorial designs, and in particular, we will consider a 2 × 2 factorial design, where groups of patients will either take treatments A, B, both or neither. We investigate the performance and characteristics of both types of designs under different scenarios and compare them using both theory and simulations. For the factorial designs, we construct appropriate test statistics to test the hypothesis of no treatment effect against the control group with overall control of the type I error. We study the effect of the choice of the allocation ratios on the critical value and sample size requirements for a target power. We also study how the possibility of an interaction between the two treatments A and B affects type I and type II errors when testing for significance of each of the treatment effects. We present both simulation results and a case study on an osteoarthritis clinical trial. We discover that in an optimal factorial design in terms of minimising the associated critical value, the corresponding allocation ratios differ substantially to those of a balanced design. We also find evidence of potentially big losses in power in factorial designs for moderate deviations from the study design assumptions and little gain compared with multi-arm multi-stage designs when the assumptions hold. © 2016 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd. © 2016 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.

Factors affecting urine reagent strip blood results in dogs and nonhuman primates and interpretation of urinalysis in preclinical toxicology studies: a Multi-Institution Contract Research Organization and BioPharmaceutical Company Perspective.

PubMed

Aulbach, Adam D; Schultze, Eric; Tripathi, Niraj K; Hall, Robert L; Logan, Michael R; Meyer, Denny J

2015-06-01

Urinalysis data in preclinical toxicology studies can be influenced by preanalytic and analytic factors which have the potential to confound interpretation. There is a paucity of information regarding positive reagent strip urinary blood reactions in healthy nonhuman primates (NHP) and Beagle dogs used in preclinical toxicology studies. The objectives were (1) to establish historical control data for reagent strip urinary blood reactions in healthy NHP and Beagle dogs, (2) to determine the incidence of positive urinary blood reactions during predose and dosing phases, and (3) to determine if collection practice was a relevant parameter. Historical control data from 2 institutions in the biopharmaceutical industry were retrospectively analyzed for reagent strip urinary blood reactions in healthy NHP and Beagles. The incidence of positive results between the 2 institutions with different urine collection practices and between males and females was compared. The incidence of positive urinary blood reactions in NHP was comparable between institutions (≤ 14% in males; ≤ 33% in females), while the incidence of positive urinary blood reactions in Beagles was more variable (≤ 77% in males; ≤ 69% in females), and higher in females during the dosing phase. Positive urinary blood results that could potentially be misinterpreted as toxicologically relevant were identified in healthy NHP and Beagles during predose and dosing phases. Different incidences of positive results between the 2 institutions were likely related to collection practices. Strategies to reduce feces and food contamination of collected urine samples should help minimize false-positive urinary blood reactions. © 2015 American Society for Veterinary Clinical Pathology.

Analysis of human tissue management models for medical research: preparation for implementation of the 2012 revision of the Bioethics and Safety Act of Korea.

PubMed

Ryu, Young-Joon; Kim, Hankyeom; Jang, Sejin; Koo, Young-Mo

2013-06-01

Efficient management of human tissue samples is a critical issue; the supply of samples is unable to satisfy the current demands for research. Lack of informed consent is also an ethical problem. One of the goals of the 2012 revision of Korea's Bioethics and Safety Act was to implement regulations that govern the management of human tissue samples. To remain competitive, medical institutions must prepare for these future changes. In this report, we review two tissue management models that are currently in use; model 1 is the most common system utilized by hospitals in Korea and model 2 is implemented by some of the larger institutions. We also propose three alternative models that offer advantages over the systems currently in use. Model 3 is a multi-bank model that protects the independence of physicians and pathologists. Model 4 utilizes a comprehensive single bioresource bank; although in this case, the pathologists gain control of the samples, which may make it difficult to implement. Model 5, which employs a bioresource utilization steering committee (BUSC), is viable to implement and still maintains the advantages of Model 4. To comply with the upcoming law, we suggest that physicians and pathologists in an institution should collaborate to choose one of the improved models of tissue management system that best fits for their situation.

Using Enrollment Data to Predict Retention Rate

ERIC Educational Resources Information Center

Bingham, Melissa A.; Solverson, Natalie Walleser

2016-01-01

First- to second-year retention rates are one metric reported by colleges and universities to convey institutional success to a variety of external constituents. But how much of a retention rate is institutional inputs, and how much can be understood by examining student inputs? The authors utilize multi-year, multi-institutional data to examine…

Entrepreneurial Decision Making and Institutional Governance within the Academy: A Case Study

ERIC Educational Resources Information Center

French, Edward F.

2011-01-01

This case study explored the relationship between entrepreneurial decision making and optimal institutional governance. The study focused on a single institution, characterized as a small, tuition-driven, private institution. Twelve participants were interviewed in the study, equally divided between members of the faculty and of the…

Blasting vibrations control: The shortcomings of traditional methods

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

Vuillaume, P.M.; Kiszlo, M.; Bernard, T.

1996-12-31

In the context of its studies for the French ministry of the environment and for the French national coal board, INERIS (the French institute for the industrial environment and hazards, formerly CERCHAR) has made a complete critical survey of the methods generally used to reduce the levels of blasting vibrations. It is generally acknowledged that the main parameter to control vibrations is the so-called instantaneous charge, or charge per delay. This should be reduced as much as possible in order to diminish vibration levels. On account of this, the use of a new generation of blasting devices, such as non-electricmore » detonators or electronic sequential timers has been developed since the seventies. INERIS has collected data from about 900 blasts in 2 quarries and 3 open pit mines. These data include input parameters such as borehole diameter, burden, spacing, charge per hole, charge per delay, total fired charge, etc ... They also include output measurements, such as vibration peak particle velocities, and main frequencies. These data have been analyzed with the help of multi variable statistical tools. Blasting tests were undertaken to evaluate new methods of vibrations control, such as the superposition of vibration signals. These methods appear to be accurate in many critical cases, but certainly would be highly improved with a better accuracy of firing delays. The development of electronic detonators seems to be the way of the future for a better blasting control.« less

A standardized curriculum to introduce novice health professional students to practice-based learning and improvement: a multi-institutional pilot study.

PubMed

Huntington, Jonathan T; Dycus, Paula; Hix, Carolyn; West, Rita; McKeon, Leslie; Coleman, Mary T; Hathaway, Donna; McCurren, Cynthia; Ogrinc, Greg

2009-01-01

Practice-based learning and improvement (PBLI) combines the science of continuous quality improvement with the pragmatics of day-to-day clinical care delivery. PBLI is a core-learning domain in nursing and medical education. We developed a workbook-based, project-focused curriculum to teach PBLI to novice health professional students. Evaluate the efficacy of a standardized curriculum to teach PBLI. Nonrandomized, controlled trial with medical and nursing students from 3 institutions. Faculty used the workbook to facilitate completion of an improvement project with 16 participants. Both participants and controls (N = 15) completed instruments to measure PBLI knowledge and self-efficacy. Participants also completed a satisfaction survey and presented project posters at a national conference. There was no significant difference in PBLI knowledge between groups. Self-efficacy of participants was higher than that of controls in identifying best practice, identifying measures, identifying successful local improvement work, implementing a structured change plan, and using Plan-Do-Study-Act methodology. Participant satisfaction with the curriculum was high. Although PBLI knowledge was similar between groups, participants had higher self-efficacy and confidently disseminated their findings via formal poster presentation. This pilot study suggests that using a workbook-based, project-focused approach may be effective in teaching PBLI to novice health professional students.

BigMouth: a multi-institutional dental data repository.

PubMed

Walji, Muhammad F; Kalenderian, Elsbeth; Stark, Paul C; White, Joel M; Kookal, Krishna K; Phan, Dat; Tran, Duong; Bernstam, Elmer V; Ramoni, Rachel

2014-01-01

Few oral health databases are available for research and the advancement of evidence-based dentistry. In this work we developed a centralized data repository derived from electronic health records (EHRs) at four dental schools participating in the Consortium of Oral Health Research and Informatics. A multi-stakeholder committee developed a data governance framework that encouraged data sharing while allowing control of contributed data. We adopted the i2b2 data warehousing platform and mapped data from each institution to a common reference terminology. We realized that dental EHRs urgently need to adopt common terminologies. While all used the same treatment code set, only three of the four sites used a common diagnostic terminology, and there were wide discrepancies in how medical and dental histories were documented. BigMouth was successfully launched in August 2012 with data on 1.1 million patients, and made available to users at the contributing institutions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Research impact in the community-based health sciences: an analysis of 162 case studies from the 2014 UK Research Excellence Framework.

PubMed

Greenhalgh, Trisha; Fahy, Nick

2015-09-21

The 2014 UK Research Excellence Framework (REF2014) generated a unique database of impact case studies, each describing a body of research and impact beyond academia. We sought to explore the nature and mechanism of impact in a sample of these. The study design was manual content analysis of a large sample of impact case studies (producing mainly quantitative data), plus in-depth interpretive analysis of a smaller sub-sample (for qualitative detail), thereby generating both breadth and depth. For all 162 impact case studies submitted to sub-panel A2 in REF2014, we extracted data on study design(s), stated impacts and audiences, mechanisms of impact, and efforts to achieve impact. We analysed four case studies (selected as exemplars of the range of approaches to impact) in depth, including contacting the authors for their narratives of impact efforts. Most impact case studies described quantitative research (most commonly, trials) and depicted a direct, linear link between research and impact. Research was said to have influenced a guideline in 122 case studies, changed policy in 88, changed practice in 84, improved morbidity in 44 and reduced mortality in 25. Qualitative and participatory research designs were rare, and only one case study described a co-production model of impact. Eighty-two case studies described strong and ongoing linkages with policymakers, but only 38 described targeted knowledge translation activities. In 40 case studies, no active efforts to achieve impact were described. Models of good implementation practice were characterised by an ethical commitment by researchers, strong institutional support and a proactive, interdisciplinary approach to impact activities. REF2014 both inspired and documented significant efforts by UK researchers to achieve impact. But in contrast with the published evidence on research impact (which depicts much as occurring indirectly through non-linear mechanisms), this sub-panel seems to have captured mainly direct and relatively short-term impacts one step removed from patient outcomes. Limited impacts on morbidity and mortality, and researchers' relatively low emphasis on the processes and interactions through which indirect impacts may occur, are concerns. These findings have implications for multi-stakeholder research collaborations such as UK National Institute for Health Research Collaborations for Leadership in Applied Health Research and Care, which are built on non-linear models of impact.

Institutional review board challenges related to community-based participatory research on human exposure to environmental toxins: A case study

PubMed Central

2010-01-01

Background We report on the challenges of obtaining Institutional Review Board (IRB) coverage for a community-based participatory research (CBPR) environmental justice project, which involved reporting biomonitoring and household exposure results to participants, and included lay participation in research. Methods We draw on our experiences guiding a multi-partner CBPR project through university and state Institutional Review Board reviews, and other CBPR colleagues' written accounts and conference presentations and discussions. We also interviewed academics involved in CBPR to learn of their challenges with Institutional Review Boards. Results We found that Institutional Review Boards are generally unfamiliar with CBPR, reluctant to oversee community partners, and resistant to ongoing researcher-participant interaction. Institutional Review Boards sometimes unintentionally violate the very principles of beneficence and justice which they are supposed to uphold. For example, some Institutional Review Boards refuse to allow report-back of individual data to participants, which contradicts the CBPR principles that guide a growing number of projects. This causes significant delays and may divert research and dissemination efforts. Our extensive education of our university Institutional Review Board convinced them to provide human subjects protection coverage for two community-based organizations in our partnership. Conclusions IRBs and funders should develop clear, routine review guidelines that respect the unique qualities of CBPR, while researchers and community partners can educate IRB staff and board members about the objectives, ethical frameworks, and research methods of CBPR. These strategies can better protect research participants from the harm of unnecessary delays and exclusion from the research process, while facilitating the ethical communication of study results to participants and communities. PMID:20637068

Shifting Tides in Global Higher Education: Agency, Autonomy, and Governance in the Global Network. Global Studies in Education, Volume 9

ERIC Educational Resources Information Center

Witt, Mary Allison

2011-01-01

The increasing connection among higher education institutions worldwide is well documented. What is less understood is how this connectivity is enacted and manifested on specific levels of the global education network. This book details the planning process of a multi-institutional program in engineering between institutions in the US and…

Value Added or Misattributed? A Multi-Institution Study on the Educational Benefit of Labs for Reinforcing Physics Content

ERIC Educational Resources Information Center

Holmes, N. G.; Olsen, Jack; Thomas, James L.; Wieman, Carl E.

2017-01-01

Instructional labs are widely seen as a unique, albeit expensive, way to teach scientific content. We measured the effectiveness of introductory lab courses at achieving this educational goal across nine different lab courses at three very different institutions. These institutions and courses encompassed a broad range of student populations and…

[Current situation of scientific research capacity of schistosomiasis control institutions of municipal cities in Hubei Province].

PubMed

Ying, Zhao-yu; Tan, Xiao-dong; Huang, Ya-dong; Jiang, Bao-jie

2014-08-01

To evaluate the levels of the Chinese literature published by the schistosomiasis control institutions of 17 municipal cities of Hubei Province. The related literature published from 2008 to 2012 was searched from the databases of CNKI, VIP and Wanfang and then screened by the exclusion criteria. NoteExpress and Excel softwares were applied to collect the literature and carry out the bibliometric analysis. A total of 168 papers were included and the schistosomiasis control institutes of Jingzhou City and Wuhan City had the highest amount. The literature was mainly published in Chinese Journal of Schistosomiasis Control and Journal of Public Health and Preventive Medicine. The comprehensive influence indexes of the schistosomiasis control institutes of Jingzhou, Wuhan and Qianjiang cities were higher. The schistosomiasis control institutes of Jingzhou City had an extensive content of literature while Wuhan was mainly focused on epidemiology, case report and Oncomelania hupensis snail control. The research of schistosomiasis in each municipal city has an extensive content and the research capacity of the schistosomiasis control institute of Jingzhou City is relatively outstanding.

Multi-institutional arrangements: relationships between governing boards and hospital chief executive officers.

PubMed

Alexander, J; Morlock, L L

1985-02-01

This investigation focuses on the impact of multi-institutional arrangements on the role of governing boards in limiting or enhancing the managerial autonomy of individual hospitals. Data from a 1979 Special Survey by the American Hospital Association (N = 4213) are used to examine governing board-administrator relationships as a function of the degree of autonomy and scope of responsibility of the hospital governing board. It is hypothesized that governing boards responsible for multiple hospitals or for multiple nonhospital organizations and those boards accountable to a higher organizational authority will exercise more formal control over hospital chief executive officers (CEOs) than will boards of single or autonomous hospitals. The analysis assumes that formal control by the governing board over the management function of the individual hospital is exercised partly through soliciting or limiting participation by hospital administrators in key policy decisions and through the evaluation of administrative performance. Therefore, it is anticipated that hospitals governed by boards with multiple responsibilities as well as hospitals governed by boards accountable to a higher authority will be (1) less likely to have CEOs who are members of the governing board executive committee, (2) more likely to have annual performance reviews of the CEO by the governing board, and (3) more likely to have such reviews conducted according to preestablished criteria. Study results provide general support for the hypotheses with respect to hospital boards with multiple responsibilities: the data suggest that such boards do exercise greater control over hospital administrators and these effects do appear to be stronger for hospitals in the private sector. Hospitals governed by boards accountable to a higher authority, however, are more likely to have CEOs who are members of the governing board executive committee--a pattern in direct opposition to that hypothesized. Furthermore, these boards are no more likely to conduct annual CEO performance reviews than are boards with more autonomy. Boards accountable to higher authorities are more likely, however, to use preestablished criteria when such reviews are conducted. This general pattern is similar whether hospital boards are accountable to religious authorities, to investor-owned corporate boards, or to the boards of not-for-profit multi-institutional systems. A different pattern emerges, however, for boards accountable to a state, county, or local government authority.(ABSTRACT TRUNCATED AT 400 WORDS)

Multi-institutional arrangements: relationships between governing boards and hospital chief executive officers.

PubMed Central

Alexander, J; Morlock, L L

1985-01-01

This investigation focuses on the impact of multi-institutional arrangements on the role of governing boards in limiting or enhancing the managerial autonomy of individual hospitals. Data from a 1979 Special Survey by the American Hospital Association (N = 4213) are used to examine governing board-administrator relationships as a function of the degree of autonomy and scope of responsibility of the hospital governing board. It is hypothesized that governing boards responsible for multiple hospitals or for multiple nonhospital organizations and those boards accountable to a higher organizational authority will exercise more formal control over hospital chief executive officers (CEOs) than will boards of single or autonomous hospitals. The analysis assumes that formal control by the governing board over the management function of the individual hospital is exercised partly through soliciting or limiting participation by hospital administrators in key policy decisions and through the evaluation of administrative performance. Therefore, it is anticipated that hospitals governed by boards with multiple responsibilities as well as hospitals governed by boards accountable to a higher authority will be (1) less likely to have CEOs who are members of the governing board executive committee, (2) more likely to have annual performance reviews of the CEO by the governing board, and (3) more likely to have such reviews conducted according to preestablished criteria. Study results provide general support for the hypotheses with respect to hospital boards with multiple responsibilities: the data suggest that such boards do exercise greater control over hospital administrators and these effects do appear to be stronger for hospitals in the private sector. Hospitals governed by boards accountable to a higher authority, however, are more likely to have CEOs who are members of the governing board executive committee--a pattern in direct opposition to that hypothesized. Furthermore, these boards are no more likely to conduct annual CEO performance reviews than are boards with more autonomy. Boards accountable to higher authorities are more likely, however, to use preestablished criteria when such reviews are conducted. This general pattern is similar whether hospital boards are accountable to religious authorities, to investor-owned corporate boards, or to the boards of not-for-profit multi-institutional systems. A different pattern emerges, however, for boards accountable to a state, county, or local government authority.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:3972592

[A case-control study on the risk factors of work-related acute pesticide poisoning among farmers from Jiangsu province].

PubMed

Tu, Zhi-bin; Cui, Meng-jing; Yao, Hong-yan; Hu, Guo-qing; Xiang, Hui-yun; Stallones, Lorann; Zhang, Xu-jun

2012-04-01

To explore the risk factors on cases regarding work-related acute pesticide poisoning among farmers of Jiangsu province. A population-based, 1:2 matched case-control study was carried out, with 121 patients as case-group paired by 242 persons with same gender, district and age less then difference of 3 years, as controls. Cases were the ones who had suffered from work-related acute pesticide poisoning. A unified questionnaire was used. Data base was established by EpiData 3.1, and SPSS 16.0 was used for both data single factor and multi-conditional logistics regression analysis. Results from the single factor logistic regression analysis showed that the related risk factors were: lack of safety guidance, lack of readable labels before praying pesticides, no regression during application, using hand to wipe sweat, using leaking knapsack, body contaminated during application and continuing to work when feeling ill after the contact of pesticides. Results from multi-conditional logistic regression analysis indicated that the lack of safety guidance (OR=2.25, 95%CI: 1.35-3.74), no readable labels before praying pesticides (OR=1.95, 95%CI: 1.19-3.18), wiping the sweat by hand during application (OR=1.97, 95%CI: 1.20-3.24) and using leaking knapsack during application (OR=1.82, 95%CI:1.10-3.01) were risk factors for the occurrence of work-related acute pesticide poisoning. The lack of safety guidance, no readable labels before praying pesticides, wiping the sweat by hand or using leaking knapsack during application were correlated to the occurrence of work-related acute pesticide poisoning.

Gastric emptying of multi-particulate dosage forms.

PubMed

Newton, J Michael

2010-08-16

The evidence in the literature for the concept that multi-particulate dosage forms below a specific size empty from the stomach as if they were liquids and hence have the potential to provide the best solution to the formulation of controlled release oral dosage forms, has been considered. There is some evidence that particles less than 1.0mm provide a more rapid response than larger size particles but there is also evidence that this is not always the case and that rapid and reproducible gastric emptying of small particles does not always occur when they are administered. There is strong evidence that food can delay the gastric emptying of multi-particulate systems. Some of the misconception for gastric emptying performance of multi-particulate system is shown to be related to the limitation of the study design and limitation of the way the data is processed. Nevertheless, there is clear evidence that multi-particulate systems can provide effective oral controlled release dosage forms. There is still some way to go with experimental techniques which would allow a definitive answer to the issue of how the variability of the gastric emptying of multi-particulate systems of less than 2.0mm arises. Copyright (c) 2010 Elsevier B.V. All rights reserved.

Determinants of institutional delivery among childbearing age women in Western Ethiopia, 2013: unmatched case control study.

PubMed

Feyissa, Tesfaye Regassa; Genemo, Gebi Agero

2014-01-01

Place of delivery is a crucial factor which affects the health and wellbeing of the mother and newborn. Institutional delivery helps the women to access skilled assistance, drugs, equipment, and referral transport. Even though 34% of pregnant women received at least one antenatal care from a skilled provider in Ethiopia by 2013, institutional delivery was 10%. The main objective of the study was to assess determinants of institutional delivery in Western Ethiopia. Retrospective unmatched case control study design was used to assess determinants of institutional delivery in Western Ethiopia from September to October 2013. A total of 320 respondents from six districts of East Wollega zone, West Ethiopia were included. Data were collected using pretested and structured questionnaires. Data were entered and cleaned by Epi-info then exported and analyzed using SPSS software. Statistical significance was determined through a 95% confidence level. Education [Adjusted Odds Ratio (AOR) (95% Confidence Interval (CI)) = 2.754(1.510-8.911)], family size [AOR (95% CI) = .454(.209-.984)], residence [AOR (95% CI) = 3.822 (1.766-8.272)] were important predictors of place of delivery. Four or more antenatal care [(ANC) (AOR (95% CI) = 2.914(1.105-7.682)], birth order [(AOR (95% CI) = .136(.054-.344), age at last delivery [(AOR (95% CI) = 9.995(2.101-47.556)], birth preparedness [AOR (95% CI) = 6.957(2.422-19.987)], duration of labour [AOR (95% CI) = 3.541(1.732-7.239)] were significantly associated with institutional delivery. Moreover service related factors such as distance from health institutions [AOR (95% CI) = .665(.173-.954)], respondents' awareness of skill of health care professionals [AOR (95% CI) = 2.454 (1.663-6.255)], mode of transportations [AOR (95% CI) = .258(.122-.549)] were significantly associated with institutional delivery. Policy makers, health service organizations, community leaders and other concerned bodies have to consider the predictors of institutional delivery like education, birth order, antenatal care utilization and residence to improve institutional delivery in the area.

Validation of Serum Markers for the Early Detection of Hepatocellular Carcinoma — EDRN Public Portal

Cancer.gov

Using the guidelines for cancer biomarker validation suggested by Pepe et al. (23), we propose to perform a Phase 2 study of DCP for the detection of early stage HCC. In this proposal, we plan to perform a larger case-control study to compare the sensitivity and specificity of DCP and AFP alone and in combination in differentiating patients with all stages of HCC and more importantly those with early HCC from patients with cirrhosis. We plan to enroll consecutive patients with HCC seen at 7 centers in the United States. Controls are frequency matched to cases (all center combined) using the following criteria: age (±10 years), gender (+10%) and etiology of liver disease (viral vs non-viral (+5%). Within each participating institution, there will be an equal number (+20%) of cases and controls.

Multi-actor involvement for integrating ecosystem services in strategic environmental assessment of spatial plans

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

Rozas-Vásquez, Daniel, E-mail: danielrozas@gmail.com; Laboratorio de Planificación Territorial, Universidad Católica de Temuco, Rudecindo ortega, 02950 Temuco; Fürst, Christine

Integrating an ecosystem services (ES) approach into Strategic Environmental Assessment (SEA) of spatial plans potentially enhances the consideration of the value of nature in decision making and policy processes. However, there is increasing concern about the institutional context and a lack of a common understanding of SEA and ecosystem services for adopting them as an integrated framework. This paper addresses this concern by analysing the current understanding and network relations in a multi-actor arrangement as a first step towards a successful integration of ES in SEA and spatial planning. Our analysis focuses on a case study in Chile, where wemore » administered a questionnaire survey to some of the main actors involved in the spatial planning process. The questionnaire focused on issues such as network relations among actors and on conceptual understanding, perceptions and challenges for integrating ES in SEA and spatial planning, knowledge on methodological approaches, and the connections and gaps in the science-policy interface. Our findings suggest that a common understanding of SEA and especially of ES in a context of multiple actors is still at an initial stage in Chile. Additionally, the lack of institutional guidelines and methodological support is considered the main challenge for integration. We conclude that preconditions exist in Chile for integrating ES in SEA for spatial planning, but they strongly depend on appropriate governance schemes that promote a close science-policy interaction, as well as collaborative work and learning. - Highlights: • Linking ecosystem services in SEA is an effective framework for sustainability. • Multi-actor understanding and networks in ecosystem services and SEA were analyzed. • Understanding of SEA and especially of ES is still in an initial stage in Chile. • A lack of institutional guidelines is one of the key challenges for this link.« less

Authorship, collaboration, and predictors of extramural funding in the emergency medicine literature.

PubMed

Rosenzweig, Jaime S; Van Deusen, Shawn K; Okpara, Okemefuna; Datillo, Paris A; Briggs, William M; Birkhahn, Robert H

2008-01-01

The objectives of the study were to examine the last decade of general emergency medicine (EM) literature published in the United States for trends with regard to authorship and multidisciplinary collaboration and to estimate the effect on extramural funding. Print articles published in the Academic Emergency Medicine, Annals of Emergency Medicine, Journal of Emergency Medicine, and American Journal of Emergency Medicine between 1994 and 2003 were reviewed. Original research, case reports/series, and others (consensus/educational) were considered; abstracts, book reviews, and editorials were not. The author byline was reviewed for number, specialty, nationality, collaboration, and presence of extramural funding. Multidisciplinary collaboration was defined as authors from 2 or more specialties, whereas multi-institutional collaboration was defined as EM authors from more than one institution. Logistic regression was used to identify predictors of extramural funding from the variables collected. Of 5728 articles identified, there were 3278 (57%) original research, 1437 (25%) case reports/series, and 975 (17%) classified as others. The percentage funded was 22% for all articles (32% for original research). The literature had at least one EM investigator as coauthor 84% of the time. Article location of origin was the United States (63%), foreign (15%), and combined (22%). Multidisciplinary collaboration increased overall from 33% in 1994 to a high of 43% in 2003. Multi-institutional collaboration also increased from 16% in 1994 to 26% in 2003. The percentage of articles having 6 or more authors increased from 12% to 18% over the decade. Of all variables studied, only article type (original research: odds ratio, 4.8; 95% confidence interval, 4.0-5.6) and foreign source (non-United States: odds ratio, 1.3; 95% confidence interval, 1.1-1.5) predicted extramural funding. The number of authors per article in the EM literature has steadily increased over the last decade, as has evidence of collaboration with other specialties. This increase in collaboration and author number has not been associated with increased extramural funding in the general EM literature published in the United States.

Risk and protective factors for the occurrence of sporadic pancreatic endocrine neoplasms.

PubMed

Valente, Roberto; Hayes, Alastair J; Haugvik, Sven-Petter; Hedenström, Per; Siuka, Darko; Korsæth, Emilie; Kämmerer, Daniel; Robinson, Stuart M; Maisonneuve, Patrick; Delle Fave, Gianfranco; Lindkvist, Bjorn; Capurso, Gabriele

2017-08-01

Pancreatic neuroendocrine neoplasms (PNENs) represent 10% of all pancreatic tumors by prevalence. Their incidence has reportedly increased over recent decades in parallel with that of pancreatic adenocarcinoma. PNENs are relatively rare, and of the few institutions that have published potential risk factors, findings have been heterogeneous. Our objective was to investigate the association between potential risk and protective factors for the occurrence of sporadic PNENs across a European population from several institutions. A multinational European case-control study was conducted to examine the association of selected environmental, family and medical exposure factors using a standardized questionnaire in face-to-face interviews. A ratio of 1:3 cases to controls were sex and age matched at each study site. Adjusted univariate and multivariate logistic regression analysis were performed for statistically significant factors. The following results were obtained: In 201 cases and 603 controls, non-recent onset diabetes (OR 2.09, CI 1.27-3.46) was associated with an increased occurrence of PNENs. The prevalence of non-recent onset diabetes was higher both in cases with metastatic disease (TNM stage III-IV) or advanced grade (G3) at the time of diagnosis. The use of metformin in combination with insulin was also associated with a more aggressive phenotype. Drinking coffee was more frequent in cases with localized disease at diagnosis. Our study concluded that non-recent onset diabetes was associated with an increased occurrence of PNENs and the combination of metformin and insulin was consistent with a more aggressive PNEN phenotype. In contrast to previous studies, smoking, alcohol and first-degree family history of cancer were not associated with PNEN occurrence. © 2017 Society for Endocrinology.

Efficient multi-scenario Model Predictive Control for water resources management with ensemble streamflow forecasts

NASA Astrophysics Data System (ADS)

Tian, Xin; Negenborn, Rudy R.; van Overloop, Peter-Jules; María Maestre, José; Sadowska, Anna; van de Giesen, Nick

2017-11-01

Model Predictive Control (MPC) is one of the most advanced real-time control techniques that has been widely applied to Water Resources Management (WRM). MPC can manage the water system in a holistic manner and has a flexible structure to incorporate specific elements, such as setpoints and constraints. Therefore, MPC has shown its versatile performance in many branches of WRM. Nonetheless, with the in-depth understanding of stochastic hydrology in recent studies, MPC also faces the challenge of how to cope with hydrological uncertainty in its decision-making process. A possible way to embed the uncertainty is to generate an Ensemble Forecast (EF) of hydrological variables, rather than a deterministic one. The combination of MPC and EF results in a more comprehensive approach: Multi-scenario MPC (MS-MPC). In this study, we will first assess the model performance of MS-MPC, considering an ensemble streamflow forecast. Noticeably, the computational inefficiency may be a critical obstacle that hinders applicability of MS-MPC. In fact, with more scenarios taken into account, the computational burden of solving an optimization problem in MS-MPC accordingly increases. To deal with this challenge, we propose the Adaptive Control Resolution (ACR) approach as a computationally efficient scheme to practically reduce the number of control variables in MS-MPC. In brief, the ACR approach uses a mixed-resolution control time step from the near future to the distant future. The ACR-MPC approach is tested on a real-world case study: an integrated flood control and navigation problem in the North Sea Canal of the Netherlands. Such an approach reduces the computation time by 18% and up in our case study. At the same time, the model performance of ACR-MPC remains close to that of conventional MPC.

What is the impact of multi-professional emergency obstetric and neonatal care training?

PubMed

Bergh, Anne-Marie; Baloyi, Shisana; Pattinson, Robert C

2015-11-01

This paper reviews evidence regarding change in health-care provider behaviour and maternal and neonatal outcomes as a result of emergency obstetric and neonatal care (EmONC) training. A refined version of the Kirkpatrick classification for programme evaluation was used to focus on change in efficiency and impact of training (levels 3 and 4). Twenty-three studies were reviewed - five randomised controlled trials, two quasi-experimental studies and 16 before-and-after observational studies. Training programmes had all been developed in high-income countries and adapted for use in low- and middle-income countries. Nine studies reported on behaviour change and 13 on process and patient outcomes. Most showed positive results. Every maternity unit should provide EmONC teamwork training, mandatory for all health-care providers. The challenges are as follows: scaling up such training to all institutions, sustaining regular in-service training, integrating training into institutional and health-system patient safety initiatives and 'thinking out of the box' in evaluation research. Copyright © 2015 Elsevier Ltd. All rights reserved.

Qualitative Insights from a Canadian Multi-Institutional Research Study: In Search of Meaningful E-Learning

ERIC Educational Resources Information Center

Carter, Lorraine M.; Salyers, Vince; Myers, Sue; Hipfner, Carol; Hoffart, Caroline; MacLean, Christa; White, Kathy; Matus, Theresa; Forssman, Vivian; Barrett, Penelope

2014-01-01

This paper reports the qualitative findings of a mixed methods research study conducted at three Canadian post-secondary institutions. Called the Meaningful E-learning or MEL project, the study was an exploration of the teaching and learning experiences of faculty and students as well as their perceptions of the benefits and challenges of…

Reliability and Prevalence of an Atypical Development of Phonological Skills in French-Speaking Dyslexics

ERIC Educational Resources Information Center

Sprenger-Charolles, Liliane; Cole, Pascale; Kipffer-Piquard, Agnes; Pinton, Florence; Billard, Catherine

2009-01-01

In the present study, conducted with French-speaking children, we examined the reliability (group study) and the prevalence (multiple-case study) of dyslexics' phonological deficits in reading and reading-related skills in comparison with Reading Level (RL) controls. All dyslexics with no comorbidity problem schooled in a special institution for…

Development of an Asia-Pacific regional network for public health.

PubMed

Loos, G P

1995-01-01

As public health by its very nature is multi-disciplinary, it may benefit individual programs to formulate a regional network, joining researchers and academics across programs. This approach may afford extended benefits, such as the establishment of regional health surveillance systems and collaborative funding initiatives. To explore this potential, member institutions comprising the Asia-Pacific Academic Consortium for Public Health provided data to form an aggregate profile of cross-institutional expertise and resources, which was presented to Health Specialists at the Asian Development Bank. The study provided a foundation for a planned regional network. A four-pronged approach was proffered detailing concurrent aspects of development: 1) network formation and expansion, 2) research coordination, 3) cross-institutional communication and instruction, and 4) promotion of self-sufficiency. The proposed plan affords the groundwork for an improved approach to public health research and practice that builds upon the established Consortium, and encourages new horizons. Regionalization is an increasing phenomenon world wide, and should be furthered as a concept for improved public health intervention and control.

Effectiveness of reactive oral cholera vaccination in rural Haiti: a case-control study

PubMed Central

Ivers, Louise C; Hilaire, Isabelle J; Teng, Jessica E; Almazor, Charles P; Jerome, J Gregory; Ternier, Ralph; Boncy, Jacques; Buteau, Josiane; Murray, Megan B; Harris, Jason B; Franke, Molly F

2015-01-01

Background Between April and June 2012, a reactive cholera vaccination campaign was conducted in Haiti using an oral inactivated bivalent whole-cell vaccine (BivWC). Methods We conducted a case-control study to estimate field effectiveness of the vaccine. Cases had acute watery diarrhea, sought treatment at one of three participating cholera treatment units from October 24, 2012 through March 9, 2014, and had a stool sample positive for cholera by culture. For each case, four controls (individuals who did not seek treatment for acute watery diarrhea) were matched by location of residence, calendar time, and age. We also conducted a bias-indicator case-control study to assess the likelihood of bias in the vaccine effectiveness (VE) study. Findings During the study period, 114 eligible individuals presented with acute watery diarrhea and were enrolled. 47 were analyzed as cases in the VE case-control study and 42 as cases in the bias-indicator study. In multivariable analyses, VE was 63% [95% confidence interval (CI): 8%–85%] by self-reported vaccination and 58% [95% CI: 13%–80%] for verified vaccination. Neither self-reported nor verified vaccination was significantly associated with non-cholera diarrhea (VE: 18% [95% CI: −208%–−78%] by self-report and −21% [95%CI: −238%–57%] for verified vaccination). Interpretation BivWC oral cholera vaccine was effective in protecting against cholera in Haiti during the study period –from 4 through 24 months after vaccination. Vaccination is an important component of epidemic cholera control efforts. Funding National Institutes of Health, Delivering Oral Vaccines Effectively project, Department of Global Health and Social Medicine at Harvard Medical School. PMID:25701994

Functional Assessment of the Vanderbilt Multigrasp Myoelectric Hand: A Continuing Case Study

PubMed Central

Dalley, Skyler A.; Bennett, Daniel A.; Goldfarb, Michael

2015-01-01

This paper presents a case study involving the functional assessment of the Vanderbilt Multigrasp (VMG) hand prosthesis on a single transradial amputee subject. In particular, a transradial amputee subject performed the Southampton Hand Assessment Procedure (SHAP) using the hand prosthesis and multigrasp myoelectric controller in a series of experimental sessions occurring over a multi-week time span. The subject’s index of function (IoF) improved with each session, although essentially plateaued after the fourth session, resulting in a IoF score of 87, which compares favorably to SHAP scores published in previous studies. PMID:25571412

Co-Prevalence of Tremor with Spasmodic Dysphonia: A Case-Control Study

PubMed Central

White, Laura; Klein, Adam; Hapner, Edie; Delgaudio, John; Hanfelt, John; Jinnah, H. A.; Johns, Michael

2011-01-01

OBJECTIVES/HYPOTHESIS The aim of this study was to define the co-prevalence of tremor with spasmodic dysphonia (SD). STUDY DESIGN A single institution prospective, case-control study was performed from May 2010 to July 2010. METHODS Consecutive patients with SD (cases) and other voice disorders (controls) were enrolled prospectively. Each participant underwent a voice evaluation and an evaluation for tremor. RESULTS 146 voice disorder controls and 128 patients with SD were enrolled. 26% of patients with SD had vocal tremor, 21% had non-vocal tremor. Patients with SD were 2.8 times more likely to have co-prevalent tremor than the control group (OR = 2.81; 95% CI, 1.55 to 5.08) and only 35% of patients with SD had been seen by a neurologist for the evaluation of dystonia and tremor. CONCLUSIONS Tremor is highly prevalent in patients with SD. It is important for each patient diagnosed with SD to undergo an evaluation for tremor, this is especially important in patients diagnosed with vocal tremor. Level of evidence 3b. PMID:21792965

Evaluation of magnetic resonance imaging for the differentiation of inflammatory, neoplastic, and vascular intradural spinal cord diseases in the dog.

PubMed

Masciarelli, Amanda E; Griffin, John F; Fosgate, Geoffrey T; Hecht, Silke; Mankin, Joseph M; Holmes, Shannon P; Platt, Simon R; Kent, Marc; Pancotto, Theresa E; Chen, Annie V; Levine, Jonathan M

2017-07-01

Magnetic resonance imaging (MRI) is a common test for dogs with suspected intradural spinal cord lesions, however studies on diagnostic performance for this test are lacking. Objectives of this multi-institutional, retrospective, case-control study were to estimate sensitivity and specificity of MRI for (1) distinguishing between histopathologically confirmed intradural spinal cord disease versus degenerative myelopathy in dogs, (2) categorizing intradural spinal cord diseases as neoplastic, inflammatory, or vascular; and (3) determining tumor type within the etiologic category of neoplasia. Additional aims were to (1) determine whether knowledge of clinical data affects sensitivity and specificity of MRI diagnoses; and (2) report interrater agreement for MRI classification of intradural spinal lesions. Cases were recruited from participating hospital databases over a 7-year period. Three reviewers independently evaluated each MRI study prior to and after provision of clinical information. A total of 87 cases were sampled (17 degenerative myelopathy, 53 neoplasia, nine inflammatory, and eight vascular). Magnetic resonance imaging had excellent (>97.6%) sensitivity for diagnosis of intradural spinal cord lesions but specificity varied before and after provision of clinical data (68.6% vs. 82.4%, P = 0.023). Magnetic resonance imaging had good sensitivity (86.8%) and moderate specificity (64.7-72.5%) for diagnosing neoplasia. Sensitivity was lower for classifying inflammatory lesions but improved with provision of clinical data (48.1% vs. 81.5%, P = 0.015). Magnetic resonance imaging was insensitive for diagnosing vascular lesions (25.0%). Interrater agreement was very good for correctly diagnosing dogs with intradural lesions (ĸ = 0.882-0.833), and good (ĸ = 0.726-0.671) for diagnosing dogs with neoplasia. © 2017 American College of Veterinary Radiology.

The work of case managers as experienced by older persons (75+) with multi-morbidity - a focused ethnography.

PubMed

Hjelm, Markus; Holst, Göran; Willman, Ania; Bohman, Doris; Kristensson, Jimmie

2015-12-17

Complex health systems make it difficult for older persons (75+) with multi-morbidity to achieve continuity of care. Case management could be one way to address this difficulty. Currently, there is a need to extend the knowledge regarding case management as experienced by those utilising the services, namely older persons (75+) with multi-morbidity. The study aimed to explore older persons' (75+) with multi-morbidity experiences of case managers. The study design was qualitative and used a focused ethnographic approach. Data was collected through individual interviews with 13 older persons and by participant observations with accompanying field notes, all conducted in 2012-2013. The data revealed four themes illustrating the older persons' experiences of case managers: 1) Someone providing me with a trusting relationship; 2) Someone assisting me; 3) Someone who is on my side; and 4) Someone I do not need at present. This study illustrates the importance of establishing trusting relationships between older persons and their case managers in order to truly provide assistance. The older persons valued the case managers acting as informed but unbiased facilitators. The findings could be of help in the development of case management interventions better designed for older persons with multi-morbidity.

Multi-Institution Study of Student Demographics and Outcomes in Electrical and Computer Engineering in the USA

ERIC Educational Resources Information Center

Lord, Susan M.; Layton, Richard A.; Ohland, Matthew W.

2015-01-01

Electrical Engineering (EE) and Computer Engineering (CpE) programs have similar curricula, but different demographics and student outcomes. This paper extends earlier longitudinal studies to a larger and more diverse dataset with 90,000 first-time-in-college and 26,000 transfer students who majored in engineering at USA institutions, including…

Canary TMA — EDRN Public Portal

Cancer.gov

This protocol describes a multi-center, retrospective, case-cohort tissue microarray (TMA) study to evaluate tissue biomarkers for their ability to predict recurrent prostate cancer at the time of radical prostatectomy (RP). Candidate biomarkers will be assessed by performing tissue localization studies on TMAs containing recurrent prostate cancer and non-recurrent prostate cancer. De-identified data will be transferred to a central repository for statistical analysis. Participating institutions will use a variation of case-cohort sampling to randomly select a subset of patients from a retrospectively constructed RP cohort and/or perform selected assays on the cohort. The study endpoint is time to recurrence; of primary interest is five year recurrence free survival. Recurrent prostate cancer is defined by 1) a single serum prostate-specific antigen (PSA) level greater than 0.2 ng/mL after RP and/or 2) receipt of salvage or secondary therapy after RP and/or 3) clinical or radiological evidence of metastatic disease. Non-recurrent prostate cancer is defined as disease with no evidence of recurrence.

Academic Performance, Persistence, and Degree Completion of Associate in Arts Degree Recipients Transferring to a Four-Year Multi-Campus Institution

ERIC Educational Resources Information Center

Reyes, Saul

2010-01-01

This study assessed if there were differences in the academic performance, persistence, and degree completion for Associate in Arts transfer students in selected majors who enrolled in the different campuses of a multi-campus university. This causal comparative study analyzed historical student enrollment data from a large, urban, public, research…

Using Case Study Multi-Methods to Investigate Close(r) Collaboration: Course-Based Tutoring and the Directive/Nondirective Instructional Continuum

ERIC Educational Resources Information Center

Corbett, Steven J.

2011-01-01

This essay presents case studies of "course-based tutoring" (CBT) and one-to-one tutorials in two sections of developmental first-year composition (FYC) at a large West Coast research university. The author's study uses a combination of rhetorical and discourse analyses and ethnographic and case study multi-methods to investigate both…

Risk factors for explantation due to infection after sacral neuromodulation: a multicenter retrospective case-control study.

PubMed

Myer, Emily N B; Petrikovets, Andrey; Slocum, Paul D; Lee, Toy Gee; Carter-Brooks, Charelle M; Noor, Nabila; Carlos, Daniela M; Wu, Emily; Van Eck, Kathryn; Fashokun, Tola B; Yurteri-Kaplan, Ladin; Chen, Chi Chiung Grace

2018-04-07

Sacral neuromodulation is an effective therapy for overactive bladder, urinary retention, and fecal incontinence. Infection after sacral neurostimulation is costly and burdensome. Determining optimal perioperative management strategies to reduce the risk of infection is important to reduce this burden. We sought to identify risk factors associated with sacral neurostimulator infection requiring explantation, to estimate the incidence of infection requiring explantation, and identify associated microbial pathogens. This is a multicenter retrospective case-control study of sacral neuromodulation procedures completed from Jan. 1, 2004, through Dec. 31, 2014. We identified all sacral neuromodulation implantable pulse generator implants as well as explants due to infection at 8 participating institutions. Cases were patients who required implantable pulse generator explantation for infection during the review period. Cases were included if age ≥18 years old, follow-up data were available ≥30 days after implantable pulse generator implant, and the implant was performed at the institution performing the explant. Two controls were matched to each case. These controls were the patients who had an implantable pulse generator implanted by the same surgeon immediately preceding and immediately following the identified case who met inclusion criteria. Controls were included if age ≥18 years old, no infection after implantable pulse generator implant, follow-up data were available ≥180 days after implant, and no explant for any reason <180 days from implant. Controls may have had an explant for reasons other than infection at >180 days after implant. Fisher exact test (for categorical variables) and Student t test (for continuous variables) were used to test the strength of the association between infection and patient and surgery characteristics. Significant variables were then considered in a multivariable logistic regression model to determine risk factors independently associated with infection. Over a 10-year period at 8 academic institutions, 1930 sacral neuromodulator implants were performed by 17 surgeons. In all, 38 cases requiring device explant for infection and 72 corresponding controls were identified. The incidence of infection requiring explant was 1.97%. Hematoma formation (13% cases, 0% controls; P = .004) and pocket depth of ≥3 cm (21% cases, 0% controls; P = .031) were independently associated with an increased risk of infection requiring explant. On multivariable regression analysis controlling for significant variables, both hematoma formation (P = .006) and pocket depth ≥3 cm (P = .020, odds ratio 3.26; 95% confidence interval, 1.20-8.89) remained significantly associated with infection requiring explant. Of the 38 cases requiring explant, 32 had cultures collected and 24 had positive cultures. All 5 cases with a hematoma had a positive culture (100%). Of the 4 cases with a pocket depth ≥3 cm, 2 had positive cultures, 1 had negative cultures, and 1 had a missing culture result. The most common organism identified was methicillin-resistant Staphylococcus aureus (38%). Infection after sacral neuromodulation requiring device explant is low. The most common infectious pathogen identified was methicillin-resistant S aureus. Demographic and health characteristics did not predict risk of explant due to infection, however, having a postoperative hematoma or a deep pocket ≥3 cm significantly increased the risk of explant due to infection. These findings highlight the importance of meticulous hemostasis as well as ensuring the pocket depth is <3 cm at the time of device implant. Copyright © 2018 Elsevier Inc. All rights reserved.

Outbreak of carbapenem-resistant Acinetobacter baumannii in the intensive care unit: a multi-level strategic management approach.

PubMed

Molter, G; Seifert, H; Mandraka, F; Kasper, G; Weidmann, B; Hornei, B; Öhler, M; Schwimmbeck, P; Kröschel, P; Higgins, P G; Reuter, S

2016-02-01

An outbreak of carbapenem-resistant Acinetobacter baumannii (CRAb) occurred in an interdisciplinary intensive care unit, affecting 10 patients. Within hours of recognition of the spread of CRAb an intervention team was instituted for collection of available data, decision-making, communication and monitoring of all interventions performed, including cohorting, temporary stop of admissions, staff education, and enforcement of infection control measures. An area was defined for cohortation of patients colonized with CRAb, with a separate nursing team and a second set of mobile equipment. New transmissions were no longer observed after only four days into the institution of enhanced infection control measures. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Multi-gene panel testing in Korean patients with common genetic generalized epilepsy syndromes.

PubMed

Lee, Cha Gon; Lee, Jeehun; Lee, Munhyang

2018-01-01

Genetic heterogeneity of common genetic generalized epilepsy syndromes is frequently considered. The present study conducted a focused analysis of potential candidate or susceptibility genes for common genetic generalized epilepsy syndromes using multi-gene panel testing with next-generation sequencing. This study included patients with juvenile myoclonic epilepsy, juvenile absence epilepsy, and epilepsy with generalized tonic-clonic seizures alone. We identified pathogenic variants according to the American College of Medical Genetics and Genomics guidelines and identified susceptibility variants using case-control association analyses and family analyses for familial cases. A total of 57 patients were enrolled, including 51 sporadic cases and 6 familial cases. Twenty-two pathogenic and likely pathogenic variants of 16 different genes were identified. CACNA1H was the most frequently observed single gene. Variants of voltage-gated Ca2+ channel genes, including CACNA1A, CACNA1G, and CACNA1H were observed in 32% of variants (n = 7/22). Analyses to identify susceptibility variants using case-control association analysis indicated that KCNMA1 c.400G>C was associated with common genetic generalized epilepsy syndromes. Only 1 family (family A) exhibited a candidate pathogenic variant p.(Arg788His) on CACNA1H, as determined via family analyses. This study identified candidate genetic variants in about a quarter of patients (n = 16/57) and an average of 2.8 variants was identified in each patient. The results reinforced the polygenic disorder with very high locus and allelic heterogeneity of common GGE syndromes. Further, voltage-gated Ca2+ channels are suggested as important contributors to common genetic generalized epilepsy syndromes. This study extends our comprehensive understanding of common genetic generalized epilepsy syndromes.

Norwegian home care in transition - heading for accountability, off-loading responsibilities.

PubMed

Vabø, Mia

2012-05-01

In Norway, home-based care forms part of the universal welfare model in that services are offered to and used by all groups of citizens. An infrastructure of in-home services has evolved within a multi-level government characterised by a combination of local autonomy and strong integration between central and local levels. In the mid-1980s and early 1990s, home care was typically organised in teams characterised by collegiality and flexible organisation. Over the past two decades, this framework has been challenged by new modes of governance introduced under the banner of transparency and accountability. This paper focuses on how this new trend in governance has been justified and put into practice. Against the backdrop of the institutional history of home care, the paper demonstrates how accountability arrangements became entangled with ongoing effort of local authorities to control costs. Drawing on existing case studies conducted at different points in time, the paper reveals how these arrangements have reshaped home care organisations in a way that also contributes to splitting up and curtailing responsibilities. It is argued that steps taken to make home care services more transparent and reliable have made them less sensitive to the particular needs of individual service recipients. Although no firm conclusion can be drawn from a limited number of case studies, the paper concludes by arguing that accountability arrangements in home care have enhanced the predictability and reliability of service delivery. However, as off-loading responsibilities may be disempowering for those who do not have additional coping resources, institutional changes may also serve to undermine the enabling role of home care services. These findings suggest a need to address the dilemma inherent in the rationing of home care services and to rethink how a contextual and situated approach to care can be better balanced against the requirement of due process. © 2012 Blackwell Publishing Ltd.

The conversion to electronic hospital notes at Mayo Clinic. Overcoming barriers and challenges.

PubMed

Andreen, Debra L; Dobie, Linda J; Jasperson, Jan C; Lucas, Thomas A; Wubbenhorst, Cathryn L

2010-01-01

This article describes the conversion to electronic hospital notes at a large, multi-specialty group practice: Mayo Clinic in Rochester, Minnesota. Because of the size of the institution and the barriers to the adoption of electronic notes, the process was a gradual one that took several years. Making a convincing case for change to institutional leaders and maintaining their support was crucial to success. Equally vital was the careful investigation of user requirements and the development of software features that allowed providers to complete their notes quickly in the fast-paced hospital environment. Care providers discovered the value of having immediate access to legible hospital notes throughout the campus and from remote locations.

The Effectiveness of Simulated Robots for Supporting the Learning of Introductory Programming: A Multi-Case Case Study

ERIC Educational Resources Information Center

Major, Louis; Kyriacou, Theocharis; Brereton, Pearl

2014-01-01

This work investigates the effectiveness of simulated robots as tools to support the learning of programming. After the completion of a systematic review and exploratory research, a multi-case case study was undertaken. A simulator, named Kebot, was developed and used to run four 10-hour programming workshops. Twenty-three student participants…

Pre-Visit Prioritization for Complex Patients with Diabetes: Randomized Trial Design and Implementation within an Integrated Health Care System

PubMed Central

Grant, Richard W; Uratsu, Connie S; Hansen, Karen R; Altschuler, Andrea; Kim, Eileen; Fireman, Bruce; Adams, Alyce S; Schmittdiel, Julie A; Heisler, Michele

2016-01-01

Background/Aims Despite robust evidence to guide clinical care, most patients with diabetes do not meet all goals of risk factor control. Improved patient-provider communication during time-limited primary care visits may represent one strategy for improving diabetes care. Methods We designed a controlled, cluster-randomized, multi-site intervention (Pre-Visit Prioritization for Complex Patients with Diabetes) that enables patients with poorly controlled type 2 diabetes to identify their top priorities prior to a scheduled visit and sends these priorities to the primary care physician progress note in the electronic medical record. In this paper, we describe strategies to address challenges to implementing our health IT-based intervention study within a large health care system. Results This study is being conducted in 30 primary care practices within a large integrated care delivery system in Northern California. Over a 12-week period (3/1/2015 – 6/6/2015), 146 primary care physicians consented to enroll in the study (90.1%) and approved contact with 2496 of their patients (97.6%). Implementation challenges included: (1) Navigating research vs. quality improvement requirements; (2) Addressing informed consent considerations; and (3) Introducing a new clinical tool into a highly time-constrained workflow. Strategies for successfully initiating this study included engagement with institutional leaders, Institutional Review Board members, and clinical stakeholders at multiple stages both before and after notice of Federal funding; flexibility by the research team in study design; and strong support from institutional leadership for “self-learning health system” research. Conclusions By paying careful attention to identifying and collaborating with a wide range of key clinical stakeholders, we have shown that researchers embedded within a learning care system can successfully apply rigorous clinical trial methods to test new care innovations. PMID:26820612

Pre-Visit Prioritization for complex patients with diabetes: Randomized trial design and implementation within an integrated health care system.

PubMed

Grant, Richard W; Uratsu, Connie S; Estacio, Karen R; Altschuler, Andrea; Kim, Eileen; Fireman, Bruce; Adams, Alyce S; Schmittdiel, Julie A; Heisler, Michele

2016-03-01

Despite robust evidence to guide clinical care, most patients with diabetes do not meet all goals of risk factor control. Improved patient-provider communication during time-limited primary care visits may represent one strategy for improving diabetes care. We designed a controlled, cluster-randomized, multi-site intervention (Pre-Visit Prioritization for Complex Patients with Diabetes) that enables patients with poorly controlled type 2 diabetes to identify their top priorities prior to a scheduled visit and sends these priorities to the primary care physician progress note in the electronic medical record. In this paper, we describe strategies to address challenges to implementing our health IT-based intervention study within a large health care system. This study is being conducted in 30 primary care practices within a large integrated care delivery system in Northern California. Over a 12-week period (3/1/2015-6/6/2015), 146 primary care physicians consented to enroll in the study (90.1%) and approved contact with 2496 of their patients (97.6%). Implementation challenges included: (1) navigating research vs. quality improvement requirements; (2) addressing informed consent considerations; and (3) introducing a new clinical tool into a highly time-constrained workflow. Strategies for successfully initiating this study included engagement with institutional leaders, Institutional Review Board members, and clinical stakeholders at multiple stages both before and after notice of Federal funding; flexibility by the research team in study design; and strong support from institutional leadership for "self-learning health system" research. By paying careful attention to identifying and collaborating with a wide range of key clinical stakeholders, we have shown that researchers embedded within a learning care system can successfully apply rigorous clinical trial methods to test new care innovations. Copyright © 2016 Elsevier Inc. All rights reserved.

[Clinical observation of apatinib mesylate for the treatment of multi-drug resistant advanced breast cancer].

PubMed

Lü, H M; Zhang, M W; Niu, L M; Zeng, H A; Yan, M

2018-04-24

Objective: To assess the clinical efficacy and adverse outcomes of apatinib mesylate for the treatment of multi-drug resistant advanced breast cancer. Methods: A total of 24 patients with multi-drug-resistant advanced breast cancer who underwent apatinib mesylate treatment were retrospectively analyzed at the Diagnosis and Treatment Center for Breast Cancer of Henan Cancer Hospital. Patients were reviewed every 4 weeks after initial treatment and then every 8 weeks after stable disease. Objective response rate (ORR), progression free survival (PFS), overall survival (OS) , toxicity and adverse outcomes of apatinib mesylate treatment were evaluated by imaging examinations. Results: Totally, 24 patients received apatinib mesylate at a dose of 500 mg QD. Out of the 24 patients treated, complete remission (CR) occurred in none of the patients, partial remission (PR) in 10 cases, stable disease (SD) in 10 cases, progressive disease (PD) in 4 cases, and drug with drawal in 2 cases due to adverse outcomes. Treatment with apatinib mesylate resulted in an ORR of 41.7% (10/24), disease control rate (DCR) of 83.3%, PFS of 4.7 months, and OS of 8.0 months. Adverse outcomes included proteinuria, high blood pressure, fatigue, hand-foot skin reaction (HFSR), hyperbilirubinemia, leukopenia, hair/skin pigmentation decreased. Most of the adverse events were tolerable and can be controlled after symptomatic management. Conclusions: Single-agent apatinib mesylate demonstrated the good short-term efficacy for multi-drug resistant advanced breast cancer in patients who previously underwent multiple line treatment failures. Adverse effects were controllable after symptomatic management. Treatment with apatinib mesylate maybe a viable option when other treatment modalities failed.

Pain as an indication for rib fixation: a bi-institutional pilot study.

PubMed

de Moya, Marc; Bramos, Thanos; Agarwal, Suresh; Fikry, Karim; Janjua, Sumbal; King, David R; Alam, Hasan B; Velmahos, George C; Burke, Peter; Tobler, William

2011-12-01

In trauma patients, open reduction and internal fixation of rib fractures remain controversial. We hypothesized that patients who have open reduction and internal fixation of rib fractures would experience less pain compared with controls and thus require fewer opiates. Further, we hypothesized that improved pain control would result in fewer pulmonary complications and decreased length of stay. This is a retrospective bi-institutional matched case-control study. Cases were matched 1:2 by age, injury severity Score, chest abbreviated injury severity score, head abbreviated injury severity score, pulmonary contusion score, and number of fractured ribs. The daily total doses of analgesic drugs were converted to equianalgesic intravenous morphine doses, and the primary outcome was inpatient narcotic administration. Sixteen patients between July 2005 and June 2009 underwent rib fixation in 5 ± 3 days after injury using an average of 3 (1-5) metallic plates. Morphine requirements decreased from 110 mg ± 98 mg preoperatively to 63 ± 57 mg postoperatively (p = 0.01). There were no significant differences between cases and controls in the mean morphine dose (79 ± 63 vs. 76 ± 55 mg, p = 0.65), hospital stay (18 ± 12 vs. 16 ± 11 days, p = 0.67), intensive care unit stay (9 ± 8 vs. 7 ± 10 days, p = 0.75), ventilation days (7 ± 8 vs. 6 ± 10, p = 0.44), and pneumonia rates (31% vs. 38%, p = 0.76). The need for analgesia was significantly reduced after rib fixation in patients with multiple rib fractures. However, no difference in outcomes was observed when these patients were compared with matched controls in this pilot study. Further study is required to investigate these preliminary findings.

Dispersed storage and generation case studies

NASA Technical Reports Server (NTRS)

Bahrami, K.; Stallkamp, J. A.; Walton, A.

1980-01-01

Three installations utilizing separate dispersed storage and generation (DSG) technologies were investigated. Each of the systems is described in costs and control. Selected institutional and environmental issues are discussed, including life cycle costs. No unresolved technical, environmental, or institutional problems were encountered in the installations. The wind and solar photovoltaic DSG were installed for test purposes, and appear to be presently uneconomical. However, a number of factors are decreasing the cost of DSG relative to conventional alternatives, and an increased DSG penetration level may be expected in the future.

Assessing Distributed Leadership for Learning and Teaching Quality: A Multi-Institutional Study

ERIC Educational Resources Information Center

Carbone, Angela; Evans, Julia; Ross, Bella; Drew, Steve; Phelan, Liam; Lindsay, Katherine; Cottman, Caroline; Stoney, Susan; Ye, Jing

2017-01-01

Distributed leadership has been explored internationally as a leadership model that will promote and advance excellence in learning and teaching in higher education. This paper presents an assessment of how effectively distributed leadership was enabled at five Australian institutions implementing a collaborative teaching quality development…

Speaking of Vocation in an Age of Spirituality

ERIC Educational Resources Information Center

VanZanten Gallagher, Susan

2007-01-01

In 2003, the UCLA Higher Education Research Institute (HERI) began surveying undergraduates and faculty in a multi-institutional, longitudinal study designed to identify patterns of spirituality and religiousness among college students. Initial results revealed a high level of student interest in spiritual values, but they also showed that most…

Mechanism of Action of the Transobturator Sling for Post-Radical Prostatectomy Incontinence: A Multi-institutional Prospective Study Using Dynamic Magnetic Resonance Imaging.

PubMed

Kahokehr, Arman A; Selph, John P; Belsante, Michael J; Bashir, Mustafa; Sofue, Keitaro; Tausch, Timothy J; Brand, Timothy C; Lloyd, Jessica C; Goldsmith, Zachariah G; Walter, Jack R; Peterson, Andrew C

2018-06-01

To compare the length of the membranous (functional) urethra in male patients who underwent the male transobturator sling (TOS) for postradical prostatectomy urinary incontinence (PPI). The TOS is in established use for treatment of PPI; however, the precise mechanism of action is unknown. This is a prospective case-controlled study on men undergoing male TOS surgery from 2008 to 2014. The comparison arm included patients without incontinence after radical prostatectomy. All participants underwent dynamic magnetic resonance imaging (MRI) at baseline and this was repeated after TOS placement for those who underwent the procedure. Three standardized points were measured using MRI and compared in both groups in addition to clinical measures. Thirty-nine patients were enrolled and 31 patients completed the protocols. The controls (N = 14) had a longer vesicourethral anastomosis to urethra measured at the penile bulb (functional urethral length) distance compared to the pre-TOS group at rest (1.92 cm controls vs 1.27 cm pre-TOS, P = .0018) and at Valsalva (2.13 cm controls vs 1.72 cm pre-TOS, P = .0371). Placement of the sling (N = 17) increased the functional urethral length distance at rest (1.92 cm control vs 1.53 cm post-TOS, P = .09) and at Valsalva (1.94 cm post-TOS vs 2.13 cm control, P = .61), so that the difference was no longer statistically significant. We identified that one possible mechanism in improvement in stress urinary incontinence post-TOS placement is the lengthening of the vesicourethral anastomosis to bulbar-urethra distance. This is the first such study utilizing dynamics MRI in post prostatectomy controls, incontinent pre-TOS, and post-TOS to assess and show these findings. Copyright © 2018 Elsevier Inc. All rights reserved.

Use of the i2b2 research query tool to conduct a matched case-control clinical research study: advantages, disadvantages and methodological considerations.

PubMed

Johnson, Emilie K; Broder-Fingert, Sarabeth; Tanpowpong, Pornthep; Bickel, Jonathan; Lightdale, Jenifer R; Nelson, Caleb P

2014-01-30

A major aim of the i2b2 (informatics for integrating biology and the bedside) clinical data informatics framework aims to create an efficient structure within which patients can be identified for clinical and translational research projects.Our objective was to describe the respective roles of the i2b2 research query tool and the electronic medical record (EMR) in conducting a case-controlled clinical study at our institution. We analyzed the process of using i2b2 and the EMR together to generate a complete research database for a case-control study that sought to examine risk factors for kidney stones among gastrostomy tube (G-tube) fed children. Our final case cohort consisted of 41/177 (23%) of potential cases initially identified by i2b2, who were matched with 80/486 (17%) of potential controls. Cases were 10 times more likely to be excluded for inaccurate coding regarding stones vs. inaccurate coding regarding G-tubes. A majority (67%) of cases were excluded due to not meeting clinical inclusion criteria, whereas a majority of control exclusions (72%) occurred due to inadequate clinical data necessary for study completion. Full dataset assembly required complementary information from i2b2 and the EMR. i2b2 was critical as a query analysis tool for patient identification in our case-control study. Patient identification via procedural coding appeared more accurate compared with diagnosis coding. Completion of our investigation required iterative interplay of i2b2 and the EMR to assemble the study cohort.

The HABP2 G534E variant is an unlikely cause of familial non-medullary thyroid cancer.

PubMed

Sahasrabudhe, Ruta; Stultz, Jacob; Williamson, John; Lott, Paul; Estrada, Ana; Bohorquez, Mabel; Palles, Claire; Polanco-Echeverry, Guadalupe; Jaeger, Emma; Martin, Lynn; Magdalena Echeverry, Maria; Tomlinson, Ian; Carvajal-Carmona, Luis G

2016-03-01

A recent study reported the non-synonymous G534E (rs7080536, allele A) variant in the HABP2 gene as causal in familial non-medullary thyroid cancer (NMTC). The objective of this study was to evaluate the causality of HABP2 G534E in the TCUKIN study, a multi-center population based study of NMTC cases from the British Isles. A case-control analysis of rs7080536 genotypes was performed using 2,105 TCUKIN cases and 5,172 UK controls. Cases comprised 2,105 NMTC cases. Patients sub-groups with papillary (N=1,056), follicular (N=691) and Hurthle cell (N=86) TC cases were studied separately. Controls comprised 5,172 individuals from the 1958 Birth Cohort (58C) and the National Blood Donor Service (NBS) study. The controls had previously been genotyped using genome-wide SNP arrays by the Wellcome Trust Case Control Consortium study. Measures: Association between HABP2 G534E (rs7080536A) and NMTC risk was evaluated using logistic regression. The frequency of HABP2 G534E was 4.2% in cases and 4.6% in controls. We did not detect an association between this variant and NMTC risk (OR=0.896, 95% CI: 0.746-1.071, P=0.233). We also failed to detect an association between HABP2 G534E and cases with papillary (1056 cases, G534E frequency= 3.5%, OR=0.74, P=0.017), follicular (691 cases, G534E frequency= 4.7%, OR=1.00, P=1.000) or Hurthle cell (86 cases, G534E frequency= 6.3%, OR=1.40, P=0.279) histology. We found that HABP2 G534E is a low-to-moderate frequency variant in the British Isles and failed to detect an association with NMTC risk, independent of histological type. Hence, our study does not implicate HABP2 G534E or a correlated polymorphism in familial NMTC and additional data are required before using this variant in NMTC risk assessment.

Vitamin K antagonists and pregnancy outcome. A multi-centre prospective study.

PubMed

Schaefer, Christof; Hannemann, Doreen; Meister, Reinhard; Eléfant, Elisabeth; Paulus, Wolfgang; Vial, Thierry; Reuvers, Minke; Robert-Gnansia, Elisabeth; Arnon, Judy; De Santis, Marco; Clementi, Maurizio; Rodriguez-Pinilla, Elvira; Dolivo, Alla; Merlob, Paul

2006-06-01

Vitamin K antagonists (VKA) are known to act as teratogens; however, there is still uncertainty about the relative risk for birth defects and the most sensitive period. In a multi-centre (n = 12), observational, prospective study we compared 666 pregnant women exposed to phenprocoumon (n = 280), acenocoumarol (n = 226), fluindione (n = 99), warfarin (n = 63) and phenindione (n = 2) to a non-exposed control group (n = 1,094). Data were collected by institutes collaborating in the European Network of Teratology Information Services (ENTIS) during individual risk counselling between 1988 and 2004. Main outcome measures were coumarin embryopathy and other birth defects, miscarriage rate, birth-weight, and prematurity. The rate of major birth defects after 1st trimester exposure was significantly increased (OR 3.86, 95% CI 1.86-8.00). However, there were only two coumarin embryopathies (0.6%; both phenprocoumon). Prematurity was more frequent (16.0% vs. 7.6%, OR 2.61, 95% CI 1.76-3.86), mean gestational age at delivery (37.9 vs.39.4, p<0.001), and mean birth weight of term infants (3,166 g vs. 3,411 g; p < 0.001) were lower compared to the controls. Using the methodology of survival analysis, miscarriage rate reached 42% vs. 14% (hazard ratio 3.36; 95% CI 2.28-4.93). In conclusion, use of VKA during pregnancy increases the risk of structural defects and other adverse pregnancy outcomes. The risk for coumarin embryopathy is, however, very small, in particular when therapy during the 1(st) trimester did not take place later than week 8 after the 1(st) day of the last menstrual period. Therefore, elective termination of a wanted pregnancy is not recommended if (inadvertent) exposure took place in early pregnancy. Close follow-up by the obstetrician including level II ultrasound should be recommended in any case of VKA exposure during pregnancy.

Questionnaire-based analysis of infection prevention and control in healthcare facilities in Saudi Arabia in regards to Middle East Respiratory Syndrome.

PubMed

Rabaan, Ali A; Alhani, Hatem M; Bazzi, Ali M; Al-Ahmed, Shamsah H

Effective implementation of infection prevention and control in healthcare facilities depends on training, awareness and compliance of healthcare workers. In Saudi Arabia recent significant hospital outbreaks, including Middle East Respiratory Syndrome Coronavirus (MERS-CoV), have resulted from lack of, or breakdown in, infection prevention and control procedures. This study was designed to assess attitudes to, and awareness of, infection prevention and control policies and guidelines among healthcare workers of different professions and institution types in Saudi Arabia. A questionnaire was administered to 607 healthcare workers including physicians (n=133), nurses (n=162), laboratory staff (n=233) and other staff (n=79) in government hospitals, private hospitals and poly clinics. Results were compared using Chi square analysis according to profession type, institution type, age group and nationality (Saudi or non-Saudi) to assess variability. Responses suggested that there are relatively high levels of uncertainty among healthcare workers across a range of infection prevention and control issues, including institution-specific issues, surveillance and reporting standards, and readiness and competence to implement policies and respond to outbreaks. There was evidence to suggest that staff in private hospitals and nurses were more confident than other staff types. Carelessness of healthcare workers was the top-cited factor contributing to causes of outbreaks (65.07% of total group), and hospital infrastructure and design was the top-cited factor contributing to spread of infection in the hospital (54.20%), followed closely by lack and shortage of staff (53.71%) and no infection control training program (51.73%). An electronic surveillance system was considered the most effective by staff (81.22%). We have identified areas of concern among healthcare workers in Saudi Arabia on infection prevention and control which vary between institutions and among different professions. This merits urgent multi-factorial actions to try to ensure outbreaks such as MERS-CoV can be minimized and contained. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

UFO-a multi-analyser option for IN12

NASA Astrophysics Data System (ADS)

Schmidt, Wolfgang; Rheinstädter, Maikel C.; Raymond, Stephane; Ohl, Michael

2004-07-01

The IN12 instrument is operated by FZ Jülich in collaboration with CEA Grenoble as a CRG-B instrument at the Institut Laue Langevin in Grenoble. As a three-axis spectrometer for cold neutrons it is dedicated for high-resolution studies of low-energy excitations. In the past years the instrument has been continuously improved and it has demonstrated its excellent performance for neutron scattering research. To meet further challenges as a state-of-the-art instrument in the next funding period we will propose to upgrade IN12 with a multi-analyser option similar to planned or existing RITA-type instruments. IN12 will then be optionally equipped with an array of individual analyser blades which can be positioned separately in order to map the scattered beam on a user-chosen path in (Q,ω)-space. We refer to this set-up as IN12-UFO (universal focusing option). Both, the feasibility and the scientific case are currently being studied. On the conference we will show details of the planned instrumental set-up and demonstrate its flexibility and multiplex advantages for specific physical applications.

Association of anti-sperm antibodies with chronic prostatitis: A systematic review and meta-analysis.

PubMed

Jiang, Yumei; Cui, Dong; Du, Yuefeng; Lu, Jun; Yang, Lin; Li, Jinmei; Zhang, Jing; Bai, Xiaojing

2016-11-01

Chronic prostatitis is a risk factor for impaired male fertility potential, and anti-sperm antibodies (ASAs) cause the autoimmune disease immune infertility, which has a negative effect on semen parameters. Current studies have investigated the ASA-positive relationship between chronic prostatitis versus normal controls, but have shown inconsistent results. Hence, we systematic searched the PubMed, EMBASE, Science Direct/Elsevier, Medline, and the Cochrane Library up to October 2015 for case-control studies that involved the ASA-positive relationship between chronic prostatitis patients versus normal controls. The meta-analysis was performed with Review Manager and Stata software. After literature search, six studies were identified, including 721 cases of chronic prostatitis and 160 normal controls. Our results illustrated a significant correlation of the ASA-positive relationship between chronic prostatitis patients versus normal controls. The combined odds ratio of the ASA-positive rate in chronic prostatitis patients and normal controls was 3.26 (1.86-5.71). There was also a significant correlation of the ASA-positive relationship between National Institutes of Health (NIH) III versus normal controls, and the combined OR was 2.46 (1.10-5.51). However, there was no significant correlation of the ASA-positive relationship between National Institutes of Health (NIH) II versus normal controls. The present study illustrates that the positive rate of ASAs in chronic prostatitis patients was significantly higher than in the control group, suggesting that chronic prostatitis has a negative effect on male reproductive function. However, studies with larger samples are needed to better illuminate the correlation between ASAs and chronic prostatitis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Individual Differences in Written Corrective Feedback: A Multi-Case Study

ERIC Educational Resources Information Center

Li, Su; Li, Pengjing

2012-01-01

Written corrective feedback (WCF) has been a long time practice in L2 writing instruction. However, in many cases, the effects are not satisfactory. There have been controversies about it both theoretically and empirically. This paper reports a multi-case study exploring individual differences that impact learners' responses to WCF. Four students'…

Effect of the 16-hour work limit on general surgery intern operative case volume: a multi-institutional study.

PubMed

Schwartz, Samuel I; Galante, Joseph; Kaji, Amy; Dolich, Matthew; Easter, David; Melcher, Marc L; Patel, Kevin; Reeves, Mark E; Salim, Ali; Senagore, Anthony J; Takanishi, Danny M; de Virgilio, Christian

2013-09-01

The 80-hour work-week limit for all residents was instituted in 2003 and studies looking at its effect have been mixed. Since the advent of the 16-hour mandate for postgraduate year 1 residents in July 2011, no data have been published regarding the effect of this additional work-hour restriction. To determine whether the 16-hour intern work limit, implemented in July 2011, has adversely affected operative experience. A retrospective review of categorical postgraduate year 1 Accreditation Council for Graduate Medical Education case logs from the intern class (N = 52) (with 16-hour work limit) compared with the 4 preceding years (2007-2010; N = 197) (without 16-hour work limit). A total of 249 categorical general surgery interns from 10 general surgery residency programs in the western United States were included. Total, major, first-assistant, and defined-category case totals. As compared with the preceding 4 years, the 2011-2012 interns recorded a 25.8% decrease in total operative cases (65.9 vs 88.8, P = .005), a 31.8% decrease in major cases (54.9 vs 80.5, P < .001), and a 46.3% decrease in first-assistant cases (11.1 vs 20.7, P = .008). There were statistically significant decreases in cases within the defined categories of abdomen, endocrine, head and neck, basic laparoscopy, complex laparoscopy, pediatrics, thoracic, and soft tissue/breast surgery in the 16-hour shift intern era, whereas there was no decrease in trauma, vascular, alimentary, endoscopy, liver, and pancreas cases. The 16-hour work limit for interns, implemented in July 2011, is associated with a significant decrease in categorical intern operative experience. If the 16-hour shift were to be extended to all postgraduate year levels, one can anticipate that additional years of training will be needed to maintain the same operative volume.

Addressing Institutional Amplifiers in the Dynamics and Control of Tuberculosis Epidemics

PubMed Central

Basu, Sanjay; Stuckler, David; McKee, Martin

2011-01-01

Tuberculosis outbreaks originating in prisons, mines, or hospital wards can spread to the larger community. Recent proposals have targeted these high-transmission institutional amplifiers by improving case detection, treatment, or reducing the size of the exposed population. However, what effects these alternative proposals may have is unclear. We mathematically modeled these control strategies and found case detection and treatment methods insufficient in addressing epidemics involving common types of institutional amplifiers. Movement of persons in and out of amplifiers fundamentally altered the transmission dynamics of tuberculosis in a manner not effectively mitigated by detection or treatment alone. Policies increasing the population size exposed to amplifiers or the per-person duration of exposure within amplifiers potentially worsened incidence, even in settings with high rates of detection and treatment success. However, reducing the total population size entering institutional amplifiers significantly lowered tuberculosis incidence and the risk of propagating new drug-resistant tuberculosis strains. PMID:21212197

Simulation of DKIST solar adaptive optics system

NASA Astrophysics Data System (ADS)

Marino, Jose; Carlisle, Elizabeth; Schmidt, Dirk

2016-07-01

Solar adaptive optics (AO) simulations are a valuable tool to guide the design and optimization process of current and future solar AO and multi-conjugate AO (MCAO) systems. Solar AO and MCAO systems rely on extended object cross-correlating Shack-Hartmann wavefront sensors to measure the wavefront. Accurate solar AO simulations require computationally intensive operations, which have until recently presented a prohibitive computational cost. We present an update on the status of a solar AO and MCAO simulation tool being developed at the National Solar Observatory. The simulation tool is a multi-threaded application written in the C++ language that takes advantage of current large multi-core CPU computer systems and fast ethernet connections to provide accurate full simulation of solar AO and MCAO systems. It interfaces with KAOS, a state of the art solar AO control software developed by the Kiepenheuer-Institut fuer Sonnenphysik, that provides reliable AO control. We report on the latest results produced by the solar AO simulation tool.

IVHS institutional issues and case studies : ADVANCE case study

DOT National Transportation Integrated Search

1994-04-01

This operational test case study is one of six performed in response to a Volpe National Transportation Systems Center technical task directive (TTD) to Science Applications International Corporation (SAIC) entitled, IVHS Institutional Issues and ...

Strange Bedfellows: The Catholic Church and Brazilian National AIDS Program in the Response to HIV/AIDS in Brazil

PubMed Central

Murray, Laura R.; Garcia, Jonathan; Muñoz-Laboy, Miguel; Parker, Richard G.

2011-01-01

The HIV epidemic has raised important tensions in the relationship between Church and State in many parts of Latin America where government policies frequently negotiate secularity with religious belief and doctrine. Brazil represents a unique country in the region due to the presence of a national religious response to HIV/AIDS articulated through the formal structures of the Catholic Church. As part of an institutional ethnography on religion and HIV/AIDS in Brazil, we conducted an extended, multi-site ethnography from October 2005 through March of 2009 to explore the relationship between the Catholic Church and the Brazilian National AIDS Program. This case study links a national, macro-level response of governmental and religious institutions with the enactment of these politics and dogmas on a local level. Shared values in solidarity and citizenship, similar organizational structures, and complex interests in forming mutually beneficial alliances were the factors that emerged as the bases for the strong partnership between the two institutions. Dichotomies of Church and State and micro and macro forces were often blurred as social actors responded to the epidemic while also upholding the ideologies of the institutions they represented. We argue that the relationship between the Catholic Church and the National AIDS Program was formalized in networks mediated through personal relationships and political opportunity structures that provided incentives for both institutions to collaborate. PMID:21324573

Clinical staging and operative reporting for multi-institutional trials in head and neck squamous cell carcinoma.

PubMed

Weymuller, E A

1997-12-01

A Strategic Planning Conference (jointly supported by NCI and NIDCD) was convened to consider potential improvements in surgical patient data for multi-institutional trials. The thesis underlying this project is that inadequacies in staging, pretreatment patient stratification, and the details of surgical resection may have obscured the detection of treatment effect. The goals of this project were multiple: (1) to consider the utility of new clinical stratification variables, (2) to increase the precision of tumor staging, and (3) to improve operative reporting for multi-institutional trials in head and neck cancer. The conference attendees came to a number of important conclusions: (1) TNM status is inadequate for describing head and neck cancer in a multi-institutional trial setting. A detailed anatomic reporting scheme is proposed; (2) comorbidity measures should be included as patient descriptors, especially those that meet the criteria "definitely important and easy to obtain"; (3) surgical reporting in multi-institutional trials should use a format that is compatible with computer analysis and use the same items as the revised (anatomic) staging system; (4) the surgeon should be personally responsible for data coding and should interact directly with the pathologist in marking the surgical specimen; (5) pathologic reporting should use an anatomic template identical to the staging and operative reporting formats.

From Beginning to End: How Engineering Students Think and Talk about Sustainability across the Life Cycle. Research Brief

ERIC Educational Resources Information Center

Kilgore, Deborah; Jocuns, Andrew; Yasuhara, Ken; Atman, Cynthia J.

2009-01-01

The Academic Pathways Study (APS) is a multi-institution, mixed-methods, longitudinal study which examines engineering students' learning and development as they move into, through, and beyond their undergraduate institutions (Atman et al., 2008; Sheppard et al., 2004). It is part of the Center for the Advancement of Engineering Education…

Post-Baccalaureate Attainment of Black, Hispanic, and White Students at Texas Public Institutions: a Multi-Year Study

ERIC Educational Resources Information Center

Franklin, Somer L.

2013-01-01

Purpose: The purpose of this study was to determine the extent to which differences were present by ethnic membership in graduate degrees attained at Texas public, 4-year institutions of higher education. Specifically, the numbers of master's, doctoral, and professional degrees awarded to White, Hispanic, and Black students in the State of Texas…

The Distillation of "VISCI": Towards a Better Identification of Suicidal Inmates

ERIC Educational Resources Information Center

Frottier, Patrick; Koenig, Franz; Seyringer, Michaela; Matschnig, Teresa; Fruehwald, Stefan

2009-01-01

The "Viennese Instrument for Suicidality in Correctional Institutions" (VISCI) presented here is based on the results of a large case-control study and on research on literature examining suicide prevention in general and in the prison population in particular. The aim of this study was to validate the properties of the VISCI to differentiate…

Large outbreak caused by methicillin resistant Staphylococcus pseudintermedius ST71 in a Finnish Veterinary Teaching Hospital--from outbreak control to outbreak prevention.

PubMed

Grönthal, Thomas; Moodley, Arshnee; Nykäsenoja, Suvi; Junnila, Jouni; Guardabassi, Luca; Thomson, Katariina; Rantala, Merja

2014-01-01

The purpose of this study was to describe a nosocomial outbreak caused by methicillin resistant Staphylococcus pseudintermedius (MRSP) ST71 SCCmec II-III in dogs and cats at the Veterinary Teaching Hospital of the University of Helsinki in November 2010 - January 2012, and to determine the risk factors for acquiring MRSP. In addition, measures to control the outbreak and current policy for MRSP prevention are presented. Data of patients were collected from the hospital patient record software. MRSP surveillance data were acquired from the laboratory information system. Risk factors for MRSP acquisition were analyzed from 55 cases and 213 controls using multivariable logistic regression in a case-control study design. Forty-seven MRSP isolates were analyzed by pulsed field gel electrophoresis and three were further analyzed with multi-locus sequence and SCCmec typing. Sixty-three MRSP cases were identified, including 27 infections. MRSPs from the cases shared a specific multi-drug resistant antibiogram and PFGE-pattern indicated clonal spread. Four risk factors were identified; skin lesion (OR = 6.2; CI95% 2.3-17.0, P = 0.0003), antimicrobial treatment (OR = 3.8, CI95% 1.0-13.9, P = 0.0442), cumulative number of days in the intensive care unit (OR = 1.3, CI95% 1.1-1.6, P = 0.0007) or in the surgery ward (OR = 1.1, CI95% 1.0-1.3, P = 0.0401). Tracing and screening of contact patients, enhanced hand hygiene, cohorting and barrier nursing, as well as cleaning and disinfection were used to control the outbreak. To avoid future outbreaks and spread of MRSP a search-and-isolate policy was implemented. Currently nearly all new MRSP findings are detected in screening targeted to risk patients on admission. Multidrug resistant MRSP is capable of causing a large outbreak difficult to control. Skin lesions, antimicrobial treatment and prolonged hospital stay increase the probability of acquiring MRSP. Rigorous control measures were needed to control the outbreak. We recommend the implementation of a search-and-isolate policy to reduce the burden of MRSP.

An investigation of air transportation technology at the Massachusetts Institute of Technology, 1990-1991

NASA Technical Reports Server (NTRS)

Simpson, Robert W.

1991-01-01

Brief summaries are given of research activities at the Massachusetts Institute of Technology (MIT) under the sponsorship of the FAA/NASA Joint University Program. Topics covered include hazard assessment and cockpit presentation issues for microburst alerting systems; the situational awareness effect of automated air traffic control (ATC) datalink clearance amendments; a graphical simulation system for adaptive, automated approach spacing; an expert system for temporal planning with application to runway configuration management; deterministic multi-zone ice accretion modeling; alert generation and cockpit presentation for an integrated microburst alerting system; and passive infrared ice detection for helicopter applications.

The Peculiar Institution?: A Multisite Case Study of Athletic Department Cultures at Small Christian Institutions

ERIC Educational Resources Information Center

Ramseyer, Paul Robert

2017-01-01

This multisite case study explored the perceptions of athletic department members of the important factors of organizational cultures in athletic departments at small Christian institutions in the Midwestern United States. The study comprised of site visits to three small Christian institutions in the Midwestern United States. At each site, six…

[Continuous bladder irrigation following transurethral resection of the prostate (TURP)].

PubMed

Nojiri, Yoshikatsu; Okamura, Kikuo; Kinukawa, Tsuneo; Ozawa, Hideo; Saito, Shiro; Okumura, Kazuhiro; Terai, Akito; Takei, Mineo

2007-09-01

We investigated whether continuous bladder irrigation after Transurethral Resection of the Prostate (TURP) would prevent catheter obstruction by the clot. We analyzed data from 761 patients registered in "a multi-institutional study of TURP clinical pathway" sponsored by the Ministry of Health, Labor and Welfare between 2001 and 2003. The difference of clinical backgrounds of the cases, resected weight, operating time, risk of being feverish, risk of catheter obstruction and chance of postoperative Transurethral Fulguration (TUF) between each institution were investigated. The risk factor of catheter obstruction is characterized and the significance of continuous bladder irrigation is discussed. The incidence of catheter obstruction in the four institutions, in which 90% or more of patients underwent continuous bladder irrigation, was significantly lower than that in the three institutions, in which continuous bladder irrigation was performed in selected patients whose hematuria was severe (4.4% VS 12.9%, p<0.001). There was no difference in the frequency of either pyrexia or postoperative TUF. Logistic regression analysis showed that significant factors for catheter obstruction are continuous bladder irrigation, resected tissue weight and preoperative urinary infection. Routine continuous bladder irrigation achieved a lower incidence of catheter obstruction. However, we recommend that urologists should decide whether to perform routine continuous irrigation, considering the frequency of catheter obstruction, safety, labor and cost.

Increased risk for an atypical autism diagnosis following Thimerosal-containing vaccine exposure in the United States: A prospective longitudinal case-control study in the Vaccine Safety Datalink.

PubMed

Geier, David A; Kern, Janet K; Geier, Mark R

2017-07-01

Thimerosal is an organic-mercury (Hg)-containing compound (49.55% Hg by weight) historically added to many multi-dose vials of vaccine as a preservative and still added to some vaccines today. Concerns about the toxic effects from Thimerosal-containing childhood vaccines and the risk of an atypical autism diagnosis were evaluated in this study. A hypothesis-testing, prospective longitudinal, case-control study assessed exposure to Hg from Thimerosal-containing hepatitis B vaccines (TM-HepB) among cases diagnosed with atypical autism (n=164) and controls (n=15,216). Automated medical records for subjects born from 1991 to 2000 and continuously enrolled in the Vaccine Safety Datalink (VSD) database were examined. Cases diagnosed with atypical autism were statistically significantly more likely to have received greater overall and dose-dependent exposures to Hg from TM-HepB vaccines administered within the first month of life, first two months of life, and first six months of life than the controls. Similar phenomena were observed when cases and controls were separated by gender. Routine childhood vaccination is an important public health tool to reduce infectious diseases. The present study provides important epidemiological evidence significantly associating increasing Hg exposure from Thimerosal-containing childhood vaccines and the subsequent risk of atypical autism diagnosis, and suggests that Thimerosal should be eliminated from vaccines. Copyright © 2017 Elsevier GmbH. All rights reserved.

Restructuring a Higher Education Institution: A Case Study from a Developing Country

ERIC Educational Resources Information Center

Sohail, M. Sadiq; Daud, Salina; Rajadurai, Jegatheesan

2006-01-01

Purpose: The competitive environment facing all organizations has forced many of them to choose strategies that enhance organizational effectiveness and efficiency. Re-engineering is one of the tools used in administering productivity improvements, cost control and asset management. Design/methodology/approach: This paper examines the…

The Quasi-Privatization of a Public Honors College

ERIC Educational Resources Information Center

Berdahl, Robert; Contardo, Jeanne Bayer

2006-01-01

This is a case study of a state institution granted charter status in 1992 in exchange for capping its request for state funds. St. Mary's College of Maryland received widespread freedom from state procedural controls, including procurement, personnel, and some capital development processes. The state, however, retained its oversight of the…

Counseling African Americans to Control Hypertension (CAATCH) Trial: A Multi-level Intervention to Improve Blood Pressure Control in Hypertensive African Americans

PubMed Central

Ogedegbe, Gbenga; Tobin, Jonathan N.; Fernandez, Senaida; Gerin, William; Diaz-Gloster, Marleny; Cassells, Andrea; Khalida, Chamanara; Pickering, Thomas; Schoenthaler, Antoinette; Ravenell, Joseph

2009-01-01

Background Despite strong evidence of effective interventions targeted at blood pressure (BP) control, there is little evidence on the translation of these approaches to routine clinical practice in care of hypertensive African Americans. The goal of this study is to evaluate the effectiveness of a multi-level, multi-component, evidence-based intervention compared to usual care in improving BP control among hypertensive African Americans who receive care in Community Health Centers (CHCs). The primary outcomes are BP control rate at 12 months; and maintenance of intervention one year after the trial. The secondary outcomes are within-patient change in BP from baseline to 12 months and cost effectiveness of the intervention. Methods and Results Counseling African Americans to Control Hypertension (CAATCH) is a group randomized clinical trial with two conditions: Intervention Condition (IC) and Usual Care (UC). Thirty CHCs were randomly assigned equally to the IC group (N=15) or the UC group (N=15). The intervention is comprised of three components targeted at patients (interactive computerized hypertension education; home BP monitoring; and monthly behavioral counseling on lifestyle modification) and two components targeted at physicians (monthly case rounds based on JNC-7 guidelines; chart audit and provision of feedback on clinical performance and patients’ home BP readings). All outcomes are assessed at quarterly study visits for one year. Chart review is conducted at 24 months to evaluate maintenance of intervention effects and sustainability of the intervention. Conclusions Poor BP control is one of the major reasons for the mortality gap between African Americans and whites. Findings from this study, if successful, will provide salient information needed for translation and dissemination of evidence-based interventions targeted at BP control into clinical practice for this high-risk population. PMID:20031845

A Three-Dimensional Target Depth-Resolution Method with a Single-Vector Sensor

PubMed Central

Zhao, Anbang; Bi, Xuejie; Hui, Juan; Zeng, Caigao; Ma, Lin

2018-01-01

This paper mainly studies and verifies the target number category-resolution method in multi-target cases and the target depth-resolution method of aerial targets. Firstly, target depth resolution is performed by using the sign distribution of the reactive component of the vertical complex acoustic intensity; the target category and the number resolution in multi-target cases is realized with a combination of the bearing-time recording information; and the corresponding simulation verification is carried out. The algorithm proposed in this paper can distinguish between the single-target multi-line spectrum case and the multi-target multi-line spectrum case. This paper presents an improved azimuth-estimation method for multi-target cases, which makes the estimation results more accurate. Using the Monte Carlo simulation, the feasibility of the proposed target number and category-resolution algorithm in multi-target cases is verified. In addition, by studying the field characteristics of the aerial and surface targets, the simulation results verify that there is only amplitude difference between the aerial target field and the surface target field under the same environmental parameters, and an aerial target can be treated as a special case of a surface target; the aerial target category resolution can then be realized based on the sign distribution of the reactive component of the vertical acoustic intensity so as to realize three-dimensional target depth resolution. By processing data from a sea experiment, the feasibility of the proposed aerial target three-dimensional depth-resolution algorithm is verified. PMID:29649173

A Three-Dimensional Target Depth-Resolution Method with a Single-Vector Sensor.

PubMed

Zhao, Anbang; Bi, Xuejie; Hui, Juan; Zeng, Caigao; Ma, Lin

2018-04-12

This paper mainly studies and verifies the target number category-resolution method in multi-target cases and the target depth-resolution method of aerial targets. Firstly, target depth resolution is performed by using the sign distribution of the reactive component of the vertical complex acoustic intensity; the target category and the number resolution in multi-target cases is realized with a combination of the bearing-time recording information; and the corresponding simulation verification is carried out. The algorithm proposed in this paper can distinguish between the single-target multi-line spectrum case and the multi-target multi-line spectrum case. This paper presents an improved azimuth-estimation method for multi-target cases, which makes the estimation results more accurate. Using the Monte Carlo simulation, the feasibility of the proposed target number and category-resolution algorithm in multi-target cases is verified. In addition, by studying the field characteristics of the aerial and surface targets, the simulation results verify that there is only amplitude difference between the aerial target field and the surface target field under the same environmental parameters, and an aerial target can be treated as a special case of a surface target; the aerial target category resolution can then be realized based on the sign distribution of the reactive component of the vertical acoustic intensity so as to realize three-dimensional target depth resolution. By processing data from a sea experiment, the feasibility of the proposed aerial target three-dimensional depth-resolution algorithm is verified.

Outcomes of Bethesda Categories III and IV Thyroid Nodules Over 5 Years and Performance of the Afirma Gene Expression Classifier: A Single-Institution Study.

PubMed

Deaver, Kelsi E; Haugen, Bryan R; Pozdeyev, Nikita; Marshall, Carrie B

2018-05-23

The second edition Bethesda System for Reporting Thyroid Cytology estimates 6-18% malignancy rate of category III (B3) and 10-40% for category IV (B4) nodules; however, reported malignancy rates have considerable variability among institutions. Use of molecular classifiers (including Afirma Gene Expression Classifier, GEC) can be utilized in management of thyroid nodules. Our objective was to analyze malignancy rates of B3 and B4 nodules and determine clinical outcomes of GEC Benign nodules. A retrospective analysis of 2019 thyroid FNAs was performed at the University of Colorado from 2011-2015, including molecular, surgical, and clinical follow-up. Of 2019 FNAs analyzed, 231 (11.4%) were diagnosed as B3 and 80 (4.0%) as B4. GEC was obtained in 54.1% of B3 cases, with nearly half (48.8%) having a Benign result. Surgery was performed in 40.7% B3 cases with a 24.5% malignancy rate, ranging 8-38% by year. In the B4 group, 52.5% underwent molecular testing with 28.6% as GEC Benign. 68.8% of B4 cases underwent surgery with a 20% malignancy rate, ranging 0-42% by year. 73 GEC Benign cases were reviewed: 5 (6.8%) underwent surgery, with none demonstrating malignancy in the target nodule. Size remained stable for most GEC Benign nodules: 75.9% (B3) and 71.4% (B4) with no malignancy on repeat FNA. Our 5-year review demonstrated that malignancy rates of B3 and B4 nodules showed year-to-year variability. We suggest that clinicians use a multi-year average of their institution's malignancy rates to optimally manage patients. Follow-up for GEC Benign cases thus far supports their indolent nature. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

The dubious effect of milnacipran for the treatment of burning mouth syndrome.

PubMed

Sugimoto, Koreaki

2011-01-01

Burning mouth syndrome (BMS) is a condition accompanied by oral burning symptoms, including glossal pain (glossodynia) without a detectable cause. Although BMS is a chronic-pain syndrome, only one self-controlled pilot study and some case reports have reported that milnacipran is effective for the treatment of chronic pain, including that caused by BMS. However, these papers assessed only pain, and the dosage of prescribed milnacipran varied from 30 to 150 mg/d in each patient. In this study, the dosage of prescribed milnacipran was set at 60 mg/d for 12 weeks for all patients, and depression and quality of life (QOL) were assessed in addition to pain. Twelve patients with glossodynia participated in this study. Milnacipran was initiated at a dosage of 15 mg/d and then raised gradually to 60 mg/d after 4 weeks of treatment; this dose was continued until the end of the study (total of 12 weeks). The evaluation included the Hamilton Rating Scale for Depression, the Visual Analog Scale score for pain evaluation, the General Oral Health Assessment Index for oral-related QOL evaluation, and the Medical Outcomes Study's 36-Item Short-Form Health Survey (SF-36) for whole QOL evaluation. The Hamilton Rating Scale for Depression score decreased significantly after treatment with a 60-mg/d dosage of milnacipran for 12 weeks. However, the Visual Analog Scale pain, General Oral Health Assessment Index, and SF-36 scores did not change. A randomized, double-blind, placebo-controlled multi-institution trial of milnacipran will be essential to determine its effectiveness for the treatment of BMS.

Multi-institutional tumor banking: lessons learned from a pancreatic cancer biospecimen repository.

PubMed

Demeure, Michael J; Sielaff, Timothy; Koep, Larry; Prinz, Richard; Moser, A James; Zeh, Herb; Hostetter, Galen; Black, Jodi; Decker, Ardis; Rosewell, Sandra; Bussey, Kimberly J; Von Hoff, Daniel

2010-10-01

Clinically annotated pancreatic cancer samples are needed for progress to be made toward developing more effective treatments for this deadly cancer. As part of a National Cancer Institute-funded program project, we established a biospecimen core to support the research efforts. This article summarizes the key hurdles encountered and solutions we found in the process of developing a successful multi-institution biospecimen repository.

New controller for functional electrical stimulation systems.

PubMed

Fisekovic, N; Popovic, D B

2001-07-01

A novel, self-contained controller for functional electrical stimulation systems has been designed. The development was motivated by the need to have a general purpose, easy to use controller capable of stimulating many muscle groups, thus restoring complex motor functions (e.g. standing, walking, reaching, and grasping). The designed controller can regulate the frequency, pulse duration, and charge balance on up to 16 channels, and execute pre-programmed and sensory-driven control operations. The controller supports up to eight analog and six digital sensors, and comprises a memory block for including history of the sensory data (time series). Five independent timers provide the basis for the multi-modal and multi-level control of movement. The PC compatible interface is realised via an IR serial communication channel. The PC based software is user friendly and fully menu driven. This paper also presents a case study where the controller was implemented to restore walking in a paraplegic subject. The assistive system comprised the novel controller, the power and output stages of an eight-channel FES system (IEEE Trans Rehabil Eng, TRE-2 (1994) 234), ankle-foot orthoses, and a rolling walker. Stimulation was applied with surface electrodes positioned over the motoneurons that innervate muscles responsible for the hip and knee flexion and extension. The sensory system included goniometers at knee and hip joints, force-sensing resistors built in the shoe insoles, and digital accelerometers at the hips. A rule-based control algorithm was generated following a two-step procedure: (1) simulation and (2) machine learning as described in earlier studies (IEEE Trans Rehab Eng, TRE-7 (1999) 69). The paraplegic subject walked faster, and with less physiological effort, when automatic control was applied as compared to hand-control. This case study, as well as a previous one for assisting grasping (The design and testing of a new programmable electronic stimulator. N. Fisekovic, MS thesis. University of Belgrade, Belgrade, 2000) indicate that the novel control unit is effectively applicable to FES systems.

Case-Control Pilot Study on Acute Diarrheal Disease in a Geographically Defined Pediatric Population in a Middle Income Country

PubMed Central

Farfán-García, Ana E.; Zhang, Chengxian; Imdad, Aamer; Arias-Guerrero, Monica Y.; Sánchez-Alvarez, Nayibe T.; Shah, Rikhil; Iqbal, Junaid; Tamborski, Maria E.

2017-01-01

Introduction Acute diarrheal disease (ADD) is a common cause of morbidity and mortality in children under 5 years of age. Understanding of the etiology of ADD is lacking in most low and middle income countries because reference laboratories detect limited number of pathogens. The objective of this study was to determine the feasibility to conduct a comprehensive case-control study to survey diarrheal pathogens among children with and without moderate-to-severe ADD. Materials and Methods Microbiology and molecular-based techniques were used to detect viral, bacterial, and parasitic enteropathogens. The study was conducted in Bucaramanga, Colombia, after Institutional Review Board approval was obtained. Results Ninety children less than 5 years of age were recruited after a written informed consent was obtained from parents or guardians. Forty-five subjects served as cases with ADD and 45 as controls. Thirty-six subjects out of 90 (40.0%) were positive for at least one enteropathogen, that is, 20 (44.4%) cases and 16 (35.5%) controls. Conclusions The three most common enteric pathogens were enteroaggregative E. coli (10.0%), Norovirus (6.7%), and Salmonella spp. (5.6%). The E. coli pathogens were 18.8% of all infections making them the most frequent pathogens. Half of ADD cases were negative for any pathogens. PMID:28855919

Associations between Medical Student Empathy and Personality: A Multi-Institutional Study

PubMed Central

Costa, Patrício; Alves, Raquel; Neto, Isabel; Marvão, Pedro; Portela, Miguel; Costa, Manuel João

2014-01-01

Background More empathetic physicians are more likely to achieve higher patient satisfaction, adherence to treatments, and health outcomes. In the context of medical education, it is thus important to understand how personality might condition the empathetic development of medical students. Single institutional evidence shows associations between students' personality and empathy. This multi-institutional study aimed to assess such associations across institutions, looking for personality differences between students with high empathy and low empathy levels. Methods Participants were 472 students from three medical schools in Portugal. They completed validated adaptations to Portuguese of self-report measures of the NEO-Five Factor Inventory(NEO-FFI) and the Jefferson Scale of Physician Empathy(JSPE-spv). Students were categorized into two groups: “Bottom” (low empathy, N = 165) and “Top” (high empathy, N = 169) according to their empathy JSPE-spv total score terciles. Correlation analysis, binary logistic regression analysis and ROC curve analysis were conducted. Results A regression model with gender, age and university had a predictive power (pseudo R2) for belonging to the top or bottom group of 6.4%. The addition of personality dimensions improved the predictive power to 16.8%. Openness to experience and Agreeableness were important to predict top or bottom empathy scores when gender, age and university were considered.” Based on the considered predictors the model correctly classified 69.3% of all students. Conclusions The present multi-institutional cross-sectional study in Portugal revealed across-school associations between the Big5 dimensions Agreeableness and Openness to experience and the empathy of medical students and that personality made a significant contribution to identify the more empathic students. Therefore, medical schools may need to pay attention to the personality of medical students to understand how to enhance the empathy of medical students. PMID:24637613

RoBlock: a prototype autonomous manufacturing cell

NASA Astrophysics Data System (ADS)

Baekdal, Lars K.; Balslev, Ivar; Eriksen, Rene D.; Jensen, Soren P.; Jorgensen, Bo N.; Kirstein, Brian; Kristensen, Bent B.; Olsen, Martin M.; Perram, John W.; Petersen, Henrik G.; Petersen, Morten L.; Ruhoff, Peter T.; Skjolstrup, Carl E.; Sorensen, Anders S.; Wagenaar, Jeroen M.

2000-10-01

RoBlock is the first phase of an internally financed project at the Institute aimed at building a system in which two industrial robots suspended from a gantry, as shown below, cooperate to perform a task specified by an external user, in this case, assembling an unstructured collection of colored wooden blocks into a specified 3D pattern. The blocks are identified and localized using computer vision and grasped with a suction cup mechanism. Future phases of the project will involve other processes such as grasping and lifting, as well as other types of robot such as autonomous vehicles or variable geometry trusses. Innovative features of the control software system include: The use of an advanced trajectory planning system which ensures collision avoidance based on a generalization of the method of artificial potential fields, the use of a generic model-based controller which learns the values of parameters, including static and kinetic friction, of a detailed mechanical model of itself by comparing actual with planned movements, the use of fast, flexible, and robust pattern recognition and 3D-interpretation strategies, integration of trajectory planning and control with the sensor systems in a distributed Java application running on a network of PC's attached to the individual physical components. In designing this first stage, the aim was to build in the minimum complexity necessary to make the system non-trivially autonomous and to minimize the technological risks. The aims of this project, which is planned to be operational during 2000, are as follows: To provide a platform for carrying out experimental research in multi-agent systems and autonomous manufacturing systems, to test the interdisciplinary cooperation architecture of the Maersk Institute, in which researchers in the fields of applied mathematics (modeling the physical world), software engineering (modeling the system) and sensor/actuator technology (relating the virtual and real worlds) could collaborate with systems integrators to construct intelligent, autonomous systems, and to provide a showpiece demonstrator in the entrance hall of the Institute's new building.

An integrated strategy for aircraft/airport noise abatement: A legal-institutional control act section 7 to the noise control act of 1972 and proposals based thereon

NASA Technical Reports Server (NTRS)

Mayo, L. H.

1975-01-01

The development of the aircraft noise control structure since the Griggs case of 1962 was examined. The Noise Control Act of 1972 is described which undertook to establish the legal-institutional framework within which an adequate aircraft/airport noise abatement program might be initiated with concern for full recognition of all the beneficial and detrimental consequences of air transportation and appropriate distribution of benefits and costs.

Loop-mediated isothermal amplification (LAMP) assay for speedy diagnosis of tubercular lymphadenitis: The multi-targeted 60-minute approach.

PubMed

Sharma, Megha; Sharma, Kusum; Sharma, Aman; Gupta, Nalini; Rajwanshi, Arvind

2016-09-01

Tuberculous lymphadenitis (TBLA), the most common presentation of tuberculosis, poses a significant diagnostic challenge in the developing countries. Timely, accurate and cost-effective diagnosis can decrease the high morbidity associated with TBLA especially in resource-poor high-endemic regions. The loop-mediated isothermal amplification assay (LAMP), using two targets, was evaluated for the diagnosis of TBLA. LAMP assay using 3 sets of primers (each for IS6110 and MPB64) was performed on 170 fine needle aspiration samples (85 confirmed, 35 suspected, 50 control cases of TBLA). Results were compared against IS6110 PCR, cytology, culture and smear. The overall sensitivity and specificity of LAMP assay, using multi-targeted approach, was 90% and 100% respectively in diagnosing TBLA. The sensitivity of multi-targeted LAMP, only MPB64 LAMP, only IS6110 LAMP and IS6110 PCR was 91.7%, 89.4%, 84.7% and 75.2%, respectively among confirmed cases and 85.7%, 77.1%, 68.5% and 60%, respectively among suspected cases of TBLA. Additional 12/120 (10%) cases were detected using multi-targeted method. The multi-targeted LAMP, with its speedy and reliable results, is a potential diagnostic test for TBLA in low-resource countries. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Cross-Layer Approach to Multi-Hop Networking with Cognitive Radios

DTIC Science & Technology

2008-11-01

recent investigations. In [2], Behzad and Rubin studied the special case that the same power level are used at each node and found that the maximum...Sep. 2, 2005. [2] A. Behzad and I. Rubin, “Impact of power control on the performance of ad hoc wireless networks,” in Proc. IEEE Infocom, pp. 102–113

Nonlinear dynamics and control of a vibrating rectangular plate

NASA Technical Reports Server (NTRS)

Shebalin, J. V.

1983-01-01

The von Karman equations of nonlinear elasticity are solved for the case of a vibrating rectangular plate by meams of a Fourier spectral transform method. The amplification of a particular Fourier mode by nonlinear transfer of energy is demonstrated for this conservative system. The multi-mode system is reduced to a minimal (two mode) system, retaining the qualitative features of the multi-mode system. The effect of a modal control law on the dynamics of this minimal nonlinear elastic system is examined.

[Diagnostic values of bronchoscopy and multi-slice spiral CT for congenital dysplasia of the respiratory system in infants: a comparative study].

PubMed

Wang, Xing-Lu; Huang, Ying; Li, Qu-Bei; Dai, Ji-Hong

2013-09-01

To investigate and compare the diagnostic values of bronchoscopy and multi-slice spiral computed tomography (CT) for congenital dysplasia of the respiratory system in infants. Analysis was performed on the clinical data, bronchoscopic findings and multi-slice spiral CT findings of 319 infants (≤1 years old) who underwent bronchoscopy and/or multi-slice spiral CT and were diagnosed with congenital dysplasia of the respiratory system. A total of 476 cases of congenital dysplasia of the respiratory system were found in the 319 infants, including primary dysplasia of the respiratory system (392 cases) and compressive dysplasia of the respiratory system (84 cases). Of the 392 cases of primary dysplasia of the respiratory system, 225 (57.4%) were diagnosed by bronchoscopy versus 167 (42.6%) by multi-slice spiral CT. There were significant differences in etiological diagnosis between bronchoscopy and multi-slice spiral CT in infants with congenital dysplasia of the respiratory system (P<0.05). All 76 cases of primary dysplasia of the respiratory system caused by tracheobronchomalacia were diagnosed by bronchoscopy and all 17 cases of primary dysplasia of the respiratory system caused by lung tissue dysplasia were diagnosed by multi-slice spiral CT. Of the 84 cases of compressive dysplasia of the respiratory system, 74 cases were diagnosed by multi-slice spiral CT and only 10 cases were diagnosed by bronchoscopy. Compared with multi-slice spiral CT, bronchoscopy can detect primary dysplasia of the respiratory system more directly. Bronchoscopy is valuable in the confirmed diagnosis of tracheobronchomalacia. Multi-slice spiral CT has a higher diagnostic value for lung tissue dysplasia than bronchoscopy.

Analysis of Unplanned Intensive Care Unit Admissions in Postoperative Pediatric Patients.

PubMed

Landry, Elizabeth K; Gabriel, Rodney A; Beutler, Sascha; Dutton, Richard P; Urman, Richard D

2017-03-01

Currently, there are only a few retrospective, single-institution studies that have addressed the prevalence and risk factors associated with unplanned admissions to the pediatric intensive care unit (ICU) after surgery. Based on the limited amount of studies, it appears that airway and respiratory complications put a child at increased risk for unplanned ICU admission. A more extensive and diverse analysis of unplanned postoperative admissions to the ICU is needed to address risk factors that have yet to be revealed by the current literature. To establish a rate of unplanned postoperative ICU admissions in pediatric patients using a large, multi-institution data set and to further characterize the associated risk factors. Data from the National Anesthesia Clinical Outcomes Registry were analyzed. We recorded the overall risk of unplanned postoperative ICU admission in patients younger than 18 years and performed univariate and multivariate logistic regression analysis to identify the associated patient, surgical, and anesthetic-related characteristics. Of the 324 818 cases analyzed, 211 reported an unexpected ICU admission. There was an increased likelihood of unplanned postoperative ICU in infants (age <1 year) and children who were classified as American Society of Anesthesiologists physical status classification of III or IV. Likewise, longer case duration and cases requiring general anesthesia were also associated with unplanned ICU admissions. This study establishes a rate of unplanned ICU admission following surgery in the heterogeneous pediatric population. This is the first study to utilize such a large data set encompassing a wide range of practice environments to identify risk factors leading to unplanned postoperative ICU admissions. Our study revealed that patient, surgical, and anesthetic complexity each contributed to an increased number of unplanned ICU admissions in the pediatric population.

The Management of University-Industry Relations: Five Institutional Case Studies from Africa, Europe, Latin America, and the Pacific Region. Improving the Managerial Effectiveness of Higher Education Institutions.

ERIC Educational Resources Information Center

Martin, Michaela, Ed.

Five case studies were conducted to collect empirical evidence on innovative mechanisms through which universities worldwide manage their relations with industry. Cases were selected from institutions of higher education in Israel, Papua New Guinea, Turkey, Brazil, and Uganda. These studies were selected for their innovative approaches, but also…

An enhanced SOCP-based method for feeder load balancing using the multi-terminal soft open point in active distribution networks

DOE PAGES

Ji, Haoran; Wang, Chengshan; Li, Peng; ...

2017-09-20

The integration of distributed generators (DGs) exacerbates the feeder power flow fluctuation and load unbalanced condition in active distribution networks (ADNs). The unbalanced feeder load causes inefficient use of network assets and network congestion during system operation. The flexible interconnection based on the multi-terminal soft open point (SOP) significantly benefits the operation of ADNs. The multi-terminal SOP, which is a controllable power electronic device installed to replace the normally open point, provides accurate active and reactive power flow control to enable the flexible connection of feeders. An enhanced SOCP-based method for feeder load balancing using the multi-terminal SOP is proposedmore » in this paper. Furthermore, by regulating the operation of the multi-terminal SOP, the proposed method can mitigate the unbalanced condition of feeder load and simultaneously reduce the power losses of ADNs. Then, the original non-convex model is converted into a second-order cone programming (SOCP) model using convex relaxation. In order to tighten the SOCP relaxation and improve the computation efficiency, an enhanced SOCP-based approach is developed to solve the proposed model. Finally, case studies are performed on the modified IEEE 33-node system to verify the effectiveness and efficiency of the proposed method.« less

An enhanced SOCP-based method for feeder load balancing using the multi-terminal soft open point in active distribution networks

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

Ji, Haoran; Wang, Chengshan; Li, Peng

The integration of distributed generators (DGs) exacerbates the feeder power flow fluctuation and load unbalanced condition in active distribution networks (ADNs). The unbalanced feeder load causes inefficient use of network assets and network congestion during system operation. The flexible interconnection based on the multi-terminal soft open point (SOP) significantly benefits the operation of ADNs. The multi-terminal SOP, which is a controllable power electronic device installed to replace the normally open point, provides accurate active and reactive power flow control to enable the flexible connection of feeders. An enhanced SOCP-based method for feeder load balancing using the multi-terminal SOP is proposedmore » in this paper. Furthermore, by regulating the operation of the multi-terminal SOP, the proposed method can mitigate the unbalanced condition of feeder load and simultaneously reduce the power losses of ADNs. Then, the original non-convex model is converted into a second-order cone programming (SOCP) model using convex relaxation. In order to tighten the SOCP relaxation and improve the computation efficiency, an enhanced SOCP-based approach is developed to solve the proposed model. Finally, case studies are performed on the modified IEEE 33-node system to verify the effectiveness and efficiency of the proposed method.« less

Who We Are: A Case Study on the Institutional Identity of One Public Institution

ERIC Educational Resources Information Center

Driggers, Mallory C.

2016-01-01

This research examined the formation, change and sustainment of institutional identity over a period of almost three decades under one leader at a public research institution in the southwest. This qualitative case study used constant comparative analysis with interview transcripts and convocation address transcripts to examine the change in…

Applying the institutional review board data repository approach to manage ethical considerations in evaluating and studying medical education

PubMed Central

Thayer, Erin K.; Rathkey, Daniel; Miller, Marissa Fuqua; Palmer, Ryan; Mejicano, George C.; Pusic, Martin; Kalet, Adina; Gillespie, Colleen; Carney, Patricia A.

2016-01-01

Issue Medical educators and educational researchers continue to improve their processes for managing medical student and program evaluation data using sound ethical principles. This is becoming even more important as curricular innovations are occurring across undergraduate and graduate medical education. Dissemination of findings from this work is critical, and peer-reviewed journals often require an institutional review board (IRB) determination. Approach IRB data repositories, originally designed for the longitudinal study of biological specimens, can be applied to medical education research. The benefits of such an approach include obtaining expedited review for multiple related studies within a single IRB application and allowing for more flexibility when conducting complex longitudinal studies involving large datasets from multiple data sources and/or institutions. In this paper, we inform educators and educational researchers on our analysis of the use of the IRB data repository approach to manage ethical considerations as part of best practices for amassing, pooling, and sharing data for educational research, evaluation, and improvement purposes. Implications Fostering multi-institutional studies while following sound ethical principles in the study of medical education is needed, and the IRB data repository approach has many benefits, especially for longitudinal assessment of complex multi-site data. PMID:27443407

Overcoming barriers to a research-ready national commercial claims database.

PubMed

Newman, David; Herrera, Carolina-Nicole; Parente, Stephen T

2014-11-01

Billions of dollars have been spent on the goal of making healthcare data available to clinicians and researchers in the hopes of improving healthcare and lowering costs. However, the problems of data governance, distribution, and accessibility remain challenges for the healthcare system to overcome. In this study, we discuss some of the issues around holding, reporting, and distributing data, including the newest "big data" challenge: making the data accessible to researchers and policy makers. This article presents a case study in "big healthcare data" involving the Health Care Cost Institute (HCCI). HCCI is a nonprofit, nonpartisan, independent research institute that serves as a voluntary repository of national commercial healthcare claims data. Governance of large healthcare databases is complicated by the data-holding model and further complicated by issues related to distribution to research teams. For multi-payer healthcare claims databases, the 2 most common models of data holding (mandatory and voluntary) have different data security requirements. Furthermore, data transport and accessibility may require technological investment. HCCI's efforts offer insights from which other data managers and healthcare leaders may benefit when contemplating a data collaborative.

Global Benchmarking of Marketing Doctoral Program Faculty and Institutions by Subarea

ERIC Educational Resources Information Center

Elbeck, Matt; Vander Schee, Brian A.

2014-01-01

This study benchmarks marketing doctoral programs worldwide in five popular subareas by faculty and institutional scholarly impact. A multi-item approach identifies a collection of top-tier scholarly journals for each subarea, while citation data over the decade 2003 to 2012 identify high scholarly impact marketing faculty by subarea used to…

Multi-Purpose Enrollment Projections: A Comparative Analysis of Four Approaches

ERIC Educational Resources Information Center

Allen, Debra Mary

2013-01-01

Providing support for institutional planning is central to the function of institutional research. Necessary for the planning process are accurate enrollment projections. The purpose of the present study was to develop a short-term enrollment model simple enough to be understood by those who rely on it, yet sufficiently complex to serve varying…

76 FR 63933 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-14

... Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting Pursuant to section 10(d) of the... Diabetes and Digestive and Kidney Diseases Special Emphasis Panel; NIDDK Multi-Center Clinical Study... and Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology Research, National Institutes...

A Multi-Institution Look at College Students Seeking Counseling: Nature and Severity of Concerns

ERIC Educational Resources Information Center

Krumrei, Elizabeth J.; Newton, Fred B.; Kim, Eunhee

2010-01-01

This study provides information about students seeking counseling (N = 3,844) at 9 institutions of higher education. The K-PIRS, an empirically validated measure, was used to assess 7 problem areas (mood difficulties, learning problems, food concerns, interpersonal conflicts, career uncertainties, self-harm indicators, and addiction issues).…

Academic Venturing in Higher Education: Institutional Effects on Performance of University Technology Transfer. ASHE Annual Meeting Paper.

ERIC Educational Resources Information Center

Powers, Joshua B.

This study investigated institutional resource factors that may explain differential performance with university technology transfer--the process by which university research is transformed into marketable products. Using multi-source data on 108 research universities, a set of internal resources (financial, physical, human capital, and…

Partisan Differences on Higher Education Accountability Policy: A Multi-State Study of Elected State Legislators

ERIC Educational Resources Information Center

Morse, Andrew Q.

2014-01-01

Public institutions in the United States face a policy challenge to adapt to accountability expectations among a variety of stakeholders (Bogue & Hall, 2012; Thelin, 2004; Richardson & Martinez, 2009). Among the major stakeholders are state legislators who hold fiscal and policy influence over public institutions, but these leaders have…

Factors associated with unreported tuberculosis cases in Spanish hospitals.

PubMed

Morales-García, Concepción; Rodrigo, Teresa; García-Clemente, Marta M; Muñoz, Ana; Bermúdez, Pilar; Casas, Francisco; Somoza, María; Milá, Celia; Penas, Antón; Hidalgo, Carmen; Casals, Martí; Caylá, Joan A

2015-07-29

Under-reporting of tuberculosis (TB) cases complicates disease control, hinders contact tracing and alters the accuracy of epidemiological data, including disease burden. The objective of the present study is to evaluate the proportion of unreported TB cases in Spanish healthcare facilities and to identify the associated factors. A multi-center retrospective study design was employed. The study included TB cases diagnosed in 16 facilities during 2011-2012. These cases were compared to those reported to the corresponding public health departments. Demographic, microbiological and clinical data were analyzed to determine the factors associated with unreported cases. Associated factors were analyzed on a bivariate level using the x(2) test and on a multivariate level using a logistic regression. Odds ratios (OR) and 95 % confidence intervals (CI) were calculated. Of the 592 TB cases included in the study, 85 (14.4 %) were not reported. The percentage of unreported cases per healthcare center ranged from 0-45.2 %. The following variables were associated to under-reporting at a multivariate level: smear-negative TB (OR = 1.87; CI:1.07-3.28), extrapulmonary disease (OR = 2.07; CI:1.05-4.09) and retired patients (OR = 3.04; CI:1.29-7.18). A nurse case manager was present in all of the centers with 100 % reporting. The percentage of reported cases among the smear-positive cases was 9.4 % and 19.4 % (p = 0.001) among the rest of the study population. Smear-positive TB was no associated to under-reporting. It is important that TB Control Programs encourage thorough case reporting to improve disease control, contact tracing and accuracy of epidemiological data. The help from a TB nurse case manager could improve the rate of under-reporting.

Multi-Institutional Experience of Stereotactic Ablative Radiation Therapy for Stage I Small Cell Lung Cancer

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

Verma, Vivek; Simone, Charles B.; Allen, Pamela K.

Purpose: For inoperable stage I (T1-T2N0) small cell lung cancer (SCLC), national guidelines recommend chemotherapy with or without conventionally fractionated radiation therapy. The present multi-institutional cohort study investigated the role of stereotactic ablative radiation therapy (SABR) for this population. Methods and Materials: The clinical and treatment characteristics, toxicities, outcomes, and patterns of failure were assessed in patients with histologically confirmed stage T1-T2N0M0 SCLC. Kaplan-Meier analysis was used to evaluate the survival outcomes. Univariate and multivariate analyses identified predictors of outcomes. Results: From 24 institutions, 76 lesions were treated in 74 patients (median follow-up 18 months). The median age and tumor sizemore » was 72 years and 2.5 cm, respectively. Chemotherapy and prophylactic cranial irradiation were delivered in 56% and 23% of cases, respectively. The median SABR dose and fractionation was 50 Gy and 5 fractions. The 1- and 3-year local control rate was 97.4% and 96.1%, respectively. The median disease-free survival (DFS) duration was 49.7 months. The DFS rate was 58.3% and 53.2% at 1 and 3 years, respectively. The median, 1-year, and 3-year disease-specific survival was 52.3 months, 84.5%, and 64.4%, respectively. The median, 1-year, and 3-year overall survival (OS) was 17.8 months, 69.9%, and 34.0% respectively. Patients receiving chemotherapy experienced an increased median DFS (61.3 vs 9.0 months; P=.02) and OS (31.4 vs 14.3 months; P=.02). The receipt of chemotherapy independently predicted better outcomes for DFS/OS on multivariate analysis (P=.01). Toxicities were uncommon; 5.2% experienced grade ≥2 pneumonitis. Post-treatment failure was most commonly distant (45.8% of recurrence), followed by nodal (25.0%) and “elsewhere lung” (20.8%). The median time to each was 5 to 7 months. Conclusions: From the findings of the largest report of SABR for stage T1-T2N0 SCLC to date, SABR (≥50 Gy) with chemotherapy should be considered a standard option.« less

Is work organisation associated with work status 3 months after injury? Results from a case-control study of New Zealand workers.

PubMed

Lilley, Rebbecca; Derrett, Sarah; Davie, Gabrielle

2015-01-01

Little empirical examination of the relationship between work organisational factors and return to work following injury has been undertaken despite the growing recognition of examining broader multi-dimensional contexts for recovery following injury. To explore relationships between pre-injury work organisational factors and work status (working/work absent) 3-month after injury among people employed prior to injury. Cases (work absent) and controls (working), selected from a larger study of injury outcomes according to reported work status 3-month after injury, completed a postal questionnaire. Work organisational factors were compared between cases and controls using univariate and multivariable analyses. One hundred and twelve participants completed the questionnaire (44 cases; 68 controls). Of 11 work organisation factors examined, organisational size was the only explanatory variable significantly associated with work status in the multivariable model. Higher odds of work absence were found in small (< 50 employees) (OR 5.6) and large (> 500 employees) (OR 7.2) workplaces, compared with medium-sized (50-500 employees) organisations. Variations in post-injury work patterns among those working pre-injury may be partly explained by organisation size. Future research examining work status following injury should examine the influence of work organisational factors in larger studies.

Improved quality monitoring of multi-center acupuncture clinical trials in China

PubMed Central

2009-01-01

Background In 2007, the Chinese Science Division of the State Administration of Traditional Chinese Medicine(TCM) convened a special conference to discuss quality control for TCM clinical research. Control and assurance standards were established to guarantee the quality of clinical research. This paper provides practical guidelines for implementing strict and reproducible quality control for acupuncture randomized controlled trials (RCTs). Methods A standard quality control program (QCP) was established to monitor the quality of acupuncture trials. Case report forms were designed; qualified investigators, study personnel and data management personnel were trained. Monitors, who were directly appointed by the project leader, completed the quality control programs. They guaranteed data accuracy and prevented or detected protocol violations. Clinical centers and clinicians were audited, the randomization system of the centers was inspected, and the treatment processes were audited as well. In addition, the case report forms were reviewed for completeness and internal consistency, the eligibility and validity of the patients in the study was verified, and data was monitored for compliance and accuracy. Results and discussion The monitors complete their reports and submit it to quality assurance and the sponsors. Recommendations and suggestions are made for improving performance. By holding regular meetings to discuss improvements in monitoring standards, the monitors can improve quality and efficiency. Conclusions Supplementing and improving the existed guidelines for quality monitoring will ensure that large multi-centre acupuncture clinical trials will be considered as valid and scientifically stringent as pharmaceutical clinical trials. It will also develop academic excellence and further promote the international recognition of acupuncture. PMID:20035630

From large-eddy simulation to multi-UAVs sampling of shallow cumulus clouds

NASA Astrophysics Data System (ADS)

Lamraoui, Fayçal; Roberts, Greg; Burnet, Frédéric

2016-04-01

In-situ sampling of clouds that can provide simultaneous measurements at satisfying spatio-temporal resolutions to capture 3D small scale physical processes continues to present challenges. This project (SKYSCANNER) aims at bringing together cloud sampling strategies using a swarm of unmanned aerial vehicles (UAVs) based on Large-eddy simulation (LES). The multi-UAV-based field campaigns with a personalized sampling strategy for individual clouds and cloud fields will significantly improve the understanding of the unresolved cloud physical processes. An extensive set of LES experiments for case studies from ARM-SGP site have been performed using MesoNH model at high resolutions down to 10 m. The carried out simulations led to establishing a macroscopic model that quantifies the interrelationship between micro- and macrophysical properties of shallow convective clouds. Both the geometry and evolution of individual clouds are critical to multi-UAV cloud sampling and path planning. The preliminary findings of the current project reveal several linear relationships that associate many cloud geometric parameters to cloud related meteorological variables. In addition, the horizontal wind speed indicates a proportional impact on cloud number concentration as well as triggering and prolonging the occurrence of cumulus clouds. In the framework of the joint collaboration that involves a Multidisciplinary Team (including institutes specializing in aviation, robotics and atmospheric science), this model will be a reference point for multi-UAVs sampling strategies and path planning.

Mobile radio alternative systems study satellite/terrestrial (hybrid) systems concepts

NASA Technical Reports Server (NTRS)

Kiesling, J. D.; Anderson, R. E.

1983-01-01

The use of satellites for mobile radio service in non-urban areas of the United States in the years from 1985 to 2000 was investigated. Several satellite concepts are considered: a system with single-beam coverage of the fifty United States and Puerto Rico, and multi-beam satellites with greater capacity. All of the needed functions and services identified in the market study are provided by the satellite systems, including nationwide radio access to vehicles without knowledge of vehicle location wideband data transmission from remote sites, two way exchange of short data and control messages between vehicles and dispatch or control centers, and automatic vehicle location (surveillance). The costs of providing the services are within acceptable limits, and the desired returns to the system investors are attractive. The criteria by which the Federal Communication judges the competing demands for public radio spectrum are reviewed with comments on how the criteria might apply to the consideration of land mobile satellites. Institutional arrangements for operating a mobile satellite system are based on the present institutional arrangements in which the services are offered to the end users through wireline and radio common carriers, with direct access by large private and government users.

Early-Career Professional Development Training for Stakeholder-Relevant, Interdisciplinary Research

NASA Astrophysics Data System (ADS)

Rosendahl, D. H.; Bamzai, A.; Mcpherson, R. A.

2015-12-01

There are many challenges to conducting inter- or multi-disciplinary research because basic research, applied research, management processes, disciplines, and even sub-disciplines have been "siloed" for so long that many research and management professionals find it difficult to communicate common interests and research needs. It is clear that the next generation of researchers must overcome these disciplinary biases and engage in more open dialogue with other disciplines and the management community in order to be better positioned to collaborate, speak a common language, and understand each other's needs. The U.S. Department of the Interior's South Central Climate Science Center recently conducted a professional development workshop for 28 early-career researchers involved in climate-related research across the South-Central U.S. The participants consisted of graduate students, postdocs, and junior faculty representing 17 different natural and social science disciplines and seven Universities/Institutions. The workshop provided the participants with guidance and instruction on how to overcome the identified challenges in conducting "actionable" research and how to better navigate multi-institutional and multi- or inter-disciplinary research. The workshop was comprised of: (1) a series of instructional presentations organized into themed sessions; (2) two keynote addresses to provide a broader perspective; (3) a real-world case study activity; (4) individual and group projects/presentations; and (5) field trips. In addition, we purposely created informal opportunities for participants to network, which met the goal of facilitating interdisciplinary interactions. An overview of the workshop experience will be provided, including a focus on those aspects leading to its ultimate success and recommendations for how to develop and implement a similar early-career workshop for your own purposes.

A study of pilot modeling in multi-controller tasks

NASA Technical Reports Server (NTRS)

Whitbeck, R. F.; Knight, J. R.

1972-01-01

A modeling approach, which utilizes a matrix of transfer functions to describe the human pilot in multiple input, multiple output control situations, is studied. The approach used was to extend a well established scalar Wiener-Hopf minimization technique to the matrix case and then study, via a series of experiments, the data requirements when only finite record lengths are available. One of these experiments was a two-controller roll tracking experiment designed to force the pilot to use rudder in order to coordinate and reduce the effects of aileron yaw. One model was computed for the case where the signals used to generate the spectral matrix are error and bank angle while another model was computed for the case where error and yaw angle are the inputs. Several anomalies were observed to be present in the experimental data. These are defined by the descriptive terms roll up, break up, and roll down. Due to these algorithm induced anomalies, the frequency band over which reliable estimates of power spectra can be achieved is considerably less than predicted by the sampling theorem.

Using public control genotype data to increase power and decrease cost of case-control genetic association studies.

PubMed

Ho, Lindsey A; Lange, Ethan M

2010-12-01

Genome-wide association (GWA) studies are a powerful approach for identifying novel genetic risk factors associated with human disease. A GWA study typically requires the inclusion of thousands of samples to have sufficient statistical power to detect single nucleotide polymorphisms that are associated with only modest increases in risk of disease given the heavy burden of a multiple test correction that is necessary to maintain valid statistical tests. Low statistical power and the high financial cost of performing a GWA study remains prohibitive for many scientific investigators anxious to perform such a study using their own samples. A number of remedies have been suggested to increase statistical power and decrease cost, including the utilization of free publicly available genotype data and multi-stage genotyping designs. Herein, we compare the statistical power and relative costs of alternative association study designs that use cases and screened controls to study designs that are based only on, or additionally include, free public control genotype data. We describe a novel replication-based two-stage study design, which uses free public control genotype data in the first stage and follow-up genotype data on case-matched controls in the second stage that preserves many of the advantages inherent when using only an epidemiologically matched set of controls. Specifically, we show that our proposed two-stage design can substantially increase statistical power and decrease cost of performing a GWA study while controlling the type-I error rate that can be inflated when using public controls due to differences in ancestry and batch genotype effects.

[Pathological and biochemical studies of 30 Niigata autopsy cases related to Minamata disease].

PubMed

Eto, Komyo; Takahashi, Hitoshi; Kakita, Akiyoshi; Tokunaga, Hidehiro; Yasutake, Akira; Nakano, Atsuhiro; Sawada, Masumi; Kinjo, Yoshihide

2007-01-01

To reevaluate pathologically and biochemically 30 autopsy cases related to Minamata disease (MD) in Niigata Prefecture (NP) and compare the findings with those of autopsy cases related to MD in Kumamoto Prefecture (KP). Recently, a set of pathological materials of these 30 autopsy cases has been sent from the Brain Research Institute at the University of Niigata to the National Institute for Minamata Disease (NIMD). The materials from each autopsy case were reexamined at the NIMD. There were no postnatal and fetal cases of MD in the NP autopsy materials. The contents of total mercury (T-Hg), methylmercury (Me-Hg), inorganic mercury (I-Hg) and selenium were measured in the organs of cerebrum, cerebellum, liver and kidney. The contents of T-Hg, Me-Hg and I-Hg were much higher in two cases than in controls. The pathological findings leading to the diagnosis of MD in the NP cases were essentially the same as those in KP, including the peripheral nerve lesions. In the most severely affected case of MD in NP, formation of multiple vacuoles of various sizes was observed in the cerebellar cortex, which was never encountered in the KP cases. The KP lesions were similar to that observed in an acute case of Me-Hg-treated common marmoset studied in the NIMD. The pathological features were essentially the same between the adult cases of MD in NP and KP.

Surgical pathology extradepartmental consultation practices.

PubMed

Azam, Muhammad; Nakhleh, Raouf E

2002-04-01

To document the practice parameters and case characteristics associated with personal (expert) consultations. We also examine the value, level of participant (customer) satisfaction, turnaround time, and rate of personal consultations. We asked participants in the College of American Pathologists' Q-Probes program to document cases sent for consultation during 4 months or up to 20 cases. They documented patient and specimen characteristics, the turnaround times, and the participants' levels of satisfaction with the consultation experience. One hundred eighty laboratories/surgical pathology practices. One hundred seventy-two (95.6%) were from the United States; the remainder were located in Canada and Australia. Rate and turnaround time of consultations and participant level of satisfaction. A total of 2746 consultation cases were examined for an aggregate consultation rate of 0.5% (median, 0.7%). Institutions with a higher occupied bed size and a greater number of surgical pathology cases both had lower consultation rates (P < or =.05). The median turnaround time (defined as the interval from the date on which the case was sent to the date on which the diagnosis was received) was 6 days. Twenty-nine percent and 68% of cases had a turnaround time within 3 and 7 days, respectively. Fifty-two percent of cases were sent to nationally known experts, and 32% were sent to local experts. Skin (18.0%), hematolymphoid (11.6%), and breast (9.6%) specimens were most commonly sent for consultation. In 70.5% of cases, the consultant confirmed the referring pathologist's original diagnosis, but in 15.9% of cases, the consultant also added significant information. Satisfaction rates were higher with faster turnaround times and verbal reporting. Satisfaction rates were lower for cases in which the patient or the clinician requested the consultation and in which the consultant's diagnosis was ambiguous. This study establishes a multi-institutional consultation rate of 0.5%, defines the nature of surgical pathology consultations, and demonstrates that satisfaction with consultations is associated with a faster turnaround time and receipt of additional, clinically meaningful information.

Impact of Multi-Media Tutorials in a Computer Science Laboratory Course--An Empirical Study

ERIC Educational Resources Information Center

Dalal, Medha

2014-01-01

Higher education institutes of North America, Europe and far-east Asia have been leveraging the advances in ICT for quite some time. However, research based knowledge on the use of ICT in the higher education institutes of central and south-east Asia is still not readily available. The study presented in this paper explores a variant of teaching…

Nomad devices for interactions in immersive virtual environments

NASA Astrophysics Data System (ADS)

George, Paul; Kemeny, Andras; Merienne, Frédéric; Chardonnet, Jean-Rémy; Thouvenin, Indira Mouttapa; Posselt, Javier; Icart, Emmanuel

2013-03-01

Renault is currently setting up a new CAVE™, a 5 rear-projected wall virtual reality room with a combined 3D resolution of 100 Mpixels, distributed over sixteen 4k projectors and two 2k projector as well as an additional 3D HD collaborative powerwall. Renault's CAVE™ aims at answering needs of the various vehicle conception steps [1]. Starting from vehicle Design, through the subsequent Engineering steps, Ergonomic evaluation and perceived quality control, Renault has built up a list of use-cases and carried out an early software evaluation in the four sided CAVE™ of Institute Image, called MOVE. One goal of the project is to study interactions in a CAVE™, especially with nomad devices such as IPhone or IPad to manipulate virtual objects and to develop visualization possibilities. Inspired by nomad devices current uses (multi-touch gestures, IPhone UI look'n'feel and AR applications), we have implemented an early feature set taking advantage of these popular input devices. In this paper, we present its performance through measurement data collected in our test platform, a 4-sided homemade low-cost virtual reality room, powered by ultra-short-range and standard HD home projectors.

Complex governance structures and incoherent policies: Implementing the EU water framework directive in Sweden.

PubMed

Söderberg, Charlotta

2016-12-01

Contemporary processes of environmental policymaking in general span over several territorial tiers. This also holds for the EU Water Framework Directive system of environmental quality standards (EQS), which are part of a complex multi-level institutional landscape, embracing both EU, national and sub-national level. Recent evaluations show that many EU member states, including Sweden, have not reached the ecological goals for water in 2015. Departing from theories on policy coherence and multi-level governance, this paper therefore analyses Swedish water governance as a case to further our understanding of policy implementation in complex governance structures: how does policy coherence (or the lack thereof) affect policy implementation in complex governance structures? To answer this question, the paper maps out the formal structure of the water governance system, focusing on power directions within the system, analyses policy coherence in Swedish water governance through mapping out policy conflicts between the EQS for water and other goals/regulations and explore how they are handled by national and sub-national water bureaucrats. The study concludes that without clear central guidance, 'good ecological status' for Swedish water will be difficult to achieve since incoherent policies makes policy implementation inefficient due to constant power struggles between different authorities, and since environmental goals are often overridden by economic and other societal goals. Further research is needed in order to explore if similar policy conflicts between water quality and other objectives occur in other EU member states and how bureaucrats handle such conflicts in different institutional settings. This study of the Swedish case indicates that the role of the state as a navigator and rudder-holder is important in order to improve policy implementation in complex governance structures - otherwise; bureaucrats risk being lost in an incoherent archipelago of ecological, social and economic goals. Copyright © 2016 Elsevier Ltd. All rights reserved.

Pediatric thymomas: report of two cases and comprehensive review of the literature.

PubMed

Fonseca, Annabelle L; Ozgediz, Doruk E; Christison-Lagay, Emily R; Detterbeck, Frank C; Caty, Michael G

2014-03-01

Thymomas are rare pediatric malignancies with indolent behavior. There are fewer than 50 reported cases and no comprehensive review. We sought to evaluate our recent experience with pediatric thymomas, and comprehensively review the extant literature. A systematic search of the PubMed database was performed using keywords: "thymoma", "pediatric", "juvenile", "childhood", and "child". Additional studies were identified by a manual search of the reference list. We report two patients with thymomas. We identified 22 case reports or series that described 48 patients; 62 % were male, 15 % presented with myasthenia gravis. Fifty percent were Masaoka Stage I, 15 % were Stage II, 13 % were Stage III, and 23 % were Stage IV. Four patients with early stage (I or II) disease were treated with adjuvant therapies in addition to surgical excision, while five patients with late stage (III or IV) disease treated with surgical excision alone. Of studies reporting at least 2-year follow-up, survival was 71 %. Pediatric thymomas are rare tumors with a slight male predominance. Wide variations were observed in the treatment of thymomas across all stages. Our review indicates a need for large database and multi-institutional studies to clearly elucidate clinical course, prognostic factors and outcome.

Multi-sensor satellite monitoring of ash and SO2 volcanic plume in support to aviation control

NASA Astrophysics Data System (ADS)

Brenot, Hugues; Theys, Nicolas; Clarisse, Lieven; van Geffen, Jos; van Gent, Jeroen; Van Roozendael, Michel; van der A, Ronald; Hurtmans, Daniel; Coheur, Pierre-Francois; Clerbaux, Cathy; Valks, Pieter; Hedelt, Pascal; Prata, Fred; Rasson, Olivier; Sievers, Klaus; Zehner, Claus

2014-05-01

The 'Support to Aviation Control Service' (SACS; http://sacs.aeronomie.be) is an ESA-funded project hosted by the Belgian Institute for Space Aeronomy since 2007. The service provides near real-time (NRT) global volcanic ash and SO2 observations, as well as notifications in case of volcanic eruptions (success rate >95% for ash and SO2). SACS is based on the combined use of UV-visible (OMI, GOME-2 MetOp-A, GOME-2 MetOp-B) and infrared (AIRS, IASI MetOp-A, IASI MetOp-B) satellite instruments. The SACS service is primarily designed to support the Volcanic Ash Advisory Centers (VAACs) in their mandate to gather information on volcanic clouds and give advice to airline and air traffic control organisations. SACS also serves other users that subscribe to the service, in particular local volcano observatories, research scientists and airliner pilots. When a volcanic eruption is detected, SACS issues a warning that takes the form of a notification sent by e-mail to users. The SACS notification points to a dedicated web page where all relevant information is available and can be visualised with user-friendly tools. Information about the volcanic plume height from GOME-2 (MetOp-A and MetOp-B) are also available. The strength of a multi-sensor approach relies in the use of satellite data with different overpasses times, minimising the time-lag for detection and enhancing the reliability of such alerts. This presentation will give an overview of the SACS service, and of the different techniques used to detect volcanic plumes (ash, SO2 and plume height). It will also highlight the strengths and limitations of the service and measurements, and some perspectives.

A Qualitative Study of Tribal Colleges and Universities that Have Transitioned: From Two-Year Associate Degree Granting Institutions to Targeted Four-Year Bachelor Degree Granting Institutions

ERIC Educational Resources Information Center

Chandler, Lynette

2010-01-01

The purpose of this qualitative case study was to analyze how tribal colleges and Universities have transitioned from two-year associate degree granting institutions to offering four-year bachelor degree granting institutions. This case study includes three tribal colleges: Sitting Bull College, Salish Kootenai College and Turtle Mountain…

[Alcoholism during pregnancy: an underestimated health problem].

PubMed

Montesinos Balboa, Jorge Eduardo; Altúzar González, Marlene; Benítez Castillejos, Fortunato

2004-10-01

To identify the frequency of consumption of alcohol in pregnant women who went to a module of prenatal control; to describe the consumption habits and to identify the number of cases in those that the physician of first level identified the addiction, using the institutional instruments. A descriptive and prospective study was carried out, the study population was selected by means of non randomized sampling of the total of pregnant women who went to receive services of prenatal control, in two units of family medicine of the Mexican Institute of Social Security, of Tapachula, Chiapas, Mexico. The instrument AUDIT (Alcoholism Disorders Identification Test) was used, to identify use-frequency, abuse, dependence and physical/mental damage conditioned by the alcohol. In 132 studied women, it found a frequency of 45.5% of pregnant women with positive consumption and a case of dependence, none of which was identified by the family doctor. The consumption of alcohol in the studied population is high, even bigger than the frequency detected in populations of non pregnant women. The use of detection tests such as the AUDIT and the implementation of measures guided to the training and the personnel's of health sensitization about the magnitude and impact of this problem are recommended.

Assessing the challenges of multi-scope clinical research sites: an example from NIH HIV/AIDS clinical trials networks.

PubMed

Rosas, Scott R; Cope, Marie T; Villa, Christie; Motevalli, Mahnaz; Utech, Jill; Schouten, Jeffrey T

2014-04-01

Large-scale, multi-network clinical trials are seen as a means for efficient and effective utilization of resources with greater responsiveness to new discoveries. Formal structures instituted within the National Institutes of Health (NIH) HIV/AIDS Clinical Trials facilitate collaboration and coordination across networks and emphasize an integrated approach to HIV/AIDS vaccine, prevention and therapeutics clinical trials. This study examines the joint usage of clinical research sites as means of gaining efficiency, extending capacity, and adding scientific value to the networks. A semi-structured questionnaire covering eight clinical management domains was administered to 74 (62% of sites) clinical site coordinators at single- and multi-network sites to identify challenges and efficiencies related to clinical trials management activities and coordination with multi-network units. Overall, respondents at multi-network sites did not report more challenges than single-network sites, but did report unique challenges to overcome including in the areas of study prioritization, community engagement, staff education and training, and policies and procedures. The majority of multi-network sites reported that such affiliations do allow for the consolidation and cost-sharing of research functions. Suggestions for increasing the efficiency or performance of multi-network sites included streamlining standards and requirements, consolidating protocol activation methods, using a single cross-network coordinating centre, and creating common budget and payment mechanisms. The results of this assessment provide important information to consider in the design and management of multi-network configurations for the NIH HIV/AIDS Clinical Trials Networks, as well as others contemplating and promoting the concept of multi-network settings. © 2013 John Wiley & Sons Ltd.

Spirocercosis in dogs in Israel: A retrospective case-control study (2004-2009).

PubMed

Aroch, Itamar; Markovics, Alexander; Mazaki-Tovi, Michal; Kuzi, Sharon; Harrus, Shimon; Yas, Einat; Baneth, Gad; Bar-El, Maya; Bdolah-Abram, Tali; Segev, Gilad; Lavy, Eran

2015-07-30

This case-control retrospective study (years 2004-2009) investigated the epidemiological, clinical, and diagnostic test findings of dogs with esophageal spirocercosis (ES) presented to the Hebrew University Veterinary Teaching Hospital (HUVTH) and coproscopy-positive dogs at the Kimron Veterinary Institute (KVI), Israel. It included 133 dogs with ES and 133 negative controls diagnosed at the hospital, and 343 dogs diagnosed at the KVI. The average incidence of ES at the HUVTH was 22.5/year, and the percentage of spirocercosis cases was stable at both institutions (HUVTH, 0.67-1.23%; KVI, 5-8%). Dogs aged > 5 years old had 100-fold likelihood to be infected compared to dogs aged ≤ 1 year of age (P < 0.001). Mean body weight (P = 0.0004), proportion of Retrievers (P = 0.002) and sporting breed dogs (P = 0.006) were higher, while proportion of toy breeds (P = 0.004) was lower in the ES group compared to the control group. The proportion of cases from Greater Tel-Aviv decreased (P = 0.002), while that of those from Judea and Jerusalem increased (P = 0.01) compared to the 1990 s. Spirocercosis occurred in 22 dogs despite past prophylactic avermectin treatment. Vomiting and regurgitation were the most common clinical signs of ES. Coproscopy was S. lupi-positive in 33/60 dogs (55.0%). The median number of esophageal nodules was two (range 1-8), with a median diameter of 3.5 cm (range 1.0-11.0). Malignant esophageal lesion transformation was confirmed in 29 dogs (22%). Despite preventive attempts, spirocercosis has spread in Israel over time, compared to previous findings, raising questions about the efficacy of the currently accepted prophylactic protocol is incompletely effective. Copyright © 2015 Elsevier B.V. All rights reserved.

Harry Mergler with His Modified Differential Analyzer

NASA Image and Video Library

1951-06-21

Harry Mergler stands at the control board of a differential analyzer in the new Instrument Research Laboratory at the National Advisory Committee for Aeronautics (NACA) Lewis Flight Propulsion Laboratory. The differential analyzer was a multi-variable analog computation machine devised in 1931 by Massachusetts Institute of Technology researcher and future NACA Committee member Vannevar Bush. The mechanical device could solve computations up to the sixth order, but had to be rewired before each new computation. Mergler modified Bush’s differential analyzer in the late 1940s to calculate droplet trajectories for Lewis’ icing research program. In four days Mergler’s machine could calculate what previously required weeks. NACA Lewis built the Instrument Research Laboratory in 1950 and 1951 to house the large analog computer equipment. The two-story structure also provided offices for the Mechanical Computational Analysis, and Flow Physics sections of the Physics Division. The division had previously operated from the lab’s hangar because of its icing research and flight operations activities. Mergler joined the Instrument Research Section of the Physics Division in 1948 after earning an undergraduate degree in Physics from the Case Institute of Technology. Mergler’s focus was on the synthesis of analog computers with the machine tools used to create compressor and turbine blades for jet engines.

Parallel Unsteady Overset Mesh Methodology for a Multi-Solver Paradigm with Adaptive Cartesian Grids

DTIC Science & Technology

2008-08-21

Engineer, U.S. Army Research Laboratory ., Matthew.W.Floros@nasa.gov, AIAA Member ‡Senior Research Scientist, Scaled Numerical Physics LLC., awissink...IV.E and IV.D). Good linear scalability was observed for all three cases up to 12 processors. Beyond that the scalability drops off depending on grid...Research Laboratory for the usage of SUGGAR module and Yikloon Lee at NAVAIR for the usage of the NAVAIR-IHC code. 13 of 22 American Institute of

Nipple sparing mastectomy: Surgical and oncological outcomes from a national multicentric registry with 913 patients (1006 cases) over a six year period.

PubMed

Orzalesi, Lorenzo; Casella, Donato; Santi, Caterina; Cecconi, Lorenzo; Murgo, Roberto; Rinaldi, Stefano; Regolo, Lea; Amanti, Claudio; Roncella, Manuela; Serra, Margherita; Meneghini, Graziano; Bortolini, Massimiliano; Altomare, Vittorio; Cabula, Carlo; Catalano, Francesca; Cirilli, Alfredo; Caruso, Francesco; Lazzaretti, Maria Grazia; Cataliotti, Luigi; Bernini, Marco

2016-02-01

Nipple sparing mastectomy is deemed surgically and oncologically safe based on a long lasting literature data from reviews of single institution series. This study aims at evaluating surgical and oncological outcomes of NSM on a large multi-institutional scale, by means of the Italian National registry. In July 2011 a panel of Italian specialists agreed upon and designed a National database of NSM. Centers with at least 150 cancers per year and following the National follow-up schedule guidelines could participate inserting any NSM case performed, retrospectively and prospectively from that moment on. In March 2015 analysis of data was accomplished. Dataset for this study consists of cases performed in the period between January 1st 2009 and December 31st 2014. 913 Women were included in the analysis, for a total of 1006 procedures. Prophylactic mastectomies were 124 (12.3%). MRI utilization increased over time. NSM failure rate, with NAC removal for any reason was 11.5%. NAC necrosis rate was 4.8%. Larger skin-flap necrosis rate was 2.3%. Major surgical complications rate was 4.4%. Oncological outcomes were calculated among primitive EBC cases only: locoregional recurrences rate was 2.9%, NAC recurrence 0.7%. Systemic recurrence rate was 1.0%. Five deaths (0.7%) were registered. More than 10% of NSM procedures are prophylactic mastectomies. MRI is gaining more importance over time. Surgical and oncological results show that NSM is effective. This National multicentric analysis enables a comparison of results with no geographical differences and a "safe" state of the art of NSM in Italy. Copyright © 2015 Elsevier Ltd. All rights reserved.

Climate change adaptation under uncertainty in the developing world: A case study of sea level rise in Kiribati

NASA Astrophysics Data System (ADS)

Donner, S. D.; Webber, S.

2011-12-01

Climate change is expected to have the greatest impact in parts of the developing world. At the 2010 meeting of U.N. Framework Convention on Climate Change in Cancun, industrialized countries agreed in principle to provide US$100 billion per year by 2020 to assist the developing world respond to climate change. This "Green Climate Fund" is a critical step towards addressing the challenge of climate change. However, the policy and discourse on supporting adaptation in the developing world remains highly idealized. For example, the efficacy of "no regrets" adaptation efforts or "mainstreaming" adaptation into decision-making are rarely evaluated in the real world. In this presentation, I will discuss the gap between adaptation theory and practice using a multi-year case study of the cultural, social and scientific obstacles to adapting to sea level rise in the Pacific atoll nation of Kiribati. Our field research reveals how scientific and institutional uncertainty can limit international efforts to fund adaptation and lead to spiraling costs. Scientific uncertainty about hyper-local impacts of sea level rise, though irreducible, can at times limit decision-making about adaptation measures, contrary to the notion that "good" decision-making practices can incorporate scientific uncertainty. Efforts to improve institutional capacity must be done carefully, or they risk inadvertently slowing the implementation of adaptation measures and increasing the likelihood of "mal"-adaptation.

Predictive Model and Methodology for Heat Treatment Distortion Final Report CRADA No. TC-298-92

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

Nikkel, D. J.; McCabe, J.

This project was a multi-lab, multi-partner CRADA involving LLNL, Los Alamos National Laboratory, Sandia National Laboratories, Oak Ridge National Laboratory, Martin Marietta Energy Systems and the industrial partner, The National Center of Manufacturing Sciences (NCMS). A number of member companies of NCMS participated including General Motors Corporation, Ford Motor Company, The Torrington Company, Gear Research, the Illinois Institute of Technology Research Institute, and Deformation Control Technology •. LLNL was the lead laboratory for metrology technology used for validation of the computational tool/methodology. LLNL was also the lead laboratory for the development of the software user interface , for the computationalmore » tool. This report focuses on the participation of LLNL and NCMS. The purpose of the project was to develop a computational tool/methodology that engineers would use to predict the effects of heat treatment on the _size and shape of industrial parts made of quench hardenable alloys. Initially, the target application of the tool was gears for automotive power trains.« less

A problem of optimal control and observation for distributed homogeneous multi-agent system

NASA Astrophysics Data System (ADS)

Kruglikov, Sergey V.

2017-12-01

The paper considers the implementation of a algorithm for controlling a distributed complex of several mobile multi-robots. The concept of a unified information space of the controlling system is applied. The presented information and mathematical models of participants and obstacles, as real agents, and goals and scenarios, as virtual agents, create the base forming the algorithmic and software background for computer decision support system. The controlling scheme assumes the indirect management of the robotic team on the basis of optimal control and observation problem predicting intellectual behavior in a dynamic, hostile environment. A basic content problem is a compound cargo transportation by a group of participants in the case of a distributed control scheme in the terrain with multiple obstacles.

Comparison of the Relationship between Women' Empowerment and Fertility between Single-child and Multi-child Families

PubMed Central

Saberi, Tahereh; Ehsanpour, Soheila; Mahaki, Behzad; Kohan, Shahnaz

2018-01-01

Background: The reduction in fertility and increase in the number of single-child families in Iran will result in an increased risk of population aging. One of the factors affecting fertility is women's empowerment. This study aimed to evaluate the relationship between women's empowerment and fertility in single-child and multi-child families. Materials and Methods: This case-control study was conducted among 350 women (120 who had only 1 child as case group and 230 who had 2 or more children as control group) of 15–49 years of age in Isfahan, Iran, in 2016. For data collection, a 2-part questionnaire was designed. Data were analyzed using independent t-test, Chi-square test, and logistic regression analysis. Results: The difference between average scores of women's empowerment in the case group 54.08 (9.88) and control group 51.47 (8.57) was significant (p = 0.002). Simple logistic regression analysis showed that under diploma education, compared to postgraduate education, (OR = 0.21, p = 0.001) and being a housewife, compared to being employed, (OR = 0.45, p = 0.004) decreased the odds of having only 1 child. Multiple logistic regression results showed that the relationship between women's empowerment and fertility was not significant (p = 0.265). Conclusions: Although women in single-child families were more empowered, this was not the main reason for their preference to have only 1 child. In fact, educated and employed women postpone marriage and childbearing and limit fertility to only 1 child despite their desire. PMID:29628961

Diagnosis of neglected tropical diseases among patients with persistent digestive disorders (diarrhoea and/or abdominal pain ≥14 days): Pierrea multi-country, prospective, non-experimental case-control study.

PubMed

Polman, Katja; Becker, Sören L; Alirol, Emilie; Bhatta, Nisha K; Bhattarai, Narayan R; Bottieau, Emmanuel; Bratschi, Martin W; Burza, Sakib; Coulibaly, Jean T; Doumbia, Mama N; Horié, Ninon S; Jacobs, Jan; Khanal, Basudha; Landouré, Aly; Mahendradhata, Yodi; Meheus, Filip; Mertens, Pascal; Meyanti, Fransiska; Murhandarwati, Elsa H; N'Goran, Eliézer K; Peeling, Rosanna W; Ravinetto, Raffaella; Rijal, Suman; Sacko, Moussa; Saye, Rénion; Schneeberger, Pierre H H; Schurmans, Céline; Silué, Kigbafori D; Thobari, Jarir A; Traoré, Mamadou S; van Lieshout, Lisette; van Loen, Harry; Verdonck, Kristien; von Müller, Lutz; Yansouni, Cédric P; Yao, Joel A; Yao, Patrick K; Yap, Peiling; Boelaert, Marleen; Chappuis, François; Utzinger, Jürg

2015-08-18

Diarrhoea still accounts for considerable mortality and morbidity worldwide. The highest burden is concentrated in tropical areas where populations lack access to clean water, adequate sanitation and hygiene. In contrast to acute diarrhoea (<14 days), the spectrum of pathogens that may give rise to persistent diarrhoea (≥14 days) and persistent abdominal pain is poorly understood. It is conceivable that pathogens causing neglected tropical diseases play a major role, but few studies investigated this issue. Clinical management and diagnostic work-up of persistent digestive disorders in the tropics therefore remain inadequate. Hence, important aspects regarding the pathogenesis, epidemiology, clinical symptomatology and treatment options for patients presenting with persistent diarrhoea and persistent abdominal pain should be investigated in multi-centric clinical studies. This multi-country, prospective, non-experimental case-control study will assess persistent diarrhoea (≥14 days; in individuals aged ≥1 year) and persistent abdominal pain (≥14 days; in children/adolescents aged 1-18 years) in up to 2000 symptomatic patients and 2000 matched controls. Subjects from Côte d'Ivoire, Indonesia, Mali and Nepal will be clinically examined and interviewed using a detailed case report form. Additionally, each participant will provide a stool sample that will be examined using a suite of diagnostic methods (i.e., microscopic techniques, rapid diagnostic tests, stool culture and polymerase chain reaction) for the presence of bacterial and parasitic pathogens. Treatment will be offered to all infected participants and the clinical treatment response will be recorded. Data obtained will be utilised to develop patient-centred clinical algorithms that will be validated in primary health care centres in the four study countries in subsequent studies. Our research will deepen the understanding of the importance of persistent diarrhoea and related digestive disorders in the tropics. A diversity of intestinal pathogens will be assessed for potential associations with persistent diarrhoea and persistent abdominal pain. Different diagnostic methods will be compared, clinical symptoms investigated and diagnosis-treatment algorithms developed for validation in selected primary health care centres. The findings from this study will improve differential diagnosis and evidence-based clinical management of digestive syndromes in the tropics. ClinicalTrials.gov; identifier: NCT02105714 .

The effects of particulate air pollution on daily deaths: a multi-city case crossover analysis

PubMed Central

Schwartz, J

2004-01-01

Background: Numerous studies have reported that day-to-day changes in particulate air pollution are associated with day-to-day changes in deaths. Recently, several reports have indicated that the software used to control for season and weather in some of these studies had deficiencies. Aims: To investigate the use of the case-crossover design as an alternative. Methods: This approach compares the exposure of each case to their exposure on a nearby day, when they did not die. Hence it controls for seasonal patterns and for all slowly varying covariates (age, smoking, etc) by matching rather than complex modelling. A key feature is that temperature can also be controlled by matching. This approach was applied to a study of 14 US cities. Weather and day of the week were controlled for in the regression. Results: A 10 µg/m3 increase in PM10 was associated with a 0.36% increase in daily deaths from internal causes (95% CI 0.22% to 0.50%). Results were little changed if, instead of symmetrical sampling of control days the time stratified method was applied, when control days were matched on temperature, or when more lags of winter time temperatures were used. Similar results were found using a Poisson regression, but the case-crossover method has the advantage of simplicity in modelling, and of combining matched strata across multiple locations in a single stage analysis. Conclusions: Despite the considerable differences in analytical design, the previously reported associations of particles with mortality persisted in this study. The association appeared quite linear. Case-crossover designs represent an attractive method to control for season and weather by matching. PMID:15550600

Study protocol for a multi-institutional, randomised, double-blinded, placebo-controlled phase III trial investigating additive efficacy of duloxetine for neuropathic cancer pain refractory to opioids and gabapentinoids: the DIRECT study.

PubMed

Matsuoka, Hiromichi; Ishiki, Hiroto; Iwase, Satoru; Koyama, Atsuko; Kawaguchi, Takashi; Kizawa, Yoshiyuki; Morita, Tatsuya; Matsuda, Yoshinobu; Miyaji, Tempei; Ariyoshi, Keisuke; Yamaguchi, Takuhiro

2017-08-28

Management of patients with cancer suffering from neuropathic pain refractory to opioids and gabapentinoids remains an important challenge. Duloxetine is one of the choices after first-line treatment fails. The efficacy of duloxetine has been reported in patients with non-cancer disease and in chemotherapy-induced peripheral neuropathy, but no randomised clinical trials have examined its effects on neuropathic cancer pain refractory to first-line treatment. The objective of this study is to assess the analgesic efficacy of duloxetine in patients suffering from neuropathic cancer pain refractory to opioids and gabapentinoids. A multi-institutional, prospective, randomised, double-blind, placebo-controlled, two-parallel trial is planned. The inclusion criteria are adult patients with cancer suffering from neuropathic cancer pain refractory to opioids and gabapentinoids, patients with a Numerical Rating Scale (NRS) pain score of 4 or higher and patients with a total Hospital Anxiety and Depression Scale score of less than 20. Patients with chemotherapy-induced peripheral neuropathy are excluded. The study will take place at 14 sites across Japan. Participants will be randomised (1:1 allocation ratio) to a duloxetine intervention group or a placebo control group. Evaluations will be made at baseline (T0 randomisation), day 0 (T1), day 3 (T2) and day 10 (T3). The primary endpoint is defined as the difference in NRS score for pain intensity (average over the previous 24 hours) at T3 between the duloxetine and placebo groups. A sample size of 70 patients will be examined between July 2015 and March 2018. Ethics approval was obtained at all participating sites.The results of this study will be submitted for publication in international peer-reviewed journals and the key findings presented at international scientific conferences. UMIN000017647; Pre-results. 2.2, 26 April 2017. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Tuberculosis recurrence and its risk factors].

PubMed

de Oliveira, H B; Moreira Filho, D de C

2000-04-01

The persistence of tuberculosis bacilli in patients who are cured, thus causing recurrence, is an important issue. This case-control study investigated individual and institutional risk factors for relapse by analyzing independent variables related to the patient, the use of antituberculosis drugs, and the service delivered at health care institutions; 56 cases and 105 controls were interviewed. Recurrence was defined as a new tuberculosis episode after the patient had been successfully treated. Controls were selected from among patients who were treated and cured of pulmonary tuberculosis and who did not experience a relapse. Regression models were proposed to control confounding factors or effect modifiers. The variables identified as risk factors for relapse were those related to erratic patient behavior (missing medical appointments and therefore not picking up the medication, not taking the medication, taking the wrong dosage), age, and stress from life events; adverse reactions to antituberculosis drugs; and problems in the organization of health care services that resulted in patients receiving insufficient dosages or amounts of antituberculosis drugs. Receiving information regarding treatment duration provided protection against recurrence. The knowledge regarding these risk factors should result in more intensive follow-up and in more use of directly observed treatment of tuberculosis in order to prevent relapse.

A GIS-based multi-source and multi-box modeling approach (GMSMB) for air pollution assessment--a North American case study.

PubMed

Wang, Bao-Zhen; Chen, Zhi

2013-01-01

This article presents a GIS-based multi-source and multi-box modeling approach (GMSMB) to predict the spatial concentration distributions of airborne pollutant on local and regional scales. In this method, an extended multi-box model combined with a multi-source and multi-grid Gaussian model are developed within the GIS framework to examine the contributions from both point- and area-source emissions. By using GIS, a large amount of data including emission sources, air quality monitoring, meteorological data, and spatial location information required for air quality modeling are brought into an integrated modeling environment. It helps more details of spatial variation in source distribution and meteorological condition to be quantitatively analyzed. The developed modeling approach has been examined to predict the spatial concentration distribution of four air pollutants (CO, NO(2), SO(2) and PM(2.5)) for the State of California. The modeling results are compared with the monitoring data. Good agreement is acquired which demonstrated that the developed modeling approach could deliver an effective air pollution assessment on both regional and local scales to support air pollution control and management planning.

Collaborative Teaching and Learning through Multi-Institutional Integrated Group Projects

ERIC Educational Resources Information Center

Long, Suzanna K.; Carlo, Héctor J.

2013-01-01

This teaching brief describes an innovative multi-institutional initiative through which integrated student groups from different courses collaborate on a common course project. In this integrated group project, students are asked to design a decentralized manufacturing organization for a company that will manufacture industrial Proton-Exchange…

A multi-institutional survey of interventional radiology for type II endoleaks after endovascular aortic repair: questionnaire results from the Japanese Society of Endoluminal Metallic Stents and Grafts in Japan.

PubMed

Ogawa, Yukihisa; Nishimaki, Hiroshi; Osuga, Keigo; Ikeda, Osamu; Hongo, Norio; Iwakoshi, Shinichi; Kawasaki, Ryota; Woodhams, Reiko; Yamaguchi, Masato; Kamiya, Mika; Kanematsu, Masayuki; Honda, Masanori; Kaminou, Toshio; Koizumi, Jun; Kichikawa, Kimihiko

2016-08-01

To investigate the current status of interventional radiology (IR) procedures for a type II endoleak (T2EL) in Japan, and to identify the technical aspects that affect treatment results. A retrospective survey was conducted by distributing questionnaires to 25 institutions. The eligibility criteria were endovascular aortic repair (EVAR) performed using commercial stent grafts and IR performed for T2EL between January 2007 and December 2013. Technical success was defined as disappearance of the EL on digital subtraction angiography immediately after embolization, and imaging success was defined as no EL on contrast-enhanced computed tomography within 6 months. Statistical comparisons of the number of involved branches, embolization level, embolic material, and changes in aneurysm size were made between the imaging success and imaging failure groups. The technical and imaging success rates were also compared between the initial therapy and repeat groups. A total of 166 cases were investigated. Initial therapy was performed in 147 cases (88.6 %), with repeat therapy in 19 cases (11.4 %). Transcatheter arterial embolization (TAE) was used most frequently, in 161 cases (97 %), with direct puncture (DP) used in 5 cases (3 %). Both coil embolization for the branches and NBCA embolization for the sac were frequently chosen. The technical success rate was 83.2 % (TAE group), and the imaging success rate was 46.5 % (TAE + DP groups). Branch + sac embolization was performed more frequently in the imaging success group. There was no significant difference in the number of involved branches or embolic material between the imaging success and imaging failure groups. Enlargement of the aneurysm was more frequently seen in the imaging failure group. There were no significant differences in the technical success and imaging success rates between the initial therapy and repeat groups. This is the first report of a multi-institutional questionnaire survey of IR procedures for T2EL after EVAR in Japan that was conducted to determine the current status. Enlargement of aneurysm size after embolization was more frequently seen in the imaging failure group. It is important to embolize both branch and sac to achieve imaging success, regardless of embolic material. Long-term outcomes need to be investigated.

Biomarkers for Early Detection of Clinically Relevant Prostate Cancer: A Multi-Institutional Validation Trial

DTIC Science & Technology

2017-10-01

been shown in many studies to improve predictive accuracy for cancer on initial biopsy,3,7-9 and to be correlated with more aggressive cancer at...our multi-center, prospectively accrued prostate cancer active surveillance cohort – the Canary Prostate Active Surveillance Study (PASS). We are in...objective of the study is to utilize analytically validated assays that take into account tumor heterogeneity to measure biomarkers in specimens that were

"This Is a Beautiful School." "This School Is Useless!!" Explaining Disengagement in a Greek Vocational School through the Examination of Teacher Ideologies

ERIC Educational Resources Information Center

Giannakaki, Marina-Stefania; Batziakas, Georgios

2016-01-01

This multi-method case study of a Greek vocational school explored teachers' culture (including beliefs about education, teachers' role, and students' nature) using the concept of pupil control ideology to explain problems of disengagement and low morale among staff and students, as well as tensions in relationships. A prominent custodial culture…

Many roads may lead to Rome: Selected features of quality control within environmental assessment systems in the US, NL, CA, and UK

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

Günther, Markus, E-mail: markus.guenther@tu-berlin.de; Geißler, Gesa; Köppel, Johann

As there is no one-and-only concept on how to precisely define and establish quality control (QC) or quality assurance (QA) in the making of environmental assessments (EA), this paper presents selected features of international approaches that address quality in EA systems in the USA, the Netherlands, Canada, and the United Kingdom. Based on explanative case studies, we highlight the embedding of specific quality control features within the EA systems, the objectives and processes, and relevant transparency challenges. Such features of QC/QA approaches can be considered in cases where substantial quality control and assurance efforts are still missing. Yet further researchmore » needs to be conducted on the efficacy of these approaches, which remains beyond the scope of this study. - Highlights: • We present four tools for quality control and assurance from different EA systems. • Approaches vary in institutional setting, objectives, procedures, and transparency. • Highlighted features might provide guidance in cases where QC/QA is still lacking.« less

Achieving cannabis cessation -- evaluating N-acetylcysteine treatment (ACCENT): design and implementation of a multi-site, randomized controlled study in the National Institute on Drug Abuse Clinical Trials Network.

PubMed

McClure, Erin A; Sonne, Susan C; Winhusen, Theresa; Carroll, Kathleen M; Ghitza, Udi E; McRae-Clark, Aimee L; Matthews, Abigail G; Sharma, Gaurav; Van Veldhuisen, Paul; Vandrey, Ryan G; Levin, Frances R; Weiss, Roger D; Lindblad, Robert; Allen, Colleen; Mooney, Larissa J; Haynes, Louise; Brigham, Gregory S; Sparenborg, Steve; Hasson, Albert L; Gray, Kevin M

2014-11-01

Despite recent advances in behavioral interventions for cannabis use disorders, effect sizes remain modest, and few individuals achieve long-term abstinence. One strategy to enhance outcomes is the addition of pharmacotherapy to complement behavioral treatment, but to date no efficacious medications targeting cannabis use disorders in adults through large, randomized controlled trials have been identified. The National Institute on Drug Abuse Clinical Trials Network (NIDA CTN) is currently conducting a study to test the efficacy of N-acetylcysteine (NAC) versus placebo (PBO), added to contingency management, for cannabis cessation in adults (ages 18-50). This study was designed to replicate positive findings from a study in cannabis-dependent adolescents that found greater odds of abstinence with NAC compared to PBO. This paper describes the design and implementation of an ongoing 12-week, intent-to-treat, double-blind, randomized, placebo-controlled study with one follow-up visit four weeks post-treatment. Approximately 300 treatment-seeking cannabis-dependent adults will be randomized to NAC or PBO across six study sites in the United States. The primary objective of this 12-week study is to evaluate the efficacy of twice-daily orally-administered NAC (1200 mg) versus matched PBO, added to contingency management, on cannabis abstinence. NAC is among the first medications to demonstrate increased odds of abstinence in a randomized controlled study among cannabis users in any age group. The current study will assess the cannabis cessation efficacy of NAC combined with a behavioral intervention in adults, providing a novel and timely contribution to the evidence base for the treatment of cannabis use disorders. Copyright © 2014 Elsevier Inc. All rights reserved.

Achieving Cannabis Cessation - Evaluating N-acetylcysteine Treatment (ACCENT): Design and implementation of a multi-site, randomized controlled study in the National Institute on Drug Abuse Clinical Trials Network

PubMed Central

McClure, Erin A.; Sonne, Susan C.; Winhusen, Theresa; Carroll, Kathleen M.; Ghitza, Udi E.; McRae-Clark, Aimee L.; Matthews, Abigail G.; Sharma, Gaurav; Van Veldhuisen, Paul; Vandrey, Ryan G.; Levin, Frances R.; Weiss, Roger D.; Lindblad, Robert; Allen, Colleen; Mooney, Larissa J.; Haynes, Louise; Brigham, Gregory S.; Sparenborg, Steve; Hasson, Albert L.; Gray, Kevin M.

2014-01-01

Despite recent advances in behavioral interventions for cannabis use disorders, effect sizes remain modest, and few individuals achieve long-term abstinence. One strategy to enhance outcomes is the addition of pharmacotherapy to complement behavioral treatment, but to date no efficacious medications targeting cannabis use disorders in adults through large, randomized controlled trials have been identified. The National Institute on Drug Abuse Clinical Trials Network (NIDA CTN) is currently conducting a study to test the efficacy of N-acetylcysteine (NAC) versus placebo (PBO), added to contingency management, for cannabis cessation in adults (ages 18–50). This study was designed to replicate positive findings from a study in cannabis-dependent adolescents that found greater odds of abstinence with NAC compared to PBO. This paper describes the design and implementation of an ongoing 12-week, intent-to-treat, double-blind, randomized, placebo-controlled study with one follow-up visit four weeks post-treatment. Approximately 300 treatment-seeking cannabis-dependent adults will be randomized to NAC or PBO across six study sites in the United States. The primary objective of this 12-week study is to evaluate the efficacy of twice-daily orally-administered NAC (1200 mg) versus matched PBO, added to contingency management, on cannabis abstinence. NAC is among the first medications to demonstrate increased odds of abstinence in a randomized controlled study among cannabis users in any age group. The current study will assess the cannabis cessation efficacy of NAC combined with a behavioral intervention in adults, providing a novel and timely contribution to the evidence base for the treatment of cannabis use disorders. PMID:25179587

A comparison of two multi-variable integrator windup protection schemes

NASA Technical Reports Server (NTRS)

Mattern, Duane

1993-01-01

Two methods are examined for limit and integrator wind-up protection for multi-input, multi-output linear controllers subject to actuator constraints. The methods begin with an existing linear controller that satisfies the specifications for the nominal, small perturbation, linear model of the plant. The controllers are formulated to include an additional contribution to the state derivative calculations. The first method to be examined is the multi-variable version of the single-input, single-output, high gain, Conventional Anti-Windup (CAW) scheme. Except for the actuator limits, the CAW scheme is linear. The second scheme to be examined, denoted the Modified Anti-Windup (MAW) scheme, uses a scalar to modify the magnitude of the controller output vector while maintaining the vector direction. The calculation of the scalar modifier is a nonlinear function of the controller outputs and the actuator limits. In both cases the constrained actuator is tracked. These two integrator windup protection methods are demonstrated on a turbofan engine control system with five measurements, four control variables, and four actuators. The closed-loop responses of the two schemes are compared and contrasted during limit operation. The issue of maintaining the direction of the controller output vector using the Modified Anti-Windup scheme is discussed and the advantages and disadvantages of both of the IWP methods are presented.

Consistency of clinical biomechanical measures between three different institutions: implications for multi-center biomechanical and epidemiological research.

PubMed

Myer, Gregory D; Wordeman, Samuel C; Sugimoto, Dai; Bates, Nathaniel A; Roewer, Benjamin D; Medina McKeon, Jennifer M; DiCesare, Christopher A; Di Stasi, Stephanie L; Barber Foss, Kim D; Thomas, Staci M; Hewett, Timothy E

2014-05-01

Multi-center collaborations provide a powerful alternative to overcome the inherent limitations to single-center investigations. Specifically, multi-center projects can support large-scale prospective, longitudinal studies that investigate relatively uncommon outcomes, such as anterior cruciate ligament injury. This project was conceived to assess within- and between-center reliability of an affordable, clinical nomogram utilizing two-dimensional video methods to screen for risk of knee injury. The authors hypothesized that the two-dimensional screening methods would provide good-to-excellent reliability within and between institutions for assessment of frontal and sagittal plane biomechanics. Nineteen female, high school athletes participated. Two-dimensional video kinematics of the lower extremity during a drop vertical jump task were collected on all 19 study participants at each of the three facilities. Within-center and between-center reliability were assessed with intra- and inter-class correlation coefficients. Within-center reliability of the clinical nomogram variables was consistently excellent, but between-center reliability was fair-to-good. Within-center intra-class correlation coefficient for all nomogram variables combined was 0.98, while combined between-center inter-class correlation coefficient was 0.63. Injury risk screening protocols were reliable within and repeatable between centers. These results demonstrate the feasibility of multi-site biomechanical studies and establish a framework for further dissemination of injury risk screening algorithms. Specifically, multi-center studies may allow for further validation and optimization of two-dimensional video screening tools. 2b.

Matched-pair analysis of a multi-institutional cohort reveals that epidermal growth factor receptor mutation is not a risk factor for postoperative recurrence of lung adenocarcinoma.

PubMed

Matsumura, Yuki; Suzuki, Hiroyuki; Ohira, Tetsuya; Shiono, Satoshi; Abe, Jiro; Sagawa, Motoyasu; Sakurada, Akira; Katahira, Masato; Machida, Yuichiro; Takahashi, Satomi; Okada, Yoshinori

2017-12-01

It is unclear whether epidermal growth factor receptor (EGFR) mutation status is a risk factor for postoperative recurrence of surgically resected lung adenocarcinoma (ADC). Therefore, we conducted a multi-institutional study employing matched-pair analysis to compare recurrence-free survival (RFS) and overall survival (OS) of patients with lung ADC according to EGFR mutation status. We collected the records of 909 patients who underwent surgical resection for lung ADC between 2005 and 2012 at five participating institutions and were also examined their EGFR mutation status. For each patient with an EGFR mutation, we selected one with the wild-type EGFR sequence and matched them according to institution, age, gender, smoking history, pathological stage (pStage), and adjuvant treatment. We compared RFS and OS of the matched cohort. The patients were allocated into groups (n=181 each) with mutated or wild-type EGFR sequences. Both cohorts had identical characteristics as follows: institution, median age (68 years), men (85, 47%), ever smokers (77, 43%), and pStage (IA, 108, 60%; IB, 48, 27%; II, 14, 8%; III, 11, 6%). The 3- and 5-year RFS rates of patients with mutated or wild-type EGFR sequence were 79%, 68% and 77%, 68%, respectively (p=0.557). The respective OS rates were 92%, 81%, and 89%, 79% (p=0.574). Matched-pair and multi-institutional analysis reveals that an EGFR mutation was not a significant risk factor for recurrence of patients with surgically resected lung adenocarcinoma. Copyright © 2017 Elsevier B.V. All rights reserved.

Breast Self Examination Practice among Female Students of Tertiary Institutions

ERIC Educational Resources Information Center

Agbonifoh, Julia Adesua

2016-01-01

Against the background of the dangers posed by breast cancer world-wide, and the importance of its early detection and therefore breast self examination (BSE), this study investigated the practice of BSE among female students in tertiary institutions in Edo state. A sample of 723 participants selected through a combination of multi-stage,…

A Multi-Institutional Examination of the Relationships between High School Activity Involvement and Leadership Characteristics

ERIC Educational Resources Information Center

Simonsen, Jon C.; Velez, Jonathan J.; Foor, Ryan M.; Birkenholz, Robert J.; Foster, Daniel D.; Wolf, Kattlyn J.; Epps, Rebekah B.

2014-01-01

Developing leaders is vital to the future of our nation. As institutions of higher education address the need for leadership through courses and experiences, there is a need to recognize and acknowledge the potential impact of high school activity participation on leadership development. This descriptive-correlational study surveyed first-time…

Evaluating Geoscience Students' Spatial Thinking Skills in a Multi-Institutional Classroom Study

ERIC Educational Resources Information Center

Ormand, Carol J.; Manduca, Cathryn; Shipley, Thomas F.; Tikoff, Basil; Harwood, Cara L.; Atit, Kinnari; Boone, Alexander P.

2014-01-01

Spatial thinking skills are critical to success in many subdisciplines of the geosciences. We tested students' spatial skills in geoscience courses at three institutions (a public research university, a comprehensive university, and a liberal arts college, all in the midwest) over a two-year period. We administered standard psychometric tests of…

Improved local and regional control with radiotherapy for Merkel cell carcinoma of the head and neck.

PubMed

Strom, Tobin; Naghavi, Arash O; Messina, Jane L; Kim, Sungjune; Torres-Roca, Javier F; Russell, Jeffery; Sondak, Vernon K; Padhya, Tapan A; Trotti, Andy M; Caudell, Jimmy J; Harrison, Louis B

2017-01-01

We hypothesized that radiotherapy (RT) would improve both local and regional control with Merkel cell carcinoma of the head and neck. A single-institution institutional review board-approved study was performed including 113 patients with nonmetastatic Merkel cell carcinoma of the head and neck. Postoperative RT was delivered to the primary tumor bed (71.7% cases) ± draining lymphatics (33.3% RT cases). Postoperative local RT was associated with improved local control (3-year actuarial local control 89.4% vs 68.1%; p = .005; Cox hazard ratio [HR] 0.18; 95% confidence interval [CI] = 0.06-0.55; p = .002). Similarly, regional RT was associated with improved regional control (3-year actuarial regional control 95.0% vs 66.7%; p = .008; Cox HR = 0.09; 95% CI = 0.01-0.69; p = .02). Regional RT played an important role for both clinical node-negative patients (3-year regional control 100% vs 44.7%; p = .03) and clinical/pathological node-positive patients (3-year regional control 90.9% vs 55.6%; p = .047). Local RT was beneficial for all patients with Merkel cell carcinoma of the head and neck, whereas regional RT was beneficial for clinical node-negative and clinical/pathological node-positive patients. © 2016 Wiley Periodicals, Inc. Head Neck 39: 48-55, 2017. © 2016 Wiley Periodicals, Inc.

Contribution of Common PCSK1 Genetic Variants to Obesity in 8,359 Subjects from Multi-Ethnic American Population

PubMed Central

Choquet, Hélène; Kasberger, Jay; Hamidovic, Ajna; Jorgenson, Eric

2013-01-01

Common PCSK1 variants (notably rs6232 and rs6235) have been shown to be associated with obesity in European, Asian and Mexican populations. To determine whether common PCSK1 variants contribute to obesity in American population, we conducted association analyses in 8,359 subjects using two multi-ethnic American studies: the Coronary Artery Risk Development in Young Adults (CARDIA) study and the Multi-Ethnic Study of Atherosclerosis (MESA). By evaluating the contribution of rs6232 and rs6235 in each ethnic group, we found that in European-American subjects from CARDIA, only rs6232 was associated with BMI (P = 0.006) and obesity (P = 0.018) but also increased the obesity incidence during the 20 years of follow-up (HR = 1.53 [1.07–2.19], P = 0.019). Alternatively, in African-American subjects from CARDIA, rs6235 was associated with BMI (P = 0.028) and obesity (P = 0.018). Further, by combining the two case-control ethnic groups from the CARDIA study in a meta-analysis, association between rs6235 and obesity risk remained significant (OR = 1.23 [1.05–1.45], P = 9.5×10−3). However, neither rs6232 nor rs6235 was associated with BMI or obesity in the MESA study. Interestingly, rs6232 was associated with BMI (P = 4.2×10−3) and obesity (P = 3.4×10−3) in the younger European-American group combining samples from the both studies [less than median age (53 years)], but not among the older age group (P = 0.756 and P = 0.935 for BMI and obesity, respectively). By combining all the case-control ethnic groups from CARDIA and MESA in a meta-analysis, we found no significant association for the both variants and obesity risk. Finally, by exploring the full PCSK1 locus, we observed that no variant remained significant after correction for multiple testing. These results indicate that common PCSK1 variants (notably rs6232 and rs6235) contribute modestly to obesity in multi-ethnic American population. Further, these results suggest that the association of rs6232 with obesity may be age-dependent in European-Americans. However, multiple replication studies in multi-ethnic American population are needed to confirm our findings. PMID:23451278

Contribution of common PCSK1 genetic variants to obesity in 8,359 subjects from multi-ethnic American population.

PubMed

Choquet, Hélène; Kasberger, Jay; Hamidovic, Ajna; Jorgenson, Eric

2013-01-01

Common PCSK1 variants (notably rs6232 and rs6235) have been shown to be associated with obesity in European, Asian and Mexican populations. To determine whether common PCSK1 variants contribute to obesity in American population, we conducted association analyses in 8,359 subjects using two multi-ethnic American studies: the Coronary Artery Risk Development in Young Adults (CARDIA) study and the Multi-Ethnic Study of Atherosclerosis (MESA). By evaluating the contribution of rs6232 and rs6235 in each ethnic group, we found that in European-American subjects from CARDIA, only rs6232 was associated with BMI (P = 0.006) and obesity (P = 0.018) but also increased the obesity incidence during the 20 years of follow-up (HR = 1.53 [1.07-2.19], P = 0.019). Alternatively, in African-American subjects from CARDIA, rs6235 was associated with BMI (P = 0.028) and obesity (P = 0.018). Further, by combining the two case-control ethnic groups from the CARDIA study in a meta-analysis, association between rs6235 and obesity risk remained significant (OR = 1.23 [1.05-1.45], P = 9.5×10(-3)). However, neither rs6232 nor rs6235 was associated with BMI or obesity in the MESA study. Interestingly, rs6232 was associated with BMI (P = 4.2×10(-3)) and obesity (P = 3.4×10(-3)) in the younger European-American group combining samples from the both studies [less than median age (53 years)], but not among the older age group (P = 0.756 and P = 0.935 for BMI and obesity, respectively). By combining all the case-control ethnic groups from CARDIA and MESA in a meta-analysis, we found no significant association for the both variants and obesity risk. Finally, by exploring the full PCSK1 locus, we observed that no variant remained significant after correction for multiple testing. These results indicate that common PCSK1 variants (notably rs6232 and rs6235) contribute modestly to obesity in multi-ethnic American population. Further, these results suggest that the association of rs6232 with obesity may be age-dependent in European-Americans. However, multiple replication studies in multi-ethnic American population are needed to confirm our findings.

Risk factors associated with multi-drug-resistant Acinetobacter baumannii nosocomial infections at a tertiary care hospital in Makkah, Saudi Arabia - a matched case–control study

PubMed Central

Al-Gethamy, Manal M; Faidah, Hani S; Adetunji, Hamed Ademola; Haseeb, Abdul; Ashgar, Sami S; Mohanned, Tayeb K; Mohammed, Al-Haj; Khurram, Muhammad; Hassali, Mohamed A

2017-01-01

Objective To determine risk factors for multi-drug-resistant Acinetobacter baumannii (MDR-AB) nosocomial infections in intensive care units in a tertiary care hospital, Makkah, Saudi Arabia. Methods We performed a hospital-based, matched case–control study in patients who were admitted to Al Noor Specialist Hospital between 1 January 2012 and 31 August 2012. The study included cases of A. baumannii nosocomial infection and controls without infection. Controls were matched to cases by age and ward of admission. Results The most frequent site of infection was the respiratory tract (77.3%). Susceptibility to antimicrobial MDR-AB was 92.0% for ceftazidime and ciprofloxacin, while it was 83.3% for imipenem, 83.0% for trimethoprim, 79.0% for amikacin, and 72.7% for gentamicin. Multiple logistic regression of risk factors showed that immunosuppression (OR = 2.9; 95% CI 1.5–5.6; p = 0.002), clinical outcome (OR = 0.4; 95% CI 0.3–0.9; p = 0.01), invasive procedures (OR = 7.9; 95% CI 1.8–34.2; p = 0.002), a central venous catheter (OR = 2.9; 95% CI 1.5–5.6; p = 0.000), and an endotracheal tube (OR = 3.4; 95% CI 1.6–7.3; p = 0.001) were associated with MDR-AB. Conclusions Acinetobacter nosocomial infections are associated with admission to the ICU (Intensive care unit) and exposure to invasive procedures. PMID:28480813

Cooperative Attention: Using Qualitative Case Studies to Study Peer Institutions

ERIC Educational Resources Information Center

Lisi, Bethany

2017-01-01

This chapter provides a conceptual model that institutional research professionals can use to develop contextual intelligence of issues of interest in higher education with the use of case studies from peer institutions. The model draws from the metaphor of the "divided brain" and how the two hemispheres must work together with both…

Issues in Institutional Benchmarking of Student Learning Outcomes Using Case Examples

ERIC Educational Resources Information Center

Judd, Thomas P.; Pondish, Christopher; Secolsky, Charles

2013-01-01

Benchmarking is a process that can take place at both the inter-institutional and intra-institutional level. This paper focuses on benchmarking intra-institutional student learning outcomes using case examples. The findings of the study illustrate the point that when the outcomes statements associated with the mission of the institution are…

Development and application of a real-time testbed for multiagent system interoperability: A case study on hierarchical microgrid control

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

Cintuglu, Mehmet Hazar; Youssef, Tarek; Mohammed, Osama A.

This article presents the development and application of a real-time testbed for multiagent system interoperability. As utility independent private microgrids are installed constantly, standardized interoperability frameworks are required to define behavioral models of the individual agents for expandability and plug-and-play operation. In this paper, we propose a comprehensive hybrid agent framework combining the foundation for intelligent physical agents (FIPA), IEC 61850, and data distribution service (DDS) standards. The IEC 61850 logical node concept is extended using FIPA based agent communication language (ACL) with application specific attributes and deliberative behavior modeling capability. The DDS middleware is adopted to enable a real-timemore » publisher-subscriber interoperability mechanism between platforms. The proposed multi-agent framework was validated in a laboratory based testbed involving developed intelligent electronic device (IED) prototypes and actual microgrid setups. Experimental results were demonstrated for both decentralized and distributed control approaches. Secondary and tertiary control levels of a microgrid were demonstrated for decentralized hierarchical control case study. A consensus-based economic dispatch case study was demonstrated as a distributed control example. Finally, it was shown that the developed agent platform is industrially applicable for actual smart grid field deployment.« less

Development and application of a real-time testbed for multiagent system interoperability: A case study on hierarchical microgrid control

DOE PAGES

Cintuglu, Mehmet Hazar; Youssef, Tarek; Mohammed, Osama A.

2016-08-10

This article presents the development and application of a real-time testbed for multiagent system interoperability. As utility independent private microgrids are installed constantly, standardized interoperability frameworks are required to define behavioral models of the individual agents for expandability and plug-and-play operation. In this paper, we propose a comprehensive hybrid agent framework combining the foundation for intelligent physical agents (FIPA), IEC 61850, and data distribution service (DDS) standards. The IEC 61850 logical node concept is extended using FIPA based agent communication language (ACL) with application specific attributes and deliberative behavior modeling capability. The DDS middleware is adopted to enable a real-timemore » publisher-subscriber interoperability mechanism between platforms. The proposed multi-agent framework was validated in a laboratory based testbed involving developed intelligent electronic device (IED) prototypes and actual microgrid setups. Experimental results were demonstrated for both decentralized and distributed control approaches. Secondary and tertiary control levels of a microgrid were demonstrated for decentralized hierarchical control case study. A consensus-based economic dispatch case study was demonstrated as a distributed control example. Finally, it was shown that the developed agent platform is industrially applicable for actual smart grid field deployment.« less

SU-E-T-544: A Radiation Oncology-Specific Multi-Institutional Federated Database: Initial Implementation

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

Hendrickson, K; Phillips, M; Fishburn, M

Purpose: To implement a common database structure and user-friendly web-browser based data collection tools across several medical institutions to better support evidence-based clinical decision making and comparative effectiveness research through shared outcomes data. Methods: A consortium of four academic medical centers agreed to implement a federated database, known as Oncospace. Initial implementation has addressed issues of differences between institutions in workflow and types and breadth of structured information captured. This requires coordination of data collection from departmental oncology information systems (OIS), treatment planning systems, and hospital electronic medical records in order to include as much as possible the multi-disciplinary clinicalmore » data associated with a patients care. Results: The original database schema was well-designed and required only minor changes to meet institution-specific data requirements. Mobile browser interfaces for data entry and review for both the OIS and the Oncospace database were tailored for the workflow of individual institutions. Federation of database queries--the ultimate goal of the project--was tested using artificial patient data. The tests serve as proof-of-principle that the system as a whole--from data collection and entry to providing responses to research queries of the federated database--was viable. The resolution of inter-institutional use of patient data for research is still not completed. Conclusions: The migration from unstructured data mainly in the form of notes and documents to searchable, structured data is difficult. Making the transition requires cooperation of many groups within the department and can be greatly facilitated by using the structured data to improve clinical processes and workflow. The original database schema design is critical to providing enough flexibility for multi-institutional use to improve each institution s ability to study outcomes, determine best practices, and support research. The project has demonstrated the feasibility of deploying a federated database environment for research purposes to multiple institutions.« less

The Case for Diabetes Population Health Improvement: Evidence-Based Programming for Population Outcomes in Diabetes.

PubMed

Golden, Sherita Hill; Maruthur, Nisa; Mathioudakis, Nestoras; Spanakis, Elias; Rubin, Daniel; Zilbermint, Mihail; Hill-Briggs, Felicia

2017-07-01

The goal of this review is to describe diabetes within a population health improvement framework and to review the evidence for a diabetes population health continuum of intervention approaches, including diabetes prevention and chronic and acute diabetes management, to improve clinical and economic outcomes. Recent studies have shown that compared to usual care, lifestyle interventions in prediabetes lower diabetes risk at the population-level and that group-based programs have low incremental medial cost effectiveness ratio for health systems. Effective outpatient interventions that improve diabetes control and process outcomes are multi-level, targeting the patient, provider, and healthcare system simultaneously and integrate community health workers as a liaison between the patient and community-based healthcare resources. A multi-faceted approach to diabetes management is also effective in the inpatient setting. Interventions shown to promote safe and effective glycemic control and use of evidence-based glucose management practices include provider reminder and clinical decision support systems, automated computer order entry, provider education, and organizational change. Future studies should examine the cost-effectiveness of multi-faceted outpatient and inpatient diabetes management programs to determine the best financial models for incorporating them into diabetes population health strategies.

Two Case Studies of Beginning Teachers in State-Mandated Induction Programs: The Influence of Institutional Factors.

ERIC Educational Resources Information Center

Paulissen, Margaret O.; And Others

The Teacher Induction Study investigated 2 state-mandated beginning teacher programs and examined the translation of state policy by 4 school districts, 13 individual schools, and 32 classrooms. From the case histories of 16 teams, 2 case histories were selected for further study. One case illustrated how institutional factors influenced team…

Influence of spatial beam inhomogeneities on the parameters of a petawatt laser system based on multi-stage parametric amplification

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

Frolov, S A; Trunov, V I; Pestryakov, Efim V

2013-05-31

We have developed a technique for investigating the evolution of spatial inhomogeneities in high-power laser systems based on multi-stage parametric amplification. A linearised model of the inhomogeneity development is first devised for parametric amplification with the small-scale self-focusing taken into account. It is shown that the application of this model gives the results consistent (with high accuracy and in a wide range of inhomogeneity parameters) with the calculation without approximations. Using the linearised model, we have analysed the development of spatial inhomogeneities in a petawatt laser system based on multi-stage parametric amplification, developed at the Institute of Laser Physics, Siberianmore » Branch of the Russian Academy of Sciences (ILP SB RAS). (control of laser radiation parameters)« less

Process simulation and dynamic control for marine oily wastewater treatment using UV irradiation.

PubMed

Jing, Liang; Chen, Bing; Zhang, Baiyu; Li, Pu

2015-09-15

UV irradiation and advanced oxidation processes have been recently regarded as promising solutions in removing polycyclic aromatic hydrocarbons (PAHs) from marine oily wastewater. However, such treatment methods are generally not sufficiently understood in terms of reaction mechanisms, process simulation and process control. These deficiencies can drastically hinder their application in shipping and offshore petroleum industries which produce bilge/ballast water and produced water as the main streams of marine oily wastewater. In this study, the factorial design of experiment was carried out to investigate the degradation mechanism of a typical PAH, namely naphthalene, under UV irradiation in seawater. Based on the experimental results, a three-layer feed-forward artificial neural network simulation model was developed to simulate the treatment process and to forecast the removal performance. A simulation-based dynamic mixed integer nonlinear programming (SDMINP) approach was then proposed to intelligently control the treatment process by integrating the developed simulation model, genetic algorithm and multi-stage programming. The applicability and effectiveness of the developed approach were further tested though a case study. The experimental results showed that the influences of fluence rate and temperature on the removal of naphthalene were greater than those of salinity and initial concentration. The developed simulation model could well predict the UV-induced removal process under varying conditions. The case study suggested that the SDMINP approach, with the aid of the multi-stage control strategy, was able to significantly reduce treatment cost when comparing to the traditional single-stage process optimization. The developed approach and its concept/framework have high potential of applicability in other environmental fields where a treatment process is involved and experimentation and modeling are used for process simulation and control. Copyright © 2015 Elsevier Ltd. All rights reserved.

Clinical use of MRI for the evaluation of acute appendicitis during pregnancy.

PubMed

Patel, Darshan; Fingard, Jordan; Winters, Sean; Low, Gavin

2017-07-01

The purpose of this study was to determine the diagnostic accuracy of MRI for detecting acute appendicitis in pregnancy in a multi-institution study involving general body MR readers with no specific expertise in MR imaging of the pregnant patient. Retrospective review of MRI examinations on PACS in 42 pregnant patients was evaluated for acute right lower quadrant pain. Three fellowship-trained general body radiologists analyzed the MRI examinations in consensus and attempted to localize the appendix, assess for features of appendicitis, and exclude alternative etiologies for the right lower quadrant pain. Of the 42 MRI examinations, the readers noted 6 cases of acute appendicitis, 16 cases of a normal appendix, and 20 cases involving non-visualization of the appendix but where there were no secondary features of acute appendicitis. Based on the surgical data and clinical follow-up, there were 3 true-positive cases, 3 false-positive cases, 34 true-negative cases, and 2 false-negative cases of acute appendicitis on MRI. This yielded an accuracy of 88.1%, sensitivity of 60%, specificity of 91.9%, positive predictive value of 50%, and negative predictive value of 94.4% for the detection of acute appendicitis in the pregnant patient on MRI. Alternative etiologies for the right lower quadrant pain on MRI included torsion of an ovarian dermoid in 1 case and pyelonephritis in 1 case. MRI is an excellent modality for excluding acute appendicitis in pregnant patients presenting with right lower quadrant pain.

BCNU wafer placement with temozolomide (TMZ) in the immediate postoperative period after tumor resection followed by radiation therapy with TMZ in patients with newly diagnosed high grade glioma: final results of a prospective, multi-institutional, phase II trial.

PubMed

Burri, Stuart H; Prabhu, Roshan S; Sumrall, Ashley L; Brick, Wendy; Blaker, Brian D; Heideman, Brent E; Boltes, Peggy; Kelly, Renee; Symanowski, James T; Wiggins, Walter F; Ashby, Lynn; Norton, H James; Judy, Kevin; Asher, Anthony L

2015-06-01

Temozolomide (TMZ) and BCNU have demonstrated anti-glioma synergism in preclinical models. We report final data from a prospective, multi-institutional study of BCNU wafers and early TMZ followed by radiation therapy with TMZ in patients with newly diagnosed malignant glioma. 65 patients were consented in 4 institutions, and 46 patients (43 GBM, 3 AA) were eligible for analysis. After resection and BCNU wafer placement, TMZ began on day four postoperatively. Radiation and TMZ (RT/TMZ) were then administered, followed by monthly TMZ at 200 mg/m2 for the first 26 patients, which was reduced to 150 mg/m2 for the remaining 20 patients. Non-hematologic toxicities were minimal. Nine of 27 patients (33 %) who received 200 mg/m2 TMZ, but only 1 of 20 (5 %) who received 150 mg/m2, experienced grade 3/4 thrombocytopenia. Median progression free survival (PFS) and overall survival (OS) period was 8.5 and 18 months, respectively. The 1-year OS rate was 76 %, which is a significant improvement compared with the historical control 1-year OS rate of 59 % (p = 0.023). However, there was no difference in 1-year OS compared with standard RT/TMZ (p = 0.12) or BCNU wafer followed by RT/TMZ (p = 0.87) in post hoc analyses. Early post-operative TMZ can be safely administered with BCNU wafers following resection of malignant glioma at the 150 mg/m2 dose level. Although there was an OS benefit compared to historical control, there was no indication of benefit for BCNU wafers and early TMZ in addition to standard RT/TMZ or early TMZ in addition to regimens of BCNU wafers followed by RT/TMZ.

The National Birth Defects Prevention Study: a review of the methods

PubMed Central

Reefhuis, Jennita; Gilboa, Suzanne M.; Anderka, Marlene; Browne, Marilyn L.; Feldkamp, Marcia L.; Hobbs, Charlotte A.; Jenkins, Mary M.; Langlois, Peter H.; Newsome, Kimberly B.; Olshan, Andrew F.; Romitti, Paul A.; Shapira, Stuart K.; Shaw, Gary M.; Tinker, Sarah C.; Honein, Margaret A.

2015-01-01

Background The National Birth Defects Prevention Study (NBDPS) is a large population-based multi-center case-control study of major birth defects in the United States. Methods Data collection took place from 1998 through 2013 on pregnancies ending between October 1997 and December 2011. Cases could be live born, stillborn or induced terminations, and were identified from birth defects surveillance programs in Arkansas, California, Georgia, Iowa, Massachusetts, New Jersey, New York, North Carolina, Texas and Utah. Controls were live born infants without major birth defects identified from the same geographical regions and time periods as cases via either vital records or birth hospitals. Computer-assisted telephone interviews were completed with women between 6 weeks and 24 months after the estimated date of delivery. After completion of interviews, families received buccal cell collection kits for the mother, father and infant (if living). Results There were 47,832 eligible cases and 18,272 eligible controls. Among these, 32,187 (67%) and 11,814 (65%) respectively, provided interview information about their pregnancies. Buccal cell collection kits with a cytobrush for at least one family member were returned by 19,065 case and 6,211 control families (65% and 59% of those who were sent a kit). More than 500 projects have been proposed by the collaborators and over 200 manuscripts published using data from the NBDPS through December 2014. Conclusion The NBDPS has made substantial contributions to the field of birth defects epidemiology through its rigorous design, including case classification, detailed questionnaire and specimen collection, large study population, and collaborative activities across Centers. PMID:26033852

Secondary science teachers' view toward and classroom translation of sustained professional development

NASA Astrophysics Data System (ADS)

Lewis, Elizabeth Blake

This study concerns the phenomenon of secondary science teacher learning and enacting instructional strategies learned at the Communication in Science Inquiry Project (CISIP) teacher professional development events, as well as teacher perception of, and relationship to, this year-long professional development program. The CISIP program teaches science teachers how to build scientific classroom discourse communities with their students. Some of the science teachers were previous participants in the professional development, and acted as mentor teachers. The research design employed an integrated conceptual framework of situated learning theory with an analytical lens of teachers' professional, institutional and affinity, identities. A multi-method approach was used to generate data. Throughout the 2007-2008 academic year, the teachers' fidelity to the professional development model was measured using a classroom observation instrument aligned with the professional development model. From these observation data a longitudinal model, using hierarchical linear modeling, was constructed. In addition, surveys and interview data were used to construct both whole group and case studies of two high school science teachers who taught biology at the same school. The results indicated that there was a significant difference between previous and new participants; specifically, the longer teachers had participated in the professional development, and adopted a mentorship role, the greater their fidelity of classroom instruction to the CISIP model. Additionally, the case study teacher who developed a CISIP model-aligned affinity identity implemented more of the instructional strategies than the teacher who maintained his school-based institutional identity.

The association between osteoporotic hip fractures and actinic lesions as a biomarker for cumulative sun exposure in older people-a retrospective case-control study in Argentina.

PubMed

Perroud, H A; Dagatti, M S; Amigot, B; Levit, G P; Tomat, M F; Morosano, M E; Masoni, A M; Pezzotto, S M

2017-05-01

The aim of this study was to analyze the association between the presence of actinic lesions (solar keratosis and non-melanoma skin cancer) and osteoporotic hip fractures in older patients. Both pathologies are common conditions in this age group. Since cumulative sun exposure is difficult to quantify, the presence of actinic lesions can be used to indirectly analyze the association between ultraviolet radiation and osteoporotic hip fractures. This was an observational case-control study. We reviewed the centralized medical records of patients with hip fracture (cases, n = 51) and patients with other diseases hospitalized in the same institution and period (controls, n = 59). The mean age of the patients was 80 ± 8.3 years (range 50-103 years). Differences in maternal hip fracture history were found between cases and controls (14.8 and 8 %, respectively; p = 0.047). Falls history in the past year was higher in cases than in controls (p < 0.0001). Actinic lesions were observed in 32.7 % of patients (prevalence rate 23.5 % in cases, 40.7 % in controls; p = 0.04). When considering patients with actinic lesions, controls have a higher FRAX score compared with cases. Although sun exposure is recommended for bone health, it represents a risk factor for actinic lesions. The presence of actinic lesions may indicate a lower osteoporotic hip fracture risk. A balance between adequate lifetime sun exposure and protection against its adverse effects is required for each patient, in the context of geographic location.

A Qualitative Multi-Site Case Study: Examining Principals' Leadership Styles and School Performance

ERIC Educational Resources Information Center

Preyear, Loukisha

2015-01-01

The purpose of this qualitative multi-site case study was to explore the impact of principals' leadership styles on student academic achievement in a high-poverty low-performing school district in Louisiana. A total of 17 participants, principals and teachers, from this school district were used in this study. Data source triangulation of…

Motivating Factors for Philanthropy at a Ministry Preparation Graduate Institution

ERIC Educational Resources Information Center

Reimer, Jay Paul

2013-01-01

A qualitative case study was conducted to determine whether major donors to an institution of higher education that existed to prepare ministers and missionaries were perceived by the institution's leaders as motivated by organizational effectiveness, financial efficiency, or evaluations by donor watchdog agencies. The case study was conducted…

Institutional Change and Leadership Associated with Blended Learning Innovation: Two Case Studies

ERIC Educational Resources Information Center

Garrison, D. Randy; Vaughan, Norman D.

2013-01-01

This article documents the institutional change and leadership associated with blended learning innovation in higher education. Two case studies are provided that demonstrate how transformational institutional change related to blended teaching and learning approaches is predicated upon committed collaborative leadership that engages all levels of…

A new pulsed laser deposition technique: scanning multi-component pulsed laser deposition method.

PubMed

Fischer, D; de la Fuente, G F; Jansen, M

2012-04-01

The scanning multi-component pulsed laser deposition (PLD) method realizes uniform depositions of desired coatings by a modified pulsed laser deposition process, preferably with a femto-second laser-system. Multi-component coatings (single or multilayered) are thus deposited onto substrates via laser induced ablation of segmented targets. This is achieved via horizontal line-scanning of a focused laser beam over a uniformly moving target's surface. This process allows to deposit the desired composition of the coating simultaneously, starting from the different segments of the target and adjusting the scan line as a function of target geometry. The sequence and thickness of multilayers can easily be adjusted by target architecture and motion, enabling inter/intra layer concentration gradients and thus functional gradient coatings. This new, simple PLD method enables the achievement of uniform, large-area coatings. Case studies were performed with segmented targets containing aluminum, titanium, and niobium. Under the laser irradiation conditions applied, all three metals were uniformly ablated. The elemental composition within the rough coatings obtained was fixed by the scanned area to Ti-Al-Nb = 1:1:1. Crystalline aluminum, titanium, and niobium were found to coexist side by side at room temperature within the substrate, without alloy formation up to 600 °C. © 2012 American Institute of Physics

The association of factor V leiden mutation with recurrent pregnancy loss.

PubMed

Kashif, Sumreen; Kashif, Muhammad Ali; Saeed, Anjum

2015-11-01

To determine the association of factor V Leiden mutation with recurrent pregnancy loss. The case-control study was conducted at the Department of Haematology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan, from January to June 2012, and comprised women of 18 to 45 years of age who had a history of recurrent pregnancy loss, and controls with no history of pregnancy loss. All the subjects belonged to Punjabi ethnic group. Three ml blood was taken from cases and controls and deoxyribonucleic acid was extracted. In order to identify Factor V Leiden mutation, polymerase chain reaction method was utilised combined with the amplification refractory mutation system. Data was analysed using SPSS 17. Of the 112 subjects, 56(50%) were in each of the two groups. The presence of factor V Leiden mutation among the cases was 3(5.4%) while it was absent among the controls. The mutation was significantly associated with recurrent pregnancy loss (p=0.017).Recurrent pregnancy loss was higher in cases than controls (p=0.001). Factor V Leiden mutation, Recurrent pregnancy loss, PCR (Polymerase chain reaction).

Pulmonary arterial hypertension in children: diagnosis using ratio of main pulmonary artery to ascending aorta diameter as determined by multi-detector computed tomography.

PubMed

Caro-Domínguez, Pablo; Compton, Gregory; Humpl, Tilman; Manson, David E

2016-09-01

The ratio of the transverse diameter of the main pulmonary artery (MPA) to ascending aorta as determined at multi-detector CT is a tool that can be used to assess the pulmonary arterial size in cases of pulmonary arterial hypertension in children. To establish a ratio of MPA to ascending aorta diameter using multi-detector CT imaging suggestive of pulmonary arterial hypertension in children. We hypothesize that a defined ratio of MPA to ascending aorta is identifiable on multi-detector CT and that higher ratios can be used to reliably diagnose the presence of pulmonary arterial hypertension in children. We calculated the multi-detector CT ratio of MPA to ascending aorta diameter in 44 children with documented pulmonary arterial hypertension by right heart catheterization and in 44 age- and gender-matched control children with no predisposing factors for pulmonary arterial hypertension. We compared this multi-detector-CT-determined ratio with the MPA pressure in the study group, as well as with the ratio of MPA to ascending aorta in the control group. A threshold ratio value was calculated to accurately identify children with pulmonary arterial hypertension. Children with documented primary pulmonary arterial hypertension have a significantly higher ratio of MPA to ascending aorta (1.46) than children without pulmonary arterial hypertension (1.11). A ratio of 1.3 carries a positive likelihood of 34 and a positive predictive value of 97% for the diagnosis of pulmonary arterial hypertension. The pulmonary arteries were larger in children with pulmonary arterial hypertension than in a control group of normal children. A CT-measured ratio of MPA to ascending aorta of 1.3 should raise the suspicion of pulmonary arterial hypertension in children.

Multi-Level Strategies in Universities: Coordination, Contestation or Creolisation?

ERIC Educational Resources Information Center

Stensaker, Bjørn; Fumasoli, Tatiana

2017-01-01

In contemporary research-intensive universities, strategies are not only found at the institutional level but also at various sub-levels in the organisation. In principle, such multi-level strategies are assumed to be a means for institutional coordination in the sense that more generic strategic objectives may give room for local adaptation…

Solitary Large Intestinal Diverticulitis in Leatherback Turtles (Dermochelys coriacea).

PubMed

Stacy, B A; Innis, C J; Daoust, P-Y; Wyneken, J; Miller, M; Harris, H; James, M C; Christiansen, E F; Foley, A

2015-07-01

Leatherback sea turtles are globally distributed and endangered throughout their range. There are limited data available on disease in this species. Initial observations of solitary large intestinal diverticulitis in multiple leatherbacks led to a multi-institutional review of cases. Of 31 subadult and adult turtles for which complete records were available, all had a single exudate-filled diverticulum, as large as 9.0 cm in diameter, arising from the large intestine immediately distal to the ileocecal junction. All lesions were chronic and characterized by ongoing inflammation, numerous intralesional bacteria, marked attenuation of the muscularis, ulceration, and secondary mucosal changes. In three cases, Morganella morganii was isolated from lesions. Diverticulitis was unrelated to the cause of death in all cases, although risk of perforation and other complications are possible. © The Author(s) 2014.

School-Based Cognitive-Behavioral Therapy for an Adolescent Presenting with ADHD and Explosive Anger: A Case Study

ERIC Educational Resources Information Center

Parker, Janise; Zaboski, Brian; Joyce-Beaulieu, Diana

2016-01-01

This case demonstrates the efficacy of utilizing an intensive, multi-faceted behavioral intervention paradigm. A comprehensive, integrative, school-based service model was applied to address attention deficit hyperactivity disorder symptomology, oppositional behaviors, and explosive anger at the secondary level. The case reviews a multi-modal…

The IHMC CmapTools software in research and education: a multi-level use case in Space Meteorology

NASA Astrophysics Data System (ADS)

Messerotti, Mauro

2010-05-01

The IHMC (Institute for Human and Machine Cognition, Florida University System, USA) CmapTools software is a powerful multi-platform tool for knowledge modelling in graphical form based on concept maps. In this work we present its application for the high-level development of a set of multi-level concept maps in the framework of Space Meteorology to act as the kernel of a space meteorology domain ontology. This is an example of a research use case, as a domain ontology coded in machine-readable form via e.g. OWL (Web Ontology Language) is suitable to be an active layer of any knowledge management system embedded in a Virtual Observatory (VO). Apart from being manageable at machine level, concept maps developed via CmapTools are intrinsically human-readable and can embed hyperlinks and objects of many kinds. Therefore they are suitable to be published on the web: the coded knowledge can be exploited for educational purposes by the students and the public, as the level of information can be naturally organized among linked concept maps in progressively increasing complexity levels. Hence CmapTools and its advanced version COE (Concept-map Ontology Editor) represent effective and user-friendly software tools for high-level knowledge represention in research and education.

Balancing the personal, local, institutional, and global: multiple case study and multidimensional scaling analysis of African experiences in addressing complexity and political economy in health research capacity strengthening.

PubMed

Ager, Alastair; Zarowsky, Christina

2015-01-17

Strengthening health research capacity in low- and middle-income countries remains a major policy goal. The Health Research Capacity Strengthening (HRCS) Global Learning (HGL) program of work documented experiences of HRCS across sub-Saharan Africa. We reviewed findings from HGL case studies and reflective papers regarding the dynamics of HRCS. Analysis was structured with respect to common challenges in such work, identified through a multi-dimensional scaling analysis of responses from 37 participants at the concluding symposium of the program of work. Symposium participants identified 10 distinct clusters of challenges: engaging researchers, policymakers, and donors; securing trust and cooperation; finding common interest; securing long-term funding; establishing sustainable models of capacity strengthening; ensuring Southern ownership; accommodating local health system priorities and constraints; addressing disincentives for academic engagement; establishing and retaining research teams; and sustaining mentorship and institutional support. Analysis links these challenges to three key and potentially competing drivers of the political economy of health research: an enduring model of independent researchers and research leaders, the globalization of knowledge and the linked mobility of (elite) individuals, and institutionalization of research within universities and research centres and, increasingly, national research and development agendas. We identify tensions between efforts to embrace the global 'Community of Science' and the promotion and protection of national and institutional agendas in an unequal global health research environment. A nuanced understanding of the dynamics and implications of the uneven global health research landscape is required, along with a willingness to explore pragmatic models that seek to balance these competing drivers.

Genome-wide study of resistant hypertension identified from electronic health records.

PubMed

Dumitrescu, Logan; Ritchie, Marylyn D; Denny, Joshua C; El Rouby, Nihal M; McDonough, Caitrin W; Bradford, Yuki; Ramirez, Andrea H; Bielinski, Suzette J; Basford, Melissa A; Chai, High Seng; Peissig, Peggy; Carrell, David; Pathak, Jyotishman; Rasmussen, Luke V; Wang, Xiaoming; Pacheco, Jennifer A; Kho, Abel N; Hayes, M Geoffrey; Matsumoto, Martha; Smith, Maureen E; Li, Rongling; Cooper-DeHoff, Rhonda M; Kullo, Iftikhar J; Chute, Christopher G; Chisholm, Rex L; Jarvik, Gail P; Larson, Eric B; Carey, David; McCarty, Catherine A; Williams, Marc S; Roden, Dan M; Bottinger, Erwin; Johnson, Julie A; de Andrade, Mariza; Crawford, Dana C

2017-01-01

Resistant hypertension is defined as high blood pressure that remains above treatment goals in spite of the concurrent use of three antihypertensive agents from different classes. Despite the important health consequences of resistant hypertension, few studies of resistant hypertension have been conducted. To perform a genome-wide association study for resistant hypertension, we defined and identified cases of resistant hypertension and hypertensives with treated, controlled hypertension among >47,500 adults residing in the US linked to electronic health records (EHRs) and genotyped as part of the electronic MEdical Records & GEnomics (eMERGE) Network. Electronic selection logic using billing codes, laboratory values, text queries, and medication records was used to identify resistant hypertension cases and controls at each site, and a total of 3,006 cases of resistant hypertension and 876 controlled hypertensives were identified among eMERGE Phase I and II sites. After imputation and quality control, a total of 2,530,150 SNPs were tested for an association among 2,830 multi-ethnic cases of resistant hypertension and 876 controlled hypertensives. No test of association was genome-wide significant in the full dataset or in the dataset limited to European American cases (n = 1,719) and controls (n = 708). The most significant finding was CLNK rs13144136 at p = 1.00x10-6 (odds ratio = 0.68; 95% CI = 0.58-0.80) in the full dataset with similar results in the European American only dataset. We also examined whether SNPs known to influence blood pressure or hypertension also influenced resistant hypertension. None was significant after correction for multiple testing. These data highlight both the difficulties and the potential utility of EHR-linked genomic data to study clinically-relevant traits such as resistant hypertension.

Medical Student Perceptions of the Learning Environment: Learning Communities Are Associated With a More Positive Learning Environment in a Multi-Institutional Medical School Study.

PubMed

Smith, Sunny D; Dunham, Lisette; Dekhtyar, Michael; Dinh, An; Lanken, Paul N; Moynahan, Kevin F; Stuber, Margaret L; Skochelak, Susan E

2016-09-01

Many medical schools have implemented learning communities (LCs) to improve the learning environment (LE) for students. The authors conducted this study to determine whether a relationship exists between medical student perceptions of the LE and presence of LCs during the preclerkship years. Students from 24 schools participating in the American Medical Association Learning Environment Study completed the 17-item Medical Student Learning Environment Survey (MSLES) at the end of their first and second years of medical school between 2011 and 2013. Mean total MSLES scores and individual item scores at the end of the first and second years in schools with and without LCs were compared with t tests, and effect sizes were calculated. Mixed-effects longitudinal models were used to control for student demographics and random school and student effects on the relationship between LC status and MSLES score. A total of 4,980 students (81% of 6,148 matriculants) from 18 schools with LCs and 6 without LCs participated. Mean [SD] MSLES scores were significantly higher in LC schools compared with non-LC schools at the end of year one (3.72 [0.44] versus 3.57 [0.43], P < .001) and year two (3.69 [0.49] versus 3.42 [0.54], P < .001). The effect size increased from 0.35 (small) at the end of year one to 0.53 (medium) at the end of year two. This large multi-institutional cohort study found that LCs at medical schools were associated with more positive perceptions of the LE by preclerkship students.

Evolution of Controllability in Interbank Networks

NASA Astrophysics Data System (ADS)

Delpini, Danilo; Battiston, Stefano; Riccaboni, Massimo; Gabbi, Giampaolo; Pammolli, Fabio; Caldarelli, Guido

2013-04-01

The Statistical Physics of Complex Networks has recently provided new theoretical tools for policy makers. Here we extend the notion of network controllability to detect the financial institutions, i.e. the drivers, that are most crucial to the functioning of an interbank market. The system we investigate is a paradigmatic case study for complex networks since it undergoes dramatic structural changes over time and links among nodes can be observed at several time scales. We find a scale-free decay of the fraction of drivers with increasing time resolution, implying that policies have to be adjusted to the time scales in order to be effective. Moreover, drivers are often not the most highly connected ``hub'' institutions, nor the largest lenders, contrary to the results of other studies. Our findings contribute quantitative indicators which can support regulators in developing more effective supervision and intervention policies.

A multi-group and preemptable scheduling of cloud resource based on HTCondor

NASA Astrophysics Data System (ADS)

Jiang, Xiaowei; Zou, Jiaheng; Cheng, Yaodong; Shi, Jingyan

2017-10-01

Due to the features of virtual machine-flexibility, easy controlling and various system environments, more and more fields utilize the virtualization technology to construct the distributed system with the virtual resources, also including high energy physics. This paper introduce a method used in high energy physics that supports multiple resource group and preemptable cloud resource scheduling, combining virtual machine with HTCondor (a batch system). It makes resource controlling more flexible and more efficient and makes resource scheduling independent of job scheduling. Firstly, the resources belong to different experiment-groups, and the type of user-groups mapping to resource-groups(same as experiment-group) is one-to-one or many-to-one. In order to make the confused group simply to be managed, we designed the permission controlling component to ensure that the different resource-groups can get the suitable jobs. Secondly, for the purpose of elastically allocating resources for suitable resource-group, it is necessary to schedule resources like scheduling jobs. So this paper designs the cloud resource scheduling to maintain a resource queue and allocate an appropriate amount of virtual resources to the request resource-group. Thirdly, in some kind of situations, because of the resource occupied for a long time, resources need to be preempted. This paper adds the preemption function for the resource scheduling that implement resource preemption based on the group priority. Additionally, the way to preempting is soft that when virtual resources are preempted, jobs will not be killed but also be held and rematched later. It is implemented with the help of HTCondor, storing the held job information in scheduler, releasing the job to idle status and doing second matcher. In IHEP (institute of high energy physics), we have built a batch system based on HTCondor with a virtual resources pool based on Openstack. And this paper will show some cases of experiment JUNO and LHAASO. The result indicates that multi-group and preemptable resource scheduling is efficient to support multi-group and soft preemption. Additionally, the permission controlling component has been used in the local computing cluster, supporting for experiment JUNO, CMS and LHAASO, and the scale will be expanded to more experiments at the first half year, including DYW, BES and so on. Its evidence that the permission controlling is efficient.

Genome-wide association analysis identifies 13 new risk loci for schizophrenia.

PubMed

Ripke, Stephan; O'Dushlaine, Colm; Chambert, Kimberly; Moran, Jennifer L; Kähler, Anna K; Akterin, Susanne; Bergen, Sarah E; Collins, Ann L; Crowley, James J; Fromer, Menachem; Kim, Yunjung; Lee, Sang Hong; Magnusson, Patrik K E; Sanchez, Nick; Stahl, Eli A; Williams, Stephanie; Wray, Naomi R; Xia, Kai; Bettella, Francesco; Borglum, Anders D; Bulik-Sullivan, Brendan K; Cormican, Paul; Craddock, Nick; de Leeuw, Christiaan; Durmishi, Naser; Gill, Michael; Golimbet, Vera; Hamshere, Marian L; Holmans, Peter; Hougaard, David M; Kendler, Kenneth S; Lin, Kuang; Morris, Derek W; Mors, Ole; Mortensen, Preben B; Neale, Benjamin M; O'Neill, Francis A; Owen, Michael J; Milovancevic, Milica Pejovic; Posthuma, Danielle; Powell, John; Richards, Alexander L; Riley, Brien P; Ruderfer, Douglas; Rujescu, Dan; Sigurdsson, Engilbert; Silagadze, Teimuraz; Smit, August B; Stefansson, Hreinn; Steinberg, Stacy; Suvisaari, Jaana; Tosato, Sarah; Verhage, Matthijs; Walters, James T; Levinson, Douglas F; Gejman, Pablo V; Kendler, Kenneth S; Laurent, Claudine; Mowry, Bryan J; O'Donovan, Michael C; Owen, Michael J; Pulver, Ann E; Riley, Brien P; Schwab, Sibylle G; Wildenauer, Dieter B; Dudbridge, Frank; Holmans, Peter; Shi, Jianxin; Albus, Margot; Alexander, Madeline; Campion, Dominique; Cohen, David; Dikeos, Dimitris; Duan, Jubao; Eichhammer, Peter; Godard, Stephanie; Hansen, Mark; Lerer, F Bernard; Liang, Kung-Yee; Maier, Wolfgang; Mallet, Jacques; Nertney, Deborah A; Nestadt, Gerald; Norton, Nadine; O'Neill, Francis A; Papadimitriou, George N; Ribble, Robert; Sanders, Alan R; Silverman, Jeremy M; Walsh, Dermot; Williams, Nigel M; Wormley, Brandon; Arranz, Maria J; Bakker, Steven; Bender, Stephan; Bramon, Elvira; Collier, David; Crespo-Facorro, Benedicto; Hall, Jeremy; Iyegbe, Conrad; Jablensky, Assen; Kahn, Rene S; Kalaydjieva, Luba; Lawrie, Stephen; Lewis, Cathryn M; Lin, Kuang; Linszen, Don H; Mata, Ignacio; McIntosh, Andrew; Murray, Robin M; Ophoff, Roel A; Powell, John; Rujescu, Dan; Van Os, Jim; Walshe, Muriel; Weisbrod, Matthias; Wiersma, Durk; Donnelly, Peter; Barroso, Ines; Blackwell, Jenefer M; Bramon, Elvira; Brown, Matthew A; Casas, Juan P; Corvin, Aiden P; Deloukas, Panos; Duncanson, Audrey; Jankowski, Janusz; Markus, Hugh S; Mathew, Christopher G; Palmer, Colin N A; Plomin, Robert; Rautanen, Anna; Sawcer, Stephen J; Trembath, Richard C; Viswanathan, Ananth C; Wood, Nicholas W; Spencer, Chris C A; Band, Gavin; Bellenguez, Céline; Freeman, Colin; Hellenthal, Garrett; Giannoulatou, Eleni; Pirinen, Matti; Pearson, Richard D; Strange, Amy; Su, Zhan; Vukcevic, Damjan; Donnelly, Peter; Langford, Cordelia; Hunt, Sarah E; Edkins, Sarah; Gwilliam, Rhian; Blackburn, Hannah; Bumpstead, Suzannah J; Dronov, Serge; Gillman, Matthew; Gray, Emma; Hammond, Naomi; Jayakumar, Alagurevathi; McCann, Owen T; Liddle, Jennifer; Potter, Simon C; Ravindrarajah, Radhi; Ricketts, Michelle; Tashakkori-Ghanbaria, Avazeh; Waller, Matthew J; Weston, Paul; Widaa, Sara; Whittaker, Pamela; Barroso, Ines; Deloukas, Panos; Mathew, Christopher G; Blackwell, Jenefer M; Brown, Matthew A; Corvin, Aiden P; McCarthy, Mark I; Spencer, Chris C A; Bramon, Elvira; Corvin, Aiden P; O'Donovan, Michael C; Stefansson, Kari; Scolnick, Edward; Purcell, Shaun; McCarroll, Steven A; Sklar, Pamela; Hultman, Christina M; Sullivan, Patrick F

2013-10-01

Schizophrenia is an idiopathic mental disorder with a heritable component and a substantial public health impact. We conducted a multi-stage genome-wide association study (GWAS) for schizophrenia beginning with a Swedish national sample (5,001 cases and 6,243 controls) followed by meta-analysis with previous schizophrenia GWAS (8,832 cases and 12,067 controls) and finally by replication of SNPs in 168 genomic regions in independent samples (7,413 cases, 19,762 controls and 581 parent-offspring trios). We identified 22 loci associated at genome-wide significance; 13 of these are new, and 1 was previously implicated in bipolar disorder. Examination of candidate genes at these loci suggests the involvement of neuronal calcium signaling. We estimate that 8,300 independent, mostly common SNPs (95% credible interval of 6,300-10,200 SNPs) contribute to risk for schizophrenia and that these collectively account for at least 32% of the variance in liability. Common genetic variation has an important role in the etiology of schizophrenia, and larger studies will allow more detailed understanding of this disorder.

Study of premixing phase of steam explosion with JASMINE code in ALPHA program

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

Moriyama, Kiyofumi; Yamano, Norihiro; Maruyama, Yu

Premixing phase of steam explosion has been studied in ALPHA Program at Japan Atomic Energy Research Institute (JAERI). An analytical model to simulate the premixing phase, JASMINE (JAERI Simulator for Multiphase Interaction and Explosion), has been developed based on a multi-dimensional multi-phase thermal hydraulics code MISTRAL (by Fuji Research Institute Co.). The original code was extended to simulate the physics in the premixing phenomena. The first stage of the code validation was performed by analyzing two mixing experiments with solid particles and water: the isothermal experiment by Gilbertson et al. (1992) and the hot particle experiment by Angelini et al.more » (1993) (MAGICO). The code predicted reasonably well the experiments. Effectiveness of the TVD scheme employed in the code was also demonstrated.« less

Promoting Affordability in Defense Acquisitions: A Multi-Period Portfolio Approach

DTIC Science & Technology

2014-04-30

has evolved out of many areas of research, ranging from economics to modern control theory (Powell, 2011). The general form of a dynamic programming...states 5 School of Aeronautics & Astronautics A Portfolio Approach: Background • Balance expected profit (performance) against risk ( variance ) in...investments (Markowitz 1952) • Efficiency frontier of optimal portfolios given investor risk averseness • Extends to multi-period case with various

Societal Risk Evaluation Scheme (SRES): Scenario-Based Multi-Criteria Evaluation of Synthetic Biology Applications

PubMed Central

2017-01-01

Synthetic biology (SB) applies engineering principles to biology for the construction of novel biological systems designed for useful purposes. From an oversight perspective, SB products come with significant uncertainty. Yet there is a need to anticipate and prepare for SB applications before deployment. This study develops a Societal Risk Evaluation Scheme (SRES) in order to advance methods for anticipatory governance of emerging technologies such as SB. The SRES is based upon societal risk factors that were identified as important through a policy Delphi study. These factors range from those associated with traditional risk assessment, such as health and environmental consequences, to broader features of risk such as those associated with reversibility, manageability, anticipated levels of public concern, and uncertainty. A multi-disciplinary panel with diverse perspectives and affiliations assessed four case studies of SB using the SRES. Rankings of the SRES components are compared within and across the case studies. From these comparisons, we found levels of controllability and familiarity associated with the cases to be important for overall SRES rankings. From a theoretical standpoint, this study illustrates the applicability of the psychometric paradigm to evaluating SB cases. In addition, our paper describes how the SRES can be incorporated into anticipatory governance models as a screening tool to prioritize research, information collection, and dialogue in the face of the limited capacity of governance systems. To our knowledge, this is the first study to elicit data on specific cases of SB with the goal of developing theory and tools for risk governance. PMID:28052080

Characterization of BRCA1 and BRCA2 variants in multi-ethnic Asian cohort from a Malaysian case-control study.

PubMed

Lai, Kah Nyin; Ho, Weang Kee; Kang, In Nee; Kang, Peter Choon Eng; Phuah, Sze Yee; Mariapun, Shivaani; Yip, Cheng-Har; Mohd Taib, Nur Aishah; Teo, Soo-Hwang

2017-02-22

Genetic testing for BRCA1 and BRCA2 has led to the accurate identification of individuals at higher risk of cancer and the development of new therapies. Approximately 10-20% of the genetic testing for BRCA1 and BRCA2 leads to the identification of variants of uncertain significance (VUS), with higher proportions in Asians. We investigated the functional significance of 7 BRCA1 and 25 BRCA2 variants in a multi-ethnic Asian cohort using a case-control approach. The MassARRAY genotyping was conducted in 1,394 Chinese, 406 Malay and 310 Indian breast cancer cases and 1,071 Chinese, 167 Malay and 255 Indian healthy controls. The association of individual variant with breast cancer risk was analyzed using logistic regression model adjusted for ethnicity, age and family history. Our study confirmed BRCA2 p.Ile3412Val is presented in >2% of unaffected women and is likely benign, and BRCA2 p.Ala1996Thr which is predicted to be likely pathogenic by in-silico models is presented in 2% of healthy Indian women suggesting that it may not be associated with breast cancer risk. Single-variant analysis suggests that BRCA1 p.Arg762Ser may be associated with breast cancer risk (OR = 7.4; 95% CI, 0.9-62.3; p = 0.06). Our study shows that BRCA2 p.Ile3412Val and p.Ala1996Thr are likely benign and highlights the need for population-specific studies to determine the likely functional significance of population-specific variants. Our study also suggests that BRCA1 p.Arg762Ser may be associated with increased risk of breast cancer but other methods or larger studies are required to determine a more precise estimate of breast cancer risk.

[Cost analyses of medical care for schizophrenia and depression in México, 2005-2013].

PubMed

Arredondo, Armando; Díaz-Castro, Lina; Cabello-Rangel, Hector; Arredondo, Pablo; Recaman, Ana Lucía

2018-02-05

The study aimed to analyze the costs of medical care for mental disorders in the Mexican health system. This was a retrospective cross-sectional evaluation study. As markers for the problem, the study selected two of the principal psychological processes in mental disorders in recent years: depression and schizophrenia. Annual accumulated incidence was identified based on epidemiological reporting by type of institution in 2005-2013. The mean annual case management cost was determined with the instrumentation and consensus technique, identifying the production functions, types of inputs, costs, and amounts of inputs ordered, concentrated in the mean case matrix. Finally, an econometric adjustment factor was applied to control the inflationary effect for each year in the study period. Mean annual case management cost was USD 2,216.00 for schizophrenia and USD 2,456.00 for depression. All the institutions in the Mexican health system showed upward and constant epidemiological and economic trends. The total cost for the two disorders in the last year of the period (2013) was USD 39,081,234.00 (USD 18,119,877.00 for schizophrenia and USD 20,961,357.00 for depression). The largest impact for the two disorders combined was in institutions serving the population without health insurance (USD 24,852,321.00) versus the population with private insurance (USD 12,891,977.00). The cost of meeting the demand for services for the two disorders differs considerably between institutions that treat the population with private health service versus the population without, and is higher in the latter. The study's epidemiological and economic indicators provide evidence for decision-making in the use and allocation of healthcare resources for these two disorders in the coming years.

Forming aspheric optics by controlled deposition

DOEpatents

Hawryluk, A.M.

1998-04-28

An aspheric optical element is disclosed formed by depositing material onto a spherical surface of an optical element by controlled deposition to form an aspheric surface of desired shape. A reflecting surface, single or multi-layer, can then be formed on the aspheric surface by evaporative or sputtering techniques. Aspheric optical elements are suitable for deep ultra-violet (UV) and x-ray wavelengths. The reflecting surface may, for example, be a thin ({approx}100 nm) layer of aluminum, or in some cases the deposited modifying layer may function as the reflecting surface. For certain applications, multi-layer reflective surfaces may be utilized, such as chromium-carbon or tungsten-carbon multi-layer, with the number of layers and thickness being determined by the intended application. 4 figs.

Forming aspheric optics by controlled deposition

DOEpatents

Hawryluk, Andrew M.

1998-01-01

An aspheric optical element formed by depositing material onto a spherical surface of an optical element by controlled deposition to form an aspheric surface of desired shape. A reflecting surface, single or multi-layer, can then be formed on the aspheric surface by evaporative or sputtering techniques. Aspheric optical elements are suitable for deep ultra-violet (UV) and x-ray wavelengths. The reflecting surface may, for example, be a thin (.about.100 nm) layer of aluminum, or in some cases the deposited modifying layer may function as the reflecting surface. For certain applications, multi-layer reflective surfaces may be utilized, such as chromium-carbon or tungsten-carbon multi-layer, with the number of layers and thickness being determined by the intended application.

A big-data model for multi-modal public transportation with application to macroscopic control and optimisation

NASA Astrophysics Data System (ADS)

Faizrahnemoon, Mahsa; Schlote, Arieh; Maggi, Lorenzo; Crisostomi, Emanuele; Shorten, Robert

2015-11-01

This paper describes a Markov-chain-based approach to modelling multi-modal transportation networks. An advantage of the model is the ability to accommodate complex dynamics and handle huge amounts of data. The transition matrix of the Markov chain is built and the model is validated using the data extracted from a traffic simulator. A realistic test-case using multi-modal data from the city of London is given to further support the ability of the proposed methodology to handle big quantities of data. Then, we use the Markov chain as a control tool to improve the overall efficiency of a transportation network, and some practical examples are described to illustrate the potentials of the approach.

Factors Influencing Teachers' Technology Self-Efficacy: A Case Study

ERIC Educational Resources Information Center

Farah, Amy Caroline

2012-01-01

Factors influencing teachers' levels of technology self-efficacy were examined through a qualitative multi-site, multi-subject case study research design. An initial survey was administered to all full-time, certified teachers at three school sites in order to gauge teachers' current level of technology self-efficacy. From that…