Coordinating a Large, Amalgamated REU Program with Multiple Funding Sources

ERIC Educational Resources Information Center

Fiorini, Eugene; Myers, Kellen; Naqvi, Yusra

2017-01-01

In this paper, we discuss the challenges of organizing a large REU program amalgamated from multiple funding sources, including diverse participants, mentors, and research projects. We detail the program's structure, activities, and recruitment, and we hope to demonstrate that the organization of this REU is not only beneficial to its…

Specifying and Refining a Measurement Model for a Simulation-Based Assessment. CSE Report 619.

ERIC Educational Resources Information Center

Levy, Roy; Mislevy, Robert J.

2004-01-01

The challenges of modeling students' performance in simulation-based assessments include accounting for multiple aspects of knowledge and skill that arise in different situations and the conditional dependencies among multiple aspects of performance in a complex assessment. This paper describes a Bayesian approach to modeling and estimating…

A Multi-organisational Approach to Service Delivery

NASA Astrophysics Data System (ADS)

Purchase, Valerie; Mills, John; Parry, Glenn

Who is involved in delivering a service? There has been growing recognition in a wide variety of contexts that service is increasingly being delivered by multi-rather than single-organisational entities. Such recognition is evident not only in our experience but in a number of areas of literature including strategy development, core competence analysis, operations and supply chain management, and is reflected in and further facilitated by ICT developments. Customers have always been involved in some degree in the process of value delivery and such involvement is increasing to include complex co-creation of value. Such interactions are challenging when they involve individual customers, however, this becomes ever more challenging when the 'customer' is another organisation or when there are multiple 'customers'. Within this chapter we will consider some of the key drivers for a multi-organisational approach to service delivery; examine the ways in which the parties involved in service co-creation have expanded to include multiple service providers and customers; and finally, identify some of the challenges created by a multi-organisational approach to service delivery.

Building effective working relationships across culturally and ethnically diverse communities.

PubMed

Hosley, Cheryl A; Gensheimer, Linda; Yang, Mai

2003-01-01

Amherst H. Wilder Foundation's Social Adjustment Program for Southeast Asians is implementing two collaborative, best practice, mental health and substance abuse prevention service models in Minnesota. It faced several issues in effectively bridging multiple cultural groups, including building a diverse collaborative team, involving families and youth, reconciling cultural variation in meeting styles, and making best practice models culturally appropriate. Researchers and program staff used multiple strategies to address these challenges and build successful partnerships. Through shared goals, flexibility, and a willingness to explore and address challenges, collaboratives can promote stronger relationships across cultural communities and improve their service delivery systems.

Using agent-based modeling to study multiple risk factors and multiple health outcomes at multiple levels.

PubMed

Yang, Yong

2017-11-01

Most health studies focus on one health outcome and examine the influence of one or multiple risk factors. However, in reality, various pathways, interactions, and associations exist not only between risk factors and health outcomes but also among the risk factors and among health outcomes. The advance of system science methods, Big Data, and accumulated knowledge allows us to examine how multiple risk factors influence multiple health outcomes at multiple levels (termed a 3M study). Using the study of neighborhood environment and health as an example, I elaborate on the significance of 3M studies. 3M studies may lead to a significantly deeper understanding of the dynamic interactions among risk factors and outcomes and could help us design better interventions that may be of particular relevance for upstream interventions. Agent-based modeling (ABM) is a promising method in the 3M study, although its potentials are far from being fully explored. Future challenges include the gap of epidemiologic knowledge and evidence, lack of empirical data sources, and the technical challenges of ABM. © 2017 New York Academy of Sciences.

Integration and Testing Challenges of Small, Multiple Satellite Missions: Experiences From The Space Technology 5 Project

NASA Technical Reports Server (NTRS)

Sauerwein, Timothy A.; Gostomski, Thomas

2007-01-01

This brief presentation describes the mechanical and electrical integration activities and environmental testing challenges of the Space Technology 5 (ST5) Project. Lessons learned during this process are highlighted, including performing mechanical activities serially to gain efficiency through repetition and performing electrical activities based on the level of subsystem expertise available.

The Enduring Challenge of Determining Pneumonia Etiology in Children: Considerations for Future Research Priorities

PubMed Central

Hammitt, Laura L.; Murdoch, David R.; O’Brien, Katherine L.; Scott, J. Anthony G.

2017-01-01

Abstract Pneumonia kills more children each year worldwide than any other disease. Nonetheless, accurately determining the causes of childhood pneumonia has remained elusive. Over the past century, the focus of pneumonia etiology research has shifted from studies of lung aspirates and postmortem specimens intent on identifying pneumococcal disease to studies of multiple specimen types distant from the lung that are tested for multiple pathogens. Some major challenges facing modern pneumonia etiology studies include the use of nonspecific and variable case definitions, poor access to pathologic lung tissue and to specimens from fatal cases, poor diagnostic accuracy of assays (especially when testing nonpulmonary specimens), and the interpretation of results when multiple pathogens are detected in a given individual. The future of childhood pneumonia etiology research will likely require integrating data from complementary approaches, including applications of advanced molecular diagnostics and vaccine probe studies, as well as a renewed emphasis on lung aspirates from radiologically confirmed pneumonia and postmortem examinations. PMID:28575369

Implementing Applied Behavior Analysis for Effective Orientation and Mobility Instruction of Students with Multiple Disabilities

ERIC Educational Resources Information Center

O'Mea, Melanie L.

2013-01-01

Working with children who have multiple disabilities that include visual impairments can be especially challenging. Many disabling conditions manifest into behavioral difficulties that may take away from learning. Acting out may be a student's way of expressing a lack of healthy coping mechanisms in relation to his or her environment. Implementing…

Event recognition in personal photo collections via multiple instance learning-based classification of multiple images

NASA Astrophysics Data System (ADS)

Ahmad, Kashif; Conci, Nicola; Boato, Giulia; De Natale, Francesco G. B.

2017-11-01

Over the last few years, a rapid growth has been witnessed in the number of digital photos produced per year. This rapid process poses challenges in the organization and management of multimedia collections, and one viable solution consists of arranging the media on the basis of the underlying events. However, album-level annotation and the presence of irrelevant pictures in photo collections make event-based organization of personal photo albums a more challenging task. To tackle these challenges, in contrast to conventional approaches relying on supervised learning, we propose a pipeline for event recognition in personal photo collections relying on a multiple instance-learning (MIL) strategy. MIL is a modified form of supervised learning and fits well for such applications with weakly labeled data. The experimental evaluation of the proposed approach is carried out on two large-scale datasets including a self-collected and a benchmark dataset. On both, our approach significantly outperforms the existing state-of-the-art.

Turning challenges into design principles: Telemonitoring systems for patients with multiple chronic conditions.

PubMed

Sultan, Mehwish; Kuluski, Kerry; McIsaac, Warren J; Cafazzo, Joseph A; Seto, Emily

2018-01-01

People with multiple chronic conditions often struggle with managing their health. The purpose of this research was to identify specific challenges of patients with multiple chronic conditions and to use the findings to form design principles for a telemonitoring system tailored for these patients. Semi-structured interviews with 15 patients with multiple chronic conditions and 10 clinicians were conducted to gain an understanding of their needs and preferences for a smartphone-based telemonitoring system. The interviews were analyzed using a conventional content analysis technique, resulting in six themes. Design principles developed from the themes included that the system must be modular to accommodate various combinations of conditions, reinforce a routine, consolidate record keeping, as well as provide actionable feedback to the patients. Designing an application for multiple chronic conditions is complex due to variability in patient conditions, and therefore, design principles developed in this study can help with future innovations aimed to help manage this population.

Orion Entry, Descent, and Landing Performance and Mission Design

NASA Technical Reports Server (NTRS)

Broome, Joel M.; Johnson, Wyatt

2007-01-01

The Orion Vehicle is the next spacecraft to take humans into space and will include missions to ISS as well as missions to the Moon. As part of that challenge, the vehicle will have to accommodate multiple mission design concepts, since return from Low Earth Orbit and return from the Moon can be quite different. Commonality between the different missions as it relates to vehicle systems, guidance capability, and operations concepts is the goal. Several unique mission design concepts include the specification of multiple land-based landing sites for a vehicle with closed-loop direct and skip entry guidance, followed by a parachute descent and landing attenuation system. This includes the ability of the vehicle to accurately target and land at a designated landing site, including site location aspects, landing site size, and landing opportunities assessments. Analyses associated with these mission design and flight performance challenges and constraints will be discussed as well as potential operational concepts to provide feasibility and/or mission commonality.

Overview of Sparse Graph for Multiple Access in Future Mobile Networks

NASA Astrophysics Data System (ADS)

Lei, Jing; Li, Baoguo; Li, Erbao; Gong, Zhenghui

2017-10-01

Multiple access via sparse graph, such as low density signature (LDS) and sparse code multiple access (SCMA), is a promising technique for future wireless communications. This survey presents an overview of the developments in this burgeoning field, including transmitter structures, extrinsic information transform (EXIT) chart analysis and comparisons with existing multiple access techniques. Such technique enables multiple access under overloaded conditions to achieve a satisfactory performance. Message passing algorithm is utilized for multi-user detection in the receiver, and structures of the sparse graph are illustrated in detail. Outlooks and challenges of this technique are also presented.

Doing a Group Presentation: Negotiations and Challenges Experienced by Five Chinese ESL Students of Commerce at a Canadian University

ERIC Educational Resources Information Center

Yang, Luxin

2010-01-01

This study investigated the negotiations and challenges experienced by five Chinese ESL (English as a second language) students of Commerce through their engagement in an academic presentation in a regular content course at a Canadian university. Multiple sources of data were collected, including interviews, class observations, group discussions,…

Getting the Message: Intuition and Reflexivity in Professional Interpretations of Non-Verbal Behaviours in People with Profound Learning Disabilities

ERIC Educational Resources Information Center

Phelvin, Andrew

2013-01-01

This paper describes the current challenges facing nurses and other professionals who care for people with profound and multiple intellectual disabilities. This particularly vulnerable group of service users often rely on a repertoire of non-verbal behaviours to communicate their needs and wishes. These challenges include the requirements of…

Shuttle ku-band communications/radar technical concepts

NASA Technical Reports Server (NTRS)

Griffin, J. W.; Kelley, J. S.; Steiner, A. W.; Vang, H. A.; Zrubek, W. E.; Huth, G. K.

1985-01-01

Technical data on the Shuttle Orbiter K sub u-band communications/radar system are presented. The more challenging aspects of the system design and development are emphasized. The technical problems encountered and the advancements made in solving them are discussed. The radar functions are presented first. Requirements and design/implementation approaches are discussed. Advanced features are explained, including Doppler measurement, frequency diversity, multiple pulse repetition frequencies and pulse widths, and multiple modes. The communications functions that are presented include advances made because of the requirements for multiple communications modes. Spread spectrum, quadrature phase shift keying (QPSK), variable bit rates, and other advanced techniques are discussed. Performance results and conclusions reached are outlined.

Announcing the Launch of CPTAC’s Proteogenomics DREAM Challenge | Office of Cancer Clinical Proteomics Research

Cancer.gov

This week, we are excited to announce the launch of the National Cancer Institute’s Clinical Proteomic Tumor Analysis Consortium (CPTAC) Proteogenomics Computational DREAM Challenge.  The aim of this Challenge is to encourage the generation of computational methods for extracting information from the cancer proteome and for linking those data to genomic and transcriptomic information.  The specific goals are to predict proteomic and phosphoproteomic data from other multiple data types including transcriptomics and genetics.

The challenges of healthcare delivery to people with multiple sclerosis in Iran.

PubMed

Yazdannik, Ahmadreza; Abolhassani, Shahla; Taleghani, Fariba; Zamani, Ahmadreza

2015-01-01

Multiple sclerosis (MS) is a chronic disease prevalent in young and middle-aged people. Patients with MS often have numerous complicated needs and, consequently, require a broad range of health services. Results of a number of studies indicate that patients' needs are only partially met. This study was conducted to explore the challenges of healthcare delivery to patients with MS in Iran. In this qualitative case study, 43 participants selected through purposeful sampling were interviewed using semi-structured method in the cities of Isfahan and Tehran in 2012-2013. Besides the interview, documentations relevant to healthcare delivery were collected from different sources, including websites of all Iranian universities of medical sciences, insurance organizations, patients' weblogs, news agencies, the MS Center forum for MS patients, and MS Payam bimonthly. The data were analyzed through the constant comparative analysis. The data were categorized into four main categories, including functional challenges (diagnosis problems, failure to pay attention to patient needs, failure to follow-up, and miscommunication), administrative challenges (resource allocation and supervision), policy-making challenges (lack of comprehensive services, bureaucracy, and problems in provision of medications), and structural challenges (difficult access to services, lack of comprehensive centers, space limit, and long wait). Despite all attempts of governmental and nongovernmental organizations for healthcare delivery to MS patients, these services cannot satisfy all needs of the patients. In this regard, service providers and administrators should pay more attention to the needs and expectations of patients and their families.

Ethical Issues in Sports Medicine

PubMed Central

Greenfield, Bruce H.; West, Charles Robert

2012-01-01

Ethical issues present a challenge for health care professionals working with athletes of sports teams. Health care professionals—including the team physician, the physical therapist, and the athletic trainer—are faced with the challenge of returning an athlete to competition as quickly as possible but as safely as possible. Conflicts of interest arise due to conflicting obligations of the team physician to the athlete and other members of the sports organization, including coaches and the team owner. The multiple stakeholders involved in sports teams challenge the traditional notion of confidentiality and autonomy. The aims of this article are to explicate the ethics of sports medicine, highlight the ethical issues, and provide some strategies and suggestions for ethical decision making. PMID:24179585

The Enduring Challenge of Determining Pneumonia Etiology in Children: Considerations for Future Research Priorities.

PubMed

Feikin, Daniel R; Hammitt, Laura L; Murdoch, David R; O'Brien, Katherine L; Scott, J Anthony G

2017-06-15

Pneumonia kills more children each year worldwide than any other disease. Nonetheless, accurately determining the causes of childhood pneumonia has remained elusive. Over the past century, the focus of pneumonia etiology research has shifted from studies of lung aspirates and postmortem specimens intent on identifying pneumococcal disease to studies of multiple specimen types distant from the lung that are tested for multiple pathogens. Some major challenges facing modern pneumonia etiology studies include the use of nonspecific and variable case definitions, poor access to pathologic lung tissue and to specimens from fatal cases, poor diagnostic accuracy of assays (especially when testing nonpulmonary specimens), and the interpretation of results when multiple pathogens are detected in a given individual. The future of childhood pneumonia etiology research will likely require integrating data from complementary approaches, including applications of advanced molecular diagnostics and vaccine probe studies, as well as a renewed emphasis on lung aspirates from radiologically confirmed pneumonia and postmortem examinations. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Visions of Restoration in Fire-Adapted Forest Landscapes: Lessons from the Collaborative Forest Landscape Restoration Program.

PubMed

Urgenson, Lauren S; Ryan, Clare M; Halpern, Charles B; Bakker, Jonathan D; Belote, R Travis; Franklin, Jerry F; Haugo, Ryan D; Nelson, Cara R; Waltz, Amy E M

2017-02-01

Collaborative approaches to natural resource management are becoming increasingly common on public lands. Negotiating a shared vision for desired conditions is a fundamental task of collaboration and serves as a foundation for developing management objectives and monitoring strategies. We explore the complex socio-ecological processes involved in developing a shared vision for collaborative restoration of fire-adapted forest landscapes. To understand participant perspectives and experiences, we analyzed interviews with 86 respondents from six collaboratives in the western U.S., part of the Collaborative Forest Landscape Restoration Program established to encourage collaborative, science-based restoration on U.S. Forest Service lands. Although forest landscapes and group characteristics vary considerably, collaboratives faced common challenges to developing a shared vision for desired conditions. Three broad categories of challenges emerged: meeting multiple objectives, collaborative capacity and trust, and integrating ecological science and social values in decision-making. Collaborative groups also used common strategies to address these challenges, including some that addressed multiple challenges. These included use of issue-based recommendations, field visits, and landscape-level analysis; obtaining support from local agency leadership, engaging facilitators, and working in smaller groups (sub-groups); and science engagement. Increased understanding of the challenges to, and strategies for, developing a shared vision of desired conditions is critical if other collaboratives are to learn from these efforts.

Visions of Restoration in Fire-Adapted Forest Landscapes: Lessons from the Collaborative Forest Landscape Restoration Program

NASA Astrophysics Data System (ADS)

Urgenson, Lauren S.; Ryan, Clare M.; Halpern, Charles B.; Bakker, Jonathan D.; Belote, R. Travis; Franklin, Jerry F.; Haugo, Ryan D.; Nelson, Cara R.; Waltz, Amy E. M.

2017-02-01

Collaborative approaches to natural resource management are becoming increasingly common on public lands. Negotiating a shared vision for desired conditions is a fundamental task of collaboration and serves as a foundation for developing management objectives and monitoring strategies. We explore the complex socio-ecological processes involved in developing a shared vision for collaborative restoration of fire-adapted forest landscapes. To understand participant perspectives and experiences, we analyzed interviews with 86 respondents from six collaboratives in the western U.S., part of the Collaborative Forest Landscape Restoration Program established to encourage collaborative, science-based restoration on U.S. Forest Service lands. Although forest landscapes and group characteristics vary considerably, collaboratives faced common challenges to developing a shared vision for desired conditions. Three broad categories of challenges emerged: meeting multiple objectives, collaborative capacity and trust, and integrating ecological science and social values in decision-making. Collaborative groups also used common strategies to address these challenges, including some that addressed multiple challenges. These included use of issue-based recommendations, field visits, and landscape-level analysis; obtaining support from local agency leadership, engaging facilitators, and working in smaller groups (sub-groups); and science engagement. Increased understanding of the challenges to, and strategies for, developing a shared vision of desired conditions is critical if other collaboratives are to learn from these efforts.

Challenging Ties between State and Tobacco Industry: Advocacy Lessons from India

PubMed Central

Bhojani, Upendra; Venkataraman, Vidya; Manganawar, Bheemaray

2013-01-01

Background: Globally, tobacco use is a major public health concern given its huge morbidity and mortality burden that is inequitably high in low- and middle-income countries. The World Health Organization has suggested banning the advertisement, promotion and sponsorship of tobacco. However, governments in some countries, including India, are either directly engaged in tobacco industry operations or have a mandate to promote tobacco industry development. This paper analyses a short-term advocacy campaign that challenged the state-tobacco industry ties to draw lessons for effective public health advocacy. Method: This paper uses a case study method to analyze advocacy efforts in India to thwart the state-tobacco industry partnership: the Indian government’s sponsorship and support to a global tobacco industry event. The paper explores multiple strategies employed in the five-month advocacy campaign (May to October 2010) to challenge this state-industry tie. In doing so, we describe the challenges faced and the lessons learnt for effective advocacy. Results: Government withdrew participation and financial sponsorship from the tobacco industry event. Use of multiple strategies including engaging all concerned government agencies from the beginning, strategic use of media, presence and mobilization of civil society, and use of legal tools to gain information and judicial action, were complementary in bringing desired outcomes. Conclusion: Use of multiple and complementary advocacy strategies could lead to positive outcomes in a short-time campaign. The Framework Convention on Tobacco Control could form an important advocacy tool, especially in countries that have ratified it, to advocate for improvements in national tobacco control regulations. PMID:24688958

Integrative data analysis in clinical psychology research.

PubMed

Hussong, Andrea M; Curran, Patrick J; Bauer, Daniel J

2013-01-01

Integrative data analysis (IDA), a novel framework for conducting the simultaneous analysis of raw data pooled from multiple studies, offers many advantages including economy (i.e., reuse of extant data), power (i.e., large combined sample sizes), the potential to address new questions not answerable by a single contributing study (e.g., combining longitudinal studies to cover a broader swath of the lifespan), and the opportunity to build a more cumulative science (i.e., examining the similarity of effects across studies and potential reasons for dissimilarities). There are also methodological challenges associated with IDA, including the need to account for sampling heterogeneity across studies, to develop commensurate measures across studies, and to account for multiple sources of study differences as they impact hypothesis testing. In this review, we outline potential solutions to these challenges and describe future avenues for developing IDA as a framework for studies in clinical psychology.

Integrative Data Analysis in Clinical Psychology Research

PubMed Central

Hussong, Andrea M.; Curran, Patrick J.; Bauer, Daniel J.

2013-01-01

Integrative Data Analysis (IDA), a novel framework for conducting the simultaneous analysis of raw data pooled from multiple studies, offers many advantages including economy (i.e., reuse of extant data), power (i.e., large combined sample sizes), the potential to address new questions not answerable by a single contributing study (e.g., combining longitudinal studies to cover a broader swath of the lifespan), and the opportunity to build a more cumulative science (i.e., examining the similarity of effects across studies and potential reasons for dissimilarities). There are also methodological challenges associated with IDA, including the need to account for sampling heterogeneity across studies, to develop commensurate measures across studies, and to account for multiple sources of study differences as they impact hypothesis testing. In this review, we outline potential solutions to these challenges and describe future avenues for developing IDA as a framework for studies in clinical psychology. PMID:23394226

Pancreatic trauma: demographics, diagnosis, and management.

PubMed

Stawicki, Stanislaw Peter; Schwab, C William

2008-12-01

Pancreatic injuries are rare, with penetrating mechanisms being causative in majority of cases. They can create major diagnostic and therapeutic challenges and require multiple diagnostic modalities, including multislice high-definition computed tomography, magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, ultrasonography, and at times, surgery and direct visualization of the pancreas. Pancreatic trauma is frequently associated with duodenal and other severe vascular and visceral injuries. Mortality is high and usually related to the concomitant vascular injury. Surgical management of pancreatic and pancreatic-duodenal trauma is challenging, and multiple surgical approaches and techniques have been described, up to and including pancreatic damage control and later resection and reconstruction. Wide surgical drainage is a key to any surgical trauma technique and access for enteral nutrition, or occasionally parenteral nutrition, are important adjuncts. Morbidity associated with pancreatic trauma is high and can be quite severe. Treatment of pancreatic trauma-related complications often requires a combination of interventional, endoscopic, and surgical approaches.

Multiple-level stakeholder engagement in malaria clinical trials: addressing the challenges of conducting clinical research in resource-limited settings.

PubMed

Mtove, George; Kimani, Joshua; Kisinza, William; Makenga, Geofrey; Mangesho, Peter; Duparc, Stephan; Nakalembe, Miriam; Phiri, Kamija S; Orrico, Russell; Rojo, Ricardo; Vandenbroucke, Pol

2018-03-22

Multinational clinical trials are logistically complex and require close coordination between various stakeholders. They must comply with global clinical standards and are accountable to multiple regulatory and ethical bodies. In resource-limited settings, it is challenging to understand how to apply global clinical standards to international, national, and local factors in clinical trials, making multiple-level stakeholder engagement an important element in the successful conduct of these clinical trials. During the planning and implementation of a large multinational clinical trial for intermittent preventive treatment of malaria in pregnancy in resource-limited areas of sub-Saharan Africa, we encountered numerous challenges, which required implementation of a range of engagement measures to ensure compliance with global clinical and regulatory standards. These challenges included coordination with ongoing global malaria efforts, heterogeneity in national regulatory structures, sub-optimal healthcare infrastructure, local practices and beliefs, and perspectives that view healthcare providers with undue trust or suspicion. In addition to engagement with international bodies, such as the World Health Organization, the Malaria in Pregnancy Consortium, the Steve Biko Centre for Bioethics, and the London School of Hygiene and Tropical Medicine, in order to address the challenges just described, Pfizer Inc. and Medicines for Malaria Venture (the "Sponsoring Entities" for these studies) and investigators liaised with national- and district-level stakeholders such as health ministers and regional/local community health workers. Community engagement measures undertaken by investigators included local meetings with community leaders to explain the research aims and answer questions and concerns voiced by the community. The investigators also engaged with family members of prospective trial participants in order to be sensitive to local practices and beliefs. Engagement with key stakeholders at international and national levels enabled the Sponsoring Entities to address challenges by aligning the study design with the requirements of health and regulatory agencies and to understand and address healthcare infrastructure needs prior to trial initiation. Local stakeholder engagement, including community members, study participants, and family enabled the investigators to address challenges by ensuring that study design and conduct were adapted to local considerations and ensuring accurate information about the study aims was shared with the public. ClinicalTrials.gov, ID: NCT01103063 . Registered on 7 April 2010.

Using the Visual and Performing Arts to Complement Young Adolescents' "Close Reading" of Texts

ERIC Educational Resources Information Center

McDermott, Peter; Falk-Ross, Francine; Medow, Sharon

2017-01-01

The educational needs of young adolescents require that curricula include a more expanded set of multiple integrative approaches, including new literacies, and that it be "challenging, exploratory, integrative, and relevant" (National Middle School Association, 2010). Although educators are now focusing on the addition of digital formats…

Threats to family planning services in Michigan: organizational responses to economic and political challenges.

PubMed

Dalton, Vanessa K; Jacobson, Peter D; Berson-Grand, Julie; Weisman, Carol S

2005-01-01

Title X is the only federal funding specifically for contraception and family planning services. This study identifies the threats and challenges Title X family planning organizations face in Michigan, and examines organizational responses to these challenges. We hypothesized that organizational responses to current challenges, including recent legislation, would differ between organizational types. We used a multiple case study design to examine safety net providers that received Title X funding in 2001. Cases were selected to represent economic and geographic diversity and included a mix of population densities. Key informants at each organization participated in face-to-face, semistructured interviews. Interviews collected data on current challenges, organizational planning processes, and organizational responses. All Title X organizations reported significant challenges, including rising costs, increasing need, and inadequate funding. Private organizations were more concerned about political challenges, especially recent Michigan legislation, than health departments. Organizational type was associated with the type of response. Health departments tended to close clinics or cut services, whereas private organizations recruited insured populations and increased patient fees. Based on these findings, the family planning safety net in Michigan appears to be undergoing significant change. These changes may decrease the availability of affordable family planning services in Michigan.

Appalachian residents’ experiences with and management of multiple morbidity

PubMed Central

Schoenberg, Nancy E.; Bardach, Shoshana H.; Manchikanti, Kavita N.; Goodenow, Anne C.

2011-01-01

Approximately three quarters of middle aged and older adults have at least two simultaneously occurring chronic conditions (“multiple morbidity” or MM), a trend expected to increase dramatically throughout the world. Rural residents, who tend to have fewer personal and health resources, are more likely to experience MM. To improve our understanding of the ways in which vulnerable, rural residents in the U.S. experience and manage MM, we interviewed twenty rural Appalachian residents with MM. We identified the following themes; (a) MM has multifaceted challenges and is viewed as more than the sum of its parts; (b) numerous challenges exist to optimal MM self-management, particularly in a rural, under-resourced context; however, (c) participants described strategic methods of managing multiple chronic conditions, including prioritizing certain conditions and management strategies and drawing heavily on assistance from informal and formal sources. PMID:21263063

Reflections on Native Ethnography by a Nurse Researcher.

PubMed

Abdulrehman, Munib Said

2017-03-01

There are benefits and challenges associated with conducting research in a familiar setting, especially when the researcher is more an insider than an outsider. The aim of this article is to explore the author's experience as a native scholar conducting ethnographic research among the Swahili peoples of Lamu, Kenya. This article focuses on methodological issues related to conducting ethnographic research among the author's own people, including examining the issues of anthropological reflexivity as a native ethnographer and highlighting the author's experiences embodying multiple identities. Native ethnographers must consider the challenges associated with negotiating multiple roles in the research setting, especially in the presence of sociocultural factors such as gender stratification, complex kinship networks, socioeconomic hierarchies, illiteracy, and poverty. Embracing rather than being confused by the multiple levels of understanding native researchers bring to studies of their communities opens up new avenues of research and possibilities.

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

J. Carmack; L. Braase; F. Goldner

The mission of the Advanced Fuels Campaign (AFC) is to perform Research, Development, and Demonstration (RD&D) activities for advanced fuel forms (including cladding) to enhance the performance and safety of the nation’s current and future reactors, enhance proliferation resistance of nuclear fuel, effectively utilize nuclear energy resources, and address the longer-term waste management challenges. This includes development of a state of the art Research and Development (R&D) infrastructure to support the use of a “goal oriented science based approach.” AFC uses a “goal oriented, science based approach” aimed at a fundamental understanding of fuel and cladding fabrication methods and performancemore » under irradiation, enabling the pursuit of multiple fuel forms for future fuel cycle options. This approach includes fundamental experiments, theory, and advanced modeling and simulation. One of the most challenging aspects of AFC is the management, integration, and coordination of major R&D activities across multiple organizations. AFC interfaces and collaborates with Fuel Cycle Technologies (FCT) campaigns, universities, industry, various DOE programs and laboratories, federal agencies (e.g., Nuclear Regulatory Commission [NRC]), and international organizations. Key challenges are the development of fuel technologies to enable major increases in fuel performance (safety, reliability, power and burnup) beyond current technologies, and development of characterization methods and predictive fuel performance models to enable more efficient development and licensing of advanced fuels. Challenged with the research and development of fuels for two different reactor technology platforms, AFC targeted transmutation fuel development and focused ceramic fuel development for Advanced LWR Fuels.« less

Ethical issues in sports medicine: a review and justification for ethical decision making and reasoning.

PubMed

Greenfield, Bruce H; West, Charles Robert

2012-11-01

Ethical issues present a challenge for health care professionals working with athletes of sports teams. Health care professionals-including the team physician, the physical therapist, and the athletic trainer-are faced with the challenge of returning an athlete to competition as quickly as possible but as safely as possible. Conflicts of interest arise due to conflicting obligations of the team physician to the athlete and other members of the sports organization, including coaches and the team owner. The multiple stakeholders involved in sports teams challenge the traditional notion of confidentiality and autonomy. The aims of this article are to explicate the ethics of sports medicine, highlight the ethical issues, and provide some strategies and suggestions for ethical decision making.

Stakeholders' perspective on issues and challenges associated with care and treatment of aging-related cognitive impairment disorders in Singapore.

PubMed

Setia, Monika; Islam, Amina M; Thompson, James P; Matchar, David B

2011-11-01

An expanding elderly population poses challenges for the provision of care and treatment for age-related physical and mental disorders. Cognitive impairment (CI)/dementia is one such mental disorder that is on the rise in Singapore and has concomitant implications for social and health systems. The objective of this study is to understand the perspectives of prominent stakeholders about current and future issues and challenges associated with CI/dementia among the elderly in Singapore. Using indepth interviews, this qualitative study obtained the views of multiple stakeholders on issues and challenges associated with CI/dementia in Singapore. The 30 individuals interviewed as part of the study included clinicians, policy-makers, researchers, community workers, administrators, and caregivers. Using a framework approach, interview texts were indexed into domains and issues by utilizing NVivo 9.0 software. The stakeholders expressed concerns related to multiple domains of the CI/dementia care system: attitude and awareness, economics, education, family caregiving, inputs to care system, living arrangements, prevention, screening and diagnosis, and treatment and management of care. Within each domain, multiple issues and challenges were identified by respondents. The study identifies a complex set of inter-related issues and challenges that are associated with the care and treatment of people with CI/dementia. The results suggest that CI and dementia profoundly affect patients, families, and communities and that the issues related to the two disorders are truly system-wide. These findings lay the foundation for utilization of a systems approach to studying CI/dementia and provide an analytic framework for future research on complex health care issues.

The challenges of healthcare delivery to people with multiple sclerosis in Iran

PubMed Central

Yazdannik, Ahmadreza; Abolhassani, Shahla; Taleghani, Fariba; Zamani, Ahmadreza

2015-01-01

Background: Multiple sclerosis (MS) is a chronic disease prevalent in young and middle-aged people. Patients with MS often have numerous complicated needs and, consequently, require a broad range of health services. Results of a number of studies indicate that patients’ needs are only partially met. Aims: This study was conducted to explore the challenges of healthcare delivery to patients with MS in Iran. Materials and Methods: In this qualitative case study, 43 participants selected through purposeful sampling were interviewed using semi-structured method in the cities of Isfahan and Tehran in 2012–2013. Besides the interview, documentations relevant to healthcare delivery were collected from different sources, including websites of all Iranian universities of medical sciences, insurance organizations, patients’ weblogs, news agencies, the MS Center forum for MS patients, and MS Payam bimonthly. The data were analyzed through the constant comparative analysis. Results: The data were categorized into four main categories, including functional challenges (diagnosis problems, failure to pay attention to patient needs, failure to follow-up, and miscommunication), administrative challenges (resource allocation and supervision), policy-making challenges (lack of comprehensive services, bureaucracy, and problems in provision of medications), and structural challenges (difficult access to services, lack of comprehensive centers, space limit, and long wait). Conclusion: Despite all attempts of governmental and nongovernmental organizations for healthcare delivery to MS patients, these services cannot satisfy all needs of the patients. In this regard, service providers and administrators should pay more attention to the needs and expectations of patients and their families. PMID:27462625

Quantifying VOC emissions from polymers: A case study

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

Schulze, J.K.; Qasem, J.S.; Snoddy, R.

1996-12-31

Evaluating residual volatile organic compound emissions emanating from low-density polyethylene can pose significant challenges. These challenges include quantifying emissions from: (a) multiple process lines with different operating conditions; (b) several different comonomers; (c) variations of comonomer content in each grade; and (d) over 120 grades of LDPE. This presentation is a Case Study outlining a project to develop grade-specific emission data for low-density polyethylene pellets. This study included extensive laboratory analyses and required the development of a relational database to compile analytical results, calculate the mean concentration and standard deviation, and generate emissions reports.

VAST Challenge 2014: The Kronos Incident

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

Whiting, Mark A.; Cook, Kristin A.; Grinstein, Georges

2014-10-31

The 2014 IEEE Visual Analytics Science and Technology (VAST) Challenge presented researchers with a single fictitious scenario: the disappearance of staff members of the GASTech oil and gas company on location on the island of Kronos. A group named the Protectors of Kronos (POK) was the prime suspect in the disappearance. Three mini-challenges and a grand challenge were offered. Mini-challenge 1 included multiple types of text data for participants to provide a timeline of key events and characterize the POK, mini-challenge 2 focused on individuals’ movement and financial data for participants to provide patterns of daily life, and mini-challenge 3more » featured real-time streaming social media and emergency service data for participants to provide hostage and kidnapper information. The grand challenge asked the participants to integrate results and generate a synopsis of events. The VAST Challenge received 73 submissions from 13 countries« less

The Long Term Agroecosystem Research Network - Shared research strategy

USDA-ARS?s Scientific Manuscript database

Agriculture faces tremendous challenges in meeting multiple societal goals, including a safe and plentiful food supply; climate change adaptation and mitigation; supplying sources of bioenergy; improving water, air, and soil quality; and maintaining biodiversity. The Long Term Agroecosystem Research...

Math Wars.

ERIC Educational Resources Information Center

Abreu, Julio

2000-01-01

Four decades ago following Russia's Sputnik satellite launching, the nation embraced "new" math as part of its commitment not to fall behind its global neighbors. Issues addressed in "new-new" math include equal access to challenging learning, problem solving, reasoning and proof, communications, multiple ways to solve…

Overview on Deaf-Blindness.

ERIC Educational Resources Information Center

Miles, Barbara

1995-01-01

This overview provides basic information on the causes of deaf-blindness and the particular challenges faced by individuals with deaf-blindness. Causes of deaf-blindness include various syndromes, multiple congenital anomalies, prematurity, congenital prenatal dysfunction, and various postnatal causes. Differences between people deaf-blind from…

Drug Use and Multiple Sex Partners among Homeless Ex-Offenders: Secondary Findings from an Experimental Study

PubMed Central

Nyamathi, Adeline M.; Zhang, Sheldon; Wall, Sarah; Hall, Elizabeth A.; Salem, Benissa E.; Farabee, David; Faucette, Mark; Yadav, Kartik

2016-01-01

Background Transitioning into society after release from incarceration presents real challenges for male offenders; in California, up to 60% return to prison within three years following release. The risk for ongoing drug use and having sex with multiple sex partners is a significant challenge for ex-offenders preparing to enter the community. Objectives The aims are to describe drug use and sexual behavior (sex with multiple partners) prior to incarceration and six and 12 months following study enrollment using data obtained as part of a randomized controlled trial (RCT). Methods This is a planned secondary analysis of data obtained as part of an RCT designed to study the effects of intensive peer coaching and nurse case management, intensive peer coaching, and brief nurse counseling on hepatitis A and B vaccination adherence compared to a usual care control treatment that also included brief peer coaching and brief nurse counseling. Self-report data from subjects enrolled at one residential drug treatment facility in Los Angeles were captured at three time points: baseline, and six- and 12-month follow up. Results Findings showed substantive and significant reductions in drug use and engaging in sex with multiple partners six months following enrollment into the study compared to the baseline data, but results did not differ by study condition. At 12-month follow up, drug use and sex with multiple partners increased, but remained less than at baseline levels. Discussion Sustaining reductions in drug use and engaging in sex with multiple partners remains a challenge following incarceration. PMID:27124254

Feasibility of an International Multiple Sclerosis Rehabilitation Data Repository: Perceived Challenges and Motivators for Sharing Data.

PubMed

Bradford, Elissa Held; Baert, Ilse; Finlayson, Marcia; Feys, Peter; Wagner, Joanne

2018-01-01

Multiple sclerosis (MS) rehabilitation evidence is limited due to methodological factors, which may be addressed by a data repository. We describe the perceived challenges of, motivators for, interest in participating in, and key features of an international MS rehabilitation data repository. A multimethod sequential investigation was performed with the results of two focus groups, using nominal group technique, and study aims informing the development of an online questionnaire. Percentage agreement and key quotations illustrated questionnaire findings. Subgroup comparisons were made between clinicians and researchers and between participants in North America and Europe. Rehabilitation professionals from 25 countries participated (focus groups: n = 21; questionnaire: n = 166). The top ten challenges (C) and motivators (M) identified by the focus groups were database control/management (C); ethical/legal concerns (C); data quality (C); time, effort, and cost (C); best practice (M); uniformity (C); sustainability (C); deeper analysis (M); collaboration (M); and identifying research needs (M). Percentage agreement with questionnaire statements regarding challenges to, motivators for, interest in, and key features of a successful repository was at least 80%, 85%, 72%, and 83%, respectively, across each group of statements. Questionnaire subgroup analysis revealed a few differences (P < .05), including that clinicians more strongly identified with improving best practice as a motivator. Findings support clinician and researcher interest in and potential for success of an international MS rehabilitation data repository if prioritized challenges and motivators are addressed and key features are included.

Challenges of Implementing a Communication-and-Resolution Program Where Multiple Organizations Must Cooperate.

PubMed

Mello, Michelle M; Armstrong, Sarah J; Greenberg, Yelena; McCotter, Patricia I; Gallagher, Thomas H

2016-12-01

To implement a communication-and-resolution program (CRP) in a setting in which liability insurers and health care facilities must collaborate to resolve incidents involving a facility and separately insured clinicians. Six hospitals and clinics and a liability insurer in Washington State. Sites designed and implemented CRPs and contributed information about cases and operational challenges over 20 months. Data were qualitatively analyzed. Data from interviews with personnel responsible for CRP implementation were triangulated with data on program cases collected by sites and notes recorded during meetings with sites and among project team members. Sites experienced small victories in resolving particular cases and streamlining some working relationships, but they were unable to successfully implement a collaborative CRP. Barriers included the insurer's distance from the point of care, passive rather than active support from top leaders, coordinating across departments and organizations, workload, nonparticipation by some physicians, and overcoming distrust. Operating CRPs where multiple organizations must collaborate can be highly challenging. Success likely requires several preconditions, including preexisting trust among organizations, active leadership engagement, physicians' commitment to participate, mechanisms for quickly transmitting information to insurers, tolerance for missteps, and clear protocols for joint investigations and resolutions. © Health Research and Educational Trust.

What are the challenges in developing effective health policies for obesity?

PubMed

Binks, M; Chin, S-H

2017-06-01

Identifying and implementing thoughtful, evidence-based (or at least evidence-informed) public health approaches to influencing obesity is a complex issue fraught with multiple challenges. These challenges begin with determining whether obesity policy approaches should be implemented. This is considered within the broader context of how common public health policy approaches may be relevant and applied to obesity. Additional challenges discussed include inconsistencies in clearly identifying obesity policy targets (for example, prevention versus treatment), selection of appropriate intervention targets and the identification and measurement of meaningful outcomes. Current policy initiatives are drawn upon to illustrate these challenges in the context of promoting solution-focused dialog aimed toward improving current initiatives and informing the development of new programs.

Cleared for Launch - Lessons Learned from the OSIRIS-REx System Requirements Verification Program

NASA Technical Reports Server (NTRS)

Stevens, Craig; Adams, Angela; Williams, Bradley; Goodloe, Colby

2017-01-01

Requirements verification of a large flight system is a challenge. It is especially challenging for engineers taking on their first role in space systems engineering. This paper describes our approach to verification of the Origins, Spectral Interpretation, Resource Identification, Security-Regolith Explorer (OSIRIS-REx) system requirements. It also captures lessons learned along the way from developing systems engineers embroiled in this process. We begin with an overview of the mission and science objectives as well as the project requirements verification program strategy. A description of the requirements flow down is presented including our implementation for managing the thousands of program and element level requirements and associated verification data. We discuss both successes and methods to improve the managing of this data across multiple organizational interfaces. Our approach to verifying system requirements at multiple levels of assembly is presented using examples from our work at instrument, spacecraft, and ground segment levels. We include a discussion of system end-to-end testing limitations and their impacts to the verification program. Finally, we describe lessons learned that are applicable to all emerging space systems engineers using our unique perspectives across multiple organizations of a large NASA program.

Challenges of Applying a Comprehensive Model of Intervention Fidelity

PubMed Central

Bosak, Kelly; Pozehl, Bunny; Yates, Bernice

2014-01-01

Applying a comprehensive model of fidelity to interventions delivered by Information and Communication Technology (ICT) has multiple challenges. Fidelity must be considered in the design, implementation, evaluation, and reporting of the intervention. The fidelity strategies must address the unique aspects of the technology, including training providers to instruct participants to use the technology and to provide standardized feedback, rather than deliver the intervention in-person. Other challenges include the nonspecific effects resulting from participants accessing unintended content in interventions delivered by the Internet. ICT allows participant receipt and enactment of intervention skills to be assessed by electronic evidence, rather than in-person observation. Interventions using ICT, such as the Internet are unique, and there is less control of participant interaction with various electronic components. Monitoring participant use and providing standardized feedback for receipt and enactment of intervention skills is key to ensuring intervention fidelity. The final challenges involve evaluating and reporting fidelity. PMID:21474676

Immune modulation of host response to coccidiosis and necrotic enteritis to reduce antibiotics

USDA-ARS?s Scientific Manuscript database

Multiple challenges confront the rising demand for poultry food products, including governmental restrictions on the use of antibiotic growth promoters, high-density production conditions, waste management, and the emergence of infectious pathogens, particularly those that cause intestinal diseases....

IHE cross-enterprise document sharing for imaging: design challenges

NASA Astrophysics Data System (ADS)

Noumeir, Rita

2006-03-01

Integrating the Healthcare Enterprise (IHE) has recently published a new integration profile for sharing documents between multiple enterprises. The Cross-Enterprise Document Sharing Integration Profile (XDS) lays the basic framework for deploying regional and national Electronic Health Record (EHR). This profile proposes an architecture based on a central Registry that holds metadata information describing published Documents residing in one or multiple Documents Repositories. As medical images constitute important information of the patient health record, it is logical to extend the XDS Integration Profile to include images. However, including images in the EHR presents many challenges. The complete image set is very large; it is useful for radiologists and other specialists such as surgeons and orthopedists. The imaging report, on the other hand, is widely needed and its broad accessibility is vital for achieving optimal patient care. Moreover, a subset of relevant images may also be of wide interest along with the report. Therefore, IHE recently published a new integration profile for sharing images and imaging reports between multiple enterprises. This new profile, the Cross-Enterprise Document Sharing for Imaging (XDS-I), is based on the XDS architecture. The XDS-I integration solution that is published as part of the IHE Technical Framework is the result of an extensive investigation effort of several design solutions. This paper presents and discusses the design challenges and the rationales behind the design decisions of the IHE XDS-I Integration Profile, for a better understanding and appreciation of the final published solution.

Multimorbidity, service organization and clinical decision making in primary care: a qualitative study.

PubMed

Bower, Peter; Macdonald, Wendy; Harkness, Elaine; Gask, Linda; Kendrick, Tony; Valderas, Jose M; Dickens, Chris; Blakeman, Tom; Sibbald, Bonnie

2011-10-01

Primary care professionals often manage patients with multiple long-term health conditions, but managing multimorbidity is challenging given time and resource constraints and interactions between conditions. To explore GP and nurse perceptions of multimorbidity and the influence on service organization and clinical decision making. A qualitative interview study with primary care professionals in practices in Greater Manchester, U.K. Interviews were conducted with 15 GPs and 10 practice nurses. Primary care professionals identified tensions between delivering care to meet quality targets and fulfilling the patient's agenda, tensions which are exacerbated in multimorbidity. They were aware of the inconvenience suffered by patients through attendance at multiple clinic appointments when care was structured around individual conditions. They reported difficulties managing patients with multimorbidity in limited consultation time, which led to adoption of an 'additive-sequential' decision-making model which dealt with problems in priority order until consultation resources were exhausted, when further management was deferred. Other challenges included the need for patients to co-ordinate their care, the difficulties of self-management support in multimorbidity and problems of making sense of the relationships between physical and mental health. Doctor and nurse accounts included limited consideration of multimorbidity in terms of the interactions between conditions or synergies between management of different conditions. Primary care professionals identify a number of challenges in care for multimorbidity and adopt a particular model of decision making to deliver care for multiple individual conditions. However, they did not describe specific decision making around managing multimorbidity per se.

Novel Control Strategy for Multiple Run-of-the-River Hydro Power Plants to Provide Grid Ancillary Services

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

Mohanpurkar, Manish; Luo, Yusheng; Hovsapian, Rob

Hydropower plant (HPP) generation comprises a considerable portion of bulk electricity generation and is delivered with a low-carbon footprint. In fact, HPP electricity generation provides the largest share from renewable energy resources, which include wind and solar. Increasing penetration levels of wind and solar lead to a lower inertia on the electric grid, which poses stability challenges. In recent years, breakthroughs in energy storage technologies have demonstrated the economic and technical feasibility of extensive deployments of renewable energy resources on electric grids. If integrated with scalable, multi-time-step energy storage so that the total output can be controlled, multiple run-of-the-river (ROR)more » HPPs can be deployed. Although the size of a single energy storage system is much smaller than that of a typical reservoir, the ratings of storages and multiple ROR HPPs approximately equal the rating of a large, conventional HPP. This paper proposes cohesively managing multiple sets of energy storage systems distributed in different locations. This paper also describes the challenges associated with ROR HPP system architecture and operation.« less

Electronic nose for detecting multiple targets

NASA Astrophysics Data System (ADS)

Chakraborty, Anirban; Parthasarathi, Ganga; Poddar, Rakesh; Zhao, Weiqiang; Luo, Cheng

2006-05-01

The discovery of high conductivity in doped polyacetylene in 1977 (garnering the 2000 Nobel Prize in Chemistry for the three discovering scientists) has attracted considerable interest in the application of polymers as the semiconducting and conducting materials due to their promising potential to replace silicon and metals in building devices. Previous and current efforts in developing conducting polymer microsystems mainly focus on generating a device of a single function. When multiple micropatterns made of different conducting polymers are produced on the same substrate, many microsystems of multiple functions can be envisioned. For example, analogous to the mammalian olfactory system which includes over 1,000 receptor genes in detecting various odors (e.g., beer, soda etc.), a sensor consisting of multiple distinct conducting polymer sensing elements will be capable of detecting a number of analytes simultaneously. However, existing techniques present significant technical challenges of degradation, low throughput, low resolution, depth of field, and/or residual layer in producing conducting polymer microstructures. To circumvent these challenges, an intermediate-layer lithography method developed in our group is used to generate multiple micropatterns made of different, commonly used conducting polymers, Polypyrrole (PPy), Poly(3,4-ethylenedioxy)thiophene (PEDOT) and Polyaniline (PANI). The generated multiple micropatterns are further used in an "electronic nose" to detect water vapor, glucose, toluene and acetone.

Tourette syndrome in children and adolescents: special considerations.

PubMed

Eapen, Valsamma; Crncec, Rudi

2009-12-01

Tourette syndrome (TS) affects people of all ages, with onset in early childhood and continuing through the different stages of the life cycle into adolescence and adults. This review focuses on barriers to diagnosis and challenges in the management of young patients with TS. Barriers to identification occur at multiple levels, including detection in the community setting (including schools), parents' help-seeking behavior, and cultural influences on such behavior, as well as diagnosis by the medical provider. Challenges to management include unfamiliarity of primary care providers, inconsistencies in the diagnosis and management plan, and failure to recognize comorbid conditions, as well as inadequate knowledge and lack of resources to effectively deal with comorbidities. In addition to the complexities posed by pharmacological interactions, there are unique psychosocial challenges experienced by young people with TS and their families. Effective communication and collaboration between families, health care providers, and school personnel, as well as supportive communities, are essential components of comprehensive management.

Spinning a stem cell ethics web.

PubMed

McDonald, Michael; Longstaff, Holly

2013-01-01

The goal of this study was to provide an ethics education resource for trainees and researchers in the Canadian Stem Cell Network that would address the multiple ethical challenges in stem cell research including accountability in and for research across its multiple dimensions. The website was built using a bottom-up type approach based on an ethics needs assessment in combination with a top-down expert-driven component. There have been 3,615 visitors to the website since it was launched in July, 2011. The ongoing rate of returning visitors (20%) indicates that the website is becoming a valuable tool used multiple times.

Planning as an Iterative Process

NASA Technical Reports Server (NTRS)

Smith, David E.

2012-01-01

Activity planning for missions such as the Mars Exploration Rover mission presents many technical challenges, including oversubscription, consideration of time, concurrency, resources, preferences, and uncertainty. These challenges have all been addressed by the research community to varying degrees, but significant technical hurdles still remain. In addition, the integration of these capabilities into a single planning engine remains largely unaddressed. However, I argue that there is a deeper set of issues that needs to be considered namely the integration of planning into an iterative process that begins before the goals, objectives, and preferences are fully defined. This introduces a number of technical challenges for planning, including the ability to more naturally specify and utilize constraints on the planning process, the ability to generate multiple qualitatively different plans, and the ability to provide deep explanation of plans.

BEST PRACTICES TO SUPPORT AND IMPROVE PAVEMENT MANAGEMENT SYSTEMS FOR LOW-VOLUME PAVED ROADS – PHASE I

DOT National Transportation Integrated Search

2018-02-02

The Colorado Department of Transportation (CDOT) has been trying to identify the most effective methods for managing low-volume roads (LVRs). These roads are facing multiple challenges including: reductions in maintenance budgets, impact of industria...

CHALLENGES OF PROCESSING BIOLOGICAL DATA FOR INCORPORATION INTO A LAKE EUTROPHICATION MODEL

EPA Science Inventory

A eutrophication model is in development as part of the Lake Michigan Mass Balance Project (LMMBP). Successful development and calibration of this model required the processing and incorporation of extensive biological data. Data were drawn from multiple sources, including nutrie...

Integrative approaches: promoting socioecological resilience

Treesearch

J.W. Long; Carl Skinner; M. North; C.T. Hunsaker; L. Quinn-Davidson

2014-01-01

This chapter begins by discussing current challenges for ecosystem management that emerged from multiple chapters of the full synthesis. It then considers integrative approaches to promote resilience, including general strategies that recognize the integrated nature of socioecological systems, the importance of promoting disturbance regimes upon which these systems...

National Rehabilitation Hospital Assistive Technology Research Center

DTIC Science & Technology

1995-10-01

methods of assembly by orthotists. Because of this, efforts have been made to overcome these challenges but have proved fruitless thus far. Becker ...people including those with muscular dystrophy , multiple sclerosis, brachial plexus injuries, and those who work in jobs requiring them to hold their

The road to treating smoldering multiple myeloma.

PubMed

Korde, Neha; Mailankody, Sham; Landgren, Ola

2014-09-01

The management of smoldering multiple myeloma (SMM) has been a challenge to clinicians, ever since the condition was first characterized in 1980. While the risk of progression to symptomatic myeloma is greater for SMM (10% per year) compared to MGUS (1% per year), several SMM patients remain asymptomatic for years without evidence of disease progression. Early clinical trials focusing on early treatment of SMM have been equivocal with no clear benefit. However, the last decade has seen a greater understanding of the pathogenesis of plasma cell disorders, including SMM, and development of better therapeutics. A recent randomized trial has provided evidence of clinical benefit with early treatment of high-risk SMM. In this review, we summarize issues related to the early treatment of SMM including risk stratification and possible outcomes with therapy initiation. In the context of reviewing recent clinical trial data supporting early treatment, we define challenges faced by clinicians and provide future directions to the road to treating SMM. Published by Elsevier Inc.

Data Acquisition and Linguistic Resources

NASA Astrophysics Data System (ADS)

Strassel, Stephanie; Christianson, Caitlin; McCary, John; Staderman, William; Olive, Joseph

All human language technology demands substantial quantities of data for system training and development, plus stable benchmark data to measure ongoing progress. While creation of high quality linguistic resources is both costly and time consuming, such data has the potential to profoundly impact not just a single evaluation program but language technology research in general. GALE's challenging performance targets demand linguistic data on a scale and complexity never before encountered. Resources cover multiple languages (Arabic, Chinese, and English) and multiple genres -- both structured (newswire and broadcast news) and unstructured (web text, including blogs and newsgroups, and broadcast conversation). These resources include significant volumes of monolingual text and speech, parallel text, and transcribed audio combined with multiple layers of linguistic annotation, ranging from word aligned parallel text and Treebanks to rich semantic annotation.

Challenges and Opportunities in Mining Neuroscience Data

PubMed Central

Akil, Huda; Martone, Maryann E.; Van Essen, David C.

2011-01-01

Understanding the brain requires a broad range of approaches and methods from the domains of biology, psychology, chemistry, physics, and mathematics. The fundamental challenge is to decipher the “neural choreography” associated with complex behaviors and functions, including thoughts, memories, actions, and emotions. This demands the acquisition and integration of vast amounts of data of many types, at multiple scales in time and in space. Here, we discuss the need for neuroinformatics approaches to accelerate progress, using several illustrative examples. The nascent field of ‘connectomics’ aims to comprehensively describe neuronal connectivity at either a macroscopic level (long-distance pathways for the entire brain) or a microscopic level (axons, dendrites, synapses in a small brain region). The Neuroscience Information Framework encompasses all of neuroscience and facilitates integration of existing knowledge and databases of many types. These examples illustrate the opportunities and challenges of data mining across multiple tiers of neuroscience information and underscore the need for cultural and infrastructure changes if neuroinformatics is to fulfill its potential to advance our understanding of the brain. PMID:21311009

Applications of Single-Cell Sequencing for Multiomics.

PubMed

Xu, Yungang; Zhou, Xiaobo

2018-01-01

Single-cell sequencing interrogates the sequence or chromatin information from individual cells with advanced next-generation sequencing technologies. It provides a higher resolution of cellular differences and a better understanding of the underlying genetic and epigenetic mechanisms of an individual cell in the context of its survival and adaptation to microenvironment. However, it is more challenging to perform single-cell sequencing and downstream data analysis, owing to the minimal amount of starting materials, sample loss, and contamination. In addition, due to the picogram level of the amount of nucleic acids used, heavy amplification is often needed during sample preparation of single-cell sequencing, resulting in the uneven coverage, noise, and inaccurate quantification of sequencing data. All these unique properties raise challenges in and thus high demands for computational methods that specifically fit single-cell sequencing data. We here comprehensively survey the current strategies and challenges for multiple single-cell sequencing, including single-cell transcriptome, genome, and epigenome, beginning with a brief introduction to multiple sequencing techniques for single cells.

International Myeloma Working Group recommendations for global myeloma care.

PubMed

Ludwig, H; Miguel, J S; Dimopoulos, M A; Palumbo, A; Garcia Sanz, R; Powles, R; Lentzsch, S; Ming Chen, W; Hou, J; Jurczyszyn, A; Romeril, K; Hajek, R; Terpos, E; Shimizu, K; Joshua, D; Hungria, V; Rodriguez Morales, A; Ben-Yehuda, D; Sondergeld, P; Zamagni, E; Durie, B

2014-05-01

Recent developments have led to remarkable improvements in the assessment and treatment of patients with multiple myeloma (MM). New technologies have become available to precisely evaluate the biology and extent of the disease, including information about cytogenetics and genetic abnormalities, extramedullary manifestations and minimal residual disease. New, more effective drugs have been introduced into clinical practice, which enable clinicians to significantly improve the outcome of patients but also pose new challenges for the prevention and management of their specific side effects. Given these various new options and challenges, it is important to identify the minimal requirements for diagnosis and treatment of patients, as access to the most sophisticated advances may vary depending on local circumstances. Here, we propose the minimal requirements and possible options for diagnosis, monitoring and treatment of patients with multiple myeloma.

Resource based view of the firm as a theoretical lens on the organisational consequences of quality improvement.

PubMed

Burton, Christopher R; Rycroft-Malone, Jo

2014-08-01

Evaluating the investment that healthcare organisations make in quality improvement requires knowledge of impact at multiple levels, including patient care, workforce and other organisational resources. The degree to which these resources help organisations to survive and thrive in the challenging contexts in which healthcare is designed and delivered is unknown. Investigating this question from the perspective of the Resource Based View (RBV) of the Firm may provide insights, although is not without challenge.

Pooling Data from Multiple Longitudinal Studies: The Role of Item Response Theory in Integrative Data Analysis

PubMed Central

Curran, Patrick J.; Hussong, Andrea M.; Cai, Li; Huang, Wenjing; Chassin, Laurie; Sher, Kenneth J.; Zucker, Robert A.

2010-01-01

There are a number of significant challenges encountered when studying development over an extended period of time including subject attrition, changing measurement structures across group and developmental period, and the need to invest substantial time and money. Integrative data analysis is an emerging set of methodologies that overcomes many of the challenges of single sample designs through the pooling of data drawn from multiple existing developmental studies. This approach is characterized by a host of advantages, but this also introduces several new complexities that must be addressed prior to broad adoption by developmental researchers. In this paper we focus on methods for fitting measurement models and creating scale scores using data drawn from multiple longitudinal studies. We present findings from the analysis of repeated measures of internalizing symptomatology that were pooled from three existing developmental studies. We describe and demonstrate each step in the analysis and we conclude with a discussion of potential limitations and directions for future research. PMID:18331129

Bayesian Estimation of Pneumonia Etiology: Epidemiologic Considerations and Applications to the Pneumonia Etiology Research for Child Health Study

PubMed Central

Fu, Wei; Shi, Qiyuan; Prosperi, Christine; Wu, Zhenke; Hammitt, Laura L.; Feikin, Daniel R.; Baggett, Henry C.; Howie, Stephen R.C.; Scott, J. Anthony G.; Murdoch, David R.; Madhi, Shabir A.; Thea, Donald M.; Brooks, W. Abdullah; Kotloff, Karen L.; Li, Mengying; Park, Daniel E.; Lin, Wenyi; Levine, Orin S.; O’Brien, Katherine L.; Zeger, Scott L.

2017-01-01

Abstract In pneumonia, specimens are rarely obtained directly from the infection site, the lung, so the pathogen causing infection is determined indirectly from multiple tests on peripheral clinical specimens, which may have imperfect and uncertain sensitivity and specificity, so inference about the cause is complex. Analytic approaches have included expert review of case-only results, case–control logistic regression, latent class analysis, and attributable fraction, but each has serious limitations and none naturally integrate multiple test results. The Pneumonia Etiology Research for Child Health (PERCH) study required an analytic solution appropriate for a case–control design that could incorporate evidence from multiple specimens from cases and controls and that accounted for measurement error. We describe a Bayesian integrated approach we developed that combined and extended elements of attributable fraction and latent class analyses to meet some of these challenges and illustrate the advantage it confers regarding the challenges identified for other methods. PMID:28575370

Overview on Deaf-Blindness. DB-LINK Fact Sheet. Revised.

ERIC Educational Resources Information Center

Miles, Barbara

This overview provides basic information on the causes of deaf-blindness and the particular challenges faced by individuals who are deaf-blind. Causes of deaf-blindness include various syndromes, multiple congenital anomalies, prematurity, congenital prenatal dysfunction, and various postnatal causes. Differences between people deaf-blind from…

Genomic Variation between Genetic lines of White Leghorns Differed in Resistance to Marek’s Disease

USDA-ARS?s Scientific Manuscript database

Genetic resistance to avian tumor virus-induced tumorigenesis and vaccine protective efficacy preventing such tumorigenicity are determined by multiple factors including host genetics, viral virulence, dose of challenge viruses, type of vaccine, vaccine dosage, and interval between vaccination and v...

Managing Curriculum Change and "Ontological Uncertainty" in Tertiary Education

ERIC Educational Resources Information Center

Keesing-Styles, Linda; Nash, Simon; Ayres, Robert

2014-01-01

Curriculum reform at institutional level is a challenging endeavour. Those charged with leading this process will encounter both enthusiasm and multiple obstacles to teacher engagement including the particularly complex issue of confronting existing teacher identities. At Unitec Institute of Technology (Unitec), the "Living Curriculum"…

Effects of Cognitive Demand on Word Encoding in Adults Who Stutter

ERIC Educational Resources Information Center

Tsai, Pei-Tzu

2011-01-01

The etiology of persistent stuttering is unknown, but stuttering has been attributed to multiple potential factors, including difficulty in processing language-related information, but findings remain inconclusive regarding any "specific" linguistic deficit potentially causing stuttering. One particular challenge in drawing conclusions is the…

Technical challenges involved in supporting the Lambda Point Experiment

NASA Technical Reports Server (NTRS)

Petrac, D.; Israelsson, U.; Otth, D.; Simmons, L.; Staats, J.; Thompson, A.

1990-01-01

The Lambda Point Experiment (LPE) is one of the instruments included in the U.S. Microgravity Payload Mission 1 planned for one of the Space Shuttle flights in 1992. The objective of the experiment is to measure the heat capacity of liquid helium within a narrow interval around the transition between superfluid and normal helium (the lambda point) with an unprecedented temperature resolution of about 10 to the -10th. Multiple technical challenges are presented in the areas of structural support, safety analysis, and modal frequency tests. This paper describes the technical challenges of JPL's multidisciplinary involvement in support of these experiments in microgravity.

Adolescents in Wartime U.S. Military Families: A Developmental Perspective on Challenges and Resources

PubMed Central

Milburn, Norweeta G.; Lightfoot, Marguerita

2013-01-01

Adolescents in wartime U.S. military families are a unique group of young people who are experiencing the usual milestones of adolescent development, including establishing their identities and becoming autonomous, while they face the challenges of military life such as multiple frequent moves, relocation and parent deployment to combat settings. This paper reviews research on adolescents in wartime U.S. military families, within the context of adolescent development, to identify their behavioral, emotional and academic risk status, and challenges and resources. Recommendations for future research and interventions to foster the healthy development of these adolescents are also provided. PMID:23780722

Multimodal Wireless Sensor Network-Based Ambient Assisted Living in Real Homes with Multiple Residents

PubMed Central

Tunca, Can; Alemdar, Hande; Ertan, Halil; Incel, Ozlem Durmaz; Ersoy, Cem

2014-01-01

Human activity recognition and behavior monitoring in a home setting using wireless sensor networks (WSNs) provide a great potential for ambient assisted living (AAL) applications, ranging from health and wellbeing monitoring to resource consumption monitoring. However, due to the limitations of the sensor devices, challenges in wireless communication and the challenges in processing large amounts of sensor data in order to recognize complex human activities, WSN-based AAL systems are not effectively integrated in the home environment. Additionally, given the variety of sensor types and activities, selecting the most suitable set of sensors in the deployment is an important task. In order to investigate and propose solutions to such challenges, we introduce a WSN-based multimodal AAL system compatible for homes with multiple residents. Particularly, we focus on the details of the system architecture, including the challenges of sensor selection, deployment, networking and data collection and provide guidelines for the design and deployment of an effective AAL system. We also present the details of the field study we conducted, using the systems deployed in two different real home environments with multiple residents. With these systems, we are able to collect ambient sensor data from multiple homes. This data can be used to assess the wellbeing of the residents and identify deviations from everyday routines, which may be indicators of health problems. Finally, in order to elaborate on the possible applications of the proposed AAL system and to exemplify directions for processing the collected data, we provide the results of several human activity inference experiments, along with examples on how such results could be interpreted. We believe that the experiences shared in this work will contribute towards accelerating the acceptance of WSN-based AAL systems in the home setting. PMID:24887044

Multimodal wireless sensor network-based ambient assisted living in real homes with multiple residents.

PubMed

Tunca, Can; Alemdar, Hande; Ertan, Halil; Incel, Ozlem Durmaz; Ersoy, Cem

2014-05-30

Human activity recognition and behavior monitoring in a home setting using wireless sensor networks (WSNs) provide a great potential for ambient assisted living (AAL) applications, ranging from health and wellbeing monitoring to resource consumption monitoring. However, due to the limitations of the sensor devices, challenges in wireless communication and the challenges in processing large amounts of sensor data in order to recognize complex human activities, WSN-based AAL systems are not effectively integrated in the home environment. Additionally, given the variety of sensor types and activities, selecting the most suitable set of sensors in the deployment is an important task. In order to investigate and propose solutions to such challenges, we introduce a WSN-based multimodal AAL system compatible for homes with multiple residents. Particularly, we focus on the details of the system architecture, including the challenges of sensor selection, deployment, networking and data collection and provide guidelines for the design and deployment of an effective AAL system. We also present the details of the field study we conducted, using the systems deployed in two different real home environments with multiple residents. With these systems, we are able to collect ambient sensor data from multiple homes. This data can be used to assess the wellbeing of the residents and identify deviations from everyday routines, which may be indicators of health problems. Finally, in order to elaborate on the possible applications of the proposed AAL system and to exemplify directions for processing the collected data, we provide the results of several human activity inference experiments, along with examples on how such results could be interpreted. We believe that the experiences shared in this work will contribute towards accelerating the acceptance of WSN-based AAL systems in the home setting.

Challenges for Electronics in the Vision for Space Exploration

NASA Technical Reports Server (NTRS)

LaBel, Kenneth A.

2005-01-01

This presentation has been a brief snapshot discussing electronics and Exploration-related challenges. The vision for Space Exploration creates a new paradigm for NASA missions. This includes transport (Crew Exploration Vehicle-CEV), and lunar and Mars Exploration and human presence. If one considers the additional hazards faced by these concepts versus more traditional NASA missions, multiple challenges surface for reliable utilization of electronic parts. The true challenge is to provide a risk as low as reasonably achievable (ALARA-a traditional biological radiation exposure term), while still providing cost effective solutions. This presentation also discusses the hazard for electronic parts and exploration, the types of electronic parts for exploration, and the critical juncture for space usage of commercial changes in the electronics world.

Air quality management in China: issues, challenges, and options.

PubMed

Wang, Shuxiao; Hao, Jiming

2012-01-01

This article analyzed the control progress and current status of air quality, identified the major air pollution issues and challenges in future, proposed the long-term air pollution control targets, and suggested the options for better air quality in China. With the continuing growth of economy in the next 10-15 years, China will face a more severe situation of energy consumption, electricity generation and vehicle population leading to increase in multiple pollutant emissions. Controlling regional air pollution especially fine particles and ozone, as well as lowering carbon emissions from fossil fuel consumption will be a big challenge for the country. To protect public health and the eco-system, the ambient air quality in all Chinese cities shall attain the national ambient air quality standards (NAAQS) and ambient air quality guideline values set by the World Health Organization (WHO). To achieve the air quality targets, the emissions of SO2, NOx, PM10, and volatile organic compounds (VOC) should decrease by 60%, 40%, 50%, and 40%, respectively, on the basis of that in 2005. A comprehensive control policy focusing on multiple pollutants and emission sources at both the local and regional levels was proposed to mitigate the regional air pollution issue in China. The options include development of clean energy resources, promotion of clean and efficient coal use, enhancement of vehicle pollution control, implementation of synchronous control of multiple pollutants including SO2, NOx, VOC, and PM emissions, joint prevention and control of regional air pollution, and application of climate friendly air pollution control measures.

A SiQuENC for Solving Physics Problems

ERIC Educational Resources Information Center

Liao, David

2018-01-01

Students often struggle in AP Physics 1 because they have not been previously trained to develop qualitative arguments. Extensive literature on multiple representations and qualitative reasoning provides strategies to address this challenge. Table I presents three examples, including SiQuENC, which I adapted from a strategy promoted by Etkina et…

Biodiversity in the city: key challenges for urban green space management

Treesearch

Myla F.J. Aronson; Christopher A. Lepczyk; Karl L. Evans; Mark A. Goddard; Susannah B. Lerman; J. Scott MacIvor; Charles H. Nilon; Timothy Vargo

2017-01-01

Cities play important roles in the conservation of global biodiversity, particularly through the planning and management of urban green spaces (UGS). However, UGS management is subject to a complex assortment of interacting social, cultural, and economic factors, including governance, economics, social networks, multiple stakeholders, individual preferences, and social...

DEVELOPMENT AND PEER REVIEW OF TIME-TO-EFFECT MODELS FOR THE ANALYSIS OF NEUROTOXICITY AND OTHER TIME DEPENDENT DATA

EPA Science Inventory

Neurobehavioral studies pose unique challenges for dose-response modeling, including small sample size and relatively large intra-subject variation, repeated measurements over time, multiple endpoints with both continuous and ordinal scales, and time dependence of risk characteri...

Perspectiva General sobre la Sordo-Ceguera (Overview on Deaf-Blindness). DB-LINK.

ERIC Educational Resources Information Center

Miles, Barbara

This overview provides basic information on the causes of deaf-blindness and the particular challenges faced by individuals who are deaf-blind. Causes of deaf-blindness include various syndromes, multiple congenital anomalies, prematurity, congenital prenatal dysfunction, and various postnatal causes. Differences between people deaf-blind from…

Leadership Values, Trust and Negative Capability: Managing the Uncertainties of Future English Higher Education

ERIC Educational Resources Information Center

Jameson, Jill

2012-01-01

The complex leadership attribute of "negative capability" in managing uncertainty and engendering trust may be amongst the qualities enabling institutions to cope with multiple recent government policy challenges affecting English higher education, including significant increases in student fees. Research findings are reported on changes…

Nursing Admission Practices to Discern "Fit": A Case Study Exemplar

ERIC Educational Resources Information Center

Sinutko, Jaime M.

2014-01-01

Admission to a baccalaureate nursing school in the United States is currently a challenging proposition for a variety of reasons. This research explored a holistic nursing school admission process at a small, private, baccalaureate college using a retrospective, mixed-method, approach. The holistic method included multiple admission criteria, both…

Designing for Learning Engagement in Remote Communities: Narratives from North of Sixty

ERIC Educational Resources Information Center

Doering, Aaron; Henrickson, Jeni

2014-01-01

There are multiple challenges to designing learning experiences for schools in remote communities, including technology and infrastructure limitations, high teacher and administrator turnover, and conflicting interests between local culture and school curricula. In this paper, we offer a brief history of educational initiatives in remote Arctic…

Teaching with and through Teams: Student-Written, Instructor-Facilitated Case Writing and the Signatory Code

ERIC Educational Resources Information Center

Bailey, James; Sass, Mary; Swiercz, Paul M.; Seal, Craig; Kayes, D. Christopher

2005-01-01

Modern organizations prize teamwork. Management schools have responded to this reality by integrating teamwork into the curriculum. Two important challenges associated with integrating teams in the management classroom include (a) designing teamwork assignments that achieve multiple, sophisticated learning outcomes and (b) instruction in, and…

Successful Recovery and Transplantation of 11 Organs Including Face, Bilateral Upper Extremities, and Thoracic and Abdominal Organs From a Single Deceased Organ Donor.

PubMed

Tullius, Stefan G; Pomahac, Bohdan; Kim, Heung Bae; Carty, Matthew J; Talbot, Simon G; Nelson, Helen M; Delmonico, Francis L

2016-10-01

We report on the to date largest recovery of 11 organs from a single deceased donor with the transplantation of face, bilateral upper extremities, heart, 1 lung, liver (split for 2 recipients), kidneys, pancreas, and intestine. Although logistically challenging, this case demonstrates the feasibility and safety of the recovery of multiple thoracic and abdominal organs with multiple vascular composite allotransplants and tissues. Our experience of 8 additional successful multiple vascular composite allotransplants, thoracic, and abdominal organ recoveries suggests that such procedures are readily accomplishable from the same deceased donor.

Lessons Learned in Evaluating a Multisite, Comprehensive Teen Dating Violence Prevention Strategy: Design and Challenges of the Evaluation of Dating Matters: Strategies to Promote Healthy Teen Relationships.

PubMed

Niolon, Phyllis Holditch; Taylor, Bruce G; Latzman, Natasha E; Vivolo-Kantor, Alana M; Valle, Linda Anne; Tharp, Andra T

2016-03-01

This paper describes the multisite, longitudinal cluster randomized controlled trial (RCT) design of the evaluation of the Dating Matters: Strategies to Promote Healthy Relationships initiative, and discusses challenges faced in conducting this evaluation. Health departments in 4 communities are partnering with middle schools in high-risk, urban communities to implement 2 models of teen dating violence (TDV) prevention over 4 years. Schools were randomized to receive either the Dating Matters comprehensive strategy or the "standard of care" strategy (an existing, evidence-based TDV prevention curriculum). Our design permits comparison of the relative effectiveness of the comprehensive and standard of care strategies. Multiple cohorts of students from 46 middle schools are surveyed in middle school and high school, and parents and educators from participating schools are also surveyed. Challenges discussed in conducting a multisite RCT include site variability, separation of implementation and evaluation responsibilities, school retention, parent engagement in research activities, and working within the context of high-risk urban schools and communities. We discuss the strengths and weaknesses of our approaches to these challenges in the hopes of informing future research. Despite multiple challenges, the design of the Dating Matters evaluation remains strong. We hope this paper provides researchers who are conducting complex evaluations of behavioral interventions with thoughtful discussion of the challenges we have faced and potential solutions to such challenges.

Lessons Learned in Evaluating a Multisite, Comprehensive Teen Dating Violence Prevention Strategy: Design and Challenges of the Evaluation of Dating Matters: Strategies to Promote Healthy Teen Relationships

PubMed Central

Niolon, Phyllis Holditch; Taylor, Bruce G.; Latzman, Natasha E.; Vivolo-Kantor, Alana M.; Valle, Linda Anne; Tharp, Andra T.

2018-01-01

Objective This paper describes the multisite, longitudinal cluster randomized controlled trial (RCT) design of the evaluation of the Dating Matters: Strategies to Promote Healthy Relationships initiative, and discusses challenges faced in conducting this evaluation. Method Health departments in 4 communities are partnering with middle schools in high-risk, urban communities to implement 2 models of teen dating violence (TDV) prevention over 4 years. Schools were randomized to receive either the Dating Matters comprehensive strategy or the “standard of care” strategy (an existing, evidence-based TDV prevention curriculum). Our design permits comparison of the relative effectiveness of the comprehensive and standard of care strategies. Multiple cohorts of students from 46 middle schools are surveyed in middle school and high school, and parents and educators from participating schools are also surveyed. Results Challenges discussed in conducting a multisite RCT include site variability, separation of implementation and evaluation responsibilities, school retention, parent engagement in research activities, and working within the context of high-risk urban schools and communities. We discuss the strengths and weaknesses of our approaches to these challenges in the hopes of informing future research. Conclusions Despite multiple challenges, the design of the Dating Matters evaluation remains strong. We hope this paper provides researchers who are conducting complex evaluations of behavioral interventions with thoughtful discussion of the challenges we have faced and potential solutions to such challenges. PMID:29607239

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.

Feasibility of an International Multiple Sclerosis Rehabilitation Data Repository

PubMed Central

Bradford, Elissa Held; Baert, Ilse; Finlayson, Marcia; Feys, Peter

2018-01-01

Abstract Background: Multiple sclerosis (MS) rehabilitation evidence is limited due to methodological factors, which may be addressed by a data repository. We describe the perceived challenges of, motivators for, interest in participating in, and key features of an international MS rehabilitation data repository. Methods: A multimethod sequential investigation was performed with the results of two focus groups, using nominal group technique, and study aims informing the development of an online questionnaire. Percentage agreement and key quotations illustrated questionnaire findings. Subgroup comparisons were made between clinicians and researchers and between participants in North America and Europe. Results: Rehabilitation professionals from 25 countries participated (focus groups: n = 21; questionnaire: n = 166). The top ten challenges (C) and motivators (M) identified by the focus groups were database control/management (C); ethical/legal concerns (C); data quality (C); time, effort, and cost (C); best practice (M); uniformity (C); sustainability (C); deeper analysis (M); collaboration (M); and identifying research needs (M). Percentage agreement with questionnaire statements regarding challenges to, motivators for, interest in, and key features of a successful repository was at least 80%, 85%, 72%, and 83%, respectively, across each group of statements. Questionnaire subgroup analysis revealed a few differences (P < .05), including that clinicians more strongly identified with improving best practice as a motivator. Conclusions: Findings support clinician and researcher interest in and potential for success of an international MS rehabilitation data repository if prioritized challenges and motivators are addressed and key features are included. PMID:29507539

Challenges and Experiences of Building Multidisciplinary Datasets across Cultures

NASA Astrophysics Data System (ADS)

Jamiyansharav, K.; Laituri, M.; Fernandez-Gimenez, M.; Fassnacht, S. R.; Venable, N. B. H.; Allegretti, A. M.; Reid, R.; Baival, B.; Jamsranjav, C.; Ulambayar, T.; Linn, S.; Angerer, J.

2017-12-01

Efficient data sharing and management are key challenges to multidisciplinary scientific research. These challenges are further complicated by adding a multicultural component. We address the construction of a complex database for social-ecological analysis in Mongolia. Funded by the National Science Foundation (NSF) Dynamics of Coupled Natural and Human (CNH) Systems, the Mongolian Rangelands and Resilience (MOR2) project focuses on the vulnerability of Mongolian pastoral systems to climate change and adaptive capacity. The MOR2 study spans over three years of fieldwork in 36 paired districts (Soum) from 18 provinces (Aimag) of Mongolia that covers steppe, mountain forest steppe, desert steppe and eastern steppe ecological zones. Our project team is composed of hydrologists, social scientists, geographers, and ecologists. The MOR2 database includes multiple ecological, social, meteorological, geospatial and hydrological datasets, as well as archives of original data and survey in multiple formats. Managing this complex database requires significant organizational skills, attention to detail and ability to communicate within collective team members from diverse disciplines and across multiple institutions in the US and Mongolia. We describe the database's rich content, organization, structure and complexity. We discuss lessons learned, best practices and recommendations for complex database management, sharing, and archiving in creating a cross-cultural and multi-disciplinary database.

AERIAL MEASURING SYSTEM IN JAPAN

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

Lyons, Craig; Colton, David

2012-01-01

The U.S. Department of Energy National Nuclear Security Agency’s Aerial Measuring System deployed personnel and equipment to partner with the U.S. Air Force in Japan to conduct multiple aerial radiological surveys. These were the first and most comprehensive sources of actionable information for U.S. interests in Japan and provided early confirmation to the government of Japan as to the extent of the release from the Fukushima Daiichi Nuclear Power Generation Station. Many challenges were overcome quickly during the first 48 hours; including installation and operation of Aerial Measuring System equipment on multiple U.S. Air Force Japan aircraft, flying over difficultmore » terrain, and flying with talented pilots who were unfamiliar with the Aerial Measuring System flight patterns. These all combined to make for a dynamic and non-textbook situation. In addition, the data challenges of the multiple and on-going releases, and integration with the Japanese government to provide valid aerial radiological survey products that both military and civilian customers could use to make informed decisions, was extremely complicated. The Aerial Measuring System Fukushima response provided insight in addressing these challenges and gave way to an opportunity for the expansion of the Aerial Measuring System’s mission beyond the borders of the US.« less

Developing effective interuniversity partnerships and community-based research to address health disparities.

PubMed

Carey, Timothy S; Howard, Daniel L; Goldmon, Moses; Roberson, James T; Godley, Paul A; Ammerman, Alice

2005-11-01

Health disparities are an enormous challenge to American society. Addressing these disparities is a priority for U.S. society and especially for institutions of higher learning, with their threefold mission of education, service, and research. Collaboration across multiple intellectual disciplines will be critical as universities address health disparities. In addition, universities must collaborate with communities, with state partners, and with each other. Development of these collaborations must be sensitive to the history and unique characteristics of each academic institution and population. The authors describe the challenges of all three types of collaboration, but primarily focus on collaboration between research-intensive universities and historically black colleges and universities. The authors describe a four-year collaboration between Shaw University and the University of North Carolina at Chapel Hill (UNC-CH). These universities strategically developed multiple research initiatives to address health disparities, building on modest early success and personal relationships. These activities included participation by Shaw faculty in faculty development activities, multiple collaborative pilot studies, and joint participation in securing grants from the Agency for Health care Research and Quality of the federal Department of Health and Human Services and the National Institutes of Health, including a P-60 Project EXPORT center grant. These multiple activities were sometimes led by UNC-CH, sometimes by Shaw University. Open discussion of problems as they arose, realistic expectations, and mutual recognition of the strengths of each institution and its faculty have been critical in achieving successful collaboration to date.

Relevancies of multiple-interaction events and signal-to-noise ratio for Anger-logic based PET detector designs

NASA Astrophysics Data System (ADS)

Peng, Hao

2015-10-01

A fundamental challenge for PET block detector designs is to deploy finer crystal elements while limiting the number of readout channels. The standard Anger-logic scheme including light sharing (an 8 by 8 crystal array coupled to a 2×2 photodetector array with an optical diffuser, multiplexing ratio: 16:1) has been widely used to address such a challenge. Our work proposes a generalized model to study the impacts of two critical parameters on spatial resolution performance of a PET block detector: multiple interaction events and signal-to-noise ratio (SNR). The study consists of the following three parts: (1) studying light output profile and multiple interactions of 511 keV photons within crystal arrays of different crystal widths (from 4 mm down to 1 mm, constant height: 20 mm); (2) applying the Anger-logic positioning algorithm to investigate positioning/decoding uncertainties (i.e., "block effect") in terms of peak-to-valley ratio (PVR), with light sharing, multiple interactions and photodetector SNR taken into account; and (3) studying the dependency of spatial resolution on SNR in the context of modulation transfer function (MTF). The proposed model can be used to guide the development and evaluation of a standard Anger-logic based PET block detector including: (1) selecting/optimizing the configuration of crystal elements for a given photodetector SNR; and (2) predicting to what extent additional electronic multiplexing may be implemented to further reduce the number of readout channels.

Developing Effective Interuniversity Partnerships and Community-Based Research to Address Health Disparities

PubMed Central

Carey, Timothy S.; Howard, Daniel L.; Goldmon, Moses; Roberson, James T.; Godley, Paul A.; Ammerman, Alice

2009-01-01

Health disparities are an enormous challenge to American society. Addressing these disparities is a priority for U.S. society and especially for institutions of higher learning, with their threefold mission of education, service, and research. Collaboration across multiple intellectual disciplines will be critical as universities address health disparities. In addition, universities must collaborate with communities, with state partners, and with each other. Development of these collaborations must be sensitive to the history and unique characteristics of each academic institution and population. The authors describe the challenges of all three types of collaboration, but primarily focus on collaboration between research-intensive universities and historically black colleges and universities. The authors describe a four-year collaboration between Shaw University and the University of North Carolina at Chapel Hill (UNC-CH). These universities strategically developed multiple research initiatives to address health disparities, building on modest early success and personal relationships. These activities included participation by Shaw faculty in faculty development activities, multiple collaborative pilot studies, and joint participation in securing grants from the Agency for Health care Research and Quality of the federal Department of Health and Human Services and the National Institutes of Health, including a P-60 Project EXPORT center grant. These multiple activities were sometimes led by UNC-CH, sometimes by Shaw University. Open discussion of problems as they arose, realistic expectations, and mutual recognition of the strengths of each institution and its faculty have been critical in achieving successful collaboration to date. PMID:16249303

Improving homology modeling of G-protein coupled receptors through multiple-template derived conserved inter-residue interactions

NASA Astrophysics Data System (ADS)

Chaudhari, Rajan; Heim, Andrew J.; Li, Zhijun

2015-05-01

Evidenced by the three-rounds of G-protein coupled receptors (GPCR) Dock competitions, improving homology modeling methods of helical transmembrane proteins including the GPCRs, based on templates of low sequence identity, remains an eminent challenge. Current approaches addressing this challenge adopt the philosophy of "modeling first, refinement next". In the present work, we developed an alternative modeling approach through the novel application of available multiple templates. First, conserved inter-residue interactions are derived from each additional template through conservation analysis of each template-target pairwise alignment. Then, these interactions are converted into distance restraints and incorporated in the homology modeling process. This approach was applied to modeling of the human β2 adrenergic receptor using the bovin rhodopsin and the human protease-activated receptor 1 as templates and improved model quality was demonstrated compared to the homology model generated by standard single-template and multiple-template methods. This method of "refined restraints first, modeling next", provides a fast and complementary way to the current modeling approaches. It allows rational identification and implementation of additional conserved distance restraints extracted from multiple templates and/or experimental data, and has the potential to be applicable to modeling of all helical transmembrane proteins.

Older Adult Spouses with Multiple Chronic Conditions: Challenges, Rewards, and Coping Strategies.

PubMed

Peacock, Shelley; Sethi, Bharati; Williams, Allison; Duggleby, Wendy; Bayly, Melanie; Swindle, Jenny; Ploeg, Jenny; Markle-Reid, Maureen

2017-06-01

There is a paucity of research exploring how spouses to older adults with multiple chronic conditions make meaning of their caregiving experience. For this study, we asked: What is the experience of spousal caregivers to persons with multiple chronic conditions? We applied Thorne's interpretive description approach, interviewing 18 spouses who provided a rich description of their caregiving experience; interviews were transcribed verbatim and thematically analysed. Themes were categorized according to challenges encountered, rewards gleaned, and sustaining strategies employed by participants in caregiving to their spouse with multiple chronic conditions. Unique findings relate to the challenges inherent in decision-making within the context of multiple chronic conditions. This article begins to address the gap in the literature regarding the caregiving experience within the context of multiple chronic conditions.

Real-Time Radar-Based Tracking and State Estimation of Multiple Non-Conformant Aircraft

NASA Technical Reports Server (NTRS)

Cook, Brandon; Arnett, Timothy; Macmann, Owen; Kumar, Manish

2017-01-01

In this study, a novel solution for automated tracking of multiple unknown aircraft is proposed. Many current methods use transponders to self-report state information and augment track identification. While conformant aircraft typically report transponder information to alert surrounding aircraft of its state, vehicles may exist in the airspace that are non-compliant and need to be accurately tracked using alternative methods. In this study, a multi-agent tracking solution is presented that solely utilizes primary surveillance radar data to estimate aircraft state information. Main research challenges include state estimation, track management, data association, and establishing persistent track validity. In an effort to realize these challenges, techniques such as Maximum a Posteriori estimation, Kalman filtering, degree of membership data association, and Nearest Neighbor Spanning Tree clustering are implemented for this application.

Perspectives on Self-Management in Multiple Sclerosis

PubMed Central

Knaster, Elizabeth S.; Johnson, Kurt; McMullen, Kara A.; Ehde, Dawn M.

2011-01-01

The aim of this study was to elucidate the experience of self-management among people with multiple sclerosis (MS) and gather their input to inform a self-management intervention. Twelve people with MS participated in focus groups in which they were asked open-ended questions about MS symptoms, challenges, overcoming challenges, symptom management, and treatment preferences. The results suggest four major themes: 1) “The Everyday Experience of MS,” including comments about symptoms and their impact on functioning; 2) “Motivation for Self-Management,” including descriptions of motivation originating from physical necessity, success with other management techniques, and external sources; 3) “Coping Strategies and Skills,” including descriptions of changing behaviors, expanding social support networks, finding resources, utilizing medical treatment, and monitoring symptoms; and 4) “Vision for a Self-Management Intervention,” including suggestions that an intervention be individualized, be motivating, and provide resources. The results of this study can inform the design and implementation of self-management interventions. Experiences described by participants are consistent with other qualitative reports suggesting the active role people with MS play in managing their condition. Intervention approaches must consider the complex constellation of symptoms associated with MS and provide individualized treatments that enhance the person's ability to manage their symptoms, barriers presented by such symptoms, and their health care. PMID:24453718

Advanced Modeling and Uncertainty Quantification for Flight Dynamics; Interim Results and Challenges

NASA Technical Reports Server (NTRS)

Hyde, David C.; Shweyk, Kamal M.; Brown, Frank; Shah, Gautam

2014-01-01

As part of the NASA Vehicle Systems Safety Technologies (VSST), Assuring Safe and Effective Aircraft Control Under Hazardous Conditions (Technical Challenge #3), an effort is underway within Boeing Research and Technology (BR&T) to address Advanced Modeling and Uncertainty Quantification for Flight Dynamics (VSST1-7). The scope of the effort is to develop and evaluate advanced multidisciplinary flight dynamics modeling techniques, including integrated uncertainties, to facilitate higher fidelity response characterization of current and future aircraft configurations approaching and during loss-of-control conditions. This approach is to incorporate multiple flight dynamics modeling methods for aerodynamics, structures, and propulsion, including experimental, computational, and analytical. Also to be included are techniques for data integration and uncertainty characterization and quantification. This research shall introduce new and updated multidisciplinary modeling and simulation technologies designed to improve the ability to characterize airplane response in off-nominal flight conditions. The research shall also introduce new techniques for uncertainty modeling that will provide a unified database model comprised of multiple sources, as well as an uncertainty bounds database for each data source such that a full vehicle uncertainty analysis is possible even when approaching or beyond Loss of Control boundaries. Methodologies developed as part of this research shall be instrumental in predicting and mitigating loss of control precursors and events directly linked to causal and contributing factors, such as stall, failures, damage, or icing. The tasks will include utilizing the BR&T Water Tunnel to collect static and dynamic data to be compared to the GTM extended WT database, characterizing flight dynamics in off-nominal conditions, developing tools for structural load estimation under dynamic conditions, devising methods for integrating various modeling elements into a real-time simulation capability, generating techniques for uncertainty modeling that draw data from multiple modeling sources, and providing a unified database model that includes nominal plus increments for each flight condition. This paper presents status of testing in the BR&T water tunnel and analysis of the resulting data and efforts to characterize these data using alternative modeling methods. Program challenges and issues are also presented.

Large system change challenges: addressing complex critical issues in linked physical and social domains

NASA Astrophysics Data System (ADS)

Waddell, Steve; Cornell, Sarah; Hsueh, Joe; Ozer, Ceren; McLachlan, Milla; Birney, Anna

2015-04-01

Most action to address contemporary complex challenges, including the urgent issues of global sustainability, occurs piecemeal and without meaningful guidance from leading complex change knowledge and methods. The potential benefit of using such knowledge is greater efficacy of effort and investment. However, this knowledge and its associated tools and methods are under-utilized because understanding about them is low, fragmented between diverse knowledge traditions, and often requires shifts in mindsets and skills from expert-led to participant-based action. We have been engaged in diverse action-oriented research efforts in Large System Change for sustainability. For us, "large" systems can be characterized as large-scale systems - up to global - with many components, of many kinds (physical, biological, institutional, cultural/conceptual), operating at multiple levels, driven by multiple forces, and presenting major challenges for people involved. We see change of such systems as complex challenges, in contrast with simple or complicated problems, or chaotic situations. In other words, issues and sub-systems have unclear boundaries, interact with each other, and are often contradictory; dynamics are non-linear; issues are not "controllable", and "solutions" are "emergent" and often paradoxical. Since choices are opportunity-, power- and value-driven, these social, institutional and cultural factors need to be made explicit in any actionable theory of change. Our emerging network is sharing and building a knowledge base of experience, heuristics, and theories of change from multiple disciplines and practice domains. We will present our views on focal issues for the development of the field of large system change, which include processes of goal-setting and alignment; leverage of systemic transitions and transformation; and the role of choice in influencing critical change processes, when only some sub-systems or levels of the system behave in purposeful ways, while others are undeniably and unavoidably deterministic.

Spintronic logic: from switching devices to computing systems

NASA Astrophysics Data System (ADS)

Friedman, Joseph S.

2017-09-01

Though numerous spintronic switching devices have been proposed or demonstrated, there has been significant difficulty in translating these advances into practical computing systems. The challenge of cascading has impeded the integration of multiple devices into a logic family, and several proposed solutions potentially overcome these challenges. Here, the cascading techniques by which the output of each spintronic device can drive the input of another device are described for several logic families, including spin-diode logic (in particular, all-carbon spin logic), complementary magnetic tunnel junction logic (CMAT), and emitter-coupled spin-transistor logic (ECSTL).

Screening for Intimate Partner Violence in Orthopedic Patients: A Comparison of Three Screening Tools

ERIC Educational Resources Information Center

Sprague, Sheila; Madden, Kim; Dosanjh, Sonia; Petrisor, Brad; Schemitsch, Emil H.; Bhandari, Mohit

2012-01-01

Accurately identifying victims of intimate partner violence (IPV) can be a challenge for clinicians and clinical researchers. Multiple instruments have been developed and validated to identify IPV in patients presenting to health care practitioners, including the Woman Abuse Screening Tool (WAST) and the Partner Violence Screen (PVS). The purpose…

An Exploration of Factors Influencing Effective Teachers' Decisions to Remain in Urban School Settings

ERIC Educational Resources Information Center

Grizzle, Alison L.

2010-01-01

Existing problems identified in the literature on teacher retention and resilience include (a) a gap in understanding factors influencing urban teacher retention; (b) lack of clarity on multiple factors swaying teachers' decisions to remain despite challenges; (c) overlapping definitions of teacher retention, attrition, and resilience; and (d)…

Grandparent Headed Families and Head Start: Developing Effective Services.

ERIC Educational Resources Information Center

Dannison, Linda L.; Smith, Andrea B.

Numerous challenges face the growing number of grandparent-headed households, including isolation from friends and social supports, and difficulties in caring for grandchildren exhibiting multiple needs. This paper describes a pilot program in which a university and a large county-wide Head Start program formed a partnership to focus on serving…

Respite Utilization and Responses to Loss among Family Caregivers: Relationship Matters

ERIC Educational Resources Information Center

DeCaporale, Lauren; Mensie, Lauren; Steffen, Ann

2013-01-01

Family caregivers of physically and cognitively impaired older adults face multiple challenges when providing care, including responses to tangible and anticipated losses. However, little is known about the grief experiences of family caregivers and how these might differentially influence the care-related behaviors of spouses and adult children.…

Hierarchical analysis of species distributions and abundance across environmental gradients

Treesearch

Jeffery Diez; Ronald H. Pulliam

2007-01-01

Abiotic and biotic processes operate at multiple spatial and temporal scales to shape many ecological processes, including species distributions and demography. Current debate about the relative roles of niche-based and stochastic processes in shaping species distributions and community composition reflects, in part, the challenge of understanding how these processes...

"Change4Life for Your Kids": Embodied Collectives and Public Health Pedagogy

ERIC Educational Resources Information Center

Evans, Bethan; Colls, Rachel; Horschelmann, Kathrin

2011-01-01

Recent work in human geography has begun to explore the fluidity of bodily boundaries and to foreground the connectedness of bodies to other bodies/objects/places. Across multiple subdisciplinary areas, including health, children's and feminist geographies, geographers have begun to challenge the notion of a singular, bounded body by highlighting…

University as Publisher: Summary of a Meeting Held at UC Berkeley on November 1, 2007

ERIC Educational Resources Information Center

Harley, Diane, Ed.

2008-01-01

With the advent of electronic publishing, the scholarly communication landscape at universities has become increasingly diverse. Multiple stakeholders including university presses, libraries, and central IT departments are challenged by the increasing volume and the rapidity of production of these new forms of publication in an environment of…

A Strategy for Embedding Functional Motor and Early Numeracy Skill Instruction into Physical Education Activities

ERIC Educational Resources Information Center

Whinnery, Stacie B.; Whinnery, Keith W.; Eddins, Daisy

2016-01-01

This article addresses the challenges educators face when attempting to find a balance between both functional and academic skill instruction for students with severe, multiple disabilities including motor impairments. The authors describe a strategy that employs embedded instruction of early numeracy and functional motor skills during physical…

Avian coccidiosis as a prototype intestinal disease: Recent advances in host protective immunity and novel disease control strategies

USDA-ARS?s Scientific Manuscript database

Poultry meat consumption has increased globally by 50% since 2000, accounting for greater than 100 million tons in 2012. Multiple challenges confront the rising demand for poultry food products, including governmental restrictions on the use of antibiotic growth promoters and novel feedstuffs, high-...

Lacking Capacity? How to Work Smart in Teacher Evaluation. Ask the Team

ERIC Educational Resources Information Center

Cushing, Ellen

2013-01-01

Capacity is a real and pressing challenge for educators tasked with implementing robust evaluation systems that include multiple measures of performance. In response to questions from the field, the Center on Great Teachers and Leaders has gathered emerging strategies from policymakers and practitioners who are grappling with capacity challenges…

Recent advances in host protective immunity and novel disease control strategies against intestinal protozoan infections in commercial poultry

USDA-ARS?s Scientific Manuscript database

Poultry meat consumption has increased globally by 50% since 2000, accounting for greater than 100 million tons in 2012. Multiple challenges confront the rising demand for poultry food products, including governmental restrictions on the use of antibiotic growth promoters and novel feedstuffs, high-...

Our Visible Work: Community & Collaboration in an Educator Inquiry Group

ERIC Educational Resources Information Center

Clark, Margaret R.

2016-01-01

Early childhood education has recently been heralded as the cornerstone of a brighter future for the United States, playing an important role in the healthy development of our youngest children (Perry, 2015; Bornfreund, 2015). However, the teachers of these children face multiple challenges in the profession, including unlivable wages, low morale…

The Mediating Effects of Approaches to Learning on the Academic Success of First-Year College Students

ERIC Educational Resources Information Center

Valadas, Sandra T.; Almeida, Leandro S.; Araújo, Alexandra M.

2017-01-01

Students' personal predictors of academic success are particularly relevant for first-year college students, given the specific challenges that these students face when entering higher education (HE). Academic success in HE has been related to multiple factors, including the students' approaches to learning (SAL), satisfaction (linked to…

Caregiver-Teacher Concordance of Challenging Behaviors in Children with Autism Spectrum Disorder Served in Community Mental Health Settings

PubMed Central

Chlebowski, Colby; Brookman-Frazee, Lauren

2018-01-01

Children with autism spectrum disorder (ASD) exhibit high rates of challenging behaviors that impair functioning and represent the primary presenting problem in mental health (MH) services. Obtaining symptom reports from multiple informants is critical for treatment planning. This study evaluated caregiver-teacher concordance of ratings of the intensity of challenging behaviors in children with ASD receiving MH services, and identified child clinical factors associated with concordance. This sample included 141 children (M = 9.07 years), their caregivers, and teachers. Caregiver-teacher concordance of challenging behaviors was low and impacted by the degree and type of child psychiatric comorbidity. Findings support need for increased attention to the range of psychiatric problems children with ASD present to tailor treatment recommendations and service delivery. PMID:28343342

Tiered analytics for purity assessment of macrocyclic peptides in drug discovery: Analytical consideration and method development.

PubMed

Qian Cutrone, Jingfang Jenny; Huang, Xiaohua Stella; Kozlowski, Edward S; Bao, Ye; Wang, Yingzi; Poronsky, Christopher S; Drexler, Dieter M; Tymiak, Adrienne A

2017-05-10

Synthetic macrocyclic peptides with natural and unnatural amino acids have gained considerable attention from a number of pharmaceutical/biopharmaceutical companies in recent years as a promising approach to drug discovery, particularly for targets involving protein-protein or protein-peptide interactions. Analytical scientists charged with characterizing these leads face multiple challenges including dealing with a class of complex molecules with the potential for multiple isomers and variable charge states and no established standards for acceptable analytical characterization of materials used in drug discovery. In addition, due to the lack of intermediate purification during solid phase peptide synthesis, the final products usually contain a complex profile of impurities. In this paper, practical analytical strategies and methodologies were developed to address these challenges, including a tiered approach to assessing the purity of macrocyclic peptides at different stages of drug discovery. Our results also showed that successful progression and characterization of a new drug discovery modality benefited from active analytical engagement, focusing on fit-for-purpose analyses and leveraging a broad palette of analytical technologies and resources. Copyright © 2017. Published by Elsevier B.V.

Multiagent Work Practice Simulation: Progress and Challenges

NASA Technical Reports Server (NTRS)

Clancey, William J.; Sierhuis, Maarten; Shaffe, Michael G. (Technical Monitor)

2001-01-01

Modeling and simulating complex human-system interactions requires going beyond formal procedures and information flows to analyze how people interact with each other. Such work practices include conversations, modes of communication, informal assistance, impromptu meetings, workarounds, and so on. To make these social processes visible, we have developed a multiagent simulation tool, called Brahms, for modeling the activities of people belonging to multiple groups, situated in a physical environment (geographic regions, buildings, transport vehicles, etc.) consisting of tools, documents, and a computer system. We are finding many useful applications of Brahms for system requirements analysis, instruction, implementing software agents, and as a workbench for relating cognitive and social theories of human behavior. Many challenges remain for representing work practices, including modeling: memory over multiple days, scheduled activities combining physical objects, groups, and locations on a timeline (such as a Space Shuttle mission), habitat vehicles with trajectories (such as the Shuttle), agent movement in 3D space (e.g., inside the International Space Station), agent posture and line of sight, coupled movements (such as carrying objects), and learning (mimicry, forming habits, detecting repetition, etc.).

Multiagent Work Practice Simulation: Progress and Challenges

NASA Technical Reports Server (NTRS)

Clancey, William J.; Sierhuis, Maarten

2002-01-01

Modeling and simulating complex human-system interactions requires going beyond formal procedures and information flows to analyze how people interact with each other. Such work practices include conversations, modes of communication, informal assistance, impromptu meetings, workarounds, and so on. To make these social processes visible, we have developed a multiagent simulation tool, called Brahms, for modeling the activities of people belonging to multiple groups, situated in a physical environment (geographic regions, buildings, transport vehicles, etc.) consisting of tools, documents, and computer systems. We are finding many useful applications of Brahms for system requirements analysis, instruction, implementing software agents, and as a workbench for relating cognitive and social theories of human behavior. Many challenges remain for representing work practices, including modeling: memory over multiple days, scheduled activities combining physical objects, groups, and locations on a timeline (such as a Space Shuttle mission), habitat vehicles with trajectories (such as the Shuttle), agent movement in 3d space (e.g., inside the International Space Station), agent posture and line of sight, coupled movements (such as carrying objects), and learning (mimicry, forming habits, detecting repetition, etc.).

Clinical application of next-generation sequencing for Mendelian diseases.

PubMed

Jamuar, Saumya Shekhar; Tan, Ene-Choo

2015-06-16

Over the past decade, next-generation sequencing (NGS) has led to an exponential increase in our understanding of the genetic basis of Mendelian diseases. NGS allows for the analysis of multiple regions of the genome in one single reaction and has been shown to be a cost-effective and efficient tool in investigating patients with Mendelian diseases. More recently, NGS has been successfully deployed in the clinics, with a reported diagnostic yield of ~25 %. However, recommendations on clinical implementation of NGS are still evolving with numerous key challenges that impede the widespread use of genetics in everyday medicine. These challenges include when to order, on whom to order, what type of test to order, and how to interpret and communicate the results, including incidental findings, to the patient and family. In this review, we discuss these challenges and suggest guidelines on implementing NGS in the routine clinical workflow.

Further Evaluations of Functional Communication Training and Chained Schedules of Reinforcement to Treat Multiple Functions of Challenging Behavior

ERIC Educational Resources Information Center

Falcomata, Terry S.; Muething, Colin S.; Gainey, Summer; Hoffman, Katherine; Fragale, Christina

2013-01-01

We evaluated functional communication training (FCT) combined with a chained schedule of reinforcement procedure for the treatment of challenging behavior exhibited by two individuals diagnosed with Asperger syndrome and autism. Following functional analyses that suggested that challenging behavior served multiple functions for both participants,…

Multiple approaches to understanding and preventing elder abuse: Introduction to the cross-disciplinary National Institutes of Health workshop.

PubMed

Saylor, Katherine Witte

2016-01-01

On October 30, 2015, the National Institutes of Health (NIH) convened a workshop, "Multiple Approaches to Understanding and Preventing Elder Abuse," in Bethesda, Maryland. The workshop brought together experts from across disciplines to discuss research challenges, opportunities, and lessons learned from other fields. Participants included experts in elder abuse, child abuse, intimate partner violence (IPV), emergency medicine, and neuroscience. In this special issue of the Journal of Elder Abuse and Neglect, participants address topics explored before, during, and after the day-long workshop.

Research design issues for evaluating complex multicomponent interventions in neighborhoods and communities.

PubMed

Komro, Kelli A; Flay, Brian R; Biglan, Anthony; Wagenaar, Alexander C

2016-03-01

Major advances in population health will not occur unless we translate existing knowledge into effective multicomponent interventions, implement and maintain these in communities, and develop rigorous translational research and evaluation methods to ensure continual improvement and sustainability. We discuss challenges and offer approaches to evaluation that are key for translational research stages 3 to 5 to advance optimized adoption, implementation, and maintenance of effective and replicable multicomponent strategies. The major challenges we discuss concern (a) multiple contexts of evaluation/research, (b) complexity of packages of interventions, and (c) phases of evaluation/research questions. We suggest multiple alternative research designs that maintain rigor but accommodate these challenges and highlight the need for measurement systems. Longitudinal data collection and a standardized continuous measurement system are fundamental to the evaluation and refinement of complex multicomponent interventions. To be useful to T3-T5 translational research efforts in neighborhoods and communities, such a system would include assessments of the reach, implementation, effects on immediate outcomes, and effects of the comprehensive intervention package on more distal health outcomes.

Challenges and strategies in applying performance measurement to federal public health programs.

PubMed

DeGroff, Amy; Schooley, Michael; Chapel, Thomas; Poister, Theodore H

2010-11-01

Performance measurement is widely accepted in public health as an important management tool supporting program improvement and accountability. However, several challenges impede developing and implementing performance measurement systems at the federal level, including the complexity of public health problems that reflect multiple determinants and involve outcomes that may take years to achieve, the decentralized and networked nature of public health program implementation, and the lack of reliable and consistent data sources and other issues related to measurement. All three of these challenges hinder the ability to attribute program results to specific public health program efforts. The purpose of this paper is to explore these issues in detail and offer potential solutions that support the development of robust and practical performance measures to meet the needs for program improvement and accountability. Adapting performance measurement to public health programs is both an evolving science and art. Through the strategies presented here, appropriate systems can be developed and monitored to support the production of meaningful data that will inform effective decision making at multiple levels. Published by Elsevier Ltd.

Health professionals' experiences providing breastfeeding-related care for obese women.

PubMed

Garner, Christine D; Ratcliff, Stephannie L; Devine, Carol M; Thornburg, Loralei L; Rasmussen, Kathleen M

2014-12-01

Obese women are at high risk of early breastfeeding cessation, and health professionals (HPs) have a unique opportunity to provide them with breastfeeding support. Our objective was to describe HPs' experiences providing breastfeeding care for obese women during the prenatal, peripartum, and postpartum periods. In-depth, qualitative interviews were conducted with 34 HPs (including obstetricians, midwives, pediatricians, nurses, and lactation consultants) who care for pregnant or lactating women. They were recruited from a variety of settings in central New York. Interviews were audio-recorded, transcribed, verified for accuracy, and then analyzed qualitatively. HPs identified obesity in multiple ways, some of which were consistent with standard cutoffs, whereas others implied extreme obesity. Nearly all HPs discussed ways they perceive obese women have challenges with breastfeeding. Some HPs described challenges as specific to obese women (e.g., limited mobility), whereas others described challenges as universal but more likely to occur among obese women (e.g., difficulties positioning the infant to breastfeed). Across professions, HPs described providing breastfeeding care for obese women as requiring more time and physical work and as being more challenging. HPs acknowledged stigma around obesity and discussed treating obese women with dignity and the same as other women. Strategies were suggested for improving breastfeeding support for obese women. HPs identified multiple challenges that obese women encounter with breastfeeding, as well as their own challenges with providing care. Comprehensive strategies are needed to assist obese women with breastfeeding and to alleviate strain on HPs who provide their care.

In-Space Assembly Capability Assessment for Potential Human Exploration and Science Applications

NASA Technical Reports Server (NTRS)

Jefferies, Sharon A.; Jones, Christopher A.; Arney, Dale C.; Stillwagen, Frederic H.; Chai, Patrick R.; Hutchinson, Craig D.; Stafford, Matthew A.; Moses, Robert W.; Dempsey, James A.; Rodgers, Erica M.;

Bayesian Estimation of Pneumonia Etiology: Epidemiologic Considerations and Applications to the Pneumonia Etiology Research for Child Health Study.

PubMed

Deloria Knoll, Maria; Fu, Wei; Shi, Qiyuan; Prosperi, Christine; Wu, Zhenke; Hammitt, Laura L; Feikin, Daniel R; Baggett, Henry C; Howie, Stephen R C; Scott, J Anthony G; Murdoch, David R; Madhi, Shabir A; Thea, Donald M; Brooks, W Abdullah; Kotloff, Karen L; Li, Mengying; Park, Daniel E; Lin, Wenyi; Levine, Orin S; O'Brien, Katherine L; Zeger, Scott L

2017-06-15

In pneumonia, specimens are rarely obtained directly from the infection site, the lung, so the pathogen causing infection is determined indirectly from multiple tests on peripheral clinical specimens, which may have imperfect and uncertain sensitivity and specificity, so inference about the cause is complex. Analytic approaches have included expert review of case-only results, case-control logistic regression, latent class analysis, and attributable fraction, but each has serious limitations and none naturally integrate multiple test results. The Pneumonia Etiology Research for Child Health (PERCH) study required an analytic solution appropriate for a case-control design that could incorporate evidence from multiple specimens from cases and controls and that accounted for measurement error. We describe a Bayesian integrated approach we developed that combined and extended elements of attributable fraction and latent class analyses to meet some of these challenges and illustrate the advantage it confers regarding the challenges identified for other methods. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Cytokines and cytokine networks target neurons to modulate long-term potentiation.

PubMed

Prieto, G Aleph; Cotman, Carl W

2017-04-01

Cytokines play crucial roles in the communication between brain cells including neurons and glia, as well as in the brain-periphery interactions. In the brain, cytokines modulate long-term potentiation (LTP), a cellular correlate of memory. Whether cytokines regulate LTP by direct effects on neurons or by indirect mechanisms mediated by non-neuronal cells is poorly understood. Elucidating neuron-specific effects of cytokines has been challenging because most brain cells express cytokine receptors. Moreover, cytokines commonly increase the expression of multiple cytokines in their target cells, thus increasing the complexity of brain cytokine networks even after single-cytokine challenges. Here, we review evidence on both direct and indirect-mediated modulation of LTP by cytokines. We also describe novel approaches based on neuron- and synaptosome-enriched systems to identify cytokines able to directly modulate LTP, by targeting neurons and synapses. These approaches can test multiple samples in parallel, thus allowing the study of multiple cytokines simultaneously. Hence, a cytokine networks perspective coupled with neuron-specific analysis may contribute to delineation of maps of the modulation of LTP by cytokines. Copyright © 2017 Elsevier Ltd. All rights reserved.

Cytokines and cytokine networks target neurons to modulate long-term potentiation

PubMed Central

Prieto, G. Aleph; Cotman, Carl W.

2017-01-01

Cytokines play crucial roles in the communication between brain cells including neurons and glia, as well as in the brain-periphery interactions. In the brain, cytokines modulate long-term potentiation (LTP), a cellular correlate of memory. Whether cytokines regulate LTP by direct effects on neurons or by indirect mechanisms mediated by non-neuronal cells is poorly understood. Elucidating neuron-specific effects of cytokines has been challenging because most brain cells express cytokine receptors. Moreover, cytokines commonly increase the expression of multiple cytokines in their target cells, thus increasing the complexity of brain cytokine networks even after single-cytokine challenges. Here, we review evidence on both direct and indirect-mediated modulation of LTP by cytokines. We also describe novel approaches based on neuron- and synaptosome-enriched systems to identify cytokines able to directly modulate LTP, by targeting neurons and synapses. These approaches can test multiple samples in parallel, thus allowing the study of multiple cytokines simultaneously. Hence, a cytokine networks perspective coupled with neuron-specific analysis may contribute to delineation of maps of the modulation of LTP by cytokines. PMID:28377062

Effort to Accelerate MBSE Adoption and Usage at JSC

NASA Technical Reports Server (NTRS)

Wang, Lui; Izygon, Michel; Okron, Shira; Garner, Larry; Wagner, Howard

2016-01-01

This paper describes the authors' experience in adopting Model Based System Engineering (MBSE) at the NASA/Johnson Space Center (JSC). Since 2009, NASA/JSC has been applying MBSE using the Systems Modeling Language (SysML) to a number of advanced projects. Models integrate views of the system from multiple perspectives, capturing the system design information for multiple stakeholders. This method has allowed engineers to better control changes, improve traceability from requirements to design and manage the numerous interactions between components. As the project progresses, the models become the official source of information and used by multiple stakeholders. Three major types of challenges that hamper the adoption of the MBSE technology are described. These challenges are addressed by a multipronged approach that includes educating the main stakeholders, implementing an organizational infrastructure that supports the adoption effort, defining a set of modeling guidelines to help engineers in their modeling effort, providing a toolset that support the generation of valuable products, and providing a library of reusable models. JSC project case studies are presented to illustrate how the proposed approach has been successfully applied.

KAMO: towards automated data processing for microcrystals.

PubMed

Yamashita, Keitaro; Hirata, Kunio; Yamamoto, Masaki

2018-05-01

In protein microcrystallography, radiation damage often hampers complete and high-resolution data collection from a single crystal, even under cryogenic conditions. One promising solution is to collect small wedges of data (5-10°) separately from multiple crystals. The data from these crystals can then be merged into a complete reflection-intensity set. However, data processing of multiple small-wedge data sets is challenging. Here, a new open-source data-processing pipeline, KAMO, which utilizes existing programs, including the XDS and CCP4 packages, has been developed to automate whole data-processing tasks in the case of multiple small-wedge data sets. Firstly, KAMO processes individual data sets and collates those indexed with equivalent unit-cell parameters. The space group is then chosen and any indexing ambiguity is resolved. Finally, clustering is performed, followed by merging with outlier rejections, and a report is subsequently created. Using synthetic and several real-world data sets collected from hundreds of crystals, it was demonstrated that merged structure-factor amplitudes can be obtained in a largely automated manner using KAMO, which greatly facilitated the structure analyses of challenging targets that only produced microcrystals. open access.

Management of familial benign chronic pemphigus

PubMed Central

Arora, Harleen; Bray, Fleta N; Cervantes, Jessica; Falto Aizpurua, Leyre A

2016-01-01

Benign familial chronic pemphigus or Hailey–Hailey disease is caused by an autosomal dominant mutation in the ATP2C1 gene leading to suprabasilar acantholysis. The disease most commonly affects intertriginous areas symmetrically. The chronic nature of the disease and multiple recurrences make the disease bothersome for patients and a treatment challenge for physicians. Treatments include topical and/or systemic agents and surgery including laser. This review summarizes the available treatment options. PMID:27695354

Sedimentary Geology Context and Challenges for Cyberinfrastructure Data Management

NASA Astrophysics Data System (ADS)

Chan, M. A.; Budd, D. A.

2014-12-01

A cyberinfrastructure data management system for sedimentary geology is crucial to multiple facets of interdisciplinary Earth science research, as sedimentary systems form the deep-time framework for many geoscience communities. The breadth and depth of the sedimentary field spans research on the processes that form, shape and affect the Earth's sedimentary crust and distribute resources such as hydrocarbons, coal, and water. The sedimentary record is used by Earth scientists to explore questions such as the continental crust evolution, dynamics of Earth's past climates and oceans, evolution of the biosphere, and the human interface with Earth surface processes. Major challenges to a data management system for sedimentary geology are the volume and diversity of field, analytical, and experimental data, along with many types of physical objects. Objects include rock samples, biological specimens, cores, and photographs. Field data runs the gamut from discrete location and spatial orientation to vertical records of bed thickness, textures, color, sedimentary structures, and grain types. Ex situ information can include geochemistry, mineralogy, petrophysics, chronologic, and paleobiologic data. All data types cover multiple order-of-magnitude scales, often requiring correlation of the multiple scales with varying degrees of resolution. The stratigraphic framework needs dimensional context with locality, time, space, and depth relationships. A significant challenge is that physical objects represent discrete values at specific points, but measured stratigraphic sections are continuous. In many cases, field data is not easily quantified, and determining uncertainty can be difficult. Despite many possible hurdles, the sedimentary community is anxious to embrace geoinformatic resources that can provide better tools to integrate the many data types, create better search capabilities, and equip our communities to conduct high-impact science at unprecedented levels.

The History and Challenges Surrounding Ovarian Stimulation in the Treatment of Infertility

PubMed Central

Beall, Stephanie A.; Decherney, Alan

2014-01-01

OBJECTIVE To examine the history of superovulation for ovulation induction, its contributions to reproductive medicine and its impact on multiple births. DESIGN A search of the relevant literature using Pubmed and other online tools. RESULT(S) Infertility has been a condition known and studied for thousands of years. However, it was not until this past century that effective treatments were developed. With the advancement of our knowledge of the hypothalamic-pituitary axis, therapies utilizing gonadotropins were developed to stimulate ovulation. Not only were we now able to treat anovulatory infertility, but also induce superovulation for in vitro fertilization. With these successes came consequences, including increased multiple pregnancies. Several countries recognized the high costs associated with multiple births and implemented regulations on the infertility industry. The rate of triplet and higher-order multiples has declined over the past decade. This is largely attributed to a decreased number of embryos transferred. Nonetheless, the twin rate has remained consistently high. CONCLUSION(S) Superovulation has become a routine medical therapy used for ovulation induction and in vitro fertilization. With the development of this technology have come effective therapies for infertility and new ethical and medical challenges. Since the advent of gonadotropin therapy we have already developed technologies to improve monitoring and decrease hyperstimulation and high order multiple pregnancies. In the future, we anticipate new tools devised to optimize one embryo for one singleton live birth. PMID:22463773

Clothing Matching for Visually Impaired Persons

PubMed Central

Yuan, Shuai; Tian, YingLi; Arditi, Aries

2012-01-01

Matching clothes is a challenging task for many blind people. In this paper, we present a proof of concept system to solve this problem. The system consists of 1) a camera connected to a computer to perform pattern and color matching process; 2) speech commands for system control and configuration; and 3) audio feedback to provide matching results for both color and patterns of clothes. This system can handle clothes in deficient color without any pattern, as well as clothing with multiple colors and complex patterns to aid both blind and color deficient people. Furthermore, our method is robust to variations of illumination, clothing rotation and wrinkling. To evaluate the proposed prototype, we collect two challenging databases including clothes without any pattern, or with multiple colors and different patterns under different conditions of lighting and rotation. Results reported here demonstrate the robustness and effectiveness of the proposed clothing matching system. PMID:22523465

Robust lane detection and tracking using multiple visual cues under stochastic lane shape conditions

NASA Astrophysics Data System (ADS)

Huang, Zhi; Fan, Baozheng; Song, Xiaolin

2018-03-01

As one of the essential components of environment perception techniques for an intelligent vehicle, lane detection is confronted with challenges including robustness against the complicated disturbance and illumination, also adaptability to stochastic lane shapes. To overcome these issues, we proposed a robust lane detection method named classification-generation-growth-based (CGG) operator to the detected lines, whereby the linear lane markings are identified by synergizing multiple visual cues with the a priori knowledge and spatial-temporal information. According to the quality of linear lane fitting, the linear and linear-parabolic models are dynamically switched to describe the actual lane. The Kalman filter with adaptive noise covariance and the region of interests (ROI) tracking are applied to improve the robustness and efficiency. Experiments were conducted with images covering various challenging scenarios. The experimental results evaluate the effectiveness of the presented method for complicated disturbances, illumination, and stochastic lane shapes.

Passing a smoke-free law in a pro-tobacco culture: a multiple streams approach.

PubMed

Greathouse, Lisa W; Hahn, Ellen J; Okoli, Chizimuzo T C; Warnick, Todd A; Riker, Carol A

2005-08-01

This article describes a case study of the policy development and political decision-making process involved in the enactment of Lexington, Kentucky's smoke-free law. The multiple streams framework is used to analyze the development of the law in a seemingly unlikely and challenging political environment. Proponents developed a dissemination research plan targeted at policy makers and the public to demonstrate the need for a comprehensive law. The existence of a strong coalition of health care providers and health care systems including the board of health, as well as long-standing tobacco control expertise and a strong legal team, were essential ingredients for success. A deliberate strategy to expose the tobacco industry was effective in preparing policy makers for the opponents' policy arguments. As expected, a hospitality industry association was formed to oppose the ordinance, resulting in a legal challenge that delayed enactment of the law.

Multiple Sclerosis: Immunopathology and Treatment Update

PubMed Central

Dargahi, Narges; Katsara, Maria; Tselios, Theodore; Androutsou, Maria-Eleni; Matsoukas, John

2017-01-01

The treatment of multiple sclerosis (MS) has changed over the last 20 years. All immunotherapeutic drugs target relapsing remitting MS (RRMS) and it still remains a medical challenge in MS to develop a treatment for progressive forms. The most common injectable disease-modifying therapies in RRMS include β-interferons 1a or 1b and glatiramer acetate. However, one of the major challenges of injectable disease-modifying therapies has been poor treatment adherence with approximately 50% of patients discontinuing the therapy within the first year. Herein, we go back to the basics to understand the immunopathophysiology of MS to gain insights in the development of new improved drug treatments. We present current disease-modifying therapies (interferons, glatiramer acetate, dimethyl fumarate, teriflunomide, fingolimod, mitoxantrone), humanized monoclonal antibodies (natalizumab, ofatumumab, ocrelizumab, alemtuzumab, daclizumab) and emerging immune modulating approaches (stem cells, DNA vaccines, nanoparticles, altered peptide ligands) for the treatment of MS. PMID:28686222

Clothing Matching for Visually Impaired Persons.

PubMed

Yuan, Shuai; Tian, Yingli; Arditi, Aries

2011-01-01

Matching clothes is a challenging task for many blind people. In this paper, we present a proof of concept system to solve this problem. The system consists of 1) a camera connected to a computer to perform pattern and color matching process; 2) speech commands for system control and configuration; and 3) audio feedback to provide matching results for both color and patterns of clothes. This system can handle clothes in deficient color without any pattern, as well as clothing with multiple colors and complex patterns to aid both blind and color deficient people. Furthermore, our method is robust to variations of illumination, clothing rotation and wrinkling. To evaluate the proposed prototype, we collect two challenging databases including clothes without any pattern, or with multiple colors and different patterns under different conditions of lighting and rotation. Results reported here demonstrate the robustness and effectiveness of the proposed clothing matching system.

Integrated Data Modeling and Simulation on the Joint Polar Satellite System Program

NASA Technical Reports Server (NTRS)

Roberts, Christopher J.; Boyce, Leslye; Smith, Gary; Li, Angela; Barrett, Larry

2012-01-01

The Joint Polar Satellite System is a modern, large-scale, complex, multi-mission aerospace program, and presents a variety of design, testing and operational challenges due to: (1) System Scope: multi-mission coordination, role, responsibility and accountability challenges stemming from porous/ill-defined system and organizational boundaries (including foreign policy interactions) (2) Degree of Concurrency: design, implementation, integration, verification and operation occurring simultaneously, at multiple scales in the system hierarchy (3) Multi-Decadal Lifecycle: technical obsolesce, reliability and sustainment concerns, including those related to organizational and industrial base. Additionally, these systems tend to become embedded in the broader societal infrastructure, resulting in new system stakeholders with perhaps different preferences (4) Barriers to Effective Communications: process and cultural issues that emerge due to geographic dispersion and as one spans boundaries including gov./contractor, NASA/Other USG, and international relationships.

Congenital microcephaly: A diagnostic challenge during Zika epidemics.

PubMed

Alvarado-Socarras, Jorge L; Idrovo, Álvaro J; Contreras-García, Gustavo A; Rodriguez-Morales, Alfonso J; Audcent, Tobey A; Mogollon-Mendoza, Adriana C; Paniz-Mondolfi, Alberto

2018-02-19

The multiple, wide and diverse etiologies of congenital microcephaly are complex and multifactorial. Recent advances in genetic testing have improved understanding of novel genetic causes of congenital microcephaly. The recent Zika virus (ZIKV) epidemic in Latin America has highlighted the need for a better understanding of the underlying pathological mechanisms of microcephaly including both infectious and non-infectious causes. The diagnostic approach to microcephaly needs to include potential infectious and genetic etiologies, as well as environmental in-utero exposures such as alcohol, toxins, and medications. Emerging genetic alterations linked to microcephaly include abnormal mitotic microtubule spindle structure and abnormal function of centrosomes. We discuss the diagnostic challenge of congenital microcephaly in the context of understanding the links with ZIKV emergence as a new etiological factor involved in this birth defect. Copyright © 2018 Elsevier Ltd. All rights reserved.

Development of a Water-Quality Lab That Enhances Learning & Connects Students to the Land

ERIC Educational Resources Information Center

Enos-Berlage, Jodi

2012-01-01

A 3-week laboratory module was developed for an undergraduate microbiology course that would connect student learning to a real-life challenge, specifically a local water-quality project. The laboratory series included multiple field trips, sampling of soil and water, and subsequent analysis for bacteria and nitrate. Laboratory results confirmed…

Community Colleges as Gateways and Gatekeepers: Moving beyond the Access "Saga" toward Outcome Equity

ERIC Educational Resources Information Center

Dowd, Alicia C.

2007-01-01

Community colleges are essential--though often overlooked--institutions of higher education. In this essay, Alicia C. Dowd draws attention to the challenges facing community colleges as they seek to balance their roles as both gateways and gatekeepers with their multiple missions, which include meeting the diverse needs of students at the…

Maritime Search and Rescue via Multiple Coordinated UAS

DTIC Science & Technology

2016-01-01

partitioning method uses the underlying probability distribution assumptions to place that probability near the geometric center of the partitions. There...During partitioning the known locations are accommodated, but the unaccounted for objects are placed into geometrically unfavorable conditions. The...Zeitlin, A.D.: UAS Sence and Avoid Develop- ment - the Challenges of Technology, Standards, and Certification. Aerospace Sciences Meeting including

Developing Form Assembly Specifications for Exams with Multiple Choice and Constructed Response Items: Balancing Reliability and Validity Concerns

ERIC Educational Resources Information Center

Hendrickson, Amy; Patterson, Brian; Ewing, Maureen

2010-01-01

The psychometric considerations and challenges associated with including constructed response items on tests are discussed along with how these issues affect the form assembly specifications for mixed-format exams. Reliability and validity, security and fairness, pretesting, content and skills coverage, test length and timing, weights, statistical…

Guiding Principles for a Research Schools Network: Successes and Challenges

ERIC Educational Resources Information Center

Schwartz, Marc S.; Gerlach, Jeanne

2011-01-01

Building on J. Dewey's (1907) original work with the laboratory school, the College of Education and Health Professions at the University of Texas-Arlington is expanding the original concept to include partners throughout a school system and the community in order to support and advance learning in multiple learning environments. The goal is to…

Effects of Kindergarten Retention on Children's Social-Emotional Development: An Application of Propensity Score Method to Multivariate, Multilevel Data

ERIC Educational Resources Information Center

Hong, Guanglei; Yu, Bing

2008-01-01

This study examines the effects of kindergarten retention on children's social-emotional development in the early, middle, and late elementary years. Previous studies have generated mixed results partly due to some major methodological challenges, including selection bias, measurement error, and divergent perceptions of multiple respondents in…

Ecological integrity of remnant montane forests along an urban gradient in the Sierra Nevada

Treesearch

K. E. Heckmann; P.N. Manley; M.D. Schlesinger

2008-01-01

Urban development typically has extensive and intensive effects on native ecosystems, including vegetation communities and their associated biota. Increasingly, urban planning strives to retain elements of native ecosystems to meet multiple social and ecological objectives. The ecological integrity of native forests in an urbanizing landscape is challenged by a myriad...

Decrypting Information Sensitivity: Risk, Privacy, and Data Protection Law in the United States and the European Union

ERIC Educational Resources Information Center

Fazlioglu, Muge

2017-01-01

This dissertation examines the risk-based approach to privacy and data protection and the role of information sensitivity within risk management. Determining what information carries the greatest risk is a multi-layered challenge that involves balancing the rights and interests of multiple actors, including data controllers, data processors, and…

A toolkit for incorporating genetics into mainstream medical services: Learning from service development pilots in England

PubMed Central

2010-01-01

Background As advances in genetics are becoming increasingly relevant to mainstream healthcare, a major challenge is to ensure that these are integrated appropriately into mainstream medical services. In 2003, the Department of Health for England announced the availability of start-up funding for ten 'Mainstreaming Genetics' pilot services to develop models to achieve this. Methods Multiple methods were used to explore the pilots' experiences of incorporating genetics which might inform the development of new services in the future. A workshop with project staff, an email questionnaire, interviews and a thematic analysis of pilot final reports were carried out. Results Seven themes relating to the integration of genetics into mainstream medical services were identified: planning services to incorporate genetics; the involvement of genetics departments; the establishment of roles incorporating genetic activities; identifying and involving stakeholders; the challenges of working across specialty boundaries; working with multiple healthcare organisations; and the importance of cultural awareness of genetic conditions. Pilots found that the planning phase often included the need to raise awareness of genetic conditions and services and that early consideration of organisational issues such as clinic location was essential. The formal involvement of genetics departments was crucial to success; benefits included provision of clinical and educational support for staff in new roles. Recruitment and retention for new roles outside usual career pathways sometimes proved difficult. Differences in specialties' working practices and working with multiple healthcare organisations also brought challenges such as the 'genetic approach' of working with families, incompatible record systems and different approaches to health professionals' autonomous practice. 'Practice points' have been collated into a Toolkit which includes resources from the pilots, including job descriptions and clinical tools. These can be customised for reuse by other services. Conclusions Healthcare services need to translate advances in genetics into benefits for patients. Consideration of the issues presented here when incorporating genetics into mainstream medical services will help ensure that new service developments build on the body of experience gained by the pilots, to provide high quality services for patients with or at risk of genetic conditions. PMID:20470377

A toolkit for incorporating genetics into mainstream medical services: Learning from service development pilots in England.

PubMed

Bennett, Catherine L; Burke, Sarah E; Burton, Hilary; Farndon, Peter A

2010-05-14

As advances in genetics are becoming increasingly relevant to mainstream healthcare, a major challenge is to ensure that these are integrated appropriately into mainstream medical services. In 2003, the Department of Health for England announced the availability of start-up funding for ten 'Mainstreaming Genetics' pilot services to develop models to achieve this. Multiple methods were used to explore the pilots' experiences of incorporating genetics which might inform the development of new services in the future. A workshop with project staff, an email questionnaire, interviews and a thematic analysis of pilot final reports were carried out. Seven themes relating to the integration of genetics into mainstream medical services were identified: planning services to incorporate genetics; the involvement of genetics departments; the establishment of roles incorporating genetic activities; identifying and involving stakeholders; the challenges of working across specialty boundaries; working with multiple healthcare organisations; and the importance of cultural awareness of genetic conditions. Pilots found that the planning phase often included the need to raise awareness of genetic conditions and services and that early consideration of organisational issues such as clinic location was essential. The formal involvement of genetics departments was crucial to success; benefits included provision of clinical and educational support for staff in new roles. Recruitment and retention for new roles outside usual career pathways sometimes proved difficult. Differences in specialties' working practices and working with multiple healthcare organisations also brought challenges such as the 'genetic approach' of working with families, incompatible record systems and different approaches to health professionals' autonomous practice. 'Practice points' have been collated into a Toolkit which includes resources from the pilots, including job descriptions and clinical tools. These can be customised for reuse by other services. Healthcare services need to translate advances in genetics into benefits for patients. Consideration of the issues presented here when incorporating genetics into mainstream medical services will help ensure that new service developments build on the body of experience gained by the pilots, to provide high quality services for patients with or at risk of genetic conditions.

"Always looking for a new balance": toward an understanding of what it takes to continue working while being diagnosed with relapsing-remitting multiple sclerosis.

PubMed

Meide, Hanneke van der; Gorp, Dennis van; van der Hiele, Karin; Visser, Leo

2017-06-22

The aim of this study was to gain insight into the meaning of work in the everyday lives of people with relapsing-remitting multiple sclerosis, and the barriers and facilitators to staying in work. Nineteen employed adults diagnosed with relapsing-remitting multiple sclerosis participated in narrative interviews. All interviews were transcribed and coded for thematic analysis. For people with relapsing-remitting multiple sclerosis, continuing to work was a precarious balancing act. Five themes influenced this balance: becoming familiar with the disease, adjusting expectations, having an understanding and realistic line manager, seeing work as meaningful life activity and strategic considerations. People receiving a diagnosis of relapsing-remitting multiple sclerosis have to refamiliarize themselves with their own body in a meaningful way to be able to continue their work. Rehabilitation professionals can support them herein by taking into account not merely functional capabilities but also identity aspects of the body. Medication that stabilizes symptoms supports making the necessary adjustments. A trusting relationship with the line manager is vital for this adaptation process. Additionally, a match between being adequately challenged by work, while still having the capacity to meet those work demands, is needed, as is long-term financial stability. Implications for rehabilitation Rehabilitation professionals can support employees with relapsing-remitting multiple sclerosis by taking into account not merely functional capabilities but also identity aspects of the body. A trusting relationship with the line manager, including a timely disclosure of the diagnosis, is vital for people with relapsing-remitting multiple sclerosis to remain at work. For people with relapsing-remitting multiple sclerosis, there is a delicate balance between being adequately challenged by work while still having the capacity to meet work demands.

Relabelling Behaviour. The Effects of Psycho-Education on the Perceived Severity and Causes of Challenging Behaviour in People with Profound Intellectual and Multiple Disabilities

ERIC Educational Resources Information Center

Poppes, P.; van der Putten, A.; Post, W.; Frans, N.; ten Brug, A.; van Es, A.; Vlaskamp, C.

2016-01-01

Background: Prevalence rates of challenging behaviour are high in children and adults with profound intellectual and multiple disabilities (PIMD). Moreover, many of these behaviours are observed daily. Direct support staff report that most challenging behaviour identified has little impact on the person with PIMD and attribute challenging…

Neonatal Vaccination: Challenges and Intervention Strategies.

PubMed

Morris, Matthew C; Surendran, Naveen

2016-01-01

While vaccines have been tremendously successful in reducing the incidence of serious infectious diseases, newborns remain particularly vulnerable in the first few months of their life to life-threatening infections. A number of challenges exist to neonatal vaccination. However, recent advances in the understanding of neonatal immunology offer insights to overcome many of those challenges. This review will present an overview of the features of neonatal immunity which make vaccination difficult, survey the mechanisms of action of available vaccine adjuvants with respect to the unique features of neonatal immunity, and propose a possible mechanism contributing to the inability of neonates to generate protective immune responses to vaccines. We surveyed recent published findings on the challenges to neonatal vaccination and possible intervention strategies including the use of novel vaccine adjuvants to develop efficacious neonatal vaccines. Challenges in the vaccination of neonates include interference from maternal antibody and excessive skewing towards Th2 immunity, which can be counteracted by the use of proper adjuvants. Synergistic stimulation of multiple Toll-like receptors by incorporating well-defined agonist-adjuvant combinations to vaccines is a promising strategy to ensure a protective vaccine response in neonates. © 2016 S. Karger AG, Basel.

Dissemination and use of a participatory ergonomics guide for workplaces.

PubMed

Van Eerd, Dwayne; King, Trevor; Keown, Kiera; Slack, Tesha; Cole, Donald C; Irvin, Emma; Amick, Benjamin C; Bigelow, Philip

2016-06-01

Musculoskeletal disorders (MSDs) result in lost-time injury claims and lost productivity worldwide, placing a substantial burden on workers and workplaces. Participatory ergonomics (PE) is a popular approach to reducing MSDs; however, there are challenges to implementing PE programmes. Using evidence to overcome challenges may be helpful but the impacts of doing so are unknown. We sought to disseminate an evidence-based PE tool and to describe its use. An easy-to-use, evidence-based PE Guide was disseminated to workplace parties, who were surveyed about using the tool. The greatest barrier to using the tool was a lack of time. Reported tool use included for training purposes, sharing and integrating the tool into existing programmes. New actions related to tool use included training, defining team responsibilities and suggesting programme implementation steps. Evidence-based tools could help ergonomists overcome some challenges involved in implementing injury reduction programmes such as PE. Practitioner Summary Practitioners experience challenges implementing programmes to reduce the burden of MSDs in workplaces. Implementing participatory interventions requires multiple workplace parties to be 'on-board'. Disseminating and using evidence-based guides may help to overcome these challenges. Using evidence-based tools may help ergonomics practitioners implement PE programmes.

Sustainable Materials Management (SMM) Food Recovery Challenge (FRC) Data

EPA Pesticide Factsheets

As part of EPA's Food Recovery Challenge (FRC), organizations pledge to improve their sustainable food management practices and report their results. The FRC is part of EPA's Sustainable Materials Management Program (SMM). SMM seeks to reduce the environmental impact of materials through their entire life cycle. This includes how they are extracted, manufactured, distributed, used, reused, recycled, and disposed. Organizations are encouraged to follow the Food Recovery Hierarchy (https://www.epa.gov/sustainable-management-food/food-recovery-hierarchy) to prioritize their actions to prevent and divert wasted food. Each tier of the Food Recovery Hierarchy focuses on different management strategies for your wasted food. The program started in 2011 and the first data were made available in 2012. The FRC is part of EPA's larger SMM program (https://www.epa.gov/smm). Sustainable Materials Management (SMM) is a systemic approach to using and reusing materials more productively over their entire lifecycles. It represents a change in how our society thinks about the use of natural resources and environmental protection. By looking at a product's entire lifecycle we can find new opportunities to reduce environmental impacts, conserve resources, and reduce costs. There are multiple challenge programs available as part of the SMM program, including the Food Recovery Challenge, the Electronics Challenge, the Federal Green Challenge, and the WasteWise program.

The lung mycobiome in the next-generation sequencing era

PubMed Central

Tipton, Laura; Ghedin, Elodie; Morris, Alison

2017-01-01

ABSTRACT The fungi that reside in the human lungs represent an understudied, but medically relevant comm-unity. From the few studies published on the lung mycobiome, we find that there are fungi in both the healthy and diseased respiratory tract, that these fungi vary widely between individuals, and that there is a trend toward lower fungal diversity among individuals with disease. This review discusses the few studies of the lung mycobiome and details the challenges that accompany lung mycobiome studies. These challenges include sample collection and processing, sequence amplification and processing, and a history of multiple names for species. Some challenges may never be solved, but others can be solved with more data and additional studies of the lung mycobiome. PMID:27687858

Trust in Vaccines: Why It Takes More than Good Faith.

PubMed

Begg, Norman

2013-08-12

This Vaccines issue on "Confidence in Vaccines" provides sound evidence through multiple perspectives of life-saving impacts when vaccination programs are effectively implemented in a population. Yet there remain challenges to achieving this impact, including scientific, medical, manufacturing, policy-related and logistical issues. Additionally, socio-cultural, religious and political agendas can come into play, taking public health hostage and sometimes allowing the circulation of myths regarding vaccination. All of these challenges play a role in public confidence in vaccines and vaccination. What we trust, we embrace. What we do not trust, we do not embrace.

Scientific challenges and opportunities in developing novel vaccines for the emerging and developing markets: New Technologies in Emerging Markets, October 16th-18th 2012, World Vaccine Congress, Lyon.

PubMed

Kochhar, Sonali

2013-04-01

Vaccines have had a major role in enhancing the quality of life and increasing life expectancy. Despite these successes and the development of new vaccine technologies, there remain multiple infectious diseases including AIDS, malaria and tuberculosis that require effective prophylactic vaccines. New and traditional technologies have a role in the development and delivery of the new vaccine candidates. The scientific challenges, opportunities and funding models for developing vaccines for low resource settings are highlighted here.

Opportunities and Challenges of Digital Technology for HIV Treatment and Prevention.

PubMed

Simoni, Jane M; Kutner, Bryan A; Horvath, Keith J

2015-12-01

Novel eHealth interventions are creating exciting opportunities for health promotion along the continuum of HIV care and prevention. Reviews of recent work indicate the use of multiple platforms (e.g., smartphones, social media), with trends toward individualized approaches and real-time assessments. However, the field needs more rigorous investigations to provide evidence of long-term impact on clinical indicators and should expand its targets beyond men who have sex with men and medication adherence. Challenges to the field include working within restricted funding timelines and disseminating eHealth interventions to those most in need.

Clinical Research Informatics: Challenges, Opportunities and Definition for an Emerging Domain

PubMed Central

Embi, Peter J.; Payne, Philip R.O.

2009-01-01

Objectives Clinical Research Informatics, an emerging sub-domain of Biomedical Informatics, is currently not well defined. A formal description of CRI including major challenges and opportunities is needed to direct progress in the field. Design Given the early stage of CRI knowledge and activity, we engaged in a series of qualitative studies with key stakeholders and opinion leaders to determine the range of challenges and opportunities facing CRI. These phases employed complimentary methods to triangulate upon our findings. Measurements Study phases included: 1) a group interview with key stakeholders, 2) an email follow-up survey with a larger group of self-identified CRI professionals, and 3) validation of our results via electronic peer-debriefing and member-checking with a group of CRI-related opinion leaders. Data were collected, transcribed, and organized for formal, independent content analyses by experienced qualitative investigators, followed by an iterative process to identify emergent categorizations and thematic descriptions of the data. Results We identified a range of challenges and opportunities facing the CRI domain. These included 13 distinct themes spanning academic, practical, and organizational aspects of CRI. These findings also informed the development of a formal definition of CRI and supported further representations that illustrate areas of emphasis critical to advancing the domain. Conclusions CRI has emerged as a distinct discipline that faces multiple challenges and opportunities. The findings presented summarize those challenges and opportunities and provide a framework that should help inform next steps to advance this important new discipline. PMID:19261934

Green Tea Extracts Epigallocatechin-3-gallate for Different Treatments

PubMed Central

Chu, Chenyu; Deng, Jia

2017-01-01

Epigallocatechin-3-gallate (EGCG), a component extracted from green tea, has been proved to have multiple effects on human pathological and physiological processes, and its mechanisms are discrepant in cancer, vascularity, bone regeneration, and nervous system. Although there are multiple benefits associated with EGCG, more and more challenges are still needed to get through. For example, EGCG shows low bioactivity via oral administration. This review focuses on effects of EGCG, including anti-cancer, antioxidant, anti-inflammatory, anticollagenase, and antifibrosis effects, to express the potential of EGCG and necessity of further studies in this field. PMID:28884125

Commercial-Aircraft Protection System

NASA Astrophysics Data System (ADS)

Case, Russell L., Jr.; Wolff, Peter H.

2004-09-01

Recent world events have identified needs for a commercial aircraft defense system against Man-Portable Air Defense Systems (MANPADS), such as SA-7 and Stinger shoulder launched surface-to-air missiles. Technical challenges include target detection, identification and countermeasures. Political and societal challenges include cost, time to deployment, ground and air safety, and reliability. These challenges, as well as many others, have been met and overcome with the development of Thor Systems' Commercial-Aircraft Protection System (C-APS). C-APS makes use of commercial technology such as radar and infrared sensors with a laser-based countermeasure. Unlike adapted military systems, C-APS detects the threat long before the military versions by employing a 360 degree hemispherical scan, identifying the threat with an infrared sensor and employing a directed laser to not only deflect the target but to permanently disable its seeker. Enhanced capabilities include multiple threat elimination and closed-loop technology for kill verification. All of this is accomplished with development costs less than half that required to convert military technology, manufacturing costs significantly less than competitive products, and a maintenance cycle coincident with standard FAA requirements, which are significantly longer than current systems.

Advancements in Nanomedicine for Multiple Myeloma.

PubMed

Detappe, Alexandre; Bustoros, Mark; Mouhieddine, Tarek H; Ghoroghchian, P Peter

2018-06-01

In the past decades, considerable progress has been made in our understanding and treatment of multiple myeloma. Several challenges remain including our abilities to longitudinally image tumor responses to treatment, to combine various therapeutic agents with different mechanisms of action but with overlapping toxicities, and to efficiently harness the power of the immune system to augment remission and/or to induce permanent cures. Nanomedicine may help to address many of these outstanding issues, affording novel diagnostic capabilities and offering disruptive technologies that promise to revolutionize treatment. Here, we review recent developments and the future of nanomedicine for multiple myeloma, highlighting new considerations in nanoparticle designs that may help to augment active targeting, to facilitate longitudinal imaging, and to improve drug delivery. Copyright © 2018 Elsevier Ltd. All rights reserved.

Data Visualization Challenges and Opportunities in User-Oriented Application Development

NASA Astrophysics Data System (ADS)

Pilone, D.; Quinn, P.; Mitchell, A. E.; Baynes, K.; Shum, D.

2015-12-01

This talk introduces the audience to some of the very real challenges associated with visualizing data from disparate data sources as encountered during the development of real world applications. In addition to the fundamental challenges of dealing with the data and imagery, this talk discusses usability problems encountered while trying to provide interactive and user-friendly visualization tools. At the end of this talk the audience will be aware of some of the pitfalls of data visualization along with tools and techniques to help mitigate them. There are many sources of variable resolution visualizations of science data available to application developers including NASA's Global Imagery Browse Services (GIBS), however integrating and leveraging visualizations in modern applications faces a number of challenges, including: - Varying visualized Earth "tile sizes" resulting in challenges merging disparate sources - Multiple visualization frameworks and toolkits with varying strengths and weaknesses - Global composite imagery vs. imagery matching EOSDIS granule distribution - Challenges visualizing geographically overlapping data with different temporal bounds - User interaction with overlapping or collocated data - Complex data boundaries and shapes combined with multi-orbit data and polar projections - Discovering the availability of visualizations and the specific parameters, color palettes, and configurations used to produce them In addition to discussing the challenges and approaches involved in visualizing disparate data, we will discuss solutions and components we'll be making available as open source to encourage reuse and accelerate application development.

Health Professionals' Experiences Providing Breastfeeding-Related Care for Obese Women

PubMed Central

Ratcliff, Stephannie L.; Devine, Carol M.; Thornburg, Loralei L.; Rasmussen, Kathleen M.

2014-01-01

Abstract Background: Obese women are at high risk of early breastfeeding cessation, and health professionals (HPs) have a unique opportunity to provide them with breastfeeding support. Our objective was to describe HPs' experiences providing breastfeeding care for obese women during the prenatal, peripartum, and postpartum periods. Materials and Methods: In-depth, qualitative interviews were conducted with 34 HPs (including obstetricians, midwives, pediatricians, nurses, and lactation consultants) who care for pregnant or lactating women. They were recruited from a variety of settings in central New York. Interviews were audio-recorded, transcribed, verified for accuracy, and then analyzed qualitatively. Results: HPs identified obesity in multiple ways, some of which were consistent with standard cutoffs, whereas others implied extreme obesity. Nearly all HPs discussed ways they perceive obese women have challenges with breastfeeding. Some HPs described challenges as specific to obese women (e.g., limited mobility), whereas others described challenges as universal but more likely to occur among obese women (e.g., difficulties positioning the infant to breastfeed). Across professions, HPs described providing breastfeeding care for obese women as requiring more time and physical work and as being more challenging. HPs acknowledged stigma around obesity and discussed treating obese women with dignity and the same as other women. Strategies were suggested for improving breastfeeding support for obese women. Conclusions: HPs identified multiple challenges that obese women encounter with breastfeeding, as well as their own challenges with providing care. Comprehensive strategies are needed to assist obese women with breastfeeding and to alleviate strain on HPs who provide their care. PMID:25347705

Comprehensive Method for Culturing Embryonic Dorsal Root Ganglion Neurons for Seahorse Extracellular Flux XF24 Analysis

PubMed Central

Lange, Miranda; Zeng, Yan; Knight, Andrew; Windebank, Anthony; Trushina, Eugenia

2012-01-01

Changes in mitochondrial dynamics and function contribute to progression of multiple neurodegenerative diseases including peripheral neuropathies. The Seahorse Extracellular Flux XF24 analyzer provides a comprehensive assessment of the relative state of glycolytic and aerobic metabolism in live cells making this method instrumental in assessing mitochondrial function. One of the most important steps in the analysis of mitochondrial respiration using the Seahorse XF24 analyzer is plating a uniform monolayer of firmly attached cells. However, culturing of primary dorsal root ganglion (DRG) neurons is associated with multiple challenges, including their propensity to form clumps and detach from the culture plate. This could significantly interfere with proper analysis and interpretation of data. We have tested multiple cell culture parameters including coating substrates, culture medium, XF24 microplate plastics, and plating techniques in order to optimize plating conditions. Here we describe a highly reproducible method to obtain neuron-enriched monolayers of securely attached dissociated primary embryonic (E15) rat DRG neurons suitable for analysis with the Seahorse XF24 platform. PMID:23248613

Comprehensive Method for Culturing Embryonic Dorsal Root Ganglion Neurons for Seahorse Extracellular Flux XF24 Analysis.

PubMed

Lange, Miranda; Zeng, Yan; Knight, Andrew; Windebank, Anthony; Trushina, Eugenia

2012-01-01

Changes in mitochondrial dynamics and function contribute to progression of multiple neurodegenerative diseases including peripheral neuropathies. The Seahorse Extracellular Flux XF24 analyzer provides a comprehensive assessment of the relative state of glycolytic and aerobic metabolism in live cells making this method instrumental in assessing mitochondrial function. One of the most important steps in the analysis of mitochondrial respiration using the Seahorse XF24 analyzer is plating a uniform monolayer of firmly attached cells. However, culturing of primary dorsal root ganglion (DRG) neurons is associated with multiple challenges, including their propensity to form clumps and detach from the culture plate. This could significantly interfere with proper analysis and interpretation of data. We have tested multiple cell culture parameters including coating substrates, culture medium, XF24 microplate plastics, and plating techniques in order to optimize plating conditions. Here we describe a highly reproducible method to obtain neuron-enriched monolayers of securely attached dissociated primary embryonic (E15) rat DRG neurons suitable for analysis with the Seahorse XF24 platform.

Sustainable Materials Management Challenge Data

EPA Pesticide Factsheets

Sustainable Materials Management (SMM) is a systemic approach to using and reusing materials more productively over their entire lifecycles. It represents a change in how our society thinks about the use of natural resources and environmental protection. By looking at a product's entire lifecycle we can find new opportunities to reduce environmental impacts, conserve resources, and reduce costs. There are multiple challenge programs available as part of the SMM program, including the Food Recovery Challenge, the Electronics Challenge, the Federal Green Challenge, and the WasteWise program. As part of EPA's Food Recovery Challenge, organizations pledge to improve their sustainable food management practices and report their results. The SMM Electronics Challenge encourages electronics manufacturers, brand owners and retailers to strive to send 100 percent of the used electronics they collect from the public, businesses and within their own organizations to third-party certified electronics refurbishers and recyclers. The Federal Green Challenge, a national effort under the EPA??s Sustainable Materials Management Program, challenges EPA and other federal agencies throughout the country to lead by example in reducing the federal government's environmental impact. EPA??s WasteWise encourages organizations and businesses to achieve sustainability in their practices and reduce select industrial wastes. WasteWise is part of EPA??s sustaina

On "Stepping Back and Letting Go": The Role of Control in the Success or Failure of Social Studies Simulations

ERIC Educational Resources Information Center

Wright-Maley, Cory

2015-01-01

This comparative case study presents one key challenge that 2 experienced teachers faced when using simulations: control. Simulations are activities that place high demands on teachers, including the ability to anticipate pitfalls in advance, act in multiple capacities, shape the direction of the activity without unduly interfering, and to be…

Examining the Benefits and Challenges of Using Audience Response Systems: A Review of the Literature

ERIC Educational Resources Information Center

Kay, Robin H.; LeSage, Ann

2009-01-01

Audience response systems (ARSs) permit students to answer electronically displayed multiple choice questions using a remote control device. All responses are instantly presented, in chart form, then reviewed and discussed by the instructor and the class. A brief history of ARSs is offered including a discussion of the 26 labels used to identify…

2005 TACOM APBI - Partnering to Reset, Recapitalize and Restructure the Force

DTIC Science & Technology

2005-10-28

training. 28 Oct 05~APBI ~9~ Force Projection ~ Technology Challenges (cont.) Force Sustainment Systems Develop smart airdrop systems using Global... UART ). General Purpose Electronic Test Equipment (GPETE) Transform multiple conventional GPETE instruments into a single Virtual Instrument with a...Consists of tools and equipment to refill and repair carbon dioxide fire extinguishers. Rapid Runway Repair - Components include sand grid sections

Impact of Game-Based Training on Classroom Learning Outcomes

DTIC Science & Technology

2010-09-01

Erwin, 2000). Several studies support the notion that GBT increases learners’ motivation. Massively multiple online role-playing games ( MMORPGs ) are...synthetic arenas where players interact, collaborate, and strategize with others. The nature of MMORPGs challenges players to think critically and...comfortable with the course, yet avoid strong influence of cumulative course learning. Each PE included several stages—classroom lecture, group

Challenges and strategies for implementing genomic services in diverse settings: experiences from the Implementing GeNomics In pracTicE (IGNITE) network.

PubMed

Sperber, Nina R; Carpenter, Janet S; Cavallari, Larisa H; J Damschroder, Laura; Cooper-DeHoff, Rhonda M; Denny, Joshua C; Ginsburg, Geoffrey S; Guan, Yue; Horowitz, Carol R; Levy, Kenneth D; Levy, Mia A; Madden, Ebony B; Matheny, Michael E; Pollin, Toni I; Pratt, Victoria M; Rosenman, Marc; Voils, Corrine I; W Weitzel, Kristen; Wilke, Russell A; Ryanne Wu, R; Orlando, Lori A

2017-05-22

To realize potential public health benefits from genetic and genomic innovations, understanding how best to implement the innovations into clinical care is important. The objective of this study was to synthesize data on challenges identified by six diverse projects that are part of a National Human Genome Research Institute (NHGRI)-funded network focused on implementing genomics into practice and strategies to overcome these challenges. We used a multiple-case study approach with each project considered as a case and qualitative methods to elicit and describe themes related to implementation challenges and strategies. We describe challenges and strategies in an implementation framework and typology to enable consistent definitions and cross-case comparisons. Strategies were linked to challenges based on expert review and shared themes. Three challenges were identified by all six projects, and strategies to address these challenges varied across the projects. One common challenge was to increase the relative priority of integrating genomics within the health system electronic health record (EHR). Four projects used data warehousing techniques to accomplish the integration. The second common challenge was to strengthen clinicians' knowledge and beliefs about genomic medicine. To overcome this challenge, all projects developed educational materials and conducted meetings and outreach focused on genomic education for clinicians. The third challenge was engaging patients in the genomic medicine projects. Strategies to overcome this challenge included use of mass media to spread the word, actively involving patients in implementation (e.g., a patient advisory board), and preparing patients to be active participants in their healthcare decisions. This is the first collaborative evaluation focusing on the description of genomic medicine innovations implemented in multiple real-world clinical settings. Findings suggest that strategies to facilitate integration of genomic data within existing EHRs and educate stakeholders about the value of genomic services are considered important for effective implementation. Future work could build on these findings to evaluate which strategies are optimal under what conditions. This information will be useful for guiding translation of discoveries to clinical care, which, in turn, can provide data to inform continual improvement of genomic innovations and their applications.

Nanoparticles for cancer gene therapy: Recent advances, challenges, and strategies.

PubMed

Wang, Kui; Kievit, Forrest M; Zhang, Miqin

2016-12-01

Compared to conventional treatments, gene therapy offers a variety of advantages for cancer treatment including high potency and specificity, low off-target toxicity, and delivery of multiple genes that concurrently target cancer tumorigenesis, recurrence, and drug resistance. In the past decades, gene therapy has undergone remarkable progress, and is now poised to become a first line therapy for cancer. Among various gene delivery systems, nanoparticles have attracted much attention because of their desirable characteristics including low toxicity profiles, well-controlled and high gene delivery efficiency, and multi-functionalities. This review provides an overview on gene therapeutics and gene delivery technologies, and highlight recent advances, challenges and insights into the design and the utility of nanoparticles in gene therapy for cancer treatment. Copyright © 2016. Published by Elsevier Ltd.

Delivering HIV care in challenging operating environments: the MSF experience towards differentiated models of care for settings with multiple basic health care needs

PubMed Central

Ssonko, Charles; Gonzalez, Lucia; Mesic, Anita; da Fonseca, Marcio Silveira; Achar, Jay; Safar, Nadia; Martin, Beatriz; Wong, Sidney; Casas, Esther C.

2017-01-01

Abstract Introduction: Countries in the West and Central African regions struggle to offer quality HIV care at scale, despite HIV prevalence being relatively low. In these challenging operating environments, basic health care needs are multiple, systems are highly fragile and conflict disrupts health care. Médecins Sans Frontières (MSF) has been working to integrate HIV care in basic health services in such settings since 2000. We review the implementation of differentiated HIV care and treatment approaches in MSF-supported programmes in South Sudan (RoSS), Central African Republic (CAR) and Democratic Republic of Congo (DRC). Methods: A descriptive analysis from CAR, DRC and RoSS programmes reviewing methodology and strategies of HIV care integration between 2010 and 2015 was performed. We describe HIV care models integrated within the provision of general health care and highlight best practices and challenges. Results: Services included provision of general health care, with out-patient care (range between countries 43,343 and 287,163 consultations/year in 2015) and in-patient care (range 1076–16,595 in 2015). By the end of 2015 antiretroviral therapy (ART) initiations reached 12–255 patients/year. A total of 1101 and 1053 patients were on ART in CAR and DRC, respectively. In RoSS 186 patients were on ART when conflict recommenced late in 2013. While ART initiation and monitoring were mostly clinically driven in the early phase of the programmes, DRC implemented CD4 monitoring and progressively HIV viral load (VL) monitoring during study period. Attacks to health care facilities in CAR and RoSS disrupted service provision temporarily. Programmatic challenges include: competing health priorities influencing HIV care and need to integrate within general health services. Differentiated care approaches that support continuity of care in these programmes include simplification of medical protocols, multi-month ART prescriptions, and community strategies such as ART delivery groups, contingency plans and peer support activities. Conclusions: The principles of differentiated HIV care for high-quality ART delivery can successfully be applied in challenging operating environments. However, success heavily depends on specific adaptations to each setting. PMID:28770590

Delivering HIV care in challenging operating environments: the MSF experience towards differentiated models of care for settings with multiple basic health care needs.

PubMed

Ssonko, Charles; Gonzalez, Lucia; Mesic, Anita; da Fonseca, Marcio Silveira; Achar, Jay; Safar, Nadia; Martin, Beatriz; Wong, Sidney; Casas, Esther C

2017-07-21

Countries in the West and Central African regions struggle to offer quality HIV care at scale, despite HIV prevalence being relatively low. In these challenging operating environments, basic health care needs are multiple, systems are highly fragile and conflict disrupts health care. Médecins Sans Frontières (MSF) has been working to integrate HIV care in basic health services in such settings since 2000. We review the implementation of differentiated HIV care and treatment approaches in MSF-supported programmes in South Sudan (RoSS), Central African Republic (CAR) and Democratic Republic of Congo (DRC). A descriptive analysis from CAR, DRC and RoSS programmes reviewing methodology and strategies of HIV care integration between 2010 and 2015 was performed. We describe HIV care models integrated within the provision of general health care and highlight best practices and challenges. Services included provision of general health care, with out-patient care (range between countries 43,343 and 287,163 consultations/year in 2015) and in-patient care (range 1076-16,595 in 2015). By the end of 2015 antiretroviral therapy (ART) initiations reached 12-255 patients/year. A total of 1101 and 1053 patients were on ART in CAR and DRC, respectively. In RoSS 186 patients were on ART when conflict recommenced late in 2013. While ART initiation and monitoring were mostly clinically driven in the early phase of the programmes, DRC implemented CD4 monitoring and progressively HIV viral load (VL) monitoring during study period. Attacks to health care facilities in CAR and RoSS disrupted service provision temporarily. Programmatic challenges include: competing health priorities influencing HIV care and need to integrate within general health services. Differentiated care approaches that support continuity of care in these programmes include simplification of medical protocols, multi-month ART prescriptions, and community strategies such as ART delivery groups, contingency plans and peer support activities. The principles of differentiated HIV care for high-quality ART delivery can successfully be applied in challenging operating environments. However, success heavily depends on specific adaptations to each setting.

Provider Experiences with Prison Care and Aftercare for Women with Co-occurring Mental Health and Substance Use Disorders: Treatment, Resource, and Systems Integration Challenges.

PubMed

Johnson, Jennifer E; Schonbrun, Yael Chatav; Peabody, Marlanea E; Shefner, Ruth T; Fernandes, Karen M; Rosen, Rochelle K; Zlotnick, Caron

2015-10-01

Incarcerated women with co-occurring mental health and substance use disorders (COD) face complex psychosocial challenges at community reentry. This study used qualitative methods to evaluate the perspectives of 14 prison and aftercare providers about service delivery challenges and treatment needs of reentering women with COD. Providers viewed the needs of women prisoners with COD as distinct from those of women with substance use alone and from men with COD. Providers described optimal aftercare for women with COD as including contact with the same provider before and after release, access to services within 24-72 hours after release, assistance with managing multiple social service agencies, assistance with relationship issues, and long-term follow-up. Providers also described larger service system and societal issues, including systems integration and ways in which a lack of prison and community aftercare resources impacted quality of care and reentry outcomes. Practice and policy implications are provided.

Provider Experiences with Prison Care and Aftercare for Women with Co-occurring Mental Health and Substance Use Disorders: Treatment, Resource, and Systems Integration Challenges

PubMed Central

Johnson, Jennifer E.; Schonbrun, Yael Chatav; Peabody, Marlanea E.; Shefner, Ruth T.; Fernandes, Karen M.; Rosen, Rochelle K.; Zlotnick, Caron

2014-01-01

Incarcerated women with co-occurring mental health and substance use disorders (COD) face complex psychosocial challenges at community reentry. This study used qualitative methods to evaluate the perspectives of 14 prison and aftercare providers about service delivery challenges and treatment needs of reentering women with COD. Providers viewed the needs of women prisoners with COD as distinct from those of women with substance use alone and from men with COD. Providers described optimal aftercare for women with COD as including contact with the same provider before and after release, access to services within 24–72 hours after release, assistance with managing multiple social service agencies, assistance with relationship issues, and long-term follow-up. Providers also described larger service system and societal issues, including systems integration and ways in which a lack of prison and community aftercare resources impacted quality of care and reentry outcomes. Practice and policy implications are provided. PMID:24595815

Approach to evaluation and management of a patient with multiple food allergies.

PubMed

Bird, J Andrew

2016-01-01

Diagnosing food allergy is often challenging, and validated testing modalities are mostly limited to immunoglobulin E (IgE)-mediated reactions to foods. Use of food-specific IgE tests and skin prick tests in individuals without a history that supports an IgE-mediated reaction to the specific food being tested diminishes the predictive capabilities of the test. To review the literature regarding evaluation of patients with a concern for multiple food allergies and to demonstrate an evidence-based approach to diagnosis and management. A literature search was performed and articles identified as relevant based on the search terms "food allergy," "food allergy diagnosis," "skin prick test," "serum IgE test," "oral food challenge", and "food allergy management." Patients at risk of food allergy are often misdiagnosed and appropriate evaluation of patients with concern for food allergy includes taking a thorough diet history and reaction history, performing specific tests intentionally and when indicated, and conducting an oral food challenge in a safe environment by an experienced provider when test results are inconclusive. An evidence-based approach to diagnosing and managing a patient at risk of having a life-threatening food allergy is reviewed.

Evolution of accelerometer methods for physical activity research.

PubMed

Troiano, Richard P; McClain, James J; Brychta, Robert J; Chen, Kong Y

2014-07-01

The technology and application of current accelerometer-based devices in physical activity (PA) research allow the capture and storage or transmission of large volumes of raw acceleration signal data. These rich data not only provide opportunities to improve PA characterisation, but also bring logistical and analytic challenges. We discuss how researchers and developers from multiple disciplines are responding to the analytic challenges and how advances in data storage, transmission and big data computing will minimise logistical challenges. These new approaches also bring the need for several paradigm shifts for PA researchers, including a shift from count-based approaches and regression calibrations for PA energy expenditure (PAEE) estimation to activity characterisation and EE estimation based on features extracted from raw acceleration signals. Furthermore, a collaborative approach towards analytic methods is proposed to facilitate PA research, which requires a shift away from multiple independent calibration studies. Finally, we make the case for a distinction between PA represented by accelerometer-based devices and PA assessed by self-report. 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.

Regional Management Units for Marine Turtles: A Novel Framework for Prioritizing Conservation and Research across Multiple Scales

PubMed Central

Wallace, Bryan P.; DiMatteo, Andrew D.; Hurley, Brendan J.; Finkbeiner, Elena M.; Bolten, Alan B.; Chaloupka, Milani Y.; Hutchinson, Brian J.; Abreu-Grobois, F. Alberto; Amorocho, Diego; Bjorndal, Karen A.; Bourjea, Jerome; Bowen, Brian W.; Dueñas, Raquel Briseño; Casale, Paolo; Choudhury, B. C.; Costa, Alice; Dutton, Peter H.; Fallabrino, Alejandro; Girard, Alexandre; Girondot, Marc; Godfrey, Matthew H.; Hamann, Mark; López-Mendilaharsu, Milagros; Marcovaldi, Maria Angela; Mortimer, Jeanne A.; Musick, John A.; Nel, Ronel; Pilcher, Nicolas J.; Seminoff, Jeffrey A.; Troëng, Sebastian; Witherington, Blair; Mast, Roderic B.

2010-01-01

Background Resolving threats to widely distributed marine megafauna requires definition of the geographic distributions of both the threats as well as the population unit(s) of interest. In turn, because individual threats can operate on varying spatial scales, their impacts can affect different segments of a population of the same species. Therefore, integration of multiple tools and techniques — including site-based monitoring, genetic analyses, mark-recapture studies and telemetry — can facilitate robust definitions of population segments at multiple biological and spatial scales to address different management and research challenges. Methodology/Principal Findings To address these issues for marine turtles, we collated all available studies on marine turtle biogeography, including nesting sites, population abundances and trends, population genetics, and satellite telemetry. We georeferenced this information to generate separate layers for nesting sites, genetic stocks, and core distributions of population segments of all marine turtle species. We then spatially integrated this information from fine- to coarse-spatial scales to develop nested envelope models, or Regional Management Units (RMUs), for marine turtles globally. Conclusions/Significance The RMU framework is a solution to the challenge of how to organize marine turtles into units of protection above the level of nesting populations, but below the level of species, within regional entities that might be on independent evolutionary trajectories. Among many potential applications, RMUs provide a framework for identifying data gaps, assessing high diversity areas for multiple species and genetic stocks, and evaluating conservation status of marine turtles. Furthermore, RMUs allow for identification of geographic barriers to gene flow, and can provide valuable guidance to marine spatial planning initiatives that integrate spatial distributions of protected species and human activities. In addition, the RMU framework — including maps and supporting metadata — will be an iterative, user-driven tool made publicly available in an online application for comments, improvements, download and analysis. PMID:21253007

Cavity-Enhanced Raman Spectroscopy for Food Chain Management

PubMed Central

Sandfort, Vincenz; Goldschmidt, Jens; Wöllenstein, Jürgen

2018-01-01

Comprehensive food chain management requires the monitoring of many parameters including temperature, humidity, and multiple gases. The latter is highly challenging because no low-cost technology for the simultaneous chemical analysis of multiple gaseous components currently exists. This contribution proposes the use of cavity enhanced Raman spectroscopy to enable online monitoring of all relevant components using a single laser source. A laboratory scale setup is presented and characterized in detail. Power enhancement of the pump light is achieved in an optical resonator with a Finesse exceeding 2500. A simulation for the light scattering behavior shows the influence of polarization on the spatial distribution of the Raman scattered light. The setup is also used to measure three relevant showcase gases to demonstrate the feasibility of the approach, including carbon dioxide, oxygen and ethene. PMID:29495501

A review of multi-risk methodologies for natural hazards: Consequences and challenges for a climate change impact assessment.

PubMed

Gallina, Valentina; Torresan, Silvia; Critto, Andrea; Sperotto, Anna; Glade, Thomas; Marcomini, Antonio

2016-03-01

This paper presents a review of existing multi-risk assessment concepts and tools applied by organisations and projects providing the basis for the development of a multi-risk methodology in a climate change perspective. Relevant initiatives were developed for the assessment of multiple natural hazards (e.g. floods, storm surges, droughts) affecting the same area in a defined timeframe (e.g. year, season, decade). Major research efforts were focused on the identification and aggregation of multiple hazard types (e.g. independent, correlated, cascading hazards) by means of quantitative and semi-quantitative approaches. Moreover, several methodologies aim to assess the vulnerability of multiple targets to specific natural hazards by means of vulnerability functions and indicators at the regional and local scale. The overall results of the review show that multi-risk approaches do not consider the effects of climate change and mostly rely on the analysis of static vulnerability (i.e. no time-dependent vulnerabilities, no changes among exposed elements). A relevant challenge is therefore to develop comprehensive formal approaches for the assessment of different climate-induced hazards and risks, including dynamic exposure and vulnerability. This requires the selection and aggregation of suitable hazard and vulnerability metrics to make a synthesis of information about multiple climate impacts, the spatial analysis and ranking of risks, including their visualization and communication to end-users. To face these issues, climate impact assessors should develop cross-sectorial collaborations among different expertise (e.g. modellers, natural scientists, economists) integrating information on climate change scenarios with sectorial climate impact assessment, towards the development of a comprehensive multi-risk assessment process. Copyright © 2015 Elsevier Ltd. All rights reserved.

Multiple Ships and Multiple Media: A Flexible Telepresence Program

NASA Astrophysics Data System (ADS)

Pelz, M.; Hoeberechts, M.; Riddell, D. J.; Ewing, N.

2016-02-01

Ocean Networks Canada (ONC) uses a number of research and exploration vessels equipped with remotely operated vehicles (ROVs) to maintain the NEPTUNE and VENUS cabled ocean observatories off the west coast of British Columbia, Canada. Maintenance expeditions range from several days to multiple weeks and encompass a range of activities including deploying new instruments, laying cable, recovering platforms, scientific sampling and conducting multibeam and visual surveys. In order to engage the widest possible participation in at-sea work, ONC uses telepresence technology to communicate from ship to shore and back with scientists, students, teachers and online viewers. In this presentation, we explore the challenge of designing a sustainable and flexible telepresence program which can be supported across multiple ship and ROV platforms, sometimes simultaneously. To meet outreach and education objectives, onboard educators conduct presentations to K-12 and post-secondary classrooms, museums and science centres on a daily basis. Online commentary by the educators, dive chief and ROV pilots accompanies the ROV dive footage and is streamed online 24/7 during underwater operations. Sharing the sights and sounds of the expeditions with students and educators ashore, including those in remote and inland communities, creates a unique learning environment for both formal and informal education audiences. As space is always a limiting factor on expeditions, the use of telepresence and other communication media enables ONC to simultaneously achieve engineering and science priorities at sea while communicating the successes and challenges of the expedition back to shore. Scientists and engineers provide guidance for operations from shore using a variety of communication technologies. We give examples from Ocean Networks Canada's most recent expedition, Fall 2015, which involved co-ordinated operations with three vessels - the R/V Thompson, the E/V Nautilus and the C/S Wave Venture.

How could health information exchange better meet the needs of care practitioners?

PubMed

Kierkegaard, P; Kaushal, R; Vest, J R

2014-01-01

Health information exchange (HIE) has the potential to improve the quality of healthcare by enabling providers with better access to patient information from multiple sources at the point of care. However, HIE efforts have historically been difficult to establish in the US and the failure rates of organizations created to foster HIE have been high. We sought to better understand how RHIO-based HIE systems were used in practice and the challenges care practitioners face using them. The objective of our study were to so investigate how HIE can better meet the needs of care practitioners. We performed a multiple-case study using qualitative methods in three communities in New York State. We conducted interviews onsite and by telephone with HIE users and non-users and observed the workflows of healthcare professionals at multiple healthcare organizations participating in a local HIE effort in New York State. The empirical data analysis suggests that challenges still remain in increasing provider usage, optimizing HIE implementations and connecting HIE systems across geographic regions. Important determinants of system usage and perceived value includes users experienced level of available information and the fit of use for physician workflows. Challenges still remain in increasing provider adoption, optimizing HIE implementations, and demonstrating value. The inability to find information reduced usage of HIE. Healthcare organizations, HIE facilitating organizations, and states can help support HIE adoption by ensuring patient information is accessible to providers through increasing patient consents, fostering broader participation, and by ensuring systems are usable.

Scientific Guidance for Rehabilitation of the Chesapeake Bay Ecosystem under the Changing Climate.

NASA Astrophysics Data System (ADS)

Boesch, D. F.; Johnson, Z. P.; Li, M.

2017-12-01

While the Chesapeake Bay is an estuary and not a marginal sea on the scale of the Baltic Sea or the Gulf of Mexico, it has a complex set of environmental issues and multiple political jurisdictions such that it can serve as a test bed for science-informed management in larger marine systems. In particular, the Chesapeake Bay possesses a relatively advanced effort to ameliorate eutrophication, reduce toxic stresses, rehabilitate critical habitats, and sustainably utilized resources. Furthermore, both scientists and managers are addressing these challenges while now beginning to incorporate the effects of changes in temperature, precipitation and runoff, sea level, ocean boundary conditions, and pH. Increases in temperature and sea level are already apparent and future conditions can be estimated from global model projections, although sea level and ocean exchanges are also affected by variations in Gulf Stream flows and mesoscale climate. Changes in the volume, seasonality and variability in freshwater delivery from the multiple rivers discharging to the bay are harder to project with confidence, but may have pervasive consequences for circulation, reducing nutrient loads to ameliorate eutrophication, biogeochemical processes, and biotic distributions and dynamics. Science is now challenged to inform multiple adaptation strategies, including minimizing the vulnerability of humans and infrastructure, sustaining important tidal wetlands, managing sediment resources, sustaining living resources, redefining achievable ecosystem rehabilitation goals, and achieving shifting goals for nutrient load reductions. At the same time, science will also have to identify effective means to meet these challenges while also reducing greenhouse gas emissions.

Long-range dismount activity classification: LODAC

NASA Astrophysics Data System (ADS)

Garagic, Denis; Peskoe, Jacob; Liu, Fang; Cuevas, Manuel; Freeman, Andrew M.; Rhodes, Bradley J.

2014-06-01

Continuous classification of dismount types (including gender, age, ethnicity) and their activities (such as walking, running) evolving over space and time is challenging. Limited sensor resolution (often exacerbated as a function of platform standoff distance) and clutter from shadows in dense target environments, unfavorable environmental conditions, and the normal properties of real data all contribute to the challenge. The unique and innovative aspect of our approach is a synthesis of multimodal signal processing with incremental non-parametric, hierarchical Bayesian machine learning methods to create a new kind of target classification architecture. This architecture is designed from the ground up to optimally exploit correlations among the multiple sensing modalities (multimodal data fusion) and rapidly and continuously learns (online self-tuning) patterns of distinct classes of dismounts given little a priori information. This increases classification performance in the presence of challenges posed by anti-access/area denial (A2/AD) sensing. To fuse multimodal features, Long-range Dismount Activity Classification (LODAC) develops a novel statistical information theoretic approach for multimodal data fusion that jointly models multimodal data (i.e., a probabilistic model for cross-modal signal generation) and discovers the critical cross-modal correlations by identifying components (features) with maximal mutual information (MI) which is efficiently estimated using non-parametric entropy models. LODAC develops a generic probabilistic pattern learning and classification framework based on a new class of hierarchical Bayesian learning algorithms for efficiently discovering recurring patterns (classes of dismounts) in multiple simultaneous time series (sensor modalities) at multiple levels of feature granularity.

Qualitative studies using in-depth interviews with older people from multiple language groups: methodological systematic review.

PubMed

Fryer, Caroline; Mackintosh, Shylie; Stanley, Mandy; Crichton, Jonathan

2012-01-01

This paper is a report of a methodological review of language appropriate practice in qualitative research, when language groups were not determined prior to participant recruitment. When older people from multiple language groups participate in research using in-depth interviews, additional challenges are posed for the trustworthiness of findings. This raises the question of how such challenges are addressed. The Cumulative Index to Nursing and Allied Health Literature, Scopus, Embase, Web of Science, Ageline, PsycINFO, Sociological abstracts, Google Scholar and Allied and Complementary Medicine databases were systematically searched for the period 1840 to September 2009. The combined search terms of 'ethnic', 'cultural', 'aged', 'health' and 'qualitative' were used. In this methodological review, studies were independently appraised by two authors using a quality appraisal tool developed for the review, based on a protocol from the McMaster University Occupational Therapy Evidence-Based Practice Research Group. Nine studies were included. Consideration of language diversity within research process was poor for all studies. The role of language assistants was largely absent from study methods. Only one study reported using participants' preferred languages for informed consent. More examples are needed of how to conduct rigorous in-depth interviews with older people from multiple language groups, when languages are not determined before recruitment. This will require both researchers and funding bodies to recognize the importance to contemporary healthcare of including linguistically diverse people in participant samples. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

New Challenges of the Computation of Multiple Sequence Alignments in the High-Throughput Era (2010 JGI/ANL HPC Workshop)

ScienceCinema

Notredame, Cedric

2018-05-02

Cedric Notredame from the Centre for Genomic Regulation gives a presentation on New Challenges of the Computation of Multiple Sequence Alignments in the High-Throughput Era at the JGI/Argonne HPC Workshop on January 26, 2010.

More are better, but the details matter: combinations of multiple Fresnel zone plates for improved resolution and efficiency in X-ray microscopy

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

Li, Kenan; Jacobsen, Chris

Fresnel zone plates used for X-ray nanofocusing face high-aspect-ratio nanofabrication challenges in combining narrow transverse features (for high spatial resolution) along with extended optical modulation along the X-ray beam direction (to improve efficiency). The stacking of multiple Fresnel zone plates along the beam direction has already been shown to offer improved characteristics of resolution and efficiency when compared with thin single zone plates. Using multislice wave propagation simulation methods, here a number of new schemes for the stacking of multiple Fresnel zone plates are considered. These include consideration of optimal thickness and spacing in the axial direction, and methods tomore » capture a fraction of the light otherwise diffracted into unwanted orders, and instead bring it into the desired first-order focus. In conclusion, the alignment tolerances for stacking multiple Fresnel zone plates are also considered.« less

Challenges for data storage in medical imaging research.

PubMed

Langer, Steve G

2011-04-01

Researchers in medical imaging have multiple challenges for storing, indexing, maintaining viability, and sharing their data. Addressing all these concerns requires a constellation of tools, but not all of them need to be local to the site. In particular, the data storage challenges faced by researchers can begin to require professional information technology skills. With limited human resources and funds, the medical imaging researcher may be better served with an outsourcing strategy for some management aspects. This paper outlines an approach to manage the main objectives faced by medical imaging scientists whose work includes processing and data mining on non-standard file formats, and relating those files to the their DICOM standard descendents. The capacity of the approach scales as the researcher's need grows by leveraging the on-demand provisioning ability of cloud computing.

Mapping Geology and Vegetation using Hyperspectral Data in Antarctica: Current Challenges, New Solutions and Looking to the Future

NASA Astrophysics Data System (ADS)

Black, M.; Riley, T. R.; Fleming, A. H.; Ferrier, G.; Fretwell, P.; Casanovas, P.

2015-12-01

Antarctica is a unique and geographically remote environment. Traditional field campaigns investigating geology and vegetation in the region encounter numerous challenges including the harsh polar climate, the invasive nature of the work, steep topography and high infrastructure costs. Additionally, such field campaigns are often limited in terms of spatial and temporal resolution, and particularly, the topographical challenges presented in the Antarctic mean that many areas remain inaccessible. Remote Sensing, particularly hyperspectral imaging, may provide a solution to overcome the difficulties associated with field based mapping in the Antarctic. Planned satellite launches, such as EnMAP and HyspIRI, if successful, will yield large-scale, repeated hyperspectral imagery of Antarctica. Hyperspectral imagery has proven mapping capabilities and can yield greater information than can be attained using multispectral data. As a precursor to future satellite imagery, we utilise hyperspectral imagery from the first known airborne hyperspectral survey carried out in the Antarctic by the British Antarctic Survey and partners in 2011. Multiple imaging spectrometers were simultaneously deployed covering the visible, shortwave and thermal infrared regions of the electromagnetic spectrum. Additional data was generated during a field campaign deploying multiple ground spectrometers covering the same wavelengths as the airborne imagers. We utilise this imagery to assess the current challenges and propose some new solutions for mapping vegetation and geology, which may be directly applicable to future satellite hyperspectral imagery in the Antarctic.

Preferred Names, Preferred Pronouns, and Gender Identity in the Electronic Medical Record and Laboratory Information System: Is Pathology Ready?

PubMed

Imborek, Katherine L; Nisly, Nicole L; Hesseltine, Michael J; Grienke, Jana; Zikmund, Todd A; Dreyer, Nicholas R; Blau, John L; Hightower, Maia; Humble, Robert M; Krasowski, Matthew D

2017-01-01

Electronic medical records (EMRs) and laboratory information systems (LISs) commonly utilize patient identifiers such as legal name, sex, medical record number, and date of birth. There have been recommendations from some EMR working groups (e.g., the World Professional Association for Transgender Health) to include preferred name, pronoun preference, assigned sex at birth, and gender identity in the EMR. These practices are currently uncommon in the United States. There has been little published on the potential impact of these changes on pathology and LISs. We review the available literature and guidelines on the use of preferred name and gender identity on pathology, including data on changes in laboratory testing following gender transition treatments. We also describe pathology and clinical laboratory challenges in the implementation of preferred name at our institution. Preferred name, pronoun preference, and gender identity have the most immediate impact on the areas of pathology with direct patient contact such as phlebotomy and transfusion medicine, both in terms of interaction with patients and policies for patient identification. Gender identity affects the regulation and policies within transfusion medicine including blood donor risk assessment and eligibility. There are limited studies on the impact of gender transition treatments on laboratory tests, but multiple studies have demonstrated complex changes in chemistry and hematology tests. A broader challenge is that, even as EMRs add functionality, pathology computer systems (e.g., LIS, middleware, reference laboratory, and outreach interfaces) may not have functionality to store or display preferred name and gender identity. Implementation of preferred name, pronoun preference, and gender identity presents multiple challenges and opportunities for pathology.

Mixed-ability secondary science in one urban school district: A multiple case study

NASA Astrophysics Data System (ADS)

Tworek, Francis A.

The standards and accountability movements demand that all students be given the opportunity to learn more science than ever before. However, there is much uncertainty about how educators should proceed with this task. Issues of concern include achievement gaps, tracking, and graduation requirements. The purpose of this multiple case study was to explore the challenges identified by four secondary science teachers in one urban public school district as they taught classes that included students representing a wide range of abilities and prior academic success. These mixed-ability science classes were generally defined as science classes which are required for high school graduation but which have no academic prerequisites. The central research questions in this qualitative study were: (1) How do secondary science teachers describe the challenges they face while teaching a mixed-ability science course required for graduation when the course has no prerequisites; and (2) What strategies do they use to deal with these challenges? Data collection was confined to four cases within one Midwest urban school district during the 2004-2005 school year. Each case involved one class taught by an individual teacher. One case was an 8th grade science class at a middle school. The other three cases represented three district-required courses in three different high schools: 9th grade biology, 10th grade chemistry, and 11th grade physics. Data sources included interviews with the teachers, observations in their classrooms, district achievement and demographic data, and school documents. Three themes emerged from the cross-case analysis: (1) a sense of belonging; (2) the teacher's focus; and (3) successful learning. The final chapter discusses the implications of these themes and makes recommendations for further study.

Preferred Names, Preferred Pronouns, and Gender Identity in the Electronic Medical Record and Laboratory Information System: Is Pathology Ready?

PubMed Central

Imborek, Katherine L.; Nisly, Nicole L.; Hesseltine, Michael J.; Grienke, Jana; Zikmund, Todd A.; Dreyer, Nicholas R.; Blau, John L.; Hightower, Maia; Humble, Robert M.; Krasowski, Matthew D.

2017-01-01

Background: Electronic medical records (EMRs) and laboratory information systems (LISs) commonly utilize patient identifiers such as legal name, sex, medical record number, and date of birth. There have been recommendations from some EMR working groups (e.g., the World Professional Association for Transgender Health) to include preferred name, pronoun preference, assigned sex at birth, and gender identity in the EMR. These practices are currently uncommon in the United States. There has been little published on the potential impact of these changes on pathology and LISs. Methods: We review the available literature and guidelines on the use of preferred name and gender identity on pathology, including data on changes in laboratory testing following gender transition treatments. We also describe pathology and clinical laboratory challenges in the implementation of preferred name at our institution. Results: Preferred name, pronoun preference, and gender identity have the most immediate impact on the areas of pathology with direct patient contact such as phlebotomy and transfusion medicine, both in terms of interaction with patients and policies for patient identification. Gender identity affects the regulation and policies within transfusion medicine including blood donor risk assessment and eligibility. There are limited studies on the impact of gender transition treatments on laboratory tests, but multiple studies have demonstrated complex changes in chemistry and hematology tests. A broader challenge is that, even as EMRs add functionality, pathology computer systems (e.g., LIS, middleware, reference laboratory, and outreach interfaces) may not have functionality to store or display preferred name and gender identity. Conclusions: Implementation of preferred name, pronoun preference, and gender identity presents multiple challenges and opportunities for pathology. PMID:29114436

Progress and challenges of disaster health management in China: a scoping review.

PubMed

Zhong, Shuang; Clark, Michele; Hou, Xiang-Yu; Zang, Yuli; FitzGerald, Gerard

2014-01-01

Despite the importance of an effective health system response to various disasters, relevant research is still in its infancy, especially in middle- and low-income countries. This paper provides an overview of the status of disaster health management in China, with its aim to promote the effectiveness of the health response for reducing disaster-related mortality and morbidity. A scoping review method was used to address the recent progress of and challenges to disaster health management in China. Major health electronic databases were searched to identify English and Chinese literature that were relevant to the research aims. The review found that since 2003 considerable progress has been achieved in the health disaster response system in China. However, there remain challenges that hinder effective health disaster responses, including low standards of disaster-resistant infrastructure safety, the lack of specific disaster plans, poor emergency coordination between hospitals, lack of portable diagnostic equipment and underdeveloped triage skills, surge capacity, and psychological interventions. Additional challenges include the fragmentation of the emergency health service system, a lack of specific legislation for emergencies, disparities in the distribution of funding, and inadequate cost-effective considerations for disaster rescue. One solution identified to address these challenges appears to be through corresponding policy strategies at multiple levels (e.g. community, hospital, and healthcare system level).

Large-Scale Transport Model Uncertainty and Sensitivity Analysis: Distributed Sources in Complex Hydrogeologic Systems

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

Sig Drellack, Lance Prothro

2007-12-01

The Underground Test Area (UGTA) Project of the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office is in the process of assessing and developing regulatory decision options based on modeling predictions of contaminant transport from underground testing of nuclear weapons at the Nevada Test Site (NTS). The UGTA Project is attempting to develop an effective modeling strategy that addresses and quantifies multiple components of uncertainty including natural variability, parameter uncertainty, conceptual/model uncertainty, and decision uncertainty in translating model results into regulatory requirements. The modeling task presents multiple unique challenges to the hydrological sciences as a result ofmore » the complex fractured and faulted hydrostratigraphy, the distributed locations of sources, the suite of reactive and non-reactive radionuclides, and uncertainty in conceptual models. Characterization of the hydrogeologic system is difficult and expensive because of deep groundwater in the arid desert setting and the large spatial setting of the NTS. Therefore, conceptual model uncertainty is partially addressed through the development of multiple alternative conceptual models of the hydrostratigraphic framework and multiple alternative models of recharge and discharge. Uncertainty in boundary conditions is assessed through development of alternative groundwater fluxes through multiple simulations using the regional groundwater flow model. Calibration of alternative models to heads and measured or inferred fluxes has not proven to provide clear measures of model quality. Therefore, model screening by comparison to independently-derived natural geochemical mixing targets through cluster analysis has also been invoked to evaluate differences between alternative conceptual models. Advancing multiple alternative flow models, sensitivity of transport predictions to parameter uncertainty is assessed through Monte Carlo simulations. The simulations are challenged by the distributed sources in each of the Corrective Action Units, by complex mass transfer processes, and by the size and complexity of the field-scale flow models. An efficient methodology utilizing particle tracking results and convolution integrals provides in situ concentrations appropriate for Monte Carlo analysis. Uncertainty in source releases and transport parameters including effective porosity, fracture apertures and spacing, matrix diffusion coefficients, sorption coefficients, and colloid load and mobility are considered. With the distributions of input uncertainties and output plume volumes, global analysis methods including stepwise regression, contingency table analysis, and classification tree analysis are used to develop sensitivity rankings of parameter uncertainties for each model considered, thus assisting a variety of decisions.« less

Benefits, Challenges, and Perceptions of the Multiple Article Dissertation Format in Instructional Technology

ERIC Educational Resources Information Center

Thomas, Rebecca Arlene; West, Richard E.; Rich, Peter

2016-01-01

This study used survey data to investigate the benefits, challenges, perceptions, and current practices of the multiple article dissertation format in instructional technology. Online surveys were sent to current students, alumni, faculty, and department representatives of instructional technology programs, and data were analysed using qualitative…

Military Children and Families: Strengths and Challenges during Peace and War

ERIC Educational Resources Information Center

Park, Nansook

2011-01-01

Throughout history, military children and families have shown great capacity for adaptation and resilience. However, in recent years, unprecedented lengthy and multiple combat deployments of service members have posed multiple challenges for U.S. military children and families. Despite needs to better understand the impact of deployment on…

Improving Response Rates among Students with Orthopedic and Multiple Disabilities

ERIC Educational Resources Information Center

Wilkens, Christian P.; Kuntzler, Patrice M.; Cardenas, Shaun; O'Malley, Eileen; Phillips, Carolyn; Singer, Jacqueline; Stoeger, Alex; Kindler, Keith

2014-01-01

One challenge teachers of students with orthopedic and multiple disabilities face is providing sufficient time and opportunity to communicate. This challenge is universal across countries, schools, and settings: teachers want students to communicate because communication lies at the core of what makes us human. Yet students with orthopedic and…

Theoretical Borderlands: Using Multiple Theoretical Perspectives to Challenge Inequitable Power Structures in Student Development Theory

ERIC Educational Resources Information Center

Abes, Elisa S.

2009-01-01

This article is an exploration of possibilities and methodological considerations for using multiple theoretical perspectives in research that challenges inequitable power structures in student development theory. Specifically, I explore methodological considerations when partnering queer theory and constructivism in research on lesbian identity…

Challenges in obesity research.

PubMed

Palou, Andreu; Bonet, M Luisa

2013-09-01

Obesity is the main nutritional problem and one of the most important health problems in developed societies. Central to the challenge of obesity prevention and management is a thoroughly understanding of its determinants. Multiple socio-cultural, socio-economic, behavioural and biological factors--often interrelated and many of them still unknown or poorly understood--can contribute to the establishment and perpetuation of obese phenotypes. Here, we address current research challenges regarding basic aspects of obesity and emerging science for its control, including brown adipose tissue thermogenesis and browning of white fat as possible therapeutic targets for obesity, the influence of the microbioma, and genetics, epigenetics, nutrigenomics and nutrigenetics of obesity. We also highlight hot topics in relation to food and lifestyle as determinants of obesity, including the brain mechanisms underlying environmental motivation to eat, the biological control of spontaneous physical activity, the possible role of concrete foods and food components, and the importance of early life nutrition and environment. Challenges regarding the connections of obesity with other alterations and pathologies are also briefly addressed, as well as social and economical challenges in relation to healthy food production and lifestyle for the prevention of obesity, and technological challenges in obesity research and management. The objective is to give a panoramic of advances accomplished and still ahead relevant to the different stakeholders engaged in understanding and combating obesity. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

Implementation of genomics research in Africa: challenges and recommendations

PubMed Central

Adebamowo, Sally N.; Francis, Veronica; Tambo, Ernest; Diallo, Seybou H.; Landouré, Guida; Nembaware, Victoria; Dareng, Eileen; Muhamed, Babu; Odutola, Michael; Akeredolu, Teniola; Nerima, Barbara; Ozumba, Petronilla J.; Mbhele, Slee; Ghanash, Anita; Wachinou, Ablo P.; Ngomi, Nicholas

2018-01-01

ABSTRACT Background: There is exponential growth in the interest and implementation of genomics research in Africa. This growth has been facilitated by the Human Hereditary and Health in Africa (H3Africa) initiative, which aims to promote a contemporary research approach to the study of genomics and environmental determinants of common diseases in African populations. Objective: The purpose of this article is to describe important challenges affecting genomics research implementation in Africa. Methods: The observations, challenges and recommendations presented in this article were obtained through discussions by African scientists at teleconferences and face-to-face meetings, seminars at consortium conferences and in-depth individual discussions. Results: Challenges affecting genomics research implementation in Africa, which are related to limited resources include ill-equipped facilities, poor accessibility to research centers, lack of expertise and an enabling environment for research activities in local hospitals. Challenges related to the research study include delayed funding, extensive procedures and interventions requiring multiple visits, delays setting up research teams and insufficient staff training, language barriers and an underappreciation of cultural norms. While many African countries are struggling to initiate genomics projects, others have set up genomics research facilities that meet international standards. Conclusions: The lessons learned in implementing successful genomics projects in Africa are recommended as strategies to overcome these challenges. These recommendations may guide the development and application of new research programs in low-resource settings. PMID:29336236

Cultural and Family Challenges to Managing Type 2 Diabetes in Immigrant Chinese Americans

PubMed Central

Chesla, Catherine A.; Chun, Kevin M.; Kwan, Christine M.L.

2009-01-01

OBJECTIVE Although Asians demonstrate elevated levels of type 2 diabetes, little attention has been directed to their unique cultural beliefs and practices regarding diabetes. We describe cultural and family challenges to illness management in foreign-born Chinese American patients with type 2 diabetes and their spouses. RESEARCH DESIGN AND METHODS This was an interpretive comparative interview study with 20 foreign-born Chinese American couples (n = 40) living with type 2 diabetes. Multiple (six to seven) semistructured interviews with each couple in individual, group, and couple settings elicited beliefs about diabetes and narratives of care within the family and community. Interpretive narrative and thematic analysis were completed. A separate respondent group of 19 patients and spouses who met the inclusion criteria reviewed and confirmed the themes developed from the initial couples. RESULTS Cultural and family challenges to diabetes management within foreign-born Chinese American families included how 1) diabetes symptoms challenged family harmony, 2) dietary prescriptions challenged food beliefs and practices, and 3) disease management requirements challenged established family role responsibilities. CONCLUSIONS Culturally nuanced care with immigrant Chinese Americans requires attentiveness to the social context of disease management. Patients' and families' disease management decisions are seldom made independent of their concerns for family well-being, family face, and the reciprocal responsibilities required by varied family roles. Framing disease recommendations to include cultural concerns for balance and significant food rituals are warranted. PMID:19628812

Cultural and family challenges to managing type 2 diabetes in immigrant Chinese Americans.

PubMed

Chesla, Catherine A; Chun, Kevin M; Kwan, Christine M L

2009-10-01

Although Asians demonstrate elevated levels of type 2 diabetes, little attention has been directed to their unique cultural beliefs and practices regarding diabetes. We describe cultural and family challenges to illness management in foreign-born Chinese American patients with type 2 diabetes and their spouses. This was an interpretive comparative interview study with 20 foreign-born Chinese American couples (n = 40) living with type 2 diabetes. Multiple (six to seven) semistructured interviews with each couple in individual, group, and couple settings elicited beliefs about diabetes and narratives of care within the family and community. Interpretive narrative and thematic analysis were completed. A separate respondent group of 19 patients and spouses who met the inclusion criteria reviewed and confirmed the themes developed from the initial couples. Cultural and family challenges to diabetes management within foreign-born Chinese American families included how 1) diabetes symptoms challenged family harmony, 2) dietary prescriptions challenged food beliefs and practices, and 3) disease management requirements challenged established family role responsibilities. Culturally nuanced care with immigrant Chinese Americans requires attentiveness to the social context of disease management. Patients' and families' disease management decisions are seldom made independent of their concerns for family well-being, family face, and the reciprocal responsibilities required by varied family roles. Framing disease recommendations to include cultural concerns for balance and significant food rituals are warranted.

Implementation of genomics research in Africa: challenges and recommendations.

PubMed

Adebamowo, Sally N; Francis, Veronica; Tambo, Ernest; Diallo, Seybou H; Landouré, Guida; Nembaware, Victoria; Dareng, Eileen; Muhamed, Babu; Odutola, Michael; Akeredolu, Teniola; Nerima, Barbara; Ozumba, Petronilla J; Mbhele, Slee; Ghanash, Anita; Wachinou, Ablo P; Ngomi, Nicholas

2018-01-01

There is exponential growth in the interest and implementation of genomics research in Africa. This growth has been facilitated by the Human Hereditary and Health in Africa (H3Africa) initiative, which aims to promote a contemporary research approach to the study of genomics and environmental determinants of common diseases in African populations. The purpose of this article is to describe important challenges affecting genomics research implementation in Africa. The observations, challenges and recommendations presented in this article were obtained through discussions by African scientists at teleconferences and face-to-face meetings, seminars at consortium conferences and in-depth individual discussions. Challenges affecting genomics research implementation in Africa, which are related to limited resources include ill-equipped facilities, poor accessibility to research centers, lack of expertise and an enabling environment for research activities in local hospitals. Challenges related to the research study include delayed funding, extensive procedures and interventions requiring multiple visits, delays setting up research teams and insufficient staff training, language barriers and an underappreciation of cultural norms. While many African countries are struggling to initiate genomics projects, others have set up genomics research facilities that meet international standards. The lessons learned in implementing successful genomics projects in Africa are recommended as strategies to overcome these challenges. These recommendations may guide the development and application of new research programs in low-resource settings.

Near Real Time Integration of Satellite and Radar Data for Probabilistic Nearcasting of Severe Weather

NASA Astrophysics Data System (ADS)

Pilone, D.; Quinn, P.; Mitchell, A. E.; Baynes, K.; Shum, D.

2014-12-01

This talk introduces the audience to some of the very real challenges associated with visualizing data from disparate data sources as encountered during the development of real world applications. In addition to the fundamental challenges of dealing with the data and imagery, this talk discusses usability problems encountered while trying to provide interactive and user-friendly visualization tools. At the end of this talk the audience will be aware of some of the pitfalls of data visualization along with tools and techniques to help mitigate them. There are many sources of variable resolution visualizations of science data available to application developers including NASA's Global Imagery Browse Services (GIBS), however integrating and leveraging visualizations in modern applications faces a number of challenges, including: - Varying visualized Earth "tile sizes" resulting in challenges merging disparate sources - Multiple visualization frameworks and toolkits with varying strengths and weaknesses - Global composite imagery vs. imagery matching EOSDIS granule distribution - Challenges visualizing geographically overlapping data with different temporal bounds - User interaction with overlapping or collocated data - Complex data boundaries and shapes combined with multi-orbit data and polar projections - Discovering the availability of visualizations and the specific parameters, color palettes, and configurations used to produce them In addition to discussing the challenges and approaches involved in visualizing disparate data, we will discuss solutions and components we'll be making available as open source to encourage reuse and accelerate application development.

Approaches to advancescientific understanding of macrosystems ecology

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

Levy, Ofir; Ball, Becky; Bond-Lamberty, Benjamin

Macrosystem ecological studies inherently investigate processes that interact across multiple spatial and temporal scales, requiring intensive sampling and massive amounts of data from diverse sources to incorporate complex cross-scale and hierarchical interactions. Inherent challenges associated with these characteristics include high computational demands, data standardization and assimilation, identification of important processes and scales without prior knowledge, and the need for large, cross-disciplinary research teams that conduct long-term studies. Therefore, macrosystem ecology studies must utilize a unique set of approaches that are capable of encompassing these methodological characteristics and associated challenges. Several case studies demonstrate innovative methods used in current macrosystem ecologymore » studies.« less

Overcoming Challenges to Childhood Immunizations Status.

PubMed

Sabnis, Svapna S; Conway, James H

2015-10-01

Vaccines are one of the greatest public health achievements, preventing both mortality and morbidity. However, overall immunization rates are still below the 90% target for Healthy People 2020. There remain significant disparities in immunization rates between children of different racial/ethnic groups, as well as among economically disadvantaged populations. There are systemic issues and challenges in providing access to immunization opportunities. In addition, vaccine hesitancy contributes to underimmunization. Multiple strategies are needed to improve immunization rates, including improving access to vaccines and minimizing financial barriers to families. Vaccine status should be assessed and vaccines given at all possible opportunities. Copyright © 2015 Elsevier Inc. All rights reserved.

The "big bang" implementation: not for the faint of heart.

PubMed

Anderson, Linda K; Stafford, Cynthia J

2002-01-01

Replacing a hospital's obsolete mainframe computer system with a modern integrated clinical and administrative information system presents multiple challenges. When the new system is activated in one weekend, in "big bang" fashion, the challenges are magnified. Careful planning is essential to ensure that all hospital staff are fully prepared for this transition, knowing this conversion will involve system downtime, procedural changes, and the resulting stress that naturally accompanies change. Implementation concerns include staff preparation and training, process changes, continuity of patient care, and technical and administrative support. This article outlines how the University of Missouri Health Care addressed these operational concerns during this dramatic information system conversion.

[Challenges of the right to health in the Colombian model].

PubMed

Bernal, Oscar; Barbosa, Samuel

2015-01-01

Health in Colombia is now a fundamental right that has to be provided and protected by the government. We evaluated the strengths and difficulties of the health system with respect to the statutory law enacted in February 2015, using methodologies for analysis of health systems proposed by the WHO and the World Bank. The challenges include the fragmentation and specialization of services, access barriers and incentives that are not aligned with the quality, weak governance, multiple actors with little coordination and information system that does not measure results. The government needs to find a necessary social agreement, a balance between the particular and the collective benefit.

Migration and self-esteem: a qualitative study among internal migrant girls in Turkey.

PubMed

Altinyelken, Hulya Kosar

2009-01-01

This article examining the impact of migration experience on self-esteem of girls enrolled at primary schools in Turkey. It is based on a broader study that explored educational and coping strategies of internal migrant girls living in a suburban town in the western part of Turkey. The study showed that students encountered a variety of challenges in their new school environment including adaptation, language, low socioeconomic background, peer relations, discrimination, and bullying. These challenges seemed to have a direct or indirect influence on the educational experiences of migrant girls, undermining their self-esteem in multiple and complex ways.

Treating Heart Failure with Preserved Ejection Fraction: A Challenge for Clinicians.

PubMed

Howard, Patricia A

2015-06-01

Despite a decline in many forms of cardiovascular disease, heart failure (HF) continues to increase. Heart failure with preserved ejection fraction (HFpEF) is common, especially among persons with multiple comorbidities. HFpEF presents many challenges for clinicians due to the incomplete understanding of the underlying mechanisms and lack of consensus on the most effective strategies for treatment. Angiotensin and beta receptor-blocking drugs, which form the cornerstone for the treatment of systolic HF, have failed to show similar benefits in patients with impaired diastolic function. This article provides an overview of drug therapy for HFpEF, including newer agents now under investigation.

Tree physiology research in a changing world.

PubMed

Kaufmann, Merrill R.; Linder, Sune

1996-01-01

Changes in issues and advances in methodology have contributed to substantial progress in tree physiology research during the last several decades. Current research focuses on process interactions in complex systems and the integration of processes across multiple spatial and temporal scales. An increasingly important challenge for future research is assuring sustainability of production systems and forested ecosystems in the face of increased demands for natural resources and human disturbance of forests. Meeting this challenge requires significant shifts in research approach, including the study of limitations of productivity that may accompany achievement of system sustainability, and a focus on the biological capabilities of complex land bases altered by human activity.

Transboundary fisheries science: Meeting the challenges of inland fisheries management in the 21st century

USGS Publications Warehouse

Midway, Stephen R.; Wagner, Tyler; Zydlewski, Joseph D.; Irwin, Brian J.; Paukert, Craig P.

2016-01-01

Managing inland fisheries in the 21st century presents several obstacles, including the need to view fisheries from multiple spatial and temporal scales, which usually involves populations and resources spanning sociopolitical boundaries. Though collaboration is not new to fisheries science, inland aquatic systems have historically been managed at local scales and present different challenges than in marine or large freshwater systems like the Laurentian Great Lakes. Therefore, we outline a flexible strategy that highlights organization, cooperation, analytics, and implementation as building blocks toward effectively addressing transboundary fisheries issues. Additionally, we discuss the use of Bayesian hierarchical models (within the analytical stage), due to their flexibility in dealing with the variability present in data from multiple scales. With growing recognition of both ecological drivers that span spatial and temporal scales and the subsequent need for collaboration to effectively manage heterogeneous resources, we expect implementation of transboundary approaches to become increasingly critical for effective inland fisheries management.

Photonic crystals possessing multiple Weyl points and the experimental observation of robust surface states

PubMed Central

Chen, Wen-Jie; Xiao, Meng; Chan, C. T.

2016-01-01

Weyl points, as monopoles of Berry curvature in momentum space, have captured much attention recently in various branches of physics. Realizing topological materials that exhibit such nodal points is challenging and indeed, Weyl points have been found experimentally in transition metal arsenide and phosphide and gyroid photonic crystal whose structure is complex. If realizing even the simplest type of single Weyl nodes with a topological charge of 1 is difficult, then making a real crystal carrying higher topological charges may seem more challenging. Here we design, and fabricate using planar fabrication technology, a photonic crystal possessing single Weyl points (including type-II nodes) and multiple Weyl points with topological charges of 2 and 3. We characterize this photonic crystal and find nontrivial 2D bulk band gaps for a fixed kz and the associated surface modes. The robustness of these surface states against kz-preserving scattering is experimentally observed for the first time. PMID:27703140

Risks, Health Consequences, and Response Challenges for Small-Island-Based Populations: Observations From the 2017 Atlantic Hurricane Season.

PubMed

Shultz, James M; Kossin, James P; Shepherd, J Marshall; Ransdell, Justine M; Walshe, Rory; Kelman, Ilan; Galea, Sandro

2018-04-06

ABSTRACTThe intensely active 2017 Atlantic basin hurricane season provided an opportunity to examine how climate drivers, including warming oceans and rising seas, exacerbated tropical cyclone hazards. The season also highlighted the unique vulnerabilities of populations residing on Small Island Developing States (SIDS) to the catastrophic potential of these storms. During 2017, 22 of the 29 Caribbean SIDS were affected by at least one named storm, and multiple SIDS experienced extreme damage. This paper aims to review the multiplicity of storm impacts on Caribbean SIDS throughout the 2017 season, to explicate the influences of climate drivers on storm formation and intensity, to explore the propensity of SIDS to sustain severe damage and prolonged disruption of essential services, to document the spectrum of public health consequences, and to delineate the daunting hurdles that challenged emergency response and recovery operations for island-based, disaster-affected populations. (Disaster Med Public Health Preparedness. 2018;page 1 of 13).

Seven challenges for modelling indirect transmission: Vector-borne diseases, macroparasites and neglected tropical diseases

PubMed Central

Hollingsworth, T. Déirdre; Pulliam, Juliet R.C.; Funk, Sebastian; Truscott, James E.; Isham, Valerie; Lloyd, Alun L.

2015-01-01

Many of the challenges which face modellers of directly transmitted pathogens also arise when modelling the epidemiology of pathogens with indirect transmission – whether through environmental stages, vectors, intermediate hosts or multiple hosts. In particular, understanding the roles of different hosts, how to measure contact and infection patterns, heterogeneities in contact rates, and the dynamics close to elimination are all relevant challenges, regardless of the mode of transmission. However, there remain a number of challenges that are specific and unique to modelling vector-borne diseases and macroparasites. Moreover, many of the neglected tropical diseases which are currently targeted for control and elimination are vector-borne, macroparasitic, or both, and so this article includes challenges which will assist in accelerating the control of these high-burden diseases. Here, we discuss the challenges of indirect measures of infection in humans, whether through vectors or transmission life stages and in estimating the contribution of different host groups to transmission. We also discuss the issues of “evolution-proof” interventions against vector-borne disease. PMID:25843376

Seven challenges for modelling indirect transmission: vector-borne diseases, macroparasites and neglected tropical diseases.

PubMed

Hollingsworth, T Déirdre; Pulliam, Juliet R C; Funk, Sebastian; Truscott, James E; Isham, Valerie; Lloyd, Alun L

2015-03-01

Many of the challenges which face modellers of directly transmitted pathogens also arise when modelling the epidemiology of pathogens with indirect transmission--whether through environmental stages, vectors, intermediate hosts or multiple hosts. In particular, understanding the roles of different hosts, how to measure contact and infection patterns, heterogeneities in contact rates, and the dynamics close to elimination are all relevant challenges, regardless of the mode of transmission. However, there remain a number of challenges that are specific and unique to modelling vector-borne diseases and macroparasites. Moreover, many of the neglected tropical diseases which are currently targeted for control and elimination are vector-borne, macroparasitic, or both, and so this article includes challenges which will assist in accelerating the control of these high-burden diseases. Here, we discuss the challenges of indirect measures of infection in humans, whether through vectors or transmission life stages and in estimating the contribution of different host groups to transmission. We also discuss the issues of "evolution-proof" interventions against vector-borne disease. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

Conceptual Questions and Challenge Problems

NASA Astrophysics Data System (ADS)

Nurrenbern, Susan C.; Robinson, William R.

1998-11-01

The JCE Internet Conceptual Question and Challenge Problem Web site is a source of questions and problems that can be used in teaching and assessing conceptual understanding and problem solving in chemistry. Here you can find a library of free-response and multiple-choice conceptual questions and challenge problems, tips for writing these questions and problems, and a discussion of types of conceptual questions. This site is intended to be a means of sharing conceptual questions and challenge problems among chemical educators. This is a living site that will grow as you share conceptual questions and challenge problems and as we find new sources of information. We would like to make this site as inclusive as possible. Please share your questions and problems with us and alert us to references or Web sites that could be included on the site. You can use email, fax, or regular mail. Email: nurrenbern@purdue.edu or wrrobin@purdue.edu Fax: 765/494-0239 Mailing address: Susan C. Nurrenbern or William R. Robinson; Department of Chemistry; Purdue University; 1393 Brown Building; West Lafayette, IN 47907-1393. The Conceptual Questions and Challenge Problems Web site can be found here.

Principles and practices for the restoration of ponderosa pine and dry mixed-conifer forests of the Colorado Front Range

Treesearch

Robert N. Addington; Gregory H. Aplet; Mike A. Battaglia; Jennifer S. Briggs; Peter M. Brown; Antony S. Cheng; Yvette Dickinson; Jonas A. Feinstein; Kristen A. Pelz; Claudia M. Regan; Jim Thinnes; Rick Truex; Paula J. Fornwalt; Benjamin Gannon; Chad W. Julian; Jeffrey L. Underhill; Brett Wolk

2018-01-01

Wildfires have become larger and more severe over the past several decades on Colorado’s Front Range, catalyzing greater investments in forest management intended to mitigate wildfire risks. The complex ecological, social, and political context of the Front Range, however, makes forest management challenging, especially where multiple management goals including forest...

Experiences of care by Australians with a diagnosis of borderline personality disorder

PubMed Central

McMahon, J.

2015-01-01

Accessible summary Borderline personality disorder (BPD) is a complex and challenging mental health condition for the person and service providers who support them.This paper reports on the results of a survey of 153 people with a diagnosis of BPD about their experiences of attempting to receive support in managing this mental health condition. It provides their perceptions of a range of experiences not reported in the existing literature, including general practitioner roles, urban and rural differences, public and private hospital differences, and comparison of usefulness of support across multiple support types.People with a diagnosis of BPD continue to experience significant discrimination when attempting to get their needs met within both public and private health services. Further education for nurses and other health professionals is indicated to address pervasive negative attitudes towards people with a diagnosis of BPD. Abstract There is limited understanding of the experience of seeking and receiving treatment and care by people with a diagnosis of borderline personality disorder (BPD), their perceptions of barriers to care and the quality of services they receive. This study aimed to explore these experiences from the perspective of Australians with this diagnosis. An invitation to participate in an online survey was distributed across multiple consumer and carer organizations and mental health services, by the Private Mental Health Consumer Carer Network (Australia) in 2011. Responses from 153 people with a diagnosis of BPD showed that they experience significant challenges and discrimination when attempting to get their needs met within both public and private health services, including general practice. Seeking help from hospital emergency departments during crises was particularly challenging. Metropolitan and rural differences, and gender differences, were also apparent. Community supports were perceived as inadequate to meet their needs. This study provides data on a range of experiences not reported in existing literature, including general practitioner roles, urban and rural differences, public and private hospital differences, and comparison of usefulness of support across multiple support types. Its findings can help inform better training for health professionals and better care for this population. PMID:26122817

Managing multiple funding streams and agendas to achieve local and global health and research objectives: lessons from the field

PubMed Central

Holmes, Charles B.; Sikazwe, Izukanji; Raelly, Roselyne; Freeman, Bethany; Wambulawae, Inonge; Silwizya, Geoffrey; Topp, Stephanie; Chilengi, Roma; Henostroza, German; Kapambwe, Sharon; Simbeye, Darius; Sibajene, Sheila; Chi, Harmony; Godfrey, Katy; Chi, Benjamin; Moore, Carolyn Bolton

2014-01-01

Multiple funding sources provide research and program implementation organizations a broader base of funding and facilitate synergy, but also entail challenges that include varying stakeholder expectations, unaligned grant cycles, and highly variable reporting requirements. Strong governance and strategic planning are essential to ensure alignment of goals and agendas. Systems to track budgets and outputs as well as procurement and human resources are required. A major goal is to transition leadership and operations to local ownership. This article details successful approaches used by the newly independent non-governmental organization, the Centre for Infectious Disease Research in Zambia (CIDRZ). PMID:24321983

Two Formal Gas Models For Multi-Agent Sweeping and Obstacle Avoidance

NASA Technical Reports Server (NTRS)

Kerr, Wesley; Spears, Diana; Spears, William; Thayer, David

2004-01-01

The task addressed here is a dynamic search through a bounded region, while avoiding multiple large obstacles, such as buildings. In the case of limited sensors and communication, maintaining spatial coverage - especially after passing the obstacles - is a challenging problem. Here, we investigate two physics-based approaches to solving this task with multiple simulated mobile robots, one based on artificial forces and the other based on the kinetic theory of gases. The desired behavior is achieved with both methods, and a comparison is made between them. Because both approaches are physics-based, formal assurances about the multi-robot behavior are straightforward, and are included in the paper.

Managing multiple funding streams and agendas to achieve local and global health and research objectives: lessons from the field.

PubMed

Holmes, Charles B; Sikazwe, Izukanji; Raelly, Roselyne L; Freeman, Bethany L; Wambulawae, Inonge; Silwizya, Geoffrey; Topp, Stephanie M; Chilengi, Roma; Henostroza, German; Kapambwe, Sharon; Simbeye, Darius; Sibajene, Sheila; Chi, Harmony; Godfrey, Katy; Chi, Benjamin; Moore, Carolyn Bolton

2014-01-01

Multiple funding sources provide research and program implementation organizations a broader base of funding and facilitate synergy, but also entail challenges that include varying stakeholder expectations, unaligned grant cycles, and highly variable reporting requirements. Strong governance and strategic planning are essential to ensure alignment of goals and agendas. Systems to track budgets and outputs, as well as procurement and human resources are required. A major goal of funders is to transition leadership and operations to local ownership. This article details successful approaches used by the newly independent nongovernmental organization, the Centre for Infectious Disease Research in Zambia.

Leadership and Cultural Challenges in Operating the International Space Station

NASA Technical Reports Server (NTRS)

Clement, J. L.; Ritsher, J. B.; Saylor, S. A.; Kanas, N.

2006-01-01

Operating the International Space Station (ISS) involves an indefinite, continuous series of long-duration international missions, and this requires an unprecedented degree of cooperation across multiple sites, organizations, and nations. ISS flight controllers have had to find ways to maintain effective team performance in this challenging new context. The goal of this study was to systematically identify and evaluate the major leadership and cultural challenges faces by ISS flight controllers, and to highlight the approaches that they have found most effective to surmount these challenges. We conducted a qualitative survey using a semi-structured interview. Subjects included 14 senior NASA flight controllers who were chosen on the basis of having had substantial experience working with international partners. Data were content analyzed using an iterative process with multiple coders and consensus meetings to resolve discrepancies. To further explore the meaning of the interview findings, we also conducted some new analyses of data from a previous questionnaire study of Russian and American ISS mission control personnel. The interview data showed that respondents had substantial consensus on several leadership and cultural challenges and on key strategies for dealing with them, and they offered a wide range of specific tactics for implementing these strategies. Surprisingly few respondents offered strategies for addressing the challenge of working with team members whose native language is not American English. The questionnaire data showed that Americans think it is more important than Russians that mission control personnel speak the same dialect of one shared common language. Although specific to the ISS program, our results are consistent with recent management, cultural, and aerospace research. We aim to use our results to improve training for current and future ISS flight controllers.

[Further challenges in collaboration and cross-specialization work in psychiatric services].

PubMed

Sakano, Yuji; Nakamura, Touru; Nakajima, Kimihiro

2011-01-01

Using a case illustrating cognitive behavioral treatment for a patient with obsessive-compulsive disorder, clinical tips and challenges are described in the context of collaboration between multiple health professionals from different backgrounds in a psychiatric hospital. Furthermore, after reviewing the current status of education and training issues related to collaboration, and introducing the fundamental concept of cross-specialization work, existing tasks and future challenges involved in the education and training of multiple health professions are discussed.

Communicating Genetic Risk Information for Common Disorders in the Era of Genomic Medicine

PubMed Central

Lautenbach, Denise M.; Christensen, Kurt D.; Sparks, Jeffrey A.; Green, Robert C.

2013-01-01

Communicating genetic risk information in ways that maximize understanding and promote health is increasingly important given the rapidly expanding availability and capabilities of genomic technologies. A well-developed literature on risk communication in general provides guidance for best practices, including presentation of information in multiple formats, attention to framing effects, use of graphics, sensitivity to the way numbers are presented, parsimony of information, attentiveness to emotions, and interactivity as part of the communication process. Challenges to communicating genetic risk information include deciding how best to tailor it, streamlining the process, deciding what information to disclose, accepting that communications may have limited influence, and understanding the impact of context. Meeting these challenges has great potential for empowering individuals to adopt healthier lifestyles and improve public health, but will require multidisciplinary approaches and collaboration. PMID:24003856

Fundamental CRISPR-Cas9 tools and current applications in microbial systems.

PubMed

Tian, Pingfang; Wang, Jia; Shen, Xiaolin; Rey, Justin Forrest; Yuan, Qipeng; Yan, Yajun

2017-09-01

Derived from the bacterial adaptive immune system, CRISPR technology has revolutionized conventional genetic engineering methods and unprecedentedly facilitated strain engineering. In this review, we outline the fundamental CRISPR tools that have been employed for strain optimization. These tools include CRISPR editing, CRISPR interference, CRISPR activation and protein imaging. To further characterize the CRISPR technology, we present current applications of these tools in microbial systems, including model- and non-model industrial microorganisms. Specially, we point out the major challenges of the CRISPR tools when utilized for multiplex genome editing and sophisticated expression regulation. To address these challenges, we came up with strategies that place emphasis on the amelioration of DNA repair efficiency through CRISPR-Cas9-assisted recombineering. Lastly, multiple promising research directions were proposed, mainly focusing on CRISPR-based construction of microbial ecosystems toward high production of desired chemicals.

Tenured Women Counselor Educators at Research Universities: Navigating Multiple Roles and Personal Well-Being

ERIC Educational Resources Information Center

Rosenberg, Melissa A.

2013-01-01

Women in academia navigate multiple professional and personal roles, and may face unique challenges to integrate their intellectual, emotional, physical, and spiritual selves. The narrative of constraint underscores the disadvantages, challenges, and inequities that women who are mothers and academics face in their lives. This lack of privilege…

The Twenty-First Century Multiple Generation Workforce: Overlaps and Differences but Also Challenges and Benefits

ERIC Educational Resources Information Center

Helyer, Ruth; Lee, Dionne

2012-01-01

Purpose: The purpose of this paper is to explore the issues around a multiple generational workforce and more specifically, the challenges and benefits for education providers and employers. Design/methodology/approach: Reviewing research papers, analysing academic texts, interrogating market intelligence and contextualising case studies, the…

How PV system ownership can impact the market value of residential homes

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

Klise, Geoffrey Taylor; Johnson, Jamie L.

2014-01-01

There are multiple ways for a homeowner to obtain the electricity generating and savings benefits offered by a photovoltaic (PV) system. These include purchasing a PV system through various financing mechanisms, or by leasing the PV system from a third party with multiple options that may include purchase, lease renewal or PV system removal. The different ownership options available to homeowners presents a challenge to appraisal and real estate professionals during a home sale or refinance in terms of how to develop a value that is reflective of the PV systems operational characteristics, local market conditions, and lender and underwritermore » requirements. This paper presents these many PV system ownership options with a discussion of what considerations an appraiser must make when developing the contributory value of a PV system to a residential property.« less

The Best Anticoagulation Therapy in Multiple-Trauma Patients with Mechanical Heart Valves: Evaluation of Latest Guidelines and Studies.

PubMed

Moeinipour, Aliasghar; Zarifian, Ahmadreza; Sheikh Andalibi, Mohammad Sobhan; Shamloo, Alireza Sepehri; Ahmadabadi, Ali; Amouzeshi, Ahmad; Hoseinikhah, Hamid

2015-12-22

It is common practice for patients with prosthetic cardiac devices, especially heart valve prosthesis, arterial stents, defibrillators, and pacemaker devices, to use anticoagulation treatment. When these patients suffer from multiple trauma after motor vehicle accidents, the best medical management for this challenging position is mandatory. This strategy should include a rapid diagnosis of all possible multiple organ injuries, with special attention to anticoagulation therapy so as to minimize the risk of thromboembolism complication in prosthetic devices. In this review, we describe the best medical management for patients with multiple trauma who use anticoagulants after heart valve replacement. We searched electronic databases PubMed/Medline, Scopus, Embase, and Google Scholar using the following terms: anticoagulant, warfarin, heparin, and multiple trauma. Also, similar studies suggested by the databases were included. Non-English articles were excluded from the review. For patients who use anticoagulation therapy, teamwork between cardiac surgeons, general surgeons, anesthesiologists, and cardiologists is essential. For optimal medical management, multiple consults between members of this team is mandatory for rapid diagnosis of all possible damaged organs, with special attention to the central nervous system, chest, and abdominal traumas. With this strategy, it is important to take note of anticoagulation drugs to minimize the risk of thromboembolism complications in cardiac devices. The best anticoagulant agents for emergency operations in patients with multiple trauma who are using an anticoagulant after heart valve replacement are fresh frozen plasma (FFP) and prothrombin complex concentrates (PCC).

DISPOSITION PATHS FOR ROCKY FLATS GLOVEBOXES: EVALUATING OPTIONS

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

Lobdell, D.; Geimer, R.; Larsen, P.

2003-02-27

The Kaiser-Hill Company, LLC has the responsibility for closure activities at the Rocky Flats Environmental Technology Site (RFETS). One of the challenges faced for closure is the disposition of radiologically contaminated gloveboxes. Evaluation of the disposition options for gloveboxes included a detailed analysis of available treatment capabilities, disposal facilities, and lifecycle costs. The Kaiser-Hill Company, LLC followed several processes in determining how the gloveboxes would be managed for disposition. Currently, multiple disposition paths have been chosen to accommodate the needs of the varying styles and conditions of the gloveboxes, meet the needs of the decommissioning team, and to best managemore » lifecycle costs. Several challenges associated with developing a disposition path that addresses both the radiological and RCRA concerns as well as offering the most cost-effective solution were encountered. These challenges included meeting the radiological waste acceptance criteria of available disposal facilities, making a RCRA determination, evaluating treatment options and costs, addressing void requirements associated with disposal, and identifying packaging and transportation options. The varying disposal facility requirements affected disposition choices. Facility conditions that impacted decisions included radiological and chemical waste acceptance criteria, physical requirements, and measurement for payment options. The facility requirements also impacted onsite activities including management strategies, decontamination activities, and life-cycle cost.« less

3D Reconstruction in the Presence of Glass and Mirrors by Acoustic and Visual Fusion.

PubMed

Zhang, Yu; Ye, Mao; Manocha, Dinesh; Yang, Ruigang

2017-07-06

We present a practical and inexpensive method to reconstruct 3D scenes that include transparent and mirror objects. Our work is motivated by the need for automatically generating 3D models of interior scenes, which commonly include glass. These large structures are often invisible to cameras. Existing 3D reconstruction methods for transparent objects are usually not applicable in such a room-sized reconstruction setting. Our simple hardware setup augments a regular depth camera with a single ultrasonic sensor, which is able to measure the distance to any object, including transparent surfaces. The key technical challenge is the sparse sampling rate from the acoustic sensor, which only takes one point measurement per frame. To address this challenge, we take advantage of the fact that the large scale glass structures in indoor environments are usually either piece-wise planar or simple parametric surfaces. Based on these assumptions, we have developed a novel sensor fusion algorithm that first segments the (hybrid) depth map into different categories such as opaque/transparent/infinity (e.g., too far to measure) and then updates the depth map based on the segmentation outcome. We validated our algorithms with a number of challenging cases, including multiple panes of glass, mirrors, and even a curved glass cabinet.

Novel Control Strategy for Multiple Run-of-the-River Hydro Power Plants to Provide Grid Ancillary Services

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

Mohanpurkar, Manish; Luo, Yusheng; Hovsapian, Rob

Electricity generated by Hydropower Plants (HPPs) contributes a considerable portion of bulk electricity generation and delivers it with a low carbon footprint. In fact, HPP electricity generation provides the largest share from renewable energy resources, which includes solar and wind energy. The increasing penetration of wind and solar penetration leads to a lowered inertia in the grid and hence poses stability challenges. In recent years, breakthrough in energy storage technologies have demonstrated the economic and technical feasibility of extensive deployments in power grids. Multiple ROR HPPs if integrated with scalable, multi time-step energy storage so that the total output canmore » be controlled. Although, the size of a single energy storage is far smaller than that of a typical reservoir, cohesively managing multiple sets of energy storage distributed in different locations is proposed. The ratings of storages and multiple ROR HPPs approximately equals the rating of a large, conventional HPP. The challenges associated with the system architecture and operation are described. Energy storage technologies such as supercapacitors, flywheels, batteries etc. can function as a dispatchable synthetic reservoir with a scalable size of energy storage will be integrated. Supercapacitors, flywheels, and battery are chosen to provide fast, medium, and slow responses to support grid requirements. Various dynamic and transient power grid conditions are simulated and performances of integrated ROR HPPs with energy storage is provided. The end goal of this research is to investigate the inertial equivalence of a large, conventional HPP with a unique set of multiple ROR HPPs and optimally rated energy storage systems.« less

Model assessment using a multi-metric ranking technique

NASA Astrophysics Data System (ADS)

Fitzpatrick, P. J.; Lau, Y.; Alaka, G.; Marks, F.

2017-12-01

Validation comparisons of multiple models presents challenges when skill levels are similar, especially in regimes dominated by the climatological mean. Assessing skill separation will require advanced validation metrics and identifying adeptness in extreme events, but maintain simplicity for management decisions. Flexibility for operations is also an asset. This work postulates a weighted tally and consolidation technique which ranks results by multiple types of metrics. Variables include absolute error, bias, acceptable absolute error percentages, outlier metrics, model efficiency, Pearson correlation, Kendall's Tau, reliability Index, multiplicative gross error, and root mean squared differences. Other metrics, such as root mean square difference and rank correlation were also explored, but removed when the information was discovered to be generally duplicative to other metrics. While equal weights are applied, weights could be altered depending for preferred metrics. Two examples are shown comparing ocean models' currents and tropical cyclone products, including experimental products. The importance of using magnitude and direction for tropical cyclone track forecasts instead of distance, along-track, and cross-track are discussed. Tropical cyclone intensity and structure prediction are also assessed. Vector correlations are not included in the ranking process, but found useful in an independent context, and will be briefly reported.

Effects of the Practiced Routines Parent Training Program on Behavioral Strategy Use, Parental Well-Being, and Child Challenging Behavior in Parents of Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Raulston, Tracy Jane

2017-01-01

In this study, a concurrent randomized multiple baseline across three parent-child dyads single-case design was employed to evaluate the effects of a brief three-week parent training program, titled Practiced Routines. The Practiced Routines parent training program included positive behavior supports (PBS) and mindfulness strategies within the…

Future clinical challenges in multiple sclerosis: Relevance to sphingosine 1-phosphate receptor modulator therapy.

PubMed

Hohlfeld, Reinhard; Barkhof, Frederik; Polman, Chris

2011-02-22

The limitations of established therapies for multiple sclerosis (MS) are well-known and include the need for injections, treatment adherence and convenience issues, partial efficacy, and, in some cases, a risk of potentially life-threatening adverse events, such as progressive multifocal leukoencephalopathy. Recently, attention has focused on developing more effective therapies that are administered orally and target neurodegeneration as well as inflammation. In this review, we provide an outlook on the future clinical challenges for MS treatment and management, and focus specifically on the emerging sphingosine 1-phosphate receptor (S1PR) modulators. We highlight the importance of improving our understanding of the neurobiological basis of MS to develop well-tolerated targeted therapies and the need to include advanced MRI assessments that quantify neurodegeneration in interventional studies in MS. As more treatments become available, often with complex pharmacodynamic actions, objective assessment of benefit-to-risk profiles becomes increasingly important to ensure that patients receive appropriate care. Pharmacovigilance and immune monitoring will become important aspects of patient treatment and management in the future. With respect to S1PR modulation, we review the experimental agents that are in clinical development for MS and summarize the steps taken in postmarketing surveillance to ensure that fingolimod (FTY720) has a well-characterized safety profile.

How could Health Information Exchange Better Meet the Needs of Care Practitioners?

PubMed Central

Kaushal, R.; Vest, J.R.

2014-01-01

Summary Background Health information exchange (HIE) has the potential to improve the quality of healthcare by enabling providers with better access to patient information from multiple sources at the point of care. However, HIE efforts have historically been difficult to establish in the US and the failure rates of organizations created to foster HIE have been high. Objectives We sought to better understand how RHIO-based HIE systems were used in practice and the challenges care practitioners face using them. The objective of our study were to so investigate how HIE can better meet the needs of care practitioners. Methods We performed a multiple-case study using qualitative methods in three communities in New York State. We conducted interviews onsite and by telephone with HIE users and non-users and observed the workflows of healthcare professionals at multiple healthcare organizations participating in a local HIE effort in New York State. Results The empirical data analysis suggests that challenges still remain in increasing provider usage, optimizing HIE implementations and connecting HIE systems across geographic regions. Important determinants of system usage and perceived value includes users experienced level of available information and the fit of use for physician workflows. Conclusions Challenges still remain in increasing provider adoption, optimizing HIE implementations, and demonstrating value. The inability to find information reduced usage of HIE. Healthcare organizations, HIE facilitating organizations, and states can help support HIE adoption by ensuring patient information is accessible to providers through increasing patient consents, fostering broader participation, and by ensuring systems are usable. PMID:25589903

A functional U-statistic method for association analysis of sequencing data.

PubMed

Jadhav, Sneha; Tong, Xiaoran; Lu, Qing

2017-11-01

Although sequencing studies hold great promise for uncovering novel variants predisposing to human diseases, the high dimensionality of the sequencing data brings tremendous challenges to data analysis. Moreover, for many complex diseases (e.g., psychiatric disorders) multiple related phenotypes are collected. These phenotypes can be different measurements of an underlying disease, or measurements characterizing multiple related diseases for studying common genetic mechanism. Although jointly analyzing these phenotypes could potentially increase the power of identifying disease-associated genes, the different types of phenotypes pose challenges for association analysis. To address these challenges, we propose a nonparametric method, functional U-statistic method (FU), for multivariate analysis of sequencing data. It first constructs smooth functions from individuals' sequencing data, and then tests the association of these functions with multiple phenotypes by using a U-statistic. The method provides a general framework for analyzing various types of phenotypes (e.g., binary and continuous phenotypes) with unknown distributions. Fitting the genetic variants within a gene using a smoothing function also allows us to capture complexities of gene structure (e.g., linkage disequilibrium, LD), which could potentially increase the power of association analysis. Through simulations, we compared our method to the multivariate outcome score test (MOST), and found that our test attained better performance than MOST. In a real data application, we apply our method to the sequencing data from Minnesota Twin Study (MTS) and found potential associations of several nicotine receptor subunit (CHRN) genes, including CHRNB3, associated with nicotine dependence and/or alcohol dependence. © 2017 WILEY PERIODICALS, INC.

The challenges, advantages and future of phenome-wide association studies.

PubMed

Hebbring, Scott J

2014-02-01

Over the last decade, significant technological breakthroughs have revolutionized human genomic research in the form of genome-wide association studies (GWASs). GWASs have identified thousands of statistically significant genetic variants associated with hundreds of human conditions including many with immunological aetiologies (e.g. multiple sclerosis, ankylosing spondylitis and rheumatoid arthritis). Unfortunately, most GWASs fail to identify clinically significant associations. Identifying biologically significant variants by GWAS also presents a challenge. The GWAS is a phenotype-to-genotype approach. As a complementary/alternative approach to the GWAS, investigators have begun to exploit extensive electronic medical record systems to conduct a genotype-to-phenotype approach when studying human disease - specifically, the phenome-wide association study (PheWAS). Although the PheWAS approach is in its infancy, this method has already demonstrated its capacity to rediscover important genetic associations related to immunological diseases/conditions. Furthermore, PheWAS has the advantage of identifying genetic variants with pleiotropic properties. This is particularly relevant for HLA variants. For example, PheWAS results have demonstrated that the HLA-DRB1 variant associated with multiple sclerosis may also be associated with erythematous conditions including rosacea. Likewise, PheWAS has demonstrated that the HLA-B genotype is not only associated with spondylopathies, uveitis, and variability in platelet count, but may also play an important role in other conditions, such as mastoiditis. This review will discuss and compare general PheWAS methodologies, describe both the challenges and advantages of the PheWAS, and provide insight into the potential directions in which PheWAS may lead. © 2013 The Authors. Immunology Published by John Wiley & Sons Ltd.

On the road to a stronger public health workforce: visual tools to address complex challenges.

PubMed

Drehobl, Patricia; Stover, Beth H; Koo, Denise

2014-11-01

The public health workforce is vital to protecting the health and safety of the public, yet for years, state and local governmental public health agencies have reported substantial workforce losses and other challenges to the workforce that threaten the public's health. These challenges are complex, often involve multiple influencing or related causal factors, and demand comprehensive solutions. However, proposed solutions often focus on selected factors and might be fragmented rather than comprehensive. This paper describes approaches to characterizing the situation more comprehensively and includes two visual tools: (1) a fishbone, or Ishikawa, diagram that depicts multiple factors affecting the public health workforce; and (2) a roadmap that displays key elements-goals and strategies-to strengthen the public health workforce, thus moving from the problems depicted in the fishbone toward solutions. The visual tools aid thinking about ways to strengthen the public health workforce through collective solutions and to help leverage resources and build on each other's work. The strategic roadmap is intended to serve as a dynamic tool for partnership, prioritization, and gap assessment. These tools reflect and support CDC's commitment to working with partners on the highest priorities for strengthening the workforce to improve the public's health. Published by Elsevier Inc.

Challenging Behaviors among Children with Autism Spectrum Disorders and Multiple Disabilities Attending Special Schools in Singapore

ERIC Educational Resources Information Center

Poon, Kenneth K.

2012-01-01

This study sought to understand the profile of and the factors which impact upon challenging behaviors among children with autism spectrum disorders (ASD) and multiple disabilities (MD). Teachers of 322 and 132 children with ASD and MD, respectively, attending special schools in Singapore, completed the Developmental Behavior Checklist, Teacher…

Spatio-Temporal Data Model for Integrating Evolving Nation-Level Datasets

NASA Astrophysics Data System (ADS)

Sorokine, A.; Stewart, R. N.

2017-10-01

Ability to easily combine the data from diverse sources in a single analytical workflow is one of the greatest promises of the Big Data technologies. However, such integration is often challenging as datasets originate from different vendors, governments, and research communities that results in multiple incompatibilities including data representations, formats, and semantics. Semantics differences are hardest to handle: different communities often use different attribute definitions and associate the records with different sets of evolving geographic entities. Analysis of global socioeconomic variables across multiple datasets over prolonged time is often complicated by the difference in how boundaries and histories of countries or other geographic entities are represented. Here we propose an event-based data model for depicting and tracking histories of evolving geographic units (countries, provinces, etc.) and their representations in disparate data. The model addresses the semantic challenge of preserving identity of geographic entities over time by defining criteria for the entity existence, a set of events that may affect its existence, and rules for mapping between different representations (datasets). Proposed model is used for maintaining an evolving compound database of global socioeconomic and environmental data harvested from multiple sources. Practical implementation of our model is demonstrated using PostgreSQL object-relational database with the use of temporal, geospatial, and NoSQL database extensions.

Multiple reaction monitoring assay based on conventional liquid chromatography and electrospray ionization for simultaneous monitoring of multiple cerebrospinal fluid biomarker candidates for Alzheimer's disease

PubMed Central

Choi1, Yong Seok; Lee, Kelvin H.

2016-01-01

Alzheimer's disease (AD) is the most common type of dementia, but early and accurate diagnosis remains challenging. Previously, a panel of cerebrospinal fluid (CSF) biomarker candidates distinguishing AD and non-AD CSF accurately (> 90%) was reported. Furthermore, a multiple reaction monitoring (MRM) assay based on nano liquid chromatography tandem mass spectrometry (nLC-MS/MS) was developed to help validate putative AD CSF biomarker candidates including proteins from the panel. Despite the good performance of the MRM assay, wide acceptance may be challenging because of limited availability of nLC-MS/MS systems laboratories. Thus, here, a new MRM assay based on conventional LC-MS/MS is presented. This method monitors 16 peptides representing 16 (of 23) biomarker candidates that belonged to the previous AD CSF panel. A 30-times more concentrated sample than the sample used for the previous study was loaded onto a high capacity trap column, and all 16 MRM transitions showed good linearity (average R2 = 0.966), intra-day reproducibility (average coefficient of variance (CV) = 4.78%), and inter-day reproducibility (average CV = 9.85%). The present method has several advantages such as a shorter analysis time, no possibility of target variability, and no need for an internal standard. PMID:26404792

Applying voting theory in natural resource management: a case of multiple-criteria group decision support.

PubMed

Laukkanen, Sanna; Kangas, Annika; Kangas, Jyrki

2002-02-01

Voting theory has a lot in common with utility theory, and especially with group decision-making. An expected-utility-maximising strategy exists in voting situations, as well as in decision-making situations. Therefore, it is natural to utilise the achievements of voting theory also in group decision-making. Most voting systems are based on a single criterion or holistic preference information on decision alternatives. However, a voting scheme called multicriteria approval is specially developed for decision-making situations with multiple criteria. This study considers the voting theory from the group decision support point of view and compares it with some other methods applied to similar purposes in natural resource management. A case study is presented, where the approval voting approach is introduced to natural resources planning and tested in a forestry group decision-making process. Applying multicriteria approval method was found to be a potential approach for handling some challenges typical for forestry group decision support. These challenges include (i) utilising ordinal information in the evaluation of decision alternatives, (ii) being readily understandable for and treating equally all the stakeholders in possession of different levels of knowledge on the subject considered, (iii) fast and cheap acquisition of preference information from several stakeholders, and (iv) dealing with multiple criteria.

Implementation and benefits of advanced process control for lithography CD and overlay

NASA Astrophysics Data System (ADS)

Zavyalova, Lena; Fu, Chong-Cheng; Seligman, Gary S.; Tapp, Perry A.; Pol, Victor

2003-05-01

Due to the rapidly reduced imaging process windows and increasingly stingent device overlay requirements, sub-130 nm lithography processes are more severely impacted than ever by systamic fault. Limits on critical dimensions (CD) and overlay capability further challenge the operational effectiveness of a mix-and-match environment using multiple lithography tools, as such mode additionally consumes the available error budgets. Therefore, a focus on advanced process control (APC) methodologies is key to gaining control in the lithographic modules for critical device levels, which in turn translates to accelerated yield learning, achieving time-to-market lead, and ultimately a higher return on investment. This paper describes the implementation and unique challenges of a closed-loop CD and overlay control solution in high voume manufacturing of leading edge devices. A particular emphasis has been placed on developing a flexible APC application capable of managing a wide range of control aspects such as process and tool drifts, single and multiple lot excursions, referential overlay control, 'special lot' handling, advanced model hierarchy, and automatic model seeding. Specific integration cases, including the multiple-reticle complementary phase shift lithography process, are discussed. A continuous improvement in the overlay and CD Cpk performance as well as the rework rate has been observed through the implementation of this system, and the results are studied.

Multiple reaction monitoring assay based on conventional liquid chromatography and electrospray ionization for simultaneous monitoring of multiple cerebrospinal fluid biomarker candidates for Alzheimer's disease.

PubMed

Choi, Yong Seok; Lee, Kelvin H

2016-03-01

Alzheimer's disease (AD) is the most common type of dementia, but early and accurate diagnosis remains challenging. Previously, a panel of cerebrospinal fluid (CSF) biomarker candidates distinguishing AD and non-AD CSF accurately (>90 %) was reported. Furthermore, a multiple reaction monitoring (MRM) assay based on nano liquid chromatography tandem mass spectrometry (nLC-MS/MS) was developed to help validate putative AD CSF biomarker candidates including proteins from the panel. Despite the good performance of the MRM assay, wide acceptance may be challenging because of limited availability of nLC-MS/MS systems in laboratories. Thus, here, a new MRM assay based on conventional LC-MS/MS is presented. This method monitors 16 peptides representing 16 (of 23) biomarker candidates that belonged to the previous AD CSF panel. A 30-times more concentrated sample than the sample used for the previous study was loaded onto a high capacity trap column, and all 16 MRM transitions showed good linearity (average R(2) = 0.966), intra-day reproducibility (average coefficient of variance (CV) = 4.78 %), and inter-day reproducibility (average CV = 9.85 %). The present method has several advantages such as a shorter analysis time, no possibility of target variability, and no need for an internal standard.

Prevention of triplets and higher order multiples: trends in reproductive medicine.

PubMed

Armour, Kim L; Callister, Lynn Clark

2005-01-01

In the United States and throughout the world, today's healthcare providers are challenged by the risks of multiple gestation pregnancy. Assisted reproductive technologies (ARTs) often used to treat infertility raise ethical issues including informed consent, veracity, and nonmalificence. In the United States, there is the need to improve maternal and fetal/neonatal mortality and morbidity by proposing legislation regulating ART and supporting single embryo transfers with no more than 2 such transfers. Beginning with the diagnosis of infertility, providers have a responsibility to educate, inform, and treat infertile couples. From the moment pregnancy with multiples is confirmed, these families are faced with incredible stressors including decision making on multifetal or selective reduction. Full disclosure of risks involved throughout the course of care should be discussed and documented in the record and plan of care. Currently in the United States, legislation does not regulate ART, including ovulation induction/enhancement and in vitro fertilization. Although the United States does have self-regulation via limited reporting through their professional organization and the Centers for Disease Control and Prevention, an unlimited number of embryos may be transferred. Unfortunately, many healthcare providers have not recognized the responsibility and burden placed on families and society as a whole. Lack of regulation means women may become pregnant with high order multiples, which raises serious moral and ethical issues.

Assessing Species Diversity Using Metavirome Data: Methods and Challenges.

PubMed

Herath, Damayanthi; Jayasundara, Duleepa; Ackland, David; Saeed, Isaam; Tang, Sen-Lin; Halgamuge, Saman

2017-01-01

Assessing biodiversity is an important step in the study of microbial ecology associated with a given environment. Multiple indices have been used to quantify species diversity, which is a key biodiversity measure. Measuring species diversity of viruses in different environments remains a challenge relative to measuring the diversity of other microbial communities. Metagenomics has played an important role in elucidating viral diversity by conducting metavirome studies; however, metavirome data are of high complexity requiring robust data preprocessing and analysis methods. In this review, existing bioinformatics methods for measuring species diversity using metavirome data are categorised broadly as either sequence similarity-dependent methods or sequence similarity-independent methods. The former includes a comparison of DNA fragments or assemblies generated in the experiment against reference databases for quantifying species diversity, whereas estimates from the latter are independent of the knowledge of existing sequence data. Current methods and tools are discussed in detail, including their applications and limitations. Drawbacks of the state-of-the-art method are demonstrated through results from a simulation. In addition, alternative approaches are proposed to overcome the challenges in estimating species diversity measures using metavirome data.

Diversity dynamics: The experience of male Robert Wood Johnson Foundation nurse faculty scholars.

PubMed

Brody, Abraham A; Farley, Jason E; Gillespie, Gordon L; Hickman, Ronald; Hodges, Eric A; Lyder, Courtney; Palazzo, Steven J; Ruppar, Todd; Schiavenato, Martin; Pesut, Daniel J

Managing diversity dynamics in academic or clinical settings for men in nursing has unique challenges resulting from their minority status within the profession. The purpose of this study was to share challenges and lessons learned identified by male scholars in the Robert Wood Johnson Foundation Nurse Faculty Scholars program and suggest strategies for creating positive organizations promoting inclusive excellence. Multiple strategies including informal mentored discussions and peer-to-peer dialogue throughout the program, formal online surveys of scholars and National Advisory Committee members, and review of scholar progress reports were analyzed as part of the comprehensive evaluation plan of the program. Diversity dynamic issues include concerns with negative stereotyping, microaggression, gender intelligence, and differences in communication and leadership styles. Male nurse faculty scholars report experiencing both opportunities and challenges residing in a predominately female profession. This article attempts to raise awareness and suggest strategies to manage diversity dynamics in service of promoting the development of a culture of health that values diversity and inclusive excellence for both men and women in academic, research, and practice contexts. Copyright © 2017 Elsevier Inc. All rights reserved.

Getting Australia more active: challenges and opportunities for health promotion.

PubMed

Hills, A P; Street, S J; Harris, N

2014-04-01

A growing body of evidence demonstrates that regular physical activity promotes health and assists in the prevention of non-communicable diseases but this is presently curtailed by low and unhealthy participation rates in Australia and comparable industrialised countries. Compounding the problem is knowledge that physical inactivity is independently associated with poor health outcomes. Despite physical activity being described as public health's 'best bet' or 'best buy', motivating individuals and groups to adopt and maintain physical activity continues to be a major challenge for health professionals. Global advocacy for prevention efforts must be operationalised through national to local strategies to promote and support physical activity in multiple settings including the home, schools and workplace. The Australian health promotion community has and continues to play a leadership role in physical activity promotion. However, there is an urgent need to continue to promote the importance of physical activity, along with its pivotal role in the prevention of non-communicable diseases, alongside related agendas including healthy diets, tobacco control and environmental sustainability. This commentary overviews the contemporary status of physical activity promotion in Australia and identifies key challenges and opportunities moving forward.

Asian Community Mental Health Services at 35: a pioneering ethnic organization (1973-2008).

PubMed

Vu, Catherine M; Schwartz, Sara L; Austin, Michael J

2011-01-01

Asian Community Mental Health Services is a nonprofit organization that delivers mental health services to primarily Asian and Pacific Islander communities. From its early beginnings and over its 35-year history, the agency has had to overcome numerous challenges, including gaining legitimacy as a culturally specific nonprofit, combating stigma surrounding mental health issues within the Asian Pacific Islander community, building resources to fund service delivery, and developing an educated and culturally sensitive workforce. The history of the organization highlights the multiple challenges and rewards of developing a culturally specific nonprofit in an urban area as well as the important role that internal operations play in relation to nonprofit expansion and growth.

Detection of Multiple Stationary Humans Using UWB MIMO Radar.

PubMed

Liang, Fulai; Qi, Fugui; An, Qiang; Lv, Hao; Chen, Fuming; Li, Zhao; Wang, Jianqi

2016-11-16

Remarkable progress has been achieved in the detection of single stationary human. However, restricted by the mutual interference of multiple humans (e.g., strong sidelobes of the torsos and the shadow effect), detection and localization of the multiple stationary humans remains a huge challenge. In this paper, ultra-wideband (UWB) multiple-input and multiple-output (MIMO) radar is exploited to improve the detection performance of multiple stationary humans for its multiple sight angles and high-resolution two-dimensional imaging capacity. A signal model of the vital sign considering both bi-static angles and attitude angle of the human body is firstly developed, and then a novel detection method is proposed to detect and localize multiple stationary humans. In this method, preprocessing is firstly implemented to improve the signal-to-noise ratio (SNR) of the vital signs, and then a vital-sign-enhanced imaging algorithm is presented to suppress the environmental clutters and mutual affection of multiple humans. Finally, an automatic detection algorithm including constant false alarm rate (CFAR), morphological filtering and clustering is implemented to improve the detection performance of weak human targets affected by heavy clutters and shadow effect. The simulation and experimental results show that the proposed method can get a high-quality image of multiple humans and we can use it to discriminate and localize multiple adjacent human targets behind brick walls.

Detection of Multiple Stationary Humans Using UWB MIMO Radar

PubMed Central

Liang, Fulai; Qi, Fugui; An, Qiang; Lv, Hao; Chen, Fuming; Li, Zhao; Wang, Jianqi

2016-01-01

Remarkable progress has been achieved in the detection of single stationary human. However, restricted by the mutual interference of multiple humans (e.g., strong sidelobes of the torsos and the shadow effect), detection and localization of the multiple stationary humans remains a huge challenge. In this paper, ultra-wideband (UWB) multiple-input and multiple-output (MIMO) radar is exploited to improve the detection performance of multiple stationary humans for its multiple sight angles and high-resolution two-dimensional imaging capacity. A signal model of the vital sign considering both bi-static angles and attitude angle of the human body is firstly developed, and then a novel detection method is proposed to detect and localize multiple stationary humans. In this method, preprocessing is firstly implemented to improve the signal-to-noise ratio (SNR) of the vital signs, and then a vital-sign-enhanced imaging algorithm is presented to suppress the environmental clutters and mutual affection of multiple humans. Finally, an automatic detection algorithm including constant false alarm rate (CFAR), morphological filtering and clustering is implemented to improve the detection performance of weak human targets affected by heavy clutters and shadow effect. The simulation and experimental results show that the proposed method can get a high-quality image of multiple humans and we can use it to discriminate and localize multiple adjacent human targets behind brick walls. PMID:27854356

Challenges in Analyzing the Biological Effects of Resveratrol

PubMed Central

Erdogan, Cihan Suleyman; Vang, Ole

2016-01-01

The suggested health effects (e.g., disease prevention) of dietary bioactive compounds such as resveratrol are challenging to prove in comparison to man-made drugs developed for therapeutic purposes. Dietary bioactive compounds have multiple cellular targets and therefore have a variety of biological effects. Extrapolating the biological effects of dietary compounds from in vitro and in vivo animal experiments to humans may lead to over- or under-estimation of the effect and role of these compounds. The present paper will discuss a few of these challenges and suggest directions for future research. Questions we address include: (1) Is the combinatorial effect of resveratrol and other compounds real? (2) What are the real and relevant doses of resveratrol after administration? and (3) Is it possible to estimate the preventive effect of resveratrol by clinical trials using standard experimental designs? The examples concerning resveratrol taken from the scientific literature are mainly from 2010 and later. The challenges pointed out in this review are similar to most naturally occurring bioactive compounds. PMID:27294953

Preprocessing Structured Clinical Data for Predictive Modeling and Decision Support

PubMed Central

Oliveira, Mónica Duarte; Janela, Filipe; Martins, Henrique M. G.

2016-01-01

Summary Background EHR systems have high potential to improve healthcare delivery and management. Although structured EHR data generates information in machine-readable formats, their use for decision support still poses technical challenges for researchers due to the need to preprocess and convert data into a matrix format. During our research, we observed that clinical informatics literature does not provide guidance for researchers on how to build this matrix while avoiding potential pitfalls. Objectives This article aims to provide researchers a roadmap of the main technical challenges of preprocessing structured EHR data and possible strategies to overcome them. Methods Along standard data processing stages – extracting database entries, defining features, processing data, assessing feature values and integrating data elements, within an EDPAI framework –, we identified the main challenges faced by researchers and reflect on how to address those challenges based on lessons learned from our research experience and on best practices from related literature. We highlight the main potential sources of error, present strategies to approach those challenges and discuss implications of these strategies. Results Following the EDPAI framework, researchers face five key challenges: (1) gathering and integrating data, (2) identifying and handling different feature types, (3) combining features to handle redundancy and granularity, (4) addressing data missingness, and (5) handling multiple feature values. Strategies to address these challenges include: cross-checking identifiers for robust data retrieval and integration; applying clinical knowledge in identifying feature types, in addressing redundancy and granularity, and in accommodating multiple feature values; and investigating missing patterns adequately. Conclusions This article contributes to literature by providing a roadmap to inform structured EHR data preprocessing. It may advise researchers on potential pitfalls and implications of methodological decisions in handling structured data, so as to avoid biases and help realize the benefits of the secondary use of EHR data. PMID:27924347

Challenges in adapting existing clinical natural language processing systems to multiple, diverse health care settings.

PubMed

Carrell, David S; Schoen, Robert E; Leffler, Daniel A; Morris, Michele; Rose, Sherri; Baer, Andrew; Crockett, Seth D; Gourevitch, Rebecca A; Dean, Katie M; Mehrotra, Ateev

2017-09-01

Widespread application of clinical natural language processing (NLP) systems requires taking existing NLP systems and adapting them to diverse and heterogeneous settings. We describe the challenges faced and lessons learned in adapting an existing NLP system for measuring colonoscopy quality. Colonoscopy and pathology reports from 4 settings during 2013-2015, varying by geographic location, practice type, compensation structure, and electronic health record. Though successful, adaptation required considerably more time and effort than anticipated. Typical NLP challenges in assembling corpora, diverse report structures, and idiosyncratic linguistic content were greatly magnified. Strategies for addressing adaptation challenges include assessing site-specific diversity, setting realistic timelines, leveraging local electronic health record expertise, and undertaking extensive iterative development. More research is needed on how to make it easier to adapt NLP systems to new clinical settings. A key challenge in widespread application of NLP is adapting existing systems to new clinical settings. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Progress and challenges of disaster health management in China: a scoping review

PubMed Central

Zhong, Shuang; Clark, Michele; Hou, Xiang-Yu; Zang, Yuli; FitzGerald, Gerard

2014-01-01

Background Despite the importance of an effective health system response to various disasters, relevant research is still in its infancy, especially in middle- and low-income countries. Objective This paper provides an overview of the status of disaster health management in China, with its aim to promote the effectiveness of the health response for reducing disaster-related mortality and morbidity. Design A scoping review method was used to address the recent progress of and challenges to disaster health management in China. Major health electronic databases were searched to identify English and Chinese literature that were relevant to the research aims. Results The review found that since 2003 considerable progress has been achieved in the health disaster response system in China. However, there remain challenges that hinder effective health disaster responses, including low standards of disaster-resistant infrastructure safety, the lack of specific disaster plans, poor emergency coordination between hospitals, lack of portable diagnostic equipment and underdeveloped triage skills, surge capacity, and psychological interventions. Additional challenges include the fragmentation of the emergency health service system, a lack of specific legislation for emergencies, disparities in the distribution of funding, and inadequate cost-effective considerations for disaster rescue. Conclusions One solution identified to address these challenges appears to be through corresponding policy strategies at multiple levels (e.g. community, hospital, and healthcare system level). PMID:25215910

"We're going through a lot of struggles that people don't even know about": the need to understand African American males' help-seeking for mental health on multiple levels.

PubMed

Lindsey, Michael A; Marcell, Arik V

2012-09-01

Young adult Black males face challenges related to addressing their mental health needs, yet there is much more to know about their help-seeking experiences. Twenty-seven Black males, recruited from four community-based organizations, participated in four focus groups to explore perceptions of help-seeking for mental health. Identified themes, which function at individual, social network, community, and health care system levels, may facilitate or hinder Black males' mental health help-seeking. Themes included (a) "taking care of it oneself" as opposed to seeking help from someone; (b) issues engaging sources of help, including the ability to trust providers or the relationship closeness with social network members; and (c) "tipping points" that activate help-seeking to avert crises. Study findings provide initial evidence about the importance of addressing mental health interventions for Black males on multiple levels beyond the individual including engaging men's social supports, community, and the health care system.

Global methane and nitrous oxide emissions from terrestrial ecosystems due to multiple environmental changes

DOE PAGES

Tian, Hanqin; Chen, Guangsheng; Lu, Chaoqun; ...

2015-03-16

Greenhouse gas (GHG)-induced climate change is among the most pressing sustainability challenges facing humanity today, posing serious risks for ecosystem health. Methane (CH 4) and nitrous oxide (N 2O) are the two most important GHGs after carbon dioxide (CO 2), but their regional and global budgets are not well known. In this paper, we applied a process-based coupled biogeochemical model to concurrently estimate the magnitude and spatial and temporal patterns of CH 4 and N 2O fluxes as driven by multiple environmental changes, including climate variability, rising atmospheric CO 2, increasing nitrogen deposition, tropospheric ozone pollution, land use change, andmore » nitrogen fertilizer use.« less

Ensuring Payload Safety in Missions with Special Partnerships

NASA Technical Reports Server (NTRS)

Staubus, Calvert A.; Willenbring, Rachel C.; Blankenship, Michael D.

2016-01-01

The National Aeronautics and Space Administration (NASA) Expendable Launch Vehicle (ELV) payload space flight missions involve cooperative work between NASA and partners including spacecraft (or payload) contractors, universities, nonprofit research centers, Agency payload organization, Range Safety organization, Agency launch service organizations, and launch vehicle contractors. The role of NASA's Safety and Mission Assurance (SMA) Directorate is typically fairly straightforward, but when a mission's partnerships become more complex, to realize cost and science benefits (e.g., multi-agency payload(s) or cooperative international missions), the task of ensuring payload safety becomes much more challenging. This paper discusses lessons learned from NASA safety professionals working multiple-agency missions and offers suggestions to help fellow safety professionals working multiple-agency missions.

Diagnostic Features of Common Oral Ulcerative Lesions: An Updated Decision Tree

PubMed Central

Safi, Yaser

2016-01-01

Diagnosis of oral ulcerative lesions might be quite challenging. This narrative review article aims to introduce an updated decision tree for diagnosing oral ulcerative lesions on the basis of their diagnostic features. Various general search engines and specialized databases including PubMed, PubMed Central, Medline Plus, EBSCO, Science Direct, Scopus, Embase, and authenticated textbooks were used to find relevant topics by means of MeSH keywords such as “oral ulcer,” “stomatitis,” and “mouth diseases.” Thereafter, English-language articles published since 1983 to 2015 in both medical and dental journals including reviews, meta-analyses, original papers, and case reports were appraised. Upon compilation of the relevant data, oral ulcerative lesions were categorized into three major groups: acute, chronic, and recurrent ulcers and into five subgroups: solitary acute, multiple acute, solitary chronic, multiple chronic, and solitary/multiple recurrent, based on the number and duration of lesions. In total, 29 entities were organized in the form of a decision tree in order to help clinicians establish a logical diagnosis by stepwise progression. PMID:27781066

Challenges and Opportunities in the Discovery of New Therapeutics Targeting the Kynurenine Pathway.

PubMed

Dounay, Amy B; Tuttle, Jamison B; Verhoest, Patrick R

2015-11-25

The kynurenine pathway is responsible for the metabolism of more than 95% of dietary tryptophan (TRP) and produces numerous bioactive metabolites. Recent studies have focused on three enzymes in this pathway: indoleamine dioxygenase (IDO1), kynurenine monooxygenase (KMO), and kynurenine aminotransferase II (KAT II). IDO1 inhibitors are currently in clinical trials for the treatment of cancer, and these agents may also have therapeutic utility in neurological disorders, including multiple sclerosis. KMO inhibitors are being investigated as potential treatments for neurodegenerative diseases, such as Huntington's and Alzheimer's diseases. KAT II inhibitors have been proposed in new therapeutic approaches toward psychiatric and cognitive disorders, including cognitive impairment associated with schizophrenia. Numerous medicinal chemistry studies are currently aimed at the design of novel, potent, and selective inhibitors for each of these enzymes. The emerging opportunities and significant challenges associated with pharmacological modulation of these enzymes will be explored in this review.

Dementia in the Oldest Old

PubMed Central

Bullain, Szófia S.; Corrada, María M.

2013-01-01

Purpose of Review: This article discusses some of the unique features of dementia in the oldest old, including some of the most common diagnostic challenges, and potential strategies to overcome them. Recent Findings: Advances include new insight into the role of common risk factors and the effects of multiple underlying neuropathologic features for dementia in the oldest old. In addition, this article contains the latest age-specific normative data for commonly used neuropsychological tests for the oldest old. Summary: The oldest old—people aged 90 years and older—are the fastest-growing segment of society and have the highest rates of dementia in the population. The risk factors, diagnostic challenges, and underlying neuropathologic features of dementia are strikingly different in the 90-years-and-older population compared to younger elderly. Special consideration of these unique features of dementia is necessary when evaluating oldest-old subjects with cognitive impairment. PMID:23558489

A Data-Based Console Logger for Mission Operations Team Coordination

NASA Technical Reports Server (NTRS)

Thronesbery, Carroll; Malin, Jane T.; Jenks, Kenneth; Overland, David; Oliver, Patrick; Zhang, Jiajie; Gong, Yang; Zhang, Tao

2005-01-01

Concepts and prototypes1,2 are discussed for a data-based console logger (D-Logger) to meet new challenges for coordination among flight controllers arising from new exploration mission concepts. The challenges include communication delays, increased crew autonomy, multiple concurrent missions, reduced-size flight support teams that include multidisciplinary flight controllers during quiescent periods, and migrating some flight support activities to flight controller offices. A spiral development approach has been adopted, making simple, but useful functions available early and adding more extensive support later. Evaluations have guided the development of the D-Logger from the beginning and continue to provide valuable user influence about upcoming requirements. D-Logger is part of a suite of tools designed to support future operations personnel and crew. While these tools can be used independently, when used together, they provide yet another level of support by interacting with one another. Recommendations are offered for the development of similar projects.

Initial evaluation of a student-run fruit and vegetable business in urban high schools.

PubMed

Sikic, Nicholas I; Erbstein, Nancy; Welch, Kearnan; Grundberg, Ethan; Miller, Elizabeth

2012-11-01

This study examined the acceptability and feasibility of Fresh Producers, a student-run fruit and vegetable distribution program at three urban high schools located in low-income neighborhoods, and its potential impact on the nutrition and professional development of participating students. Thirteen focus groups conducted with 72 students explored the program's impact on their dietary habits and professional skill development, and discussed program challenges. Responses were coded for common themes by multiple investigators. Participants reported increased fruit and vegetable consumption, and improved interpersonal, team-building, and organizational skills. Challenges included integration into the school schedule and environment and limited faculty support for business activities. This program is acceptable and feasible for secondary school students in a variety of school settings. Students reported positive changes in professional skills and nutrition. Training and support for students and faculty, including strategies to improve program integration into the school context, could increase participation.

The Massachusetts HIV, hepatitis, addiction services integration (HHASI) experience: responding to the comprehensive needs of individuals with co-occurring risks and conditions.

PubMed

Hoffman, Heidi L; Castro-Donlan, Carolyn A; Johnson, Victoria M; Church, Daniel R

2004-01-01

Categorical funding mechanisms traditionally used to fund public health programs are a challenge to providers serving individuals with complex needs that often span multiple service areas. Integration--a formalized, collaborative process among service systems--responds to the challenge by decreasing fragmentation of care and improving coordination. In 2000, the Massachusetts Department of Public Health (MDPH) received a one-year planning grant from the federal Substance Abuse and Mental Health Services Administration (SAMHSA) to evaluate opportunities for integrating HIV/AIDS programs and substance abuse treatment programs. The project was later expanded to include viral hepatitis programming. Outcomes include the development of a strategic plan, joint procurement initiatives, and an ongoing commitment to sustain inter-bureau integration efforts, even in the face of substantial budget reductions. Integrated approaches can promote greater efficiency, improving communication and coordination among clients, providers, and government funding agencies.

Pink-pigmented non-fermentative gram-negative rods associated with human infections: a clinical and diagnostic challenge.

PubMed

Hogue, R; Graves, M; Moler, S; Janda, J M

2007-06-01

Over the past several decades, the appearance of pink-pigmented bacteria in clinical specimens has gone from being a microbiologic curiosity in the clinical laboratory to the recognition of these aerobic microorganisms as etiologic agents of human disease, most notably bloodstream infections. Advances in the fields of molecular taxonomy and phylogenetics indicate that at least four distinct genera and eight different species are associated with clinical infections in susceptible patient populations. However, these bacteria are slow growing and present multiple diagnostic challenges to the microbiology laboratory including culture, isolation, and identification to species rank. This article provides a current review of these unusual non-fermentative chromogenic bacteria including their disease spectrum, taxonomy, and laboratory identification. The review also highlights the pitfalls or shortcomings we currently have in our knowledge of these microbes and their disease-producing capabilities.

The Ethical, Legal, and Social Issues Impacted by Modern Assisted Reproductive Technologies

PubMed Central

Brezina, Paul R.; Zhao, Yulian

2012-01-01

Background. While assisted reproductive technology (ART), including in vitro fertilization has given hope to millions of couples suffering from infertility, it has also introduced countless ethical, legal, and social challenges. The objective of this paper is to identify the aspects of ART that are most relevant to present-day society and discuss the multiple ethical, legal, and social challenges inherent to this technology. Scope of Review. This paper evaluates some of the most visible and challenging topics in the field of ART and outlines the ethical, legal, and social challenges they introduce. Major Conclusions. ART has resulted in a tectonic shift in the way physicians and the general population perceive infertility and ethics. In the coming years, advancing technology is likely to exacerbate ethical, legal, and social concerns associated with ART. ART is directly challenging society to reevaluate the way in which human life, social justice and equality, and claims to genetic offspring are viewed. Furthermore, these issues will force legal systems to modify existing laws to accommodate the unique challenges created by ART. Society has a responsibility to ensure that the advances achieved through ART are implemented in a socially responsible manner. PMID:22272208

The Europa Mission: Multiple Europa Flyby Trajectory Design Trades and Challenges

NASA Technical Reports Server (NTRS)

Lam, Try; Arrieta-Camacho, Juan J.; Buffington, Brent B.

2015-01-01

With potential sources of water, energy and other chemicals essential for life, Europa is a top candidate for finding current life in our Solar System outside of Earth. This paper describes the current trajectory design concept for a multiple Europa flyby mission and discusses several trajectory design challenges. The candidate reference trajectory utilizes multiple Europa flybys while around Jupiter to enable near global coverage of Europa while balancing science requirements, radiation dose, propellant usage, and flight time. Trajectory design trades and robustness are also discussed.

MANGO: a new approach to multiple sequence alignment.

PubMed

Zhang, Zefeng; Lin, Hao; Li, Ming

2007-01-01

Multiple sequence alignment is a classical and challenging task for biological sequence analysis. The problem is NP-hard. The full dynamic programming takes too much time. The progressive alignment heuristics adopted by most state of the art multiple sequence alignment programs suffer from the 'once a gap, always a gap' phenomenon. Is there a radically new way to do multiple sequence alignment? This paper introduces a novel and orthogonal multiple sequence alignment method, using multiple optimized spaced seeds and new algorithms to handle these seeds efficiently. Our new algorithm processes information of all sequences as a whole, avoiding problems caused by the popular progressive approaches. Because the optimized spaced seeds are provably significantly more sensitive than the consecutive k-mers, the new approach promises to be more accurate and reliable. To validate our new approach, we have implemented MANGO: Multiple Alignment with N Gapped Oligos. Experiments were carried out on large 16S RNA benchmarks showing that MANGO compares favorably, in both accuracy and speed, against state-of-art multiple sequence alignment methods, including ClustalW 1.83, MUSCLE 3.6, MAFFT 5.861, Prob-ConsRNA 1.11, Dialign 2.2.1, DIALIGN-T 0.2.1, T-Coffee 4.85, POA 2.0 and Kalign 2.0.

Design of lightning protection for a full-authority digital engine control

NASA Technical Reports Server (NTRS)

Dargi, M.; Rupke, E.; Wiles, K.

1991-01-01

The steps and procedures are described which are necessary to achieve a successful lightning-protection design for a state-of-the-art Full-Authority Digital Engine Control (FADEC) system. The engine and control systems used as examples are fictional, but the design and verification methods are real. Topics discussed include: applicable airworthiness regulation, selection of equipment transient design and control levels for the engine/airframe and intra-engine segments of the system, the use of cable shields, terminal-protection devices and filter circuits in hardware protection design, and software approaches to minimize upset potential. Shield terminations, grounding, and bonding are also discussed, as are the important elements of certification and test plans, and the role of tests and analyses. Also included are examples of multiple-stroke and multiple-burst testing. A review of design pitfalls and challenges, and status of applicable test standards such as RTCA DO-160, Section 22, are presented.

The Spine in Patients With Osteogenesis Imperfecta.

PubMed

Wallace, Maegen J; Kruse, Richard W; Shah, Suken A

2017-02-01

Osteogenesis imperfecta is a genetic disorder of type I collagen. Although multiple genotypes and phenotypes are associated with osteogenesis imperfecta, approximately 90% of the mutations are in the COL1A1 and COL1A2 genes. Osteogenesis imperfecta is characterized by bone fragility. Patients typically have multiple fractures or limb deformity; however, the spine can also be affected. Spinal manifestations include scoliosis, kyphosis, craniocervical junction abnormalities, and lumbosacral pathology. The incidence of lumbosacral spondylolysis and spondylolisthesis is higher in patients with osteogenesis imperfecta than in the general population. Use of diphosphonates has been found to decrease the rate of progression of scoliosis in patients with osteogenesis imperfecta. A lateral cervical radiograph is recommended in patients with this condition before age 6 years for surveillance of craniocervical junction abnormalities, such as basilar impression. Intraoperative and anesthetic considerations in patients with osteogenesis imperfecta include challenges related to fracture risk, airway management, pulmonary function, and blood loss.

Conservation of resources theory and research use in health systems.

PubMed

Alvaro, Celeste; Lyons, Renée F; Warner, Grace; Hobfoll, Stevan E; Martens, Patricia J; Labonté, Ronald; Brown, Richard E

2010-10-20

Health systems face challenges in using research evidence to improve policy and practice. These challenges are particularly evident in small and poorly resourced health systems, which are often in locations (in Canada and globally) with poorer health status. Although organizational resources have been acknowledged as important in understanding research use resource theories have not been a focus of knowledge translation (KT) research. What resources, broadly defined, are required for KT and how does their presence or absence influence research use?In this paper, we consider conservation of resources (COR) theory as a theoretical basis for understanding the capacity to use research evidence in health systems. Three components of COR theory are examined in the context of KT. First, resources are required for research uptake. Second, threat of resource loss fosters resistance to research use. Third, resources can be optimized, even in resource-challenged environments, to build capacity for KT. A scan of the KT literature examined organizational resources needed for research use. A multiple case study approach examined the three components of COR theory outlined above. The multiple case study consisted of a document review and key informant interviews with research team members, including government decision-makers and health practitioners through a retrospective analysis of four previously conducted applied health research studies in a resource-challenged region. The literature scan identified organizational resources that influence research use. The multiple case study supported these findings, contributed to the development of a taxonomy of organizational resources, and revealed how fears concerning resource loss can affect research use. Some resources were found to compensate for other resource deficits. Resource needs differed at various stages in the research use process. COR theory contributes to understanding the role of resources in research use, resistance to research use, and potential strategies to enhance research use. Resources (and a lack of them) may account for the observed disparities in research uptake across health systems. This paper offers a theoretical foundation to guide further examination of the COR-KT ideas and necessary supports for research use in resource-challenged environments.

Conservation of resources theory and research use in health systems

PubMed Central

2010-01-01

Background Health systems face challenges in using research evidence to improve policy and practice. These challenges are particularly evident in small and poorly resourced health systems, which are often in locations (in Canada and globally) with poorer health status. Although organizational resources have been acknowledged as important in understanding research use resource theories have not been a focus of knowledge translation (KT) research. What resources, broadly defined, are required for KT and how does their presence or absence influence research use? In this paper, we consider conservation of resources (COR) theory as a theoretical basis for understanding the capacity to use research evidence in health systems. Three components of COR theory are examined in the context of KT. First, resources are required for research uptake. Second, threat of resource loss fosters resistance to research use. Third, resources can be optimized, even in resource-challenged environments, to build capacity for KT. Methods A scan of the KT literature examined organizational resources needed for research use. A multiple case study approach examined the three components of COR theory outlined above. The multiple case study consisted of a document review and key informant interviews with research team members, including government decision-makers and health practitioners through a retrospective analysis of four previously conducted applied health research studies in a resource-challenged region. Results The literature scan identified organizational resources that influence research use. The multiple case study supported these findings, contributed to the development of a taxonomy of organizational resources, and revealed how fears concerning resource loss can affect research use. Some resources were found to compensate for other resource deficits. Resource needs differed at various stages in the research use process. Conclusions COR theory contributes to understanding the role of resources in research use, resistance to research use, and potential strategies to enhance research use. Resources (and a lack of them) may account for the observed disparities in research uptake across health systems. This paper offers a theoretical foundation to guide further examination of the COR-KT ideas and necessary supports for research use in resource-challenged environments. PMID:20961445

Multiple-digit resurfacing using a thin latissimus dorsi perforator flap.

PubMed

Kim, Sang Wha; Lee, Ho Jun; Kim, Jeong Tae; Kim, Youn Hwan

2014-01-01

Traumatic digit defects of high complexity and with inadequate local tissue represent challenging surgical problems. Recently, perforator flaps have been proposed for reconstructing large defects of the hand because of their thinness and pliability and minimal donor site morbidity. Here, we illustrate the use of thin latissimus dorsi perforator flaps for resurfacing multiple defects of distal digits. We describe the cases of seven patients with large defects, including digits, circumferential defects and multiple-digit defects, who underwent reconstruction with thin latissimus dorsi perforator flaps between January 2008 and March 2012. Single-digit resurfacing procedures were excluded. The mean age was 56.3 years and the mean flap size was 160.4 cm(2). All the flaps survived completely. Two patients had minor complications including partial flap loss and scar contracture. The mean follow-up period was 11.7 months. The ideal flap for digit resurfacing should be thin and amenable to moulding, have a long pedicle for microanastomosis and have minimal donor site morbidity. Thin flaps can be harvested by excluding the deep adipose layer, and their high pliability enables resurfacing without multiple debulking procedures. The latissimus dorsi perforator flap may be the best flap for reconstructing complex defects of the digits, such as large, multiple-digit or circumferential defects, which require complete wrapping of volar and dorsal surfaces. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Atypical Pneumonia: Updates on Legionella, Chlamydophila, and Mycoplasma Pneumonia.

PubMed

Sharma, Lokesh; Losier, Ashley; Tolbert, Thomas; Dela Cruz, Charles S; Marion, Chad R

2017-03-01

Community-acquired pneumonia (CAP) has multiple causes and is associated with illness that requires admission to the hospital and mortality. The causes of atypical CAP include Legionella species, Chlamydophila, and Mycoplasma. Atypical CAP remains a diagnostic challenge and, therefore, likely is undertreated. This article reviews the advancements in the evaluation and treatment of patients and discusses current conflicts and controversies of atypical CAP. Copyright © 2016 Elsevier Inc. All rights reserved.

Studio in Drawing and Painting; Graphics, Photography; Advanced Electric Courses in Art for Grades 10, 11, and 12, Volume 1.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Bureau of Secondary Curriculum Development.

This is the first volume in a series that includes the syllabi for advanced elective courses in art education for grades 10, 11, and 12. The course objective is to provide a multiplicity of visual experiences in the drawing and painting areas of the graphic arts and photography that are broad in scope and that will challenge the student's ability…

Organizations, Paradigms, and People: The Challenge of KM Interventions

NASA Technical Reports Server (NTRS)

Bailey, Teresa; Burton, Yvette

1999-01-01

This paper presents viewgraphs on Knowledge Management (KM) and how these interventions are put into practice by organizations and society. The topics include: 1) The Multiple Paradigm Tool; 2) Four Paradigms: tool for the Analyzing Organizations; 3) Assumptions About the Nature of Social Science; 4) Assumptions About the Nature of Society; 5) Schools of Sociological and Organizational Theory; 6) Meaning and Metaphors in the Four Paradigms; and 7) Possibilities and Conclusions.

Future of Hydroinformatics: Towards Open, Integrated and Interactive Online Platforms

NASA Astrophysics Data System (ADS)

Demir, I.; Krajewski, W. F.

2012-12-01

Hydroinformatics is a domain of science and technology dealing with the management of information in the field of hydrology (IWA, 2011). There is the need for innovative solutions to the challenges towards open information, integration, and communication in the Internet. This presentation provides an overview of the trends and challenges in the future of hydroinformatics, and demonstrates an information system, Iowa Flood Information System (IFIS), developed within the light of these challenges. The IFIS is a web-based platform developed by the Iowa Flood Center (IFC) to provide access to flood inundation maps, real-time flood conditions, flood forecasts both short-term and seasonal, flood-related data, information and interactive visualizations for communities in Iowa. The key element of the system's architecture is the notion of community. Locations of the communities, those near streams and rivers, define basin boundaries. The IFIS provides community-centric watershed and river characteristics, weather (rainfall) conditions, and streamflow data and visualization tools. Interactive interfaces allow access to inundation maps for different stage and return period values, and flooding scenarios with contributions from multiple rivers. Real-time and historical data of water levels, gauge heights, and rainfall conditions are available in the IFIS by streaming data from automated IFC bridge sensors, USGS stream gauges, NEXRAD radars, and NWS forecasts. 2D and 3D interactive visualizations in the IFIS make the data more understandable to general public. Users are able to filter data sources for their communities and selected rivers. The data and information on IFIS is also accessible through web services and mobile applications. The IFIS is optimized for various browsers and screen sizes to provide access through multiple platforms including tablets and mobile devices. The IFIS includes a rainfall-runoff forecast model to provide a five-day flood risk estimate for more than 1000 communities in Iowa. Multiple view modes in the IFIS accommodate different user types from general public to researchers and decision makers by providing different level of tools and details. River view mode allows users to visualize data from multiple IFC bridge sensors and USGS stream gauges to follow flooding condition along a river. The IFIS will help communities make better-informed decisions on the occurrence of floods, and will alert communities in advance to help minimize damage of floods.

Cultural Challenges Faced by American Mission Control Personnel Working with International Partners

NASA Technical Reports Server (NTRS)

Clement, J. L.; Ritsher, J. B.

2006-01-01

Operating the International Space Station (ISS) involves an indefinite, continuous series of long-duration international missions, and this requires an unprecedented degree of cooperation across multiple sites, organizations, and nations. Both junior and senior mission control personnel have had to find ways to address the cultural challenges inherent in such work, but neither have had systematic training in how to do so. The goals of this study were to identify and evaluate the major cultural challenges faced by ISS mission control personnel and to highlight the approaches that they have found most effective to surmount these challenges. We pay particular attention to the approaches successfully employed by the senior personnel and the training needs identified by the junior personnel. We also evaluate the extent to which the identified approaches and needs are consistent across the two samples. METHODS: Participants included a sample of 14 senior ISS flight controllers and a contrasting sample of 12 more junior controllers. All participants were mission operations specialists chosen on the basis of having worked extensively with international partners. Data were collected using a semi-structured qualitative interview and content analyzed using an iterative process with multiple coders and consensus meetings to resolve discrepancies. RESULTS: The senior respondents had substantial consensus on several cultural challenges and on key strategies for dealing with them, and they offered a wide range of specific tactics for implementing these strategies. Data from the junior respondents will be presented for the first time at the meeting. DISCUSSION: Although specific to American ISS personnel, our results are consistent with recent management, cultural, and aerospace research on other populations. We aim to use our results to improve training for current and future mission control personnel working in international or multicultural mission operations teams.

Multigenerational challenges in academic medicine: UCDavis's responses.

PubMed

Howell, Lydia Pleotis; Servis, Gregg; Bonham, Ann

2005-06-01

Academic medicine is a unique work environment, one of the few where members of four different generations regularly interact and where multigenerational teams are key to fulfilling its missions, particularly education. This can lead to increased creativity, but also to intergenerational conflict, since each generation has different values and expectations. The authors describe multigenerational challenges confronted at the University of California, Davis, School of Medicine, and that school's responses to them. These challenges include issues related to work hours, workload, compensation, evaluation for advancement, recruitment and retention, and attendance at required meetings. Awareness of the different generational qualities and values allowed the school of medicine to identify the multigenerational origin of many of these ongoing issues and challenges and to plan appropriate solutions within the Office of Academic Affairs. These include policy changes related to work-life balance, utilizing multiple faculty tracks with different roles, allowing part-time faculty appointments, creating a variety of faculty development programs geared toward different generational needs (which utilize flexible modules, menus of options, and alternative technologies for presentation), defining appropriate reward and incentives through compensations plans, and creating peer-reviewed awards. The authors conclude that these efforts mitigate conflict, promote diversity, and allow multigenerational teams to function more effectively and creatively in education, research, and clinical care. Ongoing evaluation will further refine this approach.

Challenges to recruitment and retention of African Americans in the gene-environment trial of response to dietary interventions (GET READI) for heart health

PubMed Central

Kennedy, Betty M.; Harsha, David W.; Bookman, Ebony B.; Hill, Yolanda R.; Rankinen, Tuomo; Rodarte, Ruben Q.; Murla, Connie D.

2011-01-01

In this paper, challenges to recruiting African Americans specifically for a dietary feeding trial are examined, learning experiences gained and suggestions to overcome these challenges in future trials are discussed. A total of 333 individuals were randomized in the trial and 234 (167 sibling pairs and 67 parents/siblings) completed the dietary intervention and required DNA blood sampling for genetic analysis. The trial used multiple strategies for recruitment. Hand distributed letters and flyers through mass distribution at various churches resulted in the largest number (n = 153, 46%) of African Americans in the trial. Word of mouth accounted for the second largest number (n = 120, 36%) and included prior study participants. These two recruitment sources represented 82% (n = 273) of the total number of individuals randomized in GET READI. The remaining 18% (n = 60) consisted of a combination of sources including printed message on check stubs, newspaper articles, radio and TV appearances, screening events and presentations. Though challenging, the recruitment efforts for GET READI produced a significant number of African American participants despite the inability to complete the trial as planned because of low recruitment yields. Nevertheless, the recruitment process produced substantial numbers that successfully completed all study requirements. PMID:21865154

Turbulent dissipation challenge: a community-driven effort

NASA Astrophysics Data System (ADS)

Parashar, Tulasi N.; Salem, Chadi; Wicks, Robert T.; Karimabadi, H.; Gary, S. Peter; Matthaeus, William H.

2015-10-01

> Many naturally occurring and man-made plasmas are collisionless and turbulent. It is not yet well understood how the energy in fields and fluid motions is transferred into the thermal degrees of freedom of constituent particles in such systems. The debate at present primarily concerns proton heating. Multiple possible heating mechanisms have been proposed over the past few decades, including cyclotron damping, Landau damping, heating at intermittent structures and stochastic heating. Recently, a community-driven effort was proposed (Parashar & Salem, 2013, arXiv:1303.0204) to bring the community together and understand the relative contributions of these processes under given conditions. In this paper, we propose the first step of this challenge: a set of problems and diagnostics for benchmarking and comparing different types of 2.5D simulations. These comparisons will provide insights into the strengths and limitations of different types of numerical simulations and will help guide subsequent stages of the challenge.

Factors influencing community nursing roles and health service provision in rural areas: a review of literature.

PubMed

Barrett, Annette; Terry, Daniel R; Lê, Quynh; Hoang, Ha

2016-02-01

This review sought to better understand the issues and challenges experienced by community nurses working in rural areas and how these factors shape their role. Databases were searched to identify relevant studies, published between 1990 and 2015, that focussed on issues and challenges experienced by rural community nurses. Generic and grey literature relating to the subject was also searched. The search was systematically conducted multiple times to assure accuracy. A total of 14 articles met the inclusion criteria. This critical review identified common issues impacting community nursing and included role definition, organisational change, human resource, workplace and geographic challenges. Community nurses are flexible, autonomous, able to adapt care to the service delivery setting, and have a diversity of knowledge and skills. Considerably more research is essential to identify factors that impact rural community nursing practice. In addition, greater advocacy is required to develop the role.

Patient safety challenges in a case study hospital--of relevance for transfusion processes?

PubMed

Aase, Karina; Høyland, Sindre; Olsen, Espen; Wiig, Siri; Nilsen, Stein Tore

2008-10-01

The paper reports results from a research project with the objective of studying patient safety, and relates the finding to safety issues within transfusion medicine. The background is an increased focus on undesired events related to diagnosis, medication, and patient treatment in general in the healthcare sector. The study is designed as a case study within a regional Norwegian hospital conducting specialised health care services. The study includes multiple methods such as interviews, document analysis, analysis of error reports, and a questionnaire survey. Results show that the challenges for improved patient safety, based on employees' perceptions, are hospital management support, reporting of accidents/incidents, and collaboration across hospital units. Several of these generic safety challenges are also found to be of relevance for a hospital's transfusion service. Positive patient safety factors are identified as teamwork within hospital units, a non-punitive response to errors, and unit manager's actions promoting safety.

Data Access, Interoperability and Sustainability: Key Challenges for the Evolution of Science Capabilities

NASA Astrophysics Data System (ADS)

Walton, A. L.

2015-12-01

In 2016, the National Science Foundation (NSF) will support a portfolio of activities and investments focused upon challenges in data access, interoperability, and sustainability. These topics are fundamental to science questions of increasing complexity that require multidisciplinary approaches and expertise. Progress has become tractable because of (and sometimes complicated by) unprecedented growth in data (both simulations and observations) and rapid advances in technology (such as instrumentation in all aspects of the discovery process, together with ubiquitous cyberinfrastructure to connect, compute, visualize, store, and discover). The goal is an evolution of capabilities for the research community based on these investments, scientific priorities, technology advances, and policies. Examples from multiple NSF directorates, including investments by the Advanced Cyberinfrastructure Division, are aimed at these challenges and can provide the geosciences research community with models and opportunities for participation. Implications for the future are highlighted, along with the importance of continued community engagement on key issues.

Challenges and opportunities for meningococcal vaccination in the developing world.

PubMed

Shaker, Rouba; Fayad, Danielle; Dbaibo, Ghassan

2018-05-04

Meningococcal disease continues to be a life threatening infection with high morbidity and mortality even in appropriately treated patients. Meningococcal vaccination plays a major role in the control of the disease; however, implementing vaccination remains problematic in the developing world. The objective of this review is to identify the challenges facing the use of meningococcal vaccines in the developing world in order to discuss the opportunities and available solutions to improve immunization in these countries. Inadequate epidemiologic information necessary to implement vaccination and financial challenges predominate. Multiple measures are needed to achieve the successful implementation of meningococcal conjugate vaccination programs that protect against circulating serogroups in developing countries including enhanced surveillance systems, financial support and aid through grants, product development partnerships that are the end result of effective collaboration and communication between different interdependent stakeholders to develop affordable vaccines, and demonstration of the cost-effectiveness of new meningococcal vaccines.

Can we beat the biotin-avidin pair?: cucurbit[7]uril-based ultrahigh affinity host-guest complexes and their applications.

PubMed

Shetty, Dinesh; Khedkar, Jayshree K; Park, Kyeng Min; Kim, Kimoon

2015-12-07

The design of synthetic, monovalent host-guest molecular recognition pairs is still challenging and of particular interest to inquire into the limits of the affinity that can be achieved with designed systems. In this regard, cucurbit[7]uril (CB[7]), an important member of the host family cucurbit[n]uril (CB[n], n = 5-8, 10, 14), has attracted much attention because of its ability to form ultra-stable complexes with multiple guests. The strong hydrophobic effect between the host cavity and guests, ion-dipole and dipole-dipole interactions of guests with CB portals helps in cooperative and multiple noncovalent interactions that are essential for realizing such strong complexations. These highly selective, strong yet dynamic interactions can be exploited in many applications including affinity chromatography, biomolecule immobilization, protein isolation, biological catalysis, and sensor technologies. In this review, we summarize the progress in the development of high affinity guests for CB[7], factors affecting the stability of complexes, theoretical insights, and the utility of these high affinity pairs in different challenging applications.

Untethered Recyclable Tubular Actuators with Versatile Locomotion for Soft Continuum Robots.

PubMed

Qian, Xiaojie; Chen, Qiaomei; Yang, Yang; Xu, Yanshuang; Li, Zhen; Wang, Zhenhua; Wu, Yahe; Wei, Yen; Ji, Yan

2018-05-27

Stimuli-responsive materials offer a distinguished platform to build tether-free compact soft robots, which can combine sensing and actuation without a linked power supply. In the past, tubular soft robots have to be made by multiple components with various internal channels or complex cavities assembled together. Moreover, robust processing, complex locomotion, simple structure, and easy recyclability represent major challenges in this area. Here, it is shown that those challenges can be tackled by liquid crystalline elastomers with allyl sulfide functional groups. The light-controlled exchange reaction between allyl sulfide groups allows flexible processing of tubular soft robots/actuators, which does not need any assisting materials. Complex locomotion demonstrated here includes reversible simultaneous bending and elongation; reversible diameter expansion; and omnidirectional bending via remote infrared light control. Different modes of actuation can be programmed into the same tube without the routine assembly of multiple tubes as used in the past. In addition, the exchange reaction also makes it possible to use the same single tube repeatedly to perform different functions by erasing and reprogramming. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Design of Multistable Origami Structures

NASA Astrophysics Data System (ADS)

Gillman, Andrew; Fuchi, Kazuko; Bazzan, Giorgio; Reich, Gregory; Alyanak, Edward; Buskohl, Philip

Origami is being transformed from an art to a mathematically robust method for device design in a variety of scientific applications. These structures often require multiple stable configurations, e.g. efficient well-controlled deployment. However, the discovery of origami structures with mechanical instabilities is challenging given the complex geometric nonlinearities and the large design space to investigate. To address this challenge, we have developed a topology optimization framework for discovering origami fold patterns that realize stable and metastable positions. The objective function targets both the desired stable positions and nonlinear loading profiles of specific vertices in the origami structure. Multistable compliant structures have been shown to offer advantages in their stability and efficiency, and certain origami fold patterns exhibit multistable behavior. Building on this previous work of single vertex multistability analysis, e.g. waterbomb origami pattern, we are expanding the solution set of multistable mechanisms to include multiple vertices and a broader set of reference configurations. Collectively, these results enable an initial classification of geometry-induced mechanical instabilities that can be programmed into active material systems. This work was supported by the Air Force Office of Scientific Research.

Co-existence of Blau syndrome and NAID? Diagnostic challenges associated with presence of multiple pathogenic variants in NOD2 gene: a case report.

PubMed

Dziedzic, Magdalena; Marjańska, Agata; Bąbol-Pokora, Katarzyna; Urbańczyk, Anna; Grześk, Elżbieta; Młynarski, Wojciech; Kołtan, Sylwia

2017-07-27

Pediatric autoinflammatory diseases are rare and still poorly understood conditions resulting from defective genetic control of innate immune system, inter alia from anomalies of NOD2 gene. The product of this gene is Nod2 protein, taking part in maintenance of immune homeostasis. Clinical form of resultant autoinflammatory condition depends on NOD2 genotype; usually patients with NOD2 defects present with Blau syndrome, NOD2-associated autoinflammatory disease (NAID) or Crohn's disease. We present the case of a 7-year-old girl with co-existing symptoms of two rare diseases, Blau syndrome and NAID. Overlapping manifestations of two syndromes raised a significant diagnostic challenge, until next-generation molecular test (NGS) identified presence of three pathogenic variants of NOD2 gene: P268S, IVS8 +158 , 1007 fs, and established the ultimate diagnosis. Presence of multiple genetical abnormalities resulted in an ambiguous clinical presentation with overlapping symptoms of Blau syndrome and NAID. Final diagnosis of autoinflammatory disease opened new therapeutic possibilities, including the use of biological treatments.

Knowledge production and learning for sustainable landscapes: seven steps using social-ecological systems as laboratories.

PubMed

Angelstam, Per; Elbakidze, Marine; Axelsson, Robert; Dixelius, Malcolm; Törnblom, Johan

2013-03-01

There are multiple challenges regarding use and governance of landscapes' goods, functions and intangible values for ecosystem health and human well-being. One group of challenges is to measure and assess principal sustainability dimensions through performance targets, so stakeholders have transparent information about states and trends. Another group is to develop adaptive governance at multiple levels, and management of larger geographical areas across scales. Addressing these challenges, we present a framework for transdisciplinary research using multiple landscapes as place-based case studies that integrates multiple research disciplines and non-academic actors: (1) identify a suite of landscapes, and for each (2) review landscape history, (3) map stakeholders, use and non-use values, products and land use, (4) analyze institutions, policies and the system of governance, (5) measure ecological, economic, social and cultural sustainability, (6) assess sustainability dimensions and governance, and finally (7) make comparisons and synthesize. Collaboration, communication and dissemination are additional core features. We discuss barriers bridges and bridges for applying this approach.

Analysis of in vitro fertilization data with multiple outcomes using discrete time-to-event analysis

PubMed Central

Maity, Arnab; Williams, Paige; Ryan, Louise; Missmer, Stacey; Coull, Brent; Hauser, Russ

2014-01-01

In vitro fertilization (IVF) is an increasingly common method of assisted reproductive technology. Because of the careful observation and followup required as part of the procedure, IVF studies provide an ideal opportunity to identify and assess clinical and demographic factors along with environmental exposures that may impact successful reproduction. A major challenge in analyzing data from IVF studies is handling the complexity and multiplicity of outcome, resulting from both multiple opportunities for pregnancy loss within a single IVF cycle in addition to multiple IVF cycles. To date, most evaluations of IVF studies do not make use of full data due to its complex structure. In this paper, we develop statistical methodology for analysis of IVF data with multiple cycles and possibly multiple failure types observed for each individual. We develop a general analysis framework based on a generalized linear modeling formulation that allows implementation of various types of models including shared frailty models, failure specific frailty models, and transitional models, using standard software. We apply our methodology to data from an IVF study conducted at the Brigham and Women’s Hospital, Massachusetts. We also summarize the performance of our proposed methods based on a simulation study. PMID:24317880

Multiple sclerosis - etiology and diagnostic potential.

PubMed

Kamińska, Joanna; Koper, Olga M; Piechal, Kinga; Kemona, Halina

2017-06-30

Multiple sclerosis (MS) is a chronic inflammatory and demyelinating disease of autoimmune originate. The main agents responsible for the MS development include exogenous, environmental, and genetic factors. MS is characterized by multifocal and temporally scattered central nervous system (CNS) damage which lead to the axonal damage. Among clinical courses of MS it can be distinguish relapsing-remitting multiple sclerosis (RRMS), secondary progressive multiple sclerosis (SPSM), primary progressive multiple sclerosis (PPMS), and progressive-relapsing multiple sclerosis (RPMS). Depending on the severity of signs and symptoms MS can be described as benign MS or malignant MS. MS diagnosis is based on McDonald's diagnostic criteria, which link clinical manifestation with characteristic lesions demonstrated by magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis, and visual evoked potentials. Among CSF laboratory tests used to the MS diagnosis are applied: Tibbling & Link IgG index, reinbegrams, and CSF isoelectrofocusing for oligoclonal bands detection. It should be emphasized, that despite huge progress regarding MS as well as the availability of different diagnostics methods this disease is still a diagnostic challenge. It may result from fact that MS has diverse clinical course and there is a lack of single test, which would be of appropriate diagnostic sensitivity and specificity for quick and accurate diagnosis.

A design study to develop young children's understanding of multiplication and division

NASA Astrophysics Data System (ADS)

Bicknell, Brenda; Young-Loveridge, Jenny; Nguyen, Nhung

2016-12-01

This design study investigated the use of multiplication and division problems to help 5-year-old children develop an early understanding of multiplication and division. One teacher and her class of 15 5-year-old children were involved in a collaborative partnership with the researchers. The design study was conducted over two 4-week periods in May-June and October-November. The focus in this article is on three key aspects of classroom teaching: instructional tasks, the use of representations, and discourse, including the mathematics register. Results from selected pre- and post-assessment tasks within a diagnostic interview showed that there were improvements in addition and subtraction as well as multiplication and division, even though the teaching had used multiplication and division problems. Students made progress on all four operational domains, with effect sizes ranging from approximately two thirds of a standard deviation to 2 standard deviations. Most of the improvement in students' number strategies was in moving from `counting all' to `counting on' and `skip counting'. The findings challenge the idea that learning experiences in addition and subtraction should precede those in multiplication and division as suggested in some curriculum documents.

Towards a Science of Community Stakeholder Engagement in Biomedical HIV Prevention Trials: An Embedded Four-Country Case Study.

PubMed

Newman, Peter A; Rubincam, Clara; Slack, Catherine; Essack, Zaynab; Chakrapani, Venkatesan; Chuang, Deng-Min; Tepjan, Suchon; Shunmugam, Murali; Roungprakhon, Surachet; Logie, Carmen; Koen, Jennifer; Lindegger, Graham

2015-01-01

Broad international guidelines and studies in the context of individual clinical trials highlight the centrality of community stakeholder engagement in conducting ethically rigorous HIV prevention trials. We explored and identified challenges and facilitators for community stakeholder engagement in biomedical HIV prevention trials in diverse global settings. Our aim was to assess and deepen the empirical foundation for priorities included in the GPP guidelines and to highlight challenges in implementation that may merit further attention in subsequent GPP iterations. From 2008-2012 we conducted an embedded, multiple case study centered in Thailand, India, South Africa and Canada. We conducted in-depth interviews and focus groups with respondents from different trial-related subsystems: civil society organization representatives, community advocates, service providers, clinical trialists/researchers, former trial participants, and key HIV risk populations. Interviews/focus groups were recorded, and coded using thematic content analysis. After intra-case analyses, we conducted cross-case analysis to contrast and synthesize themes and sub-themes across cases. Lastly, we applied the case study findings to explore and assess UNAIDS/AVAC GPP guidelines and the GPP Blueprint for Stakeholder Engagement. Across settings, we identified three cross-cutting themes as essential to community stakeholder engagement: trial literacy, including lexicon challenges and misconceptions that imperil sound communication; mistrust due to historical exploitation; and participatory processes: engaging early; considering the breadth of "community"; and, developing appropriate stakeholder roles. Site-specific challenges arose in resource-limited settings and settings where trials were halted. This multiple case study revealed common themes underlying community stakeholder engagement across four country settings that largely mirror GPP goals and the GPP Blueprint, as well as highlighting challenges in the implementation of important guidelines. GPP guidance documents could be strengthened through greater focus on: identifying and addressing the community-specific roots of mistrust and its impact on trial literacy activities; achieving and evaluating representativeness in community stakeholder groups; and addressing the impact of power and funding streams on meaningful engagement and independent decision-making.

Towards a Science of Community Stakeholder Engagement in Biomedical HIV Prevention Trials: An Embedded Four-Country Case Study

PubMed Central

Newman, Peter A.; Rubincam, Clara; Slack, Catherine; Essack, Zaynab; Chakrapani, Venkatesan; Chuang, Deng-Min; Tepjan, Suchon; Shunmugam, Murali; Roungprakhon, Surachet; Logie, Carmen; Koen, Jennifer; Lindegger, Graham

2015-01-01

Objectives Broad international guidelines and studies in the context of individual clinical trials highlight the centrality of community stakeholder engagement in conducting ethically rigorous HIV prevention trials. We explored and identified challenges and facilitators for community stakeholder engagement in biomedical HIV prevention trials in diverse global settings. Our aim was to assess and deepen the empirical foundation for priorities included in the GPP guidelines and to highlight challenges in implementation that may merit further attention in subsequent GPP iterations. Methods From 2008–2012 we conducted an embedded, multiple case study centered in Thailand, India, South Africa and Canada. We conducted in-depth interviews and focus groups with respondents from different trial-related subsystems: civil society organization representatives, community advocates, service providers, clinical trialists/researchers, former trial participants, and key HIV risk populations. Interviews/focus groups were recorded, and coded using thematic content analysis. After intra-case analyses, we conducted cross-case analysis to contrast and synthesize themes and sub-themes across cases. Lastly, we applied the case study findings to explore and assess UNAIDS/AVAC GPP guidelines and the GPP Blueprint for Stakeholder Engagement. Results Across settings, we identified three cross-cutting themes as essential to community stakeholder engagement: trial literacy, including lexicon challenges and misconceptions that imperil sound communication; mistrust due to historical exploitation; and participatory processes: engaging early; considering the breadth of “community”; and, developing appropriate stakeholder roles. Site-specific challenges arose in resource-limited settings and settings where trials were halted. Conclusions This multiple case study revealed common themes underlying community stakeholder engagement across four country settings that largely mirror GPP goals and the GPP Blueprint, as well as highlighting challenges in the implementation of important guidelines. GPP guidance documents could be strengthened through greater focus on: identifying and addressing the community-specific roots of mistrust and its impact on trial literacy activities; achieving and evaluating representativeness in community stakeholder groups; and addressing the impact of power and funding streams on meaningful engagement and independent decision-making. PMID:26295159

The Benefits and Challenges of Multiple Health Behavior Change in Research and in Practice

PubMed Central

Prochaska, Judith J.; Nigg, Claudio R.; Spring, Bonnie; Velicer, Wayne F.; Prochaska, James O.

2009-01-01

Objective The major chronic diseases are caused by multiple risks, yet the science of multiple health behavior change (MHBC) is at an early stage, and factors that facilitate or impede scientists’ involvement in MHBC research are unknown. Benefits and challenges of MHBC interventions were investigated to strengthen researchers’ commitment and prepare them for challenges. Method An online anonymous survey was emailed to listservs of the Society of Behavioral Medicine between May 2006 and 2007. Respondents (N = 69) were 83% female; 94% held a doctoral degree; 64% were psychologists, 24% were in public health; 83% targeted MHBC in their work. Results A sample majority rated 23 of the 24 benefits, but only 1 of 31 challenge items, as very-to-extremely important. Those engaged in MHBC rated the total benefits significantly higher than respondents focused on single behaviors, F(1,69) = 4.21, p<.05, and rated the benefits significantly higher than the challenges: paired t(57) = 7.50, p<.001. The two groups did not differ in ratings of challenges. Conclusion It appears individuals focused solely on single behaviors do not fully appreciate the benefits that impress MHBC researchers; it is not that substantial barriers are holding them back. Benefits of MHBC interventions need emphasizing more broadly to advance this research area. PMID:19948184

An Analysis of Student Affairs Professionals' Management of Role Conflict and Multiple Roles in Relation to Work/Life Balance

ERIC Educational Resources Information Center

Mayo, Nicole Lepone

2013-01-01

The purpose of this inquiry is to study how student affairs professionals manage role conflict in relation to work/life balance based on the challenging culture of the field. The underlying goals are to identify the barriers or challenges of managing multiple roles as a student affairs administrator and identify strategies to assist employees in…

Sevoflurane anaesthesia for nasal surgery in a patient with multiple chemical sensitivity.

PubMed

Fernández Martín, M T; Álvarez López, J C

2018-01-01

Multiple chemical sensitivity syndrome is a group of complex disorders that include psychiatric disorders, chronic fatigue and/or respiratory problems. This syndrome could be triggered by specific allergens and toxins that cause neurophysiological sensitization and the appearance of the clinical symptomatology. Anaesthesia for these patients always poses a challenge for the anaesthetist, because they need to find and use drugs that do not trigger or aggravate the symptoms of the disease. Therefore, sevoflurane in these circumstances might be "the ideal anaesthetic". Performing general anaesthesia with sevoflurane as the sole anaesthetic agent, together with a series of environmental measures formed the basis for successful anaesthesia and surgery in our patient with a multiple chemical sensitivity syndrome. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Terahertz sensing of highly absorptive water-methanol mixtures with multiple resonances in metamaterials.

PubMed

Chen, Min; Singh, Leena; Xu, Ningning; Singh, Ranjan; Zhang, Weili; Xie, Lijuan

2017-06-26

Terahertz sensing of highly absorptive aqueous solutions remains challenging due to strong absorption of water in the terahertz regime. Here, we experimentally demonstrate a cost-effective metamaterial-based sensor integrated with terahertz time-domain spectroscopy for highly absorptive water-methanol mixture sensing. This metamaterial has simple asymmetric wire structures that support multiple resonances including a fundamental Fano resonance and higher order dipolar resonance in the terahertz regime. Both the resonance modes have strong intensity in the transmission spectra which we exploit for detection of the highly absorptive water-methanol mixtures. The experimentally characterized sensitivities of the Fano and dipole resonances for the water-methanol mixtures are found to be 160 and 305 GHz/RIU, respectively. This method provides a robust route for metamaterial-assisted terahertz sensing of highly absorptive chemical and biochemical materials with multiple resonances and high accuracy.

Rapid, High-Throughput Tracking of Bacterial Motility in 3D via Phase-Contrast Holographic Video Microscopy

PubMed Central

Cheong, Fook Chiong; Wong, Chui Ching; Gao, YunFeng; Nai, Mui Hoon; Cui, Yidan; Park, Sungsu; Kenney, Linda J.; Lim, Chwee Teck

2015-01-01

Tracking fast-swimming bacteria in three dimensions can be extremely challenging with current optical techniques and a microscopic approach that can rapidly acquire volumetric information is required. Here, we introduce phase-contrast holographic video microscopy as a solution for the simultaneous tracking of multiple fast moving cells in three dimensions. This technique uses interference patterns formed between the scattered and the incident field to infer the three-dimensional (3D) position and size of bacteria. Using this optical approach, motility dynamics of multiple bacteria in three dimensions, such as speed and turn angles, can be obtained within minutes. We demonstrated the feasibility of this method by effectively tracking multiple bacteria species, including Escherichia coli, Agrobacterium tumefaciens, and Pseudomonas aeruginosa. In addition, we combined our fast 3D imaging technique with a microfluidic device to present an example of a drug/chemical assay to study effects on bacterial motility. PMID:25762336

Behavioral and neurochemical consequences of multiple MDMA administrations in the rat: role of individual differences in anxiety-related behavior.

PubMed

Ludwig, V; Mihov, Y; Schwarting, R K W

2008-05-16

Using the elevated plus-maze (EPM), Wistar rats can be distinguished into high (HA) or low anxiety (LA) subjects. These differences seem to reflect traits, since HA and LA rats vary also in other anxiety-dependent tasks, neurochemical mechanisms, and psychopharmacological reactivity, including lasting consequences after single treatment with 3,4-methylenedioxymethamphetamine (MDMA). Here, we tested whether multiple MDMA treatments also have subject-dependent effects. Based on routine EPM screening, male Wistar rats were divided into HA and LA sub-groups, which received five (i.e. multiple) daily injections of MDMA (5 mg/kg) or saline, followed by a test battery, including a challenge test with MDMA, a retest in the EPM, a novel-object test, and a final neurochemical analysis. Acutely, MDMA led to comparable hyperactivity in HA and LA rats. After multiple MDMA, behavioral sensitization was observed, especially in LA rats. Open arm time during the EPM retest (min 0-5) correlated with that of the initial one only in those rats, which had received a single injection of MDMA. Rats with multiple MDMA, especially LA-rats, showed more open-arm time and locomotion during the subsequent 5-10 min of the retest. In a novel-object test, rats with multiple MDMA, again especially LA subjects, showed more exploratory bouts towards the novel object. Neurochemically, multiple MDMA led to moderately lower serotonin in the ventral striatum, and higher dopamine levels in the frontal cortex as compared to single MDMA; these effects were also moderated by subject-dependent factors. Our data show that low-dosed multiple MDMA can lead to behavioral sensitization and outlasting consequences, which affect behavior in the EPM and a novel object task. Detecting such sequels partly requires consideration of individual differences.

The Challenge of Multiple Perspectives: Multiple Solution Tasks for Students Incorporating Diverse Tools and Representation Systems

ERIC Educational Resources Information Center

Kordaki, Maria

2015-01-01

This study focuses on the role of multiple solution tasks (MST) incorporating multiple learning tools and representation systems (MTRS) in encouraging each student to develop multiple perspectives on the learning concepts under study and creativity of thought. Specifically, two types of MST were used, namely tasks that allowed and demanded…

Field data collection, analysis, and adaptive management of green infrastructure in the urban water cycle in Cleveland and Columbus, OH

NASA Astrophysics Data System (ADS)

Darner, R.; Shuster, W.

2016-12-01

Expansion of the urban environment can alter the landscape and creates challenges for how cities deal with energy and water. Large volumes of stormwater in areas that have combined septic and stormwater systems present on challenge. Managing the water as near to the source as possible by creates an environment that allows more infiltration and evapotranspiration. Stormwater control measures (SCM) associated with this type of development, often called green infrastructure, include rain gardens, pervious or porous pavements, bioswales, green or blue roofs, and others. In this presentation, we examine the hydrology of green infrastructure in urban sewersheds in Cleveland and Columbus, OH. We present the need for data throughout the water cycle and challenges to collecting field data at a small scale (single rain garden instrumented to measure inflows, outflow, weather, soil moisture, and groundwater levels) and at a macro scale (a project including low-cost rain gardens, highly engineered rain gardens, groundwater wells, weather stations, soil moisture, and combined sewer flow monitoring). Results will include quantifying the effectiveness of SCMs in intercepting stormwater for different precipitation event sizes. Small scale deployment analysis will demonstrate the role of active adaptive management in the ongoing optimization over multiple years of data collection.

Stress Physiology in Infancy and Early Childhood: Cortisol Flexibility, Attunement and Coordination.

PubMed

Atkinson, L; Jamieson, B; Khoury, J; Ludmer, J; Gonzalez, A

2016-08-01

Research on stress physiology in infancy has assumed increasing importance due to its lifelong implications. In this review, we focus on measurement of hypothalamic-pituitary-adrenal (HPA) function, in particular, and on complementary autonomic processes. We suggest that the measure of HPA function has been overly exclusive, focusing on individual reactivity to single, pragmatically selected laboratory challenges. We advocate use of multiple, strategically chosen challenges and within-subject designs. By administering one challenge that typically does not provoke reactivity and another that does, it is possible to represent allostatic load in terms of "flexibility," the capacity to titrate response to challenge. We also recommend assessing infant reactivity in the context of the primary caregiver's physiological function. Infant-mother "attunement" is central to developmental psychology, permeating diverse developmental domains with varied consequences. A review of adrenocortical attunement suggests that attunement is a reliable process, manifest across varied populations. However, attunement appears stronger in the context of more highly stressful circumstances, such that administration of multiple, selected challenges may help evaluate the degree to which individuals titrate attunement to challenge and determine the correlates of this differential attunement. Finally, we advocate studying the "coordination" of HPA function with other aspects of stress physiology and variation in the degree of this coordination. The use of multiple stressors is important here because each stress system is differentially sensitive to different types of challenge. Therefore, use of single stressors in between-subject designs impedes full recognition of the role played by each system. Overall, we recommend measure of flexibility, attunement, and coordination in the context of multiple challenges to capture allostasis in environmental and physiological context. The simultaneous use of such inclusive and integrative metrics may yield more reliable findings than has hitherto been the case. The interrelation of these metrics can be understood in the context of the adaptive calibration model.. © 2016 British Society for Neuroendocrinology.

Trophodynamics of the Hanna Shoal Ecosystem (Chukchi Sea, Alaska): Connecting multiple end-members to a rich food web

NASA Astrophysics Data System (ADS)

McTigue, N. D.; Dunton, K. H.

2017-10-01

Predicting how alterations in sea ice-mediated primary production will impact Arctic food webs remains a challenge in forecasting ecological responses to climate change. One top-down approach to this challenge is to elucidate trophic roles of consumers as either specialists (i.e., consumers of predominantly one food resource) or generalists (i.e., consumers of multiple food resources) to categorize the dependence of consumers on each primary producer. At Hanna Shoal in the Chukchi Sea, Alaska, we used stable carbon and nitrogen isotope data to quantify trophic redundancy with standard ellipse areas at both the species and trophic guild levels. We also investigated species-level trophic plasticity by analyzing the varying extents that three end-members were assimilated by the food web using the mixing model simmr (Stable Isotope Mixing Model in R). Our results showed that ice algae, a combined phytoplankton and sediment organic matter composite (PSOM), and a hypothesized microphytobenthos (MPB) component were incorporated by consumers in the benthic food web, but their importance varied by species. Some primary consumers relied heavily on PSOM (e.g, the amphipods Ampelisca sp. and Byblis sp.; the copepod Calanus sp.), while others exhibited generalist feeding and obtained nutrition from multiple sources (e.g., the holothuroidean Ocnus glacialis, the gastropod Tachyrhynchus sp., the sipunculid Golfingia margaritacea, and the bivalves Ennucula tenuis, Nuculana pernula, Macoma sp., and Yoldia hyperborea). Most higher trophic level benthic predators, including the gastropods Buccinum sp., Cryptonatica affinis, and Neptunea sp, the seastar Leptasterias groenlandica, and the amphipod Anonyx sp. also exhibited trophic plasticity by coupling energy pathways from multiple primary producers including PSOM, ice algae, and MPB. Our stable isotope data indicate that consumers in the Hanna Shoal food web exhibit considerable trophic redundancy, while few species were specialists and assimilated only one end-member. Although most consumers were capable of obtaining nutrition from multiple food sources, the timing, quantity, and quality of ice-mediated primary production may still have pronounced effects on food web structure.

Multiple Intelligences: Current Trends in Assessment

ERIC Educational Resources Information Center

Harman, Marsha J.; Kordinak, S. Thomas; Bruce, A. Jerry

2009-01-01

With his theory of multiple intelligences, Howard Gardner challenged the presumption that intelligence is a single innate entity. He maintained that multiple intelligences exist and are related to specific brain areas and symbol systems. Each of the intelligences has its merits and limits, but by using a multiple intelligences approach, more…

Identifying the Multiple Intelligences of Your Students

ERIC Educational Resources Information Center

McClellan, Joyce A.; Conti, Gary J.

2008-01-01

One way of addressing individual differences among adult learners is to identify the Multiple Intelligences of the learner. Multiple Intelligences refers to the concept developed by Howard Gardner that challenges the traditional view of intelligence and explains the presence of nine different Multiple Intelligences. The purpose of this study was…

Teaching Thinking Skills in Context-Based Learning: Teachers' Challenges and Assessment Knowledge

NASA Astrophysics Data System (ADS)

Avargil, Shirly; Herscovitz, Orit; Dori, Yehudit Judy

2012-04-01

For an educational reform to succeed, teachers need to adjust their perceptions to the reform's new curricula and strategies and cope with new content, as well as new teaching and assessment strategies. Developing students' scientific literacy through context-based chemistry and higher order thinking skills was the framework for establishing a new chemistry curriculum for Israeli high school students. As part of this endeavor, we developed the Taste of Chemistry module, which focuses on context-based chemistry, chemical understanding, and higher order thinking skills. Our research objectives were (a) to identify the challenges and difficulties chemistry teachers faced, as well as the advantages they found, while teaching and assessing the Taste of Chemistry module; and (b) to investigate how they coped with teaching and assessing thinking skills that include analyzing data from graphs and tables, transferring between multiple representations and, transferring between chemistry understanding levels. Research participants included eight teachers who taught the module. Research tools included interviews, classroom observations, teachers-designed students' assignments, and developers-designed students' assignments. We documented different challenges teachers had faced while teaching the module and found that the teachers developed different ways of coping with these challenges. Developing teachers' assessment knowledge (AK) was found to be the highest stage in teachers' professional growth, building on teachers' content knowledge (CK), pedagogy knowledge (PK), and pedagogical-content knowledge (PCK). We propose the use of assignments designed by teachers as an instrument for determining their professional growth.

Group selection for adaptation to multiple-hen cages: humoral immune response.

PubMed

Hester, P Y; Muir, W M; Craig, J V

1996-11-01

A selected line of White Leghorns, which has shown improved survivability and reduced feather loss in large multiple-hen cages, was evaluated for humoral immune response to SRBC under both stressed and unstressed conditions. Three lines of chickens (selected, control, and commercial) were housed in either single- (1 hen) or multiple-hen cages (12 hens, social competition) and subjected to a cold ambient temperature (0 C) at 33 wk of age and to two heating episodes (38 C) at 44 wk of age. Each hen was challenged intravenously with 1 mL of a 7% saline suspension of SRBC at the time that cold exposure was initiated. Hens subjected to high ambient temperatures had been exposed previously to a cold temperature, but were not challenged with SRBC until 16 to 18 h following the end of the second heating episode. Exposure to cold caused immunosuppression in single-caged hens, but not in hens in colony cages. Single- vs colony-caged hens of the control environment challenged with SRBC at 33 wk of age had similar primary hemagglutinin responses to SRBC. Hens subjected to heat experienced immunosuppression at 9 and 12 d following challenge to SRBC when compared to the controls. Hens of multiple-bird cages challenged with antigen at 44 wk of age had a significantly lower hemagglutinin response to SRBC than those reared in single-bird cages. The three lines of genetic stock had similar primary hemagglutinin responses to SRBC; the interactions of genetic stock with cage size or environmental temperature were not significant. It was concluded that genetically selecting hens for survival in multiple-hen cages did not affect their humoral immune response to SRBC.

Participant recruitment from minority religious groups: the case of the Islamic population in South Australia.

PubMed

Mohammadi, N; Jones, T; Evans, D

2008-12-01

Participant recruitment is a fundamental component of the research process and the methods employed to attract individuals will depend on the nature of the study. Recruitment may be more challenging when the study involves people from a minority religious group. However, this issue has not been well addressed in the literature. To discuss the challenges of recruiting participants from a minority religious group (the Islamic population) to participate in an interpretive, hermeneutic study concerning the experience of hospitalization. The challenges of recruitment encountered during this study are used as the basis for a broader discussion of this important issue. To ensure the success of this phase of the study, a pre-planned recruitment strategy was essential. Multiple recruitment strategies were used, including hospital-based recruitment, snowball sampling, advertising and contact with key people. Despite the use of multiple strategies, recruitment of participants was difficult and required an extended period of time to achieve sufficiently rich data. Thirteen participants shared their lived experience to provide an in-depth understanding of the phenomenon. Recruiting participants from minority religious group involves potentially sensitive issues. There is an increased need for the researchers to carefully consider potential participants' rights and ensure that sound ethical principles underpin the study, as failure to do this may hinder the recruitment process. The two most effective strategies of recruitment were snowball sampling and contact with key Islamic people, with the least effective being advertising. This paper highlights the importance of anticipating potential difficulties and pre-planning strategies to overcome barriers to recruitment. Implementation of multiple strategies is recommended to ensure successful research recruitment.

DREAM: Distributed Resources for the Earth System Grid Federation (ESGF) Advanced Management

NASA Astrophysics Data System (ADS)

Williams, D. N.

2015-12-01

The data associated with climate research is often generated, accessed, stored, and analyzed on a mix of unique platforms. The volume, variety, velocity, and veracity of this data creates unique challenges as climate research attempts to move beyond stand-alone platforms to a system that truly integrates dispersed resources. Today, sharing data across multiple facilities is often a challenge due to the large variance in supporting infrastructures. This results in data being accessed and downloaded many times, which requires significant amounts of resources, places a heavy analytic development burden on the end users, and mismanaged resources. Working across U.S. federal agencies, international agencies, and multiple worldwide data centers, and spanning seven international network organizations, the Earth System Grid Federation (ESGF) has begun to solve this problem. Its architecture employs a system of geographically distributed peer nodes that are independently administered yet united by common federation protocols and application programming interfaces. However, significant challenges remain, including workflow provenance, modular and flexible deployment, scalability of a diverse set of computational resources, and more. Expanding on the existing ESGF, the Distributed Resources for the Earth System Grid Federation Advanced Management (DREAM) will ensure that the access, storage, movement, and analysis of the large quantities of data that are processed and produced by diverse science projects can be dynamically distributed with proper resource management. This system will enable data from an infinite number of diverse sources to be organized and accessed from anywhere on any device (including mobile platforms). The approach offers a powerful roadmap for the creation and integration of a unified knowledge base of an entire ecosystem, including its many geophysical, geographical, social, political, agricultural, energy, transportation, and cyber aspects. The resulting aggregation of data combined with analytics services has the potential to generate an informational universe and knowledge system of unprecedented size and value to the scientific community, downstream applications, decision makers, and the public.

New approaches to merging multi-sensor satellite measurements of volcanic SO2 emissions

NASA Astrophysics Data System (ADS)

Carn, S. A.; Telling, J. W.; Krotkov, N. A.

2015-12-01

As part of the NASA MEaSUREs program, we are developing a unique long-term database of volcanic sulfur dioxide (SO2) emissions for use by the scientific community, using observations from multiple satellite instruments collected since 1978. Challenges to creating such a database include assessing data continuity between multiple satellite missions and SO2 retrieval algorithms and estimating measurement uncertainties. Here, we describe the approaches that we are using to merge multi-decadal SO2 measurements from the ultraviolet (UV) Total Ozone Mapping Spectrometer (TOMS), Ozone Monitoring Instrument (OMI) and Ozone Monitoring and Profiler Suite (OMPS) sensors. A particular challenge has involved accounting for the OMI row anomaly (ORA), a data gap in OMI measurements since 2008 that partially or wholly obscures some volcanic eruption clouds, whilst still profiting from the high OMI spatial resolution and data quality, and prior OMI SO2 validation. We present a new method to substitute missing SO2 information in the ORA with near-coincident SO2 data from OMPS, providing improved estimates of eruptive volcanic SO2 emissions. The technique can also be used to assess consistency between different satellite instruments and SO2 retrieval algorithms, investigate the impact of variable sensor spatial resolution, and estimate measurement uncertainties. It is particularly effective for larger eruptions producing extensive SO2 clouds where the ORA obscures the volcanic plume in multiple contiguous orbits. Application of the technique is demonstrated using recent volcanic eruptions including the 2015 eruption of Calbuco, Chile. We also provide an update on the status of the multi-satellite long-term volcanic SO2 database (MSVOLSO2L4).

Materials for Space: It's Challenging!

NASA Technical Reports Server (NTRS)

Johnson, Sylvia M.

2016-01-01

Space environments place tremendous demands on materials that must perform with exceptional reliability to realize the goals of human or robotic space exploration missions. Materials are subjected to extremes of temperature, pressure, radiation and mechanical loads during all phases of use, including takeoff and ascent, exposure to space or entry into an atmosphere, and operation in a planetary atmosphere. Space materials must be robust and enable the formation of lightweight structures or components that perform the required functions; materials that perform multiple functions are of particular interest. This talk will review the unique challenges for materials in space and some of the specific material capabilities that will be needed for future exploration missions. A description of needs and trends in thermal protection materials and systems will complete the talk.

Diagnostic and surgical challenge: middle ear dermoid cyst in 12 month old with branchio-oto-renal syndrome and multiple middle-ear congenital anomalies.

PubMed

Johnston, D R; Whittemore, K; Poe, D; Robson, C D; Perez-Atayde, A R

2011-10-01

Described is the first case report, to our knowledge, of a middle-ear dermoid in a child with branchio-oto-renal (BOR) syndrome. Radiographic, pathologic, and intraoperative figures are shown. This was a diagnostic and surgical challenge as the presentation was similar to a congenital cholesteatoma and the child had numerous significant temporal bone abnormalities. After the intraoperative findings suggested a non-destructive process, the treatment strategy was altered. This case reiterates the need for a cautious, flexible operative approach in a syndromic child. Included is a relevant review of the literature and a detailed clinical analysis. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Big Data Analytics Solutions: The Implementation Challenges in the Financial Services Industry

ERIC Educational Resources Information Center

Ojo, Michael O.

2016-01-01

The challenges of Big Data (BD) and Big Data Analytics (BDA) have attracted disproportionately less attention than the overwhelmingly espoused benefits and game-changing promises. While many studies have examined BD challenges across multiple industry verticals, very few have focused on the challenges of implementing BDA solutions. Fewer of these…

A reflective teaching challenge to motivate educational innovation.

PubMed

Edwards, Roger A; Kirwin, Jennifer; Gonyeau, Michael; Matthews, S James; Lancaster, Jason; DiVall, Margarita

2014-06-17

To describe a teaching challenge intended to increase faculty use of evidence-based and student-centered instructional strategies in the demanding school of pharmacy context with technology-savvy students. A teaching challenge was created that required faculty members to incorporate a "new-to-you" innovative teaching method in a class, course, or experiential activity. The method was linked to at least 1 of 7 evidence-based principles for effective teaching. Faculty members were exposed to colleagues' teaching strategies via brief voluntary presentations at department meetings. A post-challenge survey provided assessment data about the challenge. Responses to a baseline survey provided additional information about what faculty members were already doing (52% response rate). Eighty-one percent of faculty respondents completed the challenge. A wide array of new strategies (13 categories such as flipped classrooms and social media) was implemented and 75% included the use of technology. Nearly all respondents (96%) thought that participation in the challenge was worth the effort and planned to participate again the following year. All faculty members intended to continue using their new strategy and 56% planned additional modifications with future implementations. The challenge demonstrated how multiple goals of curricular improvement, faculty development, and student-centered instruction could be achieved together. The teaching challenge motivated most of the faculty members to try something new to them. Links between evidence-based principles and day-to-day activities were strengthened. The new-to-you design placed the challenge within reach of faculty members regardless of their background, subject, or experience.

A Cascaded Self-Similar Rat-Race Hybrid Coupler Architecture and its Compact Ka-Band Implementation

DTIC Science & Technology

2017-03-01

real-estate and limit the system-level performance, including bandwidth, gain, and energy - efficiency. These many challenges are positioning passive...and are used in numerous RF/mm-wave systems for radar and wireless communications. Although a Marchand balun covers a large bandwidth, it is...requires multiple λ/4 transmission lines (t-lines), making its on-chip designs very costly even for RF/mm-wave bands. Reported miniaturized rat-race

Evaluating Continuing Nursing Education: A Qualitative Study of Intention to Change Practice and Perceived Barriers to Knowledge Translation.

PubMed

Wellings, Cynthea A; Gendek, Marilyn A; Gallagher, Silvia E

Evaluating the effectiveness of continuing nursing education does not always include behavioral change and patient health outcomes. A qualitative analysis of open-ended evaluation questions from continuing nursing education activities was conducted. The aim was to evaluate learners' intentions to change their practice resulting from their learning and their perceived barriers to implementing practice changes. Results revealed the multiple, interconnected challenges involved in translating new learning into practice.

Implementing a Nurse Manager Profile to Improve Unit Performance.

PubMed

Krugman, Mary E; Sanders, Carolyn L

2016-06-01

Nurse managers face significant pressures in the rapidly changing healthcare environment. Staying current with multiple sources of data, including reports that detail institutional and unit performance outcomes, is particularly challenging. A Nurse Manager Customized Profile was developed at a western academic hospital to provide a 1-page visual of pertinent data to help managers and director supervisors focus coaching to improve unit performance. Use of the Decisional Involvement Scale provided new insights into measuring manager performance.

Case Report: Perioperative management of a pregnant poly trauma patient for spine fixation surgery.

PubMed

Vandse, Rashmi; Cook, Meghan; Bergese, Sergio

2015-01-01

Trauma is estimated to complicate approximately one in twelve pregnancies, and is currently a leading non-obstetric cause of maternal death. Pregnant trauma patients requiring non-obstetric surgery pose a number of challenges for anesthesiologists. Here we present the successful perioperative management of a pregnant trauma patient with multiple injuries including occult pneumothorax who underwent T9 to L1 fusion in prone position, and address the pertinent perioperative anesthetic considerations and management.

The Chandra X-ray Center data system: supporting the mission of the Chandra X-ray Observatory

NASA Astrophysics Data System (ADS)

Evans, Janet D.; Cresitello-Dittmar, Mark; Doe, Stephen; Evans, Ian; Fabbiano, Giuseppina; Germain, Gregg; Glotfelty, Kenny; Hall, Diane; Plummer, David; Zografou, Panagoula

2006-06-01

The Chandra X-ray Center Data System provides end-to-end scientific software support for Chandra X-ray Observatory mission operations. The data system includes the following components: (1) observers' science proposal planning tools; (2) science mission planning tools; (3) science data processing, monitoring, and trending pipelines and tools; and (4) data archive and database management. A subset of the science data processing component is ported to multiple platforms and distributed to end-users as a portable data analysis package. Web-based user tools are also available for data archive search and retrieval. We describe the overall architecture of the data system and its component pieces, and consider the design choices and their impacts on maintainability. We discuss the many challenges involved in maintaining a large, mission-critical software system with limited resources. These challenges include managing continually changing software requirements and ensuring the integrity of the data system and resulting data products while being highly responsive to the needs of the project. We describe our use of COTS and OTS software at the subsystem and component levels, our methods for managing multiple release builds, and adapting a large code base to new hardware and software platforms. We review our experiences during the life of the mission so-far, and our approaches for keeping a small, but highly talented, development team engaged during the maintenance phase of a mission.

MO-D-BRC-04: Multiple-Criteria Optimization Planning

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

Donaghue, J.

Treatment planning is a central part of radiation therapy, including delineation in tumor volumes and critical organs, setting treatment goals of prescription doses to the tumor targets and tolerance doses to the critical organs, and finally generation of treatment plans to meet the treatment goals. National groups like RTOG have led the effort to standardize treatment goals of the prescription doses to the tumor targets and tolerance doses to the critical organs based on accumulated knowledge from decades of abundant clinical trial experience. The challenge for each clinical department is how to achieve or surpass these set goals within themore » time constraints of clinical practice. Using fifteen testing cases from different treatment sites such as head and neck, prostate with and without pelvic lymph nodes, SBRT spine, we will present clinically utility of advanced planning tools, including knowledge based, automatic based, and multiple criteria based tools that are clinically implemented. The objectives of this session are: Understand differences among these three advanced planning tools Provide clinical assessments on the utility of the advanced planning tools Discuss clinical challenges of treatment planning with large variations in tumor volumes and their relationships with adjacent critical organs. Ping Xia received research grant from Philips. Jackie Wu received research grant from Varian; P. Xia, Research support by Philips and Varian; Q. Wu, NIH, Varian Medical.« less

Assessing interactions among multiple physiological systems during walking outside a laboratory: An Android based gait monitor

PubMed Central

Sejdić, E.; Millecamps, A.; Teoli, J.; Rothfuss, M. A.; Franconi, N. G.; Perera, S.; Jones, A. K.; Brach, J. S.; Mickle, M. H.

2015-01-01

Gait function is traditionally assessed using well-lit, unobstructed walkways with minimal distractions. In patients with subclinical physiological abnormalities, these conditions may not provide enough stress on their ability to adapt to walking. The introduction of challenging walking conditions in gait can induce responses in physiological systems in addition to the locomotor system. There is a need for a device that is capable of monitoring multiple physiological systems in various walking conditions. To address this need, an Android-based gait-monitoring device was developed that enabled the recording of a patient's physiological systems during walking. The gait-monitoring device was tested during self-regulated overground walking sessions of fifteen healthy subjects that included 6 females and 9 males aged 18 to 35 years. The gait-monitoring device measures the patient's stride interval, acceleration, electrocardiogram, skin conductance and respiratory rate. The data is stored on an Android phone and is analyzed offline through the extraction of features in the time, frequency and time-frequency domains. The analysis of the data depicted multisystem physiological interactions during overground walking in healthy subjects. These interactions included locomotion-electrodermal, locomotion-respiratory and cardiolocomotion couplings. The current results depicting strong interactions between the locomotion system and the other considered systems (i.e., electrodermal, respiratory and cardivascular systems) warrant further investigation into multisystem interactions during walking, particularly in challenging walking conditions with older adults. PMID:26390946

Knowledge, data and interests: Challenges in participation of diverse stakeholders in HIA

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

Negev, Maya, E-mail: negevm@bgu.ac.il

2012-02-15

Stakeholder participation is considered an integral part of HIA. However, the challenges that participation implies in a multi-disciplinary and multi-ethnic society are less studied. This paper presents the manifestations of the multiplicity of sectors and population groups in HIA and discusses the challenges that such diversity imposes. Specifically, there is no common ground between participants, as their positions entail contradictory knowledge regarding the current situation, reliance on distinct data and conflicting interests. This entails usage of multiple professional and ethnic languages, disagreements regarding the definition of health and prioritizing health issues in HIA, and divergent perceptions of risk. These differencesmore » between participants are embedded culturally, socially, individually and, maybe most importantly, professionally. This complex picture of diverse stakeholder attributes is grounded in a case study of stakeholder participation in HIA, regarding zoning of a hazardous industry site in Israel. The implication is that participatory HIAs should address the multiplicity of stakeholders and types of knowledge, data and interests in a more comprehensive way. - Highlights: Black-Right-Pointing-Pointer This paper analyses challenges in participation of diverse stakeholders in HIA. Black-Right-Pointing-Pointer The multiplicity of disciplines and population groups raises fundamental challenges. Black-Right-Pointing-Pointer Stakeholders possess distinct and often contradictory knowledge, data and interests. Black-Right-Pointing-Pointer They speak different languages, and differ on approaches to health and risk perceptions. Black-Right-Pointing-Pointer Substantial amendments to diverse participation are needed, in HIA and generally.« less

A Multiple Case Study of Challenges and Successes Experienced by Founders and Directors of Nature-Based Preschools in the United States

ERIC Educational Resources Information Center

Barnett, Alexandra Michaela

2016-01-01

Nature-based preschools are defined as educational settings in which children spend three or more hours per school day in natural environments such as woods, meadows, and beaches (Knight, 2013). The purpose of this qualitative, multiple case study was to obtain a deep understanding of the challenges and successes of nature-based preschool (NBP)…

Challenges for health care providers, parents and patients who face a child hood cancer diagnosis in Zambia.

PubMed

Walubita, Mulima; Sikateyo, Bornwell; Zulu, Joseph M

2018-05-02

Zambia is experiencing high prevalence of childhood cancer. However, very few children access and complete treatment for cancer. This study aimed to document the challenges for health care providers, parents and patients who face a child hood cancer diagnosis in Zambia, and their coping strategies. This was an exploratory health facility-based qualitative study that was conducted at a Paediatric oncology ward at referral hospital in Zambia. In-depth individual interviews conducted with fifteen (15) caregivers and seven (7) key informants were analysed using thematic analysis. Several challenges related to managing the childhood cancer diagnosis were recorded. Individual and family challenges were inadequate knowledge on childhood cancer, lack of finances to meet treatment and transport costs as well as long period of hospitalisation that affected women's ability to perform multiple responsibilities. Whereas challenges at community level were inadequate support to address emotional and physical distress and social stigmatisation experienced by caregivers. Health systems issues included inadequate specialised health workers, poor communication among health workers, limited space and beds as well as insufficient supplies such as blood. Cultural related factors were the belief that cancer is a product of witchcraft as well as religious beliefs regarding the role of faith healing in childhood cancer treatment. Coping strategies used by parents/ caregivers included praying to God, material support from organisations and church as well as delaying having another child. Addressing the challenges for health care providers, parents and patients who face a childhood cancer diagnosis may require adopting a systems or an ecological approach that allows developing strategies that simultaneously address challenges related to the individual, family, community, health system and cultural aspects.

The Changing Landscape of Genetic Testing for Inherited Breast Cancer Predisposition.

PubMed

Afghahi, Anosheh; Kurian, Allison W

2017-05-01

The advent of multiple-gene germline panel testing has led to significant advances in hereditary breast and ovarian cancer risk assessment. These include guideline-specific cancer risk management recommendations for patients and their families, such as screening with breast magnetic resonance imaging and risk-reducing surgeries, which have the potential to reduce substantially the morbidity and mortality associated with a hereditary cancer predisposition. However, controversy remains about the clinical validity and actionability of genetic testing in a broader patient population. We discuss events leading to the wider availability of commercialized multiple-gene germline panel testing, the recent data that support using this powerful tool to improve cancer risk assessment and reduction strategies, and remaining challenges to clinical optimization of this new genetic technology.

O-GlcNAcylation in Cancer Biology: Linking Metabolism and Signaling.

PubMed

Ferrer, Christina M; Sodi, Valerie L; Reginato, Mauricio J

2016-08-14

The hexosamine biosynthetic pathway (HBP) is highly dependent on multiple metabolic nutrients including glucose, glutamine, and acetyl-CoA. Increased flux through HBP leads to elevated post-translational addition of β-D-N-acetylglucosamine sugars to nuclear and cytoplasmic proteins. Increased total O-GlcNAcylation is emerging as a general characteristic of cancer cells, and recent studies suggest that O-GlcNAcylation is a central communicator of nutritional status to control key signaling and metabolic pathways that regulate multiple cancer cell phenotypes. This review summarizes our current understanding of changes of O-GlcNAc cycling enzymes in cancer, the role of O-GlcNAcylation in tumorigenesis, and the current challenges in targeting this pathway therapeutically. Copyright © 2016 Elsevier Ltd. All rights reserved.

Data-driven analysis of functional brain interactions during free listening to music and speech.

PubMed

Fang, Jun; Hu, Xintao; Han, Junwei; Jiang, Xi; Zhu, Dajiang; Guo, Lei; Liu, Tianming

2015-06-01

Natural stimulus functional magnetic resonance imaging (N-fMRI) such as fMRI acquired when participants were watching video streams or listening to audio streams has been increasingly used to investigate functional mechanisms of the human brain in recent years. One of the fundamental challenges in functional brain mapping based on N-fMRI is to model the brain's functional responses to continuous, naturalistic and dynamic natural stimuli. To address this challenge, in this paper we present a data-driven approach to exploring functional interactions in the human brain during free listening to music and speech streams. Specifically, we model the brain responses using N-fMRI by measuring the functional interactions on large-scale brain networks with intrinsically established structural correspondence, and perform music and speech classification tasks to guide the systematic identification of consistent and discriminative functional interactions when multiple subjects were listening music and speech in multiple categories. The underlying premise is that the functional interactions derived from N-fMRI data of multiple subjects should exhibit both consistency and discriminability. Our experimental results show that a variety of brain systems including attention, memory, auditory/language, emotion, and action networks are among the most relevant brain systems involved in classic music, pop music and speech differentiation. Our study provides an alternative approach to investigating the human brain's mechanism in comprehension of complex natural music and speech.

AMCP Partnership Forum: Biosimilars--Ready, Set, Launch.

PubMed

2016-04-01

Through 2020, reference biologic products will lose patent protection that will be worth $54 billion to the U.S. economy. Consequently, interest in biosimilars is intensifying across the health care industry. Managed care organizations (MCOs) are depending on the savings opportunity that bio-similars promise. After the first FDA approval of a biosimilar in March 2015, the Academy of Managed Care Pharmacy (AMCP) convened a biosimilar Partnership Forum on June 10-11, 2015. The goal of this forum was to address current readiness of MCOs to optimize biosimilars; identify gaps, challenges, and opportunities with regard to biosimilars; and recommend education and training content to help AMCP best meet the needs of its members and stakeholders. The forum brought together multiple stakeholders from MCOs, pharmacy benefit managers, specialty pharmacies, integrated delivery networks, federal government and standards setting organizations, consumer advocacy groups, and the pharmaceutical industry. Through a series of 4 one-hour webinars and a 1.5-day live workgroup session, participants identified current challenges and readiness issues in addressing biosimilars. These challenges included lack of a consolidated educational strategy for incorporating biosimilars into the clinical decision-making process; deficiencies in current levels of federal (e.g., the FDA) or state (e.g., departments of insurance) guidance; limited intelligence on pricing strategies and consideration of stakeholder contracting alignment and risk sharing; and operational implementation issues. Participants identified necessary tactics for executing a successful bio-similar strategy. These tactics included creating a broad multiple stakeholder coalition to support educational efforts to gain public, provider, and other stakeholder acceptance; aligning utilization incentives through reimbursement policies and programs; encouraging benefit design and stakeholder collaboration; advancing the coding and technology infrastructure to support operations, contracting, billing, reimbursement, and reporting needs; and having appropriate active surveillance mechanisms to enable assessment of the clinical performance of biosimilars and their innovator products. Participants recommended guidance for AMCP to optimally support its membership and stakeholders with educational and training programs at multiple venues; a platform for regular communications and updates; and advocacy, community promotion, and education. The AMCP Partnership Forum entitled "Biosimilars-Ready, Set, Launch" and the development of this report were supported by Abbvie, Amgen, Apotex, Boehringer, Merck, Momenta, and Sandoz.

Aspirin challenge and desensitization: how, when and why.

PubMed

Cortellini, Gabriele; Caruso, Cristiano; Romano, Antonino

2017-08-01

To investigate the current approach to aspirin challenge (drug provocation) and/or desensitization in patients with histories of hypersensitivity reactions to it, particularly in those with cardiovascular diseases. The literature indicates that patients with coronary artery disease (CAD), including those with an acute coronary syndrome, may safely undergo low-dose aspirin challenge and/or desensitization. Recently, flowcharts regarding challenge/desensitization procedures with aspirin in patients with CAD and histories of aspirin hypersensitivity reactions have become available. Aspirin desensitization and continuous aspirin therapy constitute an effective option in patients with nonsteroidal anti-inflammatory drug-exacerbated respiratory diseases (NERD) who have suboptimally controlled asthma or rhinosinusitis, or require multiple revision polypectomies. The use of aspirin has proven to reduce morbidity and mortality associated with CAD. There is a general consensus on aspirin's effectiveness in secondary prevention of CAD. Therefore, aspirin desensitization is necessary in patients with CAD and histories of hypersensitivity reactions to it. The effectiveness of aspirin desensitization and continuous therapy in patients with NERD has been shown in numerous studies. However, shared selection criteria of candidates for aspirin challenge/desensitization procedures, and simple and homogeneous protocols are necessary. Moreover, preventive safety measures are still needed in order to reduce the potential risks of these procedures.

Training direct care staff to increase positive interactions with individuals with developmental disabilities.

PubMed

Zoder-Martell, Kimberly A; Dufrene, Brad A; Tingstrom, Daniel H; Olmi, D Joe; Jordan, Sara S; Biskie, Erika M; Sherman, Julie C

2014-09-01

This study tested the effects of direct training on direct care staff's initiation of positive interactions with individuals with developmental disabilities who resided in an intermediate care facility. Participants included four direct care staff and their residents. Direct training included real-time prompts delivered via a one-way radio, and data were collected for immediate and sustained increases in rates of direct care staff's positive interactions. Additionally, this study evaluated the link between increased rates of positive interactions and concomitant decreases in residents' challenging behaviors. A multiple baseline design across participants was used and results indicated that all direct care staff increased their rates of positive interactions during direct training. Moreover, all but one participant continued to engage residents in positive interactions at levels above the criterion during the maintenance phase and follow-up phases. The direct care staff member who did not initially meet the criterion improved to adequate levels following one brief performance feedback session. With regard to residents' challenging behaviors, across phases, residents engaged in low levels of challenging behaviors making those results difficult to evaluate. However, improvements in residents' rate of positive interactions were noted. Copyright © 2014 Elsevier Ltd. All rights reserved.

Ethical considerations in pediatric neurology.

PubMed

Ronen, Gabriel M; Dan, Bernard

2013-01-01

The practice of pediatric neurology demands a high level of responsibility at multiple levels. These include listening carefully to people's stories in order to assess each situation, planning and implementing investigations and therapies, individual and family counseling, longitudinal follow-up from fetal life throughout childhood and adolescence, organization of transition to adult care, and societal advocacy. In the 21st century these activities must be carried out in the context of major societal and technological changes which have brought about many new challenges for pediatric neurologists. In this chapter, we address ethical and moral issues that may help guide pediatric neurologists with regard to a number of specific challenges. These include physician-patient relationships that are based on benign paternalism with respect for autonomy and promoting quality of life, practicing evidence-based medicine, and the technological imperative. In addition we discuss the tension between clinical practice and research, relationships between physicians and industry, and the public role of pediatric neurologists to advocate for children with neurological and developmental conditions. We also illustrate some challenges in selected situations such as prenatal counseling (fetal neurology), neonatal encephalopathy, and persistent vegetative state. Copyright © 2013 Elsevier B.V. All rights reserved.

Identifying and overcoming implementation challenges: Experience of 59 noninstitutional long-term services and support pilot programs in the Veterans Health Administration

PubMed Central

Sullivan, Jennifer L.; Adjognon, Omonyêlé L.; Engle, Ryann L.; Shin, Marlena H.; Afable, Melissa K.; Rudin, Whitney; White, Bert; Shay, Kenneth; Lukas, Carol VanDeusen

2018-01-01

Background: From 2010 to 2013, the Department of Veterans Affairs (VA) funded a large pilot initiative to implement noninstitutional long-term services and supports (LTSS) programs to support aging Veterans. Our team evaluated implementation of 59 VA noninstitutional LTSS programs. Purpose: The specific objectives of this study are to (a) examine the challenges influencing program implementation comparing active sites that remained open and inactive sites that closed during the funding period and (b) identify ways that active sites overcame the challenges they experienced. Methodology: Key informant semistructured interviews occurred between 2011 and 2013. We conducted 217 telephone interviews over four time points. Content analysis was used to identify emergent themes. The study team met regularly to define each challenge, review all codes, and discuss discrepancies. For each follow-up interview with the sites, the list of established challenges was used as a priori themes. Emergent data were also coded. Results: The challenges affecting implementation included human resources and staffing issues, infrastructure, resources allocation and geography, referrals and marketing, leadership support, and team dynamics and processes. Programs were able to overcome challenges by communicating with team members and other areas in the organization, utilizing information technology solutions, creative use of staff and flexible schedules, and obtaining additional resources. Discussion: This study highlights several common challenges programs can address during the program implementation. The most often mentioned strategy was effective communication. Strategies also targeted several components of the organization including organizational functions and processes (e.g., importance of coordination within a team and across disciplines to provide good care), infrastructure (e.g., information technology and human resources), and program fit with priorities in the organization (e.g., leadership support). Implications: Anticipating potential pitfalls of program implementation for future noninstitutional LTSS programs can improve implementation efficiency and program sustainability. Staff at multiple levels in the organization must fully support noninstitutional LTSS programs to address these challenges. PMID:28125459

Identifying and overcoming implementation challenges: Experience of 59 noninstitutional long-term services and support pilot programs in the Veterans Health Administration.

PubMed

Sullivan, Jennifer L; Adjognon, Omonyêlé L; Engle, Ryann L; Shin, Marlena H; Afable, Melissa K; Rudin, Whitney; White, Bert; Shay, Kenneth; Lukas, Carol VanDeusen

From 2010 to 2013, the Department of Veterans Affairs (VA) funded a large pilot initiative to implement noninstitutional long-term services and supports (LTSS) programs to support aging Veterans. Our team evaluated implementation of 59 VA noninstitutional LTSS programs. The specific objectives of this study are to (a) examine the challenges influencing program implementation comparing active sites that remained open and inactive sites that closed during the funding period and (b) identify ways that active sites overcame the challenges they experienced. Key informant semistructured interviews occurred between 2011 and 2013. We conducted 217 telephone interviews over four time points. Content analysis was used to identify emergent themes. The study team met regularly to define each challenge, review all codes, and discuss discrepancies. For each follow-up interview with the sites, the list of established challenges was used as a priori themes. Emergent data were also coded. The challenges affecting implementation included human resources and staffing issues, infrastructure, resources allocation and geography, referrals and marketing, leadership support, and team dynamics and processes. Programs were able to overcome challenges by communicating with team members and other areas in the organization, utilizing information technology solutions, creative use of staff and flexible schedules, and obtaining additional resources. This study highlights several common challenges programs can address during the program implementation. The most often mentioned strategy was effective communication. Strategies also targeted several components of the organization including organizational functions and processes (e.g., importance of coordination within a team and across disciplines to provide good care), infrastructure (e.g., information technology and human resources), and program fit with priorities in the organization (e.g., leadership support). Anticipating potential pitfalls of program implementation for future noninstitutional LTSS programs can improve implementation efficiency and program sustainability. Staff at multiple levels in the organization must fully support noninstitutional LTSS programs to address these challenges.

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

Cutler, Dylan; Frank, Stephen; Slovensky, Michelle

Rich, well-organized building performance and energy consumption data enable a host of analytic capabilities for building owners and operators, from basic energy benchmarking to detailed fault detection and system optimization. Unfortunately, data integration for building control systems is challenging and costly in any setting. Large portfolios of buildings--campuses, cities, and corporate portfolios--experience these integration challenges most acutely. These large portfolios often have a wide array of control systems, including multiple vendors and nonstandard communication protocols. They typically have complex information technology (IT) networks and cybersecurity requirements and may integrate distributed energy resources into their infrastructure. Although the challenges are significant,more » the integration of control system data has the potential to provide proportionally greater value for these organizations through portfolio-scale analytics, comprehensive demand management, and asset performance visibility. As a large research campus, the National Renewable Energy Laboratory (NREL) experiences significant data integration challenges. To meet them, NREL has developed an architecture for effective data collection, integration, and analysis, providing a comprehensive view of data integration based on functional layers. The architecture is being evaluated on the NREL campus through deployment of three pilot implementations.« less

Complex systems thinking in emergency medicine: A novel paradigm for a rapidly changing and interconnected health care landscape.

PubMed

Widmer, Matthew A; Swanson, R Chad; Zink, Brian J; Pines, Jesse M

2017-12-27

The specialty of emergency medicine is experiencing the convergence of a number of transformational forces in the United States, including health care reform, technological advancements, and societal shifts. These bring both opportunity and uncertainty. 21ST CENTURY CHALLENGES: Persistent challenges such as the opioid epidemic, rising health care costs, misaligned incentives, patients with multiple chronic diseases, and emergency department crowding continue to plague the acute, unscheduled care system. The traditional approach to health care practice and improvement-reductionism-is not adequate for the complexity of the twenty-first century. Reductionist thinking will likely continue to produce unintended consequences and suboptimal outcomes. Complex systems thinking provides a perspective and set of tools better suited for the challenges and opportunities facing public health in general, and emergency medicine more specifically. This article introduces complex systems thinking and argues for its application in the context of emergency medicine by drawing on the history of the circumstances surrounding the formation of the specialty and by providing examples of its application to several practice challenges. © 2017 John Wiley & Sons, Ltd.

Towards a Rigorous Assessment of Systems Biology Models: The DREAM3 Challenges

PubMed Central

Prill, Robert J.; Marbach, Daniel; Saez-Rodriguez, Julio; Sorger, Peter K.; Alexopoulos, Leonidas G.; Xue, Xiaowei; Clarke, Neil D.; Altan-Bonnet, Gregoire; Stolovitzky, Gustavo

2010-01-01

Background Systems biology has embraced computational modeling in response to the quantitative nature and increasing scale of contemporary data sets. The onslaught of data is accelerating as molecular profiling technology evolves. The Dialogue for Reverse Engineering Assessments and Methods (DREAM) is a community effort to catalyze discussion about the design, application, and assessment of systems biology models through annual reverse-engineering challenges. Methodology and Principal Findings We describe our assessments of the four challenges associated with the third DREAM conference which came to be known as the DREAM3 challenges: signaling cascade identification, signaling response prediction, gene expression prediction, and the DREAM3 in silico network challenge. The challenges, based on anonymized data sets, tested participants in network inference and prediction of measurements. Forty teams submitted 413 predicted networks and measurement test sets. Overall, a handful of best-performer teams were identified, while a majority of teams made predictions that were equivalent to random. Counterintuitively, combining the predictions of multiple teams (including the weaker teams) can in some cases improve predictive power beyond that of any single method. Conclusions DREAM provides valuable feedback to practitioners of systems biology modeling. Lessons learned from the predictions of the community provide much-needed context for interpreting claims of efficacy of algorithms described in the scientific literature. PMID:20186320

Patient-Reported Outcome and Observer-Reported Outcome Assessment in Rare Disease Clinical Trials: An ISPOR COA Emerging Good Practices Task Force Report.

PubMed

Benjamin, Katy; Vernon, Margaret K; Patrick, Donald L; Perfetto, Eleanor; Nestler-Parr, Sandra; Burke, Laurie

Rare diseases (RDs) affect a small number of people within a population. About 5000 to 8000 distinct RDs have been identified, with an estimated 6% to 8% of people worldwide suffering from an RD. Approximately 75% of RDs affect children. Frequently, these conditions are heterogeneous; many are progressive. Regulatory incentives have increased orphan drug designations and approvals. To develop emerging good practices for RD outcomes research addressing the challenges inherent in identifying, selecting, developing, adapting, and implementing patient-reported outcome (PRO) and observer-reported outcome (ObsRO) assessments for use in RD clinical trials. This report outlines the challenges and potential solutions in determining clinical outcomes for RD trials. It follows the US Food and Drug Administration Roadmap to Patient-Focused Outcome Measurement in Clinical Trials. The Roadmap consists of three columns: 1) Understanding the Disease or Condition, 2) Conceptualizing Treatment Benefit, and 3) Selecting/Developing the Outcome Measure. Challenges in column 1 include factors such as incomplete natural history data and heterogeneity of disease presentation and patient experience. Solutions include using several information sources, for example, clinical experts and patient advocacy groups, to construct the condition's natural history and understand treatment patterns. Challenges in column 2 include understanding and measuring treatment benefit from the patient's perspective, especially given challenges in defining the context of use such as variations in age or disease severity/progression. Solutions include focusing on common symptoms across patient subgroups, identifying short-term outcomes, and using multiple types of COA instruments to measure the same constructs. Challenges in column 3 center around the small patient population and heterogeneity of the condition or study sample. Few disease-specific instruments for RDs exist. Strategies include adapting existing instruments developed for a similar condition or that contain symptoms of importance to the RD patient population, or using a generic instrument validated for the context of use. This report provides state-of-the-art solutions to patient-reported outcome (PRO) and observer-reported outcome (ObsRO) assessments challenges in clinical trials of patients with RDs. These recommended solutions are both pragmatic and creative and posed with clear recognition of the global regulatory context used in RD clinical development programs. Copyright © 2017. Published by Elsevier Inc.

Late diagnosis of multiple myeloma: a case report

NASA Astrophysics Data System (ADS)

Syahreza, A.; Gatot, D.; Mardia, A. I.

2018-03-01

Multiple myeloma is a challenging hematologic case to handle. Sometimes the disease is diagnosed too late for the patient and doctor. Therefore, careful approaches are needed to manage the patient. A 66-year-old mansuffersfrom low back pain since one year before he came to the hospital. He was diagnosed multiple compression fractures by orthopedic and had undergone two surgeries in one year. Punched out lesions werein skull radiology and lumbar compression in lumbar MRI. After further investigation, plasmacytoma and M protein in urine electrophoresis were founded. Significant improvement found after bortezomib and dexamethasone were given.Diagnosis and management of multiple myeloma is a challenge for a doctor. Systematically approach is needed for a patient with a recurrent fracture. Even a novel therapies are not widely available in our country.We reported a late diagnosis of multiple myeloma and had a significant improvement after bortezomib and dexamethasone therapy.

The rank-heat plot is a novel way to present the results from a network meta-analysis including multiple outcomes.

PubMed

Veroniki, Areti Angeliki; Straus, Sharon E; Fyraridis, Alexandros; Tricco, Andrea C

2016-08-01

To present a novel and simple graphical approach to improve the presentation of the treatment ranking in a network meta-analysis (NMA) including multiple outcomes. NMA simultaneously compares many relevant interventions for a clinical condition from a network of trials, and allows ranking of the effectiveness and/or safety of each intervention. There are numerous ways to present the NMA results, which can challenge their interpretation by research users. The rank-heat plot is a novel graph that can be used to quickly recognize which interventions are most likely the best or worst interventions with respect to their effectiveness and/or safety for a single or multiple outcome(s) and may increase interpretability. Using empirical NMAs, we show that the need for a concise and informative presentation of results is imperative, particularly as the number of competing treatments and outcomes in an NMA increases. The rank-heat plot is an efficient way to present the results of ranking statistics, particularly when a large amount of data is available, and it is targeted to users from various backgrounds. Copyright © 2016 Elsevier Inc. All rights reserved.

[Premature rupture of membranes one fetus from a multiple pregnancy].

PubMed

Malinowski, Witold

2011-10-01

In multiple gestation, premature rupture of fetal membranes (PROM) is an important risk factor for premature delivery and intrauterine infection. The incidence of PROM in twin gestations is threefold of that in singleton pregnancies. The incidence in triplets occurs even more frequently underlining the role of PROM as a leading cause of infant mortality and morbidity. Besides prematurity the complications of PROM include umbilical cord compression due to oligohydramnios, cord prolapse, placental abruption, and chorioamnionitis. Together with PROM, chorioamnionitis is held responsible for significant maternal and neonatal morbidity including endometritis and sepsis in the mother and early-onset sepsis, respiratory distress syndrome, inborn pneumonia, bronchopulmonary dysplasia, intraventricular hemorrhage, and periventricular white matter injury in the neonate. Furthermore, in twin gestations, PROM remains an independent risk factor for long-term neonatal care. An uncommon situation develops when in multiple gestation PROM affects only one of the fetuses. In such cases, the co-existence in the uterine cavity of the properly developing fetus(es) can be a challenge for the process of medical decision-making. In the present work, limited world literature on the topic was critically reviewed in search of the best possible recommendations for clinical management.

78 FR 68449 - Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-14

... RFA-HS14-002, Addressing Methodological Challenges in Research for Patients With Multiple Chronic... applications for the ``AHRQ RFA-HS14-002, Addressing Methodological Challenges in Research for Patients With...

Statistically Comparing the Performance of Multiple Automated Raters across Multiple Items

ERIC Educational Resources Information Center

Kieftenbeld, Vincent; Boyer, Michelle

2017-01-01

Automated scoring systems are typically evaluated by comparing the performance of a single automated rater item-by-item to human raters. This presents a challenge when the performance of multiple raters needs to be compared across multiple items. Rankings could depend on specifics of the ranking procedure; observed differences could be due to…

Coaching Ourselves to Perform Multiplicity and Advocacy: A Response to Stephens and Mills

ERIC Educational Resources Information Center

Cahnmann-Taylor, Melisa

2014-01-01

Cahnmann-Taylor draws on Boalian Theatre of the Oppressed to offer a practice for literacy teachers and coaches that can open up multiple perspectives and multiple levels of intentions and motivations for a teacher's decision making. She challenges coaches and teachers to engage in artistic examinations of multiplicity to move toward performing…

Food systems transition and disruptive low carbon innovation: implications for a food security research agenda.

PubMed

Tyfield, David

2011-07-01

There is a growing consensus that we are facing epochal challenges in global food security. Moreover, these challenges are multiple and complex. Meeting these challenges will involve nothing less than a wholesale socio-technical transition of the agri-food system. Optimizing the efficacy of the contribution of research to such a food security agenda will probably also need new institutional mechanisms and career structures to facilitate new kinds of collaborations and ongoing, longer-term projects. In short, the multiple challenges of food security demand a different political economy of research for effective intervention by science. In making this argument, the paper summarizes the major findings of a recent report regarding the potential impact of so-called 'disruptive' low-carbon innovations in China.

Advances in Biodegradation of Multiple Volatile Organic Compounds

NASA Astrophysics Data System (ADS)

Zhang, M.; Yoshikawa, M.

2017-12-01

Bioremediation of soil and groundwater containing multiple contaminants remains a challenge in environmental science and engineering because complete biodegradation of all components is necessary but very difficult to accomplish in practice. This presentation provides a brief overview on advances in biodegradation of multiple volatile organic compounds (VOCs) including chlorinated ethylenes, benzene, toluene and dichloromethane (DCM). Case studies on aerobic biodegradation of benzene, toluene and DCM, and integrated anaerobic-aerobic biodegradation of 7 contaminants, specifically, tetrachloroethylene (PCE), trichloroethylene (TCE), cis-dichloroethylene (cis-DCE), vinyl chloride (VC), DCM, benzene and toluene will be provided. Recent findings based on systematic laboratory experiments indicated that aerobic toluene degradation can be enhanced by co-existence of benzene. Propioniferax, not a known benzene, toluene and DCM degrader can be a key microorganism that involves in biodegradation when the three contaminants co-exist. Integrated anaerobic-aerobic biodegradation is capable of completely degrading the seven VOCs with initial concentrations less than 30 mg/L. Dehalococcoides sp., generally considered sensitive to oxygen, can survive aerobic conditions for at least 28 days, and can be activated during the subsequent anaerobic biodegradation. This presentation may provide a systematic information about biodegradation of multiple VOCs, and a scientific basis for the complete bioremediation of multiple contaminants in situ.

Multiple Sclerosis in the Contemporary Age: Understanding the Millennial Patient with Multiple Sclerosis to Create Next-Generation Care.

PubMed

Hansen, Madison R; Okuda, Darin T

2018-02-01

The average age of onset of multiple sclerosis (MS) is between 20 and 40 years of age. Therefore, most new patients diagnosed with MS within the next 10 to 15 years will be from the millennial generation, representing those born between 1982 and 2000. Certain preferences and trends of this contemporary generation will present new challenges to the MS physician and effective MS care. By first understanding these challenges, relevant and successful solutions can be created to craft a system of care that best benefits the millennial patient with MS. Copyright © 2017 Elsevier Inc. All rights reserved.

Unleashing the power of human genetic variation knowledge: New Zealand stakeholder perspectives.

PubMed

Gu, Yulong; Warren, James Roy; Day, Karen Jean

2011-01-01

This study aimed to characterize the challenges in using genetic information in health care and to identify opportunities for improvement. Taking a grounded theory approach, semistructured interviews were conducted with 48 participants to collect multiple stakeholder perspectives on genetic services in New Zealand. Three themes emerged from the data: (1) four service delivery models were identified in operation, including both those expected models involving genetic counselors and variations that do not route through the formal genetic service program; (2) multiple barriers to sharing and using genetic information were perceived, including technological, organizational, institutional, legal, ethical, and social issues; and (3) impediments to wider use of genetic testing technology, including variable understanding of genetic test utilities among clinicians and the limited capacity of clinical genetic services. Targeting these problems, information technologies and knowledge management tools have the potential to support key tasks in genetic services delivery, improve knowledge processes, and enhance knowledge networks. Because of the effect of issues in genetic information and knowledge management, the potential of human genetic variation knowledge to enhance health care delivery has been put on a "leash."

Generation of global political priority for early childhood development: the challenges of framing and governance.

PubMed

Shawar, Yusra Ribhi; Shiffman, Jeremy

2017-01-07

Despite progress, early childhood development (ECD) remains a neglected issue, particularly in resource-poor countries. We analyse the challenges and opportunities that ECD proponents face in advancing global priority for the issue. We triangulated among several data sources, including 19 semi-structured interviews with individuals involved in global ECD leadership, practice, and advocacy, as well as peer-reviewed research, organisation reports, and grey literature. We undertook a thematic analysis of the collected data, drawing on social science scholarship on collective action and a policy framework that elucidates why some global initiatives are more successful in generating political priority than others. The analysis indicates that the ECD community faces two primary challenges in advancing global political priority. The first pertains to framing: generation of internal consensus on the definition of the problem and solutions, agreement that could facilitate the discovery of a public positioning of the issue that could generate political support. The second concerns governance: building of effective institutions to achieve collective goals. However, there are multiple opportunities to advance political priority for ECD, including an increasingly favourable political environment, advances in ECD metrics, and the existence of compelling arguments for investment in ECD. To advance global priority for ECD, proponents will need to surmount the framing and governance challenges and leverage these opportunities. Copyright © 2017 Elsevier Ltd. All rights reserved.

Challenges and Opportunities for Tribal Waters: Addressing Disparities in Safe Public Drinking Water on the Crow Reservation in Montana, USA.

PubMed

Doyle, John T; Kindness, Larry; Realbird, James; Eggers, Margaret J; Camper, Anne K

2018-03-21

Disparities in access to safe public drinking water are increasingly being recognized as contributing to health disparities and environmental injustice for vulnerable communities in the United States. As the Co-Directors of the Apsaálooke Water and Wastewater Authority (AWWWA) for the Crow Tribe, with our academic partners, we present here the multiple and complex challenges we have addressed in improving and maintaining tribal water and wastewater infrastructure, including the identification of diverse funding sources for infrastructure construction, the need for many kinds of specialized expertise and long-term stability of project personnel, ratepayer difficulty in paying for services, an ongoing legacy of inadequate infrastructure planning, and lack of water quality research capacity. As a tribal entity, the AWWWA faces additional challenges, including the complex jurisdictional issues affecting all phases of our work, lack of authority to create water districts, and additional legal and regulatory gaps-especially with regards to environmental protection. Despite these obstacles, the AWWWA and Crow Tribe have successfully upgraded much of the local water and wastewater infrastructure. We find that ensuring safe public drinking water for tribal and other disadvantaged U.S. communities will require comprehensive, community-engaged approaches across a broad range of stakeholders to successfully address these complex legal, regulatory, policy, community capacity, and financial challenges.

Challenges and Opportunities for Tribal Waters: Addressing Disparities in Safe Public Drinking Water on the Crow Reservation in Montana, USA

PubMed Central

Doyle, John T.; Kindness, Larry; Realbird, James; Camper, Anne K.

2018-01-01

Disparities in access to safe public drinking water are increasingly being recognized as contributing to health disparities and environmental injustice for vulnerable communities in the United States. As the Co-Directors of the Apsaálooke Water and Wastewater Authority (AWWWA) for the Crow Tribe, with our academic partners, we present here the multiple and complex challenges we have addressed in improving and maintaining tribal water and wastewater infrastructure, including the identification of diverse funding sources for infrastructure construction, the need for many kinds of specialized expertise and long-term stability of project personnel, ratepayer difficulty in paying for services, an ongoing legacy of inadequate infrastructure planning, and lack of water quality research capacity. As a tribal entity, the AWWWA faces additional challenges, including the complex jurisdictional issues affecting all phases of our work, lack of authority to create water districts, and additional legal and regulatory gaps—especially with regards to environmental protection. Despite these obstacles, the AWWWA and Crow Tribe have successfully upgraded much of the local water and wastewater infrastructure. We find that ensuring safe public drinking water for tribal and other disadvantaged U.S. communities will require comprehensive, community-engaged approaches across a broad range of stakeholders to successfully address these complex legal, regulatory, policy, community capacity, and financial challenges. PMID:29561815

Balancing the professional and personal.

PubMed

Armstrong, Alicia Y; Alvero, Ruben J; Dunlow, Susan; Nace, Mary Catherine; Baker, Valerie; Stewart, Elizabeth A

2009-01-01

To review the common roles that physicians pursue away from work and identify related challenges and potential solutions, so that individuals can develop a personalized plan for success in each of the areas. Literature review. University-based and university-affiliated medical centers. No subjects were involved in this literature review. Literature searches in Entrez PubMed and the following Websites: http://www.apgo.org, http://www.psychiatrictimes.com, as well as other data sources. Results of physician surveys and summaries of strategies for achieving work-personal life balance. According to surveys of physicians in various specialties, a majority of physicians have high levels of job, marital, and parental satisfaction. However, professional and personal challenges faced by physicians include struggle with time management, lack of mentorship, and difficulty maintaining intimate relationships. Multiple potentially effective strategies have been described in the literature, including exerting control over hours worked, taking a long view of life that acknowledges the need for changing priorities over time, developing communication skills, seeking counseling services if needed that focus on physician relationships, and simplifying home life whenever possible. Although there are unique challenges in being a physician, partner, and parent, many of the professional challenges faced by physicians are common to many adults in the United States. Self-assessment may help individuals to clarify priorities and develop strategies that can lead to improved personal satisfaction.

Novel Process Revolutionizes Welding Industry

NASA Technical Reports Server (NTRS)

2008-01-01

Glenn Research Center, Delphi Corporation, and the Michigan Research Institute entered into a research project to study the use of Deformation Resistance Welding (DRW) in the construction and repair of stationary structures with multiple geometries and dissimilar materials, such as those NASA might use on the Moon or Mars. Traditional welding technologies are burdened by significant business and engineering challenges, including high costs of equipment and labor, heat-affected zones, limited automation, and inconsistent quality. DRW addresses each of those issues, while drastically reducing welding, manufacturing, and maintenance costs.

Cognitive culture: theoretical and empirical insights into social learning strategies.

PubMed

Rendell, Luke; Fogarty, Laurel; Hoppitt, William J E; Morgan, Thomas J H; Webster, Mike M; Laland, Kevin N

2011-02-01

Research into social learning (learning from others) has expanded significantly in recent years, not least because of productive interactions between theoretical and empirical approaches. This has been coupled with a new emphasis on learning strategies, which places social learning within a cognitive decision-making framework. Understanding when, how and why individuals learn from others is a significant challenge, but one that is critical to numerous fields in multiple academic disciplines, including the study of social cognition. Copyright © 2010 Elsevier Ltd. All rights reserved.

An Integrated Nursing Management Information System: From Concept to Reality

PubMed Central

Pinkley, Connie L.; Sommer, Patricia K.

1988-01-01

This paper addresses the transition from the conceptualization of a Nursing Management Information System (NMIS) integrated and interdependent with the Hospital Information System (HIS) to its realization. Concepts of input, throughout, and output are presented to illustrate developmental strategies used to achieve nursing information products. Essential processing capabilities include: 1) ability to interact with multiple data sources; 2) database management, statistical, and graphics software packages; 3) online, batch and reporting; and 4) interactive data analysis. Challenges encountered in system construction are examined.

Diagnosis and management of patients with clefts: a comprehensive and interdisciplinary approach.

PubMed

Hartzell, Larry D; Kilpatrick, Lauren A

2014-10-01

This article reviews the most current practice guidelines in the diagnosis and management of patients born with cleft lip and/or palate. Such patients frequently have multiple medical and social issues that benefit greatly from a team approach. Common challenges include feeding difficulty, nutritional deficiency, speech disorders, hearing problems, ear disease, dental anomalies, and both social and developmental delays, among others. Interdisciplinary evaluation and collaboration throughout a patient's development are essential. Copyright © 2014 Elsevier Inc. All rights reserved.

Implementation of a Research Information Management System in a Pediatric Hospital.

PubMed

Kissling, Alison D; Ballinger, Kimberly D

2018-01-01

Faculty publications have been collected in universities, health, and medical institutions for many years, and Cincinnati Children's is no exception. Since 1949, a yearly list of faculty publications was manually compiled using multiple data sources and disseminated by the Edward L. Pratt Research Library. Products to centralize faculty publication collection and analysis with bibliometric tools are growing in popularity. This article will review the collaborative decision to choose a Research Information Management System and the implementation process including successes, challenges, and future opportunities.

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

Ryu, Jun Hyung; Lee, Soo bin; Hodge, Bri-Mathias

The energy system of process industry are faced with a new unprecedented challenge. Renewable energies should be incorporated but single of them cannot meet its energy demand of high degree and a large quantity. This paper investigates a simulation framework to compute the capacity of multiple energy sources including solar, wind power, diesel and batteries. The framework involves actual renewable energy supply and demand profile generation and supply demand matching. Eight configurations of different supply options are evaluated to illustrate the applicability of the proposed framework with some remarks.

Building America Case Study: The Impact of Thermostat Placement in Low-Load Homes in Sunny Climates, Denver, Colorado

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

Modern, energy-efficient homes conforming to the Zero Energy Ready Home standard face the challenge of meeting high customer expectations for comfort. Traditional heating, ventilation, and air conditioning (HVAC) sizing and control strategies may be insufficient to adequately condition each zone due to unique load patterns in each room caused by a number of factors. These factors include solar heat gains, occupant-related gains, and gains associated with appliances and electronics. Because of shrinking shell loads, these intermittent factors are having an increasingly significant impact on the thermal load in each zone. Consequently, occupant comfort can be compromised. To evaluate the impactmore » of climate and house geometry, as well as HVAC system and control strategies on comfort conditions, IBACOS analyzed the results of 99 TRNSYS multiple-zone simulations. The results of this analysis indicate that for simple-geometry and single-story plans, a single zone and thermostat can adequately condition the entire house. Demanding house geometry and houses with multiple stories require the consideration of multiple thermostats and multiple zones.« less

Risk Assessment of Heating, Ventilating, and Air-Conditioning Strategies in Low-Load Homes

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

Poerschke, Andrew

2016-02-17

"Modern, energy efficient homes conforming to the Zero Energy Ready Home standard face the challenge of meeting high customer expectations for comfort. Traditional heating, ventilation, and air conditioning (HVAC) sizing and control strategies may be insufficient to adequately condition each zone due to unique load patterns in each room caused by a number of factors. These factors include solar heat gains, occupant-related gains, and gains associated with appliances and electronics. Because of shrinking shell loads, these intermittent factors are having an increasingly significant impact on the thermal load in each zone. Consequently, occupant comfort can be compromised. To evaluate themore » impact of climate and house geometry, as well as HVAC system and control strategies on comfort conditions, IBACOS analyzed the results of 99 TRNSYS multiple-zone simulations. The results of this analysis indicate that for simple-geometry and single-story plans, a single zone and thermostat can adequately condition the entire house. Demanding house geometry and houses with multiple stories require the consideration of multiple thermostats and multiple zones.« less

Multiple player tracking in sports video: a dual-mode two-way bayesian inference approach with progressive observation modeling.

PubMed

Xing, Junliang; Ai, Haizhou; Liu, Liwei; Lao, Shihong

2011-06-01

Multiple object tracking (MOT) is a very challenging task yet of fundamental importance for many practical applications. In this paper, we focus on the problem of tracking multiple players in sports video which is even more difficult due to the abrupt movements of players and their complex interactions. To handle the difficulties in this problem, we present a new MOT algorithm which contributes both in the observation modeling level and in the tracking strategy level. For the observation modeling, we develop a progressive observation modeling process that is able to provide strong tracking observations and greatly facilitate the tracking task. For the tracking strategy, we propose a dual-mode two-way Bayesian inference approach which dynamically switches between an offline general model and an online dedicated model to deal with single isolated object tracking and multiple occluded object tracking integrally by forward filtering and backward smoothing. Extensive experiments on different kinds of sports videos, including football, basketball, as well as hockey, demonstrate the effectiveness and efficiency of the proposed method.

π Berry phase and Zeeman splitting of Weyl semimetal TaP

DOE PAGES

Hu, J.; Liu, J. Y.; Graf, D.; ...

2016-01-04

Here, the recent breakthrough in the discovery of Weyl fermions in monopnictide semimetals provides opportunities to explore the exotic properties of relativistic fermions in condensed matter. The chiral anomaly-induced negative magnetoresistance and π Berry phase are two fundamental transport properties associated with the topological characteristics of Weyl semimetals. Since monopnictide semimetals are multiple-band systems, resolving clear Berry phase for each Fermi pocket remains a challenge. Here we report the determination of Berry phases of multiple Fermi pockets of Weyl semimetal TaP through high field quantum transport measurements. We show our TaP single crystal has the signatures of a Weyl state,more » including light effective quasiparticle masses, ultrahigh carrier mobility, as well as negative longitudinal magnetoresistance. Furthermore, we have generalized the Lifshitz-Kosevich formula for multiple-band Shubnikov-de Haas (SdH) oscillations and extracted the Berry phases of π for multiple Fermi pockets in TaP through the direct fits of the modified LK formula to the SdH oscillations. In high fields, we also probed signatures of Zeeman splitting, from which the Landé g-factor is extracted.« less

Addressing the Analytic Challenges of Cross-Sectional Pediatric Pneumonia Etiology Data.

PubMed

Hammitt, Laura L; Feikin, Daniel R; Scott, J Anthony G; Zeger, Scott L; Murdoch, David R; O'Brien, Katherine L; Deloria Knoll, Maria

2017-06-15

Despite tremendous advances in diagnostic laboratory technology, identifying the pathogen(s) causing pneumonia remains challenging because the infected lung tissue cannot usually be sampled for testing. Consequently, to obtain information about pneumonia etiology, clinicians and researchers test specimens distant to the site of infection. These tests may lack sensitivity (eg, blood culture, which is only positive in a small proportion of children with pneumonia) and/or specificity (eg, detection of pathogens in upper respiratory tract specimens, which may indicate asymptomatic carriage or a less severe syndrome, such as upper respiratory infection). While highly sensitive nucleic acid detection methods and testing of multiple specimens improve sensitivity, multiple pathogens are often detected and this adds complexity to the interpretation as the etiologic significance of results may be unclear (ie, the pneumonia may be caused by none, one, some, or all of the pathogens detected). Some of these challenges can be addressed by adjusting positivity rates to account for poor sensitivity or incorporating test results from controls without pneumonia to account for poor specificity. However, no classical analytic methods can account for measurement error (ie, sensitivity and specificity) for multiple specimen types and integrate the results of measurements for multiple pathogens to produce an accurate understanding of etiology. We describe the major analytic challenges in determining pneumonia etiology and review how the common analytical approaches (eg, descriptive, case-control, attributable fraction, latent class analysis) address some but not all challenges. We demonstrate how these limitations necessitate a new, integrated analytical approach to pneumonia etiology data. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Addressing the Analytic Challenges of Cross-Sectional Pediatric Pneumonia Etiology Data

PubMed Central

Feikin, Daniel R.; Scott, J. Anthony G.; Zeger, Scott L.; Murdoch, David R.; O’Brien, Katherine L.; Deloria Knoll, Maria

2017-01-01

Abstract Despite tremendous advances in diagnostic laboratory technology, identifying the pathogen(s) causing pneumonia remains challenging because the infected lung tissue cannot usually be sampled for testing. Consequently, to obtain information about pneumonia etiology, clinicians and researchers test specimens distant to the site of infection. These tests may lack sensitivity (eg, blood culture, which is only positive in a small proportion of children with pneumonia) and/or specificity (eg, detection of pathogens in upper respiratory tract specimens, which may indicate asymptomatic carriage or a less severe syndrome, such as upper respiratory infection). While highly sensitive nucleic acid detection methods and testing of multiple specimens improve sensitivity, multiple pathogens are often detected and this adds complexity to the interpretation as the etiologic significance of results may be unclear (ie, the pneumonia may be caused by none, one, some, or all of the pathogens detected). Some of these challenges can be addressed by adjusting positivity rates to account for poor sensitivity or incorporating test results from controls without pneumonia to account for poor specificity. However, no classical analytic methods can account for measurement error (ie, sensitivity and specificity) for multiple specimen types and integrate the results of measurements for multiple pathogens to produce an accurate understanding of etiology. We describe the major analytic challenges in determining pneumonia etiology and review how the common analytical approaches (eg, descriptive, case-control, attributable fraction, latent class analysis) address some but not all challenges. We demonstrate how these limitations necessitate a new, integrated analytical approach to pneumonia etiology data. PMID:28575372

Collaborative Orthopaedic Research Between and Within Institutions.

PubMed

Wolf, Brian R; Verma, Nikhil N; Spindler, Kurt P; Wright, Rick W

2017-02-15

Collaborative research is common in many medical disciplines; however, the field of orthopaedics has been relatively slow to adopt this type of research approach. Collaborative research efforts can occur between multiple institutions and, in some instances, may benefit from subspecialty society sponsorship. Collaborative research efforts between several research spheres within a single institution also can be advantageous. Collaborative research has many benefits, including a larger number of patients in studies, more power in the research, and better generalizability. In addition, collaborative research efforts allow resources to be pooled within and between institutions. The challenges of collaborative research include data management, funding, and the publication of manuscripts that have many authors.

Voltammetry Method Evaluation

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

Hoyt, N.; Pereira, C.; Willit, J.

2016-07-29

The purpose of the ANL MPACT Voltammetry project is to evaluate the suitability of previously developed cyclic voltammetry techniques to provide electroanalytical measurements of actinide concentrations in realistic used fuel processing scenarios. The molten salts in these scenarios are very challenging as they include high concentrations of multiple electrochemically active species, thereby creating a variety of complications. Some of the problems that arise therein include issues related to uncompensated resistance, cylindrical diffusion, and alloying of the electrodeposited metals. Improvements to the existing voltammetry technique to account for these issues have been implemented, resulting in good measurements of actinide concentrations acrossmore » a wide range of adverse conditions.« less

Toward Wearable Self-Charging Power Systems: The Integration of Energy-Harvesting and Storage Devices.

PubMed

Pu, Xiong; Hu, Weiguo; Wang, Zhong Lin

2018-01-01

One major challenge for wearable electronics is that the state-of-the-art batteries are inadequate to provide sufficient energy for long-term operations, leading to inconvenient battery replacement or frequent recharging. Other than the pursuit of high energy density of secondary batteries, an alternative approach recently drawing intensive attention from the research community, is to integrate energy-generation and energy-storage devices into self-charging power systems (SCPSs), so that the scavenged energy can be simultaneously stored for sustainable power supply. This paper reviews recent developments in SCPSs with the integration of various energy-harvesting devices (including piezoelectric nanogenerators, triboelectric nanogenerators, solar cells, and thermoelectric nanogenerators) and energy-storage devices, such as batteries and supercapacitors. SCPSs with multiple energy-harvesting devices are also included. Emphasis is placed on integrated flexible or wearable SCPSs. Remaining challenges and perspectives are also examined to suggest how to bring the appealing SCPSs into practical applications in the near future. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Tier-2 Optimisation for Computational Density/Diversity and Big Data

NASA Astrophysics Data System (ADS)

Fay, R. B.; Bland, J.

2014-06-01

As the number of cores on chip continues to trend upwards and new CPU architectures emerge, increasing CPU density and diversity presents multiple challenges to site administrators. These include scheduling for massively multi-core systems (potentially including Graphical Processing Units (GPU), integrated and dedicated) and Many Integrated Core (MIC)) to ensure a balanced throughput of jobs while preserving overall cluster throughput, as well as the increasing complexity of developing for these heterogeneous platforms, and the challenge in managing this more complex mix of resources. In addition, meeting data demands as both dataset sizes increase and as the rate of demand scales with increased computational power requires additional performance from the associated storage elements. In this report, we evaluate one emerging technology, Solid State Drive (SSD) caching for RAID controllers, with consideration to its potential to assist in meeting evolving demand. We also briefly consider the broader developing trends outlined above in order to identify issues that may develop and assess what actions should be taken in the immediate term to address those.

Use of Urine Biomarkers to Assess Sodium Intake: Challenges and Opportunities

PubMed Central

Maalouf, Joyce; Elliott, Paul; Loria, Catherine M.; Patel, Sheena; Bowman, Barbara A.

2017-01-01

This article summarizes current data and approaches to assess sodium intake in individuals and populations. A review of the literature on sodium excretion and intake estimation supports the continued use of 24-h urine collections for assessing population and individual sodium intake. Since 2000, 29 studies used urine biomarkers to estimate population sodium intake, primarily among adults. More than half used 24-h urine; the rest used a spot/casual, overnight, or 12-h specimen. Associations between individual sodium intake and health outcomes were investigated in 13 prospective cohort studies published since 2000. Only three included an indicator of long-term individual sodium intake, i.e., multiple 24-h urine specimens collected several days apart. Although not insurmountable, logistic challenges of 24-h urine collection remain a barrier for research on the relationship of sodium intake and chronic disease. Newer approaches, including modeling based on shorter collections, offer promise for estimating population sodium intake in some groups. PMID:25974702

Adaptation of the Electra Radio to Support Multiple Receive Channels

NASA Technical Reports Server (NTRS)

Satorius, Edgar H.; Shah, Biren N.; Bruvold, Kristoffer N.; Bell, David J.

2011-01-01

Proposed future Mars missions plan communication between multiple assets (rovers). This paper presents the results of a study carried out to assess the potential adaptation of the Electra radio to a multi-channel transceiver. The basic concept is a Frequency Division multiplexing (FDM) communications scheme wherein different receiver architectures are examined. Options considered include: (1) multiple IF slices, A/D and FPGAs each programmed with an Electra baseband modem; (2) common IF but multiple A/Ds and FPGAs and (3) common IF, single A/D and single or multiple FPGAs programmed to accommodate the FDM signals. These options represent the usual tradeoff between analog and digital complexity. Given the space application, a common IF is preferable; however, multiple users present dynamic range challenges (e.g., near-far constraints) that would favor multiple IF slices (Option 1). Vice versa, with a common IF and multiple A/Ds (Option 2), individual AGC control of the A/Ds would be an important consideration. Option 3 would require a common AGC control strategy and would entail multiple digital down conversion paths within the FPGA. In this paper, both FDM parameters as well as the different Electra design options will be examined. In particular, signal channel spacing as a function of user data rates and transmit powers will be evaluated. In addition, tradeoffs between the different Electra design options will be presented with the ultimate goal of defining an augmented Electra radio architecture for potential future missions.

Liquid biopsy: a step forward towards precision medicine in urologic malignancies.

PubMed

Di Meo, Ashley; Bartlett, Jenni; Cheng, Yufeng; Pasic, Maria D; Yousef, George M

2017-04-14

There is a growing trend towards exploring the use of a minimally invasive "liquid biopsy" to identify biomarkers in a number of cancers, including urologic malignancies. Multiple aspects can be assessed in circulating cell-free DNA, including cell-free DNA levels, integrity, methylation and mutations. Other prospective liquid biopsy markers include circulating tumor cells, circulating RNAs (miRNA, lncRNAs and mRNAs), cell-free proteins, peptides and exosomes have also emerged as non-invasive cancer biomarkers. These circulating molecules can be detected in various biological fluids, including blood, urine, saliva and seminal plasma. Liquid biopsies hold great promise for personalized medicine due to their ability to provide multiple non-invasive global snapshots of the primary and metastatic tumors. Molecular profiling of circulating molecules has been a stepping-stone to the successful introduction of several non-invasive multi-marker tests into the clinic. In this review, we provide an overview of the current state of cell-free DNA-based kidney, prostate and bladder cancer biomarker research and discuss the potential utility other circulating molecules. We will also discuss the challenges and limitations facing non-invasive cancer biomarker discovery and the benefits of this growing area of translational research.

Development of a Mental Health Nursing Simulation: Challenges and Solutions

ERIC Educational Resources Information Center

Kidd, Lori I.; Morgan, Karyn I.; Savery, John R.

2012-01-01

Nursing education programs are proliferating rapidly in the United States in an effort to meet demand for nurse professionals. Multiple challenges arise from this rapid expansion. One challenge is finding sufficient clinical sites to accommodate students. Increased competition for scarce resources requires creativity in clinical contracting. This…

The Smarties-Box Challenge: Supporting Systematic Approaches to Problem Solving

ERIC Educational Resources Information Center

Russo, James

2016-01-01

The Smarties-Box Challenge encourages students to apply several different mathematical capabilities and concepts--such as, estimation, multiplication, and the notion of being systematic--to solve a complex, multistep problem. To effectively engage in the Smarties-Box Challenge, students are required to demonstrate aspects of all four proficiency…

Challenges in Delivering Distance Education

ERIC Educational Resources Information Center

Chawdhry, Adnan A.

2010-01-01

Despite the challenges that exist with DE (Distance Education), university and faculty can provide a strong learning environment for their students if they understand and mitigate the challenges of the DE program. This paper describes a case study of a DE program that offers classroom instruction for multiple sites that are connected using a…

Making a Difference in Challenging Urban Schools: Successful Principals

ERIC Educational Resources Information Center

Michalak, Joanna M.

2009-01-01

The article reports upon findings from four multiple-perspective case studies of successful principals in challenging urban contexts. Each principal was described as making a significant difference to the quality of school education. The findings are obtained from the Polish part of the "Leading Schools Successfully in Challenging Urban…

Occupant traffic estimation through structural vibration sensing

NASA Astrophysics Data System (ADS)

Pan, Shijia; Mirshekari, Mostafa; Zhang, Pei; Noh, Hae Young

2016-04-01

The number of people passing through different indoor areas is useful in various smart structure applications, including occupancy-based building energy/space management, marketing research, security, etc. Existing approaches to estimate occupant traffic include vision-, sound-, and radio-based (mobile) sensing methods, which have placement limitations (e.g., requirement of line-of-sight, quiet environment, carrying a device all the time). Such limitations make these direct sensing approaches difficult to deploy and maintain. An indirect approach using geophones to measure floor vibration induced by footsteps can be utilized. However, the main challenge lies in distinguishing multiple simultaneous walkers by developing features that can effectively represent the number of mixed signals and characterize the selected features under different traffic conditions. This paper presents a method to monitor multiple persons. Once the vibration signals are obtained, features are extracted to describe the overlapping vibration signals induced by multiple footsteps, which are used for occupancy traffic estimation. In particular, we focus on analysis of the efficiency and limitations of the four selected key features when used for estimating various traffic conditions. We characterize these features with signals collected from controlled impulse load tests as well as from multiple people walking through a real-world sensing area. In our experiments, the system achieves the mean estimation error of +/-0.2 people for different occupant traffic conditions (from one to four) using k-nearest neighbor classifier.

Antimicrobial resistance in Saudi Arabia

PubMed Central

Zowawi, Hosam M.

2016-01-01

Antimicrobial resistance (AMR) is increasingly being highlighted as an urgent public and animal health issue worldwide. This issue is well demonstrated in bacteria that are resistant to last-line antibiotics, suggesting a future with untreatable infections. International agencies have suggested combating strategies against AMR. Saudi Arabia has several challenges that can stimulate the emergence and spread of multidrug-resistant bacteria. Tackling these challenges need efforts from multiple sectors to successfully control the spread and emergence of AMR in the country. Actions should include active surveillance to monitor the emergence and spread of AMR. Infection prevention and control precautions should also be optimized to limit further spread. Raising awareness is essential to limit inappropriate antibiotics use, and the antibiotic stewardship programs in hospital settings, outpatients, and community pharmacies, should regulate the ongoing use of antimicrobials. PMID:27570847

[Evaluative designs in public health: methodological considerations].

PubMed

López, Ma José; Marí-Dell'Olmo, Marc; Pérez-Giménez, Anna; Nebot, Manel

2011-06-01

Evaluation of public health interventions poses numerous methodological challenges. Randomization of individuals is not always feasible and interventions are usually composed of multiple factors. To face these challenges, certain elements, such as the selection of the most appropriate design and the use of a statistical analysis that includes potential confounders, are essential. The objective of this article was to describe the most frequently used designs in the evaluation of public health interventions (policies, programs or campaigns). The characteristics, strengths and weaknesses of each of these evaluative designs are described. Additionally, a brief explanation of the most commonly used statistical analysis in each of these designs is provided. Copyright © 2011 Sociedad Española de Salud Pública y Administración Sanitaria. Published by Elsevier Espana. All rights reserved.

The relationship between creativity and mood disorders

PubMed Central

Andreasen, Nancy C.

2008-01-01

Research designed to examine the relationship between creativity and mental illnesses must confront multiple challenges. What is the optimal sample to study? How should creativity be defined? What is the most appropriate comparison group? Only a limited number of studies have examined highly creative individuals using personal interviews and a noncreative comparison group. The majority of these have examined writers. The preponderance of the evidence suggests that in these creative individuals the rate of mood disorder is high, and that both bipolar disorder and unipolar depression are quite common. Clinicians who treat creative individuals with mood disorders must also confronta variety of challenges, including the fear that treatment may diminish creativity, in the case of bipolar disorder, hovt/ever, it is likely that reducing severe manic episodes may actually enhance creativity in many individuals. PMID:18689294

Lifelong antiretroviral therapy or HIV cure: The benefits for the individual patient.

PubMed

Buell, Kevin G; Chung, Christopher; Chaudhry, Zain; Puri, Aiysha; Nawab, Khizr; Ravindran, Rahul Prashanth

2016-01-01

There are an estimated 35 million people living with human immunodeficiency virus (HIV) globally, 19 million of whom are unaware of their HIV status and, in the absence of antiretroviral therapy (ART), will have a shortened life expectancy. Although ART remains the "gold standard" for treatment of HIV infection, the requirement for lifelong treatment poses multiple challenges for the patient. These include stigma, an untenable pill burden, side effects, and the threat of viral resistance in the case of non-compliance. This review evaluates the challenges of accessing, delivering, and sustaining ART for people living with HIV and will discuss the case for pursuing a goal of HIV cure, the potential benefits of such a cure for the individual patient, and the current potential candidates for such a cure.

Breast cancer and neurofibromatosis type 1: a diagnostic challenge in patients with a high number of neurofibromas.

PubMed

Da Silva, André Vallejo; Rodrigues, Fabiana Resende; Pureza, Mônica; Lopes, Vania Gloria Silami; Cunha, Karin Soares

2015-03-26

Neurofibromatosis 1 is one of the most common genetic diseases in humans, presenting with multiple neurofibromas and an increased risk of various benign and malignant tumors, including breast cancer. In this paper we report a case of a woman with neurofibromatosis 1 and the challenge associated with detecting an advanced breast cancer because of numerous skin neurofibromas, which were responsible for a substantial delay in cancer diagnosis. Literature concerning the association of neurofibromatosis 1 and breast cancer is reviewed and discussed. Best practice guidelines for breast cancer detection are not sufficient for the screening of neurofibromatosis 1 carriers. A more intensive clinical and imaging approach should be used if the same early detection rate as in non-neurofibromatosis 1 women is to be achieved.

Introduction to the special section on "Hormones and cognition: perspectives, controversies, and challenges for future research".

PubMed

Frick, Karyn M

2012-02-01

The research of the past two decades has firmly established that hormones modulate numerous aspects of cognitive function, including memory, attention, decision-making, and sensory processing. That such a wide variety of hormones influence cognition mediated by multiple nonhypothalamic brain regions illustrates the critical importance of hormones to neural and cognitive function. The diversity of hormonal effects on cognition is evident in the collection of reviews and original research articles assembled for this special section. Together, these articles provide an overview of recent research on varied topics in hormones and cognition, address controversial issues in the field, and discuss challenges that must be overcome in future research to gain a better understanding of the mechanisms through which hormones modulate cognitive function.

Development of an Aotus nancymaae Model for Shigella Vaccine Immunogenicity and Efficacy Studies

PubMed Central

Gregory, Michael; Lugo-Roman, Luis A.; Galvez Carrillo, Hugo; Tilley, Drake Hamilton; Baldeviano, Christian; Simons, Mark P.; Reynolds, Nathanael D.; Ranallo, Ryan T.; Suvarnapunya, Akamol E.; Venkatesan, Malabi M.; Oaks, Edwin V.

2014-01-01

Several animal models exist to evaluate the immunogenicity and protective efficacy of candidate Shigella vaccines. The two most widely used nonprimate models for vaccine development include a murine pulmonary challenge model and a guinea pig keratoconjunctivitis model. Nonhuman primate models exhibit clinical features and gross and microscopic colonic lesions that mimic those induced in human shigellosis. Challenge models for enterotoxigenic Escherichia coli (ETEC) and Campylobacter spp. have been successfully developed with Aotus nancymaae, and the addition of a Shigella-Aotus challenge model would facilitate the testing of combination vaccines. A series of experiments were designed to identify the dose of Shigella flexneri 2a strain 2457T that induces an attack rate of 75% in the Aotus monkey. After primary challenge, the dose required to induce an attack rate of 75% was calculated to be 1 × 1011 CFU. Shigella-specific immune responses were low after primary challenge and subsequently boosted upon rechallenge. However, preexisting immunity derived from the primary challenge was insufficient to protect against the homologous Shigella serotype. A successive study in A. nancymaae evaluated the ability of multiple oral immunizations with live-attenuated Shigella vaccine strain SC602 to protect against challenge. After three oral immunizations, animals were challenged with S. flexneri 2a 2457T. A 70% attack rate was demonstrated in control animals, whereas animals immunized with vaccine strain SC602 were protected from challenge (efficacy of 80%; P = 0.05). The overall study results indicate that the Shigella-Aotus nancymaae challenge model may be a valuable tool for evaluating vaccine efficacy and investigating immune correlates of protection. PMID:24595138

Quality measurement and improvement in liver transplantation.

PubMed

Mathur, Amit K; Talwalkar, Jayant

2018-06-01

There is growing interest in the quality of health care delivery in liver transplantation. Multiple stakeholders, including patients, transplant providers and their hospitals, payers, and regulatory bodies have an interest in measuring and monitoring quality in the liver transplant process, and understanding differences in quality across centres. This article aims to provide an overview of quality measurement and regulatory issues in liver transplantation performed within the United States. We review how broader definitions of health care quality should be applied to liver transplant care models. We outline the status quo including the current regulatory agencies, public reporting mechanisms, and requirements around quality assurance and performance improvement (QAPI) activities. Additionally, we further discuss unintended consequences and opportunities for growth in quality measurement. Quality measurement and the integration of quality improvement strategies into liver transplant programmes hold significant promise, but multiple challenges to successful implementation must be addressed to optimise value. Copyright © 2018 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

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

Rao, Nageswara S; Sen, Satyabrata; Berry, M. L..

Domestic Nuclear Detection Office s (DNDO) Intelligence Radiation Sensors Systems (IRSS) program supported the development of networks of commercial-off-the-shelf (COTS) radiation counters for detecting, localizing, and identifying low-level radiation sources. Under this program, a series of indoor and outdoor tests were conducted with multiple source strengths and types, different background profiles, and various types of source and detector movements. Following the tests, network algorithms were replayed in various re-constructed scenarios using sub-networks. These measurements and algorithm traces together provide a rich collection of highly valuable datasets for testing the current and next generation radiation network algorithms, including the ones (tomore » be) developed by broader R&D communities such as distributed detection, information fusion, and sensor networks. From this multiple TeraByte IRSS database, we distilled out and packaged the first batch of canonical datasets for public release. They include measurements from ten indoor and two outdoor tests which represent increasingly challenging baseline scenarios for robustly testing radiation network algorithms.« less

Thoracic epidural analgesia in a child with multiple traumatic rib fractures.

PubMed

Keech, Brian M

2015-12-01

The morbidity and mortality associated with blunt thoracic trauma are significant and can be multisystem in nature. Of these, pulmonary complications, including ventilatory impairment secondary to pain, have been recognized to be the most consequential. Although several analgesic strategies have emerged, thoracic epidural analgesia (TEA) has arguably demonstrated superior efficacy and is used frequently in adults. Unfortunately, TEA is rarely used in children after blunt thoracic trauma, but may be of considerable benefit. This low rate of use likely reflects one or more of several factors potentially encountered when considering the use of TEA in pediatric chest wall trauma. Among them are (1) uncertainty regarding safety and efficacy; (2) the technical challenges of pediatric thoracic epidural placement, including technique and equipment concerns; and (3) drug selection, dosing, and toxicity. The following case review describes the successful application of TEA in a 4-year-old boy after multiple traumatic rib fractures and associated pneumothorax and pulmonary contusion. Copyright © 2015 Elsevier Inc. All rights reserved.

Modelling Concentrating Solar Power with Thermal Energy Storage for Integration Studies (Presentation)

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

Hummon, M.; Jorgenson, J.; Denholm, P.

2013-10-01

Concentrating solar power with thermal energy storage (CSP-TES) can provide multiple benefits to the grid, including low marginal cost energy and the ability to levelize load, provide operating reserves, and provide firm capacity. It is challenging to properly value the integration of CSP because of the complicated nature of this technology. Unlike completely dispatchable fossil sources, CSP is a limited energy resource, depending on the hourly and daily supply of solar energy. To optimize the use of this limited energy, CSP-TES must be implemented in a production cost model with multiple decision variables for the operation of the CSP-TES plant.more » We develop and implement a CSP-TES plant in a production cost model that accurately characterizes the three main components of the plant: solar field, storage tank, and power block. We show the effect of various modelling simplifications on the value of CSP, including: scheduled versus optimized dispatch from the storage tank and energy-only operation versus co-optimization with ancillary services.« less

Modelling Concentrating Solar Power with Thermal Energy Storage for Integration Studies: Preprint

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

Hummon, M.; Denholm, P.; Jorgenson, J.

2013-10-01

Concentrating solar power with thermal energy storage (CSP-TES) can provide multiple benefits to the grid, including low marginal cost energy and the ability to levelize load, provide operating reserves, and provide firm capacity. It is challenging to properly value the integration of CSP because of the complicated nature of this technology. Unlike completely dispatchable fossil sources, CSP is a limited energy resource, depending on the hourly and daily supply of solar energy. To optimize the use of this limited energy, CSP-TES must be implemented in a production cost model with multiple decision variables for the operation of the CSP-TES plant.more » We develop and implement a CSP-TES plant in a production cost model that accurately characterizes the three main components of the plant: solar field, storage tank, and power block. We show the effect of various modelling simplifications on the value of CSP, including: scheduled versus optimized dispatch from the storage tank and energy-only operation versus co-optimization with ancillary services.« less

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

Agalgaonkar, Yashodhan P.; Hammerstrom, Donald J.

The Pacific Northwest Smart Grid Demonstration (PNWSGD) was a smart grid technology performance evaluation project that included multiple U.S. states and cooperation from multiple electric utilities in the northwest region. One of the local objectives for the project was to achieve improved distribution system reliability. Toward this end, some PNWSGD utilities automated their distribution systems, including the application of fault detection, isolation, and restoration and advanced metering infrastructure. In light of this investment, a major challenge was to establish a correlation between implementation of these smart grid technologies and actual improvements of distribution system reliability. This paper proposes using Welch’smore » t-test to objectively determine and quantify whether distribution system reliability is improving over time. The proposed methodology is generic, and it can be implemented by any utility after calculation of the standard reliability indices. The effectiveness of the proposed hypothesis testing approach is demonstrated through comprehensive practical results. It is believed that wider adoption of the proposed approach can help utilities to evaluate a realistic long-term performance of smart grid technologies.« less

System Safety in an IT Service Organization

NASA Astrophysics Data System (ADS)

Parsons, Mike; Scutt, Simon

Within Logica UK, over 30 IT service projects are considered safetyrelated. These include operational IT services for airports, railway infrastructure asset management, nationwide radiation monitoring and hospital medical records services. A recent internal audit examined the processes and documents used to manage system safety on these services and made a series of recommendations for improvement. This paper looks at the changes and the challenges to introducing them, especially where the service is provided by multiple units supporting both safety and non-safety related services from multiple locations around the world. The recommendations include improvements to service agreements, improved process definitions, routine safety assessment of changes, enhanced call logging, improved staff competency and training, and increased safety awareness. Progress is reported as of today, together with a road map for implementation of the improvements to the service safety management system. A proposal for service assurance levels (SALs) is discussed as a way forward to cover the wide variety of services and associated safety risks.

Examining the impact of succession management practices on organizational performance: A national study of U.S. hospitals.

PubMed

Groves, Kevin S

2017-08-03

Spearheaded by the industry's transition from volume- to value-based care, the health care reform movement has spurred both unprecedented challenges and opportunities for developing more effective and sustainable health care delivery organizations. Whereas the formidable challenges of leading hospitals and health systems have been widely discussed, including reimbursement degradation, the rapidly aging workforce, and the imminent wave of executive retirements, the opportunity to leverage succession management and talent development capabilities to overcome these challenges has been largely overlooked. To address this key research and practice need, this multiphase study develops and validates an assessment of succession management practices for health care organizations. Utilizing data collected from two national samples of hospital organizations, the results provide a 32-item succession management assessment comprising seven distinct sets of succession management practices. The results indicate that succession management practices are strongly associated with multiple hospital performance metrics, including patient satisfaction and Medicare Spending per Beneficiary, leadership bench strength, and internal/external placement rate for executive level positions. The author concludes this article with a discussion of several practical implications for health care executives and boards, including employing the succession management assessment for diagnosing development opportunities, benchmarking succession planning and talent development practices against similar hospitals or health systems, and elevating the profile of succession management as a strategic priority in today's increasingly uncertain health care landscape.

Safety of disease-modifying drugs for multiple sclerosis in pregnancy: current challenges and future considerations for effective pharmacovigilance.

PubMed

Lu, Ellen; Wang, Bing Wei; Guimond, Colleen; Synnes, Anne; Sadovnick, A Dessa; Dahlgren, Leanne; Traboulsee, Anthony; Tremlett, Helen

2013-03-01

When contemplating a pregnancy, women treated for multiple sclerosis (MS) with a disease-modifying drug must decide to discontinue their medication before conception or risk exposing their unborn child to potential drug toxicity. Few studies exist as reference for patients and physicians, and of those available, the majority are less than ideal due to real-world constraints, ethical issues and methodological shortcomings. The authors provide a brief summary of existing animal and human data with current recommendations regarding the safety of IFN-β, glatiramer acetate, natalizumab, mitoxantrone, fingolimod and teriflunomide during pregnancy and lactation in women with MS. We also assess the quality, strengths and limitations of the existing studies including challenges with study design. The investigation of outcomes such as spontaneous abortion and congenital anomalies are highlighted with potential methodological improvements for future studies on drug safety in pregnancy suggested. The authors explore the pharmacokinetics and pharmacodynamics of the MS disease-modifying drugs for their possible mechanistic role in fetal harm and discuss the potential role of clinical trials. Future pharmacovigilance studies should continue to pursue multicenter collaboration with an emphasis on appropriate study design.

Comprehensive security framework for the communication and storage of medical images

NASA Astrophysics Data System (ADS)

Slik, David; Montour, Mike; Altman, Tym

2003-05-01

Confidentiality, integrity verification and access control of medical imagery and associated metadata is critical for the successful deployment of integrated healthcare networks that extend beyond the department level. As medical imagery continues to become widely accessed across multiple administrative domains and geographically distributed locations, image data should be able to travel and be stored on untrusted infrastructure, including public networks and server equipment operated by external entities. Given these challenges associated with protecting large-scale distributed networks, measures must be taken to protect patient identifiable information while guarding against tampering, denial of service attacks, and providing robust audit mechanisms. The proposed framework outlines a series of security practices for the protection of medical images, incorporating Transport Layer Security (TLS), public and secret key cryptography, certificate management and a token based trusted computing base. It outlines measures that can be utilized to protect information stored within databases, online and nearline storage, and during transport over trusted and untrusted networks. In addition, it provides a framework for ensuring end-to-end integrity of image data from acquisition to viewing, and presents a potential solution to the challenges associated with access control across multiple administrative domains and institution user bases.

Thin Film Physical Sensor Instrumentation Research and Development at NASA Glenn Research Center

NASA Technical Reports Server (NTRS)

Wrbanek, John D.; Fralick, Gustave C.

2006-01-01

A range of thin film sensor technology has been demonstrated enabling measurement of multiple parameters either individually or in sensor arrays including temperature, strain, heat flux, and flow. Multiple techniques exist for refractory thin film fabrication, fabrication and integration on complex surfaces and multilayered thin film insulation. Leveraging expertise in thin films and high temperature materials, investigations for the applications of thin film ceramic sensors has begun. The current challenges of instrumentation technology are to further develop systems packaging and component testing of specialized sensors, further develop instrumentation techniques on complex surfaces, improve sensor durability, and to address needs for extreme temperature applications. The technology research and development ongoing at NASA Glenn for applications to future launch vehicles, space vehicles, and ground systems is outlined.

Survival and multiplication of Vibrio cholerae in the upper bowel of infant mice.

PubMed

Baselski, V S; Medina, R A; Parker, C D

1978-11-01

The survival and multiplication of Vibrio cholerae strains of varying virulence in the upper bowel of orally challenged infant mice early in infection has been examined. Analysis of changes in the apparent specific activity (counts per minute per colony-forming unit) of the cell population after 4 h compared with the inoculum indicated that strain CA401 established a viable, multiplying cell population, whereas strains VB12 (a rough variant) and 569B were subject to host bactericidal and bacteriolytic mechanisms. An analysis of parameters which may affect the specific activity is included. We have defined the infective potential of the strains in terms of the changes in specific activity. The relative infective potentials are CA401 greater than 569B greater than VB12.

Survival and multiplication of Vibrio cholerae in the upper bowel of infant mice.

PubMed Central

Baselski, V S; Medina, R A; Parker, C D

1978-01-01

The survival and multiplication of Vibrio cholerae strains of varying virulence in the upper bowel of orally challenged infant mice early in infection has been examined. Analysis of changes in the apparent specific activity (counts per minute per colony-forming unit) of the cell population after 4 h compared with the inoculum indicated that strain CA401 established a viable, multiplying cell population, whereas strains VB12 (a rough variant) and 569B were subject to host bactericidal and bacteriolytic mechanisms. An analysis of parameters which may affect the specific activity is included. We have defined the infective potential of the strains in terms of the changes in specific activity. The relative infective potentials are CA401 greater than 569B greater than VB12. PMID:730364

Why We (Usually) Don't Have to Worry about Multiple Comparisons

ERIC Educational Resources Information Center

Gelman, Andrew; Hill, Jennifer; Yajima, Masanao

2012-01-01

Applied researchers often find themselves making statistical inferences in settings that would seem to require multiple comparisons adjustments. We challenge the Type I error paradigm that underlies these corrections. Moreover we posit that the problem of multiple comparisons can disappear entirely when viewed from a hierarchical Bayesian…

Space shuttle main engine: Interactive design challenges

NASA Technical Reports Server (NTRS)

Mccarty, J. P.; Wood, B. K.

1985-01-01

The operating requirements established by NASA for the SSME were considerably more demanding than those for earlier rocket engines used in the military launch vehicles or Apollo program. The SSME, in order to achieve the high performance, low weight, long life, reusable objectives, embodied technical demands far in excess of its predecessor rocket engines. The requirements dictated the use of high combustion pressure and the staged combustion cycle which maximizes performance through total use of all propellants in the main combustion process. This approach presented a myriad of technical challenges for maximization of performance within attainable state of the art capabilities for operating pressures, operating temperatures and rotating machinery efficiencies. Controlling uniformity of the high pressure turbomachinery turbine temperature environment was a key challenge for thrust level and life capability demanding innovative engineering. New approaches in the design of the components were necessary to accommodate the multiple use, minimum maintenance objectives. Included were the use of line replaceable units to facilitate field maintenance automatic checkout and internal inspection capabilities.

Relative performance of academic departments using DEA with sensitivity analysis.

PubMed

Tyagi, Preeti; Yadav, Shiv Prasad; Singh, S P

2009-05-01

The process of liberalization and globalization of Indian economy has brought new opportunities and challenges in all areas of human endeavor including education. Educational institutions have to adopt new strategies to make best use of the opportunities and counter the challenges. One of these challenges is how to assess the performance of academic programs based on multiple criteria. Keeping this in view, this paper attempts to evaluate the performance efficiencies of 19 academic departments of IIT Roorkee (India) through data envelopment analysis (DEA) technique. The technique has been used to assess the performance of academic institutions in a number of countries like USA, UK, Australia, etc. But we are using it first time in Indian context to the best of our knowledge. Applying DEA models, we calculate technical, pure technical and scale efficiencies and identify the reference sets for inefficient departments. Input and output projections are also suggested for inefficient departments to reach the frontier. Overall performance, research performance and teaching performance are assessed separately using sensitivity analysis.

New strategy for protein interactions and application to structure-based drug design

NASA Astrophysics Data System (ADS)

Zou, Xiaoqin

One of the greatest challenges in computational biophysics is to predict interactions between biological molecules, which play critical roles in biological processes and rational design of therapeutic drugs. Biomolecular interactions involve delicate interplay between multiple interactions, including electrostatic interactions, van der Waals interactions, solvent effect, and conformational entropic effect. Accurate determination of these complex and subtle interactions is challenging. Moreover, a biological molecule such as a protein usually consists of thousands of atoms, and thus occupies a huge conformational space. The large degrees of freedom pose further challenges for accurate prediction of biomolecular interactions. Here, I will present our development of physics-based theory and computational modeling on protein interactions with other molecules. The major strategy is to extract microscopic energetics from the information embedded in the experimentally-determined structures of protein complexes. I will also present applications of the methods to structure-based therapeutic design. Supported by NSF CAREER Award DBI-0953839, NIH R01GM109980, and the American Heart Association (Midwest Affiliate) [13GRNT16990076].

Pollution exposure on marine protected areas: A global assessment.

PubMed

Partelow, Stefan; von Wehrden, Henrik; Horn, Olga

2015-11-15

Marine protected areas (MPAs) face many challenges in their aim to effectively conserve marine ecosystems. In this study we analyze the extent of pollution exposure on the global fleet of MPAs. This includes indicators for current and future pollution and the implications for regionally clustered groups of MPAs with similar biophysical characteristics. To cluster MPAs into characteristic signature groups, their bathymetry, baseline biodiversity, distance from shore, mean sea surface temperature and mean sea surface salinity were used. We assess the extent at which each signature group is facing exposure from multiple pollution types. MPA groups experience similar pollution exposure on a regional level. We highlight how the challenges that MPAs face can be addressed through governance at the appropriate scale and design considerations for integrated terrestrial and marine management approaches within regional level networks. Furthermore, we present diagnostic social-ecological indicators for addressing the challenges facing unsuccessful MPAs with practical applications. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Survey of Recent Advances in Particle Filters and Remaining Challenges for Multitarget Tracking

PubMed Central

Wang, Xuedong; Sun, Shudong; Corchado, Juan M.

2017-01-01

We review some advances of the particle filtering (PF) algorithm that have been achieved in the last decade in the context of target tracking, with regard to either a single target or multiple targets in the presence of false or missing data. The first part of our review is on remarkable achievements that have been made for the single-target PF from several aspects including importance proposal, computing efficiency, particle degeneracy/impoverishment and constrained/multi-modal systems. The second part of our review is on analyzing the intractable challenges raised within the general multitarget (multi-sensor) tracking due to random target birth and termination, false alarm, misdetection, measurement-to-track (M2T) uncertainty and track uncertainty. The mainstream multitarget PF approaches consist of two main classes, one based on M2T association approaches and the other not such as the finite set statistics-based PF. In either case, significant challenges remain due to unknown tracking scenarios and integrated tracking management. PMID:29168772

A comparative study of ethylene oxide gas, hydrogen peroxide gas plasma, and low-temperature steam formaldehyde sterilization.

PubMed

Kanemitsu, Keiji; Imasaka, Takayuki; Ishikawa, Shiho; Kunishima, Hiroyuki; Harigae, Hideo; Ueno, Kumi; Takemura, Hiromu; Hirayama, Yoshihiro; Kaku, Mitsuo

2005-05-01

To compare the efficacies of ethylene oxide gas (EOG), hydrogen peroxide gas plasma (PLASMA), and low-temperature steam formaldehyde (LTSF) sterilization methods. The efficacies of EOG, PLASMA, and LTSF sterilization were tested using metal and plastic plates, common medical instruments, and three process challenge devices with narrow lumens. All items were contaminated with Bacillus stearothermophilus spores or used a standard biological indicator. EOG and LTSF demonstrated effective killing of B. stearothermophilus spores, with or without serum, on plates, on instruments, and in process challenge devices. PLASMA failed to adequately sterilize materials on multiple trials in several experiments, including two of three plates, two of three instruments, and all process challenge devices. Our results suggest that PLASMA sterilization may be unsuccessful under certain conditions, particularly when used for items with complex shapes and narrow lumens. Alternatively, LTSF sterilization demonstrates excellent efficacy and is comparable to EOG sterilization. LTSF could potentially act as a substitute if EOG becomes unavailable due to environmental concerns.

Challenges to replicating evidence-based research in real-world settings: training African-American peers as patient navigators for colon cancer screening.

PubMed

Sly, Jamilia R; Jandorf, Lina; Dhulkifl, Rayhana; Hall, Diana; Edwards, Tiffany; Goodman, Adam J; Maysonet, Elithea; Azeez, Sulaiman

2012-12-01

Many cancer-prevention interventions have demonstrated effectiveness in diverse populations, but these evidenced-based findings slowly disseminate into practice. The current study describes the process of disseminating and replicating research (i.e., peer patient navigation for colonoscopy screening) in real-world settings. Two large metropolitan hospitals collaborated to replicate a peer patient navigation model within their existing navigation systems. Six African-American peer volunteers were recruited and trained to navigate patients through colonoscopy scheduling and completion. Major challenges included: (1) operating within multiple institutional settings; (2) operating within nonacademic/research infrastructures; (3) integrating into an established navigation system; (4) obtaining support of hospital staff without overburdening; and (5) competing priorities and time commitments. Bridging the gap between evidence-based research and practice is critical to eliminating many cancer health disparities; therefore, it is crucial that researchers and practitioners continue to work to achieve both diffusion and fusion of evidence-based findings. Recommendations for addressing these challenges are discussed.

Everyday resilience in district health systems: emerging insights from the front lines in Kenya and South Africa

PubMed Central

Gilson, Lucy; Barasa, Edwine; Nxumalo, Nonhlanhla; Cleary, Susan; Goudge, Jane; Molyneux, Sassy; Tsofa, Benjamin; Lehmann, Uta

2017-01-01

Recent global crises have brought into sharp relief the absolute necessity of resilient health systems that can recognise and react to societal crises. While such crises focus the global mind, the real work lies, however, in being resilient in the face of routine, multiple challenges. But what are these challenges and what is the work of nurturing everyday resilience in health systems? This paper considers these questions, drawing on long-term, primarily qualitative research conducted in three different district health system settings in Kenya and South Africa, and adopting principles from case study research methodology and meta-synthesis in its analytic approach. The paper presents evidence of the instability and daily disruptions managed at the front lines of the district health system. These include patient complaints, unpredictable staff, compliance demands, organisational instability linked to decentralisation processes and frequently changing, and sometimes unclear, policy imperatives. The paper also identifies managerial responses to these challenges and assesses whether or not they indicate everyday resilience, using two conceptual lenses. From this analysis, we suggest that such resilience seems to arise from the leadership offered by multiple managers, through a combination of strategies that become embedded in relationships and managerial routines, drawing on wider organisational capacities and resources. While stable governance structures and adequate resources do influence everyday resilience, they are not enough to sustain it. Instead, it appears important to nurture the power of leaders across every system to reframe challenges, strengthen their routine practices in ways that encourage mindful staff engagement, and develop social networks within and outside organisations. Further research can build on these insights to deepen understanding. PMID:29081995

Everyday resilience in district health systems: emerging insights from the front lines in Kenya and South Africa.

PubMed

Gilson, Lucy; Barasa, Edwine; Nxumalo, Nonhlanhla; Cleary, Susan; Goudge, Jane; Molyneux, Sassy; Tsofa, Benjamin; Lehmann, Uta

2017-01-01

Recent global crises have brought into sharp relief the absolute necessity of resilient health systems that can recognise and react to societal crises. While such crises focus the global mind, the real work lies, however, in being resilient in the face of routine, multiple challenges. But what are these challenges and what is the work of nurturing everyday resilience in health systems? This paper considers these questions, drawing on long-term, primarily qualitative research conducted in three different district health system settings in Kenya and South Africa, and adopting principles from case study research methodology and meta-synthesis in its analytic approach. The paper presents evidence of the instability and daily disruptions managed at the front lines of the district health system. These include patient complaints, unpredictable staff, compliance demands, organisational instability linked to decentralisation processes and frequently changing, and sometimes unclear, policy imperatives. The paper also identifies managerial responses to these challenges and assesses whether or not they indicate everyday resilience, using two conceptual lenses. From this analysis, we suggest that such resilience seems to arise from the leadership offered by multiple managers, through a combination of strategies that become embedded in relationships and managerial routines, drawing on wider organisational capacities and resources. While stable governance structures and adequate resources do influence everyday resilience, they are not enough to sustain it. Instead, it appears important to nurture the power of leaders across every system to reframe challenges, strengthen their routine practices in ways that encourage mindful staff engagement, and develop social networks within and outside organisations. Further research can build on these insights to deepen understanding.

Systematic Review: The Effectiveness of Interventions to Reduce Falls and Improve Balance in Adults With Multiple Sclerosis.

PubMed

Gunn, Hilary; Markevics, Sophie; Haas, Bernhard; Marsden, Jonathan; Freeman, Jennifer

2015-10-01

To evaluate the effectiveness of interventions in reducing falls and/or improving balance as a falls risk in multiple sclerosis (MS). Computer-based and manual searches included the following medical subject heading keywords: "Multiple Sclerosis AND accidental falls" OR "Multiple Sclerosis AND postural balance" OR "Multiple Sclerosis AND exercise" OR "Multiple Sclerosis AND physical/physio therapy" NOT animals. All literature published to November 2014 with available full-text details were included. Studies were reviewed against the PICO (participants, interventions, comparisons, outcomes) selection criteria: P, adults with MS; I, falls management/balance rehabilitation interventions; C, randomized/quasi-randomized studies comparing intervention with usual care or placebo control; O, falls outcomes and measures of balance. Fifteen articles of the original 529 search results were included. Two reviewers independently extracted data and assessed methodological quality using the Cochrane Risk of Bias tool. Random-effects meta-analysis indicated a small decrease in falls risk (risk ratio, .74), although the 95% confidence interval (CI) crossed 1 (95% CI, .12-4.38). The pooled standardized mean difference (SMD) for balance outcomes was .55 (95% CI, .35-.74). SMD varied significantly between exercise subgroupings; gait, balance, and functional training interventions yielded the greatest pooled effect size (ES) (SMD=.82; 95% CI, 0.55-1.10). There was a moderate positive correlation between program volume (min/wk) and ES (Cohen's d) (r=.70, P=.009), and a moderate negative correlation between program duration in weeks and ES (r=-.62, P=.03). Variations in interventions and outcomes and methodological limitations mean that results must be viewed with caution. This review suggests that balance may improve through exercise interventions, but that the magnitude of the improvements achieved in existing programs may not be sufficient to impact falls outcomes. Supporting participants to achieve an appropriate intensity of practice of highly challenging balance activities appears to be critical to maximizing effectiveness. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Making grandma's data secure: a security architecture for home telemedicine.

PubMed Central

Starren, J.; Sengupta, S.; Hripcsak, G.; Ring, G.; Klerer, R.; Shea, S.

2001-01-01

Home telemedicine presents special challenges for data security and privacy. Experience in the Informatics for Diabetes Education And Telemedicine (IDEATel) project has demonstrated that data security is not a one-size-fits-all problem. The IDEATel users include elderly patients in their homes, nurse case managers, physicians, and researchers. The project supports multiple computer systems that require a variety of user interactions, including: data entry, data review, patient education, videoconferencing, and electronic monitoring. To meet these various needs, a number of different of security solutions were utilized, including: UserID/Password, PKI certificates, time-based tokens, IP filtering, VPNs, symmetric and asymmetric encryption schemes, firewalls and dedicated connections. These were combined in different ways to meet the needs of each user groups. PMID:11825267

A matter of tradeoffs: reintroduction as a multiple objective decision

USGS Publications Warehouse

Converse, Sarah J.; Moore, Clinton T.; Folk, Martin J.; Runge, Michael C.

2013-01-01

Decision making in guidance of reintroduction efforts is made challenging by the substantial scientific uncertainty typically involved. However, a less recognized challenge is that the management objectives are often numerous and complex. Decision makers managing reintroduction efforts are often concerned with more than just how to maximize the probability of reintroduction success from a population perspective. Decision makers are also weighing other concerns such as budget limitations, public support and/or opposition, impacts on the ecosystem, and the need to consider not just a single reintroduction effort, but conservation of the entire species. Multiple objective decision analysis is a powerful tool for formal analysis of such complex decisions. We demonstrate the use of multiple objective decision analysis in the case of the Florida non-migratory whooping crane reintroduction effort. In this case, the State of Florida was considering whether to resume releases of captive-reared crane chicks into the non-migratory whooping crane population in that state. Management objectives under consideration included maximizing the probability of successful population establishment, minimizing costs, maximizing public relations benefits, maximizing the number of birds available for alternative reintroduction efforts, and maximizing learning about the demographic patterns of reintroduced whooping cranes. The State of Florida engaged in a collaborative process with their management partners, first, to evaluate and characterize important uncertainties about system behavior, and next, to formally evaluate the tradeoffs between objectives using the Simple Multi-Attribute Rating Technique (SMART). The recommendation resulting from this process, to continue releases of cranes at a moderate intensity, was adopted by the State of Florida in late 2008. Although continued releases did not receive support from the International Whooping Crane Recovery Team, this approach does provide a template for the formal, transparent consideration of multiple, potentially competing, objectives in reintroduction decision making.

Citizen Science: Data Sharing For, By, and With the Public

NASA Astrophysics Data System (ADS)

Wiggins, A.

2017-12-01

Data sharing in citizen science is just as challenging as it is for any other type of science, except that there are more parties involved, with more diverse needs and interests. This talk provides an overview of the challenges and current efforts to advance data sharing in citizen science, and suggests refocusing data management activities on supporting the needs of multiple audiences. Early work on data sharing in citizen science advocated applying the standards and practices of academia, which can only address the needs of one of several audiences for citizen science data, and academics are not always the primary audience. Practitioners still need guidance on how to better share data other key parties, such as participants and policymakers, and which data management practices to prioritize for addressing the needs of multiple audiences. The benefits to the project of investing scarce resources into data products and dissemination strategies for each target audience still remain variable, unclear, or unpredictable. And as projects mature and change, the importance of data sharing activities and audiences are likely to change as well. This combination of multiple diverse audiences, shifting priorities, limited resources, and unclear benefits creates a perfect storm of conditions to suppress data sharing. Nonetheless, many citizen science projects make the effort, with exemplars showing substantial returns on data stewardship investments, and international initiatives are underway to bolster the data sharing capacity of the field. To improve the state of data sharing in citizen science, strategic use of limited resources suggests prioritizing data management activities that support the needs of multiple audiences. These may include better transparency about data access and usage, and standardized reporting of broader impacts from secondary data users, to both reward projects and incentivize further data sharing.

Multiple environmental stressors elicit complex interactive effects in the western fence lizard (Sceloporus occidentalis).

PubMed

McFarland, Craig A; Talent, Larry G; Quinn, Michael J; Bazar, Matthew A; Wilbanks, Mitchell S; Nisanian, Mandana; Gogal, Robert M; Johnson, Mark S; Perkins, Edward J; Gust, Kurt A

2012-11-01

Evaluation of multiple-stressor effects stemming from habitat degradation, climate change, and exposure to chemical contaminants is crucial for addressing challenges to ecological and environmental health. To assess the effects of multiple stressors in an understudied taxon, the western fence lizard (Sceloporus occidentalis) was used to characterize the individual and combined effects of food limitation, exposure to the munitions constituent 2,4,6-trinitrotoluene (TNT), and Plasmodium mexicanum (lizard malaria) infection. Three experimental assays were conducted including: Experiment I--TNT × Food Limitation, Experiment II--Food Limitation × Malaria Infection, and Experiment III--TNT × Malaria Infection. All experiments had a 30 day duration, the malaria treatment included infected and non infected control lizards, food limitation treatments included an ad libitum control and at least one reduced food ration and TNT exposures consisting of daily oral doses of corn oil control or a corn oil-TNT suspension at 5, 10, 20, 40 mg/kg/day. The individual stressors caused a variety of effects including: reduced feeding, reduced testes mass, anemia, increased white blood cell (WBC) concentrations and increased mass of liver, kidney and spleen in TNT exposures; reduced cholesterol, WBC concentrations and whole body, testes and inguinal fat weights given food limitation; and increased WBC concentrations and spleen weights as well as decreased cholesterol and testes mass in malaria infected lizards. Additive and interactive effects were found among certain stressor combinations including elimination of TNT-induced hormesis for growth under food limitation. Ultimately, our study indicates the potential for effects modulation when environmental stressors are combined.

Multiple Cognitive Control Effects of Error Likelihood and Conflict

PubMed Central

Brown, Joshua W.

2010-01-01

Recent work on cognitive control has suggested a variety of performance monitoring functions of the anterior cingulate cortex, such as errors, conflict, error likelihood, and others. Given the variety of monitoring effects, a corresponding variety of control effects on behavior might be expected. This paper explores whether conflict and error likelihood produce distinct cognitive control effects on behavior, as measured by response time. A change signal task (Brown & Braver, 2005) was modified to include conditions of likely errors due to tardy as well as premature responses, in conditions with and without conflict. The results discriminate between competing hypotheses of independent vs. interacting conflict and error likelihood control effects. Specifically, the results suggest that the likelihood of premature vs. tardy response errors can lead to multiple distinct control effects, which are independent of cognitive control effects driven by response conflict. As a whole, the results point to the existence of multiple distinct cognitive control mechanisms and challenge existing models of cognitive control that incorporate only a single control signal. PMID:19030873

Systems Biophysics of Gene Expression

PubMed Central

Vilar, Jose M.G.; Saiz, Leonor

2013-01-01

Gene expression is a process central to any form of life. It involves multiple temporal and functional scales that extend from specific protein-DNA interactions to the coordinated regulation of multiple genes in response to intracellular and extracellular changes. This diversity in scales poses fundamental challenges to the use of traditional approaches to fully understand even the simplest gene expression systems. Recent advances in computational systems biophysics have provided promising avenues to reliably integrate the molecular detail of biophysical process into the system behavior. Here, we review recent advances in the description of gene regulation as a system of biophysical processes that extend from specific protein-DNA interactions to the combinatorial assembly of nucleoprotein complexes. There is now basic mechanistic understanding on how promoters controlled by multiple, local and distal, DNA binding sites for transcription factors can actively control transcriptional noise, cell-to-cell variability, and other properties of gene regulation, including precision and flexibility of the transcriptional responses. PMID:23790365

The multiple-hit pathogenesis of non-alcoholic fatty liver disease (NAFLD).

PubMed

Buzzetti, Elena; Pinzani, Massimo; Tsochatzis, Emmanuel A

2016-08-01

Nonalcoholic fatty liver disease (NAFLD) is increasingly prevalent and represents a growing challenge in terms of prevention and treatment. Despite its high prevalence, only a small minority of affected patients develops inflammation and subsequently fibrosis and chronic liver disease, while most of them only exhibit simple steatosis. In this context, the full understanding of the mechanisms underlying the development of NAFLD and non-alcoholic steatohepatitis (NASH) is of extreme importance; despite advances in this field, knowledge on the pathogenesis of NAFLD is still incomplete. The 'two-hit' hypothesis is now obsolete, as it is inadequate to explain the several molecular and metabolic changes that take place in NAFLD. The "multiple hit" hypothesis considers multiple insults acting together on genetically predisposed subjects to induce NAFLD and provides a more accurate explanation of NAFLD pathogenesis. Such hits include insulin resistance, hormones secreted from the adipose tissue, nutritional factors, gut microbiota and genetic and epigenetic factors. In this article, we review the factors that form this hypothesis. Copyright © 2016 Elsevier Inc. All rights reserved.

Using a two-phase evolutionary framework to select multiple network spreaders based on community structure

NASA Astrophysics Data System (ADS)

Fu, Yu-Hsiang; Huang, Chung-Yuan; Sun, Chuen-Tsai

2016-11-01

Using network community structures to identify multiple influential spreaders is an appropriate method for analyzing the dissemination of information, ideas and infectious diseases. For example, data on spreaders selected from groups of customers who make similar purchases may be used to advertise products and to optimize limited resource allocation. Other examples include community detection approaches aimed at identifying structures and groups in social or complex networks. However, determining the number of communities in a network remains a challenge. In this paper we describe our proposal for a two-phase evolutionary framework (TPEF) for determining community numbers and maximizing community modularity. Lancichinetti-Fortunato-Radicchi benchmark networks were used to test our proposed method and to analyze execution time, community structure quality, convergence, and the network spreading effect. Results indicate that our proposed TPEF generates satisfactory levels of community quality and convergence. They also suggest a need for an index, mechanism or sampling technique to determine whether a community detection approach should be used for selecting multiple network spreaders.

Management and integration of engineering and construction activities: Lessons learned from the AP1000{sup R} nuclear power plant China project

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

McCullough, M. C.; Ebeling-Koning, D.; Evans, M. C.

2012-07-01

The lessons learned during the early phase of design engineering and construction activities for the AP1000 China Project can be applied to any project involving multiple disciplines and multiple organizations. Implementation of a first-of-a-kind design to directly support construction activities utilizing resources assigned to design development and design delivery creates challenges with prioritization of activities, successful closure of issues, and communication between site organizations and the home office. To ensure successful implementation, teams were assigned and developed to directly support construction activities including prioritization of activities, site communication and ensuring closure of site emergent issues. By developing these teams, themore » organization is better suited to meet the demands of the construction schedule while continuing with design evolution of a standard plant and engineering delivery for multiple projects. For a successful project, proper resource utilization and prioritization are key for overcoming obstacles and ensuring success of the engineering organization. (authors)« less

Approach to a case of multiple irregular red cell antibodies in a liver transplant recipient: Need for developing competence

PubMed Central

Dara, Ravi C.; Tiwari, Aseem K.; Pandey, Prashant; Arora, Dinesh

2015-01-01

Liver transplant procedure acts as a challenge for transfusion services in terms of specialized blood components, serologic problems, and immunologic effects of transfusion. Red cell alloimmunization in patients awaiting a liver transplant complicate the process by undue delay or unavailability of compatible red blood cell units. Compatible blood units can be provided by well-equipped immunohematology laboratory, which has expertise in resolving these serological problems. This report illustrates resolution of a case with multiple alloantibodies using standard techniques, particularly rare antisera. Our case re-emphasizes the need for universal antibody screening in all patients as part of pretransfusion testing, which helps to identify atypical antibodies and plan for appropriate transfusion support well in time. We recommend that the centers, especially the ones that perform complex procedures like solid organ transplants and hematological transplants should have the necessary immunohematological reagents including rare antisera to resolve complex cases of multiple antibodies as illustrated in this case. PMID:25722585

Multiple Schwannomas of the Spine: Review of the Schwannomatosis or Congenital Neurilemmomatosis: A Case Report.

PubMed

Lee, Sang-Hoon; Kim, Se-Hoon; Kim, Bum-Joon; Lim, Dong-Jun

2015-06-01

Schwannomas are the most common benign nerve sheath tumors originating in Schwann cells. With special conditions like neurofibromatosis type 2 or entity called schwannomatosis, patients develop multiple schwannomas. But in clinical setting, distinguishing schwannomatosis from neurofibromatosis type 2 is challengeable. We describe 58-year-old male who presented with severe neuropathic pain, from schwannomatosis featuring multiple schwannomas of spine and trunk, and underwent surgical treatment. We demonstrate his radiologic and clinical findings, and discuss about important clinical features of this condition. To confirm schwannomatosis, we performed brain magnetic resonance imaging, and took his familial history. Staged surgery was done for pathological confirmation and relief of the pain. Schwannomatosis and neurofibromatosis type 2 are similar but different disease. There are diagnostic hallmarks of these conditions, including familial history, pathology, and brain imaging. Because of different prognosis, the two diseases must be distinguished, so diagnostic tests that are mentioned above should be performed in caution.

Multiple Schwannomas of the Spine: Review of the Schwannomatosis or Congenital Neurilemmomatosis: A Case Report

PubMed Central

Lee, Sang-Hoon; Kim, Bum-Joon; Lim, Dong-Jun

2015-01-01

Schwannomas are the most common benign nerve sheath tumors originating in Schwann cells. With special conditions like neurofibromatosis type 2 or entity called schwannomatosis, patients develop multiple schwannomas. But in clinical setting, distinguishing schwannomatosis from neurofibromatosis type 2 is challengeable. We describe 58-year-old male who presented with severe neuropathic pain, from schwannomatosis featuring multiple schwannomas of spine and trunk, and underwent surgical treatment. We demonstrate his radiologic and clinical findings, and discuss about important clinical features of this condition. To confirm schwannomatosis, we performed brain magnetic resonance imaging, and took his familial history. Staged surgery was done for pathological confirmation and relief of the pain. Schwannomatosis and neurofibromatosis type 2 are similar but different disease. There are diagnostic hallmarks of these conditions, including familial history, pathology, and brain imaging. Because of different prognosis, the two diseases must be distinguished, so diagnostic tests that are mentioned above should be performed in caution. PMID:26217390

Multiple intracranial aneurysms and moyamoya disease associated with microcephalic osteodysplastic primordial dwarfism type II: surgical considerations.

PubMed

Waldron, James S; Hetts, Steven W; Armstrong-Wells, Jennifer; Dowd, Christopher F; Fullerton, Heather J; Gupta, Nalin; Lawton, Michael T

2009-11-01

Microcephalic osteodysplastic primordial dwarfism type II (MOPD II) is a rare genetic syndrome characterized by extremely small stature and microcephaly, and is associated in 25% of patients with intracranial aneurysms and moyamoya disease. Although aneurysmal subarachnoid hemorrhage and stroke are leading causes of morbidity and death in these patients, MOPD II is rarely examined in the neurosurgical literature. The authors report their experience with 3 patients who presented with MOPD II, which includes a patient with 8 aneurysms (the most aneurysms reported in the literature), and the first report of a patient with both moyamoya disease and multiple aneurysms. The poor natural history of these lesions indicates aggressive microsurgical and/or endovascular therapy. Microsurgery, whether for aneurysm clip placement or extracranial-intracranial bypass, is challenging due to tight surgical corridors and diminutive arteries in these patients, but is technically feasible and strongly indicated when multiple aneurysms must be treated or cerebral revascularization is needed.

Epizootic pneumonia of bighorn sheep following experimental exposure to Mycoplasma ovipneumoniae.

PubMed

Besser, Thomas E; Cassirer, E Frances; Potter, Kathleen A; Lahmers, Kevin; Oaks, J Lindsay; Shanthalingam, Sudarvili; Srikumaran, Subramaniam; Foreyt, William J

2014-01-01

Bronchopneumonia is a population limiting disease of bighorn sheep (Ovis canadensis). The cause of this disease has been a subject of debate. Leukotoxin expressing Mannheimia haemolytica and Bibersteinia trehalosi produce acute pneumonia after experimental challenge but are infrequently isolated from animals in natural outbreaks. Mycoplasma ovipneumoniae, epidemiologically implicated in naturally occurring outbreaks, has received little experimental evaluation as a primary agent of bighorn sheep pneumonia. In two experiments, bighorn sheep housed in multiple pens 7.6 to 12 m apart were exposed to M. ovipneumoniae by introduction of a single infected or challenged animal to a single pen. Respiratory disease was monitored by observation of clinical signs and confirmed by necropsy. Bacterial involvement in the pneumonic lungs was evaluated by conventional aerobic bacteriology and by culture-independent methods. In both experiments the challenge strain of M. ovipneumoniae was transmitted to all animals both within and between pens and all infected bighorn sheep developed bronchopneumonia. In six bighorn sheep in which the disease was allowed to run its course, three died with bronchopneumonia 34, 65, and 109 days after M. ovipneumoniae introduction. Diverse bacterial populations, predominantly including multiple obligate anaerobic species, were present in pneumonic lung tissues at necropsy. Exposure to a single M. ovipneumoniae infected animal resulted in transmission of infection to all bighorn sheep both within the pen and in adjacent pens, and all infected sheep developed bronchopneumonia. The epidemiologic, pathologic and microbiologic findings in these experimental animals resembled those seen in naturally occurring pneumonia outbreaks in free ranging bighorn sheep.

Modeling oscillatory dynamics in brain microcircuits as a way to help uncover neurological disease mechanisms: A proposal

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

Skinner, F. K.; Department of Medicine; Department of Physiology, University of Toronto Medical Sciences Building, 3rd Floor, 1 King's College Circle, Toronto, Ontario M5S 1A8

There is an undisputed need and requirement for theoretical and computational studies in Neuroscience today. Furthermore, it is clear that oscillatory dynamical output from brain networks is representative of various behavioural states, and it is becoming clear that one could consider these outputs as measures of normal and pathological brain states. Although mathematical modeling of oscillatory dynamics in the context of neurological disease exists, it is a highly challenging endeavour because of the many levels of organization in the nervous system. This challenge is coupled with the increasing knowledge of cellular specificity and network dysfunction that is associated with disease.more » Recently, whole hippocampus in vitro preparations from control animals have been shown to spontaneously express oscillatory activities. In addition, when using preparations derived from animal models of disease, these activities show particular alterations. These preparations present an opportunity to address challenges involved with using models to gain insight because of easier access to simultaneous cellular and network measurements, and pharmacological modulations. We propose that by developing and using models with direct links to experiment at multiple levels, which at least include cellular and microcircuit, a cycling can be set up and used to help us determine critical mechanisms underlying neurological disease. We illustrate our proposal using our previously developed inhibitory network models in the context of these whole hippocampus preparations and show the importance of having direct links at multiple levels.« less

Achieving work-life balance in the National Collegiate Athletic Association Division I setting, part II: perspectives from head athletic trainers.

PubMed

Goodman, Ashley; Mazerolle, Stephanie M; Pitney, William A

2015-01-01

Work-life balance has been examined at the collegiate level from multiple perspectives except for the athletic trainer (AT) serving in a managerial or leadership role. To investigate challenges and strategies used in achieving work-life balance from the perspective of the head AT at a National Collegiate Athletic Association Division I university. Qualitative study. Web-based management system. A total of 18 head ATs (13 men, 5 women; age = 44 ± 8 years, athletic training experience = 22 ± 7 years) volunteered. Participants journaled their thoughts and experiences in response to a series of questions. To establish data credibility, we included multiple-analyst triangulation, stakeholder checks, and peer review. We used a general inductive approach to analyze the data. Two higher-order themes emerged from our analysis of the data: organizational challenges and work-life balance strategies. The organizational challenges theme contained 2 lower-order themes: lack of autonomy and role demands. The work-life balance strategies theme contained 3 lower-order themes: prioritization of commitments, strategic boundary setting, and work-family integration. Head ATs are susceptible to experiencing work-life imbalance just as ATs in nonsupervisory roles are. Although not avoidable, the causes are manageable. Head ATs are encouraged to prioritize their personal time, make efforts to spend time away from their demanding positions, and reduce the number of additional responsibilities that can impede time available to spend away from work.

Architecture for Cognitive Networking within NASA's Future Space Communications Infrastructure

NASA Technical Reports Server (NTRS)

Clark, Gilbert; Eddy, Wesley M.; Johnson, Sandra K.; Barnes, James; Brooks, David

2016-01-01

Future space mission concepts and designs pose many networking challenges for command, telemetry, and science data applications with diverse end-to-end data delivery needs. For future end-to-end architecture designs, a key challenge is meeting expected application quality of service requirements for multiple simultaneous mission data flows with options to use diverse onboard local data buses, commercial ground networks, and multiple satellite relay constellations in LEO, GEO, MEO, or even deep space relay links. Effectively utilizing a complex network topology requires orchestration and direction that spans the many discrete, individually addressable computer systems, which cause them to act in concert to achieve the overall network goals. The system must be intelligent enough to not only function under nominal conditions, but also adapt to unexpected situations, and reorganize or adapt to perform roles not originally intended for the system or explicitly programmed. This paper describes an architecture enabling the development and deployment of cognitive networking capabilities into the envisioned future NASA space communications infrastructure. We begin by discussing the need for increased automation, including inter-system discovery and collaboration. This discussion frames the requirements for an architecture supporting cognitive networking for future missions and relays, including both existing endpoint-based networking models and emerging information-centric models. From this basis, we discuss progress on a proof-of-concept implementation of this architecture, and results of implementation and initial testing of a cognitive networking on-orbit application on the SCaN Testbed attached to the International Space Station.

Architecture for Cognitive Networking within NASAs Future Space Communications Infrastructure

NASA Technical Reports Server (NTRS)

Clark, Gilbert J., III; Eddy, Wesley M.; Johnson, Sandra K.; Barnes, James; Brooks, David

2016-01-01

Future space mission concepts and designs pose many networking challenges for command, telemetry, and science data applications with diverse end-to-end data delivery needs. For future end-to-end architecture designs, a key challenge is meeting expected application quality of service requirements for multiple simultaneous mission data flows with options to use diverse onboard local data buses, commercial ground networks, and multiple satellite relay constellations in LEO, MEO, GEO, or even deep space relay links. Effectively utilizing a complex network topology requires orchestration and direction that spans the many discrete, individually addressable computer systems, which cause them to act in concert to achieve the overall network goals. The system must be intelligent enough to not only function under nominal conditions, but also adapt to unexpected situations, and reorganize or adapt to perform roles not originally intended for the system or explicitly programmed. This paper describes architecture features of cognitive networking within the future NASA space communications infrastructure, and interacting with the legacy systems and infrastructure in the meantime. The paper begins by discussing the need for increased automation, including inter-system collaboration. This discussion motivates the features of an architecture including cognitive networking for future missions and relays, interoperating with both existing endpoint-based networking models and emerging information-centric models. From this basis, we discuss progress on a proof-of-concept implementation of this architecture as a cognitive networking on-orbit application on the SCaN Testbed attached to the International Space Station.

A longitudinal model for disease progression was developed and applied to multiple sclerosis

PubMed Central

Lawton, Michael; Tilling, Kate; Robertson, Neil; Tremlett, Helen; Zhu, Feng; Harding, Katharine; Oger, Joel; Ben-Shlomo, Yoav

2015-01-01

Objectives To develop a model of disease progression using multiple sclerosis (MS) as an exemplar. Study Design and Settings Two observational cohorts, the University of Wales MS (UoWMS), UK (1976), and British Columbia MS (BCMS) database, Canada (1980), with longitudinal disability data [the Expanded Disability Status Scale (EDSS)] were used; individuals potentially eligible for MS disease-modifying drugs treatments, but who were unexposed, were selected. Multilevel modeling was used to estimate the EDSS trajectory over time in one data set and validated in the other; challenges addressed included the choice and function of time axis, complex observation-level variation, adjustments for MS relapses, and autocorrelation. Results The best-fitting model for the UoWMS cohort (404 individuals, and 2,290 EDSS observations) included a nonlinear function of time since onset. Measurement error decreased over time and ad hoc methods reduced autocorrelation and the effect of relapse. Replication within the BCMS cohort (978 individuals and 7,335 EDSS observations) led to a model with similar time (years) coefficients, time [0.22 (95% confidence interval {CI}: 0.19, 0.26), 0.16 (95% CI: 0.10, 0.22)] and log time [−0.13 (95% CI: −0.39, 0.14), −0.15 (95% CI: −0.70, 0.40)] for BCMS and UoWMS, respectively. Conclusion It is possible to develop robust models of disability progression for chronic disease. However, explicit validation is important given the complex methodological challenges faced. PMID:26071892

Spintronic Nanodevices for Bioinspired Computing

PubMed Central

Grollier, Julie; Querlioz, Damien; Stiles, Mark D.

2016-01-01

Bioinspired hardware holds the promise of low-energy, intelligent, and highly adaptable computing systems. Applications span from automatic classification for big data management, through unmanned vehicle control, to control for biomedical prosthesis. However, one of the major challenges of fabricating bioinspired hardware is building ultra-high-density networks out of complex processing units interlinked by tunable connections. Nanometer-scale devices exploiting spin electronics (or spintronics) can be a key technology in this context. In particular, magnetic tunnel junctions (MTJs) are well suited for this purpose because of their multiple tunable functionalities. One such functionality, non-volatile memory, can provide massive embedded memory in unconventional circuits, thus escaping the von-Neumann bottleneck arising when memory and processors are located separately. Other features of spintronic devices that could be beneficial for bioinspired computing include tunable fast nonlinear dynamics, controlled stochasticity, and the ability of single devices to change functions in different operating conditions. Large networks of interacting spintronic nanodevices can have their interactions tuned to induce complex dynamics such as synchronization, chaos, soliton diffusion, phase transitions, criticality, and convergence to multiple metastable states. A number of groups have recently proposed bioinspired architectures that include one or several types of spintronic nanodevices. In this paper, we show how spintronics can be used for bioinspired computing. We review the different approaches that have been proposed, the recent advances in this direction, and the challenges toward fully integrated spintronics complementary metal–oxide–semiconductor (CMOS) bioinspired hardware. PMID:27881881

Designs for Evaluating the Community-Level Impact of Comprehensive Prevention Programs: Examples from the CDC Centers of Excellence in Youth Violence Prevention.

PubMed

Farrell, Albert D; Henry, David; Bradshaw, Catherine; Reischl, Thomas

2016-04-01

This article discusses the opportunities and challenges of developing research designs to evaluate the impact of community-level prevention efforts. To illustrate examples of evaluation designs, we describe six projects funded by the Centers for Disease Control and Prevention to evaluate multifaceted approaches to reduce youth violence in high-risk communities. Each of these projects was designed to evaluate the community-level impact of multiple intervention strategies to address individual and contextual factors that place youth at risk for violent behavior. Communities differed across projects in their setting, size, and how their boundaries were defined. Each project is using multiple approaches to compare outcomes in one or more intervention communities to those in comparison communities. Five of the projects are using comparative interrupted time-series designs to compare outcomes in an intervention community to matched comparison communities. A sixth project is using a multiple baseline design in which the order and timing of intervention activities is randomized across three communities. All six projects are also using regression point displacement designs to compare outcomes within intervention communities to those within broader sets of similar communities. Projects are using a variety of approaches to assess outcomes including archival records, surveys, and direct observations. We discuss the strengths and weaknesses of the designs of these projects and illustrate the challenges of designing high-quality evaluations of comprehensive prevention approaches implemented at the community level.

Particle Beam Radiography

NASA Astrophysics Data System (ADS)

Peach, Ken; Ekdahl, Carl

2014-02-01

Particle beam radiography, which uses a variety of particle probes (neutrons, protons, electrons, gammas and potentially other particles) to study the structure of materials and objects noninvasively, is reviewed, largely from an accelerator perspective, although the use of cosmic rays (mainly muons but potentially also high-energy neutrinos) is briefly reviewed. Tomography is a form of radiography which uses multiple views to reconstruct a three-dimensional density map of an object. There is a very wide range of applications of radiography and tomography, from medicine to engineering and security, and advances in instrumentation, specifically the development of electronic detectors, allow rapid analysis of the resultant radiographs. Flash radiography is a diagnostic technique for large high-explosive-driven hydrodynamic experiments that is used at many laboratories. The bremsstrahlung radiation pulse from an intense relativistic electron beam incident onto a high-Z target is the source of these radiographs. The challenge is to provide radiation sources intense enough to penetrate hundreds of g/cm2 of material, in pulses short enough to stop the motion of high-speed hydrodynamic shocks, and with source spots small enough to resolve fine details. The challenge has been met with a wide variety of accelerator technologies, including pulsed-power-driven diodes, air-core pulsed betatrons and high-current linear induction accelerators. Accelerator technology has also evolved to accommodate the experimenters' continuing quest for multiple images in time and space. Linear induction accelerators have had a major role in these advances, especially in providing multiple-time radiographs of the largest hydrodynamic experiments.

I don't think general practice should be the front line: Experiences of general practitioners working with refugees in South Australia

PubMed Central

Johnson, David R; Ziersch, Anna M; Burgess, Teresa

2008-01-01

Introduction Many refugees arrive in Australia with complex health needs. In South Australia (SA), providing initial health care to refugees is the responsibility of General Practitioners (GPs) in private practice. Their capacity to perform this work effectively for current newly arrived refugees is uncertain. The aim of this study was to document the challenges faced by GPs in private practice in SA when providing initial care to refugees and to discuss the implications of this for policy relating to optimising health care services for refugees. Methods Semi-structured interviews with twelve GPs in private practice and three Medical Directors of Divisions of General Practice. Using a template analysis approach the interviews were coded and analysed thematically. Results Multiple challenges providing care to refugees were found including those related to: (1) refugee health issues; (2) the GP-refugee interaction; and (3) the structure of general practice. The Divisions also reported challenges assisting GPs to provide effective care related to a lack of funding and awareness of which GPs required support. Although respondents suggested a number of ways that GPs could be assisted to provide better initial care to refugees, strong support was voiced for the initial care of refugees to be provided via a specialist refugee health service. Conclusion GPs in this study were under-resourced, at both an individual GP level as well as a structural level, to provide effective initial care for refugees. In SA, there are likely to be a number of challenges attempting to increase the capacity of GPs in private practice to provide initial care. An alternative model is for refugees with multiple and complex health care needs as well as those with significant resettlement challenges to receive initial health care via the existing specialist refugee health service in Adelaide. PMID:18687150

Challenges of the English Teacher in the Engineering Faculty

ERIC Educational Resources Information Center

Astrid, Ramirez Valencia; Isabel, Borja-Alarcón; Alfonso, López-Vega

2018-01-01

Changes experienced in recent times focus their attention on new and multiple challenges that must be assumed by the English teacher, in the engineering context, which becomes a challenge against the demands by the current world from the English teacher in Colombia. This situation needs to be analyzed and studied. This article addresses the…

Self-Management and Parents as Interventionists to Improve Homework Independence in Students with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Hampshire, Patricia Korzekwa; Butera, Gretchen D.; Bellini, Scott

2016-01-01

Homework challenges are particularly relevant for students with autism spectrum disorders who demonstrate difficulty maintaining attention, motivation, and developing effective study skills. These challenges are often exacerbated for adolescents with disabilities who face a number of challenges during the middle school years. A multiple baseline…

Multiple Methods for Identifying Outcomes of a High Challenge Adventure Activity

ERIC Educational Resources Information Center

Davidson, Curt; Ewert, Alan; Chang, Yun

2016-01-01

The purpose of this study was to provide insight into what occurs in moments of high challenge within participants during an outdoor adventure education (OAE) program. Given the inherent risk and remote locations often associated with OAE programs, it has remained challenging to measure selected psychological constructs while the program is taking…

'I feel like a salesperson': the effect of multiple-source care funding on the experiences and views of nursing home nurses in England.

PubMed

Thompson, Juliana; Cook, Glenda; Duschinsky, Robbie

2015-06-01

The difficulties faced in the recruitment and retention of nursing staff in nursing homes for older people are an international challenge. It is therefore essential that the causes of nurses' reluctance to work in these settings are determined. This paper considers the influence that multiple-source care funding issues have on nursing home nurses' experiences and views regarding the practice and appeal of the role. The methodology for this study was hermeneutic phenomenology. Thirteen nurses from seven nursing homes in the North East of England were interviewed in a sequence of up to five interviews and data were analysed using a literary analysis method. Findings indicate that participants are uncomfortable with the business aspects that funding issues bring to their role. The primary difficulties faced are: tensions between care issues and funding issues; challenges associated with 'selling beds'; and coping with self-funding residents' changing expectations of care. The findings of the study suggest that multiple-source care funding systems that operate in nursing homes for older people pose challenges to nursing home nurses. Some of these challenges may impact on their recruitment and retention. © 2014 John Wiley & Sons Ltd.

Preparing Future Scholars for Academia and Beyond: A Mixed Method Investigation of Doctoral Students' Preparedness for Multiple Career Paths

ERIC Educational Resources Information Center

Cason, Jennifer

2016-01-01

This action research study is a mixed methods investigation of doctoral students' preparedness for multiple career paths. PhD students face two challenges preparing for multiple career paths: lack of preparation and limited engagement in conversations about the value of their research across multiple audiences. This study focuses on PhD students'…

Sit less and move more: perspectives of adults with multiple sclerosis.

PubMed

Aminian, Saeideh; Ezeugwu, Victor E; Motl, Robert W; Manns, Patricia J

2017-12-20

Multiple sclerosis is a chronic neurological disease with the highest prevalence in Canada. Replacing sedentary behavior with light activities may be a feasible approach to manage multiple sclerosis symptoms. This study explored the perspectives of adults with multiple sclerosis about sedentary behavior, physical activity and ways to change behavior. Fifteen adults with multiple sclerosis (age 43 ± 13 years; mean ± standard deviation), recruited through the multiple sclerosis Clinic at the University of Alberta, Edmonton, Canada, participated in semi-structured interviews. Interview audios were transcribed verbatim and coded. NVivo software was used to facilitate the inductive process of thematic analysis. Balancing competing priorities between sitting and moving was the primary theme. Participants were aware of the benefits of physical activity to their overall health, and in the management of fatigue and muscle stiffness. Due to fatigue, they often chose sitting to get their energy back. Further, some barriers included perceived fear of losing balance or embarrassment while walking. Activity monitoring, accountability, educational and individualized programs were suggested strategies to motivate more movement. Adults with multiple sclerosis were open to the idea of replacing sitting with light activities. Motivational and educational programs are required to help them to change sedentary behavior to moving more. IMPLICATIONS FOR REHABILITATION One of the most challenging and common difficulties of multiple sclerosis is walking impairment that worsens because of multiple sclerosis progression, and is a common goal in the rehabilitation of people with multiple sclerosis. The deterioration in walking abilities is related to lower levels of physical activity and more sedentary behavior, such that adults with multiple sclerosis spend 8 to 10.5 h per day sitting. Replacing prolonged sedentary behavior with light physical activities, and incorporating education, encouragement, and self-monitoring strategies are feasible approaches to manage the symptoms of multiple sclerosis.

Convergent Evidence Scaling for Multiple Assessment Indicators: Conceptual Issues, Applications, and Technical Challenges

ERIC Educational Resources Information Center

Busse, R. T.; Elliott, Stephen N.; Kratochwill, Thomas R.

2010-01-01

The purpose of this article is to present Convergent Evidence Scaling (CES) as an emergent method for combining data from multiple assessment indicators. The CES method combines single-case assessment data by converging data gathered across multiple persons, settings, or measures, thereby providing an overall criterion-referenced outcome on which…

Longitudinal Multiple Sclerosis Lesion Segmentation: Resource & Challenge

PubMed Central

Carass, Aaron; Roy, Snehashis; Jog, Amod; Cuzzocreo, Jennifer L.; Magrath, Elizabeth; Gherman, Adrian; Button, Julia; Nguyen, James; Prados, Ferran; Sudre, Carole H.; Cardoso, Manuel Jorge; Cawley, Niamh; Ciccarelli, Olga; Wheeler-Kingshott, Claudia A. M.; Ourselin, Sébastien; Catanese, Laurence; Deshpande, Hrishikesh; Maurel, Pierre; Commowick, Olivier; Barillot, Christian; Tomas-Fernandez, Xavier; Warfield, Simon K.; Vaidya, Suthirth; Chunduru, Abhijith; Muthuganapathy, Ramanathan; Krishnamurthi, Ganapathy; Jesson, Andrew; Arbel, Tal; Maier, Oskar; Handels, Heinz; Iheme, Leonardo O.; Unay, Devrim; Jain, Saurabh; Sima, Diana M.; Smeets, Dirk; Ghafoorian, Mohsen; Platel, Bram; Birenbaum, Ariel; Greenspan, Hayit; Bazin, Pierre-Louis; Calabresi, Peter A.; Crainiceanu, Ciprian M.; Ellingsen, Lotta M.; Reich, Daniel S.; Prince, Jerry L.; Pham, Dzung L.

2017-01-01

In conjunction with the ISBI 2015 conference, we organized a longitudinal lesion segmentation challenge providing training and test data to registered participants. The training data consisted of five subjects with a mean of 4.4 time-points, and test data of fourteen subjects with a mean of 4.4 time-points. All 82 data sets had the white matter lesions associated with multiple sclerosis delineated by two human expert raters. Eleven teams submitted results using state-of-the-art lesion segmentation algorithms to the challenge, with ten teams presenting their results at the conference. We present a quantitative evaluation comparing the consistency of the two raters as well as exploring the performance of the eleven submitted results in addition to three other lesion segmentation algorithms. The challenge presented three unique opportunities: 1) the sharing of a rich data set; 2) collaboration and comparison of the various avenues of research being pursued in the community; and 3) a review and refinement of the evaluation metrics currently in use. We report on the performance of the challenge participants, as well as the construction and evaluation of a consensus delineation. The image data and manual delineations will continue to be available for download, through an evaluation website1 as a resource for future researchers in the area. This data resource provides a platform to compare existing methods in a fair and consistent manner to each other and multiple manual raters. PMID:28087490

The relative abundance of hemocyte types in a polyphagous moth larva depends on diet.

PubMed

Vogelweith, Fanny; Moret, Yannick; Monceau, Karine; Thiéry, Denis; Moreau, Jérôme

2016-05-01

Hemocytes are crucial cells of the insect immune system because of their involvement in multiple immune responses including coagulation, phagocytosis and encapsulation. There are various types of hemocytes, each having a particular role in immunity, such that variation in their relative abundance affects the outcome of the immune response. This study aims to characterize these various types of hemocytes in larvae of the grapevine pest insect Eupoecilia ambiguella, and to assess variation in their concentration as a function of larval diet and immune challenge. Four types of hemocytes were found in the hemolymph of 5th instar larvae: granulocytes, oenocytoids, plasmatocytes and spherulocytes. We found that the total concentration of hemocytes and the concentration of each hemocyte type varied among diets and in response to the immune challenge. Irrespective of the diet, the concentration of granulocytes increased following a bacterial immune challenge, while the concentration of plasmatocytes and spherulocytes differentially varied between larval diets. The concentration of oenocytoids did not vary among diets before the immune challenge but varied between larval diets in response to the challenge. These results suggest that the resistance of insect larvae to different natural enemies critically depends on the effect of larval diet on the larvae's investment into the different types of hemocytes. Copyright © 2016 Elsevier Ltd. All rights reserved.

NASA Space Rocket Logistics Challenges

NASA Technical Reports Server (NTRS)

Neeley, James R.; Jones, James V.; Watson, Michael D.; Bramon, Christopher J.; Inman, Sharon K.; Tuttle, Loraine

2014-01-01

The Space Launch System (SLS) is the new NASA heavy lift launch vehicle and is scheduled for its first mission in 2017. The goal of the first mission, which will be uncrewed, is to demonstrate the integrated system performance of the SLS rocket and spacecraft before a crewed flight in 2021. SLS has many of the same logistics challenges as any other large scale program. Common logistics concerns for SLS include integration of discreet programs geographically separated, multiple prime contractors with distinct and different goals, schedule pressures and funding constraints. However, SLS also faces unique challenges. The new program is a confluence of new hardware and heritage, with heritage hardware constituting seventy-five percent of the program. This unique approach to design makes logistics concerns such as commonality especially problematic. Additionally, a very low manifest rate of one flight every four years makes logistics comparatively expensive. That, along with the SLS architecture being developed using a block upgrade evolutionary approach, exacerbates long-range planning for supportability considerations. These common and unique logistics challenges must be clearly identified and tackled to allow SLS to have a successful program. This paper will address the common and unique challenges facing the SLS programs, along with the analysis and decisions the NASA Logistics engineers are making to mitigate the threats posed by each.

Preface to the special issue on ;Optical Communications Exploiting the Space Domain;

NASA Astrophysics Data System (ADS)

Wang, Jian; Yu, Siyuan; Li, Guifang

2018-02-01

The demand for high capacity optical communications will continue to be driven by the exponential growth of global internet traffic. Optical communications are about the exploitation of different physical dimensions of light waves, including complex amplitude, frequency (or wavelength), time, polarization, etc. Conventional techniques such as wavelength-division multiplexing (WDM), time-division multiplexing (TDM) and polarization-division multiplexing (PDM) have almost reached their scalability limits. Space domain is the only known physical dimension left and space-division multiplexing (SDM) seems the only option to further scale the transmission capacity and spectral efficiency of optical communications. In recent years, few-mode fiber (FMF), multi-mode fiber (MMF), multi-core fiber (MCF) and few-mode multi-core fiber (FM-MCF) have been widely explored as promising candidates for fiber-based SDM. The challenges for SDM include efficient (de)multiplexer, amplifiers, and multiple-input multiple-output (MIMO) digital signal processing (DSP) techniques. Photonic integration will also be a key technology to SDM. Meanwhile, free-space and underwater optical communications have also exploited the space domain to increase the transmission capacity and spectral efficiency. The challenges include long-distance transmission limited by propagation loss, divergence, scattering and turbulence. Very recently, helically phased light beams carrying orbital angular momentum (OAM) have also seen potential applications both in free-space, underwater and fiber-based optical communications. Actually, different mode bases such as linearly polarized (LP) modes and OAM modes can be employed for SDM. Additionally, SDM could be used in chip-scale photonic interconnects and data center optical interconnects. Quantum processing exploiting the space domain is of great interest. The information capacity limit and physical layer security in SDM optical communications systems are important issues to be addressed.

A technology-enabled adherence enhancement system for people with bipolar disorder: results from a feasibility and patient acceptance analysis

PubMed Central

Sajatovic, Martha; Davis, Michael S; Cassidy, Kristin A; Nestor, Joseph; Sams, Johnny; Fuentes-Casiano, Edna

2015-01-01

Objective As poor medication adherence is common in bipolar disorder (BD), technology-assisted approaches may help to monitor and enhance adherence. This study evaluated preliminary feasibility, patient satisfaction and effects on adherence, BD knowledge, and BD symptoms associated with the use of a multicomponent technology-assisted adherence enhancement system. Methods This prospective study tested the system in five BD patients over a 15-day period. System components included: 1) an automated pill cap with remote monitoring sensor; 2) a multimedia adherence enhancement program; and 3) a treatment incentive program. This study evaluated system usability, patient satisfaction and effects on adherence (Morisky scale), knowledge (treatment knowledge test [TKT]), and symptoms (internal state scale [ISS]). Results Mean age of the sample was 62 years, 4/5 (80%) Caucasian, and 4/5 (80%) single/divorced or widowed. Most participants (4/5, 80%) were on a single BD medication. Participants had BD for an average of 21 years. Challenges included attaching the pill sensor to standard pharmacy bottles for individuals using very large pill containers or those with multiday pill boxes. Three of five (60%) individuals completed the full 15-day period. Usability scores were high overall. Mean Morisky scores improved. Means on all four subscales of the ISS were all in the direction of improvement. On the TKT, there was a 40% increase in mean scores. Conclusion A multicomponent technology-assisted BD adherence enhancement system is feasible. Challenges include accommodating multiple types of pill containers and monitoring multiple drugs simultaneously. The system can also generate adherence information that is potentially useful for treatment planning. PMID:26089652

Expanding contraceptive choice in the developing world: lessons from the Lao People's Democratic Republic and the Republic of Zambia.

PubMed

d'Arcangues, Catherine M; Ba-Thike, Katherine; Say, Lale

2013-12-01

Women need different forms of contraception over their lifetime. In the developed world, they have access to some 20 different methods. In developing countries, only a few options are available. This paper focuses on four under-used methods: intrauterine devices, implants, emergency contraception and female condoms. It examines reasons for their low uptake, strategies used for their adoption, and challenges in sustaining these efforts, in two countries: Laos and Zambia. In-country documentation and reports from international partners were reviewed; questionnaires were sent and interviews carried out with ministry officials, senior providers, and local representatives of international organisations and international non-governmental organisations. In Laos, the family planning programme is relatively young; its challenges include ensuring the sustainability of services and supplies, improving the quality of IEC to dispel misconceptions surrounding contraception, and developing novel distribution systems to reach rural populations. Zambia has a much older programme, which lost ground in the face of competing health priorities. Its challenges include strengthening the supply chain management, coordinating the multiple groups of providers and ensuring the sustainability of services in rural areas. The contrast offered by Laos and Zambia illustrates the importance of regular evaluation to identify priority areas for improving contraceptive delivery.

Noninvasive Brain Stimulation: Challenges and Opportunities for a New Clinical Specialty.

PubMed

Boes, Aaron D; Kelly, Michael S; Trapp, Nicholas T; Stern, Adam P; Press, Daniel Z; Pascual-Leone, Alvaro

2018-04-24

Noninvasive brain stimulation refers to a set of technologies and techniques with which to modulate the excitability of the brain via transcranial stimulation. Two major modalities of noninvasive brain stimulation are transcranial magnetic stimulation (TMS) and transcranial current stimulation. Six TMS devices now have approved uses by the U.S. Food and Drug Administration and are used in clinical practice: five for treating medication refractory depression and the sixth for presurgical mapping of motor and speech areas. Several large, multisite clinical trials are currently underway that aim to expand the number of clinical applications of noninvasive brain stimulation in a way that could affect multiple clinical specialties in the coming years, including psychiatry, neurology, pediatrics, neurosurgery, physical therapy, and physical medicine and rehabilitation. In this article, the authors review some of the anticipated challenges facing the incorporation of noninvasive brain stimulation into clinical practice. Specific topics include establishing efficacy, safety, economics, and education. In discussing these topics, the authors focus on the use of TMS in the treatment of medication refractory depression when possible, because this is the most widely accepted clinical indication for TMS to date. These challenges must be thoughtfully considered to realize the potential of noninvasive brain stimulation as an emerging specialty that aims to enhance the current ability to diagnose and treat disorders of the brain.

The challenges of transitioning from linear to high-order overlay control in advanced lithography

NASA Astrophysics Data System (ADS)

Adel, M.; Izikson, P.; Tien, D.; Huang, C. K.; Robinson, J. C.; Eichelberger, B.

2008-03-01

In the lithography section of the ITRS 2006 update, at the top of the list of difficult challenges appears the text "overlay of multiple exposures including mask image placement". This is a reflection of the fact that today overlay is becoming a major yield risk factor in semiconductor manufacturing. Historically, lithographers have achieved sufficient alignment accuracy and hence layer to layer overlay control by relying on models which define overlay as a linear function of the field and wafer coordinates. These linear terms were easily translated to correctibles in the available exposure tool degrees of freedom on the wafer and reticle stages. However, as the 45 nm half pitch node reaches production, exposure tool vendors have begun to make available, and lithographers have begun to utilize so called high order wafer and field control, in which either look up table or high order polynomial models are modified on a product by product basis. In this paper, the major challenges of this transition will be described. It will include characterization of the sources of variation which need to be controlled by these new models and the overlay and alignment sampling optimization problem which needs to be addressed, while maintaining the ever tightening demands on productivity and cost of ownership.

Reducing Cancer Health Disparities in the US-associated Pacific

PubMed Central

Tsark, JoAnn U.; Braun, Kathryn L.

2010-01-01

Purpose To assess cancer prevention and control capacity in the US-associated Pacific Islands (USAPI, including American Samoa, Northern Mariana Islands, Micronesia, Guam, Marshall Islands, and Palau) and to support indigenous leadership in reducing cancer health disparities. Methods Jurisdiction-specific needs assessments were conducted to assess cancer prevention and control capacity and challenges, The Cancer Council of the Pacific islands (CCPI), an indigenous health leadership team from public health and medicine, was supported to review assessment findings, develop priorities, and build capacity to address recommendations. Results Capacity varied across jurisdictions, but generally there is limited ability to measure cancer burden and a lack of programs, equipment, and trained personnel to detect and treat cancer. Most cancers are diagnosed in late stages when survival is compromised and care is most costly. Jurisdictions also are challenged by geographic, social, and political constraints and multiple in-country demands for funding. Based on findings, strategies were developed by the CCPI to guide efforts, including fund seeking, to expand cancer prevention and control capacity in regionally appropriate ways. Conclusions Concerted planning, training, and funding efforts are needed to overcome challenges and upgrade capacity in cancer education, prevention, detection, and treatment in the USAPI. Indigenous leadership and local capacity building are essential to this process. PMID:17149100

Challenging Behavior in Smith-Lemli-Opitz Syndrome: Initial Test of Biobehavioral Influences

PubMed Central

Freeman, Kurt A.; Eagle, Rose; Merkens, Louise S.; Sikora, Darryn; Pettit-Kekel, Kersti; Nguyen-Driver, Mina; Steiner, Robert D.

2013-01-01

Objective To study challenging behavior (destruction, aggression, self-injury, stereotypy) in children with Smith-Lemli-Opitz syndrome (SLOS) using a biobehavioral model that helps distinguish biological from socially mediated variables influencing the behavior. Background SLOS is an autosomal-recessive syndrome of multiple malformations and intellectual disability resulting from a genetic error in cholesterol synthesis in all cells and tissues, including brain. The exact cause of the challenging behavior in SLOS is unclear, but defective brain cholesterol synthesis may contribute. Because the precise genetic and biochemical etiology of SLOS is known, this disorder is a good model for studying biological causes of challenging behavior. Method In a preliminary application of a biobehavioral model, we studied the association between cholesterol levels (as a biochemical indicator of disease severity) and behavior subtype (“biological” vs “learned”) in 13 children with SLOS. Parents completed a questionnaire that categorized challenging behavior as influenced primarily by social or nonsocial (thus, presumably biological) factors. Results The severity of the cholesterol synthesis defect correlated significantly with behavior subtype classification for 1 of 2 challenging behaviors. Greater severity of the cholesterol synthesis defect was associated with behavior being classified as primarily influenced by biological factors. Conclusion The interplay between challenging behavior and defective cholesterol synthesis in SLOS may help explain biological influences on the behavior. Our findings have implications for research on the effectiveness of behavioral and medical treatments for behavioral difficulties in SLOS and other neurodevelopmental disorders. PMID:23538569

Measuring more than we know? An examination of the motivational and situational influences in science achievement

NASA Astrophysics Data System (ADS)

Haydel, Angela Michelle

The purpose of this dissertation was to advance theoretical understanding about fit between the personal resources of individuals and the characteristics of science achievement tasks. Testing continues to be pervasive in schools, yet we know little about how students perceive tests and what they think and feel while they are actually working on test items. This study focused on both the personal (cognitive and motivational) and situational factors that may contribute to individual differences in achievement-related outcomes. 387 eighth grade students first completed a survey including measures of science achievement goals, capability beliefs, efficacy related to multiple-choice items and performance assessments, validity beliefs about multiple-choice items and performance assessments, and other perceptions of these item formats. Students then completed science achievement tests including multiple-choice items and two performance assessments. A sample of students was asked to verbalize both thoughts and feelings as they worked through the test items. These think-alouds were transcribed and coded for evidence of cognitive, metacognitive and motivational engagement. Following each test, all students completed measures of effort, mood, energy level and strategy use during testing. Students reported that performance assessments were more challenging, authentic, interesting and valid than multiple-choice tests. They also believed that comparisons between students were easier using multiple-choice items. Overall, students tried harder, felt better, had higher levels of energy and used more strategies while working on performance assessments. Findings suggested that performance assessments might be more congruent with a mastery achievement goal orientation, while multiple-choice tests might be more congruent with a performance achievement goal orientation. A variable-centered analytic approach including regression analyses provided information about how students, on average, who differed in terms of their teachers' ratings of their science ability, achievement goals, capability beliefs and experiences with science achievement tasks perceived, engaged in, and performed on multiple-choice items and performance assessments. Person-centered analyses provided information about the perceptions, engagement and performance of subgroups of individuals who had different motivational characteristics. Generally, students' personal goals and capability beliefs related more strongly to test perceptions, but not performance, while teacher ratings of ability and test-specific beliefs related to performance.

Next-Generation Ground Network Architecture for Communications and Tracking of Interplanetary Smallsats

NASA Astrophysics Data System (ADS)

Cheung, K.-M.; Abraham, D.; Arroyo, B.; Basilio, E.; Babuscia, A.; Duncan, C.; Lee, D.; Oudrhiri, K.; Pham, T.; Staehle, R.; Waldherr, S.; Welz, G.; Wyatt, J.; Lanucara, M.; Malphrus, B.; Bellardo, J.; Puig-Suari, J.; Corpino, S.

2015-08-01

As small spacecraft venture out of Earth orbit, they will encounter challenges not experienced or addressed by the numerous low Earth orbit (LEO) CubeSat and smallsat missions staged to date. The LEO CubeSats typically use low-cost, proven CubeSat radios, antennas, and university ground stations with small apertures. As more ambitious yet cost-constrained space mission concepts to the Moon and beyond are being developed, CubeSats and smallsats have the potential to provide a more affordable platform for exploring deep space and performing the associated science. Some of the challenges that have, so far, slowed the proliferation of small interplanetary spacecraft are those of communications and navigation. Unlike Earth-orbiting spacecraft that navigate via government services such as North American Aerospace Defense Command's (NORAD's) tracking elements or the Global Positioning Satellite (GPS) system, interplanetary spacecraft would have to operate in a fundamentally different manner that allows the deep-space communications link to provide both command/telemetry and the radiometric data needed for navigation. Another challenge occurs when smallsat and CubeSat missions would involve multiple spacecraft that require near-simultaneous communication and/or navigation, but have a very limited number of ground antenna assets, as well as available spectrum, to support their links. To address these challenges, the Jet Propulsion Laboratory (JPL) and the Deep Space Network (DSN) it operates for NASA are pursuing the following efforts: (1) Developing a CubeSat-compatible, DSN-compatible transponder -- Iris -- which a commercial vendor can then make available as a product line. (2) Developing CubeSat-compatible high-gain antennas -- deployable reflectors, reflectarrays, and inflatable antennas. (3) Streamlining access and utilization processes for DSN and related services such as the Advanced Multi-Mission Operations System (AMMOS). (4) Developing methodologies for tracking and operating multiple spacecraft simultaneously, including spectrum coordination. (5) Coordination and collaboration with non-DSN facilities. This article further describes the communications and tracking challenges facing interplanetary smallsats and CubeSats, and the next-generation ground network architecture being evolved to mitigate those challenges.

Covered metal stent or multiple plastic stents for refractory pancreatic ductal strictures in chronic pancreatitis: a systematic review.

PubMed

Shen, Yonghua; Liu, Mingdong; Chen, Min; Li, Yunhong; Lu, Ying; Zou, Xiaoping

2014-01-01

Refractory chronic pancreatitis has been proposed as a challenge for endoscopists following routine single plastic stenting. However, data on the efficacy and safety of further endoscopic stenting are still controversial. The current systematic review aimed to assess the efficacy and safety of placement of fully covered self-expandable metal stent (FCSEMS) and multiple plastic stents. Databases including MEDLINE, EMBASE, the Cochrane Library, CBM, CNKI, VIP, and WANFANG Database were used to search relevant trials. Published studies were assessed by using well-defined inclusion and exclusion criteria. The process was independently performed by two investigators. A total of 5 studies provided data of 80 patients. Forest plots and publication bias were not carried out because few studies were relevant and screened studies were all case series. The technical success rate was 100% both in placement of FCSEMS and multiple plastic stents. The functional success rate after placement of FCSEMS was 100%, followed by multiple plastic stents (94.7%). Complications occurred 26.2% after FCSEMS placement, which was not described in detail in multiple plastic stents. The stent migration rate was 8.2% for FCSEMS and 10.5% for multiple plastic stents. Reintervention rate was 9.8% for FCSEMS and 15.8% for multiple plastic stents. Pain improvement rate was 85.2% for FCSEMS and 84.2% for multiple plastic stents. FCSEMS appeared to be no significant difference with multiple plastic stents in treatment of refractory chronic pancreatitis. We need to develop more investigations. Copyright © 2014 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Applying Metabolomics to differentiate amphibian responses to multiple stressors

EPA Science Inventory

Introduction/Objectives/Methods One of the biggest challenges in ecological risk assessment is determining the impact of multiple stressors on individual organisms and populations in ‘real world’ scenarios. Emerging ‘omic technologies, notably, metabolomics, pr...

Exploring challenges in the patient's discharge process from the internal medicine service: A qualitative study of patients' and providers' perceptions.

PubMed

Pinelli, Vincent; Stuckey, Heather L; Gonzalo, Jed D

2017-09-01

In hospital-based medicine units, patients have a wide range of complex medical conditions, requiring timely and accurate communication between multiple interprofessional providers at the time of discharge. Limited work has investigated the challenges in interprofessional collaboration and communication during the patient discharge process. In this study, authors qualitatively assessed the experiences of internal medicine providers and patients about roles, challenges, and potential solutions in the discharge process, with a phenomenological focus on the process of collaboration. Authors conducted interviews with 87 providers and patients-41 providers in eight focus-groups, 39 providers in individual interviews, and seven individual patient interviews. Provider roles included physicians, nurses, therapists, pharmacists, care coordinators, and social workers. Interviews were audio-recorded and transcribed verbatim, followed by iterative review of transcripts using qualitative coding and content analysis. Participants identified several barriers related to interprofessional collaboration during the discharge process, including systems insufficiencies (e.g., medication reconciliation process, staffing challenges); lack of understanding others' roles (e.g., unclear which provider should be completing the discharge summary); information-communication breakdowns (e.g., inaccurate information communicated to the primary medical team); patient issues (e.g., patient preferences misaligned with recommendations); and poor collaboration processes (e.g., lack of structured interprofessional rounds). These results provide context for targeting improvement in interprofessional collaboration in medicine units during patient discharges. Implementing changes in care delivery processes may increase potential for accurate and timely coordination, thereby improving the quality of care transitions.

Operation and challenges of home-based medical practices in the US: findings from six aggregated case studies.

PubMed

Norman, Gregory J; Orton, Kristann; Wade, Amy; Morris, Andrea M; Slaboda, Jill C

2018-01-27

Home-based primary care (HBPC) is a multidisciplinary, ongoing care strategy that can provide cost-effective, in-home treatment to meet the needs of the approximately four million homebound, medically complex seniors in the U.S. Because there is no single model of HBPC that can be adopted across all types of health organizations and U.S. geographic regions, we conducted a six-site HBPC practice assessment to better understand different operation structures, common challenges, and approaches to delivering HBPC. Six practices varying in size, care team composition and location agreed to participate. At each site we conducted unstructured interviews with key informants and directly observed practices and procedures in the field and back office. The aggregated case studies revealed important issues focused on team composition, patient characteristics, use of technology and urgent care delivery. Common challenges across the practices included provider retention and unmet community demand for home-based care services. Most practices, regardless of size, faced challenges around using electronic medical records (EMRs) and scheduling systems not designed for use in a mobile practice. Although many practices offered urgent care, practices varied in the methods used to provide care including the use of community paramedics and telehealth technology. Learnings compiled from these observations can inform other HBPC practices as to potential best practices that can be implemented in an effort to improve efficiency and scalability of HBPC so that seniors with multiple chronic conditions can receive comprehensive primary care services in their homes.

The ecology, restoration, and management of southeastern floodplain ecosystems: a synthesis

USGS Publications Warehouse

King, Sammy L.; Sharitz, Rebecca R.; Groninger, John W.; Battaglia, Loretta L.

2009-01-01

Floodplain ecosystems of the southeastern United States provide numerous services to society, but hydrologic and geomorphic alterations, agricultural practices, water quality and availability, and urban development continue to challenge restorationists and managers at multiple spatial and temporal scales. These challenges are further exacerbated by tremendous uncertainty regarding climate and land use patterns and natural variability in these systems. The symposium from which the papers in 2009 ensued was organized to provide a critical evaluation of current natural resource restoration and management practices to support the sustainability of floodplain ecosystem functions in the southeastern United States. In this paper we synthesize these concepts and evaluate restoration and conservation techniques in light of our understanding of these ecosystems. We also discuss current and future challenges and attempt to identify new approaches that may facilitate the long-term sustainability of southeastern floodplain systems. We conclude thatintegration of disciplines and approaches is necessary to meet the floodplain conservation challenges of the coming century. Integration will not only include purposeful dialogue between interdisciplinary natural resource professionals, but it also is necessary to sincerely engage the public about goals, objectives, and desirable outcomes of floodplain ecosystem restoration.

The ecology, restoration, and management of southeastern floodplain ecosystems: A synthesis

USGS Publications Warehouse

King, S.L.; Sharitz, R.R.; Groninger, John W.; Battaglia, Loretta L.

2009-01-01

Floodplain ecosystems of the southeastern United States provide numerous services to society, but hydrologic and geomorphic alterations, agricultural practices, water quality and availability, and urban development continue to challenge restorationists and managers at multiple spatial and temporal scales. These challenges are further exacerbated by tremendous uncertainty regarding climate and land use patterns and natural variability in these systems. The symposium from which the papers in 2009 ensued was organized to provide a critical evaluation of current natural resource restoration and management practices to support the sustainability of floodplain ecosystem functions in the southeastern United States. In this paper we synthesize these concepts and evaluate restoration and conservation techniques in light of our understanding of these ecosystems. We also discuss current and future challenges and attempt to identify new approaches that may facilitate the long-term sustainability of southeastern floodplain systems. We conclude that integration of disciplines and approaches is necessary to meet the floodplain conservation challenges of the coming century. Integration will not only include purposeful dialogue between interdisciplinary natural resource professionals, but it also is necessary to sincerely engage the public about goals, objectives, and desirable outcomes of floodplain ecosystem restoration. ?? 2009, The Society of Wetland Scientists.

Sexuality Research in Iran: A Focus on Methodological and Ethical Considerations.

PubMed

Rahmani, Azam; Merghati-Khoei, Effat; Moghaddam-Banaem, Lida; Zarei, Fatemeh; Montazeri, Ali; Hajizadeh, Ebrahim

2015-07-01

Research on sensitive topics, such as sexuality, could raise technical, methodological, ethical, political, and legal challenges. The aim of this paper was to draw the methodological challenges which the authors confronted during sexuality research with young population in the Iranian culture. This study was an exploratory mixed method one conducted in 2013-14. We interviewed 63 young women aged 18-34 yr in qualitative phase and 265 young women in quantitative phase in (university and non-university) dormitories and in an Adolescent Friendly Center. Data were collected using focus group discussions and individual interviews in the qualitative phase. We employed conventional content analysis to analyze the data. To enhance the rigor of the data, multiple data collection methods, maximum variation sampling, and peer checks were applied. Five main themes emerged from the data: interaction with opposite sex, sexual risk, sexual protective, sex education, and sexual vulnerability. Challenges while conducting sex research have been discussed. These challenges included assumption of promiscuity, language of silence and privacy concerns, and sex segregation policy. We described the strategies applied in our study and the rationales for each strategy. Strategies applied in the present study can be employed in contexts with the similar methodological and moral concerns.

Challenges of the New Zealand healthcare disaster preparedness prior to the Canterbury earthquakes: a qualitative analysis.

PubMed

Al-Shaqsi, Sultan; Gauld, Robin; Lovell, Sarah; McBride, David; Al-Kashmiri, Ammar; Al-Harthy, Abdullah

2013-03-15

Disasters are a growing global phenomenon. New Zealand has suffered several major disasters in recent times. The state of healthcare disaster preparedness in New Zealand prior to the Canterbury earthquakes is not well documented. To investigate the challenges of the New Zealand healthcare disaster preparedness prior to the Canterbury earthquakes. Semi-structured interviews with emergency planners in all the District Health Boards (DHBs) in New Zealand in the period between January and March 2010. The interview protocol revolved around the domains of emergency planning adopted by the World Health Organization. Seventeen interviews were conducted. The main themes included disinterest of clinical personnel in emergency planning, the need for communication backup, the integration of private services in disaster preparedness, the value of volunteers, the requirement for regular disaster training, and the need to enhance surge capability of the New Zealand healthcare system to respond to disasters. Prior to the Canterbury earthquakes, healthcare disaster preparedness faced multiple challenges. Despite these challenges, New Zealand's healthcare response was adequate. Future preparedness has to consider the lessons learnt from the 2011 earthquakes to improve healthcare disaster planning in New Zealand.

Designing multiple ligands - medicinal chemistry strategies and challenges.

PubMed

Morphy, Richard; Rankovic, Zoran

2009-01-01

It has been widely recognised over the recent years that parallel modulation of multiple biological targets can be beneficial for treatment of diseases with complex etiologies such as cancer asthma, and psychiatric disease. In this article, current strategies for the generation of ligands with a specific multi-target profile (designed multiple ligands or DMLs) are described and a number of illustrative example are given. Designing multiple ligands is frequently a challenging endeavour for medicinal chemists, with the need to appropriately balance affinity for 2 or more targets whilst obtaining physicochemical and pharmacokinetic properties that are consistent with the administration of an oral drug. Given that the properties of DMLs are influenced to a large extent by the proteomic superfamily to which the targets belong and the lead generation strategy that is pursued, an early assessment of the feasibility of any given DML project is essential.

The Challenge of Separating Effects of Simultaneous Education Projects on Student Achievement

ERIC Educational Resources Information Center

Ma, Xin; Ma, Lingling

2009-01-01

When multiple education projects operate in an overlapping or rear-ended manner, it is always a challenge to separate unique project effects on schooling outcomes. Our analysis represents a first attempt to address this challenge. A three-level hierarchical linear model (HLM) was presented as a general analytical framework to separate program…

Comparing the effects of different land management strategies across several land types on California's landscape carbon and associated greenhouse gas budgets

NASA Astrophysics Data System (ADS)

Di Vittorio, A. V.; Simmonds, M.; Nico, P. S.

2017-12-01

Land-based carbon sequestration and GreenHouse Gas (GHG) reduction strategies are often implemented in small patches and evaluated independently from each other, which poses several challenges to determining their potential benefits at the regional scales at which carbon/GHG targets are defined. These challenges include inconsistent methods, uncertain scalability to larger areas, and lack of constraints such as land ownership and competition among multiple strategies. To address such challenges we have developed an integrated carbon and GHG budget model of California's entire landscape, delineated by geographic region, land type, and ownership. This empirical model has annual time steps and includes net ecosystem carbon exchange, wildfire, multiple forest management practices including wood and bioenergy production, cropland and rangeland soil management, various land type restoration activities, and land cover change. While the absolute estimates vary considerably due to uncertainties in initial carbon densities and ecosystem carbon exchange rates, the estimated effects of particular management activities with respect to baseline are robust across these uncertainties. Uncertainty in land use/cover change data is also critical, as different rates of shrubland to grassland conversion can switch the system from a carbon source to a sink. The results indicate that reducing urban area expansion has substantial and consistent benefits, while the effects of direct land management practices vary and depend largely on the available management area. Increasing forest fuel reduction extent over the baseline contributes to annual GHG costs during increased management, and annual benefits after increased management ceases. Cumulatively, it could take decades to recover the cost of 14 years of increased fuel reduction. However, forest carbon losses can be completely offset within 20 years through increases in urban forest fraction and marsh restoration. Additionally, highly uncertain black carbon estimates dominate the overall GHG budget due to wildfire, forest management, and bioenergy production. Overall, this tool is well suited for exploring suites of management options and extents throughout California in order to quantify potential regional carbon sequestration and GHG emission benefits.

Challenges in reproducibility of genetic association studies: lessons learned from the obesity field.

PubMed

Li, A; Meyre, D

2013-04-01

A robust replication of initial genetic association findings has proved to be difficult in human complex diseases and more specifically in the obesity field. An obvious cause of non-replication in genetic association studies is the initial report of a false positive result, which can be explained by a non-heritable phenotype, insufficient sample size, improper correction for multiple testing, population stratification, technical biases, insufficient quality control or inappropriate statistical analyses. Replication may, however, be challenging even when the original study describes a true positive association. The reasons include underpowered replication samples, gene × gene, gene × environment interactions, genetic and phenotypic heterogeneity and subjective interpretation of data. In this review, we address classic pitfalls in genetic association studies and provide guidelines for proper discovery and replication genetic association studies with a specific focus on obesity.

An integrative model of the impairments in insight in schizophrenia: emerging research on causal factors and treatments.

PubMed

Vohs, Jenifer L; George, Sunita; Leonhardt, Bethany L; Lysaker, Paul H

2016-10-01

Poor insight, or unawareness of some major aspect of mental illness, is a major barrier to wellness when it interferes with persons seeking out treatment or forming their own understanding of the challenges they face. One barrier to addressing impaired insight is the absence of a comprehensive model of how poor insight develops. To explore this issue we review how poor insight is the result of multiple phenomena which interfere with the construction of narrative accounts of psychiatric challenges, rather than a single social or biological cause. Expert commentary: We propose an integrative model of poor insight in schizophrenia which involves the interaction of symptoms, deficits in neurocognition, social cognition, metacognition, and stigma. Emerging treatments for poor insight including therapies which focus on the development of metacognition are discussed.

EMIC wave events during the four QARBM challenge intervals

NASA Astrophysics Data System (ADS)

Engebretson, M. J.; Posch, J. L.; Braun, D.; Li, W.; Angelopoulos, V.; Kellerman, A. C.; Kletzing, C.; Lessard, M.; Mann, I. R.; Tero, R.; Shiokawa, K.; Wygant, J. R.

2017-12-01

We present observations of EMIC waves from multiple data sources during the four GEM challenge events in 2013 selected by the GEM focus group on Quantitative Assessment of Radiation Belt Modeling: March 17-18 (Stormtime Enhancement), May 31-June 2 (Stormtime Dropout), September 19-20 (Non-storm Enhancement), and September 23-25 (Non-storm Dropout). Observations include EMIC wave data from the Van Allen Probes and THEMIS spacecraft in the inner magnetosphere and from several arrays of ground-based search coil magnetometers worldwide, as well as localized ring current proton precipitation data from the low-altitude POES spacecraft. Each of these data sets provides only limited spatial coverage, but their combination reveals consistent occurrence patterns, which are then used to evaluate the effectiveness of EMIC waves in causing dropouts of radiation belt electrons during these GEM events.

Developing Staffing Models to Support Population Health Management And Quality Oucomes in Ambulatory Care Settings.

PubMed

Haas, Sheila A; Vlasses, Frances; Havey, Julia

2016-01-01

There are multiple demands and challenges inherent in establishing staffing models in ambulatory heath care settings today. If health care administrators establish a supportive physical and interpersonal health care environment, and develop high-performing interprofessional teams and staffing models and electronic documentation systems that track performance, patients will have more opportunities to receive safe, high-quality evidence-based care that encourages patient participation in decision making, as well as provision of their care. The health care organization must be aligned and responsive to the community within which it resides, fully invested in population health management, and continuously scanning the environment for competitive, regulatory, and external environmental risks. All of these challenges require highly competent providers willing to change attitudes and culture such as movement toward collaborative practice among the interprofessional team including the patient.

Fiber Bragg grating sensor interrogators on chip: challenges and opportunities

NASA Astrophysics Data System (ADS)

Marin, Yisbel; Nannipieri, Tiziano; Oton, Claudio J.; Di Pasquale, Fabrizio

2017-04-01

In this paper we present an overview of the current efforts towards integration of Fiber Bragg Grating (FBG) sensor interrogators. Different photonic integration platforms will be discussed, including monolithic planar lightwave circuit technology, silicon on insulator (SOI), indium phosphide (InP) and gallium arsenide (GaAs) material platforms. Also various possible techniques for wavelength metering and methods for FBG multiplexing will be discussed and compared in terms of resolution, dynamic performance, multiplexing capabilities and reliability. The use of linear filters, array waveguide gratings (AWG) as multiple linear filters and AWG based centroid signal processing techniques will be addressed as well as interrogation techniques based on tunable micro-ring resonators and Mach-Zehnder interferometers (MZI) for phase sensitive detection. The paper will also discuss the challenges and perspectives of photonic integration to address the increasing requirements of several industrial applications.

Sustainability. Systems integration for global sustainability.

PubMed

Liu, Jianguo; Mooney, Harold; Hull, Vanessa; Davis, Steven J; Gaskell, Joanne; Hertel, Thomas; Lubchenco, Jane; Seto, Karen C; Gleick, Peter; Kremen, Claire; Li, Shuxin

2015-02-27

Global sustainability challenges, from maintaining biodiversity to providing clean air and water, are closely interconnected yet often separately studied and managed. Systems integration—holistic approaches to integrating various components of coupled human and natural systems—is critical to understand socioeconomic and environmental interconnections and to create sustainability solutions. Recent advances include the development and quantification of integrated frameworks that incorporate ecosystem services, environmental footprints, planetary boundaries, human-nature nexuses, and telecoupling. Although systems integration has led to fundamental discoveries and practical applications, further efforts are needed to incorporate more human and natural components simultaneously, quantify spillover systems and feedbacks, integrate multiple spatial and temporal scales, develop new tools, and translate findings into policy and practice. Such efforts can help address important knowledge gaps, link seemingly unconnected challenges, and inform policy and management decisions. Copyright © 2015, American Association for the Advancement of Science.

A methodology for successfully producing global translations of patient reported outcome measures for use in multiple countries.

PubMed

Two, Rebecca; Verjee-Lorenz, Aneesa; Clayson, Darren; Dalal, Mehul; Grotzinger, Kelly; Younossi, Zobair M

2010-01-01

The production of accurate and culturally relevant translations of patient reported outcome (PRO) measures is essential for the success of international clinical trials. Although there are many reports in publication regarding the translation of PRO measures, the techniques used to produce single translations for use in multiple countries (global translations) are not well documented. This article addresses this apparent lack of documentation and presents the methodology used to create global translations of the Chronic Liver Disease Questionnaire-Hepatitis C Virus (CLDQ-HCV). The challenges of creating a translation for use in multiple countries are discussed, and the criteria for a global translation project explained. Based on a thorough translation and linguistic validation methodology including a concept elaboration, multiple forward translations, two back translations, reviews by in-country clinicians and the instrument developer, pilot testing in each target country and multiple sets of proofreading, the key concept of the global translation methodology is consistent international harmonization, achieved through the involvement of linguists from each target country at every stage of the process. This methodology enabled the successful resolution of the translation issues encountered, and resulted in consistent translations of the CLDQ-HCV that were linguistically and culturally appropriate for all target countries.

Impact of a comprehensive supportive care team on management of hopelessly ill patients with multiple organ failure.

PubMed

Field, B E; Devich, L E; Carlson, R W

1989-08-01

We developed a supportive care team for hopelessly ill patients in an urban emergency/trauma hospital. The team includes a clinical nurse specialist and a faculty physician as well as a chaplain and social worker. The supportive care team provides an alternative to intensive care or conventional ward management of hopelessly ill patients and concentrates on the physical and psychosocial comfort needs of patients and their families. We describe our experience with 20 hopelessly ill patients with multiple organ failure vs a similar group treated before the development of the supportive care team. Although there was no difference in mortality (100 percent), the length of stay in the medical ICU for patients with multiple organ failure decreased by 12 days to 6 days. Additionally, there were 50 percent fewer therapeutic interventions provided by the supportive care team vs intensive care or conventional ward treatment of multiple organ failure patients. We describe the methods that the supportive care team uses in an attempt to meet the physical and psychosocial comfort needs of hopelessly ill multiple organ failure patients and their families. This multidisciplinary approach to the care of the hopelessly ill may have applications in other institutions facing the ethical, medical, and administrative challenges raised by these patients.

Precise Sequential DNA Ligation on A Solid Substrate: Solid-Based Rapid Sequential Ligation of Multiple DNA Molecules

PubMed Central

Takita, Eiji; Kohda, Katsunori; Tomatsu, Hajime; Hanano, Shigeru; Moriya, Kanami; Hosouchi, Tsutomu; Sakurai, Nozomu; Suzuki, Hideyuki; Shinmyo, Atsuhiko; Shibata, Daisuke

2013-01-01

Ligation, the joining of DNA fragments, is a fundamental procedure in molecular cloning and is indispensable to the production of genetically modified organisms that can be used for basic research, the applied biosciences, or both. Given that many genes cooperate in various pathways, incorporating multiple gene cassettes in tandem in a transgenic DNA construct for the purpose of genetic modification is often necessary when generating organisms that produce multiple foreign gene products. Here, we describe a novel method, designated PRESSO (precise sequential DNA ligation on a solid substrate), for the tandem ligation of multiple DNA fragments. We amplified donor DNA fragments with non-palindromic ends, and ligated the fragment to acceptor DNA fragments on solid beads. After the final donor DNA fragments, which included vector sequences, were joined to the construct that contained the array of fragments, the ligation product (the construct) was thereby released from the beads via digestion with a rare-cut meganuclease; the freed linear construct was circularized via an intra-molecular ligation. PRESSO allowed us to rapidly and efficiently join multiple genes in an optimized order and orientation. This method can overcome many technical challenges in functional genomics during the post-sequencing generation. PMID:23897972

The big data-big model (BDBM) challenges in ecological research

NASA Astrophysics Data System (ADS)

Luo, Y.

2015-12-01

The field of ecology has become a big-data science in the past decades due to development of new sensors used in numerous studies in the ecological community. Many sensor networks have been established to collect data. For example, satellites, such as Terra and OCO-2 among others, have collected data relevant on global carbon cycle. Thousands of field manipulative experiments have been conducted to examine feedback of terrestrial carbon cycle to global changes. Networks of observations, such as FLUXNET, have measured land processes. In particular, the implementation of the National Ecological Observatory Network (NEON), which is designed to network different kinds of sensors at many locations over the nation, will generate large volumes of ecological data every day. The raw data from sensors from those networks offer an unprecedented opportunity for accelerating advances in our knowledge of ecological processes, educating teachers and students, supporting decision-making, testing ecological theory, and forecasting changes in ecosystem services. Currently, ecologists do not have the infrastructure in place to synthesize massive yet heterogeneous data into resources for decision support. It is urgent to develop an ecological forecasting system that can make the best use of multiple sources of data to assess long-term biosphere change and anticipate future states of ecosystem services at regional and continental scales. Forecasting relies on big models that describe major processes that underlie complex system dynamics. Ecological system models, despite great simplification of the real systems, are still complex in order to address real-world problems. For example, Community Land Model (CLM) incorporates thousands of processes related to energy balance, hydrology, and biogeochemistry. Integration of massive data from multiple big data sources with complex models has to tackle Big Data-Big Model (BDBM) challenges. Those challenges include interoperability of multiple, heterogeneous data sets; intractability of structural complexity of big models; equifinality of model structure selection and parameter estimation; and computational demand of global optimization with Big Models.

Real-time multiple human perception with color-depth cameras on a mobile robot.

PubMed

Zhang, Hao; Reardon, Christopher; Parker, Lynne E

2013-10-01

The ability to perceive humans is an essential requirement for safe and efficient human-robot interaction. In real-world applications, the need for a robot to interact in real time with multiple humans in a dynamic, 3-D environment presents a significant challenge. The recent availability of commercial color-depth cameras allow for the creation of a system that makes use of the depth dimension, thus enabling a robot to observe its environment and perceive in the 3-D space. Here we present a system for 3-D multiple human perception in real time from a moving robot equipped with a color-depth camera and a consumer-grade computer. Our approach reduces computation time to achieve real-time performance through a unique combination of new ideas and established techniques. We remove the ground and ceiling planes from the 3-D point cloud input to separate candidate point clusters. We introduce the novel information concept, depth of interest, which we use to identify candidates for detection, and that avoids the computationally expensive scanning-window methods of other approaches. We utilize a cascade of detectors to distinguish humans from objects, in which we make intelligent reuse of intermediary features in successive detectors to improve computation. Because of the high computational cost of some methods, we represent our candidate tracking algorithm with a decision directed acyclic graph, which allows us to use the most computationally intense techniques only where necessary. We detail the successful implementation of our novel approach on a mobile robot and examine its performance in scenarios with real-world challenges, including occlusion, robot motion, nonupright humans, humans leaving and reentering the field of view (i.e., the reidentification challenge), human-object and human-human interaction. We conclude with the observation that the incorporation of the depth information, together with the use of modern techniques in new ways, we are able to create an accurate system for real-time 3-D perception of humans by a mobile robot.

Mining Missing Membrane Proteins by High-pH Reverse-Phase StageTip Fractionation and Multiple Reaction Monitoring Mass Spectrometry.

PubMed

Kitata, Reta Birhanu; Dimayacyac-Esleta, Baby Rorielyn T; Choong, Wai-Kok; Tsai, Chia-Feng; Lin, Tai-Du; Tsou, Chih-Chiang; Weng, Shao-Hsing; Chen, Yi-Ju; Yang, Pan-Chyr; Arco, Susan D; Nesvizhskii, Alexey I; Sung, Ting-Yi; Chen, Yu-Ju

2015-09-04

Despite significant efforts in the past decade toward complete mapping of the human proteome, 3564 proteins (neXtProt, 09-2014) are still "missing proteins". Over one-third of these missing proteins are annotated as membrane proteins, owing to their relatively challenging accessibility with standard shotgun proteomics. Using nonsmall cell lung cancer (NSCLC) as a model study, we aim to mine missing proteins from disease-associated membrane proteome, which may be still largely under-represented. To increase identification coverage, we employed Hp-RP StageTip prefractionation of membrane-enriched samples from 11 NSCLC cell lines. Analysis of membrane samples from 20 pairs of tumor and adjacent normal lung tissue was incorporated to include physiologically expressed membrane proteins. Using multiple search engines (X!Tandem, Comet, and Mascot) and stringent evaluation of FDR (MAYU and PeptideShaker), we identified 7702 proteins (66% membrane proteins) and 178 missing proteins (74 membrane proteins) with PSM-, peptide-, and protein-level FDR of 1%. Through multiple reaction monitoring using synthetic peptides, we provided additional evidence of eight missing proteins including seven with transmembrane helix domains. This study demonstrates that mining missing proteins focused on cancer membrane subproteome can greatly contribute to map the whole human proteome. All data were deposited into ProteomeXchange with the identifier PXD002224.

Multiple advanced logic gates made of DNA-Ag nanocluster and the application for intelligent detection of pathogenic bacterial genes.

PubMed

Lin, Xiaodong; Liu, Yaqing; Deng, Jiankang; Lyu, Yanlong; Qian, Pengcheng; Li, Yunfei; Wang, Shuo

2018-02-21

The integration of multiple DNA logic gates on a universal platform to implement advance logic functions is a critical challenge for DNA computing. Herein, a straightforward and powerful strategy in which a guanine-rich DNA sequence lighting up a silver nanocluster and fluorophore was developed to construct a library of logic gates on a simple DNA-templated silver nanoclusters (DNA-AgNCs) platform. This library included basic logic gates, YES, AND, OR, INHIBIT, and XOR, which were further integrated into complex logic circuits to implement diverse advanced arithmetic/non-arithmetic functions including half-adder, half-subtractor, multiplexer, and demultiplexer. Under UV irradiation, all the logic functions could be instantly visualized, confirming an excellent repeatability. The logic operations were entirely based on DNA hybridization in an enzyme-free and label-free condition, avoiding waste accumulation and reducing cost consumption. Interestingly, a DNA-AgNCs-based multiplexer was, for the first time, used as an intelligent biosensor to identify pathogenic genes, E. coli and S. aureus genes, with a high sensitivity. The investigation provides a prototype for the wireless integration of multiple devices on even the simplest single-strand DNA platform to perform diverse complex functions in a straightforward and cost-effective way.

Species-specific challenges in dog cloning.

PubMed

Kim, G A; Oh, H J; Park, J E; Kim, M J; Park, E J; Jo, Y K; Jang, G; Kim, M K; Kim, H J; Lee, B C

2012-12-01

Somatic cell nuclear transfer (SCNT) is now an established procedure used in cloning of several species. SCNT in dogs involves multiple steps including the removal of the nuclear material, injection of a donor cell, fusion, activation of the reconstructed oocytes and finally transfer to a synchronized female recipient. There are therefore many factors that contribute to cloning efficiency. By performing a retrospective analysis of 2005-2012 published papers regarding dog cloning, we define the optimum procedure and summarize the specific feature for dog cloning. © 2012 Blackwell Verlag GmbH.

Patient safety - the role of human factors and systems engineering.

PubMed

Carayon, Pascale; Wood, Kenneth E

2010-01-01

Patient safety is a global challenge that requires knowledge and skills in multiple areas, including human factors and systems engineering. In this chapter, numerous conceptual approaches and methods for analyzing, preventing and mitigating medical errors are described. Given the complexity of healthcare work systems and processes, we emphasize the need for increasing partnerships between the health sciences and human factors and systems engineering to improve patient safety. Those partnerships will be able to develop and implement the system redesigns that are necessary to improve healthcare work systems and processes for patient safety.