10. VIEW OF PIPING. THE BUILDING HAD OVER 700 MILES ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

10. VIEW OF PIPING. THE BUILDING HAD OVER 700 MILES OF PIPING, OF WHICH 70 MILES WERE PLUTONIUM PROCESSING LINES. THESE PROCESS LINES RAN THROUGH WALLS AND TRAVERSED SEVERAL FLOORS. (6/29/78) - Rocky Flats Plant, Plutonium Recovery Facility, Northwest portion of Rocky Flats Plant, Golden, Jefferson County, CO

Suspension system for a wheel rolling on a flat track. [bearings for directional antennas

NASA Technical Reports Server (NTRS)

Mcginness, H. D. (Inventor)

1981-01-01

An improved suspension system for an uncrowned wheel rolling on a flat track is presented. It is characterized by a wheel frame assembly including a wheel frame and at least one uncrowned wheel connected in supporting relation with the frame. It is adapted to be seated in rolling engagement with a flat track, a load supporting bed, and a plurality of flexural struts interconnecting the bed in supported relation with the frame. Each of said struts is disposed in a plane passing through the center of the uncrowned wheel surface along a line substantially bisecting the line of contact established between the wheel surface and the flat surface of the truck and characterized by a modulus of elasticity sufficient for maintaining the axis of rotation for the wheel in substantial parallelism with the line of contact established between the surfaces of the wheel and track.

Monitoring transients in low inductance circuits

DOEpatents

Guilford, Richard P.; Rosborough, John R.

1987-01-01

A pair of flat cable transmission lines are monitored for transient current spikes by using a probe connected to a current transformer by a pickup loop and monitoring the output of the current transformer. The approach utilizes a U-shaped pickup probe wherein the pair of flat cable transmission lines are received between the legs of the U-shaped probe. The U-shaped probe is preferably formed of a flat coil conductor adhered to one side of a flexible substrate. On the other side of the flexible substrate there is a copper foil shield. The copper foil shield is connected to one end of the flat conductor coil and connected to one leg of the pickup loop which passes through the current transformer. The other end of the flat conductor coil is connected to the other leg of the pickup loop.

Symmetry-protected line nodes and Majorana flat bands in nodal crystalline superconductors

NASA Astrophysics Data System (ADS)

Kobayashi, Shingo; Sumita, Shuntaro; Yanase, Youichi; Sato, Masatoshi

2018-05-01

Line nodes in the superconducting gap are known to be a source of Majorana flat bands (MFBs) on a surface. Here, we extend this relation to all symmetry-protected line nodes where an additional constraint arising from crystal symmetry destabilizes or hides the existence of MFBs. By establishing a one-to-one correspondence between group theoretical and topological classifications, we are able to classify the possible line-node-induced MFBs, including cases with (magnetic) nonsymmorphic space groups. Our theoretical analysis reveals MFBs in antiferromagnetic superconductors.

Differences in cancer drug assessment between Spain and the United Kingdom.

PubMed

Lozano-Blázquez, Ana; Dickson, Rumona; Fraga-Fuentes, María-Dolores; Martínez-Martínez, Fernando; Calleja-Hernández, Miguel-Ángel

2015-09-01

There is no Spanish Government agency resembling the National Institute for Health and Care Excellence (NICE) in the United Kingdom (UK) that carries out a centralised evaluation and makes decisions about funding. Therefore, we aim to assess the differences between NICE and the Spanish bodies in terms of their respective processes. We compare the decisions concerning cancer drugs in the assessments made by NICE/Single Technology Appraisal with assessments made by MADRE methodology. We included all cancer drugs assessed by NICE and all MADRE reports made using a shared reports process (GENESIS) and reports from Catalonia (CAMDHA) and Andalucía (GFTHA). We compared the number of drugs assessed, the decisions taken by NICE and Spanish organizations and timelines. Between January 2011 and December 2013 NICE appraised 24 cancer drugs. In Spain, 44 reports were produced using MADRE methodology. For the 14 drugs assessed by both NICE and Spanish bodies, NICE rejected a high proportion of the drugs (50% versus 26%). GENESIS, with a median of 8 months, made decisions more quickly than NICE (13.5 months) and GFTHA (17 months). The slowest organisation was CAMDHA (24.5 months). More drugs are assessed in Spain than by NICE because there are more organisations in Spain doing this work and their processes are simpler. NICE rejects more drugs as it uses cost-effectiveness thresholds that lead to a 'not-recommended' decision, and Spanish bodies recommend cancer drugs for subgroups of patients where better results can be obtained. Timelines are better for Spanish Committees, probably because of the greater number of steps in the appraisal process by NICE. Copyright © 2015 Elsevier Ltd. All rights reserved.

In-line flat-top comb filter based on a cascaded all-solid photonic bandgap fiber intermodal interferometer.

PubMed

Geng, Youfu; Li, Xuejin; Tan, Xiaoling; Deng, Yuanlong; Yu, Yongqin

2013-07-15

In this paper, an in-line comb filter with flat-top spectral response is proposed and constructed based on a cascaded all-solid photonic bandgap fiber modal interferometer. It consists of two short pieces of all-solid photonic bandgap fiber and two standard single-mode fibers as lead fibers with core-offset splices between them. The theoretical and experimental results demonstrated that by employing a cut and resplice process on the central position of all-solid photonic bandgap fiber, the interference spectra are well tailored and flat-top spectral profiles could be realized by the controllable offset amount of the resplice. The channel position also could be tuned by applying longitudinal torsion with up to 4 nm tuning range. Such a flat-top fiber comb filter is easy-to-fabricate and with a designable passband width and flat-top profile.

Low Reynold's number boundary layers in a disturbed environment. Ph.D. Thesis - August, 1985 - Final Report

NASA Technical Reports Server (NTRS)

Paik, D. K.; Reshotko, E.

1986-01-01

Studies of flat plate boundary layer development were made in a low speed wind tunnel at turbulence levels from 2%to 7%. Only transitional and turbulent flows were observed in the range 280 Re sub theta 700. The mean turbulent velocity profiles display law-of-the-wall behavior but have negligible wake component. The u' disturbance profiles compare well with those of other experiments, the peak value of u'/u sub tau being about 2.5. The effect of free-stream turbulence level on turbulent skin friction can be nicely correlated with those of other investigations on a plot of u sub e/u sub tau versus Re sub theta. A discussion on the u' spectra for the transitional boundary-layers is presented.

The flat bottomed lines of Vega

NASA Astrophysics Data System (ADS)

Monier, R.; Gebran, M.; Royer, F.; Kılıcoǧlu, T.

2017-12-01

Using one high dispersion high quality spectrum of Vega (HR7001, A0V) obtained with the échelle spectrograph SOPHIE at Observatoire de Haute Provence, we have measured the centroids of 149 flat bottomed lines. The model atmosphere and spectrum synthesis modeling of the spectrum of Vega allows us to provide identifications for all these lines. Most of these lines are due to C I, O I, Mg I, Al I, Ca I, Sc II,Ti II, Cr I, Cr II, Mn I, Fe I, Fe II, Sr II, Ba II, the large majority being due to neutral species, in particular Fe I.

Does Methodological Guidance Produce Consistency? A Review of Methodological Consistency in Breast Cancer Utility Value Measurement in NICE Single Technology Appraisals.

PubMed

Rose, Micah; Rice, Stephen; Craig, Dawn

2018-06-01

Since 2004, National Institute for Health and Care Excellence (NICE) methodological guidance for technology appraisals has emphasised a strong preference for using the validated EuroQol 5-Dimensions (EQ-5D) quality-of-life instrument, measuring patient health status from patients or carers, and using the general public's preference-based valuation of different health states when assessing health benefits in economic evaluations. The aim of this study was to review all NICE single technology appraisals (STAs) for breast cancer treatments to explore consistency in the use of utility scores in light of NICE methodological guidance. A review of all published breast cancer STAs was undertaken using all publicly available STA documents for each included assessment. Utility scores were assessed for consistency with NICE-preferred methods and original data sources. Furthermore, academic assessment group work undertaken during the STA process was examined to evaluate the emphasis of NICE-preferred quality-of-life measurement methods. Twelve breast cancer STAs were identified, and many STAs used evidence that did not follow NICE's preferred utility score measurement methods. Recent STA submissions show companies using EQ-5D and mapping. Academic assessment groups rarely emphasized NICE-preferred methods, and queries about preferred methods were rare. While there appears to be a trend in recent STA submissions towards following NICE methodological guidance, historically STA guidance in breast cancer has generally not used NICE's preferred methods. Future STAs in breast cancer and reviews of older guidance should ensure that utility measurement methods are consistent with the NICE reference case to help produce consistent, equitable decision making.

Wetting of flat gradient surfaces.

PubMed

Bormashenko, Edward

2018-04-01

Gradient, chemically modified, flat surfaces enable directed transport of droplets. Calculation of apparent contact angles inherent for gradient surfaces is challenging even for atomically flat ones. Wetting of gradient, flat solid surfaces is treated within the variational approach, under which the contact line is free to move along the substrate. Transversality conditions of the variational problem give rise to the generalized Young equation valid for gradient solid surfaces. The apparent (equilibrium) contact angle of a droplet, placed on a gradient surface depends on the radius of the contact line and the values of derivatives of interfacial tensions. The linear approximation of the problem is considered. It is demonstrated that the contact angle hysteresis is inevitable on gradient surfaces. Electrowetting of gradient surfaces is discussed. Copyright © 2018 Elsevier Inc. All rights reserved.

Communication: Two types of flat-planes conditions in density functional theory.

PubMed

Yang, Xiaotian Derrick; Patel, Anand H G; Miranda-Quintana, Ramón Alain; Heidar-Zadeh, Farnaz; González-Espinoza, Cristina E; Ayers, Paul W

2016-07-21

Using results from atomic spectroscopy, we show that there are two types of flat-planes conditions. The first type of flat-planes condition occurs when the energy as a function of the number of electrons of each spin, Nα and Nβ, has a derivative discontinuity on a line segment where the number of electrons, Nα + Nβ, is an integer. The second type of flat-planes condition occurs when the energy has a derivative discontinuity on a line segment where the spin polarization, Nα - Nβ, is an integer, but does not have a discontinuity associated with an integer number of electrons. Type 2 flat planes are rare-we observed just 15 type 2 flat-planes conditions out of the 4884 cases we tested-but their mere existence has implications for the design of exchange-correlation energy density functionals. To facilitate the development of functionals that have the correct behavior with respect to both fractional number of electrons and fractional spin polarization, we present a dataset for the chromium atom and its ions that can be used to test new functionals.

Constraints on the outer radius of the broad emission line region of active galactic nuclei

NASA Astrophysics Data System (ADS)

Landt, Hermine; Ward, Martin J.; Elvis, Martin; Karovska, Margarita

2014-03-01

Here we present observational evidence that the broad emission line region (BELR) of active galactic nuclei (AGN) generally has an outer boundary. This was already clear for sources with an obvious transition between the broad and narrow components of their emission lines. We show that the narrow component of the higher-order Paschen lines is absent in all sources, revealing a broad emission line profile with a broad, flat top. This indicates that the BELR is kinematically separate from the narrow emission line region. We use the virial theorem to estimate the BELR outer radius from the flat top width of the unblended profiles of the strongest Paschen lines, Paα and Paβ, and find that it scales with the ionizing continuum luminosity roughly as expected from photoionization theory. The value of the incident continuum photon flux resulting from this relationship corresponds to that required for dust sublimation. A flat-topped broad emission line profile is produced by both a spherical gas distribution in orbital motion and an accretion disc wind if the ratio between the BELR outer and inner radius is assumed to be less than ˜100-200. On the other hand, a pure Keplerian disc can be largely excluded, since for most orientations and radial extents of the disc the emission line profile is double-horned.

Longing for clinical excellence: a critical outlook into the NICE recommendations on hypertension management--is nice always good?

PubMed

Zanchetti, Alberto; Mancia, Giuseppe

2012-04-01

The European Society of Hypertension and the European Society of Cardiology have started the preparation of the third edition of their joint guidelines on the management of arterial hypertension. The authors have focused on the new edition of the UK NICE guidelines to learn about the difficulties of disentangling evidence from wisdom when preparing recommendations. The two areas where the NICE guidelines have changed more importantly are the use of ambulatory blood pressure in the diagnosis of hypertension and the choices of antihypertensive agents to initiate treatment (less frequent use of diuretics and preference given to chlorthalidone and indapamide). NICE recommendations on these topics appear more based on opinion than evidence. Strenuous longing for evidence and clinical excellence is certainly meritorious, but such a nice approach is not always good.

On-Line Flatness Measurement in the Steelmaking Industry

PubMed Central

Molleda, Julio; Usamentiaga, Rubén; Garcίa, Daniel F.

2013-01-01

Shape is a key characteristic to determine the quality of outgoing flat-rolled products in the steel industry. It is greatly influenced by flatness, a feature to describe how the surface of a rolled product approaches a plane. Flatness is of the utmost importance in steelmaking, since it is used by most downstream processes and customers for the acceptance or rejection of rolled products. Flatness sensors compute flatness measurements based on comparing the length of several longitudinal fibers of the surface of the product under inspection. Two main different approaches are commonly used. On the one hand, most mechanical sensors measure the tensile stress across the width of the rolled product, while manufacturing and estimating the fiber lengths from this stress. On the other hand, optical sensors measure the length of the fibers by means of light patterns projected onto the product surface. In this paper, we review the techniques and the main sensors used in the steelmaking industry to measure and quantify flatness defects in steel plates, sheets and strips. Most of these techniques and sensors can be used in other industries involving rolling mills or continuous production lines, such as aluminum, copper and paper, to name a few. Encompassed in the special issue, State-of-the-Art Sensors Technology in Spain 2013, this paper also reviews the most important flatness sensors designed and developed for the steelmaking industry in Spain. PMID:23939583

On-line flatness measurement in the steelmaking industry.

PubMed

Molleda, Julio; Usamentiaga, Rubén; García, Daniel F

2013-08-09

Shape is a key characteristic to determine the quality of outgoing flat-rolled products in the steel industry. It is greatly influenced by flatness, a feature to describe how the surface of a rolled product approaches a plane. Flatness is of the utmost importance in steelmaking, since it is used by most downstream processes and customers for the acceptance or rejection of rolled products. Flatness sensors compute flatness measurements based on comparing the length of several longitudinal fibers of the surface of the product under inspection. Two main different approaches are commonly used. On the one hand, most mechanical sensors measure the tensile stress across the width of the rolled product, while manufacturing and estimating the fiber lengths from this stress. On the other hand, optical sensors measure the length of the fibers by means of light patterns projected onto the product surface. In this paper, we review the techniques and the main sensors used in the steelmaking industry to measure and quantify flatness defects in steel plates, sheets and strips. Most of these techniques and sensors can be used in other industries involving rolling mills or continuous production lines, such as aluminum, copper and paper, to name a few. Encompassed in the special issue, State-of-the-Art Sensors Technology in Spain 2013, this paper also reviews the most important flatness sensors designed and developed for the steelmaking industry in Spain.

Evaporation of liquid droplets on solid substrates. II. Periodic substrates with moving contact lines

NASA Astrophysics Data System (ADS)

Amini, Amirhossein; Homsy, G. M.

2017-04-01

Experiments on evaporating droplets on structured surfaces have shown that the contact line does not move with constant speed, but rather in a steplike "stick-slip" fashion. As a first step in understanding such behavior, we study the evaporation of a two-dimensional volatile liquid droplet on a nonplanar heated solid substrate with a moving contact line and fixed contact angle. The model for the flat case is adapted to include curved substrates, numerical solutions are achieved for various periodic and quasiperiodic substrate profiles, and the dynamics of the contact line and the apparent contact angle are studied. In contrast with our results for a flat substrate, for which the contact line recedes in a nearly constant speed, we observe that the contact line speed and position show significant time variation and that the contact line moves in an approximate steplike fashion on relatively steep substrates. For the simplest case of a periodic substrate, we find that the apparent contact angle is periodic in time. For doubly periodic substrates, we find that the apparent contact angle is periodic and that the problem exhibits a phase-locking behavior. For multimode quasiperiodic substrates, we find the contact line behavior to be temporally complex and not only limited to a stick-slip motion. In all cases, we find that the overall evaporation is increased relative to the flat substrate.

Monitoring transients in low inductance circuits

DOEpatents

Guilford, R.P.; Rosborough, J.R.

1985-10-21

The instant invention relates to methods of and apparatus for monitoring transients in low inductance circuits and to a probe utilized to practice said method and apparatus. More particularly, the instant invention relates to methods of and apparatus for monitoring low inductance circuits, wherein the low inductance circuits include a pair of flat cable transmission lines. The instant invention is further directed to a probe for use in monitoring pairs of flat cable transmission lines.

Gabapentin Superadded to a Pre-Existent Regime Containing Amytriptyline for Chronic Sciatica.

PubMed

Robertson, Kelvin L; Marshman, Laurence A G

2016-11-01

There is currently a gross lack of evidence base guiding the medical management of chronic sciatica (CS). Only scant previous studies have assessed gabapentin (GBP) in CS. Extrapolating NICE-UK guidelines, prescribing authorities often insist on trialling anti-depressants (e.g., amytriptyline, AMP) as a first line for neuropathic pain states such as CS. When super-adding second-line agents, such as GBP, NICE-UK encourages overlap with first-line agents to avoid decreased pain-control. No study has reflected this practice. Evaluate efficacy and side effects (SE) of GBP superadded to a pre-existent regime containing AMP for CS. Prospective cohort of patients with unilateral CS attending a specialist spine clinic. Eligible patients had experienced partial benefit to a pre-existent regime containing AMP: none had significant SE. No drugs other than GBP were added or discontinued (the latter was considered inequitable) for 3 months. Visual analog pain score (VAS), Oswestry disability index (ODI), and SE were recorded. Efficacy: in 56% (43/77) there were reductions in VAS (5.3 ± 3.6→2.8 ± 2.7, P < 0.0001) and ODI (42.8 ± 31.1→30.7 ± 25.2, P = 0.008). SE: Eighty-two SE (23 types) were reported in 53% (41/77). Efficacy was less in those with SE: a trend existed for a lesser reduction in VAS (2.0 ± 2.4 v 3.0 ± 2.7, P = 0.08), which proved significant for ODI (8.1 ± 11.4 v 16.7 ± 18.2, P = 0.01). Thirty-four percent (26/77) discontinued GBP all within 1 week (i.e., during titration). This is the first prospective cohort study of GBP super-added to a pre-existent regime containing AMP for CS, as per routine clinical practice and NICE-UK principles. Super-added GBP demonstrated further efficacy over the previous regime in 56%; however, SE were frequent (53%) and diverse (23 types), and 34% abruptly discarded GBP. Although SE were associated with decreased efficacy, 37% nevertheless tolerated GBP despite SE. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The Clinical and Cost Effectiveness of Vortioxetine for the Treatment of a Major Depressive Episode in Patients With Failed Prior Antidepressant Therapy: A Critique of the Evidence.

PubMed

Lomas, James; Llewellyn, Alexis; Soares, Marta; Simmonds, Mark; Wright, Kath; Eastwood, Alison; Palmer, Stephen

2016-09-01

The National Institute for Health and Care Excellence (NICE) invited the manufacturer of vortioxetine (Lundbeck) to submit clinical and cost-effectiveness evidence for vortioxetine for the treatment of major depressive episodes (MDEs), as part of the Institute's Single Technology Appraisal (STA) process. The Centre for Reviews and Dissemination and Centre for Health Economics at the University of York were commissioned to act as the independent Evidence Review Group (ERG). This article provides a description of the company submission, the ERG review and the resulting NICE guidance TA367 issued in November 2015. The ERG critically reviewed the evidence presented in the manufacturer's submission and identified areas requiring clarification, for which the manufacturer provided additional evidence. Two phase III randomised controlled trials for a second-line population involving vortioxetine were identified-REVIVE and TAK318. These two trials represent only 972 of over 7000 patients included in trials of vortioxetine. In REVIVE, there was a statistically significant difference in depression scores favouring vortioxetine compared with agomelatine [mean Montgomery-Åsberg Depression Rating Scale (MADRS) score difference of 2.16 points; 95 % confidence interval 0.81-3.51]. The ERG concluded that, based on all the evidence, rather than the substantially restricted subset of evidence originally considered by the manufacturer, vortioxetine is likely to be similar in efficacy to other analysed antidepressants [citalopram, sertraline, escitalopram and venlafaxine extended release (XR)], and may be more efficacious than agomelatine and inferior to duloxetine. The ERG concluded that vortioxetine may be more tolerable than other analysed antidepressants (sertraline, venlafaxine XR and bupropion), although the limited data prevent firm conclusions. The base-case incremental cost-effectiveness ratio (ICER) of vortioxetine reported by the manufacturer was £378 per quality-adjusted life-year (QALY) compared with venlafaxine. Given considerable concerns about the indirect treatment comparison undertaken by the manufacturer, the use of only a restrictive subset of the available evidence, and concerns regarding comparators and structural model assumptions, the ERG believes that this is not a valid estimate of the cost effectiveness of vortioxetine. Following corrections made to the model made by the ERG, the estimated cost effectiveness of vortioxetine was sensitive to the source of evidence used, in addition to whether certain comparators were excluded. The NICE thus asked the manufacturer to provide a revised economic model, which incorporated the broader evidence base and considered the cost effectiveness of vortioxetine as a third-line treatment. Assuming equal efficacy, vortioxetine was shown to be less costly and generate a higher QALY gain than relevant comparators at the third-line of treatment owing to its tolerability and adverse event profile. The NICE Appraisal Committee recommended vortioxetine as an option for treating MDEs in adults whose condition has responded inadequately to two antidepressants within the current episode.

Communication: Two types of flat-planes conditions in density functional theory

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

Yang, Xiaotian Derrick; Patel, Anand H. G.; González-Espinoza, Cristina E.

Using results from atomic spectroscopy, we show that there are two types of flat-planes conditions. The first type of flat-planes condition occurs when the energy as a function of the number of electrons of each spin, N{sub α} and N{sub β}, has a derivative discontinuity on a line segment where the number of electrons, N{sub α} + N{sub β}, is an integer. The second type of flat-planes condition occurs when the energy has a derivative discontinuity on a line segment where the spin polarization, N{sub α} – N{sub β}, is an integer, but does not have a discontinuity associated withmore » an integer number of electrons. Type 2 flat planes are rare—we observed just 15 type 2 flat-planes conditions out of the 4884 cases we tested—but their mere existence has implications for the design of exchange-correlation energy density functionals. To facilitate the development of functionals that have the correct behavior with respect to both fractional number of electrons and fractional spin polarization, we present a dataset for the chromium atom and its ions that can be used to test new functionals.« less

7. VIEW OF BOOSTER STATION 3, FACING NORTHWEST Nevada ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

7. VIEW OF BOOSTER STATION 3, FACING NORTHWEST - Nevada Test Site, Frenchman Flat Test Facility, Well Five Booster Stations, Intersection of 5-03 Road & Short Pole Line Road, Area 5, Frenchman Flat, Mercury, Nye County, NV

2. VIEW OF BOOSTER STATION 1, FACING NORTHEAST Nevada ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

2. VIEW OF BOOSTER STATION 1, FACING NORTHEAST - Nevada Test Site, Frenchman Flat Test Facility, Well Five Booster Stations, Intersection of 5-03 Road & Short Pole Line Road, Area 5, Frenchman Flat, Mercury, Nye County, NV

11. VIEW OF BOOSTER STATION 4, FACING SOUTHEAST Nevada ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. VIEW OF BOOSTER STATION 4, FACING SOUTHEAST - Nevada Test Site, Frenchman Flat Test Facility, Well Five Booster Stations, Intersection of 5-03 Road & Short Pole Line Road, Area 5, Frenchman Flat, Mercury, Nye County, NV

10. VIEW OF BOOSTER STATION 4, FACING NORTHWEST Nevada ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

10. VIEW OF BOOSTER STATION 4, FACING NORTHWEST - Nevada Test Site, Frenchman Flat Test Facility, Well Five Booster Stations, Intersection of 5-03 Road & Short Pole Line Road, Area 5, Frenchman Flat, Mercury, Nye County, NV

1. VIEW OF BOOSTER STATION 1, FACING SOUTHWEST Nevada ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. VIEW OF BOOSTER STATION 1, FACING SOUTHWEST - Nevada Test Site, Frenchman Flat Test Facility, Well Five Booster Stations, Intersection of 5-03 Road & Short Pole Line Road, Area 5, Frenchman Flat, Mercury, Nye County, NV

8. VIEW OF BOOSTER STATION 3, FACING SOUTHEAST Nevada ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. VIEW OF BOOSTER STATION 3, FACING SOUTHEAST - Nevada Test Site, Frenchman Flat Test Facility, Well Five Booster Stations, Intersection of 5-03 Road & Short Pole Line Road, Area 5, Frenchman Flat, Mercury, Nye County, NV

4. VIEW OF BOOSTER STATION 2, FACING NORTHWEST Nevada ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

4. VIEW OF BOOSTER STATION 2, FACING NORTHWEST - Nevada Test Site, Frenchman Flat Test Facility, Well Five Booster Stations, Intersection of 5-03 Road & Short Pole Line Road, Area 5, Frenchman Flat, Mercury, Nye County, NV

5. VIEW OF BOOSTER STATION 2, FACING SOUTHEAST Nevada ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. VIEW OF BOOSTER STATION 2, FACING SOUTHEAST - Nevada Test Site, Frenchman Flat Test Facility, Well Five Booster Stations, Intersection of 5-03 Road & Short Pole Line Road, Area 5, Frenchman Flat, Mercury, Nye County, NV

Do English NHS Microbiology laboratories offer adequate services for the diagnosis of UTI in children? Healthcare Quality Improvement Partnership (HQIP) Audit of Standard Operational Procedures.

PubMed

McNulty, Cliodna A M; Verlander, Neville Q; Moore, Philippa C L; Larcombe, James; Dudley, Jan; Banerjee, Jaydip; Jadresic, Lyda

2015-09-01

The National Institute of Care Excellence (NICE) 2007 guidance CG54, on urinary tract infection (UTI) in children, states that clinicians should use urgent microscopy and culture as the preferred method for diagnosing UTI in the hospital setting for severe illness in children under 3 years old and from the GP setting in children under 3 years old with intermediate risk of severe illness. NICE also recommends that all 'infants and children with atypical UTI (including non-Escherichia coli infections) should have renal imaging after a first infection'. We surveyed all microbiology laboratories in England with Clinical Pathology Accreditation to determine standard operating procedures (SOPs) for urgent microscopy, culture and reporting of children's urine and to ascertain whether the SOPs facilitate compliance with NICE guidance. We undertook a computer search in six microbiology laboratories in south-west England to determine urine submissions and urine reports in children under 3 years. Seventy-three per cent of laboratories (110/150) participated. Enterobacteriaceae that were not E. coli were reported only as coliforms (rather than non-E. coli coliforms) by 61% (67/110) of laboratories. Eighty-eight per cent of laboratories (97/110) provided urgent microscopy for hospital and 54% for general practice (GP) paediatric urines; 61% of laboratories (confidence interval 52-70%) cultured 1 μl volume of urine, which equates to one colony if the bacterial load is 106 c.f.u. l(-1). Only 22% (24/110) of laboratories reported non-E. coli coliforms and provided urgent microscopy for both hospital and GP childhood urines; only three laboratories also cultured a 5 μl volume of urine. Only one of six laboratories in our submission audit had a significant increase in urine submissions and urines reported from children less than 3 years old between the predicted pre-2007 level in the absence of guidance and the 2008 level following publication of the NICE guidance. Less than a quarter of laboratories were providing a service that would allow clinicians to fully comply with the first line recommendations in the 2007 NICE UTI in children guidance. Laboratory urine submission report figures suggest that the guidance has not led to an increase in diagnosis of UTI in children under 3 years old.

Investigating the use of NICE guidelines and IAPT services in the treatment of depression

PubMed Central

2012-01-01

Background There is evidence that the National Institute for Health and Clinical Excellence (NICE) guidelines for mental health disorders are used to varying degrees in primary care. A lack of access to cognitive–behavioural therapy (CBT) has been found to be a barrier to their implementation. The Improving Access to Psychological Therapies (IAPT) initiative was created in 2007 to increase the availability of NICE-recommended psychological treatments for depression and anxiety disorders within the National Health Service in England. Aim This study aims to investigate whether general practitioners (GPs) who have access to IAPT services and use NICE guidelines are more likely to use NICE concordant treatments for depression than those who do not. Depression was chosen as it is the most common mental health problem facing primary care physicians. Method Questionnaires were sent to 830 GPs in southeast England and six GPs were interviewed. The response rate to the questionnaires was 27% (n = 222). Results Ninety-five per cent of GPs were aware of the NICE guidelines for depression, and 76% had read them. Concordance with the guidelines was significantly higher when GPs had access to a local IAPT service or had read the NICE guidelines. Conclusions The interviews revealed favourable views to IAPT services when used, although access to treatments was still a common barrier to the implementation of the NICE guidelines for depression. PMID:23997821

A Study of the Invertebrates and Fishes of Salt Marshes in Two Oregon Estuaries.

DTIC Science & Technology

1981-06-01

TAXON Level Level Debris TAXON Level Level Debris Marsh Marsh Line Marsh Marsh Line Cnidaria Coleopr era Halaoampa s? p. A Carabidae A A A Turbellaria A...HAB ITAT H fAB ITAT TAXON Tidal Tidal Flat Tidal Tidal Flat Lan Creek Sandy Mudd TAXON PA Creek SandyMdd Cnidaria A A Tanaidacea Nemertea A A Pancolus...INVERTEBRATES Phylum Protozoa Subphylum Sarcomastigophora Class Rhizopodea Order Foraminifera Phylum Cnidaria Class Anthozoa Subclass Zoantharia Order

9. VIEW OF BOOSTER STATION 3 INTERIOR, FACING NORTHEAST ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

9. VIEW OF BOOSTER STATION 3 INTERIOR, FACING NORTHEAST - Nevada Test Site, Frenchman Flat Test Facility, Well Five Booster Stations, Intersection of 5-03 Road & Short Pole Line Road, Area 5, Frenchman Flat, Mercury, Nye County, NV

6. VIEW OF BOOSTER STATION 2 INTERIOR, FACING WEST ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. VIEW OF BOOSTER STATION 2 INTERIOR, FACING WEST - Nevada Test Site, Frenchman Flat Test Facility, Well Five Booster Stations, Intersection of 5-03 Road & Short Pole Line Road, Area 5, Frenchman Flat, Mercury, Nye County, NV

12. VIEW OF BOOSTER STATION 4 INTERIOR, FACING SOUTHWEST ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

12. VIEW OF BOOSTER STATION 4 INTERIOR, FACING SOUTHWEST - Nevada Test Site, Frenchman Flat Test Facility, Well Five Booster Stations, Intersection of 5-03 Road & Short Pole Line Road, Area 5, Frenchman Flat, Mercury, Nye County, NV

3. VIEW OF BOOSTER STATION 1 INTERIOR, FACING EAST ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

3. VIEW OF BOOSTER STATION 1 INTERIOR, FACING EAST - Nevada Test Site, Frenchman Flat Test Facility, Well Five Booster Stations, Intersection of 5-03 Road & Short Pole Line Road, Area 5, Frenchman Flat, Mercury, Nye County, NV

An audit of growth hormone replacement for GH-deficient adults in Scotland.

PubMed

Philip, Sam; Howat, Isobel; Carson, Maggie; Booth, Anne; Campbell, Karen; Grant, Donna; Patterson, Catherine; Schofield, Christopher; Bevan, John; Patrick, Alan; Leese, Graham; Connell, John

2013-04-01

Guidelines on the clinical use of growth hormone therapy in adults were issued by the UK National Institute for Clinical Excellence (NICE) in August 2003. We conducted a retrospective clinical audit on the use of growth hormone (GH) in Scotland to evaluate the use of these guidelines and their impact on clinical practice. The audit had two phases. In phase I, the impact of NICE criteria on specialist endocrine practice in starting and continuing GH replacement was assessed. In phase II, the reasons why some adults in Scotland with growth hormone deficiency were not on replacement therapy were evaluated. A retrospective cross-sectional case note review was carried out of all adult patients being followed up for growth hormone deficiency during the study period (1 March 2005 to 31 March 2008). Phase I of the audit included 208 patients and phase II 108 patients. Sellar tumours were the main cause of GH deficiency in both phases of the audit. In phase I, 53 patients (77%) had an AGHDA-QoL score >11 documented before commencing GH post-NICE guidance, compared with 35 (25%) pre-NICE guidance. Overall, only 39 patients (18%) met the full NICE criteria for starting and continuing GH (pre-NICE, 11%; post-NICE, 35%). Phase II indicated that the main reasons for not starting GH included perceived satisfactory quality of life (n = 47, 43%), patient reluctance (16, 15%) or a medical contraindication (16, 15%). Although the use of quality of life assessments has increased following publication of the NICE guidelines, most adults on GH in Scotland did not fulfil the complete set of NICE criteria. The main reason for not starting GH therapy in adult GH-deficient patients was perceived satisfactory quality of life. © 2012 Blackwell Publishing Ltd.

13. VIEW OF BOOSTER STATION 4 CHLORINATOR INTERIOR, FACING NORTH ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. VIEW OF BOOSTER STATION 4 CHLORINATOR INTERIOR, FACING NORTH - Nevada Test Site, Frenchman Flat Test Facility, Well Five Booster Stations, Intersection of 5-03 Road & Short Pole Line Road, Area 5, Frenchman Flat, Mercury, Nye County, NV

The Universal Transverse Mercator (UTM) grid

USGS Publications Warehouse

,

1997-01-01

The most convenient way to identify points on the curved surface of the Earth is with a system of reference lines called parallels of latitude and meridians of longitude. On some maps the meridians and parallels appear as straight lines. On most modern maps, however, the meridians and parallels may appear as curved lines. These differences are due to the mathematical treatment required to portray a curved surface on a flat surface so that important properties of the map (such as distance and areal accuracy) are shown with minimum distortion. The system used to portray a portion of the round Earth on a flat surface is called a map projection.

The Universal Transverse Mercator (UTM) grid

USGS Publications Warehouse

,

1999-01-01

The most convenient way to identify points on the curved surface of the Earth is with a system of reference lines called parallels of latitude and meridians of longitude. On some maps, the meridians and parallels appear as straight lines. On most modern maps, however, the meridians and parallels appear as curved lines. These differences sre due to the mathematical treatment required to portray a curved surface on a flat surface so that important properties of the map (such as distance and areal accuracy) are shown with minimum distortion. The system used to portray a portion of the round Earth on a flat surface is called a map projection.

A Very Large Array Survey of Polar BAL Quasar Candidates

NASA Astrophysics Data System (ADS)

Olson, Kianna Alexandra; Brotherton, Michael S.; DiPompeo, Michael; Maithil, Jaya

2018-06-01

Polar broad absorption line quasars posses flat radio spectra and jets seen at small angles to the line of sight. Using the VLA we observed twelve polar broad absorption line quasar candidates at L (1.5GHz), C (4.5-5.5GHz), and X (8.5-9.5GHz) bands, and found that their cores display flat spectra. Compared to previous observations in the NVSS and First surveys, the peak flux densities all show significant variation σvar > 3, and brightness temperatures TB ≥ 1012K. Based on these findings, our quasars have the properties expected for objects that posses jets seen nearly pole on.

Optical Arbitrary Waveform Generators Based on Temporal and Spectral Shaping of Optical Pulses in Nonlinear Metamaterials

DTIC Science & Technology

2011-06-01

of a flat-top (thin lines) and a kink (thick lines) soliton . Here = 0.25,Q = 1.786 553 604 650 208 for the dark soliton (Q = 1.786 553 7 for the flat...localization and transport in different physical settings, ranging from metal-dielectric (i.e. plasmonic) to photonic crystal waveguides. The solitons ...settings, ranging from metal--dielectric (i.e. plasmonic) to photonic crystal waveguides. The solitons exist for focusing, defocusing and even for

Enumerative Geometry of Hyperplane Arrangements

DTIC Science & Technology

2012-05-11

they show that the Zariski closure of M(L) as viewed as a subvariety of (Cn+1)` is not the variety given only by the solutions to the determinantal ...equations supplied by L. These determinantal equations are presented nicely in Terao [28]. We study in detail the case when L is the lattice of the braid...4.1.1. Let A be a generic arrangement of 4 lines through 8 points in general position in P2. There are no triple points inA, so there are no determinantal

Switching gears and changing lanes

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

Hammock, Earlene C.

2002-01-01

From musing over Shakespeare's fine lines and metaphors to teaching technical writing and editing, and finally, to cranking out scientific and technical documents, writing articles, and editing publications-how'd a nice girl like me end up in a place like this? Twice, after having prepared for an academic career of teaching and research, I found myself in a technical communications position-first, at the University of Texas at El Paso College of Engineering and later, at Los Alamos National Laboratory. What happened?

Worldsheet scattering in AdS3/CFT2

NASA Astrophysics Data System (ADS)

Sundin, Per; Wulff, Linus

2013-07-01

We confront the recently proposed exact S-matrices for AdS 3/ CFT 2 with direct worldsheet calculations. Utilizing the BMN and Near Flat Space (NFS) expansions for strings on AdS 3 × S 3 × S 3 × S 1 and AdS 3 × S 3 × T 4 we compute both tree-level and one-loop scattering amplitudes. Up to some minor issues we find nice agreement in the tree-level sector. At the one-loop level however we find that certain non-zero tree-level processes, which are not visible in the exact solution, contribute, via the optical theorem, and give an apparent mismatch for certain amplitudes. Furthermore we find that a proposed one-loop modification of the dressing phase correctly reproduces the worldsheet calculation while the standard Hernandez-Lopez phase does not. We also compute several massless to massless processes.

On the Shapes of Spandex

NASA Astrophysics Data System (ADS)

White, Gary

2003-03-01

What is the shape that results when a flat rubber sheet with fixed circular boundary is warped by placing a heavy ball upon it? We show that, at distance R far from the center of a ball of mass M, the height h of the surface above the ball's center is given by h(R) = A*M^1/3*R^2/3, where A is a constant determined by the stretchiness of the rubber and the earths gravitational constant. This happy result allows one to analyze the orbits of marbles and coins as they roll across the surface in some detail, providing very nice analogues for a wealth of topics in celestial mechanics, from Kepler's Laws to tides and the Roche limit. It also allows undergraduates the chance to engage in physics research that they can write home about, while providing the author with the opportunity to defend the value of undergraduate research against those who might label it an oxymoron.

Avances en la formación de los planetas gigantes del sistema solar

NASA Astrophysics Data System (ADS)

Guilera, O. M.; Fortier, A.; Brunini, A.; Benvenuto, O. G.

In the framework of the "Nice model", we compute the formation of the solar system giant planets by concurrent accretion of solids and gas, and study the dependence of this process on the surface profile of the protoplan- etary disk and the size distribution of the accreted planetesimals. We focus on the conditions that lead to the simultaneous formation of two massive cores, corresponding to Jupiter and Saturn, which should be able to reach the cross-over mass (where the mass of the envelope equals the mass of the core, and gaseous runway starts), while two other cores should be able to grow up to Uranus and Neptune's current masses. We find that the si- multaneous formation of the giant planets is favored by flat surface density profiles and by the accretion of relatively small planetesimals. FULL TEXT IN SPANISH

Can the NICE "end-of-life premium" be given a coherent ethical justification?

PubMed

Cookson, Richard

2013-12-01

In 2009 the UK National Institute for Health and Clinical Excellence (NICE) announced that its health technology appraisal committees would henceforth give special additional weight to health gains from life-extending end-of-life treatments. This was a response to mounting concern from NICE's stakeholders that effective new drugs for end-stage cancer often fail NICE's standard test of cost effectiveness. This change of policy may be justifiable on procedural grounds as the result of a democratic political process responding to stakeholder concerns. However, according to the "accountability for reasonableness" framework proposed by the philosopher Norman Daniels and endorsed by NICE, there also needs to be transparency about the substantive ethical grounds for public health care resource allocation decisions. In that spirit, I analyze eleven potentially relevant justifications for the NICE "end-of-life premium," drawn from the economics and philosophy literature: (1) rule of rescue, (2) fair chances, (3) ex post willingness to pay, (4) caring externality, (5) financial protection, (6) symbolic value, (7) diminishing marginal value of future life years, (8) concentration of benefits, (9) dread, (10) time to set your affairs in order, and (11) severity of illness. I conclude that none of them yields a coherent ethical justification for the NICE end-of-life premium.

An Update on Improvements to NiCE Support for RELAP-7

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

McCaskey, Alex; Wojtowicz, Anna; Deyton, Jordan H.

The Multiphysics Object-Oriented Simulation Environment (MOOSE) is a framework that facilitates the development of applications that rely on finite-element analysis to solve a coupled, nonlinear system of partial differential equations. RELAP-7 represents an update to the venerable RELAP-5 simulator that is built upon this framework and attempts to model the balance-of-plant concerns in a full nuclear plant. This report details the continued support and integration of RELAP-7 and the NEAMS Integrated Computational Environment (NiCE). RELAP-7 is fully supported by the NiCE due to on-going work to tightly integrate NiCE with the MOOSE framework, and subsequently the applications built upon it.more » NiCE development throughout the first quarter of FY15 has focused on improvements, bug fixes, and feature additions to existing MOOSE-based application support. Specifically, this report will focus on improvements to the NiCE MOOSE Model Builder, the MOOSE application job launcher, and the 3D Nuclear Plant Viewer. This report also includes a comprehensive tutorial that guides RELAP-7 users through the basic NiCE workflow: from input generation and 3D Plant modeling, to massively parallel job launch and post-simulation data visualization.« less

Reliability evaluation of hermetic dual in-line flat microcircuit packages

NASA Technical Reports Server (NTRS)

Johnson, G. M.; Conaway, L. K.

1977-01-01

The relative strengths and weaknesses of 35 commonly used hermetic flat and dual in-line packages were determined and used to rank each of the packages according to a numerical weighting scheme for package attributes. The list of attributes included desirable features in five major areas: lead and lead seal, body construction, body materials, lid and lid seal, and marking. The metal flat pack and multilayer integral ceramic flat pack and DIP received the highest rankings, and the soft glass Cerdip and Cerpak types received the lowest rankings. Loss of package hermeticity due to lead and lid seal problems was found to be the predominant failure mode from the literature/data search. However, environmental test results showed that lead and lid seal failures due to thermal stressing was only a problem with the hard glass (Ceramic) body DIP utilizing a metal lid and/or bottom. Insufficient failure data were generated for the other package types tested to correlate test results with the package ranking.

NICE recommendations for the assessment of stable chest pain: assessing the early economic and service impact in the rapid-access chest pain service.

PubMed

Ashrafi, Reza; Raga, Santosh; Abdool, Ali; Disney, Andrew; Wong, Peter; Davis, Gershan K

2013-05-01

In 2010, guidelines published by the National Institute for Clinical Excellence (NICE) suggested a change in the way patients with stable chest pain of suspected cardiac origin were investigated. These guidelines removed exercise treadmill testing from routine use and introduced cardiac CT to regular use. To investigate whether these guidelines had improved our service provision by reducing the number of further investigations required to make a diagnosis, and to see if our costs had increased now that the less expensive exercise treadmill tests were not recommended. Clinic letters were used to assess patients pretest likelihood of coronary artery disease for two six-month cohorts of consecutive patients seen in the rapid access chest pain clinic (January-June 2010 and July-December 2011) using NICE published methodology, and to ascertain which investigations patients had. Using NICE modelled costs, we generated comparative hypothetical costs for each cohort and an average cost per patient. In the January-June 2010 cohort, 435 patients with chest pain were seen, and in July-December 2011, 334 patients were seen. In the pre-NICE guidelines cohort, 23% of patients required two investigations as compared with 11.4% in the post-NICE guidelines cohort, with no patient requiring three investigations as compared with 3% in the original cohort. There was no significant increase in costs per patient in the post-NICE guidance group. Implementing NICE guidance reduced the number of investigations needed per patient, and did not prove more expensive for our department in the short term.

Neutron Star Interior Composition Explorer (NICE)

NASA Technical Reports Server (NTRS)

Gendreau, Keith C.; Arzoumanian, Zaven

2008-01-01

This viewgraph presentation contains an overview of the mission of the Neutron Star Interior Composition Explorer (NICE), a proposed International Space Station (ISS) payload dedicated ot the study of neutron stars. There are also reviews of the Science Objectives of the payload,the science measurements, the design and the expected performance for the instruments for NICE,

(Non-adiabatic) string creation on nice slices in Schwarzschild black holes

NASA Astrophysics Data System (ADS)

Puhm, Andrea; Rojas, Francisco; Ugajin, Tomonori

2017-04-01

Nice slices have played a pivotal role in the discussion of the black hole information paradox as they avoid regions of strong spacetime curvature and yet smoothly cut through the infalling matter and the outgoing Hawking radiation, thus, justifying the use of low energy field theory. To avoid information loss it has been argued recently, however, that local effective field theory has to break down at the horizon. To assess the extent of this breakdown in a UV complete framework we study string-theoretic effects on nice slices in Schwarzschild black holes. Our purpose is two-fold. First, we use nice slices to address various open questions and caveats of [1] where it was argued that boost-enhanced non-adiabatic string-theoretic effects at the horizon could provide a dynamical mechanism for the firewall. Second, we identify two non-adiabatic effects on nice slices in Schwarzschild black holes: pair production of open strings near the horizon enhanced by the presence of the infinite tower of highly excited string states and a late-time non-adiabatic effect intrinsic to nice slices.

Flat band in disorder-driven non-Hermitian Weyl semimetals

NASA Astrophysics Data System (ADS)

Zyuzin, A. A.; Zyuzin, A. Yu.

2018-01-01

We study the interplay of disorder and band-structure topology in a Weyl semimetal with a tilted conical spectrum around the Weyl points. The spectrum of particles is given by the eigenvalues of a non-Hermitian matrix, which contains contributions from a Weyl Hamiltonian and complex self-energy due to electron elastic scattering on disorder. We find that the tilt-induced matrix structure of the self-energy gives rise to either a flat band or a nodal line segment at the interface of the electron and hole pockets in the bulk band structure of type-II Weyl semimetals depending on the Weyl cone inclination. For the tilt in a single direction in momentum space, each Weyl point expands into a flat band lying on the plane, which is transverse to the direction of the tilt. The spectrum of the flat band is fully imaginary and is separated from the in-plane dispersive part of the spectrum by the "exceptional nodal ring" where the matrix of the Green's function in momentum-frequency space is defective. The tilt in two directions might shrink a flat band into a nodal line segment with "exceptional edge points." We discuss the connection to the non-Hermitian topological theory.

Absolute flatness measurements of silicon mirrors by a three-intersection method by near-infrared interferometry

PubMed Central

2013-01-01

Absolute flatness of three silicon plane mirrors have been measured by a three-intersection method based on the three-flat method using a near-infrared interferometer. The interferometer was constructed using a near-infrared laser diode with a 1,310-nm wavelength light where the silicon plane mirror is transparent. The height differences at the coordinate values between the absolute line profiles by the three-intersection method have been evaluated. The height differences of the three flats were 4.5 nm or less. The three-intersection method using the near-infrared interferometer was useful for measuring the absolute flatness of the silicon plane mirrors. PMID:23758916

Surface inspection of flat products by means of texture analysis: on-line implementation using neural networks

NASA Astrophysics Data System (ADS)

Fernandez, Carlos; Platero, Carlos; Campoy, Pascual; Aracil, Rafael

1994-11-01

This paper describes some texture-based techniques that can be applied to quality assessment of flat products continuously produced (metal strips, wooden surfaces, cork, textile products, ...). Since the most difficult task is that of inspecting for product appearance, human-like inspection ability is required. A common feature to all these products is the presence of non- deterministic texture on their surfaces. Two main subjects are discussed: statistical techniques for both surface finishing determination and surface defect analysis as well as real-time implementation for on-line inspection in high-speed applications. For surface finishing determination a Gray Level Difference technique is presented to perform over low resolution images, that is, no-zoomed images. Defect analysis is performed by means of statistical texture analysis over defective portions of the surface. On-line implementation is accomplished by means of neural networks. When a defect arises, textural analysis is applied which result in a data-vector, acting as input of a neural net, previously trained in a supervised way. This approach tries to reach on-line performance in automated visual inspection applications when texture is presented in flat product surfaces.

Examining the implementation of NICE guidance: cross-sectional survey of the use of NICE interventional procedures guidance by NHS Trusts.

PubMed

Lowson, Karin; Jenks, Michelle; Filby, Alexandra; Carr, Louise; Campbell, Bruce; Powell, John

2015-06-30

In the UK, NHS hospitals receive large amounts of evidence-based recommendations for care delivery from the National Institute for Health and Care Excellence (NICE) and other organisations. Little is known about how NHS organisations implement such guidance and best practice for doing so. This study was therefore designed to examine the dissemination, decision-making, and monitoring processes for NICE interventional procedures (IP) guidance and to investigate the barriers and enablers to the implementation of such guidance. A cross-sectional survey questionnaire was developed and distributed to individuals responsible for managing the processes around NICE guidance in all 181 acute NHS hospitals in England, Scotland, Wales and Northern Ireland. A review of acute NHS hospital policies for implementing NICE guidance was also undertaken using information available in the public domain and from organisations' websites. The response rate to the survey was 75 % with 135 completed surveys received. Additionally, policies from 25 % of acute NHS hospitals were identified and analysed. NHS acute hospitals typically had detailed processes in place to implement NICE guidance, although organisations recognised barriers to implementation including organisational process barriers, clinical engagement and poor targeting with a large number of guidance issued. Examples of enablers to, and good practice for, implementation of guidance were found, most notably the value of shared learning experiences between NHS hospitals. Implications for NICE were also identified. These included making improvements to the layout of guidance, signposting on the website and making better use of their shared learning platform. Most organisations have robust processes in place to deal with implementing guidance. However, resource limitations and the scope of guidance received by organisations create barriers relating to organisational processes, clinician engagement and financing of new procedures. Guidance implementation can be facilitated through encouragement of shared learning by organisations such as NICE and open knowledge transfer between organisations.

Numerical studies of the KP line-solitons

NASA Astrophysics Data System (ADS)

Chakravarty, S.; McDowell, T.; Osborne, M.

2017-03-01

The Kadomtsev-Petviashvili (KP) equation admits a class of solitary wave solutions localized along distinct rays in the xy-plane, called the line-solitons, which describe the interaction of shallow water waves on a flat surface. These wave interactions have been observed on long, flat beaches, as well as have been recreated in laboratory experiments. In this paper, the line-solitons are investigated via direct numerical simulations of the KP equation, and the interactions of the evolved solitary wave patterns are studied. The objective is to obtain greater insight into solitary wave interactions in shallow water and to determine the extent the KP equation is a good model in describing these nonlinear interactions.

Exotic Phenomena in Quantum limit in nodal-line semimetal ZrSiS

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

Hu, Jin; Liu, Jinyu; Mao, Zhiqiang

2017-03-01

In quantum limit, all carriers condense to the lowest Landau level, leading to possible exotic quantum phenomena such as Lifshitz transition and density waves. Usually, quantum limit is not easily achieved due to relatively large Fermi surface in metals. Fortunately, the nodal-line semimetal ZrSiS possesses a very small Fermi pocket with a characteristic quantum oscillation frequency of 8.4T, which represents the 2D Dirac states protected by non-symmorphic symmetry. The quantum limit of such Dirac bands can be reached in moderate magnetic field ~25T, indicating that ZrSiS could be a nice platform to explore the novel quantum phenomena of Dirac fermionsmore » in quantum limit.« less

Radiological assessment of paediatric cervical spine injury in blunt trauma: the potential impact of new NICE guidelines on the use of CT.

PubMed

Davies, J; Cross, S; Evanson, J

2016-09-01

To determine the potential effect of changes to the National Institute for Health and Care Excellence (NICE) guidelines to the use of computed tomography (CT) in the assessment of suspected paediatric cervical spine (c-spine) injury. A 5 year retrospective study was conducted of c-spine imaging in paediatric (<10 years) patients presenting following blunt trauma at a Level 1 trauma centre in London. All patients under the age of 10 years who underwent any imaging of the c-spine following blunt trauma were included. Clinical data relating to the presenting signs and symptoms were obtained from the retrospective review of electronic records and paper notes. This was then applied to the previous NICE guideline (CG56) and to the new NICE guideline (CG176). Patients with incomplete data were excluded. Two hundred and seventy-eight patients <10 years underwent imaging of the c-spine following blunt trauma. Two hundred and seventy (97.12%) examinations had complete data and were included in further analysis. One hundred and forty-nine (55.19%) met the criteria for a CT of the c-spine under NICE CG56, whereas 252 (93.33%) met the updated NICE CG176 criteria for c-spine CT. Five (1.85%) patients had a c-spine injury and met the criteria under both CG56 and CG176 NICE guidelines. Recent changes to NICE Head Injury Guidelines relating to radiological assessment of paediatric c-spine following blunt trauma are likely to result in an increased usage of CT as the initial radiological investigation over plain radiographs, without an apparent increase in specificity in the present series. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Do English NHS Microbiology laboratories offer adequate services for the diagnosis of UTI in children? Healthcare Quality Improvement Partnership (HQIP) Audit of Standard Operational Procedures

PubMed Central

Verlander, Neville Q.; Moore, Philippa C. L.; Larcombe, James; Dudley, Jan; Banerjee, Jaydip; Jadresic, Lyda

2015-01-01

The National Institute of Care Excellence (NICE) 2007 guidance CG54, on urinary tract infection (UTI) in children, states that clinicians should use urgent microscopy and culture as the preferred method for diagnosing UTI in the hospital setting for severe illness in children under 3 years old and from the GP setting in children under 3 years old with intermediate risk of severe illness. NICE also recommends that all ‘infants and children with atypical UTI (including non-Escherichia coli infections) should have renal imaging after a first infection’. We surveyed all microbiology laboratories in England with Clinical Pathology Accreditation to determine standard operating procedures (SOPs) for urgent microscopy, culture and reporting of children's urine and to ascertain whether the SOPs facilitate compliance with NICE guidance. We undertook a computer search in six microbiology laboratories in south-west England to determine urine submissions and urine reports in children under 3 years. Seventy-three per cent of laboratories (110/150) participated. Enterobacteriaceae that were not E. coli were reported only as coliforms (rather than non-E. coli coliforms) by 61 % (67/110) of laboratories. Eighty-eight per cent of laboratories (97/110) provided urgent microscopy for hospital and 54 % for general practice (GP) paediatric urines; 61 % of laboratories (confidence interval 52–70 %) cultured 1 μl volume of urine, which equates to one colony if the bacterial load is 106 c.f.u. l− 1. Only 22 % (24/110) of laboratories reported non-E. coli coliforms and provided urgent microscopy for both hospital and GP childhood urines; only three laboratories also cultured a 5 μl volume of urine. Only one of six laboratories in our submission audit had a significant increase in urine submissions and urines reported from children less than 3 years old between the predicted pre-2007 level in the absence of guidance and the 2008 level following publication of the NICE guidance. Less than a quarter of laboratories were providing a service that would allow clinicians to fully comply with the first line recommendations in the 2007 NICE UTI in children guidance. Laboratory urine submission report figures suggest that the guidance has not led to an increase in diagnosis of UTI in children under 3 years old. PMID:26297550

Ledipasvir-Sofosbuvir for Treating Chronic Hepatitis C: A NICE Single Technology Appraisal-An Evidence Review Group Perspective.

PubMed

Thokala, P; Simpson, E L; Tappenden, P; Stevens, J W; Dickinson, K; Ryder, S; Harrison, P

2016-08-01

The National Institute for Health and Care Excellence (NICE) invited Gilead, the company manufacturing ledipasvir-sofosbuvir (LDV/SOF), to submit evidence for the clinical effectiveness and cost effectiveness of LDV/SOF for treating chronic hepatitis C. The School of Health and Related Research (ScHARR) Technology Assessment Group was commissioned as the Evidence Review Group (ERG). This paper describes the company's submission (CS), the ERG review and the subsequent decision of the NICE Appraisal Committee (AC). The ERG produced a critical review of the clinical effectiveness and cost-effectiveness evidence of LDV/SOF based upon the CS. The clinical effectiveness data for LDV/SOF were taken from ten trials: three phase III trials and seven phase II trials. Trials compared different durations of LDV/SOF, with and without ribavirin (RBV). There were no head-to-head trials comparing LDV/SOF with any comparator listed in the NICE scope. Data from the trials were mostly from populations with genotype 1 (GT1) disease, although some limited data were available for populations with genotypes 3 and 4. For GT1 treatment-naïve patients, sustained viral response for 12 weeks (SVR12) rates for LDV/SOF ranged from 93.1 to 99.4 % for subgroups of patients with non-cirrhotic disease, whilst SVR rates of 94.1 to 100 % were reported for subgroups of patients with compensated cirrhosis. For GT1 treatment-experienced patients, SVR12 rates ranging from 95.4 to 100 % were reported for subgroups of non-cirrhotic patients, and SVR rates ranging from 81.8 to 100 % were reported within subgroups of patients with compensated cirrhosis. Comparator data were not searched systematically as part of the submission, but were based on the company's previous NICE submission of sofosbuvir, with additional targeted searches. The ERG's critical appraisal of the company's economic evaluation highlighted a number of concerns. The ERG's base case analyses suggested that the incremental cost-effectiveness ratios (ICERs) for LDV/SOF (+RBV) are dependent on (a) treatment durations, (b) whether patients have been previously treated and (c) whether patients have liver cirrhosis or not. The AC concluded that it was appropriate to use the approach taken in the ERG's exploratory analyses, in line with the marketing authorisation, which considered people with and without cirrhosis separately, and estimated the cost effectiveness for each recommended treatment duration of LDV/SOF.

The xyloglucan-cellulose assembly at the atomic scale.

PubMed

Hanus, Jaroslav; Mazeau, Karim

2006-05-01

The assembly of cell wall components, cellulose and xyloglucan (XG), was investigated at the atomistic scale using molecular dynamics simulations. A molecular model of a cellulose crystal corresponding to the allomorph Ibeta and exhibiting a flexible complex external morphology was employed to mimic the cellulose microfibril. The xyloglucan molecules considered were the three typical basic repeat units, differing only in the size of one of the lateral chain. All the investigated XG fragments adsorb nonspecifically onto cellulose fiber; multiple arrangements are equally probable, and every cellulose surface was capable of binding the short XG molecules. The following structural effects emerged: XG molecules that do not have any long side chains tended to adapt themselves nicely to the topology of the microfibril, forming a flat, outstretched conformation with all the sugar residues interacting with the surface. In contrast, the XG molecules, which have long side chains, were not able to adopt a flat conformation that would enable the interaction of all the XG residues with the surface. In addition to revealing the fundamental atomistic details of the XG adsorption on cellulose, the present calculations give a comprehensive understanding of the way the XG molecules can unsorb from cellulose to create a network that forms the cell wall. Our revisited view of the adsorption features of XG on cellulose microfibrils is consistent with experimental data, and a model of the network is proposed. Copyright (c) 2006 Wiley Periodicals, Inc.

Introduction to the computational structural mechanics testbed

NASA Technical Reports Server (NTRS)

Lotts, C. G.; Greene, W. H.; Mccleary, S. L.; Knight, N. F., Jr.; Paulson, S. S.; Gillian, R. E.

1987-01-01

The Computational Structural Mechanics (CSM) testbed software system based on the SPAR finite element code and the NICE system is described. This software is denoted NICE/SPAR. NICE was developed at Lockheed Palo Alto Research Laboratory and contains data management utilities, a command language interpreter, and a command language definition for integrating engineering computational modules. SPAR is a system of programs used for finite element structural analysis developed for NASA by Lockheed and Engineering Information Systems, Inc. It includes many complementary structural analysis, thermal analysis, utility functions which communicate through a common database. The work on NICE/SPAR was motivated by requirements for a highly modular and flexible structural analysis system to use as a tool in carrying out research in computational methods and exploring computer hardware. Analysis examples are presented which demonstrate the benefits gained from a combination of the NICE command language with a SPAR computational modules.

A Model to Aid Topo-Map Interpretation

ERIC Educational Resources Information Center

Westerback, Mary

1976-01-01

Describes how to construct models of contour lines from flexible, colored bell wire. These models are used to illustrate three-dimensional terrain characteristics represented by contour lines printed on a flat map. (MLH)

Nitrogen Cycle Evaluation (NiCE) Chip for the Simultaneous Analysis of Multiple N-Cycle Associated Genes.

PubMed

Oshiki, Mamoru; Segawa, Takahiro; Ishii, Satoshi

2018-02-02

Various microorganisms play key roles in the Nitrogen (N) cycle. Quantitative PCR (qPCR) and PCR-amplicon sequencing of the N cycle functional genes allow us to analyze the abundance and diversity of microbes responsible in the N transforming reactions in various environmental samples. However, analysis of multiple target genes can be cumbersome and expensive. PCR-independent analysis, such as metagenomics and metatranscriptomics, is useful but expensive especially when we analyze multiple samples and try to detect N cycle functional genes present at relatively low abundance. Here, we present the application of microfluidic qPCR chip technology to simultaneously quantify and prepare amplicon sequence libraries for multiple N cycle functional genes as well as taxon-specific 16S rRNA gene markers for many samples. This approach, named as N cycle evaluation (NiCE) chip, was evaluated by using DNA from pure and artificially mixed bacterial cultures and by comparing the results with those obtained by conventional qPCR and amplicon sequencing methods. Quantitative results obtained by the NiCE chip were comparable to those obtained by conventional qPCR. In addition, the NiCE chip was successfully applied to examine abundance and diversity of N cycle functional genes in wastewater samples. Although non-specific amplification was detected on the NiCE chip, this could be overcome by optimizing the primer sequences in the future. As the NiCE chip can provide high-throughput format to quantify and prepare sequence libraries for multiple N cycle functional genes, this tool should advance our ability to explore N cycling in various samples. Importance. We report a novel approach, namely Nitrogen Cycle Evaluation (NiCE) chip by using microfluidic qPCR chip technology. By sequencing the amplicons recovered from the NiCE chip, we can assess diversities of the N cycle functional genes. The NiCE chip technology is applicable to analyze the temporal dynamics of the N cycle gene transcriptions in wastewater treatment bioreactors. The NiCE chip can provide high-throughput format to quantify and prepare sequence libraries for multiple N cycle functional genes. While there is a room for future improvement, this tool should significantly advance our ability to explore the N cycle in various environmental samples. Copyright © 2018 American Society for Microbiology.

Does the cancer drugs fund lead to faster uptake of cost-effective drugs? A time-trend analysis comparing England and Wales.

PubMed

Chamberlain, C; Collin, S M; Stephens, P; Donovan, J; Bahl, A; Hollingworth, W

2014-10-28

The Cancer Drugs Fund (CDF) provides £200 million annually in England for 'anti-cancer' drugs. We used a controlled pre-/post-intervention design to compare IMS Health dispensing data for 15 cancer drugs (2007-2012) in England vs Wales, stratified by pre-CDF NICE drug approval status (rejected, mixed recommendations, recommended, not appraised). The CDF was associated with increased prescribing in England for three of five drugs rejected or with mixed NICE recommendations. The prescribing volume ratios (PVR) ranged from 1.29 (95% CI 1.00, 1.67) for sorafenib to 3.28 (2.59, 4.14) for bevacizumab (NICE rejected) and 0.93 (0.81, 1.06) and 1.35 (1.21, 1.49) for sunitinib and imatinib respectively (mixed recommendations). Post CDF prescribing in England increased for both drugs awaiting NICE appraisal pre-CDF (lapatinib PVR=7.44 (5.81, 9.54), panitumumab PVR=5.40 (1.20, 24.42)) and subsequently rejected. The CDF was not associated with increased prescribing in England of NICE-recommended drugs. The three most recently launched, subsequently recommended drugs were adopted faster in Wales (from pazopanib PVR=0.51 (0.28, 0.96) to abiraterone PVR=0.78 (0.61-0.99)). These data indicate that the CDF is used to access drugs deemed not cost-effective by NICE. The CDF did not expedite access to new cost-effective cancer agents prior to NICE approval.

Elucidating the Complex Lineshapes Resulting from the Highly Sensitive, Ion Selective, Technique Nice-Ohvms

NASA Astrophysics Data System (ADS)

Hodges, James N.; Siller, Brian; McCall, Benjamin J.

2015-06-01

The technique Noise Immune Cavity Enhanced Optical Heterodyne Velocity Modulation Spectroscopy, or NICE-OHVMS, has been used to great effect to precisely and accurately measure a variety of molecular ion transitions from species such as H_3^+, CH_5^+, HeH^+, and HCO^+, achieving MHz or in some cases sub-MHz uncertainty. It is a powerful technique, but a complete theoretical understanding of the complex NICE-OHVMS lineshape is needed to fully unlock its potential. NICE-OHVMS is the direct result of the combination of the highly sensitive spectroscopic technique Noise Immune Cavity Enhanced Optical Heterodyne Molecular Spectroscopy(NICE-OHMS) with Velocity Modulation Spectroscopy(VMS), applying the most sensitive optical detection method with ion species selectivity. The theoretical underpinnings of NICE-OHMS lineshapes are well established, as are those of VMS. This presentation is the logical extension of those two preceding bodies of work. Simulations of NICE-OHVMS lineshapes under a variety of conditions and fits of experimental data to the model are presented. The significance and accuracy of the various inferred parameters, along with the prospect of using them to extract additional information from observed transitions, are discussed. J.~N. Hodges, et al. J. Chem. Phys. (2013), 139, 164201. A.~J. Perry, et al. J. Chem. Phys. (2014), 141, 101101. K.~N. Crabtree, et al. Chem. Phys. Lett. (2012), 551, 1-6. F.~M. Schmidt, et al. J. Opt. Soc. Amer. A (2008), 24, 1392--1405. J.~W. Farley, J. Chem. Phys. (1991), 95, 5590--5602.

Great Salt Lake and Bonneville Salt Flats, UT, USA

NASA Technical Reports Server (NTRS)

1992-01-01

This is a view of the Great Salt Lake and nearby Bonneville Salt Flats, UT, (41.0N, 112.5W). A railroad causeway divides the lake with a stark straight line changing the water level and chemistry of the lake as a result. Fresh water runoff enters from the south adding to the depth and reducing the salinity. The north half receives little frsh water and is more saline and shallow. The Bonnieville Salt Flats is the lakebed of a onetime larger lake.

Great Salt Lake and Bonneville Salt Flats, UT, USA

NASA Image and Video Library

1992-04-02

This is a view of the Great Salt Lake and nearby Bonneville Salt Flats, UT, (41.0N, 112.5W). A railroad causeway divides the lake with a stark straight line changing the water level and chemistry of the lake as a result. Fresh water runoff enters from the south adding to the depth and reducing the salinity. The north half receives little frsh water and is more saline and shallow. The Bonnieville Salt Flats is the lakebed of a onetime larger lake.

Stretched Loops

NASA Image and Video Library

2017-03-16

When an active region rotated over to the edge of the sun, it presented us with a nice profile view of its elongated loops stretching and swaying above it (Mar. 8-9, 2017). These loops are actually charged particles (made visible in extreme ultraviolet light) swirling along the magnetic field lines of the active region. The video covers about 30 hours of activity. Also of note is a darker twisting mass of plasma to the left of the active region being pulled and spun about by magnetic forces. Video is available at http://photojournal.jpl.nasa.gov/catalog/PIA21562

Evaporation of liquid droplets on solid substrates. I. Flat substrate with pinned or moving contact line

NASA Astrophysics Data System (ADS)

Amini, Amirhossein; Homsy, G. M.

2017-04-01

We study the evolution of the profile of a two-dimensional volatile liquid droplet that is evaporating on a flat heated substrate. We adopt a one-sided model with thermal control that, together with the lubrication approximation, results in an evolution equation for the local height of the droplet. Without requiring any presumption for the shape of the drop, the problem is formulated for the two modes of evaporation: a pinned contact line and a moving contact line with fixed contact angle. Numerical solutions are provided for each case. For the pinned contact line case, we observe that after a time interval the contact angle dynamics become nonlinear and, interestingly, the local contact angle goes to zero in advance of total evaporation of the drop. For the case of a moving contact line, in which the singularity at the contact line is treated by a numerical slip model, we find that the droplet nearly keeps its initial circular shape and that the contact line recedes with constant speed.

A semiflexible alternating copolymer chain adsorption on a flat and a fluctuating surface.

PubMed

Mishra, Pramod Kumar

2010-04-21

A lattice model of a directed self-avoiding walk is used to investigate adsorption properties of a semiflexible alternating copolymer chain on an impenetrable flat and fluctuating surface in two (square, hexagonal and rectangular lattice) and three dimensions (cubic lattice). In the cubic lattice case the surface is two-dimensional impenetrable flat and in two dimensions the surface is a fluctuating impenetrable line (hexagonal lattice) and also flat impenetrable line (square and rectangular lattice). Walks of the copolymer chains are directed perpendicular to the plane of the surface and at a suitable value of monomer surface attraction, the copolymer chain gets adsorbed on the surface. To calculate the exact value of the monomer surface attraction, the directed walk model has been solved analytically using the generating function method to discuss results when one type of monomer of the copolymer chain has attractive, repulsive or no interaction with the surface. Results obtained in the flat surface case show that, for a stiffer copolymer chain, adsorption transition occurs at a smaller value of monomer surface attraction than a flexible copolymer chain while in the case of a fluctuating surface, the adsorption transition point is independent of bending energy of the copolymer chain. These features are similar to that of a semiflexible homopolymer chain adsorption.

Ghost Dark Energy with Sign-changeable Interaction Term

NASA Astrophysics Data System (ADS)

Zadeh, M. Abdollahi; Sheykhi, A.; Moradpour, H.

2017-11-01

Regarding the Veneziano ghost of QCD and its generalized form, we consider a Friedmann-Robertson-Walker (FRW) universe filled by a pressureless matter and a dark energy component interacting with each other through a mutual sign-changeable interaction of positive coupling constant. Our study shows that, at the late time, for the deceleration parameter we have q → -1, while the equation of state parameter of the interacting ghost dark energy (GDE) does not cross the phantom line, namely ω D ≥ -1. We also extend our study to the generalized ghost dark energy (GGDE) model and show that, at late time, the equation of state parameter of the interacting GGDE also respects the phantom line in both flat and non-flat universes. Moreover, we find out that, unlike the non-flat universe, we have q → -1 at late time for flat FRW universe. In order to make the behavior of the underlying models more clear, the deceleration parameter q as well as the equation of state parameter w D for flat and closed universes have been plotted against the redshift parameter, z. All of the studied cases admit a transition in the expansion history of universe from a deceleration phase to an accelerated one around z ≈ 0.6.

The Happiest thought of Einstein's Life

NASA Astrophysics Data System (ADS)

Heller, Michael

Finally, let us have a closer look at the place of the equivalence principle in the logical scheme of Einstein's general relativity theory. First, Einstein new well, from Minkowski's geometric formulation of his own special relativity, that accelerated motions should be represented as curved lines in a flat space-time. Second, the Galileo principle asserts that all bodies are accelerated in the same way in a given gravitational field, and consequently their motions are represented in the flat space-time by curved lines, all exactly in the same way. Third, since all lines representing free motions are curved exactly in the same way in the flat space-time, one can say that the lines remain straight (as far as possible) but the space-time itself becomes curved. Fourth, and last, since acceleration is (locally) equivalent to a gravitational field (here we have the equivalence principle), one is entitled to assert that it is the gravitational field (and not acceleration) that is represented as the curvature of space-time. This looks almost like an Aristotelian syllogism. However, to put all the pieces of evidence into the logical chain took Einstein a few years of hard thinking. The result has been incorporated into the field equations which quantitatively show how the curvature of space-time and gravity are linked together.

Biomechanics of Tetrahymena escaping from a dead end

PubMed Central

Kikuchi, Kenji

2018-01-01

Understanding the behaviours of swimming microorganisms in various environments is important for understanding cell distribution and growth in nature and industry. However, cell behaviour in complex geometries is largely unknown. In this study, we used Tetrahymena thermophila as a model microorganism and experimentally investigated cell behaviour between two flat plates with a small angle. In this configuration, the geometry provided a ‘dead end' line where the two flat plates made contact. The results showed that cells tended to escape from the dead end line more by hydrodynamics than by a biological reaction. In the case of hydrodynamic escape, the cell trajectories were symmetric as they swam to and from the dead end line. Near the dead end line, T. thermophila cells were compressed between the two flat plates while cilia kept beating with reduced frequency; those cells again showed symmetric trajectories, although the swimming velocity decreased. These behaviours were well reproduced by our computational model based on biomechanics. The mechanism of hydrodynamic escape can be understood in terms of the torque balance induced by lubrication flow. We therefore conclude that a cell's escape from the dead end was assisted by hydrodynamics. These findings pave the way for understanding cell behaviour and distribution in complex geometries. PMID:29491169

British Thoracic Society community acquired pneumonia guideline and the NICE pneumonia guideline: how they fit together

PubMed Central

Lim, W S; Smith, D L; Wise, M P; Welham, S A

2015-01-01

The British Thoracic Society (BTS) guideline for the management of adults with community acquired pneumonia (CAP) published in 2009 was compared with the 2014 National Institute for Health and Care Excellence (NICE) Pneumonia Guideline. Of the 36 BTS recommendations that overlapped with NICE recommendations, no major differences were found in 31, including those covering key aspects of CAP management: timeliness of diagnosis and treatment, severity assessment and empirical antibiotic choice. Of the five BTS recommendations where major differences with NICE were identified, one related to antibiotic duration in low and moderate severity CAP, two to the timing of review of patients and two to legionella urinary antigen testing. PMID:25977290

Is a flat-line a good thing? On the privatization of Israel's healthcare system.

PubMed

Seidman, Guy I

2010-01-01

Israel presents an intriguing conundrum: on the one hand, it provides quality healthcare in a near-universal healthcare system; on the other, it has maintained healthcare costs level at approximately 7.7% of GDP. This comes at a time when all western nations struggle with one or both sides of the equation: how to offer affordable, good quality health care to the population while curbing the sharp rise in health related costs. This paper explains both how Israel has achieved this 'flat line" effect and the social and political costs of this achievement.

One-Step Generation of Multifunctional Polyelectrolyte Microcapsules via Nanoscale Interfacial Complexation in Emulsion (NICE)

DOE PAGES

Kim, Miju; Yeo, Seon Ju; Highley, Christopher B.; ...

2015-07-14

Polyelectrolyte microcapsules represent versatile stimuli-responsive structures that enable the encapsulation, protection, and release of active agents. Their conventional preparation methods, however, tend to be time-consuming, yield low encapsulation efficiency, and seldom allow for the dual incorporation of hydrophilic and hydrophobic materials, limiting their widespread utilization. In this work, we present a method to fabricate stimuli-responsive polyelectrolyte microcapsules in one step based on nanoscale interfacial complexation in emulsions (NICE) followed by spontaneous droplet hatching. NICE microcapsules can incorporate both hydrophilic and hydrophobic materials and also can be induced to trigger the release of encapsulated materials by changes in the solution pHmore » or ionic strength. We also show that NICE microcapsules can be functionalized with nanomaterials to exhibit useful functionality, such as response to a magnetic field and disassembly in response to light. NICE represents a potentially transformative method to prepare multifunctional nanoengineered polyelectrolyte microcapsules for various applications such as drug delivery and cell mimicry.« less

One-Step Generation of Multifunctional Polyelectrolyte Microcapsules via Nanoscale Interfacial Complexation in Emulsion (NICE).

PubMed

Kim, Miju; Yeo, Seon Ju; Highley, Christopher B; Burdick, Jason A; Yoo, Pil J; Doh, Junsang; Lee, Daeyeon

2015-08-25

Polyelectrolyte microcapsules represent versatile stimuli-responsive structures that enable the encapsulation, protection, and release of active agents. Their conventional preparation methods, however, tend to be time-consuming, yield low encapsulation efficiency, and seldom allow for the dual incorporation of hydrophilic and hydrophobic materials, limiting their widespread utilization. In this work, we present a method to fabricate stimuli-responsive polyelectrolyte microcapsules in one step based on nanoscale interfacial complexation in emulsions (NICE) followed by spontaneous droplet hatching. NICE microcapsules can incorporate both hydrophilic and hydrophobic materials and also can be induced to trigger the release of encapsulated materials by changes in the solution pH or ionic strength. We also show that NICE microcapsules can be functionalized with nanomaterials to exhibit useful functionality, such as response to a magnetic field and disassembly in response to light. NICE represents a potentially transformative method to prepare multifunctional nanoengineered polyelectrolyte microcapsules for various applications such as drug delivery and cell mimicry.

One-Step Generation of Multifunctional Polyelectrolyte Microcapsules via Nanoscale Interfacial Complexation in Emulsion (NICE)

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

Kim, Miju; Yeo, Seon Ju; Highley, Christopher B.

Polyelectrolyte microcapsules represent versatile stimuli-responsive structures that enable the encapsulation, protection, and release of active agents. Their conventional preparation methods, however, tend to be time-consuming, yield low encapsulation efficiency, and seldom allow for the dual incorporation of hydrophilic and hydrophobic materials, limiting their widespread utilization. In this work, we present a method to fabricate stimuli-responsive polyelectrolyte microcapsules in one step based on nanoscale interfacial complexation in emulsions (NICE) followed by spontaneous droplet hatching. NICE microcapsules can incorporate both hydrophilic and hydrophobic materials and also can be induced to trigger the release of encapsulated materials by changes in the solution pHmore » or ionic strength. We also show that NICE microcapsules can be functionalized with nanomaterials to exhibit useful functionality, such as response to a magnetic field and disassembly in response to light. NICE represents a potentially transformative method to prepare multifunctional nanoengineered polyelectrolyte microcapsules for various applications such as drug delivery and cell mimicry.« less

"Patients with amyotrophic lateral sclerosis (ALS) are usually nice persons"-How physicians experienced in ALS see the personality characteristics of their patients.

PubMed

Mehl, Theresa; Jordan, Berit; Zierz, Stephan

2017-01-01

Physicians experienced in the treatment of patients with amyotrophic lateral sclerosis (ALS) occasionally describe these patients as "nice" persons. ALS experienced physicians ( n  =   36) were asked to assess the personality characteristics of ALS patients using a multidimensional personality questionnaire based on the five-factor model of personality. Control groups consisted of physicians experienced in Myasthenia gravis (MG) ( n  =   21) and lung cancer (LC) ( n  =   36). In the dimension Agreeableness ALS patients were rated significantly higher than the other groups ( p  <   .001). This was mainly due to the high scores for converse adjective pairs "stubborn-compliant" and "selfish-helpful". The dimension Agreeableness is very similar to "niceness". Results support the anecdotal description of ALS patients as "nice" persons. Personality characteristics of ALS patients differentiate them from other patient groups. It remains open whether the "nice" personality structure is linked to the susceptibility to the disease.

Towards an Integrated Approach to Sexual Health Services: The Contribution of NICE Guidance on One-to-One Interventions to Prevent STIs and under 18 Conceptions

ERIC Educational Resources Information Center

Killoran, Amanda; McCormick, Geraldine

2010-01-01

Objective: To describe the development of the National Institute for Health and Clinical Excellence (NICE) evidence-based guidance on one-to-one interventions for prevention of STIs and under 18 conceptions, as a focus for an integrated approach to sexual health services. Method: Documentation of the process for developing NICE guidance that is…

Applicability and accuracy of pretest probability calculations implemented in the NICE clinical guideline for decision making about imaging in patients with chest pain of recent onset.

PubMed

Roehle, Robert; Wieske, Viktoria; Schuetz, Georg M; Gueret, Pascal; Andreini, Daniele; Meijboom, Willem Bob; Pontone, Gianluca; Garcia, Mario; Alkadhi, Hatem; Honoris, Lily; Hausleiter, Jörg; Bettencourt, Nuno; Zimmermann, Elke; Leschka, Sebastian; Gerber, Bernhard; Rochitte, Carlos; Schoepf, U Joseph; Shabestari, Abbas Arjmand; Nørgaard, Bjarne; Sato, Akira; Knuuti, Juhani; Meijs, Matthijs F L; Brodoefel, Harald; Jenkins, Shona M M; Øvrehus, Kristian Altern; Diederichsen, Axel Cosmus Pyndt; Hamdan, Ashraf; Halvorsen, Bjørn Arild; Mendoza Rodriguez, Vladimir; Wan, Yung Liang; Rixe, Johannes; Sheikh, Mehraj; Langer, Christoph; Ghostine, Said; Martuscelli, Eugenio; Niinuma, Hiroyuki; Scholte, Arthur; Nikolaou, Konstantin; Ulimoen, Geir; Zhang, Zhaoqi; Mickley, Hans; Nieman, Koen; Kaufmann, Philipp A; Buechel, Ronny Ralf; Herzog, Bernhard A; Clouse, Melvin; Halon, David A; Leipsic, Jonathan; Bush, David; Jakamy, Reda; Sun, Kai; Yang, Lin; Johnson, Thorsten; Laissy, Jean-Pierre; Marcus, Roy; Muraglia, Simone; Tardif, Jean-Claude; Chow, Benjamin; Paul, Narinder; Maintz, David; Hoe, John; de Roos, Albert; Haase, Robert; Laule, Michael; Schlattmann, Peter; Dewey, Marc

2018-03-19

To analyse the implementation, applicability and accuracy of the pretest probability calculation provided by NICE clinical guideline 95 for decision making about imaging in patients with chest pain of recent onset. The definitions for pretest probability calculation in the original Duke clinical score and the NICE guideline were compared. We also calculated the agreement and disagreement in pretest probability and the resulting imaging and management groups based on individual patient data from the Collaborative Meta-Analysis of Cardiac CT (CoMe-CCT). 4,673 individual patient data from the CoMe-CCT Consortium were analysed. Major differences in definitions in the Duke clinical score and NICE guideline were found for the predictors age and number of risk factors. Pretest probability calculation using guideline criteria was only possible for 30.8 % (1,439/4,673) of patients despite availability of all required data due to ambiguity in guideline definitions for risk factors and age groups. Agreement regarding patient management groups was found in only 70 % (366/523) of patients in whom pretest probability calculation was possible according to both models. Our results suggest that pretest probability calculation for clinical decision making about cardiac imaging as implemented in the NICE clinical guideline for patients has relevant limitations. • Duke clinical score is not implemented correctly in NICE guideline 95. • Pretest probability assessment in NICE guideline 95 is impossible for most patients. • Improved clinical decision making requires accurate pretest probability calculation. • These refinements are essential for appropriate use of cardiac CT.

Site-specific mutagenesis of the nodule-infected cell expression (NICE) element and the AT-rich element ATRE-BS2* of the Sesbania rostrata leghemoglobin glb3 promoter.

PubMed Central

Szczyglowski, K; Szabados, L; Fujimoto, S Y; Silver, D; de Bruijn, F J

1994-01-01

Sesbania rostrata leghemoglobin glb3 (Srglb3) promoter sequences responsible for expression in infected cells of transgenic Lotus corniculatus nodules were delimited to a 78-bp Dral-Hinfl fragment. This region, which is located between coordinates -194 to -116 relative to the start codon of the Srglb3 gene, was named the nodule-infected cell expression (NICE) element. Insertion of the NICE element into the truncated nopaline synthase promoter was found to confer a nodule-specific expression pattern on this normally root-enhanced promoter. Within the NICE element, three distinct motifs ([A]AAAGAT, TTGTCTCTT, and CACCC[T]) were identified; they are highly conserved in the promoter regions of a variety of plant (leg)hemoglobin genes. The NICE element and the adjacent AT-rich element (ATRE-BS2*) were subjected to site-directed mutagenesis. The expression patterns of nine selected Srglb3 promoter fragments carrying mutations in ATRE-BS2* and 19 with mutations in the NICE element were examined. Mutations in ATRE-BS2* had varying effects on Srglb3 promoter activity, ranging from a two- to threefold reduction to a slight stimulation of activity. Mutations in the highly conserved (A)AAAGAT motif of the NICE element reduced Srglb3 promoter activity two- to fourfold, whereas mutations in the TCTT portion of the TTGTCTCTT motif virtually abolished promoter activity, demonstrating the essential nature of these motifs for Srglb3 gene expression. An A-to-T substitution in the CACCC(T) motif of the NICE element also abolished Srglb3 promoter activity, while a C-to-T mutation at position 4 resulted in a threefold reduction of promoter strength. The latter phenotypes resemble the effect of similar mutations in the conserved CACCC motif located in the promoter region of mammalian beta-globin genes. The possible analogies between these two systems will be discussed. PMID:8180496

Trends in procedures for infertility and caesarean sections: was NICE disinvestment guidance implemented? NICE recommendation reminders.

PubMed

Chamberlain, Charlotte A; Martin, Richard M; Busby, John; Gilbert, Rebecca; Cahill, David J; Hollingworth, William

2013-02-06

National Institute for Health and Clinical Excellence (NICE) clinical guidelines and subsequent NICE issued 'recommendation reminders' advocate discontinuing two fertility procedures and caesarean sections in women with hepatitis. We assess whether NICE guidance in 2004 and recommendation reminders were associated with a change in the rate of clinical procedures performed. Routine inpatient Hospital Episode Statistics (HES) data were extracted from the HES database for 1st April 1998 to 31st March 2010 using OPCS procedure codes for varicocele operations in infertile men, endometrial biopsies in infertile women and caesarean sections in women with hepatitis B or C. We used Joinpoint regression to identify points in time when the trend in procedure rates changed markedly, to identify any influence of the release of NICE guidance. Between 1998-2010, planned caesarean sections in women with and without hepatitis B or C increased yearly (annual percentage change (APC) 4.9%, 95% CI 2.1% to 7.7%) in women with hepatitis, compared with women without (APC 4.0% [95% CI 2.7% to 5.3%] up to 2001, APC -0.6% [95% CI -2.8% to 1.8%] up to 2004 and 1.3% [95% CI 0.8% to 1.8%] up to 2010). In infertile women under 40 years of age, endometrial biopsies for investigation of infertility increased, APC 6.0% (95% CI 3.6% to 8.4%) up to 2003, APC 1.5% (95% CI -4.3% to 7.7%) to 2007 followed by APC 12.8% (95% CI 1.0% to 26.0%) to 2010. Varicocele procedures remained relatively static between 1998 and 2010 (APC -0.5%, 95% CI -2.3% to 1.3%). There was no decline in use of the three studied procedures, contrary to NICE guidance, and no change in uptake associated with the timing of NICE guidance or recommendation reminders. 'Do not do' recommendation reminders may be ineffective at improving clinical practice or achieving disinvestment.

High Precision Spectroscopy of CH_5^+ Using Nice-Ohvms

NASA Astrophysics Data System (ADS)

Hodges, James N.; Perry, Adam J.; McCall, Benjamin J.

2013-06-01

The elusive methonium ion, CH_5^+, is of great interest due to its highly fluxional nature. The only published high-resolution infrared spectrum remains completely unassigned to this date. The primary challenge in understanding the CH_5^+ spectrum is that traditional spectroscopic approaches rely on a molecule having only small (or even large) amplitude motions about a well-defined reference geometry, and this is not the case with CH_5^+. We are in the process of re-scanning Oka's spectrum, in the original Black Widow discharge cell, using the new technique of Noise Immune Cavity Enhanced Optical Heterodyne Velocity Modulation Spectroscopy (NICE-OHVMS). The high precision afforded by optical saturation in conjunction with a frequency comb allows transition line centers to be determined with sub-MHz accuracy and precision -- a substantial improvement over the 90 MHz precision of Oka's work. With a high-precision linelist in hand, we plan to search for four line combination differences to directly determine the spacings between rotational energy levels. Such a search is currently infeasible due to the large number of false positives resulting from the relatively low precision and high spectral density of Oka's spectrum. The resulting combination differences, in conjunction with state-of-the-art theoretical calculations from Tucker Carrington, may provide the first insight into the rotational structure of this unique molecular system. E. T. White, J. Tang, T. Oka, Science (1999) 284, 135--137. B. M. Siller, et al. Opt. Express (2011), 19, 24822--24827. K. N. Crabtree, et al. Chem. Phys. Lett. (2012), 551, 1--6. X. Wang, T. Carrington, J. Chem. Phys., (2008), 129, 234102.

Descriptive and Computer Aided Drawing Perspective on an Unfolded Polyhedral Projection Surface

NASA Astrophysics Data System (ADS)

Dzwierzynska, Jolanta

2017-10-01

The aim of the herby study is to develop a method of direct and practical mapping of perspective on an unfolded prism polyhedral projection surface. The considered perspective representation is a rectilinear central projection onto a surface composed of several flat elements. In the paper two descriptive methods of drawing perspective are presented: direct and indirect. The graphical mapping of the effects of the representation is realized directly on the unfolded flat projection surface. That is due to the projective and graphical connection between points displayed on the polyhedral background and their counterparts received on the unfolded flat surface. For a significant improvement of the construction of line, analytical algorithms are formulated. They draw a perspective image of a segment of line passing through two different points determined by their coordinates in a spatial coordinate system of axis x, y, z. Compared to other perspective construction methods that use information about points, for computer vision and the computer aided design, our algorithms utilize data about lines, which are applied very often in architectural forms. Possibility of drawing lines in the considered perspective enables drawing an edge perspective image of an architectural object. The application of the changeable base elements of perspective as a horizon height and a station point location enable drawing perspective image from different viewing positions. The analytical algorithms for drawing perspective images are formulated in Mathcad software, however, they can be implemented in the majority of computer graphical packages, which can make drawing perspective more efficient and easier. The representation presented in the paper and the way of its direct mapping on the flat unfolded projection surface can find application in presentation of architectural space in advertisement and art.

27 CFR 9.169 - Red Hills Lake County.

Code of Federal Regulations, 2010 CFR

2010-04-01

... intersection with the 1,400-foot contour line, section 3, T12N, R7W (Clearlake Highlands Quadrangle); then (2) Proceed east-southeasterly along the meandering 1,400-foot contour line onto the Lower Lake map south of Anderson Flat, then reverse direction with the contour line and continue westerly, leaving the Lower Lake...

27 CFR 9.169 - Red Hills Lake County.

Code of Federal Regulations, 2011 CFR

2011-04-01

... intersection with the 1,400-foot contour line, section 3, T12N, R7W (Clearlake Highlands Quadrangle); then (2) Proceed east-southeasterly along the meandering 1,400-foot contour line onto the Lower Lake map south of Anderson Flat, then reverse direction with the contour line and continue westerly, leaving the Lower Lake...

Friction factor data for flat plate tests of smooth and honeycomb surfaces. M.S. Thesis

NASA Technical Reports Server (NTRS)

Ha, Tae Woong

1989-01-01

Friction factors for honeycomb surfaces were measured with a flat plate tester. The flat plate test apparatus was described and a method was discussed for determining the friction factor experimentally. The friction factor model was developed for the flat plate test based on the Fanno Line Flow. The comparisons of the friction factor were plotted for smooth surfaces and six-honeycomb surfaces with three-clearances, 6.9 bar to 17.9 bar range of inlet pressures, and 5,000 to 100,000 range of the Reynolds number. The optimum geometries for the maximum friction factor were found as a function of cell width to cell depth and cell width to clearance ratios.

Optimal Cluster Mill Pass Scheduling With an Accurate and Rapid New Strip Crown Model

NASA Astrophysics Data System (ADS)

Malik, Arif S.; Grandhi, Ramana V.; Zipf, Mark E.

2007-05-01

Besides the requirement to roll coiled sheet at high levels of productivity, the optimal pass scheduling of cluster-type reversing cold mills presents the added challenge of assigning mill parameters that facilitate the best possible strip flatness. The pressures of intense global competition, and the requirements for increasingly thinner, higher quality specialty sheet products that are more difficult to roll, continue to force metal producers to commission innovative flatness-control technologies. This means that during the on-line computerized set-up of rolling mills, the mathematical model should not only determine the minimum total number of passes and maximum rolling speed, it should simultaneously optimize the pass-schedule so that desired flatness is assured, either by manual or automated means. In many cases today, however, on-line prediction of strip crown and corresponding flatness for the complex cluster-type rolling mills is typically addressed either by trial and error, by approximate deflection models for equivalent vertical roll-stacks, or by non-physical pattern recognition style models. The abundance of the aforementioned methods is largely due to the complexity of cluster-type mill configurations and the lack of deflection models with sufficient accuracy and speed for on-line use. Without adequate assignment of the pass-schedule set-up parameters, it may be difficult or impossible to achieve the required strip flatness. In this paper, we demonstrate optimization of cluster mill pass-schedules using a new accurate and rapid strip crown model. This pass-schedule optimization includes computations of the predicted strip thickness profile to validate mathematical constraints. In contrast to many of the existing methods for on-line prediction of strip crown and flatness on cluster mills, the demonstrated method requires minimal prior tuning and no extensive training with collected mill data. To rapidly and accurately solve the multi-contact problem and predict the strip crown, a new customized semi-analytical modeling technique that couples the Finite Element Method (FEM) with classical solid mechanics was developed to model the deflection of the rolls and strip while under load. The technique employed offers several important advantages over traditional methods to calculate strip crown, including continuity of elastic foundations, non-iterative solution when using predetermined foundation moduli, continuous third-order displacement fields, simple stress-field determination, and a comparatively faster solution time.

The use of HVSR measurements for investigating buried tectonic structures: the Mirandola anticline, Northern Italy, as a case study

NASA Astrophysics Data System (ADS)

Tarabusi, G.; Caputo, R.

2017-01-01

The Mirandola anticline represents a buried fault-propagation fold which has been growing during Quaternary due to the seismogenic activity of a blind segment belonging to the broader Ferrara Arc. The last reactivation occurred during the May 2012 Emilia sequence. In correspondence with this structure, the thickness of the marine and continental deposits of the Po Plain foredeep is particularly reduced. In order to better define the shallow geometry of this tectonic structure, and hence its recent activity, we investigated in a depth range which is intermediate between the surficial morphological observations and seismic profiles information. In particular, we carried out numerous passive seismic measurements (single-station microtremor) for obtaining the horizontal-to-vertical spectral ratio. The results of a combined analysis of the peak frequency and its amplitude nicely fit the available geological information, suggesting that this low-cost geophysical technique could be successfully applied in other sectors of wide morphologically flat alluvial plains to investigate blind and completely buried potential seismogenic structures.

Review of the role of NICE in promoting the adoption of innovative cardiac technologies.

PubMed

Groves, Peter H; Pomfrett, Chris; Marlow, Mirella

2018-05-17

The National Institute for Health and Care Excellence (NICE) Medical Technologies Evaluation Programme (MTEP) promotes the adoption of innovative diagnostic and therapeutic technologies into National Health Service (NHS) clinical practice through the publication of guidance and briefing documents. Since the inception of the programme in 2009, there have been 7 medical technologiesguidance, 3 diagnostics guidance and 23 medtechinnovation briefing documents published that are relevant to the heart and circulation. Medical technologies guidance is published by NICE for selected single technologies if they offer plausible additional benefits to patients and the healthcare system. Diagnostic guidance is published for diagnostic technologies if they have the potential to improve health outcomes, but if their introduction may be associated with an increase in overall cost to the NHS. Medtechinnovation briefings provide evidence-based advice to those considering the implementation of new medical devices or diagnostic technologies. This review provides reference to all of the guidance and briefing medical technology documents that NICE has published that are relevant to the heart and circulation and reflect on their diverse recommendations. The interaction of MTEP with other NICE programmes is integral to its effectiveness and the means by which consistency is ensured across the different NICE programmes is described. The importance of the input of clinical experts from the cardiovascular professional community and the engagement by NICE with cardiovascular professional societies is highlighted as being fundamental to ensuring the quality of guidance outputs as well as to promoting their implementation and adoption. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Impact of the National Institute for Health and Care Excellence (NICE) guidance on medical technology uptake: analysis of the uptake of spinal cord stimulation in England 2008–2012

PubMed Central

Vyawahare, Bharati; Hallas, Natalie; Brookes, Morag; Taylor, Rod S; Eldabe, Sam

2014-01-01

Background The National Institute for Health and Care Excellence (NICE) Technology Appraisal Guidance on spinal cord stimulation (SCS) was published in 2008 and updated in 2012 with no change. This guidance recommends SCS as a cost-effective treatment for patients with neuropathic pain. Objective To assess the impact of NICE guidance by comparing SCS uptake in England pre-NICE (2008–2009) and post-NICE (2009–2012) guidance. We also compared the English SCS uptake rate with that of Belgium, the Netherlands, France and Germany. Design SCS implant data for England was obtained from the Hospital Episode Statistics (HES) database and compared with other European countries where comparable data were available. Results The HES data showed small increases in SCS implantation and replacement/revision procedures, and a large increase in SCS trials between 2008 and 2012. The increase in the total number of SCS procedures per million of population in England is driven primarily by revision/replacements and increased trial activity. Marked variability in SCS uptake at both health regions and primary care trust level was observed. Conclusions Despite the positive NICE recommendation for the routine use of SCS, we found no evidence of a significant impact on SCS uptake in England. Rates of SCS implantation in England are lower than many other European countries. PMID:24398364

Urgent revision required of NICE guidance relating to prevention of spread of vCJD through neurosurgical instruments.

PubMed

George, Kuriakose

2014-04-01

In 2006, NICE brought out guidance relating to prevention of vCJD through contaminated surgical instruments. This was with the aim of protecting patients born after 1997 who did not have any risk of developing vCJD through eating beef contaminated with BSE through the food chain. Many adult neurosurgical units did not pay much attention to this until 2013 when they were suddenly faced with these children who were now 16 and being admitted to the adult neurosurgical service rather than pediatric. The NICE guidance requires that most patients born after 1997 be operated on using a separate set of neurosurgical instruments than those born before this. This is proving to be a huge financial, as well as logistical, challenge and also a clinical risk as attention is being diverted to searching for the right kit when it should be spent on saving lives. It is now clear in 2013 that the risks that NICE feared were perhaps overstated as there is nowhere near the number of deaths from vCJD that NICE had feared would happen. Worldwide there have been only five cases whereby CJD was transmitted through contaminated neurosurgical instruments and the last case was in 1976. There have been no cases of vCJD transmission attributed to use of contaminated neurosurgical instruments. NICE should revisit this guidance urgently in view of these circumstances.

Degarelix for Treating Advanced Hormone-Dependent Prostate Cancer: An Evidence Review Group Perspective of a NICE Single Technology Appraisal.

PubMed

Uttley, Lesley; Whyte, Sophie; Gomersall, Timothy; Ren, Shijie; Wong, Ruth; Chambers, Duncan; Tappenden, Paul

2017-07-01

As part of its Single Technology Appraisal Process, the National Institute for Health and Care Excellence (NICE) invited the manufacturer of degarelix (Ferring Pharmaceuticals) to submit evidence for the clinical and cost effectiveness of degarelix for the treatment of advanced hormone-dependent prostate cancer. The School of Health and Related Research Technology Appraisal Group at the University of Sheffield was commissioned to act as the independent Evidence Review Group (ERG). The ERG produced a critical review of the evidence contained within the company's submission to NICE. The evidence, which included a randomised controlled trial (RCT) of degarelix versus leuprorelin, found that degarelix was non-inferior to leuprorelin for reduction of testosterone levels and that degarelix achieved a more rapid suppression of prostate-specific antigen levels and subsequently decreased incidences of testosterone flare associated with luteinising hormone releasing-hormone (LHRH) agonists. However, protection against testosterone flare for the comparators in the clinical trials was not employed in line with UK clinical practice. Further claims surrounding overall survival, cardiovascular adverse events and clinical equivalence of the comparator drugs from six RCTs of degarelix should be regarded with caution because of flaws and inconsistencies in the pooling of trial data to draw conclusions. The cost-effectiveness evidence included a de novo economic model. Based on the ERG's preferred base case, the deterministic incremental cost-effectiveness analysis (ICER) for degarelix versus 3-monthly triptorelin was £14,798 per quality-adjusted life-year (QALY) gained. Additional scenario analyses undertaken by the ERG resulted in ICERs for degarelix versus 3-monthly triptorelin ranging from £17,067 to £35,589 per QALY gained. Subgroup analyses undertaken using the Appraisal Committee's preferred assumptions suggested that degarelix was not cost effective for the subgroup with metastatic disease but could be cost effective for the subgroup with spinal metastases. The company submitted further evidence to NICE following an initial negative Appraisal Committee decision. Further analyses from the Decision Support Unit found that that, whilst some evidence indicated that degarelix could be cost effective for a small subgroup of people with spinal cord compression (SCC), data on the potential size of this subgroup and the rate of SCC were insufficient to estimate an ICER based on the evidence submitted by the company and a separately commissioned systematic review. NICE recommended degarelix as an option for treating advanced hormone-dependent prostate cancer in people with spinal metastases, only if the commissioner can achieve at least the same discounted drug cost as that available to the UK NHS in June 2016.

(Non-adiabatic) string creation on nice slices in Schwarzschild black holes

DOE PAGES

Puhm, Andrea; Rojas, Francisco; Ugajin, Tomonori

2017-04-27

Nice slices have played a pivotal role in the discussion of the black hole information paradox as they avoid regions of strong spacetime curvature and yet smoothly cut through the infalling matter and the outgoing Hawking radiation, thus, justifying the use of low energy field theory. To avoid information loss it has been argued recently, however, that local effective field theory has to break down at the horizon. To assess the extent of this breakdown in a UV complete framework we study string-theoretic effects on nice slices in Schwarzschild black holes. Here, our purpose is two-fold. First, we use nicemore » slices to address various open questions and caveats of [1] where it was argued that boost-enhanced non-adiabatic string-theoretic effects at the horizon could provide a dynamical mechanism for the firewall. Second, we identify two non-adiabatic effects on nice slices in Schwarzschild black holes: pair production of open strings near the horizon enhanced by the presence of the infinite tower of highly excited string states and a late-time non-adiabatic effect intrinsic to nice slices.« less

(Non-adiabatic) string creation on nice slices in Schwarzschild black holes

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

Puhm, Andrea; Rojas, Francisco; Ugajin, Tomonori

Nice slices have played a pivotal role in the discussion of the black hole information paradox as they avoid regions of strong spacetime curvature and yet smoothly cut through the infalling matter and the outgoing Hawking radiation, thus, justifying the use of low energy field theory. To avoid information loss it has been argued recently, however, that local effective field theory has to break down at the horizon. To assess the extent of this breakdown in a UV complete framework we study string-theoretic effects on nice slices in Schwarzschild black holes. Here, our purpose is two-fold. First, we use nicemore » slices to address various open questions and caveats of [1] where it was argued that boost-enhanced non-adiabatic string-theoretic effects at the horizon could provide a dynamical mechanism for the firewall. Second, we identify two non-adiabatic effects on nice slices in Schwarzschild black holes: pair production of open strings near the horizon enhanced by the presence of the infinite tower of highly excited string states and a late-time non-adiabatic effect intrinsic to nice slices.« less

Nanoengineered Ionic-Covalent Entanglement (NICE) Bioinks for 3D Bioprinting.

PubMed

Chimene, David; Peak, Charles W; Gentry, James L; Carrow, James K; Cross, Lauren M; Mondragon, Eli; Cardoso, Guinea B; Kaunas, Roland; Gaharwar, Akhilesh K

2018-03-28

We introduce an enhanced nanoengineered ionic-covalent entanglement (NICE) bioink for the fabrication of mechanically stiff and elastomeric 3D biostructures. NICE bioink formulations combine nanocomposite and ionic-covalent entanglement (ICE) strengthening mechanisms to print customizable cell-laden constructs for tissue engineering with high structural fidelity and mechanical stiffness. Nanocomposite and ICE strengthening mechanisms complement each other through synergistic interactions, improving mechanical strength, elasticity, toughness, and flow properties beyond the sum of the effects of either reinforcement technique alone. Herschel-Bulkley flow behavior shields encapsulated cells from excessive shear stresses during extrusion. The encapsulated cells readily proliferate and maintain high cell viability over 120 days within the 3D-printed structure, which is vital for long-term tissue regeneration. A unique aspect of the NICE bioink is its ability to print much taller structures, with higher aspect ratios, than can be achieved with conventional bioinks without requiring secondary supports. We envision that NICE bioinks can be used to bioprint complex, large-scale, cell-laden constructs for tissue engineering with high structural fidelity and mechanical stiffness for applications in custom bioprinted scaffolds and tissue engineered implants.

33 CFR 110.155 - Port of New York.

Code of Federal Regulations, 2014 CFR

2014-07-01

... and Goose Island breakwater; southwest of a line bearing southeasterly from the southwest end of Goose.... On Hammond Flats north of a line bearing 260° from the head of the pier on Throgs Neck at the foot of.... North of a line bearing 259° between the north tower of the Bronx-Whitestone Bridge at Old Ferry Point...

33 CFR 110.155 - Port of New York.

Code of Federal Regulations, 2013 CFR

2013-07-01

... and Goose Island breakwater; southwest of a line bearing southeasterly from the southwest end of Goose.... On Hammond Flats north of a line bearing 260° from the head of the pier on Throgs Neck at the foot of.... North of a line bearing 259° between the north tower of the Bronx-Whitestone Bridge at Old Ferry Point...

33 CFR 110.155 - Port of New York.

Code of Federal Regulations, 2012 CFR

2012-07-01

... and Goose Island breakwater; southwest of a line bearing southeasterly from the southwest end of Goose.... On Hammond Flats north of a line bearing 260° from the head of the pier on Throgs Neck at the foot of.... North of a line bearing 259° between the north tower of the Bronx-Whitestone Bridge at Old Ferry Point...

NASA Innovations in Climate Education Connects Audiences Coast-to-Coast for Climate Literacy via the NASA Digital Learning Network

NASA Astrophysics Data System (ADS)

Murray, B.; Barnes, M. H.; Chambers, L. H.; Pippin, M. R.; Martin, A. M.; Geyer, A. J.; Leber, M.; Joyner, E.; Small, C.; Dublin, D.

2013-12-01

The Minority University Research and Education Program (MUREP) NASA Innovations in Climate Education (NICE) project advances NASA's Office of Education's strategic initiative to improve the quality of the nation's Science, Technology, Engineering and Mathematics (STEM) education and enhance literacy about climate and other Earth systems environmental changes. NICE also strategically supports the United States' progressive initiative to enhance the science and technology enterprise for successful competition in the 21st century global community. To extend to wider networks in 2013, MUREP NICE partnered with the NASA Digital Learning Network (DLNTM) in a unique, non-traditional collaborative model to significantly increase the impact and connection with formal and informal educators, curriculum developers, science education specialists, and researchers regarding climate literacy. DLN offers an expansive distance learning capability that bridges presenters with education audiences for interactive, web-based, synchronous and asynchronous Educator Professional Development (EPD). DLN services over 10,000 educators each year. In 3rd quarter FY13 alone DLN totaled 3,361 connections with educators. The DLN allows for cost effective (no travel) engagement of multiple geographically dispersed audiences with presenters from remote locations. This facilitates interactive communication among participants through distance education, allowing them to share local experiences with one another. A comprehensive four-part EPD workshop, featuring several NICE Principal Investigators (PI) and NASA subject matter experts was developed for NICE in April 2013. Topics covered in the workshop progressed from a simple introduction of Earth's energy budget, through explanation of temperature data collection and evidence of temperature rise, impacts on phenology, and finally consequences for bugs and birds. This event was an innovative hybrid workshop, connecting onsite teachers interactively with remotely connected participants and presenters across the nation. In addition to the 19 educators who participated live, 298 watched the sessions via a webcast. A similar workshop series experienced 300% growth in 2 years indicating the potential for comparable growth of NICE events. Due to unanimous requests for more information on these and other topics, beginning Fall 2013, NICE will reach into additional educators' classrooms via the DLN to deliver continued EPD from NICE PIs and other NASA researchers. With DLN capability, hundreds of additional unique viewers have been exposed to NICE via the DLN this year. This large-scale effort allows for long term, sustained engagement of the global community. We intend to take advantage of capabilities of the DLN as we continue to scale NICE events to wider audiences. The use of distance education allows for immediate release of new information and more frequent connections, resulting in sustained engagement of participants. This presentation will explore the various successes and future opportunities for expanding the impact of climate literacy via the NASA DLN, a large-scale collaborative network.

[How it should be enabled network cooperation on healthcare services. Towards an HispaNICE?

PubMed

Abellán Perpiñán, José María; Martínez Pérez, Jorge Eduardo

2016-11-01

Although the Spanish Network of Health Technology Assessment was founded in 2012, it is true that its actual influence on the rationalization of the National Health System's healthcare basket is scarce. The main argument of this article is that the Spanish Network of HTA should work "as if" it was an HispaNICE. That is to say, transferring the NICE's advantages to Spanish context. Copyright © 2016. Publicado por Elsevier España, S.L.U.

TIGA-CUB - manualised psychoanalytic child psychotherapy versus treatment as usual for children aged 5-11 years with treatment-resistant conduct disorders and their primary carers: study protocol for a randomised controlled feasibility trial.

PubMed

Edginton, Elizabeth; Walwyn, Rebecca; Burton, Kayleigh; Cicero, Robert; Graham, Liz; Reed, Sadie; Tubeuf, Sandy; Twiddy, Maureen; Wright-Hughes, Alex; Ellis, Lynda; Evans, Dot; Hughes, Tom; Midgley, Nick; Wallis, Paul; Cottrell, David

2017-09-15

The National Institute for Health and Care Excellence (NICE) recommends evidence-based parenting programmes as a first-line intervention for conduct disorders (CD) in children aged 5-11 years. As these are not effective in 25-33% of cases, NICE has requested research into second-line interventions. Child and Adolescent Psychotherapists (CAPTs) address highly complex problems where first-line treatments have failed and there have been small-scale studies of Psychoanalytic Child Psychotherapy (PCP) for CD. A feasibility trial is needed to determine whether a confirmatory trial of manualised PCP (mPCP) versus Treatment as Usual (TaU) for CD is practicable or needs refinement. The aim of this paper is to publish the abridged protocol of this feasibility trial. TIGA-CUB (Trial on improving Inter-Generational Attachment for Children Undergoing Behaviour problems) is a two-arm, pragmatic, parallel-group, multicentre, individually randomised (1:1) controlled feasibility trial (target n = 60) with blinded outcome assessment (at 4 and 8 months), which aims to develop an optimum practicable protocol for a confirmatory, pragmatic, randomised controlled trial (RCT) (primary outcome: child's behaviour; secondary outcomes: parental reflective functioning and mental health, child and parent quality of life), comparing mPCP and TaU as second-line treatments for children aged 5-11 years with treatment-resistant CD and inter-generational attachment difficulties, and for their primary carers. Child-primary carer dyads will be recruited following a referral to, or re-referral within, National Health Service (NHS) Child and Adolescent Mental Health Services (CAMHS) after an unsuccessful first-line parenting intervention. PCP will be delivered by qualified CAPTs working in routine NHS clinical practice, using a trial-specific PCP manual (a brief version of established PCP clinical practice). Outcomes are: (1) feasibility of recruitment methods, (2) uptake and follow-up rates, (3) therapeutic delivery, treatment retention and attendance, intervention adherence rates, (4) follow-up data collection, and (5) statistical, health economics, process evaluation, and qualitative outcomes. TIGA-CUB will provide important information on the feasibility and potential challenges of undertaking a confirmatory RCT to evaluate the effectiveness and cost-effectiveness of mPCP. Current Controlled Trials, ID: ISRCTN86725795 . Registered on 31 May 2016.

Trends in procedures for infertility and caesarean sections: was NICE disinvestment guidance implemented? NICE recommendation reminders

PubMed Central

2013-01-01

Background National Institute for Health and Clinical Excellence (NICE) clinical guidelines and subsequent NICE issued ‘recommendation reminders’ advocate discontinuing two fertility procedures and caesarean sections in women with hepatitis. We assess whether NICE guidance in 2004 and recommendation reminders were associated with a change in the rate of clinical procedures performed. Methods Routine inpatient Hospital Episode Statistics (HES) data were extracted from the HES database for 1st April 1998 to 31st March 2010 using OPCS procedure codes for varicocele operations in infertile men, endometrial biopsies in infertile women and caesarean sections in women with hepatitis B or C. We used Joinpoint regression to identify points in time when the trend in procedure rates changed markedly, to identify any influence of the release of NICE guidance. Results Between 1998-2010, planned caesarean sections in women with and without hepatitis B or C increased yearly (annual percentage change (APC) 4.9%, 95% CI 2.1% to 7.7%) in women with hepatitis, compared with women without (APC 4.0% [95% CI 2.7% to 5.3%] up to 2001, APC -0.6% [95% CI -2.8% to 1.8%] up to 2004 and 1.3% [95% CI 0.8% to 1.8%] up to 2010). In infertile women under 40 years of age, endometrial biopsies for investigation of infertility increased, APC 6.0% (95% CI 3.6% to 8.4%) up to 2003, APC 1.5% (95% CI -4.3% to 7.7%) to 2007 followed by APC 12.8% (95% CI 1.0% to 26.0%) to 2010. Varicocele procedures remained relatively static between 1998 and 2010 (APC -0.5%, 95% CI -2.3% to 1.3%). Conclusions There was no decline in use of the three studied procedures, contrary to NICE guidance, and no change in uptake associated with the timing of NICE guidance or recommendation reminders. ‘Do not do’ recommendation reminders may be ineffective at improving clinical practice or achieving disinvestment. PMID:23388377

Visibility of Prominences Using the He i D3 Line Filter on the PROBA-3/ASPIICS Coronagraph

NASA Astrophysics Data System (ADS)

Jejčič, S.; Heinzel, P.; Labrosse, N.; Zhukov, A. N.; Bemporad, A.; Fineschi, S.; Gunár, S.

2018-02-01

We determine the optimal width and shape of the narrow-band filter centered on the He i D3 line for prominence and coronal mass ejection (CME) observations with the ASPIICS ( Association of Spacecraft for Polarimetric and Imaging Investigation of the Corona of the Sun) coronagraph onboard the PROBA-3 ( Project for On-board Autonomy) satellite, to be launched in 2020. We analyze He i D3 line intensities for three representative non-local thermal equilibrium prominence models at temperatures 8, 30, and 100 kK computed with a radiative transfer code and the prominence visible-light (VL) emission due to Thomson scattering on the prominence electrons. We compute various useful relations at prominence line-of-sight velocities of 0, 100, and 300 km s-1 for 20 Å wide flat filter and three Gaussian filters with a full-width at half-maximum (FWHM) equal to 5, 10, and 20 Å to show the relative brightness contribution of the He i D3 line and the prominence VL to the visibility in a given narrow-band filter. We also discuss possible signal contamination by Na i D1 and D2 lines, which otherwise may be useful to detect comets. Our results mainly show that i) an optimal narrow-band filter should be flat or somewhere between flat and Gaussian with an FWHM of 20 Å in order to detect fast-moving prominence structures, ii) the maximum emission in the He i D3 line is at 30 kK and the minimal at 100 kK, and iii) the ratio of emission in the He i D3 line to the VL emission can provide a useful diagnostic for the temperature of prominence structures. This ratio is up to 10 for hot prominence structures, up to 100 for cool structures, and up to 1000 for warm structures.

13. VIEW OF THE MOLTEN SALT EXTRACTION LINE. THE MOLTEN ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. VIEW OF THE MOLTEN SALT EXTRACTION LINE. THE MOLTEN SALT EXTRACTION PROCESS WAS USED TO PURIFY PLUTONIUM BY REMOVING AMERICIUM, A DECAY BY-PRODUCT OF PLUTONIUM. (1/98) - Rocky Flats Plant, Plutonium Fabrication, Central section of Plant, Golden, Jefferson County, CO

Habitat risk: Use of intertidal flats by foraging red knots (Calidris canutus rufa), ruddy turnstones, (Arenaria interpres), semipalmated sandpipers (Calidris pusilla), and sanderling (Calidris alba) on Delaware Bay beaches.

PubMed

Burger, Joanna; Niles, Lawrence; Jeitner, Christian; Gochfeld, Michael

2018-05-04

Shorebirds usually forage on intertidal flats that are exposed during low tide, and roost on higher areas when the tidal flats are covered with water. During spring migration on Delaware Bay (New Jersey) shorebirds mainly forage on horseshoe crab (Limulus polyphemus) eggs that are concentrated at the high tide line. However, they also use other habitats for foraging. We examined habitat use of 4 species of shorebirds (with declining populations) at five Delaware Bay beaches to determine their use of the intertidal habitat (2015, 2016). We observed birds in three sections at different distances from the mean high tideline (< 100 m, 101-200 m, and 201-300 m)ne. We examined the presence of red knots (Calidris canutus rufa), ruddy turnstones (Arenaria interpres), semipalmated sandpipers (Calidris pusilla), and sanderling (Calidris alba) as a function of date, tide cycle, section shorebirds foraged from the mean high tide line, and presence of other shorebird species. Understanding how these species use the intertidal flats is important because these habitats are at risk from coastal development, sea level rise, and decreases in intertidal space, including the possible expansion of intertidal oyster culture. Overall, knots were present in the intertidal on 67% of the surveys, turnstones were present on 86% of the surveys, semipalmated sandpipers were present on 77% of the surveys, and sanderling were present on 86% of the surveys. Use of the intertidal flats varied among beaches. Peak and mean numbers of shorebirds/ decreased in each census section, as distance to mean high tideline increased. In general, shorebirds foraged at the waters' edge during high tide, and then moved out onto the intertidal flats. The strongest interspecific associations were between red knots and ruddy turnstones, and the lowest associations were between sanderling and semipalmated sandpipers. Variations in numbers of each species in 2016 were mainly explained by the number of other species, section (distance from the mean high tide line), location (one of 5 beaches), and date for all species (and minutes to low tide for sanderling). These data indicate that these 4 species use intertidal flats as they become available, and that the mean number in each newly exposed census section of the flats may be lower than in the previous one, partly as a result of some birds remaining in each previously-exposed section. We discuss the management and regulatory implications of shorebird use of the intertidal flats, which include protection of high quality intertidal for foraging by shorebirds. Copyright © 2018 Elsevier Inc. All rights reserved.

Efforts of the occupant to change physical quality of residential unit through the change of building material at low cost flats in Jakarta

NASA Astrophysics Data System (ADS)

Nurdiani, N.

2018-03-01

Low cost flats in Jakarta – Indonesia is provided by the government for low-income people in urban areas, in line with the program to redevelop or renew slum areas. Low cost flat is built with the minimum standard of building materials. The purpose of this study is to know efforts of the occupants to change of building materials at residential unit of low cost flats. The research was conducted by descriptive method at four of low cost housing in Jakarta: Rusuna Bendungan Hilir 1, Rusuna Tambora IIIA, Rusuna Bidara Cina, and Rusuna Sukapura. The results showed that physical changes which happened in low cost flats are aesthetic (residence paint color change), or improvement of physical quality of residential unit (change of building material), become dominant aspects done by residents in four rusuna.

A Randomized Controlled Trial Comparing the Low FODMAP Diet vs. Modified NICE Guidelines in US Adults with IBS-D.

PubMed

Eswaran, Shanti L; Chey, William D; Han-Markey, Theresa; Ball, Sarah; Jackson, Kenya

2016-12-01

There has been an increasing interest in the role of fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) in irritable bowel syndrome (IBS). We report results from the first randomized controlled trial of the low FODMAP diet in US adults with IBS and diarrhea (IBS-D). The objectives were to compare the efficacy of the low FODMAP diet vs. a diet based upon modified National Institute for Health and Care Excellence guidelines (mNICE) on overall and individual symptoms in IBS-D patients. This was a single-center, randomized-controlled trial of adult patients with IBS-D (Rome III) which compared 2 diet interventions. After a 2-week screening period, eligible patients were randomized to a low FODMAP or mNICE diet for 4 weeks. The primary end point was the proportion of patients reporting adequate relief of IBS-D symptoms ≥50% of intervention weeks 3-4. Secondary outcomes included a composite end point which required response in both abdominal pain (≥30% reduction in mean daily pain score compared with baseline) and stool consistency (decrease in mean daily Bristol Stool Form of ≥1 compared with baseline), abdominal pain and stool consistency responders, and other key individual IBS symptoms assessed using daily questionnaires. After screening, 92 subjects (65 women, median age 42.6 years) were randomized. Eighty-four patients completed the study (45 low FODMAP, 39 mNICE). Baseline demographics, symptom severity, and nutrient intake were similar between groups. Fifty-two percent of the low FODMAP vs. 41% of the mNICE group reported adequate relief of their IBS-D symptoms (P=0.31). Though there was no significant difference in the proportion of composite end point responders (P=0.13), the low FODMAP diet resulted in a higher proportion of abdominal pain responders compared with the mNICE group (51% vs. 23%, P=0.008). Compared with baseline scores, the low FODMAP diet led to greater reductions in average daily scores of abdominal pain, bloating, consistency, frequency, and urgency than the mNICE diet. In this US trial, 40-50% of patients reported adequate relief of their IBS-D symptoms with the low FODMAP diet or a diet based on modified NICE guidelines. The low FODMAP diet led to significantly greater improvement in individual IBS symptoms, particularly pain and bloating, compared with the mNICE diet.

NICE guidelines for imaging studies in children with UTI adequate only in boys under the age of 6 months.

PubMed

Ristola, Marko Tapani; Hurme, Timo

2013-03-01

The purpose of this study was to evaluate the applicability of the National Institute for Health and Clinical Excellence (NICE) guidelines for imaging studies in children under the age of three with first urinary tract infection (UTI). In our cohort of 112 patients, we gathered data regarding the occurrence of indications for ultrasonography (US) and voiding cystourethrography (VCUG) according to the NICE guidelines, dimercaptosuccinic acid (DMSA) scintigraphy examinations, UTI recurrence, antimicrobial prophylaxis (AMP), anti-reflux procedures, and other urological procedures. If the NICE guidelines had been applied, 13 of the 25 patients (52 %) with vesicoureteral reflux (VUR), including 6 of the 12 patients (50 %) with dilating VUR and 3 of the 4 patients who underwent endoscopic anti-reflux treatment, would have been missed, and a negative VCUG would have been avoided in 25 of the 42 patients (60 %) with no VUR. None of the missed diagnoses occurred in the younger boys' group. Based on these preliminary analyses, we feel that the NICE guidelines for imaging studies in children under 3 years old with UTI may be applicable to clinical use only in boys under 6 months of age. For other patients the guidelines were unsuccessful.

[Guideline-conform psychiatric psychotherapeutic treatment for patients with schizophrenia : A normative evaluation of necessary personnel requirements].

PubMed

Mehl, S; Falkai, P; Berger, M; Löhr, M; Rujescu, D; Wolff, J; Kircher, T

2016-03-01

Although national treatment guidelines and current publications of the German Federal Joint Committee (Gemeinsamer Bundesausschuss) recommend cognitive behavior therapy for all patients with schizophrenia, the implementation of these recommendations in current inpatient and outpatient treatment is only rudimentary. The aim of this study was to systematically search randomized controlled studies (RCTs), meta-analyses and the guidelines of the German Association for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN) and the British National Institute for Health and Clinical Excellence (NICE) in order to assess the number of personnel necessary for psychiatric and therapeutic inpatient treatment in line with present guidelines. Moreover, the number of staff required was compared with the personnel resources designated by the German psychiatry personnel regulations (Psych-PV). The German and NICE guidelines, RCTs and meta-analyses were analyzed and an adequate weekly treatment plan for an inpatient unit was developed. Moreover, the number of personnel necessary to realize the treatment plan was calculated. In order to realize adequate inpatient treatment approximately 107 min extra for medical psychotherapeutic personnel per patient and week (of which 72 min for psychotherapy) and another 60 min for nursing staff per patient and week are required in addition to the current Psych-PV regulations. Thus, implementation in an open ward with 20 inpatients would require 3.62 positions for physicians, 0.7 positions in psychology and 12.85 positions for nursing staff (including management positions and night shifts). These evidence-based recommendations for precise specifications of inpatient treatment should lead to improved inpatient treatment in line with present guidelines. Moreover, outpatients and day patients could be included in this treatment model. The results should be considered in the construction of the future prospective payment system for inpatient psychiatric healthcare in Germany.

Multiwavelength generation in a random distributed feedback fiber laser using an all fiber Lyot filter.

PubMed

Sugavanam, S; Yan, Z; Kamynin, V; Kurkov, A S; Zhang, L; Churkin, D V

2014-02-10

Multiwavelength lasing in the random distributed feedback fiber laser is demonstrated by employing an all fiber Lyot filter. Stable multiwavelength generation is obtained, with each line exhibiting sub-nanometer line-widths. A flat power distribution over multiple lines is obtained, which indicates that the power between lines is redistributed in nonlinear mixing processes. The multiwavelength generation is observed both in first and second Stokes waves.

Developing the revised NICE appraisal technical guidance to manufacturers and sponsors: opportunity or threat?

PubMed

Taylor, Rod S; Hutton, John; Culyer, Anthony J

2002-01-01

One of the principal roles of the National Institute for Clinical Excellence (NICE) is to appraise selected existing and emerging healthcare technologies and, as a result, produce guidance for the National Health Service (NHS) in England and Wales. A central part of this appraisal is the potential for manufacturers and sponsors to make a data submission. This paper describes the process of development of the second edition of technical guidance to manufacturers and sponsors for submission to NICE. The revision process took place during the period May 2000 and January 2001 and involved a number of key steps -- establishment of a guidance steering committee, review of current international guidelines of clinical and cost effectiveness, drafting of the guidance, detailed consultation with stakeholders, revision of the guidance and, finally, publication. The lessons learnt from revision of the NICE guidance for manufacturers and sponsors and some main issues for its future development are discussed.

Cetuximab for recurrent and/or metastatic squamous cell carcinoma of the head and neck: a NICE single technology appraisal.

PubMed

Bagust, Adrian; Greenhalgh, Janette; Boland, Angela; Fleeman, Nigel; McLeod, Claire; Dickson, Rumona; Dundar, Yenal; Proudlove, Christine; Shaw, Richard

2010-01-01

The National Institute for Health and Clinical Excellence (NICE) invited the manufacturer of cetuximab (Merck Serono) to submit evidence for the clinical and cost effectiveness of cetuximab in combination with platinum-based chemotherapy (CTX) for the treatment of patients with recurrent and/or metastatic squamous cell cancer of the head and neck (SCCHN) according to the Institute's Single Technology Appraisal (STA) process. The Liverpool Reviews and Implementation Group at the University of Liverpool was commissioned to act as the Evidence Review Group (ERG). This article summarizes the ERG's review of the evidence submitted by the manufacturer. A summary of the Appraisal Committee (AC) decision is provided. The ERG reviewed the clinical evidence in accordance with the decision problem defined by NICE. The analysis of the submitted model assessed the appropriateness of the manufacturer's approach to modelling the decision problem, the reliability of model implementation and the extent of conformity to published standards and prevailing norms of practice within the health economics modelling community. Particular attention was paid to issues likely to impact substantially on the base-case cost-effectiveness results. Clinical-effectiveness evidence was derived from a single randomized controlled trial (RCT). Results presented for clinical outcomes were strongly supportive of benefits resulting from the use of cetuximab. Cetuximab + platinum-based CTX with 5 fluorouracil (5-FU) extended median overall survival (OS) from 7.4 months in the CTX group to 10.1 months in the cetuximab + CTX group. Median progression-free survival rose from 3.3 months to 5.6 months, best overall response to therapy increased from 19.5% to 35.6%, disease control rate rose from 60% to 81.1% and median time to treatment failure was 4.8 months compared with 3.0 months. Exploratory subgroup analyses indicated significant OS benefits in 11 of 16 pre-planned analyses. The ERG identified a number of issues relating to the clinical-effectiveness results: consideration was limited to first-line use of cetuximab; patients in the trial were younger and fitter than those presenting in UK clinical practice; there was no evidence of survival advantage for patients with metastatic disease; there was no evidence of effectiveness in patients not cetuximab-naive; and the quality-of-life data were poor. The submitted incremental cost-effectiveness ratio was considerably above the NICE threshold. The ERG questioned the submitted economic model on a number of grounds: the rationale for creating an economic model rather than direct analysis of trial data; the use of Weibull functions for survival models; inaccurate CTX costs; selection of health state utilities; inaccurate unit costs; and lack of mid-cycle correction. After amending the model, the ERG considered the use of cetuximab to be not cost effective for NICE at any price. The AC concluded that cetuximab in combination with platinum-based CTX should not be recommended for the treatment of patients with recurrent and/or metastatic SCCHN. Patients already receiving this treatment for this indication should have the option to continue treatment until they and their clinician consider it appropriate to stop. This was the first appraisal to consider the end-of-life medicines criteria introduced by NICE in January 2009.

Fragile surface zero-energy flat bands in three-dimensional chiral superconductors

NASA Astrophysics Data System (ADS)

Kobayashi, Shingo; Tanaka, Yukio; Sato, Masatoshi

2015-12-01

We study surface zero-energy flat bands in three-dimensional chiral superconductors with pz(px+i py) ν -wave pairing symmetry (ν is a nonzero integer), based on topological arguments and tunneling conductance. It is shown that the surface flat bands are fragile against (i) the surface misorientation and (ii) the surface Rashba spin-orbit interaction. The fragility of (i) is specific to chiral SCs, whereas that of (ii) happens for general odd-parity SCs. We demonstrate that these flat-band instabilities vanish or suppress a zero-bias conductance peak in a normal/insulator/superconductor junction, which behavior is clearly different from high-Tc cuprates and noncentrosymmetric superconductors. By calculating the angle-resolved conductance, we also discuss a topological surface state associated with the coexistence of line and point nodes.

Design charts for arbitrarily pivoted, liquid-lubricated flat-sector-pad thrust bearing

NASA Technical Reports Server (NTRS)

Etsion, I.

1977-01-01

A flat, sector-shaped geometry for a liquid-lubricated thrust bearing is analyzed considering both the pitch and roll of the pad. Results are presented in design charts that enable a direct approach to the design of point- and line-pivoted, tilting pad bearings. A comparison is made with the Mitchell bearing approximation and it is found that this approximation always overestimates load capacity.

33 CFR 110.127b - Flaming Gorge Lake, Wyoming-Utah.

Code of Federal Regulations, 2011 CFR

2011-07-01

... following points, excluding a 150-foot-wide fairway, extending southeasterly from the launching ramp, as... inclosed by the shore and a line connecting the following points, excluding a 100-foot-wide fairway.... (c) Antelope Flat, Utah. That portion of Flaming Gorge Lake inclosed by the shore and a line...

A Review of NICE Methods and Processes Across Health Technology Assessment Programmes: Why the Differences and What is the Impact?

PubMed

Cowles, Emma; Marsden, Grace; Cole, Amanda; Devlin, Nancy

2017-08-01

Decisions made by the National Institute for Health and Care Excellence (NICE) exert an influence on the allocation of resources within 'fixed' National Health Service budgets. Yet guidance for different types of health interventions is handled via different 'programmes' within NICE, which follow different methods and processes. The objective of this research was to identify differences in the processes and methods of NICE health technology assessment programmes and to explore how these could impact on allocative efficiency within the National Health Service. Data were extracted from the NICE technology appraisal programme, medical technologies guidance, diagnostic assessment programme, highly specialised technologies programme, and clinical guidelines process and methods manuals to undertake a systematic comparison. Five qualitative interviews were carried out with NICE members of staff and committee members to explore the reasons for the differences found. The main differences identified were in the required evidence review period, or lack thereof, mandatory funding status, the provision of a reference case for economic evaluation, the requirement for and the type of economic analysis undertaken, and the decision making criteria used for appraisal. Many of the differences found can be justified on grounds of practicality and relevance to the health technologies under assessment. Nevertheless, from a strict utilitarian view, there are several potential areas of inefficiency that could lead to the misallocation of resources within the National Health Service, although some of these might be eliminated or reduced if an egalitarian view is taken. The challenge is determining where society is willing to trade health gains between different people.

Drug reimbursement recommendations by the National Institute for Health and Clinical Excellence: have they impacted the National Health Service budget?

PubMed

Mauskopf, Josephine; Chirila, Costel; Birt, Julie; Boye, Kristina S; Bowman, Lee

2013-04-01

Determine whether reimbursement restrictions recommended by the National Institute for Health and Clinical Excellence (NICE) have impacted the United Kingdom (UK) National Health Service (NHS) budget. Data were abstracted from NICE guidance documents and costing statements through March 2011. Estimated maximum and adjusted potential budget impact (PBI) on the NHS was derived using estimates of the UK marketing-approved population and the annual cost for the new drug. Descriptive and logistic analyses were used to estimate the correlation between the degree of restrictions on reimbursement recommended by NICE for each new drug indication and the PBI controlling for clinical effectiveness and cost-effectiveness. PBI was significantly correlated with the degree of reimbursement restrictions. In descriptive analysis, the adjusted PBI for drugs that were recommended without restrictions was £20.3 million (SD = 22.2) compared with £49.8 million (SD = 90.8) for those recommended with restrictions and £71.1 million (SE = 99.9) for those not recommended. In logistic analysis, the odds ratio for less restrictive reimbursement was 0.848 (95% CI, 0.762-0.945) for each £20 million increase in the adjusted PBI. Results were similar using the maximum PBI. After controlling for clinical effectiveness and cost-effectiveness, the degree of reimbursement restriction recommended by NICE remains significantly correlated with the PBI, despite that fact that the NICE decision process does not consider budget impact. This correlation might be due to NICE consideration of effectiveness and cost-effectiveness for subgroups of the approved population. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

33 CFR 110.140 - Buzzards Bay, Nantucket Sound, and adjacent waters, Mass.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Phoenix Point; thence 154° along a line which passes 100 yards east of New Bedford Channel Buoys 8, 6, and... ranging 222° from the southwest corner of Fort Phoenix to the New Bedford shore; west of a line ranging 154° from Palmer Island Light to Butler Flats Light; and north of a line bearing 267° from Butler...

WE-G-204-06: Grid-Line Artifact Minimization for High Resolution Detectors Using Iterative Residual Scatter Correction

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

Rana, R; Bednarek, D; Rudin, S

2015-06-15

Purpose: Anti-scatter grid-line artifacts are more prominent for high-resolution x-ray detectors since the fraction of a pixel blocked by the grid septa is large. Direct logarithmic subtraction of the artifact pattern is limited by residual scattered radiation and we investigate an iterative method for scatter correction. Methods: A stationary Smit-Rοntgen anti-scatter grid was used with a high resolution Dexela 1207 CMOS X-ray detector (75 µm pixel size) to image an artery block (Nuclear Associates, Model 76-705) placed within a uniform head equivalent phantom as the scattering source. The image of the phantom was divided by a flat-field image obtained withoutmore » scatter but with the grid to eliminate grid-line artifacts. Constant scatter values were subtracted from the phantom image before dividing by the averaged flat-field-with-grid image. The standard deviation of pixel values for a fixed region of the resultant images with different subtracted scatter values provided a measure of the remaining grid-line artifacts. Results: A plot of the standard deviation of image pixel values versus the subtracted scatter value shows that the image structure noise reaches a minimum before going up again as the scatter value is increased. This minimum corresponds to a minimization of the grid-line artifacts as demonstrated in line profile plots obtained through each of the images perpendicular to the grid lines. Artifact-free images of the artery block were obtained with the optimal scatter value obtained by this iterative approach. Conclusion: Residual scatter subtraction can provide improved grid-line artifact elimination when using the flat-field with grid “subtraction” technique. The standard deviation of image pixel values can be used to determine the optimal scatter value to subtract to obtain a minimization of grid line artifacts with high resolution x-ray imaging detectors. This study was supported by NIH Grant R01EB002873 and an equipment grant from Toshiba Medical Systems Corp.« less

First principles studies of the dependence of magnetism on the crystal phase in 4d and 5d late transition metals

NASA Astrophysics Data System (ADS)

Hüger, E.; Osuch, K.

2005-03-01

We investigate the possibility of inducing ferromagnetic order in 4d and 5d late transition metals through crystal symmetry change. First principles, self-consistent density functional theory calculations, with spin-orbit coupling included, performed at 0 K show that ferromagnetism occurs in the bulk of Rh and Pd at the optimum lattice constant if Rh is in the bcc and Pd in the hcp/dhcp phase. The ferromagnetic order originates in the d-band occupancy of Rh or Pd which locates the Fermi energy at the top of the highest peak of the respective (paramagnetic) density of states induced by the bcc or hcp/dhcp structure. This peak in the density of states is caused by flat bands which lie at the surface of the respective Brillouin zone. For a bcc crystal these flat bands have the eg character and are positioned at the surface of the bcc Brillouin zone along the N-P line. The origin of the flatness of the bands was found to be the translation symmetry of the cubic lattice which causes the bands with the eg character to be narrow along the k-lines whose k-vector directions are furthest off the directions to which the orbitals of the eg symmetry point. Due to the d-band occupancy of Rh these flat bands lie in the paramagnetic state at the Fermi energy, whereas in the ferromagnetic state they exhibit the largest energetic split. This indicates that a smaller degree of orbital overlap narrows electronic bands enhancing the tendency of the system for ferromagnetic band split. For the hcp/dhcp structure the states contributing to the high density of para-magnetic states at the Fermi level of Pd lie in the vicinity of the M-L line of the hcp Brillouin zone boundary, which possesses a high number of symmetry (M and L) points. Moreover, the M-L line is aligned with the stacking sequence direction ([0001]) which is furthest off the densest-packed atomic chain direction of an hcp-crystal and, consequently, the weakest-bond direction in the crystal. This makes the narrow bands along the M-L line flat. The instability of the bcc and the meta-stability of the hcp crystal phase modifications for metals with native close-packed crystal structures is subsequently analysed in order to find whether they can be grown as films on suitable substrates.

Size Fluctuations of Near Critical Nuclei and Gibbs Free Energy for Nucleation of BDA on Cu(001)

NASA Astrophysics Data System (ADS)

Schwarz, Daniel; van Gastel, Raoul; Zandvliet, Harold J. W.; Poelsema, Bene

2012-07-01

We present a low-energy electron microscopy study of nucleation and growth of BDA on Cu(001) at low supersaturation. At sufficiently high coverage, a dilute BDA phase coexists with c(8×8) crystallites. The real-time microscopic information allows a direct visualization of near-critical nuclei, determination of the supersaturation and the line tension of the crystallites, and, thus, derivation of the Gibbs free energy for nucleation. The resulting critical nucleus size nicely agrees with the measured value. Nuclei up to 4-6 times larger still decay with finite probability, urging reconsideration of the classic perception of a critical nucleus.

Size fluctuations of near critical nuclei and Gibbs free energy for nucleation of BDA on Cu(001).

PubMed

Schwarz, Daniel; van Gastel, Raoul; Zandvliet, Harold J W; Poelsema, Bene

2012-07-06

We present a low-energy electron microscopy study of nucleation and growth of BDA on Cu(001) at low supersaturation. At sufficiently high coverage, a dilute BDA phase coexists with c(8×8) crystallites. The real-time microscopic information allows a direct visualization of near-critical nuclei, determination of the supersaturation and the line tension of the crystallites, and, thus, derivation of the Gibbs free energy for nucleation. The resulting critical nucleus size nicely agrees with the measured value. Nuclei up to 4-6 times larger still decay with finite probability, urging reconsideration of the classic perception of a critical nucleus.

Peer teaching and information retrieval: the role of the NICE Evidence search student champion scheme in enhancing students' confidence.

PubMed

Sbaffi, Laura; Hallsworth, Elaine; Weist, Anne

2018-03-01

This research reports on the NICE Evidence search (ES) student champion scheme (SCS) first five years of activity (2011-2016) in terms of its impact on health care undergraduate students' information search skills and search confidence. A review of students' evaluation of the scheme was carried out to chart the changes in attitude towards NICE Evidence search as an online health care information source and to monitor students' approach to information seeking. This study is based on the results of questionnaires distributed to students before and after attending a training session on NICE Evidence search delivered by their own peers. The exercise was implemented in health related universities in England over a period of five consecutive academic years. (i) Students' search confidence improved considerably after the training; (ii) ES was perceived as being an increasingly useful resource of evidence based information for their studies; (iii) the training helped students develop discerning search skills and use evidence based information sources more consistently and critically. The NICE SCS improves confidence in approaching information tasks amongst health care undergraduate students. Future developments could involve offering the training at the onset of a course of study and adopting online delivery formats to expand its geographical reach. © 2018 Health Libraries Group.

Modeling and performance analysis using extended fuzzy-timing Petri nets for networked virtual environments.

PubMed

Zhou, Y; Murata, T; Defanti, T A

2000-01-01

Despite their attractive properties, networked virtual environments (net-VEs) are notoriously difficult to design, implement, and test due to the concurrency, real-time and networking features in these systems. Net-VEs demand high quality-of-service (QoS) requirements on the network to maintain natural and real-time interactions among users. The current practice for net-VE design is basically trial and error, empirical, and totally lacks formal methods. This paper proposes to apply a Petri net formal modeling technique to a net-VE-NICE (narrative immersive constructionist/collaborative environment), predict the net-VE performance based on simulation, and improve the net-VE performance. NICE is essentially a network of collaborative virtual reality systems called the CAVE-(CAVE automatic virtual environment). First, we introduce extended fuzzy-timing Petri net (EFTN) modeling and analysis techniques. Then, we present EFTN models of the CAVE, NICE, and transport layer protocol used in NICE: transmission control protocol (TCP). We show the possibility analysis based on the EFTN model for the CAVE. Then, by using these models and design/CPN as the simulation tool, we conducted various simulations to study real-time behavior, network effects and performance (latencies and jitters) of NICE. Our simulation results are consistent with experimental data.

In-Situ Sampling and Characterization of Naturally Occurring Marine Methane Hydrate Using the D/V JOIDES Resolution

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

Rack, Frank

2003-06-30

The primary accomplishments of the JOI Cooperative Agreement with DOE/NETL in this quarter were that: (1) Frank Rack, Anne Trehu, and Tim Collett presented preliminary results and operational outcomes of ODP Leg 204 at the American Association of Petroleum Geologists annual meeting in Salt Lake City, UT; (2) several Leg 204 scientists participated in special hydrate sessions at the international EGS/AGU/EUG meeting in Nice, France and presented initial science results from the cruise, which included outcomes arising from this cooperative agreement; and, (3) postcruise evaluation of the data, tools and measurement systems that were used during ODP Leg 204 continuedmore » in the preparation of deliverables under this agreement. At the EGS/EUG/AGU meeting in Nice, France in April, Leg 204 Co-chiefs Anne Trehu and Gerhard Bohrmann, as well as ODP scientists Charlie Paull, Erwin Suess, and Jim Kennett, participated in a press conference on hydrates. The well-attended press conference entitled ''Gas Hydrates: Free methane found and controversy over the 'hydrate gun''' led to stories in Nature on-line and BBC radio, among others. There were six (6) oral and fifteen (15) poster presentations on ODP Leg 204 hydrate science at the EGS/AGU/EUG Meeting in Nice, France on April 6-11, 2003. This was a very strong showing at a meeting just over six month following the completion of the drilling cruise and highlighted many of the results of the leg, including the results obtained with instruments and equipment funded under this cooperative agreement. At the AAPG annual meeting in Salt Lake City, UT on May 11-14, 2003, Anne Trehu gave an oral presentation about the scientific results of Leg 204, and Frank Rack presented a poster outlining the operational and technical accomplishments. Work continued on analyzing data collected during ODP Leg 204 and preparing reports on the outcomes of Phase 1 projects as well as developing plans for Phase 2.« less

A nurse-led clinic for patients consulting with osteoarthritis in general practice: development and impact of training in a cluster randomised controlled trial.

PubMed

Healey, Emma L; Main, Chris J; Ryan, Sarah; McHugh, Gretl A; Porcheret, Mark; Finney, Andrew G; Morden, Andrew; Dziedzic, Krysia S

2016-12-21

Despite a lack of service provision for people with osteoarthritis (OA), each year 1 in 5 of the general population consults a GP about a musculoskeletal condition such as OA. Consequently this may provide an opportunity for practice nurses to take an active role in helping patients manage their condition. A nurse led clinic for supporting patients with OA was developed for the MOSAICS study investigating how to implement the NICE 2014 OA Guideline core recommendations. This paper has two main objectives, firstly to provide an overview of the nurse-led OA clinic, and secondly to describe the development, key learning objectives, content and impact of the training to support its delivery. A training programme was developed and delivered to provide practice nurses with the knowledge and skill set needed to run the nurse-led OA clinic. The impact of the training programme on knowledge, confidence and OA management was evaluated using case report forms and pre and post training questionnaires. The pre-training questionnaire identified a gap between what practice nurses feel they can do and what they should be doing in line with NICE OA guidelines. Evaluation of the training suggests that it enabled practice nurses to feel more knowledgeable and confident in supporting patients to manage their OA and this was reflected in the clinical management patients received in the nurse-led OA clinics. A significant gap between what is recommended and what practice nurses feel they can currently provide in terms of OA management was evident. The development of a nurse training programme goes some way to develop a system in primary care for delivering the core recommendations by NICE. The cluster trial linked to this training was conducted from May 2012 through February 2014 by the Arthritis Research UK Primary Care Centre, Keele University, UK (Trial registration number ISRCTN06984617 ).

Innovation in Building Design

NASA Technical Reports Server (NTRS)

1983-01-01

Thomas & Betts Corporation's Flat Conductor Cables, or FCC, were developed of necessity as aircraft and spacecraft became increasingly complex. In order to reduce size and weight of components, the use of thin flat wire instead of relatively thick and protrusive round cable, provided a dramatic reduction of the space occupied by the many miles of power distribution lines in an aerospace vehicle. Commercially, FCC offers cost savings in simplified building construction, reduced installation time and ease of alteration.

Here Comes the Bride... and Her Teeth Are Nice and Bright

MedlinePlus

FOR THE DENTAL PATIENT ... Here comes the bride … … and her teeth are nice and bright! P lanning a wedding? There will ... SMILE Professional cleaning. A professional cleaning in a dental office before your wedding can help remove stains ...

Flat Terahertz Reflective Focusing Metasurface with Scanning Ability.

PubMed

Yi, Huan; Qu, Shi-Wei; Chen, Bao-Jie; Bai, Xue; Ng, Kung Bo; Chan, Chi Hou

2017-06-14

The ability to manipulate the propagation properties of electromagnetic waves, e.g., divergence, focusing, holography or deflection, is very significant in terahertz applications. Metasurfaces with flat structures are attractive for achieving such manipulations in terahertz band, as they feature low profile, lightweight, and ease of design and installation. Several types of terahertz reflective or transmitting metasurfaces with focusing function have been implemented recently, but none of them can provide scanning ability with controllable focus. Here, a flat reflective metasurface featuring controllable focal shift is proposed and experimentally demonstrated. Furthermore, the principle of designing a focus scanning reflective metasurface is presented and the focusing characteristics are discussed, including focus scanning along a line parallel or orthogonal to the metasurface with a large bandwidth. These interesting properties indicate that this flat reflective metasurface could play a key role in many terahertz imaging and detection systems.

Ultraflat and broadband optical frequency comb generator based on cascaded two dual-electrode Mach-Zehnder modulators

NASA Astrophysics Data System (ADS)

Qu, Kun; Zhao, Shanghong; Li, Xuan; Tan, Qinggui; Zhu, Zihang

2018-04-01

A novel scheme for the generation of ultraflat and broadband optical frequency comb (OFC) is proposed based on cascaded two dual-electrode Mach-Zehnder modulators (DE-MZM). The first DE-MZM can generate a four-comb-line OFC, then the OFC is injected into the second DE-MZM as a carrier, which can increase the number of comb lines. Our modified scheme finally can generate a broadband OFC with high flatness by simply modifying the electrical power and the bias voltage of the DE-MZM. Theoretical analysis and simulation results reveal that a 16-comb-line OFC with a frequency spacing that two times the frequency of the RF signal can be obtained. The power fluctuation of the OFC lines is 0.48 dB and the unwanted-mode suppression ratio (UMSR) can reach 16.5 dB. Additionally, whether the bias drift of the DE-MZMs has little influence on the power fluctuation is also analyzed. These results demonstrate the robustness of our scheme and verify its good accuracy and high stability with perfect flatness.

Vertical thermodynamic structure of the troposphere during the Norwegian young sea ICE expedition (N-ICE2015)

NASA Astrophysics Data System (ADS)

Kayser, Markus; Maturilli, Marion; Graham, Robert M.; Hudson, Stephen R.; Rinke, Annette; Cohen, Lana; Kim, Joo-Hong; Park, Sang-Jong; Moon, Woosok; Granskog, Mats A.

2017-10-01

The Norwegian young sea ICE (N-ICE2015) expedition was designed to investigate the atmosphere-snow-ice-ocean interactions in the young and thin sea ice regime north of Svalbard. Radiosondes were launched twice daily during the expedition from January to June 2015. Here we use these upper air measurements to study the multiple cyclonic events observed during N-ICE2015 with respect to changes in the vertical thermodynamic structure, moisture content, and boundary layer characteristics. We provide statistics of temperature inversion characteristics, static stability, and boundary layer extent. During winter, when radiative cooling is most effective, we find the strongest impact of synoptic cyclones. Changes to thermodynamic characteristics of the boundary layer are associated with transitions between the radiatively "clear" and "opaque" atmospheric states. In spring, radiative fluxes warm the surface leading to lifted temperature inversions and a statically unstable boundary layer. Further, we compare the N-ICE2015 static stability distributions to corresponding profiles from ERA-Interim reanalysis, from the closest land station in the Arctic North Atlantic sector, Ny-Ålesund, and to soundings from the SHEBA expedition (1997/1998). We find similar stability characteristics for N-ICE2015 and SHEBA throughout the troposphere, despite differences in location, sea ice thickness, and snow cover. For Ny-Ålesund, we observe similar characteristics above 1000 m, while the topography and ice-free fjord surrounding Ny-Ålesund generate great differences below. The long-term radiosonde record (1993-2014) from Ny-Ålesund indicates that during the N-ICE2015 spring period, temperatures were close to the climatological mean, while the lowest 3000 m were 1-3°C warmer than the climatology during winter.

Dietetic practice in refeeding syndrome.

PubMed

Wagstaff, G

2011-10-01

The physiology and consequences of refeeding syndrome have long been recognised, although its management continues to be debated, despite the recommendations made by The National Institute for Health and Clinical Excellence (NICE) in their guideline 'Nutrition Support in Adults' (2006). The present study aims to assess current dietetic opinion and practice in this area, as well as whether the NICE recommendations have been adopted. An anonymous, self-completed Internet survey was designed investigating current practice and opinions on the NICE (2006) guidance on this subject. A link to the questionnaire was distributed with a covering letter via e-mail to the heads of department of National Health Service Trusts in the London region, UK, requesting that it be disseminated to all dietitians working with adults. After the closing date, all responses were collated and analysed. The survey elicited a 30.8% response rate. Some 89.8% of respondents have read the NICE guidance on Nutrition Support in Adults (2006) and 66.9% have changed their practice regarding refeeding syndrome management as a result. Sixty-two percent do not wait for biochemistry to normalise before commencing nutrition. Ninety-two percent of respondents completed the mini case studies indicating that current practice is inconsistent among dietitians. Neither NICE criteria for recognising patients at risk of refeeding, nor the recommended starting rates are universally followed. Seventy-five percent continue to supplement electrolytes reactively. Although limited by a small sample size, the findings of the present study suggest that dietetic practice regarding refeeding syndrome management remains inconsistent with the recommendations made by NICE, although some aspects have been adopted. © 2011 The Author. Journal of Human Nutrition and Dietetics © 2011 The British Dietetic Association Ltd.

Has NICE got it right? An international perspective considering the case of Technology Appraisal No. 98 by the National Institute for Health and Clinical Excellence (NICE).

PubMed

Schlander, Michael

2008-04-01

The National Institute for Health and Clinical Excellence (NICE) has been widely recognised as setting an international standard for high-quality health technology assessments (HTAs) including economic evaluation. A previous critical analysis of NICE Technology Appraisal No. 98 (TA98), evaluating methylphenidate, dexamphetamine and atomoxetine for the treatment of attention-deficit/hyperactivity disorder (ADHD) in children, revealed a number of issues, which must cast doubt on the robustness of the NICE approach when addressing a complex clinical decision problem. The exploration of potential underlying problems will be followed by a discussion of lessons for international healthcare policy-makers, and is intended to be an invitation to further debate and inquiry, not a presentation of definitive conclusions. Pertaining to the technology assessment report, potential problems were identified relating to an unnecessarily narrow scope, data search and selection strategy, the distinction between efficacy and effectiveness, data synthesis across studies and clinical effect measures, and limitations of the economic model. The appraisal process moderated the asserted 'clear conclusions' of the assessment but could not compensate for some of its gaps. It is suggested that key issues contributing to these problems may have included a separation of clinical and economic perspectives, a highly standardised reference case analysis that was followed schematically, the absence of an effective system for quality assurance of technology assessments, and transparency deficits of the economic evaluation. Further considerations for international policy-makers looking at NICE as a potential role model for HTAs are discussed, such as institutional context, the objectives of collectively financed healthcare and related value judgments, the reliance on QALYs as a universal and comprehensive measure of health benefits, the appropriate perspective for analysis, and process-related implications.

Assessing the appropriateness of information on childhood fever in thermometer package leaflets: a systematic audit of thermometers available in the UK.

PubMed

Hernandez, Jose; Nicholson, Brian D; Thompson, Matthew

2015-06-01

Thermometers are found in most parents' homes, but little is known about the quality and accuracy of the information they provide, nor its consistency with current guidelines for managing fever. To compare information included with commonly available thermometers with National Institute for Health and Care Excellence (NICE) guidance for management of feverish illness in children. Systematic thermometer sampling from UK retailers between February 2013 and May 2013. Information was extracted from device packaging and leaflets on details and type of thermometer, instructions for use, normal ranges, and fever thresholds cited. This was compared with key parental recommendations from the 2013 NICE guidance on feverish illness in children. Associations were explored between cost of device and level of information. There were 123 thermometers identified (ranging from £0.99 to £69.99), none of which made explicit reference to NICE guidance. Most (n = 81, 65.9%) recommended use at a body site consistent with NICE guidance, but only 17 (13.8%) defined fever using the correct threshold (≥38.0°C), and few (n = 12, 9.8%) included advice on fever management, of which four suggested actions not advised by NICE. There was no association between thermometer cost and provision of information consistent with NICE guidance. Parents and caregivers have access to a large number of thermometers, yet they lack evidence-based information about fever detection and management, and in some cases contain misleading information. This represents a missed opportunity to disseminate best practices from guidelines for management of fever in children, and thermometer manufacturers are urged to include information consistent with current guidance. © British Journal of General Practice 2015.

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

Phillion, D.

This code enables one to display, take line-outs on, and perform various transformations on an image created by an array of integer*2 data. Uncompressed eight-bit TIFF files created on either the Macintosh or the IBM PC may also be read in and converted to a 16 bit signed integer image. This code is designed to handle all the formats used for PDS (photo-densitometer) files at the Lawrence Livermore National Laboratory. These formats are all explained by the application code. The image may be zoomed infinitely and the gray scale mapping can be easily changed. Line-outs may be horizontal or verticalmore » with arbitrary width, angled with arbitrary end points, or taken along any path. This code is usually used to examine spectrograph data. Spectral lines may be identified and a polynomial fit from position to wavelength may be found. The image array can be remapped so that the pixels all have the same change of lambda width. It is not necessary to do this, however. Lineouts may be printed, saved as Cricket tab-delimited files, or saved as PICT2 files. The plots may be linear, semilog, or logarithmic with nice values and proper scientific notation. Typically, spectral lines are curved.« less

A Successful Senior Seminar: Unsolved Problems in Number Theory

ERIC Educational Resources Information Center

Styer, Robert

2014-01-01

The "Unsolved Problems in Number Theory" book by Richard Guy provides nice problems suitable for a typical math major. We give examples of problems that have worked well in our senior seminar course and some nice results that senior math majors can obtain.

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

Phillion, D.

This code enables one to display, take line-outs on, and perform various transformations on an image created by an array of integer*2 data. Uncompressed eight-bit TIFF files created on either the Macintosh or the IBM PC may also be read in and converted to a 16 bit signed integer image. This code is designed to handle all the formates used for PDS (photo-densitometer) files at the Lawrence Livermore National Laboratory. These formats are all explained by the application code. The image may be zoomed infinitely and the gray scale mapping can be easily changed. Line-outs may be horizontal or verticalmore » with arbitrary width, angled with arbitrary end points, or taken along any path. This code is usually used to examine spectrograph data. Spectral lines may be identified and a polynomial fit from position to wavelength may be found. The image array can be remapped so that the pixels all have the same change of lambda width. It is not necessary to do this, however. Lineouts may be printed, saved as Cricket tab-delimited files, or saved as PICT2 files. The plots may be linear, semilog, or logarithmic with nice values and proper scientific notation. Typically, spectral lines are curved. By identifying points on these lines and fitting their shapes by polyn.« less

Bringing Global Climate Change Education to Alabama Middle School and High School Classrooms

NASA Astrophysics Data System (ADS)

Lee, M.; Mitra, C.; Percival, E.; Thomas, A.; Lucy, T.; Hickman, E.; Cox, J.; Chaudhury, S. R.; Rodger, C.

2013-12-01

A NASA-funded Innovations in Climate Education (NICE) Program has been launched in Alabama to improve high school and middle school education in climate change science. The overarching goal is to generate a better informed public that understands the consequences of climate change and can contribute to sound decision making on related issues. Inquiry based NICE modules have been incorporated into the existing course of study for 9-12 grade biology, chemistry, and physics classes. In addition, new modules in three major content areas (earth and space science, physical science, and biological science) have been introduced to selected 6-8 grade science teachers in the summer of 2013. The NICE modules employ five E's of the learning cycle: Engage, Explore, Explain, Extend and Evaluate. Modules learning activities include field data collection, laboratory measurements, and data visualization and interpretation. Teachers are trained in the use of these modules for their classroom through unique partnership with Alabama Science in Motion (ASIM) and the Alabama Math Science Technology Initiative (AMSTI). Certified AMSTI teachers attend summer professional development workshops taught by ASIM and AMSTI specialists to learn to use NICE modules. During the school year, the specialists in turn deliver the needed equipment to conduct NICE classroom exercises and serve as an in-classroom resource for teachers and their students. Scientists are partnered with learning and teaching specialists and lead teachers to implement and test efficacy of instructional materials, models, and NASA data used in classroom. The assessment by professional evaluators after the development of the modules and the training of teachers indicates that the modules are complete, clear, and user-friendly. The overall teacher satisfaction from the teacher training was 4.88/5.00. After completing the module teacher training, the teachers reported a strong agreement that the content developed in the NICE modules should be included in the Alabama secondary curriculum. Eventually, the NICE program has the potential to reach over 200,000 students when the modules are fully implemented in every school in the state of Alabama. The project can give these students access to expertise and equipment, thereby strengthening the connections between the universities, state education administrators, and the community.

They're NICE and Neat, but Are They Useful? A Grounded Theory of Clinical Psychologists' Beliefs About and Use of NICE Guidelines.

PubMed

Court, Alex John; Cooke, Anne; Scrivener, Amanda

2017-07-01

Guidelines are ubiquitous but inconsistently used in UK mental health services. Clinical psychologists are often influential in guideline development and implementation, but opinion within the profession is divided. This study utilized grounded theory methodology to examine clinical psychologists' beliefs about and use of NICE guidelines. Eleven clinical psychologists working in the NHS were interviewed. The overall emerging theme was; NICE guidelines are considered to have benefits but to be fraught with dangers. Participants were concerned that guidelines can create an unhelpful illusion of neatness. They managed the tension between the helpful and unhelpful aspects of guidelines by relating to them in a flexible manner. The participants reported drawing on specialist skills such as idiosyncratic formulation and integration. However, due to the pressures and dominant discourses within services they tended to practice in ways that prevent these skills from being recognized. This led to fears that their professional identity was threatened, which impacted upon perceptions of the guidelines. To our knowledge, the theoretical framework presented in this paper is the first that attempts to explain why NICE guidelines are not consistently utilized in UK mental health services. The current need for services to demonstrate 'NICE compliance' may be leading to a perverse incentive for clinical psychologists in particular to do one thing but say another and for specialist skills to be obscured. If borne out by future studies, this represents a threat to continued quality improvement and also to the profession. Copyright © 2016 John Wiley & Sons, Ltd. Guidelines have many benefits, but the current pressure for services to be 'NICE compliant' may be having unintended negative as well as positive effects. Lack of implementation may be partly the result of active choice by clinicians concerned to use the full range of professional skills and to offer flexibility and choice to service users. The current context is creating a perverse incentive for clinicians to say one thing but do another. This is problematic for services and a potential threat to the profession of clinical psychology. Copyright © 2016 John Wiley & Sons, Ltd.

Development of a fast multi-line x-ray CT detector for NDT

NASA Astrophysics Data System (ADS)

Hofmann, T.; Nachtrab, F.; Schlechter, T.; Neubauer, H.; Mühlbauer, J.; Schröpfer, S.; Ernst, J.; Firsching, M.; Schweiger, T.; Oberst, M.; Meyer, A.; Uhlmann, N.

2015-04-01

Typical X-ray detectors for non-destructive testing (NDT) are line detectors or area detectors, like e.g. flat panel detectors. Multi-line detectors are currently only available in medical Computed Tomography (CT) scanners. Compared to flat panel detectors, line and multi-line detectors can achieve much higher frame rates. This allows time-resolved 3D CT scans of an object under investigation. Also, an improved image quality can be achieved due to reduced scattered radiation from object and detector themselves. Another benefit of line and multi-line detectors is that very wide detectors can be assembled easily, while flat panel detectors are usually limited to an imaging field with a size of approx. 40 × 40 cm2 at maximum. The big disadvantage of line detectors is the limited number of object slices that can be scanned simultaneously. This leads to long scan times for large objects. Volume scans with a multi-line detector are much faster, but with almost similar image quality. Due to the promising properties of multi-line detectors their application outside of medical CT would also be very interesting for NDT. However, medical CT multi-line detectors are optimized for the scanning of human bodies. Many non-medical applications require higher spatial resolutions and/or higher X-ray energies. For those non-medical applications we are developing a fast multi-line X-ray detector.In the scope of this work, we present the current state of the development of the novel detector, which includes several outstanding properties like an adjustable curved design for variable focus-detector-distances, conserving nearly uniform perpendicular irradiation over the entire detector width. Basis of the detector is a specifically designed, radiation hard CMOS imaging sensor with a pixel pitch of 200 μ m. Each pixel has an automatic in-pixel gain adjustment, which allows for both: a very high sensitivity and a wide dynamic range. The final detector is planned to have 256 lines of pixels. By using a modular assembly of the detector, the width can be chosen as multiples of 512 pixels. With a frame rate of up to 300 frames/s (full resolution) or 1200 frame/s (analog binning to 400 μ m pixel pitch) time-resolved 3D CT applications become possible. Two versions of the detector are in development, one with a high resolution scintillator and one with a thick, structured and very efficient scintillator (pitch 400 μ m). This way the detector can even work with X-ray energies up to 450 kVp.

Detection for flatness of large surface based on structured light

NASA Astrophysics Data System (ADS)

He, Wenyan; Cao, Xuedong; Long, Kuang; Peng, Zhang

2016-09-01

In order to get flatness of a large plane, this paper set up a measurement system, composed by Line Structured Light, imaging system, CCD, etc. Line Structured Light transmits parallel fringes at a proper angle onto the plane which is measured; the imaging system and CCD locate above the plane to catch the fringes. When the plane is perfect, CCD will catch straight fringes; however, the real plane is not perfect; according to the theory of projection, the fringes caught by CCD will be distorted by convex and concave. Extract the center of line fringes to obtain the distortion of the fringe, according to the functional relationship between the distortion of fringes and the height which is measured, then we will get flatness of the entire surface. Data from experiment approached the analysis of theory. In the simulation, the vertical resolution is 0.0075 mm per pixel when measuring a plane of 400mm×400mm, choosing the size of CCD 4096×4096, at the angle 85°. Helped by sub-pixel, the precision will get the level of submicron. There are two obvious advantages: method of surface sampling can increase the efficiency for auto-repairing of machines; considering the center of fringe is required mainly in this system, as a consequence, there is no serious demand for back light.

Screen Study Guides.

ERIC Educational Resources Information Center

Duncan, Barry

1969-01-01

This study guide for Arthur Lipsett's film "Very Nice, Very Nice" is in four parts. First, it describes and evaluates the film, discusses Lipsett's unusual juxtapositions, fast cutting, and fragmented speeches as indications of his satirical intent, and suggests that the only meaningful summation of the film's content is through pattern…

Modelling of Folding Patterns in Flat Membranes and Cylinders by Origami

NASA Astrophysics Data System (ADS)

Nojima, Taketoshi

This paper describes folding methods of thin flat sheets as well as cylindrical shells by modelling folding patterns through Japanese traditional Origami technique. New folding patterns have been devised in thin flat squared or circular membrane by modifying so called Miura-Ori in Japan (one node with 4 folding lines). Some folding patterns in cylindrical shells have newly been developed including spiral configurations. Devised foldable cylindrical shells were made by using polymer sheets, and it has been assured that they can be folded quite well. The devised models will make it possible to construct foldable/deployable space structures as well as to manufacture foldable industrial products and living goods, e. g., bottles for soft drinks.

Noise-immune cavity-enhanced analytical atomic spectrometry - NICE-AAS - A technique for detection of elements down to zeptogram amounts

NASA Astrophysics Data System (ADS)

Axner, Ove; Ehlers, Patrick; Hausmaninger, Thomas; Silander, Isak; Ma, Weiguang

2014-10-01

Noise-immune cavity-enhanced optical heterodyne molecular spectroscopy (NICE-OHMS) is a powerful technique for detection of molecular compounds in gas phase that is based on a combination of two important concepts: frequency modulation spectroscopy (FMS) for reduction of noise, and cavity enhancement, for prolongation of the interaction length between the light and the sample. Due to its unique properties, it has demonstrated unparalleled detection sensitivity when it comes to detection of molecular constituents in the gas phase. However, despite these, it has so far not been used for detection of atoms, i.e. for elemental analysis. The present work presents an assessment of the expected performance of Doppler-broadened (Db) NICE-OHMS for analytical atomic spectrometry, then referred to as noise-immune cavity-enhanced analytical atomic spectrometry (NICE-AAS). After a description of the basic principles of Db-NICE-OHMS, the modulation and detection conditions for optimum performance are identified. Based on a previous demonstrated detection sensitivity of Db-NICE-OHMS of 5 × 10- 12 cm- 1 Hz- 1/2 (corresponding to a single-pass absorbance of 7 × 10- 11 over 10 s), the expected limits of detection (LODs) of Hg and Na by NICE-AAS are estimated. Hg is assumed to be detected in gas phase directly while Na is considered to be atomized in a graphite furnace (GF) prior to detection. It is shown that in the absence of spectral interferences, contaminated sample compartments, and optical saturation, it should be feasible to detect Hg down to 10 zg/cm3 (10 fg/m3 or 10- 5 ng/m3), which corresponds to 25 atoms/cm3, and Na down to 0.5 zg (zg = zeptogram = 10- 21 g), representing 50 zg/mL (parts-per-sextillion, pps, 1:1021) in liquid solution (assuming a sample of 10 μL) or solely 15 atoms injected into the GF, respectively. These LODs are several orders of magnitude lower (better) than any previous laser-based absorption technique previously demonstrated under atmospheric pressure conditions. It is prophesied that NICE-AAS could provide such high detection sensitivity that the instrumentation should not, by itself, be the limiting factor of an assessment of elemental abundance; the accuracy of an assessment would then instead be limited by concomitant species, e.g. originating from the handling procedures of the sample or the environment.

Narrow-band EUV Multilayer Coating for the MOSES Sounding Rocket

NASA Technical Reports Server (NTRS)

Owens, Scott M.; Gum, Jeffery S.; Tarrio, Charles; Dvorak, Joseph; Kjornrattanawanich, Benjawan; Keski-Kuha, Ritva; Thomas, Roger J.; Kankelborg, Charles C.

2005-01-01

The Multi-order Solar EUV Spectrograph (MOSES) is a slitless spectrograph designed to study solar He II emission at 303.8 Angstroms, to be launched on a sounding rocket payload. One difference between MOSES and other slitless spectrographs is that the images are recorded simultaneously at three spectral orders, m = -1,0, +l. Another is the addition of a narrow-band multilayer coating on both the grating and the fold flat, which will reject out-of-band lines that normally contaminate the image of a slitless instrument. The primary metrics f a the mating were high peak reflectivity and suppression of Fe XV and XVI emission lines at 284 Angstroms and 335 Angstroms, respectively. We chose B4C/Mg2Si for our material combination since it provides better values for all three metrics together than the other leading candidates Si/Ir, Si/B4C or Si/SiC. Measurements of witness flats at NIST indicate the peak reflectivity at 303.6 is 38.5% for a 15 bilayer stack, while the suppression at 284 Angstroms, is 4.5x and at 335 Angstroms is 18.3x for each of two reflections in the instrument. We present the results of coating the MOSES flight gratings and fold flat, including the spectral response of the fold flat and grating as measured at NIST's SURF III and Brookhaven's X24C beamline.

Tropospheric characteristics over sea ice during N-ICE2015

NASA Astrophysics Data System (ADS)

Kayser, Markus; Maturilli, Marion; Graham, Robert; Hudson, Stephen; Cohen, Lana; Rinke, Annette; Kim, Joo-Hong; Park, Sang-Jong; Moon, Woosok; Granskog, Mats

2017-04-01

Over recent years, the Arctic Ocean region has shifted towards a younger and thinner sea-ice regime. The Norwegian young sea ICE (N-ICE2015) expedition was designed to investigate the atmosphere-snow-ice-ocean interactions in this new ice regime north of Svalbard. Here we analyze upper-air measurements made by radiosondes launched twice daily together with surface meteorology observations during N-ICE2015 from January to June 2015. We study the multiple cyclonic events observed during N-ICE2015 with respect to changes in the vertical thermodynamic structure, sudden increases in moisture content and temperature, temperature inversions and boundary layer dynamics. The influence of synoptic cyclones is strongest under polar night conditions, when radiative cooling is most effective and the moisture content is low. We find that transitions between the radiatively clear and opaque state are the largest drivers of changes to temperature inversion and stability characteristics in the boundary layer during winter. In spring radiative fluxes warm the surface leading to lifted temperature inversions and a statically unstable boundary layer. The unique N-ICE2015 dataset is used for case studies investigating changes in the vertical structure of the atmosphere under varying synoptic conditions. The goal is to deepen our understanding of synoptic interactions within the Arctic climate system, to improve model performance, as well as to identify gaps in instrumentation, which precludes further investigations.

Sensitivity analysis in economic evaluation: an audit of NICE current practice and a review of its use and value in decision-making.

PubMed

Andronis, L; Barton, P; Bryan, S

2009-06-01

To determine how we define good practice in sensitivity analysis in general and probabilistic sensitivity analysis (PSA) in particular, and to what extent it has been adhered to in the independent economic evaluations undertaken for the National Institute for Health and Clinical Excellence (NICE) over recent years; to establish what policy impact sensitivity analysis has in the context of NICE, and policy-makers' views on sensitivity analysis and uncertainty, and what use is made of sensitivity analysis in policy decision-making. Three major electronic databases, MEDLINE, EMBASE and the NHS Economic Evaluation Database, were searched from inception to February 2008. The meaning of 'good practice' in the broad area of sensitivity analysis was explored through a review of the literature. An audit was undertaken of the 15 most recent NICE multiple technology appraisal judgements and their related reports to assess how sensitivity analysis has been undertaken by independent academic teams for NICE. A review of the policy and guidance documents issued by NICE aimed to assess the policy impact of the sensitivity analysis and the PSA in particular. Qualitative interview data from NICE Technology Appraisal Committee members, collected as part of an earlier study, were also analysed to assess the value attached to the sensitivity analysis components of the economic analyses conducted for NICE. All forms of sensitivity analysis, notably both deterministic and probabilistic approaches, have their supporters and their detractors. Practice in relation to univariate sensitivity analysis is highly variable, with considerable lack of clarity in relation to the methods used and the basis of the ranges employed. In relation to PSA, there is a high level of variability in the form of distribution used for similar parameters, and the justification for such choices is rarely given. Virtually all analyses failed to consider correlations within the PSA, and this is an area of concern. Uncertainty is considered explicitly in the process of arriving at a decision by the NICE Technology Appraisal Committee, and a correlation between high levels of uncertainty and negative decisions was indicated. The findings suggest considerable value in deterministic sensitivity analysis. Such analyses serve to highlight which model parameters are critical to driving a decision. Strong support was expressed for PSA, principally because it provides an indication of the parameter uncertainty around the incremental cost-effectiveness ratio. The review and the policy impact assessment focused exclusively on documentary evidence, excluding other sources that might have revealed further insights on this issue. In seeking to address parameter uncertainty, both deterministic and probabilistic sensitivity analyses should be used. It is evident that some cost-effectiveness work, especially around the sensitivity analysis components, represents a challenge in making it accessible to those making decisions. This speaks to the training agenda for those sitting on such decision-making bodies, and to the importance of clear presentation of analyses by the academic community.

Chemically amplified i-line positive resist for next-generation flat panel display

NASA Astrophysics Data System (ADS)

Lee, Hsing-Chieh; Lu, Ying-Hao; Huang, Shin-Yih; Lan, Wei-Jen; Hanabata, Makoto

2017-03-01

Traditional diazonaphthoquinone (DNQ) positive photoresists are widely used for TFT-LCD array process. Current LTPS technology has more than 600ppi resolution is required for small or middle-sized TFT liquid crystal display panels. One of the ways to enhance resolution is to apply i-line single exposure system instead of traditional g/h/ibroadband exposure system. We have been developing i-line chemically amplified photoresist ECA 200 series for the next generation flat panel display (FPD). ECA 200 consists of three components: a phenol resin, a photo acid generator and dissolution enhancer. We applied two different types of dissolution enhancers with two different kinds of protected groups to our resist materials. As a result, we achieved higher sensitivity, higher resolution, less footing of the resist profile and reduced standing wave effect compared with traditional DNQ photoresists. In addition, we have found further property of photoresist that does not need post exposure bake (PEB) process. This resist has a great advantage at most of current panel plants without PEB process.

Theoretical investigation of dielectric corona pre-ionization TEA nitrogen laser based on transmission line method

NASA Astrophysics Data System (ADS)

Bahrampour, Alireza; Fallah, Robabeh; Ganjovi, Alireza A.; Bahrampour, Abolfazl

2007-07-01

This paper models the dielectric corona pre-ionization, capacitor transfer type of flat-plane transmission line traveling wave transverse excited atmospheric pressure nitrogen laser by a non-linear lumped RLC electric circuit. The flat-plane transmission line and the pre-ionizer dielectric are modeled by a lumped linear RLC and time-dependent non-linear RC circuit, respectively. The main discharge region is considered as a time-dependent non-linear RLC circuit where its resistance value is also depends on the radiated pre-ionization ultra violet (UV) intensity. The UV radiation is radiated by the resistance due to the surface plasma on the pre-ionizer dielectric. The theoretical predictions are in a very good agreement with the experimental observations. The electric circuit equations (including the ionization rate equations), the equations of laser levels population densities and propagation equation of laser intensities, are solved numerically. As a result, the effects of pre-ionizer dielectric parameters on the electrical behavior and output laser intensity are obtained.

Children's Sociolinguistic Evaluations of Nice Foreigners and Mean Americans

ERIC Educational Resources Information Center

Kinzler, Katherine D.; DeJesus, Jasmine M.

2013-01-01

Three experiments investigated 5- to 6-year-old monolingual English-speaking American children's sociolinguistic evaluations of others based on their accent (native, foreign) and social actions (nice, mean, neutral). In Experiment 1, children expressed social preferences for native-accented English speakers over foreign-accented speakers, and they…

Flat Epithelial Atypia of the Breast.

PubMed

Collins, Laura C

2009-06-01

Lesions of the breast characterized by enlarged terminal duct lobular units lined by columnar epithelial cells are being encountered increasingly in breast biopsy specimens. Some of these lesions feature cuboidal to columnar epithelial cells in which the lining cells exhibit cytologic atypia. The role of these lesions (recently designated "flat epithelial atypia" [FEA]) in breast tumor progression is still emerging. FEA commonly coexists with well-developed examples of atypical ductal hyperplasia, low-grade ductal carcinoma in situ, lobular neoplasia, and tubular carcinoma. These findings and those of recent genetic studies suggest that FEA is a neoplastic lesion that may represent a precursor to or the earliest morphologic manifestation of ductal carcinoma in situ. Additional studies are needed to better understand the biologic nature and clinical significance of these lesions. Copyright © 2009 Elsevier Inc. All rights reserved.

An overview of NICE guidance: acute kidney injury.

PubMed

Ellis, Peter; Jenkins, Karen

Acute Kidney Injury (AKI) as a financial, resource and human burden on both the NHS and people with AKI. Clearly if AKI is the cause of much morbidity and mortality and significant amounts of it can be prevented and/or detected earlier, this could only be a good thing. In part, the problem with AKI is that it has historically been regarded as little more than a sequal to other more pressing physical illnesses and therefore not taken as seriously as it might. The 2013 guidance from NICE-clinical guideline 169-and the accompanying pathway, seek to address this with an emphasis on assessment and prevention, identification of disease, management and subsequent chronic disease management ( NICE, 2013a ).

Wind shear over the Nice Côte d'Azur airport: case studies

NASA Astrophysics Data System (ADS)

Boilley, A.; Mahfouf, J.-F.

2013-09-01

The Nice Côte d'Azur international airport is subject to horizontal low-level wind shears. Detecting and predicting these hazards is a major concern for aircraft security. A measurement campaign took place over the Nice airport in 2009 including 4 anemometers, 1 wind lidar and 1 wind profiler. Two wind shear events were observed during this measurement campaign. Numerical simulations were carried out with Meso-NH in a configuration compatible with near-real time applications to determine the ability of the numerical model to predict these events and to study the meteorological situations generating an horizontal wind shear. A comparison between numerical simulation and the observation dataset is conducted in this paper.

Wind shear over the Nice Côte d'Azur airport: case studies

NASA Astrophysics Data System (ADS)

Boilley, A.; Mahfouf, J.-F.

2013-04-01

The Nice Côte d'Azur international airport is subject to horizontal low-level wind shears. Detecting and predicting these hazards is a major concern for aircraft security. A measurement campaign took place over the Nice airport in 2009 including 4 anemometers, 1 wind lidar and 1 wind profiler. Two wind shear events were observed during this measurement campaign. Numerical simulations were carried out with Meso-NH in a configuration compatible with near-real time applications to determine the ability of the numerical model to predict these events and to study the meteorological situations generating a horizontal wind shear. A comparison between numerical simulation and the observation dataset is conducted in this paper.

Far-infrared spectrophotometry of SN 1987A - Days 265 and 267

NASA Technical Reports Server (NTRS)

Moseley, S. H.; Dwek, E.; Silverberg, R. F.; Glaccum, W.; Graham, J. R.; Loewenstein, R. F.

1989-01-01

The paper presents 16-66-micron spectra of SN 1987A taken on days 266 and 268 after core collapse. The spectrum consists of a nearly flat continuum, strong emission lines of hydrogen, and fine-structure lines of Fe II, Fe III, Co II, S I, and possibly Fe I, Ni II, and S III. From the relative strength of three lines which arise from transitions within the ground and excited states of Fe II, the temperature and a lower limit on the density of the line-emitting region are derived. From the line strengths, the abundances of Fe and S I, the end products of explosive nucleosynthesis in the supernova are estimated. An upper limit is also set to the amount of Co II remaining in the mantle. The low measured mass of Fe suggests that the ejecta are clumpy. The flat continuum is most likely free-free emission from the expanding supernova ejecta. About 35 percent of this emission arises from the ionized metals in the mantle; the rest arises from ionized hydrogen. At the time of these observations, there is no evidence for any emission from dust that may have formed in the supernova ejecta or from preexisting dust in the surrounding medium.

High-temperature superconductors for space power transmission lines

NASA Astrophysics Data System (ADS)

Hull, John R.; Myers, Ira T.

1989-08-01

Analysis of high temperature superconductors (HTS) for space power transmission lines shows that they have the potential to provide low weight alternatives to conventional power distribution systems, especially for line lengths greater than 100 m. The use of directional radiators, combined with the natural vacuum of space, offers the possibility of reducing or eliminating the heat flux from the environment that dominates loss in terrestrial systems. This leads to scaling laws that favor flat conductor geometries. From a total launch weight viewpoint, HTS transmission lines appear superior, even with presently attainable values of current density.

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

Liu, Adrian; Zhang, Yunfan; Parsons, Aaron R., E-mail: acliu@berkeley.edu

Intensity mapping is a promising technique for surveying the large-scale structure of our universe from z  = 0 to z  ∼ 150, using the brightness temperature field of spectral lines to directly observe previously unexplored portions of our cosmic timeline. Examples of targeted lines include the 21 cm hyperfine transition of neutral hydrogen, rotational lines of carbon monoxide, and fine-structure lines of singly ionized carbon. Recent efforts have focused on detections of the power spectrum of spatial fluctuations, but have been hindered by systematics such as foreground contamination. This has motivated the decomposition of data into Fourier modes perpendicular and parallel tomore » the line of sight, which has been shown to be a particularly powerful way to diagnose systematics. However, such a method is well-defined only in the limit of a narrow-field, flat-sky approximation. This limits the sensitivity of intensity mapping experiments, as it means that wide surveys must be separately analyzed as a patchwork of smaller fields. In this paper, we develop a framework for analyzing intensity mapping data in a spherical Fourier–Bessel basis, which incorporates curved sky effects without difficulty. We use our framework to generalize a number of techniques in intensity mapping data analysis from the flat sky to the curved sky. These include visibility-based estimators for the power spectrum, treatments of interloper lines, and the “foreground wedge” signature of spectrally smooth foregrounds.« less

Spherical Harmonic Analyses of Intensity Mapping Power Spectra

NASA Astrophysics Data System (ADS)

Liu, Adrian; Zhang, Yunfan; Parsons, Aaron R.

2016-12-01

Intensity mapping is a promising technique for surveying the large-scale structure of our universe from z = 0 to z ˜ 150, using the brightness temperature field of spectral lines to directly observe previously unexplored portions of our cosmic timeline. Examples of targeted lines include the 21 cm hyperfine transition of neutral hydrogen, rotational lines of carbon monoxide, and fine-structure lines of singly ionized carbon. Recent efforts have focused on detections of the power spectrum of spatial fluctuations, but have been hindered by systematics such as foreground contamination. This has motivated the decomposition of data into Fourier modes perpendicular and parallel to the line of sight, which has been shown to be a particularly powerful way to diagnose systematics. However, such a method is well-defined only in the limit of a narrow-field, flat-sky approximation. This limits the sensitivity of intensity mapping experiments, as it means that wide surveys must be separately analyzed as a patchwork of smaller fields. In this paper, we develop a framework for analyzing intensity mapping data in a spherical Fourier-Bessel basis, which incorporates curved sky effects without difficulty. We use our framework to generalize a number of techniques in intensity mapping data analysis from the flat sky to the curved sky. These include visibility-based estimators for the power spectrum, treatments of interloper lines, and the “foreground wedge” signature of spectrally smooth foregrounds.

Being "Nice" or Being "Normal": Girls Resisting Discourses of "Coolness"

ERIC Educational Resources Information Center

Paechter, Carrie; Clark, Sheryl

2016-01-01

In this paper we consider discourses of friendship and belonging mobilised by girls who are not part of the dominant "cool" group in one English primary school. We explore how, by investing in alternative and, at times, resistant, discourses of "being nice" and "being normal" these "non-cool" girls were able…

An Update on Improvements to NiCE Support for PROTEUS

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

Bennett, Andrew; McCaskey, Alexander J.; Billings, Jay Jay

2015-09-01

The Department of Energy Office of Nuclear Energy's Nuclear Energy Advanced Modeling and Simulation (NEAMS) program has supported the development of the NEAMS Integrated Computational Environment (NiCE), a modeling and simulation workflow environment that provides services and plugins to facilitate tasks such as code execution, model input construction, visualization, and data analysis. This report details the development of workflows for the reactor core neutronics application, PROTEUS. This advanced neutronics application (primarily developed at Argonne National Laboratory) aims to improve nuclear reactor design and analysis by providing an extensible and massively parallel, finite-element solver for current and advanced reactor fuel neutronicsmore » modeling. The integration of PROTEUS-specific tools into NiCE is intended to make the advanced capabilities that PROTEUS provides more accessible to the nuclear energy research and development community. This report will detail the work done to improve existing PROTEUS workflow support in NiCE. We will demonstrate and discuss these improvements, including the development of flexible IO services, an improved interface for input generation, and the addition of advanced Fortran development tools natively in the platform.« less

Ramucirumab for Treating Advanced Gastric Cancer or Gastro-Oesophageal Junction Adenocarcinoma Previously Treated with Chemotherapy: An Evidence Review Group Perspective of a NICE Single Technology Appraisal.

PubMed

Büyükkaramikli, Nasuh C; Blommestein, Hedwig M; Riemsma, Rob; Armstrong, Nigel; Clay, Fiona J; Ross, Janine; Worthy, Gill; Severens, Johan; Kleijnen, Jos; Al, Maiwenn J

2017-12-01

The National Institute for Health and Care Excellence (NICE) invited the company that manufactures ramucirumab (Cyramza ® , Eli Lilly and Company) to submit evidence of the clinical and cost effectiveness of the drug administered alone (monotherapy) or with paclitaxel (combination therapy) for treating adults with advanced gastric cancer or gastro-oesophageal junction (GC/GOJ) adenocarcinoma that were previously treated with chemotherapy, as part of the Institute's single technology appraisal (STA) process. Kleijnen Systematic Reviews Ltd (KSR), in collaboration with Erasmus University Rotterdam, was commissioned to act as the Evidence Review Group (ERG). This paper describes the company's submission, the ERG review, and NICE's subsequent decisions. Clinical effectiveness evidence for ramucirumab monotherapy (RAM), compared with best supportive care (BSC), was based on data from the REGARD trial. Clinical effectiveness evidence for ramucirumab combination therapy (RAM + PAC), compared with paclitaxel monotherapy (PAC), was based on data from the RAINBOW trial. In addition, the company undertook a network meta-analysis (NMA) to compare RAM + PAC with BSC and docetaxel. Cost-effectiveness evidence of monotherapy and combination therapy relied on partitioned survival, cost-utility models. The base-case incremental cost-effectiveness ratio (ICER) of the company was £188,640 (vs BSC) per quality-adjusted life-year (QALY) gained for monotherapy and £118,209 (vs BSC) per QALY gained for combination therapy. The ERG assessment indicated that the modelling structure represented the course of the disease; however, a few errors were identified and some of the input parameters were challenged. The ERG provided a new base case, with ICERs (vs BSC) of £188,100 (monotherapy) per QALY gained and £129,400 (combination therapy) per QALY gained and conducted additional exploratory analyses. The NICE Appraisal Committee (AC), considered the company's decision problem was in line with the NICE scope, with the exception of the choice of comparators for the combination therapy model. The most plausible ICER for ramucirumab monotherapy compared with BSC was £188,100 per QALY gained. The Committee considered that the ERG's exploratory analysis in which RAM + PAC was compared with PAC by using the direct head-to-head data (including utilities) from the RAINBOW trial, provided the most plausible ICER (i.e. £408,200 per QALY gained) for ramucirumab combination therapy. The Committee concluded that end-of-life considerations cannot be applied for either case, since neither failed to offer an extension to life of at least 3 months. The company did not submit a patient access scheme (PAS). After consideration of the evidence, the Committee concluded that ramucirumab alone or with paclitaxel could not be considered a cost-effective use of National Health Service resources for treating advanced GC/GOJ patients that were previously treated with chemotherapy, and therefore its use could not be recommended. We might wonder if a complete STA process is necessary for treatments without a PAS, which are, according to the company's submission, already associated with ICERs far above the currently accepted threshold in all (base-case, sensitivity and scenario) analyses.

Quality of data collected for severity of illness scores in the Dutch National Intensive Care Evaluation (NICE) registry.

PubMed

Arts, Daniëlle; de Keizer, Nicolette; Scheffer, Gert-Jan; de Jonge, Evert

2002-05-01

To analyse the quality of data used to measure severity of illness in the Dutch National Intensive Care Evaluation (NICE) registry, after implementation of quality improving procedures. Data were re-abstracted from the paper records of patients or the Patient Data Management System and compared to the data contained in the registry. The re-abstracted data were considered to be the gold standard. ICUs of nine Dutch hospitals that had been collecting data for the NICE registry for at least 1 year. The mean percentages of inaccurate and incomplete data, per hospital, over all variables, were 6.1%+/-4.4 (SD) and 2.7%+/-4.4 (SD), respectively. The mean difference in severity of illness scores between registry data and re-abstracted data was 0.2 points for APACHE II and 0.4 points for SAPS II. The mean difference in predicted mortality according to APACHE II and SAPS II between registry data and re-abstracted data was 0.4% and 0.02%, respectively. The current data quality of the NICE registry is good and justifies evaluative research. These positive results might be explained by the implementation of several quality assurance procedures in the NICE registry, such as training and automatic data checks. Electronic supplementary material to this paper can be obtained by using the Springer LINK server located at http://dx.doi.org/10.1007/s00134-002-1272-z

DECISION-COMPONENTS OF NICE'S TECHNOLOGY APPRAISALS ASSESSMENT FRAMEWORK.

PubMed

de Folter, Joost; Trusheim, Mark; Jonsson, Pall; Garner, Sarah

2018-01-01

Value assessment frameworks have gained prominence recently in the context of U.S. healthcare. Such frameworks set out a series of factors that are considered in funding decisions. The UK's National Institute of Health and Care Excellence (NICE) is an established health technology assessment (HTA) agency. We present a novel application of text analysis that characterizes NICE's Technology Appraisals in the context of the newer assessment frameworks and present the results in a visual way. A total of 243 documents of NICE's medicines guidance from 2007 to 2016 were analyzed. Text analysis was used to identify a hierarchical set of decision factors considered in the assessments. The frequency of decision factors stated in the documents was determined and their association with terms related to uncertainty. The results were incorporated into visual representations of hierarchical factors. We identified 125 decision factors, and hierarchically grouped these into eight domains: Clinical Effectiveness, Cost Effectiveness, Condition, Current Practice, Clinical Need, New Treatment, Studies, and Other Factors. Textual analysis showed all domains appeared consistently in the guidance documents. Many factors were commonly associated with terms relating to uncertainty. A series of visual representations was created. This study reveals the complexity and consistency of NICE's decision-making processes and demonstrates that cost effectiveness is not the only decision-criteria. The study highlights the importance of processes and methodology that can take both quantitative and qualitative information into account. Visualizations can help effectively communicate this complex information during the decision-making process and subsequently to stakeholders.

Quality Measurement Recommendations Relevant to Clinical Guidelines in Germany and the United Kingdom: (What) Can We Learn From Each Other?

PubMed Central

Petzold, Thomas; Deckert, Stefanie; Williamson, Paula R.; Schmitt, Jochen

2018-01-01

We conducted a systematic review of clinical guidelines (CGs) to examine the methodological approaches of quality indicator derivation in CGs, the frequency of quality indicators to check CG recommendations in routine care, and clinimetric properties of quality indicators. We analyzed the publicly available CG databases of the Association of the Scientific Medical Societies in Germany (AWMF) and National Institute for Health and Care Excellence (NICE). Data on the methodology of subsequent quality indicator derivation, the content and definition of recommended quality indicators, and clinimetric properties of measurement instruments were extracted. In Germany, no explicit methodological guidance exists, but 3 different approaches are used. For NICE, a general approach is used for the derivation of quality indicators out of quality standards. Quality indicators were defined in 34 out of 87 CGs (39%) in Germany and for 58 out of 133 (43%) NICE CGs. Statements regarding measurement properties of instruments for quality indicator assessment were missing in German and NICE documents. Thirteen pairs of CGs (32%) have associated quality indicators. Thirty-four quality indicators refer to the same aspect of the quality of care, which corresponds to 27% of the German and 7% of NICE quality indicators. The development of a standardized and internationally accepted methodology for the derivation of quality indicators relevant to CGs is needed to measure and compare quality of care in health care systems. PMID:29591538

Directed Self-Assembly of Gradient Concentric Carbon Nanotube Rings

NASA Astrophysics Data System (ADS)

Hong, Suck Won; Jeong, Wonje; Ko, Hyunhyub; Tsukruk, Vladimir; Kessler, Michael; Lin, Zhiqun

2008-03-01

Hundreds of gradient concentric rings of linear conjugated polymer, (poly[2-methoxy-5-(2-ethylhexyloxy)-1,4- phenylenevinylene], i.e., MEH-PPV) with remarkable regularity over large areas were produced by controlled, repetitive ``stick- slip'' motions of the contact line in a confined geometry consisting of a sphere on a flat substrate (i.e., sphere-on-flat geometry). Subsequently, MEH-PPV rings exploited as template to direct the formation of gradient concentric rings of multiwalled carbon nanotubes (MWNTs) with controlled density. This method is simple, cost effective, and robust, combining two consecutive self-assembly processes, namely, evaporation-induced self- assembly of polymers in a sphere-on-flat geometry, followed by subsequent directed self-assembly of MWNTs on the polymer- templated surfaces.

Cost-effectiveness modeling for neuropathic pain treatments: investigating the relative importance of parameters using an open-source model.

PubMed

Hirst, Matthew; Bending, Matthew W; Baio, Gianluca; Yesufu-Udechuku, Amina; Dunlop, William C N

2018-06-08

The study objective was to develop an open-source replicate of a cost-effectiveness model developed by National Institute for Health and Care (NICE) in order to explore uncertainties in health economic modeling of novel pharmacological neuropathic pain treatments. The NICE model, consisting of a decision tree with branches for discrete levels of pain relief and adverse event (AE) severities, was replicated using R and used to compare a hypothetical neuropathic pain drug to pregabalin. Model parameters were sourced from NICE's clinical guidelines and associated with probability distributions to account for underlying uncertainty. A simulation-based scenario analysis was conducted to assess how uncertainty in efficacy and AEs affected the net monetary benefit (NMB) for the hypothetical treatment at a cost-effectiveness threshold of £20,000 per QALY. Relative to pregabalin, an increase in efficacy was associated with greater NMB than an improvement in tolerability. A greater NMB was observed when efficacy was marginally higher than that of pregabalin while maintaining the same level of AEs than when efficacy was equivalent to pregabalin but with a more substantial reduction in AEs. In the latter scenario, the NMB was only positive at a low cost-effectiveness threshold. The replicate model shares the limitations described in the NICE guidelines. There is a lack of support in scientific literature for the assumption that increased efficacy is associated with a greater reduction in tolerability. The replicate model also included a single comparator, unlike the NICE model. Pain relief is a stronger driver of NMB than tolerability at a cost-effectiveness threshold of £20,000 per QALY. Health technology assessment decisions which are influenced by NICE's model may reward efficacy gains even if they are associated with more severe AEs. This contrasts with recommendations from clinical guidelines for neuropathic pain which place more equal weighting on improvements in efficacy and tolerability as value drivers.

76 FR 75786 - International Product and Price Changes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-05

... Ascension, Bolivia, Cuba, Falkland Islands, and North Korea, revise the lines of text for the Flat Rate..., commercial base, or commercial plus price. [For Ascension, Bolivia, Cuba, and the Falkland Islands revise the...

Cell behavior on surface modified polydimethylsiloxane (PDMS).

PubMed

Stanton, Morgan M; Rankenberg, Johanna M; Park, Byung-Wook; McGimpsey, W Grant; Malcuit, Christopher; Lambert, Christopher R

2014-07-01

Designing complex tissue culture systems requires cell alignment and directed extracellular matrix (ECM) and gene expression. Here, a micro-rough, polydimethylsiloxane (PDMS) surface, that also integrates a micro-pattern of 50 µm wide lines of fibronectin (FN) separated by 60 µm wide lines of bovine serum albumin (BSA), is developed. Human fibroblasts cultured on the rough, patterned substrate have aligned growth and a significant change in morphology when compared to cells on a flat, patterned surface. The rough PDMS topography significantly decreases cell area and induces the upregulation of several ECM related genes by two-fold when compared to cells cultured on flat PDMS. This study describes a simple surface engineering procedure for creating surface architecture for scaffolds to design and control the cell-surface interface. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

23. VIEW OF SECTION DRAWINGS. THE SECTION LINES FOR AA ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

23. VIEW OF SECTION DRAWINGS. THE SECTION LINES FOR A-A AND C-C CUT THE BUILDING EAST-WEST; SECTION LINE B-B CUTS THE BUILDING NORTH-SOUTH. THE ORIGINAL DRAWING HAS BEEN ARCHIVED ON MICROFILM. THE DRAWING WAS REPRODUCED AT THE BEST QUALITY POSSIBLE. LETTERS AND NUMBERS IN THE CIRCLES INDICATE FOOTER AND/OR COLUMN LOCATIONS. - Rocky Flats Plant, Non-Nuclear Production Facility, South of Cottonwood Avenue, west of Seventh Avenue & east of Building 460, Golden, Jefferson County, CO

Application developer's tutorial for the CSM testbed architecture

NASA Technical Reports Server (NTRS)

Underwood, Phillip; Felippa, Carlos A.

1988-01-01

This tutorial serves as an illustration of the use of the programmer interface on the CSM Testbed Architecture (NICE). It presents a complete, but simple, introduction to using both the GAL-DBM (Global Access Library-Database Manager) and CLIP (Command Language Interface Program) to write a NICE processor. Familiarity with the CSM Testbed architecture is required.

When Nice Won't Suffice: Honest Discourse Is Key to Shifting School Culture

ERIC Educational Resources Information Center

MacDonald, Elisa

2011-01-01

The "culture of nice" is the underlying culture that inhibits a team of teachers from reaching a level of rigorous collaborative discourse where teachers are challenging each other's and their own thinking, beliefs, assumptions, and practice. This article discusses how honest discourse can be the key to shifting school culture. The act of…

Generating Nice Linear Systems for Matrix Gaussian Elimination

ERIC Educational Resources Information Center

Homewood, L. James

2004-01-01

In this article an augmented matrix that represents a system of linear equations is called nice if a sequence of elementary row operations that reduces the matrix to row-echelon form, through matrix Gaussian elimination, does so by restricting all entries to integers in every step. Many instructors wish to use the example of matrix Gaussian…

Collaboration Promotes Proportional Reasoning about Resource Distribution in Young Children

ERIC Educational Resources Information Center

Ng, Rowena; Heyman, Gail D.; Barner, David

2011-01-01

The authors investigated how children and adults evaluate the "niceness" of individuals who engage in resource distribution, with a focus on their sensitivity to the proportion of resources given. Across 3 experiments, subjects evaluated the niceness of a child who gave a quantity of pennies to another child. In Study 1 (N = 30), adults showed…

Children's behaviour problems: a NICE mess.

PubMed

Timimi, S

2014-09-01

The potential harms of medicalisation are well known. A good illustration comes from the medicalisation of children's behaviour problems. National Institute for health and Clinical Excellence (NICE) guidelines on conditions such as Attention Deficit Hyperactivity Disorder (ADHD), Autistic Spectrum Disorder (ASD) and Conduct Disorder (CD) reflect how attempts to regulate medical practice in this area has spawned guidelines based more on wish fulfilment (that getting kids to behave themselves can be accomplished by simple technological interventions that exist independent of context) than scientific evidence. In this perspective piece, I explain why these NICE guidelines are more a reflection of cultural confusion about how to deal with children, than the outcome of sound scientific understanding in this area. © 2014 John Wiley & Sons Ltd.

Dynamic Roughness Ratio-Based Framework for Modeling Mixed Mode of Droplet Evaporation.

PubMed

Gunjan, Madhu Ranjan; Raj, Rishi

2017-07-18

The spatiotemporal evolution of an evaporating sessile droplet and its effect on lifetime is crucial to various disciplines of science and technology. Although experimental investigations suggest three distinct modes through which a droplet evaporates, namely, the constant contact radius (CCR), the constant contact angle (CCA), and the mixed, only the CCR and the CCA modes have been modeled reasonably. Here we use experiments with water droplets on flat and micropillared silicon substrates to characterize the mixed mode. We visualize that a perfect CCA mode after the initial CCR mode is an idealization on a flat silicon substrate, and the receding contact line undergoes intermittent but recurring pinning (CCR mode) as it encounters fresh contaminants on the surface. The resulting increase in roughness lowers the contact angle of the droplet during these intermittent CCR modes until the next depinning event, followed by the CCA mode of evaporation. The airborne contaminants in our experiments are mostly loosely adhered to the surface and travel along with the receding contact line. The resulting gradual increase in the apparent roughness and hence the extent of CCR mode over CCA mode forces appreciable decrease in the contact angle observed during the mixed mode of evaporation. Unlike loosely adhered airborne contaminants on flat samples, micropillars act as fixed roughness features. The apparent roughness fluctuates about the mean value as the contact line recedes between pillars. Evaporation on these surfaces exhibits stick-jump motion with a short-duration mixed mode toward the end when the droplet size becomes comparable to the pillar spacing. We incorporate this dynamic roughness into a classical evaporation model to accurately predict the droplet evolution throughout the three modes, for both flat and micropillared silicon surfaces. We believe that this framework can also be extended to model the evaporation of nanofluids and the coffee-ring effect, among others.

The Type and Impact of Evidence Review Group Exploratory Analyses in the NICE Single Technology Appraisal Process.

PubMed

Carroll, Christopher; Kaltenthaler, Eva; Hill-McManus, Daniel; Scope, Alison; Holmes, Michael; Rice, Stephen; Rose, Micah; Tappenden, Paul; Woolacott, Nerys

2017-06-01

As part of the UK National Institute for Health and Care Excellence (NICE) single technology appraisal process, independent evidence review groups (ERGs) critically appraise a company's submission relating to a specific technology and indication. To explore the type of additional exploratory analyses conducted by ERGs and their impact on the recommendations made by NICE. The 100 most recently completed single technology appraisals with published guidance were selected for inclusion. A content analysis of relevant documents was undertaken to identify and extract relevant data, and narrative synthesis was used to rationalize and present these data. The types of exploratory analysis conducted in relation to companies' models were fixing errors, addressing violations, addressing matters of judgment, and the provision of a new, ERG-preferred base case. Ninety-three of the 100 ERG reports contained at least one of these analyses. The most frequently reported type of analysis in these 93 ERG reports related to the category "Matters of judgment," which was reported in 83 reports (89%). At least one of the exploratory analyses conducted and reported by an ERG is mentioned in 97% of NICE appraisal consultation documents and 94% of NICE final appraisal determinations, and had a clear influence on recommendations in 72% of appraisal consultation documents and 47% of final appraisal determinations. These results suggest that the additional analyses undertaken by ERGs in the appraisal of company submissions are highly influential in the policy-making and decision-making process. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Opening the black box: a study of the process of NICE guidelines implementation.

PubMed

Spyridonidis, Dimitrios; Calnan, Michael

2011-10-01

This study informs 'evidence-based' implementation by using an innovative methodology to provide further understanding of the implementation process in the English NHS using two distinctly different NICE clinical guidelines as exemplars. The implementation process was tracked retrospectively and prospectively using a comparative case-study and longitudinal design. 74 unstructured interviews were carried out with 48 key informants (managers and clinicians) between 2007 and 2009. This study has shown that the NICE guidelines implementation process has both planned and emergent components, which was well illustrated by the use of the prospective longitudinal design in this study. The implementation process might be characterised as strategic and planned to begin with but became uncontrolled and subject to negotiation as it moved from the planning phase to adoption in everyday practice. The variations in the implementation process could be best accounted for in terms of differences in the structure and nature of the local organisational context. The latter pointed to the importance of managers as well as clinicians in decision-making about implementation. While national priorities determine the context for implementation the shape of the process is influenced by the interactions between doctors and managers, which influence the way they respond to external policy initiatives such as NICE guidelines. NICE and other national health policy-makers need to recognise that the introduction of planned change 'initiatives' in clinical practice are subject to social and political influences at the micro level as well as the macro level. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

What is the actual cost of providing the intrauterine system for contraception in a UK community sexual and reproductive health setting?

PubMed

Cook, Louise; Fleming, Charlotte

2014-01-01

The anticipated increase in uptake of intrauterine system (IUS) fittings is slower than predicted by the National Institute for Health and Clinical Excellence (NICE). There is evidence to suggest that this is because of a high perceived cost of providing this contraceptive method. Whereas studies to date have all guessed at these costs, we calculated the actual costs of providing the IUS. We tracked the notes of 283 women who had an IUS fitted in our community sexual and reproductive health service for 5 years. We recorded duration of use, measured the actual cost of all appointments and interventions over the lifespan of the device, and compared our findings with NICE predicted costs. With 70% complete follow-up, the average duration of use of the IUS was 3.44 years compared to NICE's prediction of 3.32. The average annual cost of providing an IUS for contraception in community clinics was £54.55 per woman; this compares with £70.49 modelled by NICE for provision in primary care. Most (80%) of the cost is incurred in the first year. The cost of managing problems is small. Providing the IUS for contraception was 23% cheaper in the present study than that predicted by NICE and cheaper than providing combined oral contraception in our service. Fitting IUSs in community clinics may be cheaper than in primary care. Streamlining the patient pathway will reduce costs further. Restricting access to the IUS because of initial cost is a false economy.

Managing conflicts of interest in the UK National Institute for Health and Care Excellence (NICE) clinical guidelines programme: qualitative study.

PubMed

Graham, Tanya; Alderson, Phil; Stokes, Tim

2015-01-01

There is international concern that conflicts of interest (COI) may bias clinical guideline development and render it untrustworthy. Guideline COI policies exist with the aim of reducing this bias but it is not known how such policies are interpreted and used by guideline producing organisations. This study sought to determine how conflicts of interest (COIs) are disclosed and managed by a national clinical guideline developer (NICE: the UK National Institute for Health and Care Excellence). Qualitative study using semi-structured telephone interviews with 14 key informants: 8 senior staff of NICE's guideline development centres and 6 chairs of guideline development groups (GDGs). We conducted a thematic analysis. Participants regard the NICE COI policy as comprehensive leading to transparent and independent guidance. The application of the NICE COI policy is, however, not straightforward and clarity could be improved. Disclosure of COI relies on self reporting and guideline developers have to take "on trust" the information they receive, certain types of COI (non-financial) are difficult to categorise and manage and disclosed COI can impact on the ability to recruit clinical experts to GDGs. Participants considered it both disruptive and stressful to exclude members from GDG meetings when required by the COI policy. Nonetheless the impact of this disruption can be minimised with good group chairing skills. We consider that the successful implementation of a COI policy in clinical guideline development requires clear policies and procedures, appropriate training of GDG chairs and an evaluation of how the policy is used in practice.

Reconstruction of combustion temperature and gas concentration distributions using line-of-sight tunable diode laser absorption spectroscopy

NASA Astrophysics Data System (ADS)

Zhang, Zhirong; Sun, Pengshuai; Pang, Tao; Xia, Hua; Cui, Xiaojuan; Li, Zhe; Han, Luo; Wu, Bian; Wang, Yu; Sigrist, Markus W.; Dong, Fengzhong

2016-07-01

Spatial temperature and gas concentration distributions are crucial for combustion studies to characterize the combustion position and to evaluate the combustion regime and the released heat quantity. Optical computer tomography (CT) enables the reconstruction of temperature and gas concentration fields in a flame on the basis of line-of-sight tunable diode laser absorption spectroscopy (LOS-TDLAS). A pair of H2O absorption lines at wavelengths 1395.51 and 1395.69 nm is selected. Temperature and H2O concentration distributions for a flat flame furnace are calculated by superimposing two absorption peaks with a discrete algebraic iterative algorithm and a mathematical fitting algorithm. By comparison, direct absorption spectroscopy measurements agree well with the thermocouple measurements and yield a good correlation. The CT reconstruction data of different air-to-fuel ratio combustion conditions (incomplete combustion and full combustion) and three different types of burners (one, two, and three flat flame furnaces) demonstrate that TDLAS has the potential of short response time and enables real-time temperature and gas concentration distribution measurements for combustion diagnosis.

The Imaging Properties of a Silicon Wafer X-Ray Telescope

NASA Technical Reports Server (NTRS)

Joy, M. K.; Kolodziejczak, J. J.; Weisskopf, M. C.; Fair, S.; Ramsey, B. D.

1994-01-01

Silicon wafers have excellent optical properties --- low microroughness and good medium-scale flatness --- which Make them suitable candidates for inexpensive flat-plate grazing-incidence x-ray mirrors. On short spatial scales (less than 3 mm) the surface quality of silicon wafers rivals that expected of the Advanced X-Ray Astrophysics Facility (AXAF) high-resolution optics. On larger spatial scales, however, performance may be degraded by the departure from flatness of the wafer and by distortions induced by the mounting scheme. In order to investigate such effects, we designed and constructed a prototype silicon-wafer x-ray telescope. The device was then tested in both visible light and x rays. The telescope module consists of 94 150-mm-diameter wafers, densely packed into the first stage of a Kirkpatrick-Baez configuration. X-ray tests at three energies (4.5, 6.4, and 8.0 keV) showed an energy-independent line spread function with full width at half maximum (FWHM) of 150 arcseconds, dominated by deviations from large-scale flatness.

Proper Conformal Killing Vectors in Kantowski-Sachs Metric

NASA Astrophysics Data System (ADS)

Hussain, Tahir; Farhan, Muhammad

2018-04-01

This paper deals with the existence of proper conformal Killing vectors (CKVs) in Kantowski-Sachs metric. Subject to some integrability conditions, the general form of vector filed generating CKVs and the conformal factor is presented. The integrability conditions are solved generally as well as in some particular cases to show that the non-conformally flat Kantowski-Sachs metric admits two proper CKVs, while it admits a 15-dimensional Lie algebra of CKVs in the case when it becomes conformally flat. The inheriting conformal Killing vectors (ICKVs), which map fluid lines conformally, are also investigated.

The Role of Nice and Nasty Theory of Mind in Teacher-Selected Peer Models for Adolescents with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Laghi, Fiorenzo; Lonigro, Antonia; Levanto, Simona; Ferraro, Maurizio; Baumgartner, Emma; Baiocco, Roberto

2016-01-01

The study aimed at verifying if nice and nasty theory of mind behaviors, in association with teachers' peer buddy nomination, could be used to correctly select peer models for adolescents with autism spectrum disorder. Mentalizing abilities and emotional and behavioral characteristics of 601 adolescents were assessed. Results suggest that teachers…

Graduate Students Rate Institutional Websites: The Must Have, Nice to Have, and Delighted to Have Services

ERIC Educational Resources Information Center

Meyer, Katrina A.; Jones, Stephanie J.

2012-01-01

The graduate students admitted to the online and blended programs in higher education at Texas Tech University and the University of Memphis were surveyed about their respective university websites, or the institution's "virtual face." A total of 42 students rated 30 web-based services as "must have," "nice to have," "delighted to have (but not…

Use of PZT's for adaptive control of Fabry-Perot etalon plate figure

NASA Technical Reports Server (NTRS)

Skinner, WIlbert; Niciejewski, R.

2005-01-01

A Fabry Perot etalon, consisting of two spaced and reflective glass flats, provides the mechanism by which high resolution spectroscopy may be performed over narrow spectral regions. Space based applications include direct measurements of Doppler shifts of airglow absorption and emission features and the Doppler broadening of spectral lines. The technique requires a high degree of parallelism between the two flats to be maintained through harsh launch conditions. Monitoring and adjusting the plate figure by illuminating the Fabry Perot interferometer with a suitable monochromatic source may be performed on orbit to actively control of the parallelism of the flats. This report describes the use of such a technique in a laboratory environment applied to a piezo-electric stack attached to the center of a Fabry Perot etalon.

Compliance with NICE guidance on the use of anti-TNFalpha agents in ankylosing spondylitis: an east and west Midlands regional audit.

PubMed

Rees, Frances; Peffers, Gillian; Bell, Carolyn; Obrenovic, Karen; Sandhu, Ravinder; Packham, Jonathan; Erb, Nicola

2012-08-01

Here we report on an audit performed to examine compliance with National Institute for Health and Clinical Excellence (NICE) guidelines for the use of anti-tumour necrosis factor alpha (anti-TNFalpha) in treating patients with ankylosing spondylitis (AS). Data from 17 rheumatology centres across the Midlands were collected prospectively from patients with AS attending outpatient clinics and retrospectively in patients receiving anti-TNFalpha but not attending outpatient clinics during the audit. In total, 80% of the 416 patients for whom data were collected were male. Of the 238 patients recruited prospectively, 41% were receiving anti-TNFalpha. Reviewing all patients on anti-TNFalpha (N=275), pre-treatment assessments 12 weeks apart were documented in 55% of patients. After anti-TNFalpha treatment had started, regular 12-weekly assessments occurred in 46% of patients. Therefore, compliance with NICE guidance was found to vary among centres. Based on our audit, clinical capacity, and clinical or patient choice might be influencing the suboptimal adherence seen in assessment timing suggested by NICE guidelines relating to the use of anti-TNFalpha in treating patients with AS.

Substructure analysis using NICE/SPAR and applications of force to linear and nonlinear structures. [spacecraft masts

NASA Technical Reports Server (NTRS)

Razzaq, Zia; Prasad, Venkatesh; Darbhamulla, Siva Prasad; Bhati, Ravinder; Lin, Cai

1987-01-01

Parallel computing studies are presented for a variety of structural analysis problems. Included are the substructure planar analysis of rectangular panels with and without a hole, the static analysis of space mast, using NICE/SPAR and FORCE, and substructure analysis of plane rigid-jointed frames using FORCE. The computations are carried out on the Flex/32 MultiComputer using one to eighteen processors. The NICE/SPAR runstream samples are documented for the panel problem. For the substructure analysis of plane frames, a computer program is developed to demonstrate the effectiveness of a substructuring technique when FORCE is enforced. Ongoing research activities for an elasto-plastic stability analysis problem using FORCE, and stability analysis of the focus problem using NICE/SPAR are briefly summarized. Speedup curves for the panel, the mast, and the frame problems provide a basic understanding of the effectiveness of parallel computing procedures utilized or developed, within the domain of the parameters considered. Although the speedup curves obtained exhibit various levels of computational efficiency, they clearly demonstrate the excellent promise which parallel computing holds for the structural analysis problem. Source code is given for the elasto-plastic stability problem and the FORCE program.

Successful White teachers of Black students: Teaching across racial lines in urban middle school science classrooms

NASA Astrophysics Data System (ADS)

Coleman, Bobbie

The majority of urban minority students, particularly Black students, continue to perform below proficiency on standardized state and national testing in all areas that seriously impact economically advanced career options, especially in areas involving science. If education is viewed as a way out of poverty, there is a need to identify pedagogical methodologies that assist Black students in achieving higher levels of success in science, and in school in general. The purpose of this study was to explore White teachers' and Black students' perceptions about the teaching strategies used in their low socioeconomic status (LSES) urban science classrooms, that led to academic success for Black students. Participants included three urban middle school White teachers thought to be the best science teachers in the school, and five randomly selected Black students from each of their classrooms. Methods of inquiry involving tenets of grounded theory were used to examine strategies teachers used to inspire Black students into academic success. Data collection included teacher and student interviews, field notes from classroom observations, group discussions, and questionaires. Data were analyzed using open, axial, and selective coding. The teachers' perceptions indicated that their prior belief systems, effective academic and personal communication, caring and nurturing strategies, using relevant and meaningful hands-on activities in small learner-centered groups, enhanced the learning capabilities of all students in their classrooms, especially the Black students. Black students' perceptions indicated that their academic success was attributable to what teachers personally thought about them, demonstrated that they cared, communicated with them on a personal and academic level, gave affirmative feedback, simplified, and explained content matter. Black students labeled teachers who had these attributes as "nice" teachers. The nurturing and caring behaviors of "nice" teachers caused Black students to feel a sense of community and a sense of belonging in their classrooms. Black students demonstrated that they respected and always "had the back" of these "nice" teachers. Results from this study could play a significant role in teacher retention and in informing best practices for preservice and other teachers who are struggling to meet the needs of LSES urban students.

Interaction of the 100-year old X-Ray flare produced by a central black hole with diffuse gas in the Galactic center

NASA Astrophysics Data System (ADS)

Chernyshov, D.; Cheng, K.; Dogiel, V.; Kong, A.; Ko, C.; Tatischeff, V.; Terrier, R.

2017-10-01

We investigate an old X-Ray flare produced by a central black hole which is most likely responsible for the transient X-Ray emission from massive molecular clouds in the Galactic center. This flare should ionize diffuse molecular gas and also excite fluorescence lines e.g. neutral iron line at 6.4 keV. It turns out that the observed diffuse 6.4 keV line can be explained by the same X-Ray flare which illuminates dense molecular clouds. The diffuse emission can also be considered as a tool to limit potential duration and intensity of the primary X-Ray flare. We show that charged particles cannot provide necessary iron ionization rate to reproduce the observed emission. On the other hand ionization of neutral hydrogen cannot be provided by a primary flare and should be done by other mechanisms like for example charged particles. We also claim that recently found afterglow from Swift J1644+57 can be produced by similar event and can be a nice example of a Compton echo observed in a distant galaxy.

Very Fast Current Diagnostic for Linear Pulsed Beams

NASA Astrophysics Data System (ADS)

Nassisi, Vincenzo; Delle Side, Domenico; Turco, Vito

2018-01-01

Fast current pulses manage lasers and particle accelerators and require sophisticate systems to be detected. At today Rogowski coils are well known. They are designed and built with a toroidal structure. In recently application, flat transmission lines are imploded and for this reason we develop a linear Rogowski coil to detect current pulses inside flat conductors. To get deep information from the system, it was approached by means of the theory of the transmission lines. The coil we build presents a resistance but it doesn't influence the rise time of the response, instead the integrating time. We also studied the influence of the magnetic properties of coil support. The new device was able to record pulses of more hundred nanoseconds depending on the inductance, load impedance and resistance of the coil. Furthermore, its response was characterized by a sub-nanosecond rise time ( 100 ps), The attenuation coefficient depends mainly on the turn number of the coil, while the quality of the response depends both on the manufacture quality of the coil and on the magnetic core characteristics. In biophysical applications often, a double line is employed in order to have a sample as control and a sample stressed by a light source. So, in this case we build two equal plane lines by 100 Ω characteristic resistance connected in parallel. We diagnosed the current present in a line. The attenuation factor resulted to be 11,5 A/V.

Implementing NICE Guidelines on Recall Intervals into General Practice.

PubMed

Akram, Sarah; D’Cruz, Len

2010-09-01

The NICE guidelines require practitioners to ensure that each patient has a specific recall interval based on an oral health needs assessment. There appears to be a hesitancy in the profession to move away from the ‘six-month recall’. In England and Wales, Primary Care Organizations (PCOs) monitor activity using quantitative data. One particular metric measures how many patients are seen by the practice within 3 months and also between 3 and 9 months from their last course of treatment. The purpose of this paper is to introduce a quick reference chart based on the NICE guidelines which, when used in combination with clinical judgement, can aid the clinician in selecting a tailored recall interval. This paper discusses the purpose and benefits for using the guidelines in relation to NHS contractual obligations.

All-Sky Infrared Survey

NASA Image and Video Library

2009-11-17

This infrared view of the whole sky highlights the flat plane of our Milky Way galaxy line across middle of image. NASA WISE, will take a similar infrared census of the whole sky, only with much improved resolution and sensitivity.

Glue, steam and Clarivein--Best practice techniques and evidence.

PubMed

Whiteley, Mark S

2015-11-01

In July 2013, the National Institute of Health and Clinical Excellence (NICE) recommended "endothermal" ablation (meaning endovenous thermal ablation) is the first line treatment for truncal venous reflux in varicose veins. The initial endovenous thermoablation devices were radiofrequency ablation and endovenous laser ablation. More recently, Glue (cyanoacrylate), endovenous steam and Clarivein (mechanochemical ablation or MOCA) have entered the market as new endovenous techniques for the treatment of varicose veins. Glue and Clarivein do not require tumescent anaesthesia and do not use heat and therefore termed non-tumescent non-thermal (NTNT). Steam both requires tumescence and is also a thermal technique (TT). This article reviews the current position of these 3 new technologies in the treatment of varicose veins. © The Author(s) 2015.

[The acceptability of the NICE recommendations for schizophrenia in the Italian Departments of Mental Health. The SIEP-DIRECT'S Project on the discrepancy between routine practice and evidence].

PubMed

Semisa, Domenico; Lasalvia, Antonio; Miceli, Maurizio; Dall'Agnola, Rosa Bruna; Pucci, Cristina; Bissoli, Sarah; Visani, Enrico; Pismataro, Carmine Pasquale; Vanetti, Michele; Pioli, Rosaria; Ruggeri, Mirella; Lora, Antonio

2008-01-01

This paper aims at presenting the most significant results emerging from the work carried out by the focus groups of the multi-centre Project SIEP-DIRECT'S. The Project is aimed at assessing the existing discrepancies between the evidence-based NICE guidelines for schizophrenia and the usual practices of care given by Italian mental health services. Each focus group was requested to give an evaluation on: (a) appropriateness of the English NICE guidelines in the context of the Italian mental health services; (b) clarity and usefulness of the 103 indicators developed on the basis of the NICE recommendations to measure their level of application within the services. In each of the 19 mental health departments or psychiatric services participating in the Project there were organized "multidisciplinary" focus groups and "specialistic" focus groups. The former included, amongst others, professional operators of the mental health services, patients, their relatives, representatives of patient organizations and general practitioners. They examined the recommendations and indicators upon which the participants could express their opinion or judgment based on their knowledge, experience or information in their possession. The latter group, composed only of psychiatrists, examined the recommendations and indicators relative to pharmacological treatments that regarded the specific competences of their professional category. Most NICE recommendations seemed appropriate to the working context of the Italian services. However, some perplexity emerged as regards specific organizational models of the services, such as the specific services for psychotic onsets or the assertive outreach teams, which were believed not to be strictly pertinent to the traditional organization of mental health care in our Country. There were also some criticisms regarding the cognitive-behavioural treatments which the NICE Guidelines recommend as the principle psychotherapeutic option for patients with schizophrenia, since in many Italian services, when the use of psychological interventions are needed, the tendency is to prefer interventions based on psychodynamic theories. The SIEP indicators were generally held to be clear and acceptable. In the view of the focus groups, the NICE guidelines are on the whole useful and suitable for orientating the services in the choice of more efficacious practices in the treatment of patients with schizophrenia. Moreover, the results obtained legitimate the use of the set of SIEP indicators for the evaluation of good practices and the quality of care offered by Italian services. Finally, the use of focus groups delines to a different context as well as the verification of the comprehensibility and applicability of SIEP indicators.

23. VIEW OF SECTION DRAWINGS. THE SECTION LINES CUT THE ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

23. VIEW OF SECTION DRAWINGS. THE SECTION LINES CUT THE BUILDING EAST-WEST. THE ORIGINAL DRAWING HAS BEEN ARCHIVED ON MICROFILM. THE DRAWING WAS REPRODUCED AT THE BEST QUALITY POSSIBLE. LETTERS AND NUMBERS IN THE CIRCLES INDICATE FOOTER AND/OR COLUMN LOCATIONS. - Rocky Flats Plant, Uranium Rolling & Forming Operations, Southeast section of plant, southeast quadrant of intersection of Central Avenue & Eighth Street, Golden, Jefferson County, CO

NICE recommendations for psychotherapy in depression: Of limited clinical utility.

PubMed

McQueen, D; Smith, P St John

2015-01-01

In 2009/10 NICE partially updated its guidelines on the treatment and management of depression in adults. Due to methodological shortcomings the recommendations for psychotherapy must be treated with caution. Despite recognising the heterogeneous and comorbid nature of depression, and the limitations of depression as a unitary diagnostic category, NICE treats depression as if it were a unitary entity differentiated only by severity. The guidance ignores important aetiological factors such as trauma, loss and maltreatment, personality and interpersonal difficulties. It excludes the largest naturalistic studies on clinical populations treated in the National Health Service on the grounds that they are observational studies conducted in heterogeneous groups with mixed neurotic disorders. It unquestioningly accepts that the "brand" of psychotherapy has construct validity, and ignores psychotherapy process research indicating significant commonalities, and overlap, between treatment modalities and evidence that individual practitioner effects are larger than the differences between treatment modalities. It fails to consider patient differences and preferences, which are known to influence uptake, completion and response. It takes an exclusively short-term perspective on a chronic relapsing disorder. It does not consider the evidence for longer-term treatments. It is of special concern that NICE misrepresents the findings of its own systematic review by implying that CBT and IPT are superior treatments. NICE's systematic review actually found no evidence of superiority between CBT, IPT, psychodynamic psychotherapy, or counselling. Based on the exclusion of much clinically relevant research demonstrating the effectiveness of psychodynamic psychotherapy and counselling many commentators have alleged a bias towards CBT in the guidance. With regard to service delivery NICE proposes the replacement of psychiatric assessment and individualised treatment plans, with an unproven stepped-care model. These clinical and theoretical limitations, perceived bias in the selection of studies, neglect of patient differences, preferences and values, misrepresentation of results of the systematic review, and the proposal for an unproven service delivery model together seriously undermine the validity of the guidance. The guidance, lacking validity is of questionable use, it undermines patient autonomy, professional expertise and, ultimately, patient welfare.

Doppler-broadened NICE-OHMS beyond the cavity-limited weak absorption condition - II: Experimental verification

NASA Astrophysics Data System (ADS)

Hausmaninger, Thomas; Silander, Isak; Ma, Weiguang; Axner, Ove

2016-01-01

Doppler-broadened (Db) noise-immune cavity-enhanced optical heterodyne molecular spectrometry (NICE-OHMS) is normally described by an expression, here termed the conventional (CONV) description, that is restricted to the conventional cavity-limited weak absorption condition (CCLWA), i.e. when the single pass absorbance is significantly smaller than the empty cavity losses, i.e. when α0 L < < π / F. To describe NICE-OHMS signals beyond this limit two simplified extended descriptions (termed the extended locking and extended transmission description, ELET, and the extended locking and full transmission description, ELFT), which are assumed to be valid under the relaxed cavity-limited weak absorption condition (RCLWA), i.e. when α0 L < π / F, and a full description (denoted FULL), presumed to be valid also when the α0 L < π / F condition does not hold, have recently been derived in an accompanying work (Ma W, et al. Doppler-broadened NICE-OHMS beyond the cavity-limited weak absorption condition - I. Theoretical Description. J Quant Spectrosc Radiat Transfer, 2015, http://dx.doi.org/10.1016/j.jqsrt.2015.09.007). The present work constitutes an experimental verification and assessment of the validity of these, performed in the Doppler limit for a set of Fα0 L / π values (up to 3.5); it is shown under which conditions the various descriptions are valid. It is concluded that for samples with Fα0 L / π up to 0.01, all descriptions replicate the data well. It is shown that the CONV description is adequate and provides accurate assessments of the signal strength (and thereby the analyte concentration) up to Fα0 L / π of around 0.1, while the ELET is accurate for Fα0 L / π up to around 0.3. The ELFT description mimics the Db NICE-OHMS signal well for Fα0 L / π up to around unity, while the FULL description is adequate for all Fα0 L / π values investigated. Access to these descriptions both increases considerably the dynamic range of the technique and facilitates calibration using certified reference gases, which thereby significantly broadens the applicability of the Db NICE-OHMS technique.

A Diet Low in Fermentable Oligo-, Di-, and Monosaccharides and Polyols Improves Quality of Life and Reduces Activity Impairment in Patients With Irritable Bowel Syndrome and Diarrhea.

PubMed

Eswaran, Shanti; Chey, William D; Jackson, Kenya; Pillai, Sivaram; Chey, Samuel W; Han-Markey, Theresa

2017-12-01

We investigated the effects of a diet low in fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) vs traditional dietary recommendations on health-related quality of life (QOL), anxiety and depression, work productivity, and sleep quality in patients with irritable bowel syndrome and diarrhea (IBS-D). We conducted a prospective, single-center, single-blind trial of 92 adult patients with IBS-D (65 women; median age, 42.6 years) randomly assigned to groups placed on a diet low in FODMAPs or a modified diet recommended by the National Institute for Health and Care Excellence (mNICE) for 4 weeks. IBS-associated QOL (IBS-QOL), psychosocial distress (based on the Hospital Anxiety and Depression Scale), work productivity (based on the Work Productivity and Activity Impairment), and sleep quality were assessed before and after diet periods. Eighty-four patients completed the study (45 in the low-FODMAP group and 39 in the mNICE group). At 4 weeks, patients on the diet low in FODMAPs had a larger mean increase in IBS-QOL score than did patients on the mNICE diet (15.0 vs 5.0; 95% CI, -17.4 to -4.3). A significantly higher proportion of patients in the low-FODMAP diet group had a meaningful clinical response, based on IBS-QOL score, than in the mNICE group (52% vs 21%; 95% CI, -0.52 to -0.08). Anxiety scores decreased in the low-FODMAP diet group compared with the mNICE group (95% CI, 0.46-2.80). Activity impairment was significantly reduced with the low-FODMAP diet (-22.89) compared with the mNICE diet (-9.44; 95% CI, 2.72-24.20). In a randomized, controlled trial, a diet low in FODMAPs led to significantly greater improvements in health-related QOL, anxiety, and activity impairment compared with a diet based on traditional recommendations for patients with IBS-D. ClinicalTrials.gov, number NCT01624610. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

CEDAR/TIMED: Thermospheric Vertical Wind Observations from Three Sites in the Northern Auroral Zone

NASA Technical Reports Server (NTRS)

Lummerzheim, D.

2005-01-01

The objective of this project was to operate ground based Fabry-Perot Interferometers at several points under the auroral zone to analyze and quantify the vertical wind in the thermosphere. These measurements were made in conjunction with TIMED, especially GUVI data, to relate the observed wind to the resulting mixing and compositional changes in the thermosphere. The ground based wind measurements were obtained from a scanning Doppler imager (SDI) in Poker Flat, and a vertically aligned Fabry Perot Imager (FPI) in Inuvik. A third FPI at Eagle, Alaska, was operated for a brief overlapping period as well. The SDI at Poker Flat had been in operation for several years, and was continued to run with little support from this grant. The much more expensive operation, maintenance, and data acquisition of the remote Inuvik FPI was made possible with funds from this project. During the 2003/2004 and 2004/2005 seasons, we operated the Inuvik FPI from September to April during hours of darkness. Two trips to service the instrument were required per year, and a local caretaker was funded to help keep the instrument going during the winter seasons. The data were transfered via modem and phone line to Poker Flat and were then analyzed to obtain wind and temperature at the altitude of the auroral green line OI(557.7 nm). The final data product was archived and transferred to the GEDDS system at Poker Flat were it is available on the web: http://gedds.pfrr.alaska.edu/. The data set is also available from the CEDAR data base: http://cedarweb.hao.ucar.edu/.

Residual Strahls in Solar Wind Electron Dropouts: Signatures of Magnetic Connection to the Sun, Disconnection, or Interchange Reconnection?

NASA Technical Reports Server (NTRS)

Crooker, N. U.; Pagel, C.

2008-01-01

A recent assessment of suprathermal electron heat flux dropouts (HFDs) in the solar wind eliminated 90% as possible signatures of field lines disconnected from the Sun at both ends (Pagel et al., 2005b). The primary reason for elimination was the presence of a residual field-aligned strahl presumably signaling field lines connected to the Sun. Using high-time-resolution data from the Wind spacecraft, this paper tests whether the residual strahls were an artifact of averaging over pitch angle distributions (PADs) with and without strahls. An automated search for PADs without strahls (flat PADs) yields an occurrence rate of only 14% within HFDs, but a detailed case study shows that these flat PADs are imbedded within intervals of nearly flat PADs, that is, PADS with residual strahls that cannot be artifacts of averaging. An attractive alternative is that the residual strahls result from intermixing of originally back-scattered fluxes (haloes) of unequal intensities on field lines that have either disconnected or interchange reconnected at the Sun. A reevaluation of reported streaming of higher-energy electrons in HFDs suggests a similar cause. While the high-time-resolution data show high variability of PAD profiles within HFDs, this paper reopens the possibility that a substantial fraction signal disconnection or interchange reconnection. Estimated occurrence rates of fields having undergone these processes based upon published HFD rates are of the same order of magnitude as the surprisingly low values of 1-5% recently predicted by a model of a balanced heliospheric flux budget (Owens and Crooker, 2007).

From Progressive to Flat: How Tax Reform would Affect the Military

DTIC Science & Technology

2012-06-01

l,e:s dedJe1ic:n. Al:taeh Fam eoco 36 36 Add lines23 Uro ~.gh 3:5 36 37 Subtract line36 1rom line :22. ThS S vour adjusted gross income .. 37 156...name I Fore1111 provtnce/county I For«11’P05tilco:le tJI"Uf, ’NiUr. $SID9) lO ~IS ~n:1 Ct’l:Ctang I IIC. DD’ •• ld cti !’Qt )’OUf l&x or ""’ .... 0 Yov

Interaction of part-through cracks in a flat plate

NASA Technical Reports Server (NTRS)

Aksel, B.; Erdogan, F.

1985-01-01

The accuracy of the line spring model is determined. The effect of interaction between two and three cracks is investigated, and extensive numerical results which may be useful in applications are provided. Line spring model with Reissner's plate theory is formulated to be used for any number and configurations of cracks provided that there is symmetry. This model is used to find stress intensity factors for elliptic internal cracks, elliptic edge cracks and two opposite elliptic edge cracks. Despite the simplicity of the line spring model, the results are found to be close.

Spectral Atlas of X-ray Lines Emitted During Solar Flares Based on CHIANTI

NASA Technical Reports Server (NTRS)

Landi, E.; Phillips, K. J. H.

2005-01-01

A spectral atlas of X-ray lines in the wavelength range 7.47-18.97 Angstroms is presented, based on high-resolution spectra obtained during two M-class solar flares (on 1980 August 25 and 1985 July 2) with the Flat Crystal Spectrometer on board the Solar Maximum Mission. The physical properties of the flaring plasmas are derived as a function of time using strong, isolated lines. From these properties predicted spectra using the CHIANTI database have been obtained which were then compared with wavelengths and fluxes of lines in the observed spectra to establish line identifications. identifications for nearly all the observed lines in the resulting atlas are given, with some significant corrections to previous analysis of these flare spectra.

Cross Coating Weight Control by Electromagnetic Strip Stabilization at the Continuous Galvanizing Line of ArcelorMittal Florange

NASA Astrophysics Data System (ADS)

Guelton, Nicolas; Lopès, Catherine; Sordini, Henri

2016-08-01

In hot dip galvanizing lines, strip bending around the sink roll generates a flatness defect called crossbow. This defect affects the cross coating weight distribution by changing the knife-to-strip distance along the strip width and requires a significant increase in coating target to prevent any risk of undercoating. The already-existing coating weight control system succeeds in eliminating both average and skew coating errors but cannot do anything against crossbow coating errors. It has therefore been upgraded with a flatness correction function which takes advantage of the possibility of controlling the electromagnetic stabilizer. The basic principle is to split, for every gage scan, the coating weight cross profile of the top and bottom sides into two, respectively, linear and non-linear components. The linear component is used to correct the skew error by realigning the knives with the strip, while the non-linear component is used to distort the strip in the stabilizer in such a way that the strip is kept flat between the knives. Industrial evaluation is currently in progress but the first results have already shown that the strip can be significantly flattened between the knives and the production tolerances subsequently tightened without compromising quality.

Mandatory implementation of NICE Guidelines for the care of bipolar disorder and other conditions in England and Wales.

PubMed

Morriss, Richard

2015-09-30

Bipolar disorder is a common long-term mental health condition characterised by episodes of mania or hypomania and depression resulting in disability, early death, and high health and society costs. Public money funds the National Institute of Healthcare and Clinical Excellence (NICE) to produce clinical guidelines by systematically identifying the most up to date research evidence and costing its main recommendations for healthcare organisations and professionals to follow in England and Wales. Most governments, including those of England and Wales, need to improve healthcare but at reduced cost. There is evidence, particularly in bipolar disorder, that systematically following clinical guidelines achieves these outcomes. NICE clinical guidelines, including those regarding bipolar disorder, remain variably implemented. They give clinicians and patients a non-prescriptive basis for deciding their care. Despite the passing of the Health and Social Care Act in 2012 in England requiring all healthcare organisations to consider NICE clinical guidelines in commissioning, delivering, and inspecting healthcare services, healthcare organisations in the National Health Service may ignore them with little accountability and few consequences. There is no mechanism to ensure that healthcare professionals know or consider them. Barriers to their implementation include the lack of political and professional leadership, the complexity of the organisation of care and policy, mistrust of some processes and recommendations of clinical guidelines, and a lack of a clear implementation model, strategy, responsibility, or accountability. Mitigation to these barriers is presented herein. The variability, safety, and quality of healthcare might be improved and its cost reduced if the implementation of NICE clinical guidelines, such as those for bipolar disorder, were made the minimum starting point for clinical decision-making and mandatory responsibilities of all healthcare organisations and professionals.

Antibiotic prophylaxis in dentistry: part II. A qualitative study of patient perspectives and understanding of the NICE guideline.

PubMed

Soheilipour, S; Scambler, S; Dickinson, C; Dunne, S M; Burke, M; Jabbarifar, S E; Newton, J T

2011-07-08

The National Institute for Health and Clinical Excellence (NICE) recommendations in 2008 for antibiotic prophylaxis before dental treatment contradict previous practice. There is a potential difficulty in explaining the new guidance to patients who have long believed that they must receive antibiotics before their dental treatment. This study investigated the patient-related barriers and facilitating factors in implementation of the NICE guidance. In-depth interviews were conducted with nine patients concerning their views about barriers and factors that could influence the implementation of the NICE guidance on antibiotic prophylaxis before dental treatment. Data were analysed using framework analysis. For patients the rationale for the NICE guidance was unclear. They understood that at the population level the risk of infective endocarditis was less than the risk of adverse reaction to antibiotics. However, on an individual level they felt that the latter risk was negligible given their previous experience of antibiotics. They were aware that standards of care change over time but were concerned that this may be an example where a mistake had been made. Patients felt that the characteristics of the person advising them about the new guidance were important in whether or not they would accept them - they wished to be advised by a clinician that they knew and trusted, and who was perceived as having appropriate expertise. Patients generally felt that they would be most reassured by information provided by a clinician who they felt they could trust and who was qualified to comment on the issue by respecting their autonomy. The implications of the findings for the development of patient information are discussed.

Likelihood of cesarean delivery after applying leading active labor diagnostic guidelines.

PubMed

Neal, Jeremy L; Lowe, Nancy K; Phillippi, Julia C; Ryan, Sharon L; Knupp, Amy M; Dietrich, Mary S; Thung, Stephen F

2017-06-01

Friedman, the United Kingdom's National Institute for Health and Care Excellence (NICE), and the American College of Obstetricians and Gynecologists/Society for Maternal-Fetal Medicine (ACOG/SMFM) support different active labor diagnostic guidelines. Our aims were to compare likelihoods for cesarean delivery among women admitted before vs in active labor by diagnostic guideline (within-guideline comparisons) and between women admitted in active labor per one or more of the guidelines (between-guideline comparisons). Active labor diagnostic guidelines were retrospectively applied to cervical examination data from nulliparous women with spontaneous labor onset (n = 2573). Generalized linear models were used to determine outcome likelihoods within- and between-guideline groups. At admission, 15.7%, 48.3%, and 10.1% of nulliparous women were in active labor per Friedman, NICE, and ACOG/SMFM diagnostic guidelines, respectively. Cesarean delivery was more likely among women admitted before vs in active labor per the Friedman (AOR 1.75 [95% CI 1.08-2.82] or NICE guideline (AOR 2.55 [95% CI 1.84-3.53]). Between guidelines, cesarean delivery was less likely among women admitted in active labor per the NICE guideline, as compared with the ACOG/SMFM guideline (AOR 0.55 [95% CI 0.35-0.88]). Many nulliparous women are admitted to the hospital before active labor onset. These women are significantly more likely to have a cesarean delivery. Diagnosing active labor before admission or before intervention to speed labor may be one component of a multi-faceted approach to decreasing the primary cesarean rate in the United States. The NICE diagnostic guideline is more inclusive than Friedman or ACOG/SMFM guidelines and its use may be the most clinically useful for safely lowering cesarean rates. © 2017 Wiley Periodicals, Inc.

Impact of the QOF and the NICE guideline in the diagnosis andmanagement of depression: a qualitative study

PubMed Central

Mitchell, Caroline; Dwyer, Rachel; Hagan, Teresa; Mathers, Nigel

2011-01-01

Background The National Institute for Health and clinical Excellence (NICE) depression guideline (2004) and the updated Quality and Outcomes Framework (QOF) ( 2006) in general practice have introduced the concepts of screening severity assessment, for example using the Patient Health Questionnaire 9 (PHQ-9), and ‘stepped care’ for depression. Aim To explore primary care practitioner perspectives on the clinical utility of the NICE guideline and the impact of the QOF on diagnosis and management of depression in routine practice. Design and setting Qualitative study using focus groups from four multidisciplinary practice teams with diverse populations in south Yorkshire. Method Four focus groups were conducted, using a topic guide and audiotaping. There were 38 participants: GPs, nurses, doctors in training, mental health workers, and a manager. Data analysis was iterative and thematic. Results The NICE guideline, with its embedded principles of holism and evidence-based practice, was viewed positively but its impact was compromised by resource and practitioner barriers to implementation. The perceived imposition of the screening questions and severity assessments (PHQ-9) with no responsive training had required practitioners to work hard to minimise negative impacts on their work, for example: constantly adapting consultations to tick boxes; avoiding triggering open displays of distress without the time to offer appropriate care; positively managing how their patients were labelled. Further confusion was experienced around the evolving content of psychological interventions for depression. Conclusion Organisational barriers to the implementation of the NICE guideline and the limited scope of the QOF highlight the need for policy makers to work more effectively with the complex realities of general practice in order to systematically improve the quality and delivery of ‘managed’ care for depression. PMID:21619752

Health benefit assessment of pharmaceuticals: An international comparison of decisions from Germany, England, Scotland and Australia.

PubMed

Fischer, Katharina Elisabeth; Heisser, Thomas; Stargardt, Tom

2016-10-01

Little is known on the performance of the newly introduced health benefit assessment process, AMNOG, in Germany compared to other health technology assessment agencies. We analysed whether decisions of the German Federal Joint Committee (FJC) deviate from decisions of the UK National Institute for Health and Care Excellence (NICE), the Scottish Medicines Consortium (SMC) and the Australian Pharmaceutical Benefits Advisory Committee (PBAC). We analysed decisions made for comparable patient subgroups by the four agencies between 2011 and 2014. First, decisions were compared (a) by their final outcome, i.e. whether a health benefit was identified, and (b) by the agencies' judgement on comparative effectiveness. Subsequently, we partially explored reasons for differences between HTA agencies. From the 192 FJC decisions, we identified 55 that overlapped with NICE, 166 with SMC and 119 with PBAC. FJC agreed with NICE in 40% in final outcome (Cohen's Kappa=-0.13). Similar results were obtained for FJC and SMC (47.6%, kappa=0.03) and FJC and PBAC (48.7%, kappa=0.07). Agreement increased when comparing judgements based on comparative effectiveness only. However, the FJC's final decision was positive only in 43.6%, 39.2% and 44.5% of the patient subgroups, as opposed to 74.5% (NICE), 68.7% (SMC), and 68.9% (PBAC), respectively. We show that the FJC - an agency relatively new in structurally assessing the health benefit of pharmaceuticals - deviates considerably in decisions compared to other HTA agencies. Our study also reveals that the FJC tends to appraise stricter than NICE. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Implementing core NICE guidelines for osteoarthritis in primary care with a model consultation (MOSAICS): a cluster randomised controlled trial.

PubMed

Dziedzic, K S; Healey, E L; Porcheret, M; Afolabi, E K; Lewis, M; Morden, A; Jinks, C; McHugh, G A; Ryan, S; Finney, A; Main, C; Edwards, J J; Paskins, Z; Pushpa-Rajah, A; Hay, E M

2018-01-01

To determine the effectiveness of a model osteoarthritis consultation, compared with usual care, on physical function and uptake of National Institute for Health and Care Excellence (NICE) osteoarthritis recommendations, in adults ≥45 years consulting with peripheral joint pain in UK general practice. Two-arm cluster-randomised controlled trial with baseline health survey. Eight general practices in England. 525 adults ≥45 years consulting for peripheral joint pain, amongst 28,443 population survey recipients. Four intervention practices delivered the model osteoarthritis consultation to patients consulting with peripheral joint pain; four control practices continued usual care. The primary clinical outcome of the trial was the SF-12 physical component score (PCS) at 6 months; the main secondary outcome was uptake of NICE core recommendations by 6 months, measured by osteoarthritis quality indicators. A Linear Mixed Model was used to analyse clinical outcome data (SF-12 PCS). Differences in quality indicator outcomes were assessed using logistic regression. 525 eligible participants were enrolled (mean age 67.3 years, SD 10.5; 59.6% female): 288 from intervention and 237 from control practices. There were no statistically significant differences in SF-12 PCS: mean difference at the 6-month primary endpoint was -0.37 (95% CI -2.32, 1.57). Uptake of core NICE recommendations by 6 months was statistically significantly higher in the intervention arm compared with control: e.g., increased written exercise information, 20.5% (7.9, 28.3). Whilst uptake of core NICE recommendations was increased, there was no evidence of benefit of this intervention, as delivered in this pragmatic randomised trial, on the primary outcome of physical functioning at 6 months. ISRCTN06984617. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Glycolic acid 15% plus salicylic acid 2%: a new therapeutic pearl for facial flat warts.

PubMed

Rodríguez-Cerdeira, Carmen; Sánchez-Blanco, Elena

2011-09-01

Facial flat warts are a contagious viral disease that can cause disturbing cosmetic problems. Topical glycolic acid has been reported to be effective in dermatological treatment depending on the exfoliant capacity, but has not often been reported to be effective in the treatment of facial flat warts. The aim of this paper was to evaluate the efficacy and safety of glycolic acid 15% topical gel plus salicylic acid 2% in the treatment of recalcitrant facial flat warts. A total of 20 consecutive patients 7 to 16 years of age with recalcitrant facial flat warts were enrolled in this study. Patients having warts by the eye and lip regions were excluded from the study. A fine layer of face gel was applied to the treatment area once daily. Most of the participants had tried different treatments with no success. Assessments for the response and the occurrence of side effects were performed every two weeks at Weeks 2, 4, 6, and 8. All the patients were clinically cured within eight weeks. Seven patients cleared in four weeks, and 13 patients cleared in eight weeks. No noticeable adverse events were related to the skin. Topical gel of glycolic acid 15% plus salicylic acid 2% is safe and effective when applied to facial flat warts once daily until clearance and may be considered as first-line treatment.

The computational structural mechanics testbed architecture. Volume 4: The global-database manager GAL-DBM

NASA Technical Reports Server (NTRS)

Wright, Mary A.; Regelbrugge, Marc E.; Felippa, Carlos A.

1989-01-01

This is the fourth of a set of five volumes which describe the software architecture for the Computational Structural Mechanics Testbed. Derived from NICE, an integrated software system developed at Lockheed Palo Alto Research Laboratory, the architecture is composed of the command language CLAMP, the command language interpreter CLIP, and the data manager GAL. Volumes 1, 2, and 3 (NASA CR's 178384, 178385, and 178386, respectively) describe CLAMP and CLIP and the CLIP-processor interface. Volumes 4 and 5 (NASA CR's 178387 and 178388, respectively) describe GAL and its low-level I/O. CLAMP, an acronym for Command Language for Applied Mechanics Processors, is designed to control the flow of execution of processors written for NICE. Volume 4 describes the nominal-record data management component of the NICE software. It is intended for all users.

Flat field concave holographic grating with broad spectral region and moderately high resolution.

PubMed

Wu, Jian Fen; Chen, Yong Yan; Wang, Tai Sheng

2012-02-01

In order to deal with the conflicts between broad spectral region and high resolution in compact spectrometers based on a flat field concave holographic grating and line array CCD, we present a simple and practical method to design a flat field concave holographic grating that is capable of imaging a broad spectral region at a moderately high resolution. First, we discuss the principle of realizing a broad spectral region and moderately high resolution. Second, we provide the practical method to realize our ideas, in which Namioka grating theory, a genetic algorithm, and ZEMAX are used to reach this purpose. Finally, a near-normal-incidence example modeled in ZEMAX is shown to verify our ideas. The results show that our work probably has a general applicability in compact spectrometers with a broad spectral region and moderately high resolution.

Metallic line profiles of the AOV star Vega

NASA Technical Reports Server (NTRS)

Fletcher, J. Murray; Gulliver, Austin F.; Adelman, Saul J.; Crowley, Charles R.

1990-01-01

High dispersion ultrahigh signal to noise Reticon spectra of Vega were obtained with the coude spectrograph of the 1.2 m telescope. A mean signal to noise ratio of 2500 over the spectral region lambdas from 3825 to 5435 was achieved. Examination of the line profiles confirmed the presence of two different types of profiles which were previously seen in IIIaJ and lower signal to noise Reticon spectra. The profiles of the strong lines are essentially classical rotational profiles with enhanced wings which are slightly stronger than expected while those of weak lines are clearly flat-bottomed resulting in a trapezoidal appearance. A few possible theoretical explanations are presented.

Metallic line profiles of the AO V star Vega

NASA Technical Reports Server (NTRS)

Gulliver, Austin F.; Adelman, Saul J.; Cowley, Charles R.; Fletcher, J. M.

1991-01-01

High dispersion ultrahigh signal to noise Reticon spectra of Vega were obtained with the coude spectrograph of the 1.2 m telescope. A mean signal to noise ratio of 2500 over the spectral region lambdas from 3825 to 5435 was achieved. Examination of the line profiles confirmed the presence of two different types of profiles which were previously seen in IIIaJ and lower signal to noise Reticon spectra. The profiles of the strong lines are essentially classical rotational profiles with enhanced wings which are slightly stronger than expected while those of weak lines are clearly flat-bottomed resulting in a trapezoidal appearance. A few possible theoretical explanations are presented.

A time-series study of percutaneous closure of patent foramen ovale: premature adoption?

PubMed Central

Lew, Kian Nian; Angelini, Gianni D; Hollingworth, William

2016-01-01

Objectives To evaluate the impact of National Institute for Health and Care Excellence (NICE) guidance in January 2005 and subsequent trial evidence on the adoption of percutaneous closure of patent foramen ovale (PCPFO). Methods A retrospective time series study was conducted using the Inpatient Hospital Episode Statistics (HES) England. A total of 3801 patients, aged ≥18 and ≤60 years, who had PCPFO from 1 April 2006 to 31 March 2012 in England. Percentage change annualised (PCA) in PCPFO procedure rates between initial NICE guidance and publication of trial results was analysed. Results Between Quarter 2, 2006 and Quarter 4, 2009, 2163 PCPFO procedures were performed, with an increasing PCA of 48.4%. The procedure rate peaked before the presentation of equivocal results from the first randomised controlled trial (RCT) in late 2010, and declined between Quarter 4, 2009 and Quarter 4, 2011 (PCA=−15.3%). Of more than 2300 patients recruited to three RCTs, only 71 were recruited in English hospitals. Conclusions PCPFO was rapidly adopted after the publication of initial NICE guidance despite the absence of RCT evidence of efficacy. Very few English patients participated in international RCTs of PCPFO, suggesting that NICE recommendations also failed to encourage the generation of RCT evidence. PMID:26835140

Transparency in practice: Evidence from 'verification analyses' issued by the Polish Agency for Health Technology Assessment in 2012-2015.

PubMed

Ozierański, Piotr; Löblová, Olga; Nicholls, Natalia; Csanádi, Marcell; Kaló, Zoltán; McKee, Martin; King, Lawrence

2018-01-08

Transparency is recognised to be a key underpinning of the work of health technology assessment (HTA) agencies, yet it has only recently become a subject of systematic inquiry. We contribute to this research field by considering the Polish Agency for Health Technology Assessment (AHTAPol). We situate the AHTAPol in a broader context by comparing it with the National Institute for Health and Care Excellence (NICE) in England. To this end, we analyse all 332 assessment reports, called verification analyses, that the AHTAPol issued from 2012 to 2015, and a stratified sample of 22 Evidence Review Group reports published by NICE in the same period. Overall, by increasingly presenting its key conclusions in assessment reports, the AHTAPol has reached the transparency standards set out by NICE in transparency of HTA outputs. The AHTAPol is more transparent than NICE in certain aspects of the HTA process, such as providing rationales for redacting assessment reports and providing summaries of expert opinions. Nevertheless, it is less transparent in other areas of the HTA process, such as including information on expert conflicts of interest. Our findings have important implications for understanding HTA in Poland and more broadly. We use them to formulate recommendations for policymakers.

NICE technology appraisals: working with multiple levels of uncertainty and the potential for bias.

PubMed

Brown, Patrick; Calnan, Michael

2013-05-01

One of the key roles of the English National Institute for Health and Clinical Excellence (NICE) is technology appraisal. This essentially involves evaluating the cost effectiveness of pharmaceutical products and other technologies for use within the National Health Service. Based on a content analysis of key documents which shed light on the nature of appraisals, this paper draws attention to the multiple layers of uncertainty and complexity which are latent within the appraisal process, and the often socially constructed mechanisms for tackling these. Epistemic assumptions, bounded rationality and more explicitly relational forms of managing knowledge are applied to this end. These findings are discussed in the context of the literature highlighting the inherently social process of regulation. A framework is developed which posits the various forms of uncertainty, and responses to these, as potential conduits of regulatory bias-in need of further research. That NICE's authority is itself regulated by other actors within the regulatory regime, particularly the pharmaceutical industry, exposes it to the threat of regulatory capture. Following Lehoux, it is concluded that a more transparent and reflexive format for technological appraisals is necessary. This would enable a more robust, defensible form of decision-making and moreover enable NICE to preserve its legitimacy in the midst of pressures which threaten this.

Seeing the NICE side of cost-effectiveness analysis: a qualitative investigation of the use of CEA in NICE technology appraisals.

PubMed

Bryan, Stirling; Williams, Iestyn; McIver, Shirley

2007-02-01

Resource scarcity is the raison d'être for the discipline of economics. Thus, the primary purpose of economic analysis is to help decision-makers when addressing problems arising due to the scarcity problem. The research reported here was concerned with how cost-effectiveness information is used by the National Institute for Health & Clinical Excellence (NICE) in national technology coverage decisions in the UK, and how its impact might be increased. The research followed a qualitative case study methodology with semi-structured interviews, supported by observation and analysis of secondary sources. Our research highlights that the technology appraisal function of NICE represents an important progression for the UK health economics community: new cost-effectiveness work is commissioned for each technology and that work directly informs national health policy. However, accountability in policy decisions necessitates that the information upon which decisions are based (including cost-effectiveness analysis, CEA) is accessible. This was found to be a serious problem and represents one of the main ongoing challenges. Other issues highlighted include perceived weaknesses in analysis methods and the poor alignment between the health maximisation objectives assumed in economic analyses and the range of other objectives facing decision-makers in reality. Copyright (c) 2006 John Wiley & Sons, Ltd.

Numerical investigation of the flat band Bloch modes in a 2D photonic crystal with Dirac cones

DOE PAGES

Zhang, Peng; Fietz, Chris; Tassin, Philippe; ...

2015-04-14

A numerical method combining complex-k band calculations and absorbing boundary conditions for Bloch waves is presented. We use this method to study photonic crystals with Dirac cones. We demonstrate that the photonic crystal behaves as a zero-index medium when excited at normal incidence, but that the zero-index behavior is lost at oblique incidence due to excitation of modes on the flat band. We also investigate the formation of monomodal and multimodal cavity resonances inside the photonic crystals, and the physical origins of their different line-shape features.

A penny saved is ten dollars earned: fifteen ways to lower overhead and boost the bottom line.

PubMed

Pollock, Kim

2013-01-01

As expenses rise and reimbursements remain flat or decline, it's more important than ever to scrutinize practice expenditures on a regular basis. This article provides tips for evaluating individual line items on the profit and loss statement and identifying expenses that can be reduced without sacrificing quality of care or patient satisfaction. When aggregated, even seemingly small reductions add up to big annual savings.

A Bayesian-based system to assess wave-driven flooding hazards on coral reef-lined coasts

USGS Publications Warehouse

Pearson, S. G.; Storlazzi, Curt; van Dongeren, A. R.; Tissier, M. F. S.; Reniers, A. J. H. M.

2017-01-01

Many low-elevation, coral reef-lined, tropical coasts are vulnerable to the effects of climate change, sea level rise, and wave-induced flooding. The considerable morphological diversity of these coasts and the variability of the hydrodynamic forcing that they are exposed to make predicting wave-induced flooding a challenge. A process-based wave-resolving hydrodynamic model (XBeach Non-Hydrostatic, “XBNH”) was used to create a large synthetic database for use in a “Bayesian Estimator for Wave Attack in Reef Environments” (BEWARE), relating incident hydrodynamics and coral reef geomorphology to coastal flooding hazards on reef-lined coasts. Building on previous work, BEWARE improves system understanding of reef hydrodynamics by examining the intrinsic reef and extrinsic forcing factors controlling runup and flooding on reef-lined coasts. The Bayesian estimator has high predictive skill for the XBNH model outputs that are flooding indicators, and was validated for a number of available field cases. It was found that, in order to accurately predict flooding hazards, water depth over the reef flat, incident wave conditions, and reef flat width are the most essential factors, whereas other factors such as beach slope and bed friction due to the presence or absence of corals are less important. BEWARE is a potentially powerful tool for use in early warning systems or risk assessment studies, and can be used to make projections about how wave-induced flooding on coral reef-lined coasts may change due to climate change.

Propagation dynamics of off-axis symmetrical and asymmetrical vortices embedded in flat-topped beams

NASA Astrophysics Data System (ADS)

Zhang, Xu; Wang, Haiyan

2017-11-01

In this paper, propagation dynamics of off-axis symmetrical and asymmetrical optical vortices(OVs) embedded in flat-topped beams have been explored numerically based on rigorous scalar diffraction theory. The distribution properties of phase and intensity play an important role in driving the propagation dynamics of OVs. Numerical results show that the single off-axis vortex moves in a straight line. The displacement of the single off-axis vortex becomes smaller, when either the order of flatness N and the beam size ω0are increased or the off-axis displacement d is decreased. In addition, the phase singularities of high order vortex beams can be split after propagating a certain distance. It is also demonstrated that the movement of OVs are closely related with the spatial symmetrical or asymmetrical distribution of vortex singularities field. Multiple symmetrical and asymmetrical optical vortices(OVs) embedded in flat-topped beams can interact and rotate. The investment of the propagation dynamics of OVs may have many applications in optical micro-manipulation and optical tweezers.

An audit of NICE guidelines on antenatal pelvic floor exercises.

PubMed

Ismail, Sharif I M F

2009-12-01

The National Institute for Health and Clinical Excellence (NICE) recommends antenatal pelvic floor exercises during first pregnancy to reduce postpartum stress incontinence. The aim of this audit was to assess patient awareness and compliance with this guideline. An anonymous self-constructed questionnaire was given to patients after their first delivery. A total of 223 questionnaires were returned over a 6-month period. Although 95% of patients were aware of the importance of pelvic floor exercises, only a limited proportion of them had the right information and a minority practised them. Printed material seemed to be very influential in getting the message across. The importance of giving information early in pregnancy and national awareness was shown in the suggestions for improvement. Patient awareness and actual practise of antenatal pelvic floor exercises did not meet NICE guidelines, calling for strategies to improve awareness and adherence.

The computational structural mechanics testbed architecture. Volume 5: The Input-Output Manager DMGASP

NASA Technical Reports Server (NTRS)

Felippa, Carlos A.

1989-01-01

This is the fifth of a set of five volumes which describe the software architecture for the Computational Structural Mechanics Testbed. Derived from NICE, an integrated software system developed at Lockheed Palo Alto Research Laboratory, the architecture is composed of the command language (CLAMP), the command language interpreter (CLIP), and the data manager (GAL). Volumes 1, 2, and 3 (NASA CR's 178384, 178385, and 178386, respectively) describe CLAMP and CLIP and the CLIP-processor interface. Volumes 4 and 5 (NASA CR's 178387 and 178388, respectively) describe GAL and its low-level I/O. CLAMP, an acronym for Command Language for Applied Mechanics Processors, is designed to control the flow of execution of processors written for NICE. Volume 5 describes the low-level data management component of the NICE software. It is intended only for advanced programmers involved in maintenance of the software.

Evaluation of a prototype correction algorithm to reduce metal artefacts in flat detector computed tomography of scaphoid fixation screws.

PubMed

Filli, Lukas; Marcon, Magda; Scholz, Bernhard; Calcagni, Maurizio; Finkenstädt, Tim; Andreisek, Gustav; Guggenberger, Roman

2014-12-01

The aim of this study was to evaluate a prototype correction algorithm to reduce metal artefacts in flat detector computed tomography (FDCT) of scaphoid fixation screws. FDCT has gained interest in imaging small anatomic structures of the appendicular skeleton. Angiographic C-arm systems with flat detectors allow fluoroscopy and FDCT imaging in a one-stop procedure emphasizing their role as an ideal intraoperative imaging tool. However, FDCT imaging can be significantly impaired by artefacts induced by fixation screws. Following ethical board approval, commercially available scaphoid fixation screws were inserted into six cadaveric specimens in order to fix artificially induced scaphoid fractures. FDCT images corrected with the algorithm were compared to uncorrected images both quantitatively and qualitatively by two independent radiologists in terms of artefacts, screw contour, fracture line visibility, bone visibility, and soft tissue definition. Normal distribution of variables was evaluated using the Kolmogorov-Smirnov test. In case of normal distribution, quantitative variables were compared using paired Student's t tests. The Wilcoxon signed-rank test was used for quantitative variables without normal distribution and all qualitative variables. A p value of < 0.05 was considered to indicate statistically significant differences. Metal artefacts were significantly reduced by the correction algorithm (p < 0.001), and the fracture line was more clearly defined (p < 0.01). The inter-observer reliability was "almost perfect" (intra-class correlation coefficient 0.85, p < 0.001). The prototype correction algorithm in FDCT for metal artefacts induced by scaphoid fixation screws may facilitate intra- and postoperative follow-up imaging. Flat detector computed tomography (FDCT) is a helpful imaging tool for scaphoid fixation. The correction algorithm significantly reduces artefacts in FDCT induced by scaphoid fixation screws. This may facilitate intra- and postoperative follow-up imaging.

Do NICE and CHI have no interest in safety? Opinion of the book NICE, CHI and the NHS reforms. Enabling excellence or imposing control?

PubMed

Fletcher, P

2000-08-01

Seventeen eminent and experienced people have contributed to this most valuable review of NICE and CHI and their potential impact on clinical practice in the UK. There is essentially 100% agreement that the basic concept is a good one; we all want to have the highest possible quality of clinical practice and improvements in health care. This is all motherhood and apple-pie stuff which goes without question but the problem is how it is put into effect. The contributors are also in agreement and fear that central desire for control will outweigh the benefits. The most recent NICE action, which was leaked to the media as a 'preliminary opinion', concerned the use of beta-interferon for the treatment of multiple sclerosis (MS). The opinion seems to be that beta-interferon is very expensive, that, yes, it does help some sufferers but, no, it does not help others and because it costs more than the NHS can afford no one can have it. This seems to me to be a most unsatisfactory outcome. Surely what clinical excellence demands is the refinement of diagnostic capabilities so that those who will benefit may be distinguished from those who will not. In the meantime we do the best we can even if it does mean that the NHS has to pay for some patients who do not respond. This is the inevitable consequence of the belief that a 'free' and comprehensive health service can be provided out of general taxation. Beta-interferon for the treatment of MS is an example of the observable fact that medical science is advancing at a rate considerably in excess of possible increases in funding. Possibly the most important problem identified in this book is the absence of a relevant, high quality data source for the preparation of the numerous guidelines that NICE is expected to produce each year. In a fully grown science a starting point for a quantitative procedure is the establishment of a baseline and, having done that, the scientist's next step is to produce a standard curve for use in the measurement of further investigations. I have said previously that medicine is not a fully grown science (which is one of the problems) but that does not mean that basic scientific method can be abandoned. What is the baseline for the evaluation of clinical practice? The best would be records of the progression of a disease-state in untreated patients. That, for obvious reasons, is clearly not possible so a compromise is unavoidable. Unfortunately we do not even have that compromise baseline so how do we know what is better and what is worse? In simple, single disease states and within the limits of RCTs that is sometimes possible but in a population composed of many elderly people with multiple pathology it is greatly more difficult. If NICE is to produce authoritative guidelines then its first task is to define a (compromise) baseline. For the readers of this journal the absence of safety as one of the measures of clinical excellence must be a matter of concern. All clinical interventions may be casually related to adverse reactions which may, on occasion, be serious or even fatal. Perhaps excluding safety was a conscious decision by those who created NICE. At the time of market approval information on safety is almost always limited to events occurring more frequently than 1 in 1000 exposures which is far below the desirable level of precision. If NICE is to provide advice at the time of market authorization or shortly after then it will never be in a position to include an acceptable evaluation of safety. So why give a hostage to fortune by mentioning it in NICE's remit? Time alone will tell whether NICE and CHI achieve health improvement or whether they prove to be no more than a political gesture.

Statically determined slip-line field solution for the axial forming force estimation in the radial-axial ring rolling process

NASA Astrophysics Data System (ADS)

Quagliato, Luca; Berti, Guido A.

2017-10-01

In this paper, a statically determined slip-line solution algorithm is proposed for the calculation of the axial forming force in the radial-axial ring rolling process of flat rings. The developed solution is implemented in an Excel spreadsheet for the construction of the slip-line field and the calculation of the pressure factor to be used in the force model. The comparison between analytical solution and authors' FE simulation allows stating that the developed model supersedes the previous literature ones and proves the reliability of the proposed approach.

The application of pentaprism scanning technology on the manufacturing of M3MP

NASA Astrophysics Data System (ADS)

Qi, Erhui; Hu, Haixiang; Hu, Haifei; Cole, Glen; Luo, Xiao; Ford, Virginia; Zhang, Xuejun

2016-10-01

The PSS (pentaprism scanning system) has advantages of simple structure, needless of reference flat, be able of on-site testing, etc, it plays an important role in large flat reflective mirror's manufacturing, especially the high accuracy testing of low order aberrations. The PSS system measures directly the slope information of the tested flat surface. Aimed at the unique requirement of M3MP, which is the prototype mirror of the tertiary mirror in TMT (Thirty Meter Telescope) project, this paper analyzed the slope distribution of low order aberrations, power and astigmatism, which is very important in the manufacturing process of M3MP. Then the sample route lines of PSS are reorganized and new data process algorism is implemented. All this work is done to improve PSS's measure sensitivity of power and astigmatism, for guiding the manufacturing process of M3MP.

Coronal Diagnostics of Intermediate Activity Star XI Boo A

NASA Technical Reports Server (NTRS)

Drake, Jeremy

2005-01-01

The analysis of Xi Boo A proved difficult to adapt to our line-by-line approach because of the strong wings of the RGS instrumental profile, as has been detailed in earlier reports. While progress was also delayed because of problems in using SAS v4, we succeeded in the past year or so to bring the analysis to conclusion. Abundances have been derived using both EPIC and RGS data, confirming earlier EUVE findings of a mild solar-like FIP effect, though with some evidence of a turn-up in abundances of elements with higher FIP. Plasma densities appear normal for a moderately active stellar corona. Xi Boo A nicely bridges the gap between the very active stars and stars like the Sun, and it indeed does appear that these are the stars in which the solar-like FIP effects begins to change to the "inverse FIP" type of effect seen in the very active stars. Probing this divide was the main goal of the proposal. These results are in the process of being prepared for publication, though we have not decided the target journal as yet.

The effects of NICE guidelines on the management of third molar teeth.

PubMed

McArdle, L W; Renton, T

2012-09-01

Third molar surgery (TMS) is probably one of the most commonly performed surgical procedures undertaken in the NHS. In 2000, the National Institute of Clinical Excellence (NICE) introduced guidelines relating to TMS. These recommended against the prophylactic removal of third molars and listed specific clinical indications for surgery. The impact of these guidelines has not been fully evaluated and this research hopes to focus the effect of these guidelines over the last ten years. Using data obtained from a variety of NHS databases such as HES (Eng & Wales), the NHSBSA and data from NHS Scotland, we looked at the age range of patients requiring third molar removal and the number of patients having third molars removed in both primary and secondary care environments from 1989 to 2009. In addition we looked at the clinical indications for TMS activity in secondary care. The mean age of patients increased from 25 years in 2000 to 32 years in 2010, with the modal (most common) age increasing from 26 to 29 years. After the introduction of clinical guidelines the number of patients requiring third molar removal in secondary care dropped by over 30%, however, since 2003 the number of patients has risen by 97%. There is also a significant increase in caries as an indication for third molar removal. More patients are requiring third molar removal with an increasing number of patients having caries related to their third molars. Patients are, on average, older confirming that the removal of third molars is shifting from a young adult population group to an older adult population group. NICE guidelines did appear to have contributed to a fall in the volume of third molars removed within the NHS post 2000. However, concluding that this reduction demonstrates the success of NICE's guidance would be a premature assumption. The number of patients now requiring third molar removal is comparable to that of the mid 1990s. NICE has influenced the management of patients with third molars but this has not resulted in any reduction in the number of patients requiring third molar removal. Coding and data collection for third molars is not uniform, leading to potential misrepresentation of data. This perhaps raises the issue that an improved universal coding system is required for the NHS and that the NICE guidelines need review.

Lightweight, Economical Device Alleviates Drop Foot

NASA Technical Reports Server (NTRS)

Deis, B. C.

1983-01-01

Corrective apparatus alleviates difficulties in walking for victims of drop foot. Elastic line attached to legband provides flexible support to toe of shoe. Device used with flat (heelless) shoes, sneakers, crepe-soled shoes, canvas shoes, and many other types of shoes not usable with short leg brace.

The connection between the giant optical outbursts of the flat spectrum radio quasars and the black hole precession

NASA Astrophysics Data System (ADS)

Bachev, Rumen

2018-02-01

Flat Spectrum Radio Quasars (FSRQ) are a part of the blazar family, which in addition to the dominated nonthermal jet emission shows signatures, normally associated with the presence of a standard thin accretion disk, such like thermal continuum and broad emission lines. Furthermore, there is emerging evidence that the FSRQ are more likely to exhibit giant outbursts in the optical, with amplitudes reaching sometimes up to five magnitudes, compared to their quiescent state. We give examples, compiled from the literature and public archives in support of this statement. The most promising mechanism to account for such outbursts appears to be the changing Doppler factor (orientation with respect to the line of sights) of the jet. We attribute such orientation changes of the jet to the presence of misaligned thin accretion disk, leading to a black hole/accretion disk precession. Such a scheme can explain why FSRQ tend to produce large outbursts while other blazar types do not.

Preparing Brigade Combat Team Soldiers for Mission Readiness Through Research on Intangible Psychological Constructs and their Applications: Validation and Pilot

DTIC Science & Technology

2015-01-01

and their Applications: Validation and Pilot Steven N. Aude Kenneth Nicely Michael A. Lodato ICF International Christopher L. Vowels...CONTRACT OR GRANT NUMBER W5J9CQ-11-0009 5b. PROGRAM ELEMENT NUMBER 622785 6. AUTHOR(S) Steven N. Aude, Kenneth Nicely, Michael A... Michael A. Lodato ICF International Christopher L. Vowels U.S. Army Research Institute Fort Hood Research Unit Brian T. Crabb

What is the current NHS service provision for patients severely affected by chronic fatigue syndrome/myalgic encephalomyelitis? A national scoping exercise

PubMed Central

McDermott, Clare; Al Haddabi, Atheer; Akagi, Hiroko; Selby, Michelle; Cox, Diane; Lewith, George

2014-01-01

Background Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), in its most severe clinical presentation, can result in patients becoming housebound and bedbound so unable to access most available specialist services. This presents particular clinical risks and treatment needs for which the National Institute for Health and Care Excellence (NICE) advises specialist medical care and monitoring. The extent of National Health Service (NHS) specialist provision in England for severe CFS/ME is currently unknown. Objectives To establish the current NHS provision for patients with severe CFS/ME in England. Setting and participants All 49 English NHS specialist CFS/ME adult services in England, in 2013. Method Cross-sectional survey by email questionnaire. Primary outcome measures Adherence to NICE guidelines for severe CFS/ME. Results All 49 services replied (100%). 33% (16/49) of specialist CFS/ME services provided no service for housebound patients. 55% (27/49) services did treat patients with severe CFS/ME and their interventions followed the NICE guidelines. The remaining services (12%, 6/49) offered occasional or minimal support where funding allowed. There was one NHS unit providing specialist inpatient CFS/ME provision in England. Conclusions Study findings highlight substantial variation in access to specialist care for patients with severe presentation of CFS/ME. Where treatment was provided, this appeared to comply with NICE recommendations for this patient group. PMID:24984956

Audit of Helicobacter pylori Testing in Microbiology Laboratories in England: To Inform Compliance with NICE Guidance and the Feasibility of Routine Antimicrobial Resistance Surveillance

PubMed Central

Allison, Rosalie; Lecky, Donna M.; Bull, Megan; Turner, Kim; Godbole, Gauri

2016-01-01

Introduction. The National Institute for Health and Clinical Excellence (NICE) guidance recommends that dyspeptic patients are tested for Helicobacter pylori using a urea breath test, stool antigen test, or serology. Antibiotic resistance in H. pylori is globally increasing, but treatment in England is rarely guided by susceptibility testing or surveillance. Aims. To determine compliance of microbiology laboratories in England with NICE guidance and whether laboratories perform culture and antibiotic susceptibility testing (AST). Methods. In 2015, 170 accredited English microbiology laboratories were surveyed, by email. Results. 121/170 (71%) laboratories responded; 96% provided H. pylori testing (78% on site). 94% provided H. pylori diagnosis using stool antigen; only four provided serology as their noninvasive test; 3/4 of these encouraged urea breath tests in their acute trusts. Only 22/94 (23%) of the laboratories performed H. pylori cultures from gastric biopsies on site; 9/22 performed AST, but the vast majority processed less than one specimen/week. Conclusions. Only five laboratories in England do not comply with NICE guidance; these will need the guidance reinforced. National surveillance needs to be implemented; culture-based AST would need to be centralised. Moving forward, detection of resistance in H. pylori from stool specimens using molecular methods (PCR) needs to be explored. PMID:27829836

Doing Pre-operative Investigations in Emergency Department; a Clinical Audit.

PubMed

Rafiq, Muhammad Salman; Rafiq, Maria; Rafiq, Muhammad Imran; Salman, Seema Gul; Hafeez, Sania

2017-01-01

Pre-operative investigations for emergency surgical patients differ between centers. Following established guidelines can reduce unnecessary investigation, cost of treatment and hospital stay. The present audit was carried out to evaluate the condition of doing pre-operative investigations for three common surgical emergencies compared to National Institute for Health and Care Excellence (NICE) guidelines and local criteria. A retrospective clinical audit of acute-appendicitis, abscess and hernia patients admitted to the emergency department was carried out over a one-year period from July 2014 to July 2015. Data of laboratory investigations, their indication, cost and duration of hospital stay was collected and compared with NICE-guidelines. A total of 201 patients were admitted to the emergency department during the audit period. These included 77(38.3%) cases of acute-appendicitis, 112 (55.7%) cases of abscesses, and 12 (6%) cases of hernia. Investigations not indicated by NICE-guidelines included 42 (20.9%) full blood counts, 29 (14.4%) random blood sugars, 26 (12.9%) urea tests, 4 (2%) chest x-rays, 13 (6.5%) electrocardiographs, and 58 (28.9%) urine analyses. These cost 25,675 Rupees (245.46 Dollars) in unnecessary investigation costs and 65.7 days of additional hospital stay. Unnecessary investigations for emergency surgical patients can be reduced by following NICE-guidelines. This will reduce workload on emergency services, treatment costs and the length of hospital stay.

Probabilistic sensitivity analysis for NICE technology assessment: not an optional extra.

PubMed

Claxton, Karl; Sculpher, Mark; McCabe, Chris; Briggs, Andrew; Akehurst, Ron; Buxton, Martin; Brazier, John; O'Hagan, Tony

2005-04-01

Recently the National Institute for Clinical Excellence (NICE) updated its methods guidance for technology assessment. One aspect of the new guidance is to require the use of probabilistic sensitivity analysis with all cost-effectiveness models submitted to the Institute. The purpose of this paper is to place the NICE guidance on dealing with uncertainty into a broader context of the requirements for decision making; to explain the general approach that was taken in its development; and to address each of the issues which have been raised in the debate about the role of probabilistic sensitivity analysis in general. The most appropriate starting point for developing guidance is to establish what is required for decision making. On the basis of these requirements, the methods and framework of analysis which can best meet these needs can then be identified. It will be argued that the guidance on dealing with uncertainty and, in particular, the requirement for probabilistic sensitivity analysis, is justified by the requirements of the type of decisions that NICE is asked to make. Given this foundation, the main issues and criticisms raised during and after the consultation process are reviewed. Finally, some of the methodological challenges posed by the need fully to characterise decision uncertainty and to inform the research agenda will be identified and discussed. Copyright (c) 2005 John Wiley & Sons, Ltd.

Entanglement entropy in Galilean conformal field theories and flat holography.

PubMed

Bagchi, Arjun; Basu, Rudranil; Grumiller, Daniel; Riegler, Max

2015-03-20

We present the analytical calculation of entanglement entropy for a class of two-dimensional field theories governed by the symmetries of the Galilean conformal algebra, thus providing a rare example of such an exact computation. These field theories are the putative holographic duals to theories of gravity in three-dimensional asymptotically flat spacetimes. We provide a check of our field theory answers by an analysis of geodesics. We also exploit the Chern-Simons formulation of three-dimensional gravity and adapt recent proposals of calculating entanglement entropy by Wilson lines in this context to find an independent confirmation of our results from holography.

An explanation for the anomalous wave profiles obtained in composition B-3 impacted by flat nosed steel rods

NASA Astrophysics Data System (ADS)

James, H. R.; Gustavsen, R. L.; Dattelbaum, D. M.

2017-01-01

In previous work involving firing flat nosed steel rods into the 60/40 RDX/TNT explosive Composition B-3, we found an apparently anomalous "hump" in particle velocity wave profiles. The "hump" occurred on the center-line established by the rod, and at relatively late times, > 1 µs, after detonation onset. Several explanations, including that of a late time reaction, were postulated. This report will present evidence that the anomalous late time "hump" is due to the arrival of rarefaction waves from the rod's periphery. Simple analytic calculations and reactive-burn hydro-code calculations will be presented supporting this hypothesis.

Nanocrystalline copper films are never flat

NASA Astrophysics Data System (ADS)

Zhang, Xiaopu; Han, Jian; Plombon, John J.; Sutton, Adrian P.; Srolovitz, David J.; Boland, John J.

2017-07-01

We used scanning tunneling microscopy to study low-angle grain boundaries at the surface of nearly planar copper nanocrystalline (111) films. The presence of grain boundaries and their emergence at the film surface create valleys composed of dissociated edge dislocations and ridges where partial dislocations have recombined. Geometric analysis and simulations indicated that valleys and ridges were created by an out-of-plane grain rotation driven by reduction of grain boundary energy. These results suggest that in general, it is impossible to form flat two-dimensional nanocrystalline films of copper and other metals exhibiting small stacking fault energies and/or large elastic anisotropy, which induce a large anisotropy in the dislocation-line energy.

A Large Sparse Aperture Densified Pupil Hypertelescope Concept for Ground Based Detection of Extra-Solar Earth-Like Planets

NASA Technical Reports Server (NTRS)

Gezari, D.; Lyon, R.; Woodruff, R.; Labeyrie, A.; Oegerle, William (Technical Monitor)

2002-01-01

A concept is presented for a large (10 - 30 meter) sparse aperture hyper telescope to image extrasolar earth-like planets from the ground in the presence of atmospheric seeing. The telescope achieves high dynamic range very close to bright stellar sources with good image quality using pupil densification techniques. Active correction of the perturbed wavefront is simplified by using 36 small flat mirrors arranged in a parabolic steerable array structure, eliminating the need for large delat lines and operating at near-infrared (1 - 3 Micron) wavelengths with flats comparable in size to the seeing cells.

Low-dose-rate brachytherapy for the treatment of localised prostate cancer in men with a high risk of disease relapse.

PubMed

Laing, Robert; Uribe, Jennifer; Uribe-Lewis, Santiago; Money-Kyrle, Julian; Perna, Carla; Chintzoglou, Stylianos; Khaksar, Sara; Langley, Stephen E M

2018-04-01

To report clinical outcomes of 125 I low-dose-rate prostate brachytherapy (LDR-PB) as monotherapy or combined with androgen-deprivation therapy (ADT) and/or external beam radiotherapy (EBRT) in high-risk localised prostate cancer. Analysis of clinical outcomes from a prospective cohort of patients treated with LDR-PB alone or combined treatment in a single institution. Men with a high risk of disease relapse were identified by the National Institute for Health and Care Excellence (NICE) criteria or by the National Comprehensive Cancer Network (NCCN) criteria. Relapse-free survival (RFS), overall survival (OS), prostate cancer-specific survival (PCSS), and metastases-free survival (MFS), were analysed together with patient-reported symptom scores and physician-reported adverse events. The NICE and NCCN criteria identified 267 and 202 high-risk patients, respectively. NICE-defined patients had significantly lower pre-treatment PSA levels, Gleason scores <7, and a greater proportion of patients who received LDR-PB monotherapy. At 9 years after implantation RFS was 89% and 87% in the NICE and NCCN groups, respectively (log-rank P = 0.637), and OS 93% and 94%, respectively (log-rank P = 0.481). All of the survival estimates were similar between LDR-PB monotherapy and combined therapies. Cox proportional hazards regression confirmed RFS was similar between the treatment types. Treatment-related toxicity was also similar between the treatment methods. LDR-PB is effective at controlling localised prostate cancer in patients with a high risk of disease relapse. As the present study was not randomised, it is not possible to define those patients who need the addition of ADT and/or EBRT. However, the NICE criteria appear suitable to define treatment options where patients could benefit from LDR-PB as monotherapy or combined treatment. This choice should be discussed with the patient taking into account comorbidities and presence of multiple high-risk factors. © 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.

Diagnosis of gestational diabetes mellitus: falling through the net.

PubMed

Meek, Claire L; Lewis, Hannah B; Patient, Charlotte; Murphy, Helen R; Simmons, David

2015-09-01

Gestational diabetes mellitus (GDM) is associated with increased risks to mother and child, but globally agreed diagnostic criteria remain elusive. Identification of women with GDM is important, as treatment reduces adverse outcomes such as perinatal death, shoulder dystocia and neonatal hypoglycaemia. Recently, the UK's National Institute for Health and Care Excellence (NICE) recommended new diagnostic thresholds for GDM which are different from the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria endorsed by the WHO. The study aim was to assess neonatal and obstetric outcomes among women who would test positive for the IADPSG criteria but negative for the NICE 2015 criteria. Data from 25,543 consecutive singleton live births (2004-2008) were obtained retrospectively from hospital records. Women were screened with a random plasma glucose (RPG; 12-16 weeks) and a 50 g glucose challenge test (GCT; 26-28 weeks). If RPG >7.0 mmol/l, GCT >7.7 mmol/l or symptoms were present, a 75 g OGTT was offered (n = 3,848). In this study, GDM prevalence was 4.13% (NICE 2015) and 4.62% (IADPSG). Women who 'fell through the net', testing NICE-negative but IADPSG-positive (n = 387), had a higher risk of having a large-for-gestational-age (LGA) infant (birthweight >90th percentile for gestational age; adjusted OR [95% CI] 3.12 [2.44, 3.98]), Caesarean delivery (1.44 [1.15, 1.81]) and polyhydramnios (6.90 [3.94, 12.08]) compared with women with negative screening results and no OGTT (n = 21,695). LGA risk was highest among women with fasting plasma glucose 5.1-5.5 mmol/l (n = 167): the mean birthweight was 350 g above that of the reference population and 37.7% of infants were LGA. The IADPSG criteria identify women at substantial risk of complications who would not be identified by the NICE 2015 criteria.

Are current UK National Institute for Health and Clinical Excellence (NICE) obesity risk guidelines useful? Cross-sectional associations with cardiovascular disease risk factors in a large, representative English population.

PubMed

Tabassum, Faiza; Batty, G David

2013-01-01

The National Institute for Health and Clinical Excellence (NICE) has recently released obesity guidelines for health risk. For the first time in the UK, we estimate the utility of these guidelines by relating them to the established cardiovascular disease (CVD) risk factors. Health Survey for England (HSE) 2006, a population-based cross-sectional study in England was used with a sample size of 7225 men and women aged ≥35 years (age range: 35-97 years). The following CVD risk factor outcomes were used: hypertension, diabetes, total and high density lipoprotein cholesterol, glycated haemoglobin, fibrinogen, C-reactive protein and Framingham risk score. Four NICE categories of obesity were created based on body mass index (BMI) and waist circumference (WC): no risk (up to normal BMI and low/high WC); increased risk (normal BMI & very high WC, or obese & low WC); high risk (overweight & very high WC, or obese & high WC); and very high risk (obese I & very high WC or obese II/III with any levels of WC. Men and women in the very high risk category had the highest odds ratios (OR) of having unfavourable CVD risk factors compared to those in the no risk category. For example, the OR of having hypertension for those in the very high risk category of the NICE obesity groupings was 2.57 (95% confidence interval 2.06 to 3.21) in men, and 2.15 (1.75 to 2.64) in women. Moreover, a dose-response association between the adiposity groups and most of the CVD risk factors was observed except total cholesterol in men and low HDL in women. Similar results were apparent when the Framingham risk score was the outcome of interest. In conclusion, the current NICE definitions of obesity show utility for a range of CVD risk factors and CVD risk in both men and women.

Are Current UK National Institute for Health and Clinical Excellence (NICE) Obesity Risk Guidelines Useful? Cross-Sectional Associations with Cardiovascular Disease Risk Factors in a Large, Representative English Population

PubMed Central

Tabassum, Faiza; Batty, G. David

2013-01-01

The National Institute for Health and Clinical Excellence (NICE) has recently released obesity guidelines for health risk. For the first time in the UK, we estimate the utility of these guidelines by relating them to the established cardiovascular disease (CVD) risk factors. Health Survey for England (HSE) 2006, a population-based cross-sectional study in England was used with a sample size of 7225 men and women aged ≥35 years (age range: 35–97 years). The following CVD risk factor outcomes were used: hypertension, diabetes, total and high density lipoprotein cholesterol, glycated haemoglobin, fibrinogen, C-reactive protein and Framingham risk score. Four NICE categories of obesity were created based on body mass index (BMI) and waist circumference (WC): no risk (up to normal BMI and low/high WC); increased risk (normal BMI & very high WC, or obese & low WC); high risk (overweight & very high WC, or obese & high WC); and very high risk (obese I & very high WC or obese II/III with any levels of WC. Men and women in the very high risk category had the highest odds ratios (OR) of having unfavourable CVD risk factors compared to those in the no risk category. For example, the OR of having hypertension for those in the very high risk category of the NICE obesity groupings was 2.57 (95% confidence interval 2.06 to 3.21) in men, and 2.15 (1.75 to 2.64) in women. Moreover, a dose-response association between the adiposity groups and most of the CVD risk factors was observed except total cholesterol in men and low HDL in women. Similar results were apparent when the Framingham risk score was the outcome of interest. In conclusion, the current NICE definitions of obesity show utility for a range of CVD risk factors and CVD risk in both men and women. PMID:23844088

An experimental water line list at 1950 K in the 6250-6670 cm-1 region

NASA Astrophysics Data System (ADS)

Rutkowski, Lucile; Foltynowicz, Aleksandra; Schmidt, Florian M.; Johansson, Alexandra C.; Khodabakhsh, Amir; Kyuberis, Aleksandra A.; Zobov, Nikolai F.; Polyansky, Oleg L.; Yurchenko, Sergei N.; Tennyson, Jonathan

2018-01-01

An absorption spectrum of H216O at 1950 K is recorded in a premixed methane/air flat flame using a cavity-enhanced optical frequency comb-based Fourier transform spectrometer. 2417 absorption lines are identified in the 6250-6670 cm-1 region with an accuracy of about 0.01 cm-1. Absolute line intensities are retrieved using temperature and concentration values obtained by tunable diode laser absorption spectroscopy. Line assignments are made using a combination of empirically known energy levels and predictions from the new POKAZATEL variational line list. 2030 of the observed lines are assigned to 2937 transitions, once blends are taken into account. 126 new energy levels of H216O are identified. The assigned transitions belong to 136 bands and span rotational states up to J = 27 .

30. INTERIOR VIEW TO THE NORTH OF THE WEST CORRIDOR ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

30. INTERIOR VIEW TO THE NORTH OF THE WEST CORRIDOR OF THE BASEMENT IN THE HOT DISASSEMBLY AREA. ELECTRIC MOTORS LINE THE WEST WALL. - Nevada Test Site, Reactor Maintenance Assembly & Dissassembly Facility, Area 25, Jackass Flats, Junction of Roads F & G, Mercury, Nye County, NV

Characteristics of depositional environments in the Nakdong River Estuary, South Korea

NASA Astrophysics Data System (ADS)

Woo, Han Jun; Lee, Jun-Ho; Kang, Jeongwon; Choi, Jae Ung

2017-04-01

Most of the major Korean estuaries, under high pressure from development, have dams with environmental problems, including restricted water circulation, low water quality, decreased biodiversity and wetland destruction. The Nakdong estuary on the southeastern coast of Korean Peninsula is an enclosed type with two large estuarine dams that were constructed in 1934 and between 1983 and 1987. The construction of dams has led to geomorphologic evolution of the barrier islands within Nakdong estuary. The estuary has been characterized as barrier-lagoon system with various subenvironments and microtidal with a 1.5 m tidal range. The sedimentary analyses and monitoring short-term sedimentation rates were investigated to understand characteristics of depositional environments in barrier-lagoon system of the Nakdong River Estuary. The surface sediments in the system were classified into three sedimentary facies in summer 2015. Generally, sand sediment was dominated in the seaward side of barrier islands and muddy sand sediment was dominated on the lagoon. Sandy mud and mud sediments were distributed in the tidal flat near Noksan industrial district and channels near dams. Fourteen a priori subenvironments were distinguished based on differences in landscape characterization (sediment texture, salinity, total organic carbon, pH and C/N ratios). The dendrogram resulting from cluster analysis of environmental variables from 14 a priori subenvironments could be clustered into 4 groups that were characterized by different sediment texture and hydrodynamic energy. The short-term sedimentation rates were obtained seasonally from three lines by burying a plate at sub-bottom depth from May 2015 to May 2016. The deposition was dominated on the tidal flat between mainland and Jinudo (JW- Line) and Sinjado (SJ-Line) with the net deposition rate of 10.09 mm/year and 12.38 mm/year, respectively. The erosion was dominated on the tidal flats at Eulsukdo (ES-Line) on the east side of the system with an annual erosion rate of -13.15 mm/year. Two 12.5-hours anchoring surveys at inlets were revealed that net suspended sediments were transported to the open sea during a tidal cycle in summer 2015 and 2016. The sedimentary processes of the anthropogenically altered barrier-lagoon system in Nakdong estuary showed that sediments transported into the lagoon through inlets during flood condition and moved to westward and deposited sediments on the tidal flat and channels near dams in low energy environments. In the east side of the system, sediments flowed out the sea with discharge from Nakdong Dam during ebb condition. These data will provide an important baseline for future assessments of environmental quality on dam open.

Carrington Maps of Ca II K-Line Emission for the Years 1915-1985

DTIC Science & Technology

2011-03-03

contained relatively large numbers of faculae (Sheeley 2008) 6 The Astrophysical Journal, 730:51 (17pp), 2011 March 20 Sheeley, Cooper, & Anderson...The Astrophysical Journal, 730:51 (17pp), 2011 March 20 doi:10.1088/0004-637X/730/1/51 Copyright is not claimed for this article. All rights reserved... Astrophysical Journal, 730:51 (17pp), 2011 March 20 14. ABSTRACT We have used Mount Wilson Observatory calcium K-line images, digitized and flat fielded by the

5. VIEW LOOKING SOUTH DOWN SIXTH STREET AT THE INTERSECTION ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. VIEW LOOKING SOUTH DOWN SIXTH STREET AT THE INTERSECTION WITH CENTRAL AVENUE. AS PART OF THE INITIAL SITE DEVELOPMENT, A RAILROAD SPUR, ACCESS ROADS, POWER LINES, AND TELEPHONE LINES WERE BUILT. ALL FACILITIES WERE HEATED BY STEAM GENERATED IN BUILDING 443 AND PIPED THROUGHOUT THE SITE. THE BUILDING IN THE BACKGROUND OF THE PHOTOGRAPH IS BUILDING 664, A LOW - LEVEL WASTE STORAGE FACILITY. - Rocky Flats Plant, Bounded by Indiana Street & Routes 93, 128 & 72, Golden, Jefferson County, CO

Helmet Mounted Eye Tracking for Virtual Panoramic Displays. Volume 1: Review of Current Eye Movement Measurement Technology

DTIC Science & Technology

1989-08-01

paths for integration with the off-aperture and dual-mirror VPD designs. PREFACE The goal of this work was to explore integration of an eye line-of- gaze ...Relationship in one plane between point-of- gaze on a flat scene and relative eye, detector, and scene positions...and eye line-of- gaze measurement. As a first step towards the design of an appropriate eye trac.<ing system for interface with the virtual cockpit

Theoretical investigations into the influence of the position of a breaking line on the tensile failure of flat, round, bevel-edged tablets using finite element methodology (FEM) and its practical relevance for industrial tablet strength testing.

PubMed

Podczeck, Fridrun; Newton, J Michael; Fromme, Paul

2014-12-30

Flat, round tablets may have a breaking ("score") line. Pharmacopoeial tablet breaking load tests are diametral in their design, and industrially used breaking load testers often have automatic tablet feeding systems, which position the tablets between the loading platens of the machine with the breaking lines in random orientation to the applied load. The aim of this work was to ascertain the influence of the position of the breaking line in a diametral compression test using finite element methodology (FEM) and to compare the theoretical results with practical findings using commercially produced bevel-edged, scored tablets. Breaking line test positions at an angle of 0°, 22.5°, 45°, 67.5° and 90° relative to the loading plane were studied. FEM results obtained for fully elastic and elasto-plastic tablets were fairly similar, but they highlighted large differences in stress distributions depending on the position of the breaking line. The stress values at failure were predicted to be similar for tablets tested at an angle of 45° or above, whereas at lower test angles the predicted breaking loads were up to three times larger. The stress distributions suggested that not all breaking line angles would result in clean tensile failure. Practical results, however, did not confirm the differences in the predicted breaking loads, but they confirmed differences in the way tablets broke. The results suggest that it is not advisable to convert breaking loads obtained on scored tablets into tablet tensile strength values, and comparisons between different tablets or batches should carefully consider the orientation of the breaking line with respect to the loading plane, as the failure mechanisms appear to vary. Copyright © 2014 Elsevier B.V. All rights reserved.

Transmission line design for a power distribution system at 20 kHz for aircraft

NASA Technical Reports Server (NTRS)

Zelby, L. W.; Mathes, J. B.; Shawver, J. W.

1986-01-01

A low inductance, low characteristic impedance transmission line was designed for a 20 kHz power distribution system. Several different conductor configurations were considered: strip lines, interdigitated metal ribbons, and standard insulated wires in multiwire configurations (circular and rectangular cylindrical arrangements). The final design was a rectangular arrangement of multiple wires of the same gauge with alternating polarities from wire to wire. This offered the lowest inductance per unit length (on the order of several nanohenries/meter) and the lowest characteristic impedance (on the order of one Ohm). Standard multipin connectors with gold-plated elements were recommended with this transmission line, the junction boxes to be internally connected with flat metal ribbons for low inductance, and the line to be constructed in sections of suitable length. Computer programs for the calculation of inductance of multiwire lines and of capacitances of strip lines were developed.

Severe Weather Guide - Mediterranean Ports. 11. Nice

DTIC Science & Technology

1988-03-01

CAPTAIN’S SUMMARY Nice is located on the south coast of France in the region known as the French Riviera (Figure 2-1), about 12 n mi west of the Italian...southern coast of France in the region known as the French Riviera approximately 12 n mi west of the Italian border. High mountains back the coastline...CA 93943-5006 9. PROCUREMENT INSTRUMENT IDENTIFICATION NUMBER N00228-84-D-3187 10. SOURCE OF FUNDING NUMBERS PROGRAM ELEMENT NO. PROJECT NO

The Gordon Conference on Inorganic Chemistry Held in Wolfboro, New Hampshire on 30 July-3 August 1990

DTIC Science & Technology

1991-06-01

Amgerst, MA 01002 Facultad De Ciencias Exactas Y Naturales Pabellon 1 - C Universitaria Dissado, Leonard N4 Buenos Aires 1428 Kings College Argentina...Laboratories 6 Universitatstrasse 2nd Floor B-2 Zurich Switzerland CH-8092 Rochester NY 14652-3208 Diebold, Michael P. Dunham, Stephen Dupont De Nemours...Laboratoire De Chimie Moleculaire Univ. of Paris-Sud URAAU CNRS Laboratoire De Chimie Theorique Univ. De Nice, Parc Vairose Batiment 490 Nice France 06034

The nuclear region of low luminosity flat radio spectrum sources. II. Emission-line spectra

NASA Astrophysics Data System (ADS)

Gonçalves, A. C.; Serote Roos, M.

2004-01-01

We report on the spectroscopic study of 19 low luminosity Flat Radio Spectrum (LL FRS) sources selected from Marchã's et al. (\\cite{March96}) 200 mJy sample. In the optical, these objects are mainly dominated by the host galaxy starlight. After correcting the data for this effect, we obtain a new set of spectra clearly displaying weak emission lines; such features carry valuable information concerning the excitation mechanisms at work in the nuclear regions of LL FRS sources. We have used a special routine to model the spectra and assess the intensities and velocities of the emission lines; we have analyzed the results in terms of diagnostic diagrams. Our analysis shows that 79% of the studied objects harbour a Low Ionization Nuclear Emission-line Region (or LINER) whose contribution was swamped by the host galaxy starlight. The remaining objects display a higher ionization spectrum, more typical of Seyferts; due to the poor quality of the spectra, it was not possible to identify any possible large Balmer components. The fact that we observe a LINER-type spectrum in LL FRS sources supports the idea that some of these objects could be undergoing an ADAF phase; in addition, such a low ionization emission-line spectrum is in agreement with the black hole mass values and sub-Eddington accretion rates published for some FRS sources. Based on observations collected at the Multiple Mirror Telescope on Mt. Hopkins. Full Fig. 1 is only available in electronic form at http://www.edpsciences.org

Comparing patient access to pharmaceuticals in the UK and US.

PubMed

Cohen, Joshua; Cairns, Catherine; Paquette, Cherie; Faden, Laura

2006-01-01

The debate on access to new drugs has focused on the time lag between applications for approval and granting of marketing authorisation. This delay was identified as the first barrier with respect to patient access to new drugs, encompassing the hurdles of safety, efficacy and quality. Additional barriers have since been identified. These pertain to reimbursement and pricing of approved drugs, the so-called fourth and fifth hurdles. We reviewed 38 National Institute for Health and Clinical Excellence (NICE) guidance appraisals carried out between April 1999 and April 2005. These appraisals included 71 recently approved drugs considered to have either high clinical or cost impact. For each drug we first determined its marketing approval date by the British Medicines Healthcare Products Agency (MHRA) or European Medicines Evaluation Agency (EMEA). Secondly, we determined if each drug was approved by the US FDA for marketing and, if so, the date when it was approved. Thirdly, we considered whether and when each drug was recommended for reimbursement and use by NICE, and whether conditions of reimbursement applied. Fourthly, for the subset of FDA-approved drugs, we examined formulary placement, cost sharing and conditions of reimbursement on three-tier formularies used by seven leading US third-party payers serving Medicare beneficiaries. Fifthly, we reviewed each NICE recommendation to determine if cost-effectiveness data were referred to either in the appraisal documentation or in the final recommendation. Sixthly, we asked a spokesperson from each US payer whether cost-effectiveness assessments or rebates played a role in determining formulary placement of drugs in our sample, and whether there was a lag between marketing approval and reimbursement for any of the covered drugs. Of the 71 drugs contained in 38 NICE guidance appraisals, the US FDA approved 64. On average, the subset of 64 drugs received marketing authorisation in the US prior to the UK. On average, US plans covered 87% of the 64 drugs, the same percentage of drugs recommended for NHS reimbursement and use. Cost sharing in the US was significantly higher than in the UK, with wider variation across plans. On average, drugs covered in the US had fewer conditions of reimbursement (15%) than the percentage of drugs given conditions by NICE (46%). US plans were quicker to decide to reimburse drugs following marketing approval than NICE. The US provides faster, more flexible access to most, but not all, of the UK-approved pharmaceuticals in our sample. However, US patients have higher cost sharing than the UK and coverage is less evenly spread across the population. From a policy perspective, our study findings confirm the need to bolster the NICE fast-track initiative to decrease the amount of time it takes to appraise certain new pharmaceuticals. Also, the study findings point to the need in the US for careful monitoring of plan compliance with regulations pertaining to the Medicare drug benefit, particularly with respect to formulary restrictions and limits on cost sharing.

NICeSim: an open-source simulator based on machine learning techniques to support medical research on prenatal and perinatal care decision making.

PubMed

Cerqueira, Fabio Ribeiro; Ferreira, Tiago Geraldo; de Paiva Oliveira, Alcione; Augusto, Douglas Adriano; Krempser, Eduardo; Corrêa Barbosa, Helio José; do Carmo Castro Franceschini, Sylvia; de Freitas, Brunnella Alcantara Chagas; Gomes, Andreia Patricia; Siqueira-Batista, Rodrigo

2014-11-01

This paper describes NICeSim, an open-source simulator that uses machine learning (ML) techniques to aid health professionals to better understand the treatment and prognosis of premature newborns. The application was developed and tested using data collected in a Brazilian hospital. The available data were used to feed an ML pipeline that was designed to create a simulator capable of predicting the outcome (death probability) for newborns admitted to neonatal intensive care units. However, unlike previous scoring systems, our computational tool is not intended to be used at the patients bedside, although it is possible. Our primary goal is to deliver a computational system to aid medical research in understanding the correlation of key variables with the studied outcome so that new standards can be established for future clinical decisions. In the implemented simulation environment, the values of key attributes can be changed using a user-friendly interface, where the impact of each change on the outcome is immediately reported, allowing a quantitative analysis, in addition to a qualitative investigation, and delivering a totally interactive computational tool that facilitates hypothesis construction and testing. Our statistical experiments showed that the resulting model for death prediction could achieve an accuracy of 86.7% and an area under the receiver operating characteristic curve of 0.84 for the positive class. Using this model, three physicians and a neonatal nutritionist performed simulations with key variables correlated with chance of death. The results indicated important tendencies for the effect of each variable and the combination of variables on prognosis. We could also observe values of gestational age and birth weight for which a low Apgar score and the occurrence of respiratory distress syndrome (RDS) could be less or more severe. For instance, we have noticed that for a newborn with 2000 g or more the occurrence of RDS is far less problematic than for neonates weighing less. The significant accuracy demonstrated by our predictive model shows that NICeSim might be used for hypothesis testing to minimize in vivo experiments. We observed that the model delivers predictions that are in very good agreement with the literature, demonstrating that NICeSim might be an important tool for supporting decision making in medical practice. Other very important characteristics of NICeSim are its flexibility and dynamism. NICeSim is flexible because it allows the inclusion and deletion of variables according to the requirements of a particular study. It is also dynamic because it trains a just-in-time model. Therefore, the system is improved as data from new patients become available. Finally, NICeSim can be extended in a cooperative manner because it is an open-source system. Copyright © 2014 Elsevier B.V. All rights reserved.

Doppler-broadened NICE-OHMS beyond the cavity-limited weak absorption condition - I. Theoretical description

NASA Astrophysics Data System (ADS)

Ma, Weiguang; Silander, Isak; Hausmaninger, Thomas; Axner, Ove

2016-01-01

Doppler-broadened (Db) noise-immune cavity-enhanced optical heterodyne molecular spectrometry (NICE-OHMS) is conventionally described by an expression (here referred to as the CONV expression) that is restricted to the case when the single-pass absorbance, α0L, is much smaller than the empty cavity losses, π/F [here termed the conventional cavity-limited weak absorption (CCLWA) condition]. This limits the applicability of the technique, primarily its dynamic range and calibration capability. To remedy this, this work derives extended descriptions of Db NICE-OHMS that are not restricted to the CCLWA condition. First, the general principles of Db NICE-OHMS are scrutinized in some detail. Based solely upon a set of general assumptions, predominantly that it is appropriate to linearize the Beer-Lambert law, that the light is modulated to a triplet, and that the Pound-Drever-Hall sidebands are fully reflected, a general description of Db NICE-OHMS that is not limited to any specific restriction on α0L vs. π/F, here referred to as the FULL description, is derived. However, this description constitutes a set of equations to which no closed form solution has been found. Hence, it needs to be solved numerically (by iterations), which is inconvenient. To circumvent this, for the cases when α0L<π/F but without the requirement that the stronger CCLWA condition needs to be fulfilled, a couple of simplified extended expressions that are expressible in closed analytical form, referred to as the extended locking and extended transmission description, ELET, and the extended locking and full transmission description, ELFT, have been derived. An analysis based on simulations validates the various descriptions and assesses to which extent they agree. It is shown that in the CCLWA limit, all extended descriptions revert to the CONV expression. The latter one deviates though from the extended ones for α0L around and above 0.1π/F. The two simplified extended descriptions agree with the FULL description for a larger range of α0 L than the CONV expression, viz. for the ELET description for α0L up to 0.3π/F and for ELFT for α0L up to 0.6 or 1.0 π/F (depending on the mode of detection). It is then demonstrated that the conventional view of Db NICE-OHMS, which states that the out-of-phase and the in-phase signals can be referred to as a pure absorption and dispersion signal, respectively, breaks down when the CCLWA condition does not hold. In this case, the out-of-phase signal is additionally affected by the phase shifts of the laser components (i.e. dispersion) while the in-phase signal is also influenced by their attenuation. Access to new descriptions broadens considerably the dynamic range of Db NICE-OHMS and facilitates calibration using standard references samples, and thereby its applicability.

Spectrum of histopathological changes encountered in stented colorectal carcinomas.

PubMed

Fryer, Eve; Gorissen, Kim J; Wang, Lai Mun; Guy, Richard; Chetty, Runjan

2015-03-01

Self-expanding metallic stents (SEMS) are increasingly being used in obstructing colorectal cancer (CRC) as a 'bridge to surgery', allowing conversion of potentially high-risk emergency resections to elective procedures. Stenting may cause a wide array of histological changes. We present the largest series to date of stented CRC, performed and reported at a single institution. Stented CRC specimens received in January 2006 to December 2011 were identified from our pathology database. Slides for each case were independently reviewed by two pathologists, and a consensus was reached. A total of 72 CRCs were identified, 15 at or proximal to the splenic flexure, and 57 left-sided. Thirty-six were stage pT3 and 36 were stage pT4. Perforation was observed in 14 cases. The effects of stenting on the tumour included tumour necrosis (100%) and flat ulceration (77.8%). The spectrum of changes in the background bowel included mimics of inflammatory bowel disease, tumour regression post-neoadjuvant therapy, and ischaemia. Given the inclusion of stenting of CRC as a bridge to surgery in the current NICE guidelines, we expect to see increasing numbers of such cases. In our study, a range of changes were encountered that mimic other bowel diseases, from simple fissuring to chronic inflammatory bowel disease and neoadjuvant regression change. © 2014 John Wiley & Sons Ltd.

Curing behavior and reaction kinetics of binder resins for 3D-printing investigated by dielectric analysis (DEA)

NASA Astrophysics Data System (ADS)

Möginger, B.; Kehret, L.; Hausnerova, B.; Steinhaus, J.

2016-05-01

3D-Printing is an efficient method in the field of additive manufacturing. In order to optimize the properties of manufactured parts it is essential to adapt the curing behavior of the resin systems with respect to the requirements. Thus, effects of resin composition, e.g. due to different additives such as thickener and curing agents, on the curing behavior have to be known. As the resin transfers from a liquid to a solid glass the time dependent ion viscosity was measured using DEA with flat IDEX sensors. This allows for a sensitive measurement of resin changes as the ion viscosity changes two to four decades. The investigated resin systems are based on the monomers styrene and HEMA. To account for the effects of copolymerization in the calculation of the reaction kinetics it was assumed that the reaction can be considered as a homo-polymerization having a reaction order n≠1. Then the measured ion viscosity curves are fitted with the solution of the reactions kinetics - the time dependent degree of conversion (DC-function) - for times exceeding the initiation phase representing the primary curing. The measured ion viscosity curves can nicely be fitted with the DC-function and the determined fit parameters distinguish distinctly between the investigated resin compositions.

O-regime dynamics and modeling in Tore Supra

NASA Astrophysics Data System (ADS)

Turco, F.; Giruzzi, G.; Imbeaux, F.; Udintsev, V. S.; Artaud, J. F.; Barana, O.; Dumont, R.; Mazon, D.; Ségui, J.-L.

2009-06-01

The regime of nonlinear temperature oscillations (O-regime), characteristic of noninductive discharges on Tore Supra [Équipe Tore Supra, Proceedings of the 12th International Conference on Plasma Physics and Controlled Nuclear Fusion Research, Nice, France, 1988 (International Atomic Energy Agency, Vienna, 1989), Vol. 1, p. 9], is investigated in its triggering and suppressing mechanism. This regime can be described by two nonlinearly coupled equations for the current density j(r ) and the electron temperature Te(r) where the equation coefficients are functions of j and Te themselves. Both the integrated modeling code CRONOS [V. Basiuk et al., Nucl. Fusion 43, 822 (2003)] and a two-patch predator-prey system with diffusion and noise have been used and results have been compared to the experimental observations of the O-regime. A database of discharges is analyzed which features monotonic, flat, and reversed safety factor (q) profiles in order to characterize the action of external actuators on the regime dynamics with the widest generality. Electron cyclotron current drive and neutral beam injections have been used in order to induce localized perturbations in the total current profile j(r ) as well as to change the plasma confinement conditions in the central region. Magnetic shear perturbations and modifications of the heat transport turn out to be the central parameters governing the dynamics of the O-regime.

Highly Anisotropic Adhesive Film Made from Upside-Down, Flat, and Uniform Vertically Aligned CNTs.

PubMed

Hong, Sanghyun; Lundstrom, Troy; Ghosh, Ranajay; Abdi, Hamed; Hao, Ji; Jeoung, Sun Kyoung; Su, Paul; Suhr, Jonghwan; Vaziri, Ashkan; Jalili, Nader; Jung, Yung Joon

2016-12-14

We have created a multifunctional dry adhesive film with transferred vertically aligned carbon nanotubes (VA-CNTs). This unique VA-CNT film was fabricated by a multistep transfer process, converting the flat and uniform bottom of VA-CNTs grown on atomically flat silicon wafer substrates into the top surface of an adhesive layer. Unlike as-grown VA-CNTs, which have a nonuniform surface, randomly entangled CNT arrays, and a weak interface between the CNTs and substrates, this transferred VA-CNT film shows an extremely high coefficient of static friction (COF) of up to 60 and a shear adhesion force 30 times higher (12 N/cm 2 ) than that of the as-grown VA-CNTs under a very small preloading of 0.2 N/cm 2 . Moreover, a near-zero normal adhesion force was observed with 20 mN/cm 2 preloading and a maximum 100-μm displacement in a piezo scanner, demonstrating ideal properties for an artificial gecko foot. Using this unique structural feature and anisotropic adhesion properties, we also demonstrate effective removal and assembly of nanoparticles into organized micrometer-scale circular and line patterns by a single brushing of this flat and uniform VA-CNT film.

A Theoretically Based Behavioral Nutrition Intervention for Community Elders at High Risk: The B-NICE Randomized Controlled Clinical Trial

PubMed Central

LOCHER, JULIE L.; BALES, CONNIE W.; ELLIS, AMY C.; LAWRENCE, JEANNINE C.; NEWTON, LAURA; RITCHIE, CHRISTINE S.; ROTH, DAVID L.; BUYS, DAVID L.; VICKERS, KRISTIN S.

2012-01-01

We conducted a study designed to evaluate the efficacy and feasibility of a multilevel self-management intervention to improve nutritional intake in a group of older adults receiving Medicare home health services who were at especially high risk for experiencing undernutrition. The Behavioral Nutrition Intervention for Community Elders (B-NICE) trial used a prospective randomized controlled design to determine whether individually tailored counseling focused on social and behavioral aspects of eating resulted in increased caloric intake and improved nutrition-related health outcomes in a high-risk population of older adults. The study was guided by the theoretical approaches of the Ecological Model and Social Cognitive Theory. The development and implementation of the B-NICE protocol, including the theoretical framework, methodology, specific elements of the behavioral intervention, and assurances of the treatment fidelity, as well as the health policy implications of the trial results, are presented in this article. PMID:22098180

Do children go for the nice guys? The influence of speaker benevolence and certainty on selective word learning.

PubMed

Bergstra, Myrthe; DE Mulder, Hannah N M; Coopmans, Peter

2018-04-06

This study investigated how speaker certainty (a rational cue) and speaker benevolence (an emotional cue) influence children's willingness to learn words in a selective learning paradigm. In two experiments four- to six-year-olds learnt novel labels from two speakers and, after a week, their memory for these labels was reassessed. Results demonstrated that children retained the label-object pairings for at least a week. Furthermore, children preferred to learn from certain over uncertain speakers, but they had no significant preference for nice over nasty speakers. When the cues were combined, children followed certain speakers, even if they were nasty. However, children did prefer to learn from nice and certain speakers over nasty and certain speakers. These results suggest that rational cues regarding a speaker's linguistic competence trump emotional cues regarding a speaker's affective status in word learning. However, emotional cues were found to have a subtle influence on this process.

The topography of generosity: asymmetric evaluations of prosocial actions.

PubMed

Klein, Nadav; Epley, Nicholas

2014-12-01

Prosociality is considered a virtue. Those who care for others are admired, whereas those who care only for themselves are despised. For one's reputation, it pays to be nice. Does it pay to be even nicer? Four experiments assess reputational inferences across the entire range of prosocial outcomes in zero-sum interactions, from completely selfish to completely selfless actions. We observed consistent nonlinear evaluations: Participants evaluated selfish actions more negatively than equitable actions, but they did not evaluate selfless actions markedly more favorably than equitable actions. This asymptotic pattern reflected monotonic evaluations for increasingly selfish actions and insensitivity to increasingly selfless actions. It pays to be nice but not to be really nice. Additional experiments suggest that this pattern stems partly from failing to make spontaneous comparisons between varying degrees of selflessness. We suggest that these reputational incentives could guide social norms, encouraging equitable actions but discouraging extremely selfless actions. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Alcohol and sexual health in young people: the role of PSHE.

PubMed

Rowlinson, Louise

2014-12-01

This paper explores the relationship between sexual health and alcohol in young people in contemporary society, and the role of personal, social and health and economic education (PSHE). This research was prompted by the decision of the Department of Health (DH) not to publish National Institute for Health and Care Excellence (NICE) guidance on PSHE in January 2011. The guidance was requested following a Department for Education internal review into PSHE education. This paper will review qualitative and quantitative research, and data pertaining to the issue of sexual health behaviour and alcohol use among young people in the UK and the role of PSHE education. NICE guidance remains the 'gold standard' for evidence-based healthcare service provision and its implications for sexually transmitted infection and teenage pregnancy rates remains a high priority. Equally, research supports that addressing the issue of alcohol is an increasing priority in young people. This paper will argue that the NICE PSHE review findings should be updated, published and implemented.

Memories of good deeds past: The reinforcing power of prosocial behavior in children.

PubMed

Tasimi, Arber; Young, Liane

2016-07-01

Does considering one's past prosociality affect future behavior? Prior research has revealed instances in which adults engage in additional prosocial behavior-moral reinforcement-as well as instances in which adults engage in worse behavior-moral licensing. The current study examined the developmental origins of these effects by testing whether 6- to 8-year-old children (N=225) are more or less generous after recalling their own good deeds. Children were asked to recount a time when they were nice, were mean, or watched a movie. Children behaved more generously after recalling a time when they were nice. We show that this boost in generosity was not simply the result of instructing children to consider nice behavior; children's giving did not increase after recalling others' good deeds. We also show that, even after recounting multiple instances of their past goodness, children continue to behave more generously. These findings suggest that doing good leads to more good in children. Copyright © 2016 Elsevier Inc. All rights reserved.

SPECIAL ISSUE ON OPTICAL PROCESSING OF INFORMATION: Reconstruction of vector physical fields by optical tomography

NASA Astrophysics Data System (ADS)

Kulchin, Yurii N.; Vitrik, O. B.; Kamenev, O. T.; Kirichenko, O. V.; Petrov, Yu S.

1995-10-01

Reconstruction of vector physical fields by optical tomography, with the aid of a system of fibre-optic measuring lines, is considered. The reported experimental results are used to reconstruct the distribution of the square of the gradient of transverse displacements of a flat membrane.

3. NORTH ELEVATION OF THE HOT BAY, SHOWING RAILROAD TRACKS ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

3. NORTH ELEVATION OF THE HOT BAY, SHOWING RAILROAD TRACKS LEADING TO THE MASSIVE STEEL-LINED CONCRETE ENTRANCE DOOR. PART OF THE INTRICATE HVAC SYSTEM IS WEST (RIGHT) OF THE DOOR. - Nevada Test Site, Engine Maintenance Assembly & Disassembly Facility, Area 25, Jackass Flats, Mercury, Nye County, NV

On the existence of the field line solutions of the Einstein-Maxwell equations

NASA Astrophysics Data System (ADS)

Vancea, Ion V.

The main result of this paper is the proof that there are local electric and magnetic field configurations expressed in terms of field lines on an arbitrary hyperbolic manifold. This electromagnetic field is described by (dual) solutions of the Maxwell’s equations of the Einstein-Maxwell theory. These solutions have the following important properties: (i) they are general, in the sense that the knot solutions are particular cases of them and (ii) they reduce to the electromagnetic fields in the field line representation in the flat space-time. Also, we discuss briefly the real representation of these electromagnetic configurations and write down the corresponding Einstein equations.

Simulation of forming a flat forging

NASA Astrophysics Data System (ADS)

Solomonov, K.; Tishchuk, L.; Fedorinin, N.

2017-11-01

The metal flow in some of the metal shaping processes (rolling, pressing, die forging) is subjected to the regularities which determine the scheme of deformation in the metal samples upsetting. The object of the study was the research of the metal flow picture including the contour of the part, the demarcation lines of the metal flow and the flow lines. We have created an algorithm for constructing the metal flow picture, which is based on the representation of the metal flow demarcation line as an equidistant. Computer and physical simulation of the metal flow picture with the help of various software systems confirms the suggested hypothesis.

RF current sensor

DOEpatents

Moore, James A.; Sparks, Dennis O.

1998-11-10

An RF sensor having a novel current sensing probe and a voltage sensing probe to measure voltage and current. The current sensor is disposed in a transmission line to link all of the flux generated by the flowing current in order to obtain an accurate measurement. The voltage sensor is a flat plate which operates as a capacitive plate to sense voltage on a center conductor of the transmission line, in which the measured voltage is obtained across a resistance leg of a R-C differentiator circuit formed by the characteristic impedance of a connecting transmission line and a capacitance of the plate, which is positioned proximal to the center conductor.

Tri-linear color multi-linescan sensor with 200 kHz line rate

NASA Astrophysics Data System (ADS)

Schrey, Olaf; Brockherde, Werner; Nitta, Christian; Bechen, Benjamin; Bodenstorfer, Ernst; Brodersen, Jörg; Mayer, Konrad J.

2016-11-01

In this paper we present a newly developed linear CMOS high-speed line-scanning sensor realized in a 0.35 μm CMOS OPTO process for line-scan with 200 kHz true RGB and 600 kHz monochrome line rate, respectively. In total, 60 lines are integrated in the sensor allowing for electronic position adjustment. The lines are read out in rolling shutter manner. The high readout speed is achieved by a column-wise organization of the readout chain. At full speed, the sensor provides RGB color images with a spatial resolution down to 50 μm. This feature enables a variety of applications like quality assurance in print inspection, real-time surveillance of railroad tracks, in-line monitoring in flat panel fabrication lines and many more. The sensor has a fill-factor close to 100%, preventing aliasing and color artefacts. Hence the tri-linear technology is robust against aliasing ensuring better inspection quality and thus less waste in production lines.

Visualization of the contact line during the water exit of flat plates

NASA Astrophysics Data System (ADS)

Tassin, A.; Breton, T.; Forest, B.; Ohana, J.; Chalony, S.; Le Roux, D.; Tancray, A.

2017-08-01

We investigate experimentally the time evolution of the wetted surface during the lifting of a body initially floating at the water surface. This phenomenon is referred to as the water exit problem. The water exit experiments were conducted with transparent (PMMA) mock-ups of two different shapes: a circular disc and a square flat plate. Two different lighting systems were used to diffuse light in the mock-up material: a central high-power LED light normal to the surface and an edge-lighting system featuring an array of LED lights. These setups make it possible to illuminate the contact line, which delimits the surface of contact between the mock-up and the water. The characteristic size of the mock-ups is about 20 cm and the acceleration of the mock-up oscillates between 0 and 25 m/s^2. We show that the central light setup gives satisfactory results for the circular disc and that the edge lighting technique makes it possible to follow a contact line with a time-evolving complex shape (strong changes of convexity) up to 1000 fps. The observations presented in the paper support the possibility of extending this promising technique to more general three-dimensional bodies with arbitrary motion (e.g., including pitch motion).

Challenging current views on bile acid diarrhoea and malabsorption.

PubMed

Kurien, Matthew; Thurgar, Elizabeth; Davies, Ashley; Akehurst, Ron; Andreyev, Jervoise

2018-04-01

In 2012, the National Institute for Health and Care Excellence (NICE) assessed guidance (DG7) on the use of tauroselcholic ( 75 selenium) acid (also known as SeHCAT) for the investigation of diarrhoea due to bile acid malabsorption (BAM) in patients with IBS-D and in patients with Crohn's disease who have not had an ileal resection. NICE concluded that tauroselcholic ( 75 selenium) acid was recommended for use in research only. NICE will be reviewing the decision to update the guidance for tauroselcholic ( 75 selenium) acid, for these populations, in March 2017. Our aim is to summarise advances in BAM, also known as bile acid diarrhoea (BAD), and encourage clinicians to re-evaluate their understanding of this disorder. We review the prevalence, diagnosis and treatment of BAD/BAM. We describe the new evidence available since the original NICE review in 2012, and discuss the economic issues associated with failure to diagnose or to treat BAD/BAM accurately. There is new and compelling evidence available since DG7, which shows that tauroselcholic ( 75 selenium) acid scanning is a powerful tool in the diagnosis of BAD/BAM. We summarise published prevalence data (approximately 1% prevalence in the UK, as suggested by clinical practice diagnosis rates), and highlight that the true prevalence of BAD/BAM could be far greater than this. We present evidence that challenges current opinion about this disorder, and we commend both clinicians and health technology assessment (HTA) agencies for being open to arguments and new evidence in any future HTAs.

Blood transfusion practice in the UK and Ireland: a survey of palliative care physicians.

PubMed

Neoh, Karen; Stanworth, Simon; Bennett, Michael I

2018-03-23

Red cell (blood) transfusions are used in palliative care to manage patients with symptomatic anaemia or when patients have lost blood. We aimed to understand current blood transfusion practice among palliative medicine doctors and compare this with National Institute for Health and Care Excellence (NICE) guidance. NICE guidance advocates more restrictive transfusion practice but is based on clinical trials in non-palliative care contexts; the extent to which these findings should be applied to palliative care remains unclear. Four clinical vignettes of common clinical palliative care scenarios were developed. Members of the Association for Palliative Medicine were invited to complete the survey. Results were compared with acceptable responses based on current NICE recommendations and analysed to determine the influence of respondents' gender, experience or work setting. 27% of 1070 members responded. Overall, ideal or acceptable responses were selected by less than half of doctors to all four vignettes. Doctors were more liberal in prescribing blood transfusions than NICE guidance would advocate. Senior doctors were less likely to choose an acceptable response than junior colleagues. Palliative care practice is varied and not consistent with a restrictive blood transfusion policy. More recently trained doctors follow less liberal practices than senior colleagues. More direct evidence of benefits and harms of blood transfusion is needed in palliative care to inform practice. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The National Institute for Health and Clinical Excellence (NICE) guidelines for early detection of ovarian cancer: the pivotal role of the clinical laboratory.

PubMed

Sturgeon, Catharine M; Duffy, Michael J; Walker, Graeme

2011-07-01

The National Institute for Health and Clinical Excellence (NICE) has recently reviewed optimal means of early recognition and initial management of ovarian cancer, the leading cause of gynaecological death in the UK. The NICE guidelines state that general practitioners should measure serum CA125 in women presenting with persistent and continuous symptoms suggestive of ovarian cancer (e.g. abdominal distension, early satiety and loss of appetite or pelvic pain). If CA125 is ≥35 kU/L, the general practitioner should arrange an ultrasound scan of the abdomen and pelvis to enable calculation of the risk of malignancy score (RMI). Women with an RMI score of ≥250 should then be referred to a specialist multidisciplinary team. Successful implementation of these guidelines requires close liaison between primary care and laboratory medicine to ensure that CA125 is requested as a diagnostic aid only for women meeting the criteria stated in the guidelines. Preanalytical criteria must also be met and it is essential that both requestors and patients be aware of other possible causes of increases in CA125, as well as the fact that it is not raised in all patients with ovarian cancer. Guidance is being prepared to enable appropriate interpretation and implementation of the NICE guidelines. Continuous audit of the outcomes will also be essential to determine the effectiveness of this approach to early detection of ovarian cancer.

Deliberating Tarceva: A case study of how British NHS managers decide whether to purchase a high-cost drug in the shadow of NICE guidance.

PubMed

Hughes, David; Doheny, Shane

2011-11-01

This paper examines audio-recorded data from meetings in which NHS managers decide whether to fund high-cost drugs for individual patients. It investigates the work of a Welsh individual patient commissioning (IPC) panel responsible for sanctioning the purchase of 'un-commissioned' treatments for exceptional cases. The case study presented highlights the changing rationales used for approving or denying a cancer drug, Tarceva, during a period when NICE first suggested it was not cost effective, but then changed its position in a final technology appraisal recommending use when the cost did not exceed that of an alternative product. Our data show how decisions taken in the shadow of NICE guidance remain complex and subject to local discretion. Guidance that takes time to prepare, is released in stages, and relates to particular disease stages, must be interpreted in the context of particular cases. The case-based IPC panel discourse stands in tension with the standardised population-based recommendations in guidance. Panel members, who based their decisions on the central notions of 'efficacy' and 'exceptionality', often struggled to apply NICE information on cost-effectiveness to their deliberations on efficacy (clinical effectiveness). The case study suggests that the complex nature of decision making makes standardization of outcomes very difficult to achieve, so that local professional judgement is likely to remain central to health care rationing at this level. Copyright © 2011 Elsevier Ltd. All rights reserved.

Cardanols, long chain cyclohexenones and cyclohexenols from Lannea schimperi (Anacardiaceae).

PubMed

Okoth, Dorothy A; Koorbanally, Neil A

2015-01-01

Alkenyl cyclohexenones (1a-d), alkenyl cyclohexenols (2a-c and 3b-d) and cardanols (4a-d) were isolated from the stem bark and root of Lannea schimperi. The alkenyl cyclohexenones (1a and 1d) and cardanols (4a and 4d) have side chains which have not been reported previously, in combination with the core skeletal structures. In addition, compounds 2a-c and 3b-d are all new cyclohexenols. Also isolated were the triterpenes, taraxerone and taraxerol, and sitosterol. The suite of compounds isolated (cyclohexenones and cyclohexenols) make up a nice biosynthetic pathway to the cardanols. The 5-[alkenyl]-4,5- dihydroxycyclohex-2-enone mixture (1a-d) exhibited good in vitro cytotoxicity against the Chinese Hamster Ovarian mammalian cell-line. The compounds were identified mainly from GCMS and NMR spectroscopic techniques.

Pelvic floor muscle training for urinary incontinence postpartum.

PubMed

Hall, Bethany; Woodward, Sue

The offering of pelvic floor muscle exercises to all women during their first pregnancy is recommended by National Institute for Health and Care Excellence (NICE) guidelines. Pelvic floor muscles suffer significant trauma throughout pregnancy and childbirth, which may sometimes lead to urinary incontinence postpartum. However, it is uncertain how effective pelvic floor muscle exercises are in treating this incontinence. Several trials have been analysed to try to understand this question. Issues such as when the exercises were undertaken, how often they were performed and in what circumstances they were carried out, have all been considered. While it is still uncertain whether they are effective in reducing urinary incontinence postpartum, as they are non-invasive and fairly simple to carry out, they are still the first-line management for urinary incontinence postpartum with other treatments being considered if this is ineffective.

What and How Are We Evaluating? Meta-Evaluation Study of the NASA Innovations in Climate Education (NICE) Portfolio

NASA Astrophysics Data System (ADS)

Martin, A. M.; Barnes, M. H.; Chambers, L. H.; Pippin, M. R.

2011-12-01

As part of NASA's Minority University Research and Education Program (MUREP), the NASA Innovations in Climate Education (NICE) project at Langley Research Center has funded 71 climate education initiatives since 2008. The funded initiatives span across the nation and contribute to the development of a climate-literate public and the preparation of a climate-related STEM workforce through research experiences, professional development opportunities, development of data access and modeling tools, and educational opportunities in both K-12 and higher education. Each of the funded projects proposes and carries out its own evaluation plan, in collaboration with external or internal evaluation experts. Using this portfolio as an exemplar case, NICE has undertaken a systematic meta-evaluation of these plans, focused primarily on evaluation questions, approaches, and methods. This meta-evaluation study seeks to understand the range of evaluations represented in the NICE portfolio, including descriptive information (what evaluations, questions, designs, approaches, and methods are applied?) and questions of value (do these evaluations meet the needs of projects and their staff, and of NASA/NICE?). In the current climate, as federal funders of climate change and STEM education projects seek to better understand and incorporate evaluation into their decisions, evaluators and project leaders are also seeking to build robust understanding of program effectiveness. Meta-evaluations like this provide some baseline understanding of the current status quo and the kinds of evaluations carried out within such funding portfolios. These explorations are needed to understand the common ground between evaluative best practices, limited resources, and agencies' desires, capacity, and requirements. When NASA asks for evaluation of funded projects, what happens? Which questions are asked and answered, using which tools? To what extent do the evaluations meet the needs of projects and program officers? How do they contribute to best practices in climate science education? These questions are important to ask about STEM and climate literacy work more generally; the NICE portfolio provides a broad test case for thinking strategically, critically, and progressively about evaluation in our community. Our findings can inform the STEM education, communication, and public outreach communities, and prompt us to consider a broad range of informative evaluation options. During this presentation, we will consider the breadth, depth and utility of evaluations conducted through a NASA climate education funding opportunity. We will examine the relationship between what we want to know about education programs, what we want to achieve with our interventions, and what we ask in our evaluations.

What and How Are We Evaluating? Meta-Evaluation Study of the NASA Innovations in Climate Education (NICE) Portfolio

NASA Astrophysics Data System (ADS)

Martin, A. M.; Barnes, M. H.; Chambers, L. H.; Pippin, M. R.

2013-12-01

As part of NASA's Minority University Research and Education Program (MUREP), the NASA Innovations in Climate Education (NICE) project at Langley Research Center has funded 71 climate education initiatives since 2008. The funded initiatives span across the nation and contribute to the development of a climate-literate public and the preparation of a climate-related STEM workforce through research experiences, professional development opportunities, development of data access and modeling tools, and educational opportunities in both K-12 and higher education. Each of the funded projects proposes and carries out its own evaluation plan, in collaboration with external or internal evaluation experts. Using this portfolio as an exemplar case, NICE has undertaken a systematic meta-evaluation of these plans, focused primarily on evaluation questions, approaches, and methods. This meta-evaluation study seeks to understand the range of evaluations represented in the NICE portfolio, including descriptive information (what evaluations, questions, designs, approaches, and methods are applied?) and questions of value (do these evaluations meet the needs of projects and their staff, and of NASA/NICE?). In the current climate, as federal funders of climate change and STEM education projects seek to better understand and incorporate evaluation into their decisions, evaluators and project leaders are also seeking to build robust understanding of program effectiveness. Meta-evaluations like this provide some baseline understanding of the current status quo and the kinds of evaluations carried out within such funding portfolios. These explorations are needed to understand the common ground between evaluative best practices, limited resources, and agencies' desires, capacity, and requirements. When NASA asks for evaluation of funded projects, what happens? Which questions are asked and answered, using which tools? To what extent do the evaluations meet the needs of projects and program officers? How do they contribute to best practices in climate science education? These questions are important to ask about STEM and climate literacy work more generally; the NICE portfolio provides a broad test case for thinking strategically, critically, and progressively about evaluation in our community. Our findings can inform the STEM education, communication, and public outreach communities, and prompt us to consider a broad range of informative evaluation options. During this presentation, we will consider the breadth, depth and utility of evaluations conducted through a NASA climate education funding opportunity. We will examine the relationship between what we want to know about education programs, what we want to achieve with our interventions, and what we ask in our evaluations.

Peripheral Avascular Retina in a Term Male Neonate With Microvillus Inclusion Disease and Pancreatic Insufficiency.

PubMed

Paulus, Yannis M; Alcorn, Deborah M; Gaynon, Michael; Moshfeghi, Darius M

2015-05-01

The authors present the first case of peripheral avascular retina in a term male neonate with pancreatic exocrine insufficiency, atypical microvillus inclusion disease, flat tympanograms, and recurrent urinary tract infections. Clinical examination showed avascular peripheral retina to posterior zone II temporally, with a flat stage 1-like demarcation line, and no plus disease. Genetic testing results were normal. The patient developed peripheral neovascularization and underwent panretinal photocoagulation. This case likely represents mild Norrie disease, familial exudative vitreoretinopathy, or incontinentia pigmenti due to a Wnt signaling abnormality. While these conditions are usually more severe, a variable spectrum of Wnt abnormalities exists throughout the body. Copyright 2015, SLACK Incorporated.

Spectrophotometry of 2 complete samples of flat radio spectrum quasars

NASA Technical Reports Server (NTRS)

Wampler, E. J.; Gaskell, C. M.; Burke, W. L.; Baldwin, J. A.

1983-01-01

Spectrophotometry of two complete samples of flat-spectrum radio quasars show that for these objects there is a strong correlation between the equivalent width of the CIV wavelength 1550 emission line and the luminosity of the underlying continuum. Assuming Friedmann cosmologies, the scatter in this correlation is a minimum for q (sub o) is approximately 1. Alternatively, luminosity evolution can be invoked to give compact distributions for q (sub o) is approximately 0 models. A sample of Seyfert galaxies observed with IUE shows that despite some dispersion the average equivalent width of CIV wavelength 1550 in Seyfert galaxies is independent of the underlying continuum luminosity. New redshifts for 4 quasars are given.

Measurements of axisymmetric temperature and H2O concentration distributions on a circular flat flame burner based on tunable diode laser absorption tomography

NASA Astrophysics Data System (ADS)

Xia, Huihui; Kan, Ruifeng; Xu, Zhenyu; Liu, Jianguo; He, Yabai; Yang, Chenguang; Chen, Bing; Wei, Min; Yao, Lu; Zhang, Guangle

2016-10-01

In this paper, the reconstruction of axisymmetric temperature and H2O concentration distributions in a flat flame burner is realized by tunable diode laser absorption spectroscopy (TDLAS) and filtered back-projection (FBP) algorithm. Two H2O absorption transitions (7154.354/7154.353 cm-1 and 7467.769 cm-1) are selected as line pair for temperature measurement, and time division multiplexing technology is adopted to scan this two H2O absorption transitions simultaneously at 1 kHz repetition rate. In the experiment, FBP algorithm can be used for reconstructing axisymmetric distributions of flow field parameters with only single view parallel-beam TDLAS measurements, and the same data sets from the given parallel beam are used for other virtual projection angles and beams scattered between 0° and 180°. The real-time online measurements of projection data, i.e., integrated absorbance both for pre-selected transitions on CH4/air flat flame burner are realized by Voigt on-line fitting, and the fitting residuals are less than 0.2%. By analyzing the projection data from different views based on FBP algorithm, the distributions of temperature and concentration along radial direction can be known instantly. The results demonstrate that the system and the proposed innovative FBP algorithm are capable for accurate reconstruction of axisymmetric temperature and H2O concentration distribution in combustion systems and facilities.

Chemistry of the older supracrustals of Archaean age around Sargur

NASA Technical Reports Server (NTRS)

Janardhan, A. S.; Shadaksharaswamy, N.; Capdevila, R.

1988-01-01

In the Archaeans of the Karnataka craton two stratigraphically distinct volcano-sedimentary sequences occur, namely the older supracrustals of the Sargur type and the younger Dharwar greenstones. The dividing line between these is the 3 by old component of the Peninsular gneiss. The trace and rare earth element chemistry of the Sargur metasediments show, in general, marked similarity to the Archaean sediments. The significant departures are in the nickel and chromium abundances. The REE data of the Sargur pelites of the Terakanambi region represented by Silli-gt-bio-feldspar schists and paragneisses show LREE enrichment and flat to depleted HREE pattern. Banded iron formations have very low REE abundance. They show slightly enriched LREE and flat to depleted HREE pattern. REE abundance in the Mn-horizons is comparable to that of the Archaean sediments. Mn-horizons show enriched LREE and flat HREE with anamolous Eu. REE patterns of these bands is well evolved and has similarities with PAAS.

[An increase of infective endocarditis cases in England seen with concomitant reduction in antibiotic prophylaxis since the implementation of NICE guidelines in 2008: possible explanations].

PubMed

Tiberi, Simon; Pink, Frederick; Jayakumar, Angelina; Arioli, Francesco

2015-01-01

Dayer and colleagues recently reported in The Lancet an increased incidence of infective endocarditis in England since 2008, year of NICE guideline on the restriction of antibiotic prophylaxis. They observed a concomitant decrease in the use of antibiotic prophylaxis. The temporal link between reduction of prophylaxis prescribing and increase of infective endocarditis raises the question of whether there is a causal association. In view of this observation, should we rethink antibiotic prophylaxis to prevent infective endocarditis?

External cavity diode laser-based detection of trace gases with NICE-OHMS using current modulation.

PubMed

Centeno, R; Mandon, J; Cristescu, S M; Axner, O; Harren, F J M

2015-03-09

We combine an external cavity diode laser with noise-immune cavity-enhanced optical heterodyne molecular spectroscopy (NICE-OHMS) using current modulation. With a finesse of 1600, we demonstrate noise equivalent absorption sensitivities of 4.1 x 10(-10) cm(-1) Hz(-1/2), resulting in sub-ppbv detection limits for Doppler-broadened transitions of CH(4) at 6132.3 cm(-1), C(2)H(2) at 6578.5 cm(-1) and HCN at 6541.7 cm(-1). The system is used for hydrogen cyanide detection from sweet almonds.

Combat Vehicle Technology Report

DTIC Science & Technology

1992-05-01

to stay within the lines to meet optical scanning requirements. Block 1. Agency Use Only (Leave blank). Block 12a. Distribution/Availability Statement...Optronics ( Optical Energy Circuits)...-,..................... 465.3o Fiber Optics ....... ............ o..........o................... 46 5.4. Flat...Technology Objective Remarks Survivability o Protected Vision Enhanced Crew Function The application of filters and other optical (Directed Energy Through

United States housing brief, December 2017

Treesearch

Delton Alderman

2018-01-01

Although the aggregate U.S. housing market was mixed in December, both new single-family (SF) sales and starts were revised substantially downward. Other housing data appear to have flat-lined on a month-over-month basis. Regionally, data were mixed across all sectors. New SF construction and remodeling spending remain positive, increasing at an incremental pace.

7 CFR 51.2338 - Standard pack.

Code of Federal Regulations, 2013 CFR

2013-01-01

.... (c) Boxes, flats, lugs, or cartons: (1) Fruit packed in containers with cell compartments, cardboard fillers or molded trays shall be of proper size for the cells, fillers, or molds in which they are packed...” means the greatest dimension measured at right angles to a line from stem to blossom end. (f) In order...

7 CFR 51.2338 - Standard pack.

Code of Federal Regulations, 2014 CFR

2014-01-01

.... (c) Boxes, flats, lugs, or cartons: (1) Fruit packed in containers with cell compartments, cardboard fillers or molded trays shall be of proper size for the cells, fillers, or molds in which they are packed...” means the greatest dimension measured at right angles to a line from stem to blossom end. (f) In order...

My Pencils Have Names

ERIC Educational Resources Information Center

Block, Phillip

2011-01-01

As personal computers have evolved steadily into handhelds and teachers continue the march toward lining the walls of the classroom with flat screen work stations, many assume that the old-timey "number 2" lead yellow pencil is probably on the high road to extinction. Yet most classrooms still flow with them like miniature telephone poles fresh…

Transformer-Feedback Interstage Bandwidth Enhancement for MMIC Multistage Amplifiers

NASA Astrophysics Data System (ADS)

Nikandish, Gholamreza; Medi, Ali

2015-02-01

The transformer-feedback (TRFB) interstage bandwidth enhancement technique for broadband multistage amplifiers is presented. Theory of the TRFB bandwidth enhancement and the design conditions for maximum bandwidth, maximally flat gain, and maximally flat group delay are provided. It is shown that the TRFB bandwidth enhancement can provide higher bandwidth compared to the conventional techniques based on reactive impedance matching networks. A three-stage low-noise amplifier (LNA) monolithic microwave integrated circuit with the TRFB between its consecutive stages is designed and implemented in a 0.1- μm GaAs pHEMT process. The TRFB is realized by coupling between the drain bias lines of transistors. The reuse of bias lines leads to bandwidth enhancement without increasing the chip area and power consumption. The LNA features average gain of 23 dB and 3-dB bandwidth of 11-39 GHz. It provides a noise figure of 2.1-3.0 dB and an output 1-dB compression point of 8.6 dBm, while consuming 40 mA of current from a 2-V supply.

Confirmation of Down syndrome critical region by FISH analysis in a patient with add(21)(p11)

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

Matsumoto, Naomichi; Niikawa, Norio; Mikawa, Makoto

1995-12-04

We have studied a patient with clinical Down syndrome (DS) who has a mosaic 46, XX/46, XX, 21p+ karyotype. The patient was born at 39 weeks of gestation with a birth weight of 3,025 g to healthy parents. At age 2 months, she was diagnosed clinically to have DS; she had flat facies, upslanted palpebral fissures, epicanthal folds, telecanthus, flat nasal bridge, abnormal dentition, malformed ears, short neck, short fingers, clinodactyly with single flexion crease of the fifth fingers, hyperextension of joints, pes planus, distal axial triradii, and bilateral tibial arch patterns. Chromosome analysis showed mosaicism consisting of a normalmore » 46,XX cell line and a line with a 21p+ chromosome, the final karyotype being mos46,XX[57]/46,XX,add(21)(p11)[43]. Although the origin of an additional segment on chromosome 21 was not identified with conventional banding analyses, it was suspected to represent partial trisomy 21 on the basis of clinical manifestations. 6 refs., 2 figs.« less

The soft X-ray polychromator for the Solar Maximum Mission

NASA Technical Reports Server (NTRS)

Acton, L. W.; Finch, M. L.; Gilbreth, C. W.; Culhane, J. L.; Bentley, R. D.; Bowles, J. A.; Guttridge, P.; Gabriel, A. H.; Firth, J. G.; Hayes, R. W.

1980-01-01

The paper considers the soft X-ray polychromator (XRP) operating in the 1.4-22.4 A range of the soft X-ray spectrum which includes many emission lines important for the diagnosis of plasmas in the 1.5-50 million deg temperature range. The flat crystal scanning spectrometer provides for a channel polychromatic mapping of flares and active regions in the resonance lines of O VIII, Ne IX, and Mg XI; in its spectral scanning mode it covers essentially the entire 1.4-22.5 A region.

The soft X-ray polychromator for the Solar Maximum Mission

NASA Astrophysics Data System (ADS)

Acton, L. W.; Culhane, J. L.; Gabriel, A. H.; Bentley, R. D.; Bowles, J. A.; Firth, J. G.; Finch, M. L.; Gilbreth, C. W.; Guttridge, P.; Hayes, R. W.; Joki, E. G.; Jones, B. B.; Kent, B. J.; Leibacher, J. W.; Nobles, R. A.; Patrick, T. J.; Phillips, K. J. H.; Rapley, C. G.; Sheather, P. H.; Sherman, J. C.; Stark, J. P.; Springer, L. A.; Turner, R. F.; Wolfson, C. J.

1980-02-01

The paper considers the soft X-ray polychromator (XRP) operating in the 1.4-22.4 A range of the soft X-ray spectrum which includes many emission lines important for the diagnosis of plasmas in the 1.5-50 million deg temperature range. The flat crystal scanning spectrometer provides for a channel polychromatic mapping of flares and active regions in the resonance lines of O VIII, Ne IX, and Mg XI; in its spectral scanning mode it covers essentially the entire 1.4-22.5 A region.

A primary care audit of familial risk in patients with a personal history of breast cancer.

PubMed

Nathan, Paul; Ahluwalia, Aneeta; Chorley, Wendy

2014-12-01

Breast cancer is the most common cancer diagnosed in women, both in the UK and worldwide. A small proportion of women are at very high risk of breast cancer, having a particularly strong family history. The National Institute for Health and Clinical Excellence (NICE) has advised that practitioners should not, in most instances, actively seek to identify women with a family history of breast cancer. An audit was undertaken at an urban primary care practice of 15,000 patients, using a paper-based, self-administered questionnaire sent to patients identified with a personal history of breast cancer. The aim of this audit was to determine whether using targeted screening of relatives of patients with breast cancer to identify familial cancer risk is worthwhile in primary care. Since these patients might already expected to have been risk assessed following their initial diagnosis, this audit acts as a quality improvement exercise. The audit used a validated family history questionnaire and risk assessment tool as a screening approach for identifying and grading familial risk in line with the NICE guidelines, to guide referral to the familial cancer screening service. The response rate to family history questionnaires was 54 % and the majority of patients responded positively to their practitioner seeking to identify familial cancer risks in their family. Of the 57 returned questionnaires, over a half (54 %) contained pedigrees with individuals eligible for referral. Patients and their relatives who are often registered with the practice welcome the discussion. An appropriate referral can therefore be made. The findings suggest a role for primary care practitioners in the identification of those at higher familial risk. However integrated systems and processes need designing to facilitate this work.

A discrete event simulation to model the cost-utility of fingolimod and natalizumab in rapidly evolving severe relapsing-remitting multiple sclerosis in the UK.

PubMed

Montgomery, Stephen M; Maruszczak, Maciej J; Slater, David; Kusel, Jeanette; Nicholas, Richard; Adlard, Nicholas

2017-05-01

Two disease-modifying therapies are licensed in the EU for use in rapidly-evolving severe (RES) relapsing-remitting multiple sclerosis (RRMS), fingolimod and natalizumab. Here a discrete event simulation (DES) model to analyze the cost-effectiveness of natalizumab and fingolimod in the RES population, from the perspective of the National Health Service (NHS) in the UK, is reported. A DES model was developed to track individual RES patients, based on Expanded Disability Status Scale scores. Individual patient characteristics were taken from the RES sub-groups of the pivotal trials for fingolimod. Utility data were in line with previous models. Published costs were inflated to NHS cost year 2015. Owing to the confidential patient access scheme (PAS) discount applied to fingolimod in the UK, a range of discount levels were applied to the fingolimod list price, to capture the likelihood of natalizumab being cost-effective in a real-world setting. At the lower National Institute of Health and Care Excellence (NICE) threshold of £20,000/quality-adjusted life year (QALY), fingolimod only required a discount greater than 0.8% of list price to be cost-effective. At the upper threshold of £30,000/QALY employed by the NICE, fingolimod was cost-effective if the confidential discount is greater than 2.5%. Sensitivity analyses conducted using fingolimod list-price showed the model to be most sensitive to changes in the cost of each drug, particularly fingolimod. The DES model shows that only a modest discount to the UK fingolimod list-price is required to make fingolimod a more cost-effective option than natalizumab in RES RRMS.

Line segment extraction for large scale unorganized point clouds

NASA Astrophysics Data System (ADS)

Lin, Yangbin; Wang, Cheng; Cheng, Jun; Chen, Bili; Jia, Fukai; Chen, Zhonggui; Li, Jonathan

2015-04-01

Line segment detection in images is already a well-investigated topic, although it has received considerably less attention in 3D point clouds. Benefiting from current LiDAR devices, large-scale point clouds are becoming increasingly common. Most human-made objects have flat surfaces. Line segments that occur where pairs of planes intersect give important information regarding the geometric content of point clouds, which is especially useful for automatic building reconstruction and segmentation. This paper proposes a novel method that is capable of accurately extracting plane intersection line segments from large-scale raw scan points. The 3D line-support region, namely, a point set near a straight linear structure, is extracted simultaneously. The 3D line-support region is fitted by our Line-Segment-Half-Planes (LSHP) structure, which provides a geometric constraint for a line segment, making the line segment more reliable and accurate. We demonstrate our method on the point clouds of large-scale, complex, real-world scenes acquired by LiDAR devices. We also demonstrate the application of 3D line-support regions and their LSHP structures on urban scene abstraction.

The implementation of nice guidance on venous thromboembolism risk assessment and prophylaxis: a before-after observational study to assess the impact on patient safety across four hospitals in England

PubMed Central

2013-01-01

Background Venous thromboembolism (VTE) is a major cause of morbidity and mortality in hospitalised patients. VTE prevention has been identified as a major health need internationally to improve patient safety. A National Institute for Health and Clinical Excellence (NICE) guideline was issued in February 2010. Its key priorities were to assess patients for risk of VTE on admission to hospital, assess patients for bleeding risk and evaluate the risks and benefits of prescribing VTE prophylaxis. The aim of this study was to evaluate the implementation of NICE guidance and its impact on patient safety. Methods A before-after observational design was used to investigate changes in VTE risk assessment documentation and inappropriate prescribing of prophylaxis between the year prior to (2009) and the year following (2010) the implementation of NICE guidance, using data from a 3-week period during each year. A total of 408 patients were sampled in each year across four hospitals in the NHS South region. Results Implementation strategies such as audit, education and training were used. The percentage of patients for whom a VTE risk assessment was documented increased from 51.5% (210/408) in 2009 to 79.2% (323/408) in 2010; difference 27.7% (95% CI: 21.4% to 33.9%; p < 0.001). There was little evidence of change in the percentage who were prescribed prophylaxis amongst patients without a risk assessment (71.7% (142/198) in 2009 and 68.2% (58/85) in 2010; difference −3.5% (95% CI: -15.2% to 8.2%; p =0.56) nor the percentage who were prescribed low molecular weight heparin amongst patients with a contraindication (14% (4/28) in 2009 and 15% (6/41) in 2010; RD = 0.3% (95% CI: -16.5% to 17.2%; p =0.97). Conclusions The documentation of risk assessment improved following the implementation of NICE guidance; it is questionable, however, whether this led to improved patient safety with respect to prescribing appropriate prophylaxis. PMID:23734903

Fully digital programmable optical frequency comb generation and application.

PubMed

Yan, Xianglei; Zou, Xihua; Pan, Wei; Yan, Lianshan; Azaña, José

2018-01-15

We propose a fully digital programmable optical frequency comb (OFC) generation scheme based on binary phase-sampling modulation, wherein an optimized bit sequence is applied to phase modulate a narrow-linewidth light wave. Programming the bit sequence enables us to tune both the comb spacing and comb-line number (i.e., number of comb lines). The programmable OFCs are also characterized by ultra-flat spectral envelope, uniform temporal envelope, and stable bias-free setup. Target OFCs are digitally programmed to have 19, 39, 61, 81, 101, or 201 comb lines and to have a 100, 50, 20, 10, 5, or 1 MHz comb spacing. As a demonstration, a scanning-free temperature sensing system using a proposed OFC with 1001 comb lines was also implemented with a sensitivity of 0.89°C/MHz.

Modelling Watershed and Estuarine Controls on Salt Marsh Distributions

NASA Astrophysics Data System (ADS)

Yousefi Lalimi, F.; Marani, M.; Murray, A. B.; D'Alpaos, A.

2017-12-01

The formation and evolution of tidal platforms have been extensively studied through observations and models, describing landform dynamics as a result of the local interactions and feedbacks among hydrodynamics, vegetation, and sediment transport. However, existing work mainly focuses on individual marsh platforms and, possibly, their immediate surrounding, such that the influence and controls on marsh dynamics of inland areas (through fluvial inputs) and of exchanges with the ocean have not been comprehensively and simultaneously accounted for. Here, we develop and use a process-based model to evaluate the relative role of watershed, estuarine, and ocean controls on salt marsh accretionary and depositional/erosional dynamics and define how these factors interact to determine salt marsh resilience to environmental change at the whole-estuary scale. Our results, in line with previous work, show that no stable equilibrium exists for the erosional dynamics of the marsh/tidal flat boundary. In addition, we find that under some circumstances, vertical accretion/erosion dynamics can lead to transitions between salt marsh and tidal flat equilibrium states that occur much more rapidly than marsh/tidal flat boundary erosion or accretion could. We further define, in the multidimensional space of estuarine-scale morphodynamic forcings, the basins of attractions leading to marsh-dominated and tidal-flat-dominated estuaries. The relatively slow dynamics asymptotically leading to marsh- or tidal-flat- dominance in many cases suggest that estuaries are likely to be found, at any given time, in a transition state dictated by temporal variations in environmental forcings.

Incident wave, infragravity wave, and non-linear low-frequency bore evolution across fringing coral reefs

NASA Astrophysics Data System (ADS)

Storlazzi, C. D.; Griffioen, D.; Cheriton, O. M.

2016-12-01

Coral reefs have been shown to significantly attenuate incident wave energy and thus provide protection for 100s of millions of people globally. To better constrain wave dynamics and wave-driven water levels over fringing coral reefs, a 4-month deployment of wave and tide gauges was conducted across two shore-normal transects on Roi-Namur Island and two transects on Kwajalein Island in the Republic of the Marshall Islands. At all locations, although incident wave (periods <25 s) heights were an order of magnitude greater than infragravity wave (periods > 250 s) heights on the outer reef flat just inshore of the zone of wave breaking, the infragravity wave heights generally equaled the incident wave heights by the middle of the reef flat and exceeded the incident wave heights on the inner reef flat by the shoreline. The infragravity waves generally were asymmetric, positively skewed, bore-like forms with incident-band waves riding the infragravity wave crest at the head of the bore; these wave packets have similar structure to high-frequency internal waves on an internal wave bore. Bore height was shown to scale with water depth, offshore wave height, and offshore wave period. For a given tidal elevation, with increasing offshore wave heights, such bores occurred more frequently on the middle reef flat, whereas they occurred less frequently on the inner reef flat. Skewed, asymmetric waves are known to drive large gradients in velocity and shear stress that can transport material onshore. Thus, a better understanding of these low-frequency, energetic bores on reef flats is critical to forecasting how coral reef-lined coasts may respond to sea-level rise and climate change.

Design and analysis of all-dielectric subwavelength focusing flat lens

NASA Astrophysics Data System (ADS)

Turduev, M.; Bor, E.; Kurt, H.

2017-09-01

In this letter, we numerically designed and experimentally demonstrated a compact photonic structure for the subwavelength focusing of light using all-dielectric absorption-free and nonmagnetic scattering objects distributed in an air medium. In order to design the subwavelength focusing flat lens, an evolutionary algorithm is combined with the finite-difference time-domain method for determining the locations of cylindrical scatterers. During the multi-objective optimization process, a specific objective function is defined to reduce the full width at half maximum (FWHM) and diminish side lobe level (SLL) values of light at the focal point. The time-domain response of the optimized flat lens exhibits subwavelength light focusing with an FWHM value of 0.19λ and an SLL value of 0.23, where λ denotes the operating wavelength of light. Experimental analysis of the proposed flat lens is conducted in a microwave regime and findings exactly verify the numerical results with an FWHM of 0.192λ and an SLL value of 0.311 at the operating frequency of 5.42 GHz. Moreover, the designed flat lens provides a broadband subwavelength focusing effect with a 9% bandwidth covering frequency range of 5.10 GHz-5.58 GHz, where corresponding FWHM values remain under 0.21λ. Also, it is important to note that the designed flat lens structure performs a line focusing effect. Possible applications of the designed structure in telecom wavelengths are speculated upon for future perspectives. Namely, the designed structure can perform well in photonic integrated circuits for different fields of applications such as high efficiency light coupling, imaging and optical microscopy, with its compact size and ability for strong focusing.

Contact line motion over substrates with spatially non-uniform properties

NASA Astrophysics Data System (ADS)

Ajaev, Vladimir; Gatapova, Elizaveta; Kabov, Oleg

2017-11-01

We develop mathematical models of moving contact lines over flat solid surfaces with spatial variation of temperature and wetting properties under the conditions when evaporation is significant. The gas phase is assumed to be pure vapor and a lubrication-type framework is employed for describing viscous flow in the liquid. Marangoni stresses at the liquid surface arise as a result of temperature variation in the vapor phase, non-equilibrium effects during evaporation at the interface, and Kelvin effect. The relative importance of these three factors is determined. Variation of wetting properties is modeled through a two-component disjoining pressure, with the main focus on spatially periodic patterns leading to time-periodic variation of the contact line speed.

Three tooth kinematic coupling

DOEpatents

Hale, Layton C.

2000-01-01

A three tooth kinematic coupling based on having three theoretical line contacts formed by mating teeth rather than six theoretical point contacts. The geometry requires one coupling half to have curved teeth and the other coupling half to have flat teeth. Each coupling half has a relieved center portion which does not effect the kinematics, but in the limit as the face width approaches zero, three line contacts become six point contacts. As a result of having line contact, a three tooth coupling has greater load capacity and stiffness. The kinematic coupling has application for use in precision fixturing for tools or workpieces, and as a registration device for a work or tool changer or for optics in various products.

Capacitively coupled RF voltage probe having optimized flux linkage

DOEpatents

Moore, James A.; Sparks, Dennis O.

1999-02-02

An RF sensor having a novel current sensing probe and a voltage sensing probe to measure voltage and current. The current sensor is disposed in a transmission line to link all of the flux generated by the flowing current in order to obtain an accurate measurement. The voltage sensor is a flat plate which operates as a capacitive plate to sense voltage on a center conductor of the transmission line, in which the measured voltage is obtained across a resistance leg of a R-C differentiator circuit formed by the characteristic impedance of a connecting transmission line and a capacitance of the plate, which is positioned proximal to the center conductor.

The surface pH of glass ionomer cavity lining agents.

PubMed

Woolford, M J

1989-12-01

It is considered that acid release from the surface of glass ionomer (polyalkenoate) cements may be associated with early pulpal sensitivity following the use of these materials. This study was carried out to examine the surface pH of different types of glass ionomer lining cements using a flat-ended pH electrode. It was found that the surface pH remains low for this group of materials during the first hour of setting. Different types of glass ionomer lining cement were also shown to behave differently when considering acid release from the surface. Conclusions regarding the behaviour of glass ionomers should only be made with reference to the specific material tested.

Electronic and optical properties of MAPbX3 perovskites (X = I, Br, Cl): a unified DFT and GW theoretical analysis.

PubMed

Mosconi, Edoardo; Umari, Paolo; De Angelis, Filippo

2016-10-05

Materials engineering is a key for the enhancement of photovoltaics technology. This is particularly true for the novel class of perovskite solar cells. Accurate theoretical modelling can help establish general trends of behavior when addressing structural changes. Here, we consider the effects due to halide substitution in organohalide CH 3 NH 3 PbX 3 perovskites exploring the halide series with X = Cl, Br, I. For this task, we use accurate DFT and GW methods including spin-orbit coupling. We find the expected band gap increase when moving from X = I to Cl, in line with the experimental data. Most notably, the calculated absorption coefficients for I, Br and Cl are nicely reproducing the behavior reported experimentally. A common feature of all the simulated band structures is a significant Rashba effect. This is similar for MAPbI 3 and MAPbBr 3 while MAPbCl 3 shows in general a reduced Rashba interaction coefficient. Finally, a monotonic increase of the exciton reduced masses is calculated when moving from I to Br to Cl, in line with the stronger excitonic character of the lighter perovskite halides.

Comparing the costs of three prostate cancer follow-up strategies: a cost minimisation analysis.

PubMed

Pearce, Alison M; Ryan, Fay; Drummond, Frances J; Thomas, Audrey Alforque; Timmons, Aileen; Sharp, Linda

2016-02-01

Prostate cancer follow-up is traditionally provided by clinicians in a hospital setting. Growing numbers of prostate cancer survivors mean that this model of care may not be economically sustainable, and a number of alternative approaches have been suggested. The aim of this study was to develop an economic model to compare the costs of three alternative strategies for prostate cancer follow-up in Ireland-the European Association of Urology (EAU) guidelines, the National Institute of Health Care Excellence (NICE) guidelines and current practice. A cost minimisation analysis was performed using a Markov model with three arms (EAU guidelines, NICE guidelines and current practice) comparing follow-up for men with prostate cancer treated with curative intent. The model took a health care payer's perspective over a 10-year time horizon. Current practice was the least cost efficient arm of the model, the NICE guidelines were most cost efficient (74 % of current practice costs) and the EAU guidelines intermediate (92 % of current practice costs). For the 2562 new cases of prostate cancer diagnosed in 2009, the Irish health care system could have saved €760,000 over a 10-year period if the NICE guidelines were adopted. This is the first study investigating costs of prostate cancer follow-up in the Irish setting. While economic models are designed as a simplification of complex real-world situations, these results suggest potential for significant savings within the Irish health care system associated with implementation of alternative models of prostate cancer follow-up care.

Peer-teaching of evidence-based medicine.

PubMed

Rees, Eliot; Sinha, Yashashwi; Chitnis, Abhishek; Archer, James; Fotheringham, Victoria; Renwick, Stephen

2014-07-01

Many medical schools teach the principles of evidence-based medicine (EBM) as part of their undergraduate curriculum. Medical students perceive that EBM is valuable to their undergraduate and postgraduate career. Students may experience barriers to applying EBM principles, especially when searching for evidence or identifying high-quality resources. The UK National Institute for Health and Care Excellence (NICE) Evidence Search is a service that enables access to authoritative clinical and non-clinical evidence and best practice through a web-based portal. Evidence-based medicine workshops were organised and delivered by fourth-year medical students, having first received training from NICE to become NICE student champions. The workshops covered the basic principles of EBM and focused on retrieving EBM resources for study through the NICE Evidence Search portal. The scheme was evaluated using a pre-workshop survey and an 8-12 week post-workshop survey. Self-reported confidence in searching for evidence-based resources increased from 29 per cent before the workshop to 87 per cent after the workshop. Only 1 per cent of students rated evidence-based resources as their first preference pre-workshop, compared with 31 per cent post-workshop. The results show that although many students were aware of evidence-based resources, they tended not to use them as their preferred resource. Despite appreciating the value of evidence-based resources, few students were confident in accessing and using such resources for pre-clinical study. A peer-taught workshop in EBM improved students' confidence with, and use of, evidence-based resources. © 2014 John Wiley & Sons Ltd.

Having your cake and eating it: office of fair trading proposal for funding new drugs to benefit patients and innovative companies.

PubMed

Godman, Brian; Haycox, Alan; Schwabe, Ulrich; Joppi, Roberta; Garattini, Silvio

2008-01-01

There are insufficient resources in the UK to fund all new technologies and new indications approved by the National Institute for Health and Clinical Excellence (NICE). Diverting funding from existing sources will have a detrimental effect on the provision of other priority services. The UK Office of Fair Trading (OFT) recently suggested a value-based pricing approach that appears workable but has generated considerable debate. Their proposal of a 25% premium for the originator product once generics are available is more generous than seen in a number of other European countries, where typically only the lowest priced product is reimbursed. The OFT proposal for a maximum 50% premium for patent-protected products, versus the prices of generics in a class or related classes, is also more generous than the proposed reforms for the pricing of proton pump inhibitors in Sweden or current reforms in Germany. In our opinion, the OFT proposals are persuasive and in accordance with the reforms seen in other European countries, and therefore should be adopted. The alternatives to fully funding new drugs or new indications as approved by NICE are either tightening the cost per QALY threshold, giving NICE an annual national budget to fund its advice alongside suggested areas for disinvestment, proactively switching patients from high-cost brand-name drugs to generics, or further delaying funding for new drugs and new indications approved by NICE. The majority of these suggestions are not in the best interests of patients or innovative pharmaceutical companies seeking to reap the rewards of their efforts.

Using Nice-Ohvms Lineshapes to Study Relaxation Rates and Transition Dipole Moments

NASA Astrophysics Data System (ADS)

Hodges, James N.; McCall, Benjamin J.

2016-06-01

Noise Immune Cavity Enhanced Optical Heterodyne Velocity Modulation Spectroscopy (NICE-OHVMS) is a successful technique that we have developed to sensitively, precisely, and accurately record transitions of molecular ions. It has been used exclusively as a method for precise transition frequency measurement via saturation and fitting of the resultant Lamb dips. NICE-OHVMS has been employed to improve the uncertainties on H_3^+, CH_5^+, HeH^+, and OH^+, reducing the transition frequency uncertainties by two orders of magnitude. Because NICE-OHVMS is a saturation technique, this provides a unique opportunity to access information about the ratio of the transition dipole moment to the relaxation rate of the transition. This can be done in two ways, either through comparison of Lamb dip depth to the transition profile or comparison of the absorption intensity and dispersion intensity. Due to the complexity of the modulation scheme, there are many parameters that affect the apparent intensity of the recorded lineshape. A complete understanding of the lineshape is required to make the measurements of interest. Here we present a model that accounts for the heterodyne modulation and velocity modulation, assuming that the fundamental lineshape is represented by a Voigt profile. Fits to data are made and interpreted in order to extract the saturation parameter. K.N. Crabtree et al., Chem. Phys. Lett. 551, 1 (2012). J.N. Hodges et al., J. Chem. Phys. 139, 164201 (2013). A.J. Perry et al., J. Mol. Spectrosc. 317, 71 (2015). A.J. Perry et al., J. Chem. Phys. 141, 101101 (2014). C.R. Marcus et al., Astrophys. J. 817, 138 (2016).

Non-ischemic cerebral enhancing lesions secondary to endovascular aneurysm therapy: nickel allergy or foreign body reaction? Case series and review of the literature.

PubMed

Shotar, Eimad; Law-Ye, Bruno; Baronnet-Chauvet, Flore; Zeidan, Sinead; Psimaras, Dimitri; Bielle, Franck; Pecquet, Catherine; Navarro, Soledad; Rosso, Charlotte; Cohen, Fleur; Chiras, Jacques; Di Maria, Federico; Sourour, Nader; Clarençon, Frédéric

2016-09-01

Delayed onset of non-ischemic cerebral enhancing (NICE) lesions is a rare complication of intracranial aneurysms' endovascular therapy (EVT). The purpose of this study is to report this rare complication and its potential pathophysiology in a single-center case series and review the relevant literature. After retrospective review of all patients managed by EVT at our institution from January 1, 2012 to December 31, 2014, 2 out of 374 patients (0.5 %) with such a complication were identified. Skin patch testing was performed with all endovascular devices used in the two patients and with the European baseline series, including nickel. All previously published cases in the English literature were reviewed based on exhaustive PubMed and Embase research. Patient no. 1 developed NICE lesions 1 month after balloon-assisted coiling of a ruptured anterior communicating artery aneurysm. Patient no. 2 developed NICE lesions 12 months (the longest delay reported to date for such a complication) after the treatment of a right carotid-ophthalmic aneurysm by loose coiling and flow diversion. Patient no. 2 demonstrated nickel skin reactivity, but none of the two patients presented allergic reaction to the devices used during interventions. Based on our observations and review of the literature, we hypothesize that delayed non-ischemic cerebral enhancing lesions after EVT are more likely related to foreign body emboli rather than nickel allergy. The two presented cases demonstrate the potential for recurrence and prolonged fluctuation of NICE lesions, warranting long-term follow-up for all patients presenting this complication.

Nutritional rehabilitation after ICU - does it happen: a qualitative interview and observational study.

PubMed

Merriweather, Judith; Smith, Pam; Walsh, Timothy

2014-03-01

To compare and contrast current nutritional rehabilitation practices against recommendations from National Institute for Health and Excellence guideline Rehabilitation after critical illness (NICE) (2009, http://www.nice.org.uk/cg83). Recovery from critical illness has gained increasing prominence over the last decade but there is remarkably little research relating to nutritional rehabilitation. The study is a qualitative study based on patient interviews and observations of ward practice. Seventeen patients were recruited into the study at discharge from the intensive care unit (ICU) of a large teaching hospital in central Scotland in 2011. Semi-structured interviews were conducted on transfer to the ward and weekly thereafter. Fourteen of these patients were followed up at three months post-ICU discharge, and a semi-structured interview was carried out. Observations of ward practice were carried out twice weekly for the duration of the ward stay. Current nutritional practice for post-intensive care patients did not reflect the recommendations from the NICE guideline. A number of organisational issues were identified as influencing nutritional care. These issues were categorised as ward culture, service-centred delivery of care and disjointed discharge planning. Their influence on nutritional care was compounded by the complex problems associated with critical illness. The NICE guideline provides few nutrition-specific recommendations for rehabilitation; however, current practice does not reflect the nutritional recommendations that are detailed in the rehabilitation care pathway. Nutritional care of post-ICU patients is problematic and strategies to overcome these issues need to be addressed in order to improve nutritional intake. © 2013 John Wiley & Sons Ltd.

Searching for Chips of Kuiper Belt Objects in Meteorites

NASA Technical Reports Server (NTRS)

Zolensky, M. E.; Ohsumi, K.; Briani, G.; Gounelle, M.; Mikouchi, T.; Satake, W.; Kurihara, T.; Weisberg, M. K.; Le, L.

2009-01-01

The Nice model [1&2] describes a scenario whereby the Jovian planets experienced a violent reshuffling event approx.3:9 Ga the giant planets moved, existing small body reservoirs were depleted or eliminated, and new reservoirs were created in particular locations. The Nice model quantitatively explains the orbits of the Jovian planets and Neptune [1], the orbits of bodies in several different small body reservoirs in the outer solar system (e.g., Trojans of Jupiter [2], the Kuiper belt and scattered disk [3], the irregular satellites of the giant planets [4], and the late heavy bombardment on the terrestrial planets approx.3:9 Ga [5]. This model is unique in plausibly explaining all of these phenomena. One issue with the Nice model is that it predicts that transported Kuiper Belt Objects (KBOs) (things looking like D class asteroids) should predominate in the outer asteroid belt, but we know only about 10% of the objects in the outer main asteroid belt appear to be D-class objects [6]. However based upon collisional modeling, Bottke et al. [6] argue that more than 90% of the objects captured in the outer main belt could have been eliminated by impacts if they had been weakly-indurated objects. These disrupted objects should have left behind pieces in the ancient regoliths of other, presumably stronger asteroids. Thus, a derived prediction of the Nice model is that ancient regolith samples (regolith-bearing meteorites) should contain fragments of collisionally-destroyed Kuiper belt objects. In fact KBO pieces might be expected to be present in most ancient regolith- bearing meteorites [7&8].

The MAGEC system for spinal lengthening in children with scoliosis: A NICE Medical Technology Guidance.

PubMed

Jenks, Michelle; Craig, Joyce; Higgins, Joanne; Willits, Iain; Barata, Teresa; Wood, Hannah; Kimpton, Christine; Sims, Andrew

2014-12-01

Scoliosis-structural lateral curvature of the spine-affects around four children per 1,000. The MAGEC system comprises a magnetically distractible spinal rod implant and an external remote controller, which lengthens the rod; this system avoids repeated surgical lengthening. Rod implants brace the spine internally and are lengthened as the child grows, preventing worsening of scoliosis and delaying the need for spinal fusion. The Medical Technologies Advisory Committee at the National Institute for Health and Care Excellence (NICE) selected the MAGEC system for evaluation in a NICE medical technologies guidance. Six studies were identified by the sponsor (Ellipse Technologies Inc.) as being relevant to the decision problem. Meta-analysis was used to compare the clinical evidence results with those of one conventional growth rod study, and equal efficacy of the two devices was concluded. The key weakness was selection of a single comparator study. The External Assessment Centre (EAC) identified 16 conventional growth rod studies and undertook meta-analyses of relevant outcomes. Its critique highlighted limitations around study heterogeneity and variations in baseline characteristics and follow-up duration, precluding the ability to draw firm conclusions. The sponsor constructed a de novo costing model showing that MAGEC rods generated cost savings of £9,946 per patient after 6 years, compared with conventional rods. The EAC critiqued and updated the model structure and inputs, calculating robust cost savings of £12,077 per patient with MAGEC rods compared with conventional rods over 6 years. The year of valuation was 2012. NICE issued a positive recommendation as supported by the evidence (Medical Technologies Guidance 18).

Ponatinib for Treating Chronic Myeloid Leukaemia: An Evidence Review Group Perspective of a NICE Single Technology Appraisal.

PubMed

Pandor, Abdullah; Stevenson, Matt; Stevens, John; James, Marrissa Martyn-St; Hamilton, Jean; Byrne, Jenny; Rudin, Claudius; Rawdin, Andrew; Wong, Ruth

2018-02-26

As part of its single technology appraisal process, the National Institute for Health and Care Excellence (NICE) invited the company that manufactures ponatinib (Inclusig ® ; Incyte Corporation) to submit evidence for the clinical and cost effectiveness for previously treated chronic myeloid leukaemia (CML) and Philadelphia-chromosome-positive acute lymphoblastic leukaemia (Ph+ ALL). This paper focusses on the three phases of CML: the chronic phase (CP), the accelerated phase (AP) and the blast crisis phase (BP). The School of Health and Related Research Technology Appraisal Group at the University of Sheffield was commissioned to act as the independent Evidence Review Group (ERG). This article presents the critical review of the company's submission by the ERG and the outcome of the NICE guidance. Clinical evidence for ponatinib was derived from a phase II, industry-sponsored, single-arm, open-label, multicentre, non-comparative study. Despite the limited evidence and potential for biases, this study demonstrated that ponatinib was likely to be an effective treatment (in terms of major cytogenetic response and major haematological response) with an acceptable safety profile for patients with CML. Given the absence of any head-to-head studies comparing ponatinib with other relevant comparators, the company undertook a matching-adjusted indirect comparison (MAIC) of ponatinib with bosutinib. The approach was only used for patients with CP-CML because comprehensive data were not available for the AP- or BP-CML groups to allow the matching technique to be used. Despite the uncertainty about the MAIC approach, ponatinib was considered likely to offer advantages over bosutinib in the third-line setting, particularly for complete cytogenetic response. The company developed two health economic models to assess the cost effectiveness of ponatinib for the treatment of patients in CP-CML or in advanced CML (AP- or BP-CML, which were modelled separately). The company did not adequately explore the uncertainty in the survivor functions. As a result, the ERG believed the uncertainty in the decision problem was underestimated. Exploratory analyses undertaken by the ERG produced the following results for ponatinib. In CP-CML, from £18,246 to £27,667 per quality-adjusted life-year (QALY) gained compared with best supportive care (BSC), from £19,680 to £37,381 per QALY gained compared with bosutinib and from £18,279 per QALY gained to dominated compared with allogeneic stem cell transplant (allo-SCT). In AP-CML, the cost per QALY gained for ponatinib ranged from £7123 to £17,625 compared with BSC, and from dominating to £61,896 per QALY gained compared with allo-SCT. In BP-CML, the cost effectiveness of ponatinib ranged from £5033 per QALY gained to dominated compared with allo-SCT, although it was likely to be at the more favourable end of this range, and dominant in all scenarios compared with BSC. The NICE appraisal committee concluded that ponatinib is a cost-effective use of NHS resources in the considered population, subject to the company providing the agreed discount in the Patient Access Scheme.

A line transect model for aerial surveys

USGS Publications Warehouse

Quang, Pham Xuan; Lanctot, Richard B.

1991-01-01

We employ a line transect method to estimate the density of the common and Pacific loon in the Yukon Flats National Wildlife Refuge from aerial survey data. Line transect methods have the advantage of automatically taking into account “visibility bias” due to detectability difference of animals at different distances from the transect line. However, line transect methods must overcome two difficulties when applied to inaccurate recording of sighting distances due to high travel speeds, so that in fact only a few reliable distance class counts are available. We propose a unimodal detection function that provides an estimate of the effective area lost due to the blind strip, under the assumption that a line of perfect detection exists parallel to the transect line. The unimodal detection function can also be applied when a blind strip is absent, and in certain instances when the maximum probability of detection is less than 100%. A simple bootstrap procedure to estimate standard error is illustrated. Finally, we present results from a small set of Monte Carlo experiments.

Decreasing Caregivers' Positive Attitudes Toward Spanking.

PubMed

Burkhart, Kimberly; Knox, Michele; Hunter, Kimberly; Pennewitt, Deanna; Schrouder, Karyssa

2018-02-19

The Play Nicely program is a multimedia training program designed to teach caregivers and health care professionals how to manage early childhood aggression and to use positive parenting practices. The aim of this article is to help the practicing clinician determine whether the Play Nicely program should be incorporated into his/her practice and to evaluate whether the program is effective at decreasing positive attitudes toward spanking in a socioeconomically disadvantaged population in both a resident pediatric clinic and a community center. Thirty-three caregivers of children aged 2 to 5 years viewed the Play Nicely program and completed pre- and post-training questionnaires. Decreased positive attitudes toward spanking were reported after training. Favorable attitudes toward spanking were associated with increased use of harsher discipline and higher child externalizing behavior. This study provides support that this brief intervention is effective in a socioeconomically disadvantaged population, is portable, and can be used in a group setting. This program may serve as a prevention and population-based approach to addressing the adverse childhood experience of spanking. Copyright © 2017 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Construction of two Lactococcus lactis expression vectors combining the Gateway and the NIsin Controlled Expression systems.

PubMed

Douillard, François P; Mahony, Jennifer; Campanacci, Valérie; Cambillau, Christian; van Sinderen, Douwe

2011-09-01

Over the last 10 years, the NIsin Controlled Expression (NICE) system has been extensively used in the food-grade bacterium Lactococcus lactis subsp. cremoris to produce homologous and heterologous proteins for academic and biotechnological purposes. Although various L. lactis molecular tools have been developed, no expression vectors harboring the popular Gateway recombination system are currently available for this widely used cloning host. In this study, we constructed two expression vectors that combine the NICE and the Gateway recombination systems and we tested their applicability by recombining and over-expressing genes encoding structural proteins of lactococcal phages Tuc2009 and TP901-1. Over-expressed phage proteins were analyzed by immunoblotting and purified by His-tag affinity chromatography with protein productions yielding 2.8-3.7 mg/l of culture. This therefore is the first description of L. lactis NICE expression vectors which integrate the Gateway cloning technology and which are suitable for the production of sufficient amounts of proteins to facilitate subsequent structural and functional analyses. Copyright © 2011 Elsevier Inc. All rights reserved.

Cost-effective public health guidance: asking questions from the decision-maker's viewpoint.

PubMed

Chalkidou, Kalipso; Culyer, Anthony; Naidoo, Bhash; Littlejohns, Peter

2008-03-01

In February 2004, in his assessment of the long-term financial viability of the NHS, Derek Wanless recommended the use of 'a consistent framework, such as the methodology developed by NICE, to evaluate the cost-effectiveness of interventions and initiatives across health care and public health'. One year later public health was added to NICE's remit and the new National Institute for Health and Clinical Excellence (NICE) was established, with amended statutory instruments to permit consideration of broader public sector costs when developing cost-effective guidance for public health. With the principle of 'a consistent framework' put forward by Wanless as the starting point, this paper provides an insight into the most challenging aspects of applying the principles of cost-effectiveness analysis in the public health context from the policymaker's perspective. It reflects on the long-term consequences of taking on responsibility for producing public health guidance on the Institute's overall approach to guidance development and describes the tension between striving for consistency and cross-evaluation comparability while ensuring that the methodological tools used are fit for the purpose of developing public health guidance.

Evaluating portable wire-flooring models for inducing bacterial chondronecrosis with osteomyelitis in broilers.

PubMed

Gilley, A D; Lester, H; Pevzner, I Y; Anthony, N B; Wideman, R F

2014-06-01

Rearing broilers on flat or sloping wire flooring is an effective method for consistently triggering lameness attributable to bacterial chondronecrosis with osteomyelitis (BCO). Portable obstacles known as speed bumps (SB) also consistently trigger modest incidences of BCO when they are installed between feed and water lines in litter flooring facilities. Two experiments were conducted to determine the most effective broiler age for introducing the SB into litter flooring pens, and to evaluate alternative configurations of the traditional SB with the expectation that amplified mechanical challenges to the legs of broilers should increase the incidence of BCO. Broiler chicks obtained from commercial hatcheries (lines B and D in experiment 1, lines A and B in experiment 2) were reared in floor pens with ad libitum feed and water and a 23L:1D photoperiod. In experiment 1, the 5 floor treatments included wood shavings litter only (L), flat wire only (W), or litter plus SB installed at 14, 28, or 42 d of age. Line B was more susceptible to lameness than line D (25.9 vs. 15.3% for all treatments combined; P = 0.001). Both lines developed low incidences of lameness on L (11 to 13%), intermediate incidences on SB regardless of day of installation (12 to 23%), and high incidences on W (21 to 39%). In experiment 2, broilers were reared with 7 floor treatments, including L, W, SB with a 50% slope (SB50%); SB50% with a limbo bar installed over the apex; SB with a 66% slope and limbo bar; SB50% with a nipple water line suspended over the apex; and a pagoda-top SB. All SB were inserted on d 28. Line B was more susceptible to lameness than line A (20.2 vs. 16.1% for all treatments combined; P < 0.05), and for both lines combined the lameness percentages averaged 7.7 (L), 29.2 (W), 17.3 (SB50%), 16.2 (SB50% with a limbo bar), 21.5 (SB with a 66% slope and limbo bar), 20.8 (SB50% with a nipple water line), and 11.5% (pagoda-top). These studies demonstrate the portable SB can be effectively used to experimentally trigger BCO in broilers. Poultry Science Association Inc.

Line-driven disc wind model for ultrafast outflows in active galactic nuclei - scaling with luminosity

NASA Astrophysics Data System (ADS)

Nomura, M.; Ohsuga, K.

2017-03-01

In order to reveal the origin of the ultrafast outflows (UFOs) that are frequently observed in active galactic nuclei (AGNs), we perform two-dimensional radiation hydrodynamics simulations of the line-driven disc winds, which are accelerated by the radiation force due to the spectral lines. The line-driven winds are successfully launched for the range of MBH = 106-9 M⊙ and ε = 0.1-0.5, and the resulting mass outflow rate (dot{M_w}), momentum flux (dot{p_w}), and kinetic luminosity (dot{E_w}) are in the region containing 90 per cent of the posterior probability distribution in the dot{M}_w-Lbol plane, dot{p}_w-Lbol plane, and dot{E}_w-Lbol plane shown in Gofford et al., where MBH is the black hole mass, ε is the Eddington ratio, and Lbol is the bolometric luminosity. The best-fitting relations in Gofford et al., d log dot{M_w}/d log {L_bol}˜ 0.9, d log dot{p_w}/d log {L_bol}˜ 1.2, and d log dot{E_w}/d log {L_bol}˜ 1.5, are roughly consistent with our results, d log dot{M_w}/d log {L_bol}˜ 9/8, d log dot{p_w}/d log {L_bol}˜ 10/8, and d log dot{E_w}/d log {L_bol}˜ 11/8. In addition, our model predicts that no UFO features are detected for the AGNs with ε ≲ 0.01, since the winds do not appear. Also, only AGNs with MBH ≲ 108 M⊙ exhibit the UFOs when ε ∼ 0.025. These predictions nicely agree with the X-ray observations. These results support that the line-driven disc wind is the origin of the UFOs.

Characteristics of gamma-ray line flares

NASA Technical Reports Server (NTRS)

Bai, T.; Dennis, B.

1983-01-01

Observations of solar gamma rays by the Solar Maximum Mission (SMM) demonstrate that energetic protons and ions are rapidly accelerated during the impulsive phase. To understand the acceleration mechanisms for these particles, the characteristics of the gamma ray line flares observed by SMM were studied. Some very intense hard X-ray flares without detectable gamma ray lines were also investigated. Gamma ray line flares are distinguished from other flares by: (1) intense hard X-ray and microwave emissions; (2) delay of high energy hard X-rays; (3) emission of type 2 and/or type 4 radio bursts; and (4) flat hard X-ray spectra (average power law index: 3.1). The majority of the gamma ray line flares shared all these characteristics, and the remainder shared at least three of them. Positive correlations were found between durations of spike bursts and spatial sizes of flare loops as well as between delay times and durations of spike bursts.

Simulations of Scatterometry Down to 22 nm Structure Sizes and Beyond with Special Emphasis on LER

NASA Astrophysics Data System (ADS)

Osten, W.; Ferreras Paz, V.; Frenner, K.; Schuster, T.; Bloess, H.

2009-09-01

In recent years, scatterometry has become one of the most commonly used methods for CD metrology. With decreasing structure size for future technology nodes, the search for optimized scatterometry measurement configurations gets more important to exploit maximum sensitivity. As widespread industrial scatterometry tools mainly still use a pre-set measurement configuration, there are still free parameters to improve sensitivity. Our current work uses a simulation based approach to predict and optimize sensitivity of future technology nodes. Since line edge roughness is getting important for such small structures, these imperfections of the periodic continuation cannot be neglected. Using fourier methods like e.g. rigorous coupled wave approach (RCWA) for diffraction calculus, nonperiodic features are hard to reach. We show that in this field certain types of fieldstitching methods show nice numerical behaviour and lead to useful results.

Vega: A rapidly rotating pole-on star

NASA Technical Reports Server (NTRS)

Gulliver, Austin F.; Hill, Graham; Adelman, Saul J.

1994-01-01

High-dispersion (2.4 A/mm), ultrahigh signal-to-noise ratio (3000:1) Reticon spectra of Vega revealed two distinct types of profiles. The strong lines exhibit classical rotational profiles with enhanced wings, but the weak lines have distinctly different, flat-bottomed profiles. Using ATLAS9 model atmopheres and SYNTHE synthetic spectra, Vega has been modeled as a rapidly rotating, pole-on star with a gradient in temperature and gravity over the photosphere. By fitting to the flat-bottomed line profiles of Fe 1 lambda 4528 and Ti 2 lambda 4529, we find least-squares fit values of V sin i = 21.8 plus or minus 0.2 km/sec polar T(sub eff) = 9695 plus or minus 25 K, polar log(base 10)g = 3.75 plus or minus 0.02 dex, V(sub eq) = 245 plus or minus 15 km/sec, and inclination 5 deg .1 plus or minus 0 deg .3. The variations in T(sub eff) and log(base 10)g over the photosphere total 390 K and 0.08 dex, respectively. Assuming V sin i = 21.8 km/sec, an independent fit to the observed continuous flux from 1200 to 10,500 A produced a similar set of values with polar T(sub eff) = 9595 plus or minus 20 K, polar log(base 10)g = 3.80 plus or minus 0.03 dex, and inclination 6 deg .0 plus or minus 0 deg .7.

Measurement of emission cross sections for n = 3 → 2 transitions in Neon-like Fe XVII and Ni XIX ions

NASA Astrophysics Data System (ADS)

Lockard, Tom; Brown, Gregory V.; Hell, Natalie; Scofield, J. H.; Beiersdorfer, Peter; Porter, Frederick Scott; Kilbourne, Caroline; Kelley, Richard L.; Leutenegger, Maurice A.; Betancourt-Martinez, Gabriele

2018-06-01

The absolute excitation cross sections of the strong 1s2 2s2 2p51/2 3d3/2 1P1 → 1s2 2s2 2p6 1S0 and 1s2 2s2 2p53/2 3d5/2 3D1 → 1s2 2s2 2p6 1S0 strong resonance and intercombination lines, commonly known as 3C and 3D, have been measured in neon-like Fe16+ and Ni18+. These measurements were carried out at the Lawrence Livermore National Laboratory's EBIT-I electron beam ion trap facility using the EBIT Calorimeter Spectrometer (ECS) quantum microcalorimeter and a flat crystal spectrometer. The absolute excitation cross sections were determined by normalizing the measured spectrum to the X-ray emission from radiative recombination. The direct excitation lines 3C and 3D and radiative recombination (RR) lines were measured simultaneously using the ECS. By normalizing the measured RR flux to their theoretical cross sections, the emission from lines 3C and 3D was made absolute. Using simultaneous measurements from the higher resolution flat crystal spectrometer, it was possible to check for potential blends from lower charge states. Results of our measurements including comparison to theory, will be presented.This work was performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344.

A direct numerical method for predicting concentration profiles in a turbulent boundary layer over a flat plate. M.S. Thesis

NASA Technical Reports Server (NTRS)

Dow, J. W.

1972-01-01

A numerical solution of the turbulent mass transport equation utilizing the concept of eddy diffusivity is presented as an efficient method of investigating turbulent mass transport in boundary layer type flows. A FORTRAN computer program is used to study the two-dimensional diffusion of ammonia, from a line source on the surface, into a turbulent boundary layer over a flat plate. The results of the numerical solution are compared with experimental data to verify the results of the solution. Several other solutions to diffusion problems are presented to illustrate the versatility of the computer program and to provide some insight into the problem of mass diffusion as a whole.

The role of health economics in the evaluation of surgery and operative technologies.

PubMed

Taylor, Matthew

2017-02-01

Dr Matthew Taylor is the director of York Health Economics Consortium and leads the Consortium's health technology assessment program. The work of York Health Economics Consortium involves empirical research in health economics for both the private and public sectors. Dr Taylor is the scientific lead for the National Institute for Health and Care Excellence (NICE) Economic and Methodological Unit and a former member of NICE's Public Health Advisory Committee. He is also managing director (Europe) of Minerva, an international network of health economics consultancies. Copyright © 2016 Elsevier Inc. All rights reserved.

Innovations to Build On

ERIC Educational Resources Information Center

Laney, Kahliah; Giles, David; Bowles, Jonathan

2013-01-01

To be sure, there is a lot the Bloomberg administration has not accomplished in the social policy arena. City funding for a number of vital social programs--from child care to summer jobs for young adults--has been cut or flat-lined even as demand for these services has increased. Many of those interviewed say that the administration moved away…

10. Elevation view of south side of FrankJensen Summer Home. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

10. Elevation view of south side of Frank-Jensen Summer Home. Note that the steep angle of view gives an illusion of a flat roof. For a more accurate depiction of the roof line, see photos WA-207-4 and WA-207-8. - Frank-Jensen Summer Home, 17423 North Lake Shore Drive, Telma, Chelan County, WA

Good Instructional Leadership: Principals' Actions to Increase Composite ACT School Scores

ERIC Educational Resources Information Center

Xu, Bo; Liu, Dongfang

2016-01-01

Due to increased college admission requirements and a 20-year flat-lined trend in ACT scores, it is imperative for education leaders across the nation to implement effective strategies to increase ACT composite scores. High school principals, as instructional leaders and decision makers, are the major stakeholders who are vested in the outcomes of…

4D Sommerfeld quantization of the complex extended charge

NASA Astrophysics Data System (ADS)

Bulyzhenkov, Igor E.

2017-12-01

Gravitational fields and accelerations cannot change quantized magnetic flux in closed line contours due to flat 3D section of curved 4D space-time-matter. The relativistic Bohr-Sommerfeld quantization of the imaginary charge reveals an electric analog of the Compton length, which can introduce quantitatively the fine structure constant and the Plank length.

Flourishing as the Aim of Education: Towards an Extended, "Enchanted" Aristotelian Account

ERIC Educational Resources Information Center

Kristjánsson, Kristján

2016-01-01

Flourishing, understood along Aristotelian or quasi-Aristotelian lines as objective "eudaimonic" well-being, is re-emerging as a paradigm for the ideal aim of education in the 21st century. This paper aims to venture beyond the current accounts and Aristotle's own, by arguing that both suffer from a kind of "flatness" or…

49 CFR 572.76 - Limbs assembly and test procedure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... between 1g and 2g. (ii) Place the dummy legs in a plane parallel to the dummy's midsagittal plane with the knee pivot center line perpendicular to the dummy's midsagittal plane, and with the feet flat on the... parallel to the midsagittal plane at the specified velocity. (5) Guide the test probe during impact so that...

Shearlet-based edge detection: flame fronts and tidal flats

NASA Astrophysics Data System (ADS)

King, Emily J.; Reisenhofer, Rafael; Kiefer, Johannes; Lim, Wang-Q.; Li, Zhen; Heygster, Georg

2015-09-01

Shearlets are wavelet-like systems which are better suited for handling geometric features in multi-dimensional data than traditional wavelets. A novel method for edge and line detection which is in the spirit of phase congruency but is based on a complex shearlet transform will be presented. This approach to detection yields an approximate tangent direction of detected discontinuities as a byproduct of the computation, which then yields local curvature estimates. Two applications of the edge detection method will be discussed. First, the tracking and classification of flame fronts is a critical component of research in technical thermodynamics. Quite often, the flame fronts are transient or weak and the images are noisy. The standard methods used in the field for the detection of flame fronts do not handle such data well. Fortunately, using the shearlet-based edge measure yields good results as well as an accurate approximation of local curvature. Furthermore, a modification of the method will yield line detection, which is important for certain imaging modalities. Second, the Wadden tidal flats are a biodiverse region along the North Sea coast. One approach to surveying the delicate region and tracking the topographical changes is to use pre-existing Synthetic Aperture Radar (SAR) images. Unfortunately, SAR data suffers from multiplicative noise as well as sensitivity to environmental factors. The first large-scale mapping project of that type showed good results but only with a tremendous amount of manual interaction because there are many edges in the data which are not boundaries of the tidal flats but are edges of features like fields or islands. Preliminary results will be presented.

IUE short-wavelength high-dispersion line list for the symbiotic nova RR Telescopii

NASA Technical Reports Server (NTRS)

Aufdenberg, Jason P.

1993-01-01

An 820 minute and other long-exposure archival SWP IUE high-dispersion spectra of symbiotic star RR Tel have been combined to form a composite spectrum. In most of these spectra many lines are saturated, but weaker features appear above the continuum. Their wavelengths were measured from the composite spectrum and compared with the line list from a thorough study of RR Tel by Penston et al. (1983). Among the revised line list are 22 new line identifications from ions C III, O I, N I, Mg VI, Si I, S I, S IV, Fe II, and Ni II. N I exists inside RR Tel's H II region and is pumped by the hot component's continuum. The fluxes for all the lines in each of the spectra are presented. All of the observed ions show a secular flux decrease between 1978 and 1988. A list of SWP high-dispersion camera artifacts is also presented. The list was generated by comparing RR Tel spectra to a long-exposure sky flat.

A prospective audit of the impact of additional staff on the care of diabetic patients in a community podiatry service

PubMed Central

Ryan, Alexandra; Uppal, Meenakshi; Cunning, Imelda; Buckley, Claire M.

2015-01-01

Objective The purpose of this study was to evaluate the impact of the employment of additional podiatry staff on patients with diabetes attending a community-based podiatry service. Methods An audit was conducted to evaluate the intervention of two additional podiatry staff. All patients with diabetes referred to and attending community podiatry services in a specified area in the Republic of Ireland between June 2011 and June 2012 were included. The service was benchmarked against the UK gold standard outlined in the ‘Guidelines on prevention & management of foot problems in Type 2 Diabetes’ by the National Institute of Clinical Excellence (NICE). Process of care measures addressed were the number of patients with diabetes receiving treatment and the waiting times of patients with diabetes from referral to initial review. Results An increase in the number of patients with diabetes receiving treatment was seen in all risk categories (ranging from low risk to the emergency foot). Waiting times for patients with diabetes decreased post-intervention but did not reach the targets outlined in the NICE guidelines. The average time from referral to initial review of patients with an emergency diabetic foot was 37 weeks post-intervention. NICE guidelines recommend that these patients are seen within 24 hours. Discussion During the life cycle of this audit, increased numbers of patients were treated and waiting times for patients with diabetes were reduced. An internal re-organisation of the services coincided with the commencement of the additional staff. The improvements observed were due to the effects of a combination of additional staff and service re-organisation. Efficient organisation of services is key to optimal performance. Continued efforts to improve services are required to reach the standards outlined in the NICE guidelines. PMID:26048860

A prospective audit of the impact of additional staff on the care of diabetic patients in a community podiatry service.

PubMed

Ryan, Alexandra; Uppal, Meenakshi; Cunning, Imelda; Buckley, Claire M

2015-01-01

The purpose of this study was to evaluate the impact of the employment of additional podiatry staff on patients with diabetes attending a community-based podiatry service. An audit was conducted to evaluate the intervention of two additional podiatry staff. All patients with diabetes referred to and attending community podiatry services in a specified area in the Republic of Ireland between June 2011 and June 2012 were included. The service was benchmarked against the UK gold standard outlined in the 'Guidelines on prevention & management of foot problems in Type 2 Diabetes' by the National Institute of Clinical Excellence (NICE). Process of care measures addressed were the number of patients with diabetes receiving treatment and the waiting times of patients with diabetes from referral to initial review. An increase in the number of patients with diabetes receiving treatment was seen in all risk categories (ranging from low risk to the emergency foot). Waiting times for patients with diabetes decreased post-intervention but did not reach the targets outlined in the NICE guidelines. The average time from referral to initial review of patients with an emergency diabetic foot was 37 weeks post-intervention. NICE guidelines recommend that these patients are seen within 24 hours. During the life cycle of this audit, increased numbers of patients were treated and waiting times for patients with diabetes were reduced. An internal re-organisation of the services coincided with the commencement of the additional staff. The improvements observed were due to the effects of a combination of additional staff and service re-organisation. Efficient organisation of services is key to optimal performance. Continued efforts to improve services are required to reach the standards outlined in the NICE guidelines.

The effects of the NICE Technology Appraisal 121 (gliadel and temozolomide) on survival in high-grade glioma.

PubMed

Barr, James Geoffrey; Grundy, Paul L

2012-12-01

The prognosis of high-grade glioma (HGG) is poor with a median survival of about 1 year for glioblastoma. In 2007, NICE published a technology appraisal (TA121) recommending the use of carmustine wafers (Gliadel) and systemic therapy with temozolomide for selected patients with HGG. Outcomes for HGG surgery in the United Kingdom with these combined treatments have not been published. Retrospective audit of consecutive patients in a single unit with carmustine wafer implantation. Fifty-nine patients had carmustine wafers implanted at primary surgery, between October 2005 and October 2010 at Wessex Neurological Centre, Southampton, UK. Patients were given chemotherapeutic treatments strictly according to NICE TA121. Survival was calculated using Kaplan-Meier method. Fifty-five patients had WHO grade IV tumours and four had grade III. Median age was 61 years. At follow-up, 39 patients had died. Median survival was 15.3 months. Eight patients (13.5%) experienced post-operative complications (including five infections) for which four had the carmustine wafers removed. Forty-seven (80%) patients were treated with radical radiotherapy (55-60 Gy) and six (10%) patients received palliative radiotherapy (30 Gy). Thirty-seven patients (63%) received concomitant temozolomide chemotherapy. In the subset of 37 patients receiving multimodal treatment with radical radiotherapy and concomitant temozolomide, median survival was 15.8 months compared with 7.4 months in those not receiving multimodal treatment. Carmustine wafers for primary HGG surgery in accordance with the NICE TA121 were associated with a median survival of 15.3 months; this is improved compared with previously reported randomised trials. Multimodal treatment with carmustine wafers, radical radiotherapy and concomitant temozolomide was associated with improved survival. Increased incidence of infections was observed in cases receiving carmustine wafers.

Development of Advanced Eco-hydrologic and Biogeochemical Coupling Model to Constrain Missing Role of Inland Waters on Boundless Biogeochemical Cycle

NASA Astrophysics Data System (ADS)

Nakayama, T.; Maksyutov, S. S.

2016-12-01

Inland waters including rivers, lakes, and groundwater are suggested to act as a transport pathway for water and dissolved substances, and play some role in continental biogeochemical cycling (Cole et al., 2007; Battin et al., 2009). The authors have developed process-based National Integrated Catchment-based Eco-hydrology (NICE) model (Nakayama, 2014, 2015, etc.), which includes feedback between hydrologic-geomorphic-ecological processes. In this study, NICE was further developed to couple with various biogeochemical cycle models in biosphere, those for water quality in aquatic ecosystems, and those for carbon weathering, etc. (NICE-BGC) (Nakayama, accepted). The new model incorporates connectivity of the biogeochemical cycle accompanied by hydrologic cycle between surface water and groundwater, hillslopes and river networks, and other intermediate regions. The model also includes reaction between inorganic and organic carbons, and its relation to nitrogen and phosphorus in terrestrial-aquatic continuum. The model results of CO2 evasion to the atmosphere, sediment storage, and carbon transport to the ocean (DOC, POC, and DIC flux) were reasonably in good agreement with previous compiled data. The model also showed carbon budget in major river basins and in each continent in global scale. In order to decrease uncertainty about carbon cycle, it became clear the previous empirical estimation by compiled data should be extended to this process-oriented model and higher resolution data to further clarify mechanistic interplay between inorganic and organic carbon and its relationship to nitrogen and phosphorus in terrestrial-aquatic linkages. NICE-BGC would play important role to re-evaluate greenhouse gas budget of the biosphere, and to bridge gap between top-down and bottom-up approaches (Battin et al., 2009; Regnier et al., 2013).

Age-related references in national public health, technology appraisal and clinical guidelines and guidance: documentary analysis.

PubMed

Forrest, Lynne F; Adams, Jean; Ben-Shlomo, Yoav; Buckner, Stefanie; Payne, Nick; Rimmer, Melanie; Salway, Sarah; Sowden, Sarah; Walters, Kate; White, Martin

2017-05-01

older people may be less likely to receive interventions than younger people. Age bias in national guidance may influence entire public health and health care systems. We examined how English National Institute for Health & Care Excellence (NICE) guidance and guidelines consider age. we undertook a documentary analysis of NICE public health (n = 33) and clinical (n = 114) guidelines and technology appraisals (n = 212). We systematically searched for age-related terms, and conducted thematic analysis of the paragraphs in which these occurred ('age-extracts'). Quantitative analysis explored frequency of age-extracts between and within document types. Illustrative quotes were used to elaborate and explain quantitative findings. 2,314 age-extracts were identified within three themes: age documented as an a-priori consideration at scope-setting (518 age-extracts, 22.4%); documentation of differential effectiveness, cost-effectiveness or other outcomes by age (937 age-extracts, 40.5%); and documentation of age-specific recommendations (859 age-extracts, 37.1%). Public health guidelines considered age most comprehensively. There were clear examples of older-age being considered in both evidence searching and in making recommendations, suggesting that this can be achieved within current processes. we found inconsistencies in how age is considered in NICE guidance and guidelines. More effort may be required to ensure age is consistently considered. Future NICE committees should search for and document evidence of age-related differences in receipt of interventions. Where evidence relating to effectiveness and cost-effectiveness in older populations is available, more explicit age-related recommendations should be made. Where there is a lack of evidence, it should be stated what new research is needed. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society.

The structure of the distant Kuiper belt in a Nice model scenario

NASA Astrophysics Data System (ADS)

Pike, Rosemary E.; Lawler, Samantha; Brasser, Ramon; Shankman, Cory; Alexandersen, Mike; Kavelaars, J. J.

2016-10-01

By utilizing a well-sampled migration model and characterized survey detections, we demonstrate that the Nice-model scenario results in consistent populations of scattering trans-Neptunian objects (TNOs) and several resonant TNO populations, but fails to reproduce the large population of 5:1 resonators discovered in surveys. We examine in detail the TNO populations implanted by the Nice model simulation from Brasser and Morbidelli (2013, B&M). This analysis focuses on the region from 25-155 AU, probing the classical, scattering, detached, and major resonant populations. Additional integrations were necessary to classify the test particles and determine population sizes and characteristics. The classified simulation objects are compared to the real TNOs from the Canada-France Ecliptic Plane Survey (CFEPS), CFEPS high latitude fields, and the Alexandersen (2016) survey. These surveys all include a detailed characterization of survey depth, pointing, and tracking efficiency, which allows detailed testing of this independently produced model of TNO populations. In the B&M model, the regions of the outer Solar System populated via capture of scattering objects are consistent with survey constraints. The scattering TNOs and most n:1 resonant populations have consistent orbital distributions and population sizes with the real detections, as well as a starting disk mass consistent with expectations. The B&M 5:1 resonators have a consistent orbital distribution with the real detections and previous models. However, the B&M 5:1 Neptune resonance is underpopulated by a factor of ~100 and would require a starting proto-planetesimal disk with a mass of ~100 Earth masses. The large population in the 5:1 Neptune resonance is unexplained by scattering capture in a Nice-model scenario, however this model accurately produces the TNO subpopulations that result from scattering object capture and provides additional insight into sub-population orbital distributions.

Genetic testing for BRCA1: effects of a randomised study of knowledge provision on interest in testing and long term test uptake; implications for the NICE guidelines.

PubMed

Hall, Julia; Gray, Susan; A'Hern, Roger; Shanley, Susan; Watson, Maggie; Kash, Kathryn; Croyle, Robert; Eeles, Rosalind

2009-01-01

Interest in searching for mutations in BRCA1 and BRCA2 is high. Knowledge regarding these genes and the advantages and limitations of genetic testing is limited. It is unknown whether increasing knowledge about breast cancer genetic testing alters interest in testing. Three hundred and seventy nine women (260 with a family history of breast cancer; 119 with breast cancer) from The Royal Marsden NHS Foundation Trust were randomised to receive or not receive written educational information on cancer genetics. A questionnaire was completed assessing interest in BRCA1 testing and knowledge on breast cancer genetics and screening. Actual uptake of BRCA1 testing is reported with a six year follow-up. Eighty nine percent of women at risk of breast cancer and 76% of women with breast cancer were interested in BRCA1 testing (P < 0.0001). Provision of educational information did not affect level of interest. Knowledge about breast cancer susceptibility genes was poor. According to the NICE guidelines regarding eligibility for BRCA1 and BRCA2 testing, the families of 66% of the at risk group and 13% of the women with breast cancer would be eligible for testing (probability of BRCA1 mutation >or=20%). Within six years of randomisation, genetic testing was actually undertaken on 12 women, only 10 of whom would now be eligible, on the NICE guidelines. There is strong interest in BRCA1 testing. Despite considerable ignorance of factors affecting the inheritance of breast cancer, education neither reduced nor increased interest to undergo testing. The NICE guidelines successfully triage those with a high breast cancer risk to be managed in cancer genetics clinics.

National Survey of Neurosurgeons and Stroke Physicians on Decompressive Hemicraniectomy for Malignant Middle Cerebral Artery Infarction.

PubMed

Basu, Pallavi; Jenkins, Harri; Tsang, Kevin; Vakharia, Vejay N

2017-06-01

Several studies have evaluated the use of decompressive hemicraniectomy (DHC) in malignant middle cerebral artery infarction (MMCAI). In the United Kingdom, the National Institute for Health and Care Excellence (NICE) has set criteria for selection of patients for DHC in MMCAI. We set out to survey the attitudes and practice of neurosurgeons and stroke physicians within the United Kingdom towards DHC in MMCAI. An electronic survey of questions on management of MMCAI in various clinical scenarios was submitted to the academic committees of the Society of British Neurological Surgeons and the British Association of Stroke Physicians for approval before dissemination through the consultant members. Responses were collected over 2 months. A total of 78 responses, from 51 neurosurgeons and 27 stroke physicians, were included in final analysis. A total of 54% and 24% of all respondents would recommend DHC in patients aged 60-70 and 70-80 years, respectively; 60% would advocate surgery between 48 and 72 hours and 27% beyond 72 hours. A total of 36% indicated DHC with preoperative Glasgow Coma Scale 15/15. These findings do not conform to current NICE guidelines. Stroke physicians were statistically more likely to recommend DHC in patients older than 60 years (P = 0.032) and in those with dominant multiterritorial infarcts (P = 0.042) and accept a greater postoperative modified Rankin Scale (P = 0.034) compared with neurosurgeons. In view of evidence from recent trials and differences in NICE guidelines and current clinical practice within the United Kingdom, based on our survey results, it is important to reevaluate NICE guidelines. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Health technology adoption and the politics of governance in the UK.

PubMed

Milewa, Timothy

2006-12-01

The manner in which clinical and cost-effectiveness data are used to inform decisions about the funding and availability of drugs, therapies and medical devices is inherently politicised within collectively financed systems of health care. The National Institute for Health and Clinical Excellence (NICE) was established by the British government in 1999 to reach evidence-based decisions on whether selected health technologies should be made available by the National Health Service in England and Wales. But NICE is also required to involve a broad range of interested parties in the decision-making process, provide detailed rationales for its rulings and defend appeals from aggrieved parties. Debates about the emergence of "deliberative" forms of policy governance--based upon participation by a broad range of stakeholders rather than reliance on scientific, bureaucratic or political expertise alone--are thus particularly apposite. This article draws on a study of decision-making within NICE by focusing upon the tenor and orientation of deliberation about the adoption of health technologies. Does such deliberation take place upon a level playing field for different interests? Or do implicit parameters and understandings in the deliberative process tend to privilege some interests by structuring debate and attendant outcomes? Findings suggest that deliberative assumptions and parameters pertaining to fluid and contestable ideas of transparent reasoning and domain competence both reflect and shape relationships of influence and marginality among participants. Broader analytical implications centre on a distinction between "deliberative democracy" and "democratic deliberation". The extent to which this distinction is acknowledged and addressed in policy and practise will have marked implications for the substantive nature of attempts to broaden involvement in decision-making within public sector bodies such as NICE.

The U.K. service level audit of insulin pump therapy in adults.

PubMed

White, H D; Goenka, N; Furlong, N J; Saunders, S; Morrison, G; Langridge, P; Paul, P; Ghatak, A; Weston, P J

2014-04-01

The National Institute for Health and Clinical Excellence (NICE) published guidelines for the use of continuous subcutaneous insulin infusion in 2008 (technology appraisal 151). The first U.K.-wide insulin pump audit took place in 2012 with the aim of determining adherence to the guidance issued in NICE technology appraisal 151. The results of the adult service level audit are reported here. All centres providing continuous subcutaneous insulin infusion services to adults with diabetes in the U.K. were invited to participate. Audit metrics were aligned to technology appraisal 151. Data entry took place online using a DiabetesE formatted data collection tool. One hundred and eighty-three centres were identified as delivering adult continuous subcutaneous insulin infusion services in the U.K., of which 178 (97.3%) participated in the audit. At the time of the audit, 13 428 adults were using insulin pump therapy, giving an estimated prevalence of use of 6%. Ninety-three per cent of centres did not report any barriers in obtaining funding for patients who fulfilled NICE criteria. The mean number of consultant programmed activities dedicated to continuous subcutaneous insulin infusion services was 0.96 (range 0-8), mean whole-time equivalent diabetes specialist nurses was 0.62 (range 0-3) and mean whole-time equivalent dietitian services was 0.3 (range 0-2), of which 39, 61 and 60%, respectively, were not formally funded. The prevalence of continuous subcutaneous insulin infusion use in the U.K. falls well below the expectation of NICE (15-20%) and that of other European countries (> 15%) and the U.S.A. (40%). This may be attributable, in part, to lack of healthcare professional time needed for identification and training of new pump therapy users. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

UK service level audit of insulin pump therapy in paediatrics.

PubMed

Ghatak, A; Paul, P; Hawcutt, D B; White, H D; Furlong, N J; Saunders, S; Morrison, G; Langridge, P; Weston, P J

2015-12-01

To conduct an audit of insulin pump therapy in the UK after the issue of guidelines for the use of continuous subcutaneous insulin infusion by NICE in 2008 (Technology Appraisal 151). All centres in the UK, providing pump services to children and young people were invited to participate in an online audit. Audit metrics were aligned to NICE Technology Appraisal 151 and an electronic data collection tool was used. Of the 176 UK centres identified as providing pump services, 166 (94.3%) participated in the study. A total of 5094 children and young people were identified as using continuous subcutaneous insulin infusion (19% of all paediatric patients with Type 1 diabetes), with a median (range) of 16.9 (0.67-69.4)% per centre. Units had a median of 0.58 consultant sessions, 0.43 full-time equivalent diabetic specialist nurses, and 0.1 full-time equivalent dieticians delivering the pump service. The majority of this time was not formally funded. Families could access 24-h clinical and technical support (83% units), although the delivery varied between consultant, diabetic specialist nurse and company representatives. Only 53% of units ran, or accessed, structured education programmes for continuous subcutaneous insulin infusion use. Most units (86%) allowed continuous subcutaneous insulin infusion use for paediatric inpatients, but only 56% had written guidelines for this scenario. Nine percent of units had encountered funding refusal for a patient fulfilling NICE (Technology Appraisal 151) criteria. The number of children and young people on continuous subcutaneous insulin infusion therapy is consistent with numbers estimated by NICE. There is a worrying lack of funded healthcare professional time. The audit also identified gaps in the provision of structured education and absence of written inpatient guidelines. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.

Application of the Canadian CT head rules in managing minor head injuries in a UK emergency department: implications for the implementation of the NICE guidelines

PubMed Central

Sultan, H; Boyle, A; Pereira, M; Antoun, N; Maimaris, C

2004-01-01

Objective: : In 2002 a new protocol was introduced based on the Canadian CT rules. Before this the Royal College of Surgeons "Galasko" report guidelines had been followed. This study evaluates the effects of the protocol and discusses the impact of the implementation of the NICE head injury guidelines—also based on the Canadian CT rules. Methods: A "before and after" study was undertaken, using data from accident and emergency cards and hospital notes of adult patients with head injuries presenting to the emergency department over seven months in 2001 and nine months in 2002. The two groups were compared to see how rates of computed tomography (CT), admission for observation, discharge, and skull radiography had changed after introduction of the protocol. Results: : Head CT rates in patients with minor head injuries (MHI) increased significantly from 47 of 330 (14%) to 58 of 267 (20%) (p<0.05). There were also significantly increased rates of admission for observation, from 111 (34%) to 119 (45%). Skull radiography rates fell considerably from 33% of all patients with head injuries in 2001 to 1.6% in 2002, without any adverse effect. Conclusions: This study shows that it is possible to replace the current practice in the UK of risk stratification of adult MHI based on skull radiography, with slightly modified versions of the Canadian CT rule/NICE guidelines. This will result in a large reduction in skull radiography and will be associated with modest increases in CT and admissions rates. If introduction of the NICE guideline is to be realistic, the study suggests that it will not be cost neutral. PMID:15208222

[How to assess clinical practice guidelines with AGREE II: The example of neonatal jaundice].

PubMed

Renesme, L; Bedu, A; Tourneux, P; Truffert, P

2016-03-01

Neonatal jaundice is a very frequent condition that occurs in approximately 50-70% of term or near-term (>35 GA) babies in the 1st week of life. In some cases, a high bilirubin blood level can lead to kernicterus. There is no consensus for the management of neonatal jaundice and few countries have published national clinical practice guidelines for the management of neonatal jaundice. The aim of this study was to assess the quality of these guidelines. We conducted a systematic review of the literature for national clinical practice guidelines for the management of neonatal jaundice in term or near-term babies. Four independent reviewers assessed the quality of each guideline using the AGREE II evaluation. For each of the clinical practice guidelines, the management modalities were analyzed (screening, treatment, follow-up, etc.). Seven national clinical practice guidelines were found (South Africa, USA AAP, UK NICE, Canada, Norway, Switzerland, and Israel). The AGREE II score showed widespread variation regarding the quality of these national guidelines. There was no major difference between the guidelines concerning the clinical management of these babies. The NICE guideline is the most valuable guideline regarding the AGREE II score. NICE showed that, despite a strong and rigorous methodology, there is no evidenced-based recommended code of practice (RCP). Comparing RCPs, we found no major differences. The NICE guideline showed the best quality. The AGREE II instrument should be used as a framework when developing clinical practice guidelines to improve the quality of the future guideline. In France, a national guideline is needed for a more standardized management of neonatal jaundice. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Achieving high-quality care: a view from NICE.

PubMed

Leng, Gillian; Partridge, Gemma

2018-01-01

The National Institute for Health and Care Excellence (NICE) was established in 1999 to provide evidence-based guidance. The task of producing guidance by reviewing primary research data and using an advisory committee to develop evidence-based recommendations, is not straightforward. Guidance production is, however, less challenging than the task of putting evidence-based recommendations into practice.NICE is very sensitive to this challenge as, since 1999, over 1500 pieces of NICE guidance have been published. A number of pieces of guidance relate to heart disease, including pharmaceutical agents, new medical technologies and clinical guidelines. Examples include guidelines on acute heart failure and atrial fibrillation, and advice on technologies including edoxaban and implantable cardioverter defibrillators.The research evidence is clear that a change in practice rarely comes about as a result of simply disseminating guidance on best practice. Simple dissemination is particularly ineffective if the guidance has not been produced by a well-respected, credible organisation. It is also clear from the literature that implementation is more successful when more than one approach is taken, and when there is alignment between efforts at organisational, local and national levels.At an organisational level, there should be support from the Board for quality improvement, with ongoing measurement of progress. Resources should be provided for targeted change programmes, particularly where new guidance suggests improvements are required. A systematic process for putting change in place should include identifying barriers to change, agreeing interventions to overcome the barriers and drive forward improvement and planning for implementation and evaluation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Comparative study of fluvial lakes in floodplains of the Elbe, Lužnice and Svratka Rivers based on hydrochemical and biological approach.

PubMed

Havlíková, Petra; Chuman, Tomáš; Janský, Bohumír

2017-11-17

The aim of the thesis was to specify key differences in chemistry and biota (zooplankton communities) among fluvial lakes in three regions of the Czech Republic: the central part of the Elbe River, the upper part of the Lužnice River and the upper part of the Svratka River. The ten studied lakes of the three regions differ in size, geology, shading, connection with the river and the level of anthropogenic impact. The following hypotheses were tested: (1) The water chemistry of fluvial lakes significantly differs in different floodplains. In the central Elbe River floodplain, there are the highest values of conductivity and concentrations of organic matter and nutrients. Fluvial lakes of the Svratka River floodplain show the lowest level of these parameters, and fluvial lakes of the upper Lužnice River have levels intermediate between the two previous regions. (2) The chemistry of fluvial lakes that have contact with the river through surface connection is significantly influenced by the river. (3) The structure of zooplankton differs in different lakes due to the geographical distance between locations, their different altitude and water chemistry. The PCA analysis of selected parameters of the water chemistry revealed a close relationship of locations in the central Elbe River floodplain on the one side and close relationship of the locations in the upper Lužnice River and Svratka River on the other. However, the amount of organic matter, nitrogen (with the exception of nitrates) and phosphorus was independent of the region. The relationship between the extent of the lake-river connection and the water chemistry was not significant. The hypothesis that the zooplankton differ in different lakes was not proved-the species composition was similar in all the lakes.

Integrating health technology assessment requirements in the clinical development of medicines: the experience from NICE scientific advice.

PubMed

Maignen, François; Osipenko, Leeza; Pinilla-Dominguez, Pilar; Crowe, Emily

2017-03-01

The primary objective of the study was to analyse the proposed clinical development and economic evaluation plans for investigational medicinal products for which pharmaceutical companies have sought health technology assessment (HTA) scientific advice (SA). We have selected and analysed all the scientific advice procedures undertaken by National Institute for Health and Care Excellence (NICE) SA between 1 January 2009 and 3 December 2015 for investigational medicinal products. We have mapped the questions asked by the companies and the areas of advice highlighted in the advice reports to the sections of the NICE methods guide to the technology appraisals (2013). An overwhelming proportion of SA procedures have addressed questions related to the clinical development and specifically the main pivotal efficacy studies. Approximately a quarter of the questions relate to the approaches to economic evaluation. Questions raised in European Medicines Agency-HTA procedures generally focus on clinical efficacy issues whereas cost-effectiveness ones tend to dominate in NICE-only procedures. Our analysis shows that the issues mostly discussed in the HTA SA are the choice of comparator, the generalisability of the clinical trial evidence to the NHS practice and the impact of the clinical trial outcomes on quality of life and survival. Less disagreement with the developers' plans was seen in the choice of clinical endpoints, population definition, position of the technology in the treatment pathway and study design. Scientific advice is designed to improve the quality of evidence and approaches to evidence generation for future regulatory approval and HTA evaluation. Our experience to date suggests that payer requirements are inconsistently integrated in the clinical development programmes. More efforts should be dedicated to demonstrating the clinical value of new medicinal products to patients and key decision-makers.

ASCA observations of NGC 1068

NASA Technical Reports Server (NTRS)

Ueno, Shiro; Mushotzky, Richard F.; Koyama, Katsuji; Iwasawa, Kazushi; Awaki, Hisamitsu; Hayashi, Ichizo

1994-01-01

With the high sensitivity and spectral resolution of the Advanced Satellite for Cosmology and Astrophysics (ASCA) satellite, we have discovered strong emission lines from the H-like and/or He-like ions of Ne, Mg, Si, and S as well as Fe L and confirmed the complex structure of Fe K line emission in the Seyfert II galaxy NGC 1068. The continuum emission above 3 keV exhibits rather flat shape with no evidence of low energy absorption. The overall X-ray spectrum can be well explained with a model involving starburst activity plus an obscured active galactic nucleus.

VLBA Observations of Low Luminosity Flat Spectrum Radio Galaxies and BL Lac Objects: Polarisation Properties

NASA Astrophysics Data System (ADS)

Bondi, M.; Dallacasa, D.; Stanghellini, C.; Marchã, M. J. M.

We obtained two-epoch VLBA observations at 5 GHz of a list of radio galaxies drawn from the 200 mJy sample (Marcha et al. 1996). The objects selected for milli-arcsecond scale observations are classified, on the basis of their optical spectroscopic and polarimetric properties, as BL Lac objects, normal weak line radio galaxies, broad line radio galaxies, and transition objects (those with intermediate properties). We present preliminary results on the radio polarization properties, on the milli-arcsecond scale, of objects with different optical properties and discuss structural variations detected from the two epochs.

30. VIEW OF A GLOVEBOX LINE USED IN PLUTONIUM OPERATIONS. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

30. VIEW OF A GLOVEBOX LINE USED IN PLUTONIUM OPERATIONS. SAFETY AND HEALTH CONCERNS WERE OF MAJOR IMPORTANCE AT THE PLANT, BECAUSE OF THE RADIOACTIVE NATURE OF THE MATERIALS USED. PLUTONIUM GIVES OFF ALPHA AND BETA PARTICLES, GAMMA PROTONS, NEUTRONS, AND IS ALSO PYROPHORIC. AS A RESULT, PLUTONIUM OPERATIONS ARE PERFORMED UNDER CONTROLLED CONDITIONS THAT INCLUDE CONTAINMENT, FILTERING, SHIELDING, AND CREATING AN INERT ATMOSPHERE. PLUTONIUM WAS HANDLED WITHIN GLOVEBOXES THAT WERE INTERCONNECTED AND RAN SEVERAL HUNDRED FEET IN LENGTH (5/5/70). - Rocky Flats Plant, Bounded by Indiana Street & Routes 93, 128 & 72, Golden, Jefferson County, CO

X-ray Spectroscopy of E2 and M3 Transitions in Ni-like W

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

Clementson, J; Beiersdorfer, P; Gu, M F

2009-11-09

The electric quadrupole (E2) and magnetic octupole (M3) ground state transitions in Ni-like W{sup 46+} have been measured using high-resolution crystal spectroscopy at the Livermore electron beam ion trap facility. The lines fall in the soft x-ray region near 7.93 {angstrom} and were originally observed as an unresolved feature in tokamak plasmas. Using flat ADP and quartz crystals the wavelengths, intensities, and polarizations of the two lines have been measured for various electron beam energies and compared to intensity and polarization calculations performed using the Flexible Atomic Code (FAC).

Wavelength Measurements of Ni L-shell Lines between 9 and 15 A

NASA Astrophysics Data System (ADS)

Gu, Ming F.; Beiersdorfer, P.; Brown, G. V.; Chen, H.; Thorn, D. B.; Kahn, S. M.

2006-09-01

We present accurate wavelength measurements of nikel L-shell X-ray lines resulting from Δ n ≥ 1 transitions (mostly, 2 - 3 transitions) between 9 and 15 Å. We have used the electron beam ion trap, SuperEBIT, at the Lawrence Livermore National Laboratory and a flat field grating spectrometer to record the spectra. Most significant emission lines of Ni XIX -- XXVI in our spectral coverage are identified. The resulting data set provides valuable input in the analyses of high resolution X-ray spectra of stellar coronae sources, including the Sun. This work was performed under the auspices of U.S. DOE contract No. W-7405-Eng-48, and supported by NASA APRA Grant NAG5-5419.

Sulphur abundances in halo giants from the [S I] line at 1082 nm and the [S I] triplet around 1045 nm

NASA Astrophysics Data System (ADS)

Jönsson, H.; Ryde, N.; Nissen, P. E.; Collet, R.; Eriksson, K.; Asplund, M.; Gustafsson, B.

2011-06-01

Context. It is still debated whether or not the Galactic chemical evolution of sulphur in the halo follows the flat trend with [Fe/H] that is ascribed to the result of explosive nucleosynthesis in type II SNe. It has been suggested that the disagreement between different investigations of sulphur abundances in halo stars might be owing to problems with the diagnostics used, that a new production source of sulphur might be needed in the early Universe, like hypernovae, or that the deposition of supernova ejecta into the interstellar medium is time-delayed. Aims: The aim of this study is to try to clarify this situation by measuring the sulphur abundance in a sample of halo giants using two diagnostics: the S i triplet around 1045 nm and the [S i] line at 1082 nm. The latter of the two is not believed to be sensitive to non-LTE effects. We can thereby minimize the uncertainties in the diagnostic used and estimate the usefulness of the triplet for the sulphur determination in halo K giants. We will also be able to compare our sulphur abundance differences from the two diagnostics with the expected non-LTE effects in the 1045 nm triplet previously calculated by others. Methods: High-resolution near-infrared spectra of ten K giants were recorded using the spectrometer CRIRES mounted at VLT. Two standard settings were used, one covering the S i triplet and one covering the [S i] line. The sulphur abundances were individually determined with equivalent widths and synthetic spectra for the two diagnostics using tailored 1D model atmospheres and relying on non-LTE corrections from the litterature. Effects of convective inhomogeneities in the stellar atmospheres are investigated. Results: The sulphur abundances derived from both the [S i] line and the non-LTE corrected 1045 nm triplet favor a flat trend for the evolution of sulphur. In contrast to some previous studies, we saw no "high" values of [S/Fe] in our sample. Conclusions: We corroborate the flat trend in the [S/Fe] vs. [Fe/H] plot for halo stars found in some previous studies but do not find a scatter or a rise in [S/Fe] as obtained in other works. We find the sulphur abundances deduced from the non-LTE corrected triplet to be somewhat lower than the abundances from the [S i] line, possibly indicating too large non-LTE corrections. Considering 3D modeling, however, they might instead be too small. Moreover, we show that the [S i] line can be used as a sulphur diagnostic down to [Fe/H] ~ -2.3 in giants. Based on observations collected at the European Southern Observatory, Chile (ESO program 080.D-0675(A)).

Modified hoop conjecture in expanding spacetimes and primordial black hole production in FRW universe

NASA Astrophysics Data System (ADS)

Saini, Anshul; Stojkovic, Dejan

2018-05-01

According to a variant of the hoop conjecture, if we localize two particles within the Schwarzschild radius corresponding to their center of mass energy, then a black hole will form. Despite a large body of work on the formation of primordial black holes, so far this conjecture has not been generalized to expanding spacetimes. We derive a formula which gives the distance within which two particles must be localized to give a black hole, and which crucially depends on the expansion rate of the background space. In the limit of a very slow expansion, we recover the flat spacetime case. In the opposite limit of the large expansion rate when the inverse Hubble radius is smaller than the Schwarzschild radius of a "would be" black hole, the new critical distance between two particles that can make a black hole becomes equal to the particle horizon, which is just a requirement that the particles are in a causal contact. This behavior also nicely illustrates why the Big Bang singularity is not a black hole. We then use our formula to calculate the number density, energy density and production rate of black holes produced in collisions of particles. We find that though black holes might be numerous at high temperatures, they never dominate over the background radiation below the Planck temperature.

The Narrow-Line Region of Narrow-Line Seyfert 1 Galaxies

NASA Astrophysics Data System (ADS)

Rodríguez-Ardila, A.; Binette, Luc; Pastoriza, Miriani G.; Donzelli, Carlos J.

2000-08-01

This work studies the optical emission-line properties and physical conditions of the narrow-line region (NLR) of seven narrow-line Seyfert 1 galaxies (NLS1's) for which high signal-to-noise ratio spectroscopic observations were available. The resolution is 340 km s-1 (at Hα) over the wavelength interval 3700-9500 Å, enabling us to separate the broad and narrow components of the permitted emission lines. Our results show that the flux carried out by the narrow component of Hβ is, on average, 50% of the total line flux. As a result, the [O III] λ5007/Hβ ratio emitted in the NLR varies from 1 to 5, instead of the universally adopted value of 10. This has strong implications for the required spectral energy distribution that ionizes the NLR gas. Photoionization models that consider a NLR composed of a combination of matter-bounded and ionization-bounded clouds are successful at explaining the low [O III] λ5007/Hβ ratio and the weakness of low-ionization lines of NLS1's. Variation of the relative proportion of these two type of clouds nicely reproduces the dispersion of narrow-line ratios found among the NLS1 sample. Assuming similar physical model parameters of both NLS1's and the normal Seyfert 1 galaxy NGC 5548, we show that the observed differences of emission-line ratios between these two groups of galaxies can be explained, to a first approximation, in terms of the shape of the input ionizing continuum. Narrow emission-line ratios of NLS1's are better reproduced by a steep power-law continuum in the EUV-soft X-ray region, with spectral index α~-2. Flatter spectral indices (α~-1.5) match the observed line ratios of NGC 5548 but are unable to provide a good match to the NLS1 ratios. This result is consistent with ROSAT observations of NLS1's, which show that these objects are characterized by steeper power-law indices than those of Seyfert 1 galaxies with strong broad optical lines. Based on observations made at CASLEO. Complejo Astronómico El Leoncito (CASLEO) is operated under agreement between the Consejo Nacional de Investigaciones Científicas y técnicas de la República Argentina and the National Universities of La Plata, Córdoba and San Juán.

Transmission type flat-panel X-ray source using ZnO nanowire field emitters

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

Chen, Daokun; Song, Xiaomeng; Zhang, Zhipeng

2015-12-14

A transmission type flat-panel X-ray source in diode structure was fabricated. Large-scale patterned ZnO nanowires grown on a glass substrate by thermal oxidation were utilized as field emitters, and tungsten thin film coated on silica glass was used as the transmission anode. Uniform distribution of X-ray generation was achieved, which benefited from the uniform electron emission from ZnO nanowires. Self-ballasting effect induced by the intrinsic resistance of ZnO nanowire and decreasing of screening effect caused by patterned emitters account for the uniform emission. Characteristic X-ray peaks of W-L lines and bremsstrahlung X-rays have been observed under anode voltages at amore » range of 18–20 kV, the latter of which were the dominant X-ray signals. High-resolution X-ray images with spatial resolution less than 25 μm were obtained by the flat-panel X-ray source. The high resolution was attributed to the small divergence angle of the emitted X-rays from the transmission X-ray source.« less

Heat-Transfer and Pressure Measurements on a Flat-Face Cylinder at a Mach Number Range of 2.49 to 4.44

NASA Technical Reports Server (NTRS)

Burbank, Paige B.; Stallings, Robert L., Jr.

1959-01-01

Heat-transfer coefficients and pressure distributions were obtained on a 4-inch-diameter flat-face cylinder in the Langley Unitary Plan wind tunnel. The measured stagnation heat-transfer coefficient agrees well with 55 percent of the theoretical value predicted by the modified Sibulkin method for a hemisphere. Pressure measurements indicated the dimensionless velocity gradient parameter r du\\ a(sub t) dx, where x=0 at the stagnation point was approximately 0.3 and invariant throughout the Mach number range from 2.49 to 4.44 and the Reynolds number range from 0.77 x 10(exp 6) to 1.46 x 10(exp 6). The heat-transfer coefficients on the cylindrical afterbody could be predicted with reasonable accuracy by flat-plate theory at an angle of attack of 0 deg. At angles of attack the cylindrical afterbody stagnation-line heat transfer could be computed from swept-cylinder theory for large distances back of the nose when the Reynolds number is based on the distance from the flow reattachment points.

Sodium chloride crystallization from thin liquid sheets, thick layers, and sessile drops in microgravity

NASA Astrophysics Data System (ADS)

Fontana, Pietro; Pettit, Donald; Cristoforetti, Samantha

2015-10-01

Crystallization from aqueous sodium chloride solutions as thin liquid sheets, 0.2-0.7 mm thick, with two free surfaces supported by a wire frame, thick liquid layers, 4-6 mm thick, with two free surfaces supported by metal frame, and hemispherical sessile drops, 20-32 mm diameter, supported by a flat polycarbonate surface or an initially flat gelatin film, were carried out under microgravity on the International Space Station (ISS). Different crystal morphologies resulted based on the fluid geometry: tabular hoppers, hopper cubes, circular [111]-oriented crystals, and dendrites. The addition of polyethylene glycol (PEG-3350) inhibited the hopper growth resulting in flat-faced surfaces. In sessile drops, 1-4 mm tabular hopper crystals formed on the free surface and moved to the fixed contact line at the support (polycarbonate or gelatin) self-assembling into a shell. Ring formation created by sessile drop evaporation to dryness was observed but with crystals 100 times larger than particles in terrestrially formed coffee rings. No hopper pyramids formed. By choosing solution geometries offered by microgravity, we found it was possible to selectively grow crystals of preferred morphologies.

Pyramidal-Reflector Solar Heater

NASA Technical Reports Server (NTRS)

1982-01-01

Motor-driven reflector compensates for seasonal changes in Sun's altitude. System has flat-plate absorbers mounted on north side of attic interior. Skylight window on south-facing roof admits Sunlight into attic, lined with mirrors that reflect light to absorbers. Reflectors are inner surfaces of a pyramid lying on its side with window at its base and absorber plates in a cross-sectional plane near its apex.

46 CFR 69.183 - Figures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... fresh and tropical waters. EC01FE91.046 W=1/48 of the distance from the top of the flat keel to the... though the second deck were the freeboard deck. EC01FE91.047 k=a distance between 21 inches and six feet... inches and six feet six inches. a=the distance between the line of the second deck and the uppermost part...

46 CFR 69.183 - Figures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... fresh and tropical waters. EC01FE91.046 W=1/48 of the distance from the top of the flat keel to the... though the second deck were the freeboard deck. EC01FE91.047 k=a distance between 21 inches and six feet... inches and six feet six inches. a=the distance between the line of the second deck and the uppermost part...

Influence of Nose Shape and L/D Ratio on Projectile Penetration in Frozen Soil

DTIC Science & Technology

1980-04-01

unexpected when soil properties are considered. Decreasing temperature below -10%C by 100 or 150 has little effect on the constitutive properties of... Effect ....... ............ ............. 10 L/D Influence .......................... .10 Target Temperature Effects ...10. Effect of L/D ratio and mass on flat nose pro- jectile penetration (the solid lines are least square curve fits to the data

New Textbook Publishing Model for the Internet Age

ERIC Educational Resources Information Center

DiMaria, Frank

2012-01-01

College students living at or below the poverty line often have difficult choices to make: buy groceries, pay rent, or purchase textbooks. To Eric Frank, cofounder of Flat World Knowledge, this is not really a choice. When it comes to eating or buying a textbook, most will choose to eat. According to Frank, the biggest barrier to learning on scale…

EMU helmet mounted display

NASA Technical Reports Server (NTRS)

Marmolejo, Jose (Inventor); Smith, Stephen (Inventor); Plough, Alan (Inventor); Clarke, Robert (Inventor); Mclean, William (Inventor); Fournier, Joseph (Inventor)

1990-01-01

A helmet mounted display device is disclosed for projecting a display on a flat combiner surface located above the line of sight where the display is produced by two independent optical channels with independent LCD image generators. The display has a fully overlapped field of view on the combiner surface and the focus can be adjusted from a near field of four feet to infinity.

Installation Management Command - Flattening or Flat-lining?

DTIC Science & Technology

2012-03-22

3624 Market Street, Philadelphia, PA 19104, (215) 662-5606. The Commission on Higher Education is an institutional accrediting agency recognized by...3624 Market Street, Philadelphia, PA 19104, (215) 662-5606. The Commission on Higher Education is an institutional accrediting agency recognized by...for functional support. Key account management is a concept used in the corporate realm, with companies such as Pepsi Bottling Group, International

Linear Rogowski coil

NASA Astrophysics Data System (ADS)

Nassisi, V.; Delle Side, D.

2017-02-01

Nowadays, the employment and development of fast current pulses require sophisticated systems to perform measurements. Rogowski coils are used to diagnose cylindrical shaped beams; therefore, they are designed and built with a toroidal structure. Recently, to perform experiments of radiofrequency biophysical stresses, flat transmission lines have been developed. Therefore, in this work we developed a linear Rogowski coil to detect current pulses inside flat conductors. The system is first approached by means of transmission line theory. We found that, if the pulse width to be diagnosed is comparable with the propagation time of the signal in the detector, it is necessary to impose a uniform current as input pulse, or to use short coils. We further analysed the effect of the resistance of the coil and the influence of its magnetic properties. As a result, the device we developed is able to record pulses lasting for some hundreds of nanoseconds, depending on the inductance, load impedance, and resistance of the coil. Furthermore, its response is characterized by a sub-nanosecond rise time (˜100 ps). The attenuation coefficient depends mainly on the turn number of the coil, while the fidelity of the response depends both on the magnetic core characteristics and on the current distribution along the plane conductors.

Looking beyond satisfaction: evaluating the value and impact of information skills training.

PubMed

Raynor, Michael; Craven, Jenny

2015-03-01

In this feature guest writers Michael Raynor and Jenny Craven from the National Institute for Health and Care Excellence (NICE) present an overview of their evaluative research study on the value and impact of the information skills training courses they provide at NICE. In particular, this small study used a combination of qualitative and quantitative data to look beyond satisfaction and confidence levels and identify whether learning had actually taken place as a result of attending the sessions, and how new skills were used by the attendees in their day-to-day work. H.S. © 2015 Health Libraries Journal.

Reshaping policy to deliver holistic care for adolescents with Crohn's disease.

PubMed

Smith, Claudia; Gettings, Sheryl

2016-12-08

The number of adolescents with Crohn's disease (CD) is rising, with one third of cases diagnosed before turning 21 years old. Evidence shows that long-term medical intervention, school absence and the physical toll of CD on the growing adolescent also have a psychological effect on patients. In addition, poorly defined transition pathways are extending these problems into adulthood. The National Institute for Health and Care Excellence (NICE) guidelines are important in shaping service delivery and distribution. However, analysis of the full 2012 NICE CD management guidelines indicates they fall short of providing adequate recommendations for holistic management of the disease in young populations. An update in 2016 added a new clinical recommendation to the guidelines, but no further exploration of the psychosocial aspects of the impact of the disease. The authors of this article used a critical review of literature and concluded that service provision for adolescents with CD could be made better by improving CD support networks, involving young people in the development of policy centred on their care, as well as incorporating other (non-NICE) well-researched CD guidelines in national policy. These changes would improve quality of life for this vulnerable population.

Impact of NICE guidance on rates of haemorrhage after tonsillectomy: an evaluation of guidance issued during an ongoing national tonsillectomy audit.

PubMed

Audit, National Prospective Tonsillectomy

2008-08-01

The National Institute for Health and Clinical Excellence (NICE) issued guidance on surgical techniques for tonsillectomy during a national audit of surgical practice and postoperative complications. To assess the impact of the guidance on tonsillectomy practice and outcomes. An interrupted time-series analysis of routinely collected Hospital Episodes Statistics data, and an analysis of longitudinal trends in surgical technique using data from the National Prospective Tonsillectomy Audit. Patients undergoing tonsillectomy in English NHS hospitals between January 2002 and December 2004. Postoperative haemorrhage within 28 days. The rate of haemorrhage increased by 0.5% per year from 2002, reaching 6.4% when the guidance was published. After publication, the rate of haemorrhage fell immediately to 5.7% (difference 0.7%: 95% CI -1.3% to 0.0%) and the rate of increase appeared to have stopped. Data from the National Prospective Tonsillectomy Audit showed that the fall coincided with a shift in surgical techniques, which was consistent with the guidance. NICE guidance influenced surgical tonsillectomy technique and in turn produced an immediate fall in postoperative haemorrhage. The ongoing national audit and strong support from the surgical specialist association may have aided its implementation.

ICP-MS determination of trace elements in aerosols using a dynamic reaction cell: first results in PM10 comparing road and aerial traffic in Nice area (France).

PubMed

Fabretti, Jean-François; Sauret, Nathalie; Gal, Jean-François; Maria, Pierre-Charles; Schärer, Urs

2007-09-01

An analytical methodology was developed for the determination of 21 trace elements in suspended particulate matter (PM) using a microwave digestion procedure associated with an inductively coupled plasma mass spectrometry (ICP-MS). The dynamic reaction cell (DRC) of the instrument was carefully optimized to eliminate polyatomic species causing spectral interferences for three specified elements (Cr, Fe, Mn). With this method, the detection limits based on the analysis of seven quartz fibre filters (QFF) considering a one-week sample (250 m3) varied between 0.2 and 650 pg m(-3) for trace elements and between 2.1 and 5.6 ng m(-3) for major elements (Fe, Ti, Zn). The recovery of the analytes was tested with NIST SRM 1648 urban dust within 10% of the certified values only for 3-4 mg of material. The first results were discussed for a field campaign which was carried out simultaneously in the heaviest traffic road tunnel of the centre of Nice and near the landing-taking-off runways in the international airport of Nice Côte d'Azur. The behaviour of some combustion tracers was especially studied.

What is the quality of economic evaluations of non-drug therapies? A systematic review and critical appraisal of economic evaluations of radiotherapy for cancer.

PubMed

Barbieri, M; Weatherly, H L A; Ara, R; Basarir, H; Sculpher, M; Adams, R; Ahmed, H; Coles, C; Guerrero-Urbano, T; Nutting, C; Powell, M

2014-10-01

Breast, cervical and colorectal cancers are the three most frequent cancers in women, while lung, prostate and colorectal cancers are the most frequent in men. Much attention has been given to the economic evaluation of pharmaceuticals for treatment of cancer by the National Institute for Health and Care Excellence (NICE) in the UK and similar authorities internationally, while economic analysis developed for other types of anti-cancer interventions, including radiotherapy and surgery, are less common. Our objective was to review methods used in published cost-effectiveness studies evaluating radiotherapy for breast, cervical, colorectal, head and neck and prostate cancer, and to compare the economic evaluation methods applied with those defined in the guidelines used by the NICE technology appraisal programme. A systematic search of seven databases (MEDLINE, EMBASE, CDSR, NHSEED, HTA, DARE, EconLit) as well as research registers, the NICE website and conference proceedings was conducted in July 2012. Only economic evaluations of radiotherapy interventions in individuals diagnosed with cancer that included quality-adjusted life-years (QALYs) or life-years (LYs) were included. Included studies were appraised on the basis of satisfying essential, preferred and UK-specific methods requirements, building on the NICE Reference Case for economic evaluations and on other methods guidelines. A total of 29 studies satisfied the inclusion criteria (breast 14, colorectal 2, prostate 10, cervical 0, head and neck 3). Only two studies were conducted in the UK (13 in the USA). Among essential methods criteria, the main issue was that only three (10%) of the studies used clinical-effectiveness estimates identified through systematic review of the literature. Similarly, only eight (28%) studies sourced health-related quality-of-life data directly from patients with the condition of interest. Other essential criteria (e.g. clear description of comparators, patient group indication and appropriate time horizon) were generally fulfilled, while most of the UK-specific requirements were not met. Based on this review there is a dearth of up-to-date, robust evidence on the cost effectiveness of radiotherapy in cancer suitable to support decision making in the UK. Studies selected did not fully satisfy essential method standards currently recommended by NICE.

Implementing the NICE osteoarthritis guidelines: a mixed methods study and cluster randomised trial of a model osteoarthritis consultation in primary care--the Management of OsteoArthritis In Consultations (MOSAICS) study protocol.

PubMed

Dziedzic, Krysia S; Healey, Emma L; Porcheret, Mark; Ong, Bie Nio; Main, Chris J; Jordan, Kelvin P; Lewis, Martyn; Edwards, John J; Jinks, Clare; Morden, Andrew; McHugh, Gretl A; Ryan, Sarah; Finney, Andrew; Jowett, Sue; Oppong, Raymond; Afolabi, Ebenezer; Pushpa-Rajah, Angela; Handy, June; Clarkson, Kris; Mason, Elizabeth; Whitehurst, Tracy; Hughes, Rhian W; Croft, Peter R; Hay, Elaine M

2014-08-27

There is as yet no evidence on the feasibility of implementing recommendations from the National Institute of Health and Care Excellence (NICE) osteoarthritis (OA) guidelines in primary care, or of the effect these recommendations have on the condition. The primary aim of this study is to determine the clinical and cost effectiveness of a model OA consultation (MOAC), implementing the core recommendations from the NICE OA guidelines in primary care. Secondary aims are to investigate the impact, feasibility and acceptability of the MOAC intervention; to develop and evaluate a training package for management of OA by general practitioners (GPs) and practice nurses; test the feasibility of deriving 'quality markers' of OA management using a new consultation template and medical record review; and describe the uptake of core NICE OA recommendations in participants aged 45 years and over with joint pain. A mixed methods study with a nested cluster randomised controlled trial. This study was developed according to a defined theoretical framework (the Whole System Informing Self-management Engagement). An overarching model (the Normalisation Process Theory) will be employed to undertake a comprehensive 'whole-system' evaluation of the processes and outcomes of implementing the MOAC intervention. The primary outcome is general physical health (Short Form-12 Physical component score [PCS]) (Ware 1996). The impact, acceptability and feasibility of the MOAC intervention at practice level will be assessed by comparing intervention and control practices using a Quality Indicators template and medical record review. Impact and acceptability of the intervention for patients will be assessed via self-completed outcome measures and semi-structured interviews. The impact, acceptability and feasibility of the MOAC intervention and training for GPs and practice nurses will be evaluated using a variety of methods including questionnaires, semi-structured interviews, and observations. The main output from the study will be to determine whether the MOAC intervention is clinically and cost effective. Additional outputs will be the development of the MOAC for patients consulting with joint pain in primary care, training and educational materials, and resources for patients and professionals regarding supported self-management and uptake of NICE guidance. ISRCTN number: ISRCTN06984617.

Spin-tunnel investigation of the spinning characteristics of typical single-engine general aviation airplane designs. 2: Low-wing model A; tail parachute diameter and canopy distance for emergency spin recovery

NASA Technical Reports Server (NTRS)

Burk, S. M., Jr.; Bowman, J. S., Jr.; White, W. L.

1977-01-01

A spin tunnel study is reported on a scale model of a research airplane typical of low-wing, single-engine, light general aviation airplanes to determine the tail parachute diameter and canopy distance (riser length plus suspension-line length) required for energency spin recovery. Nine tail configurations were tested, resulting in a wide range of developed spin conditions, including steep spins and flat spins. The results indicate that the full-scale parachute diameter required for satisfactory recovery from the most critical conditions investigated is about 3.2 m and that the canopy distance, which was found to be critical for flat spins, should be between 4.6 and 6.1 m.

Differential characters and cohomology of the moduli of flat connections

NASA Astrophysics Data System (ADS)

Castrillón López, Marco; Ferreiro Pérez, Roberto

2018-05-01

Let π {:} P→ M be a principal bundle and p an invariant polynomial of degree r on the Lie algebra of the structure group. The theory of Chern-Simons differential characters is exploited to define a homology map χ k {:} H_{2r-k-1}(M)× Hk(F/G)→ R/Z , for k

Control of Leakage Flow by Triple Squealer Configuration in Axial Flow Turbine

NASA Astrophysics Data System (ADS)

El-Ghandour, Mohamed; Ibrahim, Mohammed K.; Mori, Koichi; Nakamura, Yoshiaki

A new turbine blade tip shape called triple squealer is proposed. This shape is based on the conventional double squealer, and the cavity on the tip surface is divided into two parts by using a third squealer along the blade camber line. The effect of the ratio of groove depth to span (GDS ratio) was investigated. The flat-tip case (baseline case) and double-squealer case were calculated for comparison. In-house, unstructured, 3D, Navier-Stokes, finite volume, multiblock code with DES (Detached Eddy Simulation) as turbulence model was used to calculate the flow field around the tip. The computational results show that the reduction in the mass flow rate of the leakage flow for the triple squealer is 15.69% compared to the flat-tip case.

Contact sheet recording with a self-acting negative air bearing

NASA Technical Reports Server (NTRS)

Muftu , Sinan (Inventor); Hinteregger, Hans F (Inventor)

2000-01-01

A flat head and a tape transport arrangement impart a wrap angle to the tape at the upstream corner of the head. The wrap angle, corner sharpness and tape stiffness are sufficient to cause a moving tape to form a hollow bump at the upstream corner, thereby creating a hollow into which entrained air can expand, causing a subambient pressure within and downstream of the bump. This pressure keeps the tape in contact with the head. It is created without the need for a groove or complex pressure relief slot(s). No contact pressure arises at the signal exchange site due to media wrap. The highest contact pressures are developed at a wrapped upstream corner. For a tape drive, traveling in both forward and reverse, the wrap can be at both the upstream and downstream (which is the reverse upstream) corners. Heads that are not flat can also be used, if the wrap angle relative to a main surface is sufficient and not too large. The wrapped head can also be used with rotating media, such as disks (floppy and hard) and rotating heads, such as helical wound heads for video recording. Multiple flat tape bearing surfaces can be separated by grooves and/or angles. Each flat can carry heads along one or more gap lines. Multiple adjacent narrow tracks can thus be written for extreme high track density recording.

Perioral Rejuvenation With Ablative Erbium Resurfacing.

PubMed

Cohen, Joel L

2015-11-01

Since the introduction of the scanning full-field erbium laser, misconceptions regarding ablative erbium resurfacing have resulted in its being largely overshadowed by ablative fractional resurfacing. This case report illustrates the appropriateness of full-field erbium ablation for perioral resurfacing. A patient with profoundly severe perioral photodamage etched-in lines underwent full-field ablative perioral resurfacing with an erbium laser (Contour TRL, Sciton Inc., Palo Alto, CA) that allows separate control of ablation and coagulation. The pre-procedure consultations included evaluation of the severity of etched-in lines, and discussion of patient goals, expectations, and appropriate treatment options, as well as a review of patient photos and post-treatment care required. The author generally avoids full-field erbium ablation in patients with Fitzpatrick type IV and above. For each of 2 treatment sessions (separated by approximately 4 months), the patient received (12 cc plain 2% lidodaine) sulcus blocks before undergoing 4 passes with the erbium laser at 150 μ ablation, no coagulation, and then some very focal 30 μ ablation to areas of residual lines still visualized through the pinpoint bleeding. Similarly, full-field ablative resurfacing can be very reliable for significant wrinkles and creping in the lower eyelid skin--where often a single treatment of 80 μ ablation, 50 μ coagulation can lead to a nice improvement. Standardized digital imaging revealed significant improvement in deeply etched rhytides without significant adverse events. For appropriately selected patients requiring perioral (or periorbital) rejuvenation, full-field ablative erbium resurfacing is safe, efficacious and merits consideration.

Over-exposure correction in knee cone-beam CT imaging with automatic exposure control using a partial low dose scan

NASA Astrophysics Data System (ADS)

Choi, Jang-Hwan; Muller, Kerstin; Hsieh, Scott; Maier, Andreas; Gold, Garry; Levenston, Marc; Fahrig, Rebecca

2016-03-01

C-arm-based cone-beam CT (CBCT) systems with flat-panel detectors are suitable for diagnostic knee imaging due to their potentially flexible selection of CT trajectories and wide volumetric beam coverage. In knee CT imaging, over-exposure artifacts can occur because of limitations in the dynamic range of the flat panel detectors present on most CBCT systems. We developed a straightforward but effective method for correction and detection of over-exposure for an Automatic Exposure Control (AEC)-enabled standard knee scan incorporating a prior low dose scan. The radiation dose associated with the low dose scan was negligible (0.0042mSv, 2.8% increase) which was enabled by partially sampling the projection images considering the geometry of the knees and lowering the dose further to be able to just see the skin-air interface. We combined the line integrals from the AEC and low dose scans after detecting over-exposed regions by comparing the line profiles of the two scans detector row-wise. The combined line integrals were reconstructed into a volumetric image using filtered back projection. We evaluated our method using in vivo human subject knee data. The proposed method effectively corrected and detected over-exposure, and thus recovered the visibility of exterior tissues (e.g., the shape and density of the patella, and the patellar tendon), incorporating a prior low dose scan with a negligible increase in radiation exposure.

Velocity field and physical conditions in the active lenticular galaxy NGC 3998

NASA Technical Reports Server (NTRS)

Blackman, C. P.; Wilson, A. S.; Ward, M. J.

1983-01-01

A rotating and expanding flattened distribution of gas is suggested by measurements of the emission line velocity field for the line elliptical/lenticular galaxy NGC 3998, using seven long slit spectrograms in five position angles. Expanding material kinetic energy values of 10 to the 53rd to 10 to the 54th ergs, together with the flat spectrum radio source and nucleus X-ray emission, indicate pronounced nuclear activity. Spectrophotometry of the galactic nucleus shows emission line strengths typical of shocks rather than of photoionization, and line ratios indicate a postshock temperature of 60,000 K and a preshock density of 25 particles/cu cm. Both the stars and the ionized gas of the galaxy have central velocity dispersions of 260 km/s. In view of the high rotational velocity of the stars, NGC 3998 is a lenticular rather than elliptical galaxy.

Computation of saddle point of attachment

NASA Technical Reports Server (NTRS)

Hung, Ching-Mao; Sung, Chao-Ho; Chen, Chung-Lung

1991-01-01

Low-speed flows over a cylinder mounted on a flat plate are studied numerically in order to confirm the existence of a saddle point of attachment in the flow before an obstacle, to analyze the flow characteristics near the saddle point theoretically, and to address the significance of the saddle point of attachment to the construction of external flow structures, the interpretation of experimental surface oil-flow patterns, and the theoretical definition of three-dimensional flow separation. Two numerical codes, one for an incompressible flow and another for a compressible flow, are used for various Mach numbers, Reynolds numbers, grid sizes, and numbers of grid points. It is pointed out that the potential presence of a saddle point of attachment means that a line of 'oil accumulation' from both sides of a skin-friction line emanating outward from a saddle point can be either a line of separation or a line of attachment.

Identification of geometric faces in hand-sketched 3D objects containing curved lines

NASA Astrophysics Data System (ADS)

El-Sayed, Ahmed M.; Wahdan, A. A.; Youssif, Aliaa A. A.

2017-07-01

The reconstruction of 3D objects from 2D line drawings is regarded as one of the key topics in the field of computer vision. The ongoing research is mainly focusing on the reconstruction of 3D objects that are mapped only from 2D straight lines, and that are symmetric in nature. Commonly, this approach only produces basic and simple shapes that are mostly flat or rather polygonized in nature, which is normally attributed to inability to handle curves. To overcome the above-mentioned limitations, a technique capable of handling non-symmetric drawings that encompass curves is considered. This paper discusses a novel technique that can be used to reconstruct 3D objects containing curved lines. In addition, it highlights an application that has been developed in accordance with the suggested technique that can convert a freehand sketch to a 3D shape using a mobile phone.

Spectroscopic Study of the Polar BS Tri

NASA Astrophysics Data System (ADS)

Borisov, N. V.; Gabdeev, M. M.; Shimansky, V. V.; Katysheva, N. A.; Shugarov, S. Yu.

2015-11-01

We have analyzed the spectra of the cataclysmic variable BS Tri taken in September 2011 and August 2012 with the 6-m BTA SAO RAS telescope. The object's spectra exhibit a flat continuum with superimposed strong hydrogen Balmer, neutral and ionized helium emission lines. Our analysis of the line profiles has shown that they consist of several components that are formed in the accretion structure and on the irradiated red dwarf surface. The measured radial velocities of one of the components of the line forming in a spot on the red dwarf surface have allowed the parameters of the system to be estimated: M 1 = 0.75 ± 0.02 M ⊙, M 2 = 0.16 ± 0.01 M ⊙, q = 0.21 ± 0.02, and R L2 = 0.18 ± 0.02 R ⊙. The Doppler maps constructed from the emission lines show no disk accretion, defining the system as a polar.

Electron-density-sensitive Line Ratios of Fe XIII– XVI from Laboratory Sources Compared to CHIANTI

NASA Astrophysics Data System (ADS)

Weller, M. E.; Beiersdorfer, P.; Soukhanovskii, V. A.; Scotti, F.; LeBlanc, B. P.

2018-02-01

We present electron-density-sensitive line ratios for Fe XIII– XVI measured in the spectral wavelength range of 200–440 Å and an electron density range of (1–4) × 1013 cm‑3. The results provide a test at the high-density limit of density-sensitive line ratios useful for astrophysical studies. The measurements were performed on the National Spherical Torus Experiment-Upgrade, where electron densities were measured independently by the laser Thomson scattering diagnostic. Spectra were collected with a flat-field grazing-incidence spectrometer, which provided a spectral resolution of up to 0.3 Å, i.e., high resolution across the broad wavelength range. The response of the instrument was relatively calibrated using spectroscopic techniques in order to improve accuracy. The line ratios are compared to other laboratory sources and the latest version of CHIANTI (8.0.2), and an agreement within 30% is found.

Olaparib for Maintenance Treatment of BRCA 1 or 2 Mutated, Relapsed, Platinum-Sensitive Ovarian, Fallopian Tube and Peritoneal Cancer in People Whose Relapsed Disease has Responded to Platinum-Based Chemotherapy: An Evidence Review Group Perspective of a NICE Single Technology Appraisal.

PubMed

Tappenden, Paul; Harnan, Sue; Ren, Shijie; Thokala, Praveen; Wong, Ruth; Mukuria, Clara; Green, Clare; Pledge, Simon; Tidy, John

2017-01-01

As part of its Single Technology Appraisal process, the National Institute for Health and Care Excellence (NICE) invited the manufacturer of olaparib (AstraZeneca) to submit evidence on the clinical and cost effectiveness of olaparib for the maintenance treatment of BRCA1/2 mutated (BRCAm), platinum-sensitive relapsed (PSR) ovarian, fallopian tube and peritoneal cancer in people whose relapsed disease has responded to platinum-based chemotherapy. The Evidence Review Group (ERG) produced a critical review of the evidence contained within the company's submission (CS) to NICE. The clinical evidence related to one phase II, double-blind randomised controlled trial that recruited 265 patients with PSR serous ovarian cancer (OC) regardless of BRCAm status. Patients received olaparib 400 mg twice daily (b.i.d.) or matched placebo. In the whole population, the primary endpoint of progression-free survival (PFS) was met (hazard ratio [HR] 0.35; 95 % confidence interval [CI] 0.25-0.49, p < 0.01) for olaparib versus placebo. The BRCAm subgroup analysis (added after the study commenced but 1 month before the primary analysis was undertaken) reported an HR for PFS of 0.18 (95 % CI 0.10-0.31, p < 0.0001) for olaparib versus placebo, though interaction tests appeared inconclusive. Overall survival was not statistically significant in the whole group (HR 0.88; 95 % CI 0.64-1.21; p = 0.44) or the BRCAm subgroup (0.73; 95 % CI 0.45-1.17; p = 0.19), though treatment switching may have confounded results. The exclusion of data from sites allowing crossover resulted in an HR for overall survival (OS) of 0.52 (95 % CI 0.28-0.97, p = 0.039) in the BRCAm group. Health-related quality-of-life measures were not significantly different between groups. All post hoc exploratory outcomes (time to treatment discontinuation/death, time to first subsequent therapy/death, and time to second subsequent therapy/death) were statistically significantly better in the olaparib arm in the whole population and the BRCAm subgroup analyses. Adverse events were more frequent for olaparib but were largely minor or manageable. The company's semi-Markov model assessed the cost effectiveness of olaparib versus routine surveillance in patients with BRCAm PSR OC from a National Health Service (NHS) and Personal Social Services (PSS) perspective over a lifetime horizon. The model suggests that the incremental cost-effectiveness ratio (ICER) for olaparib versus routine surveillance is expected to be approximately £49,146 per quality-adjusted life-year (QALY) gained. The ERG did not consider the company's cost-effectiveness estimates to be credible. Additional ERG analyses suggested that the ICER is likely to be more than £92,214 per QALY gained. Additional analyses provided by the company in patients who received three or more lines of chemotherapy suggested a more favourable cost-effectiveness profile for olaparib. The NICE Appraisal Committee recommended olaparib for this subgroup provided the cost of olaparib for people who continue to receive treatment after 15 months will be met by the company.

Stress Analysis and Permeability Testing of Cryogenic Composite Feed Line

NASA Technical Reports Server (NTRS)

Chu, Tsuchin Philip

1999-01-01

For the next generation Single-Stage-To-Orbit (SSTO) Reusable Launch Vehicle (RLV), the use of advanced composite materials is highly desirable and critical to the success of the mission. NASA Marshall Space Flight Center (MSFC) has been working with the aerospace industry for many years to develop and demonstrate the cryogenic composite propellant tanks and feed lines technologies. A 50.8-mm diameter composite feed line for the Clipper Graham (DCY.A) was developed and tested. The purpose of the program is to demonstrate the LH2 permeability, composite to composite and metal joints, as well as composite flange interface of the composite feed line. Stress analysis and permeability testing have been performed on this article. Recently, a larger composite feed line design is being investigated and developed at MSFC for potential use in future RLV. The diameter of the feed line is 203 mm and the overall length is approximately 2.2 meters. This one piece unlined feed line consists of three straight tubular sections joined by two 90 degree elbows. The material chosen is IM7/977-3 prepreg fabric. The lay-up pattern is [0/90, plus or minus 45]s and is built up to 18 plies to the flanges at both ends. A preliminary stress analysis has been conducted to identify potential critical stresses and to develop the finite element analysis (FEA) capability of composite feed lines. As expected, the critical stresses occurred at the rims of some flange holes and the onset of the tapered tubular sections. Further analysis is required to determine the loads, flange deflection, vibration, and combined maximum loads. Two permeability-testing apparatuses were also designed for both flat panel specimens and curved feed line sections after impact damage. A larger permeant gas exposed area is required to accurately determine the effect of impact damage on the permeability of the feed line materials. The flat panel tester was fabricated and assembled. Three test coupons were made of graphite/epoxy plain weave prepreg and unidirectional prepreg. The flow rate was calculated by measuring the change of manometer fluid height per unit time. The permeability of the coupons is then calculated according to Darcy's Law. The pressure increase due to the head rise in the manometer was not considered for the initial estimation. The result of the unidirectional composite coupon agreed with that obtained from the DC-XA feed line testing of a similar material. Further improvement on the design may be required to improve the accuracy and efficiency of permeability testing.

Topographic mapping on large-scale tidal flats with an iterative approach on the waterline method

NASA Astrophysics Data System (ADS)

Kang, Yanyan; Ding, Xianrong; Xu, Fan; Zhang, Changkuan; Ge, Xiaoping

2017-05-01

Tidal flats, which are both a natural ecosystem and a type of landscape, are of significant importance to ecosystem function and land resource potential. Morphologic monitoring of tidal flats has become increasingly important with respect to achieving sustainable development targets. Remote sensing is an established technique for the measurement of topography over tidal flats; of the available methods, the waterline method is particularly effective for constructing a digital elevation model (DEM) of intertidal areas. However, application of the waterline method is more limited in large-scale, shifting tidal flats areas, where the tides are not synchronized and the waterline is not a quasi-contour line. For this study, a topographical map of the intertidal regions within the Radial Sand Ridges (RSR) along the Jiangsu Coast, China, was generated using an iterative approach on the waterline method. A series of 21 multi-temporal satellite images (18 HJ-1A/B CCD and three Landsat TM/OLI) of the RSR area collected at different water levels within a five month period (31 December 2013-28 May 2014) was used to extract waterlines based on feature extraction techniques and artificial further modification. These 'remotely-sensed waterlines' were combined with the corresponding water levels from the 'model waterlines' simulated by a hydrodynamic model with an initial generalized DEM of exposed tidal flats. Based on the 21 heighted 'remotely-sensed waterlines', a DEM was constructed using the ANUDEM interpolation method. Using this new DEM as the input data, it was re-entered into the hydrodynamic model, and a new round of water level assignment of waterlines was performed. A third and final output DEM was generated covering an area of approximately 1900 km2 of tidal flats in the RSR. The water level simulation accuracy of the hydrodynamic model was within 0.15 m based on five real-time tide stations, and the height accuracy (root mean square error) of the final DEM was 0.182 m based on six transects of measured data. This study aimed at construction of an accurate DEM for a large-scale, high-variable zone within a short timespan based on an iterative way of the waterline method.

Flat battery

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

Waki, E.; Kobayashi, S.; Hashimoto, Y.

A flat battery is described comprising: an electrically insulative sheathing film including a first film portion and a second film portion on opposite sides of a fold line, the film having an outer surface and an inner surface opposite the outer surface, on both of the first and the second film portions. The fold line divides the inner surface into a first inner surface portion on the first film portion and a second inner surface portion on the second film portion, the film being folded along the fold line so that the first inner surface portion faces the second innermore » surface portion. The first and second film portions are sealed to one another along the entire peripheries thereof except along the fold line, the first film portion having first a first terminal hole and a second terminal hole formed therein; a first collector formed in a plane on the first inner surface portion and having a first terminal portion covering the first terminal hole, the first terminal portion being exposed to the exterior of the battery through the first terminal hole so as to define a first terminal; and a second collector consisting of a first part formed on the first inner surface portion and a second part continuous to the first part formed on the second inner surface portion. The second collector extends across and is folded along the fold line, the second part having a second terminal portion covering the second terminal hole, the second terminal portion being exposed to the exterior of the battery through the second terminal hole so as to define a second terminal. The second part is formed in the plane in spaced non-overlapping relation to the first collector, one of the first and second collectors consisting of a positive collector, the other of the first and second collectors consisting of a negative collector.« less

Spreading law of non-Newtonian power-law liquids on a spherical substrate by an energy-balance approach.

PubMed

Iwamatsu, Masao

2017-07-01

The spreading of a cap-shaped spherical droplet of non-Newtonian power-law liquids, both shear-thickening and shear-thinning liquids, that completely wet a spherical substrate is theoretically investigated in the capillary-controlled spreading regime. The crater-shaped droplet model with the wedge-shaped meniscus near the three-phase contact line is used to calculate the viscous dissipation near the contact line. Then the energy balance approach is adopted to derive the equation that governs the evolution of the contact line. The time evolution of the dynamic contact angle θ of a droplet obeys a power law θ∼t^{-α} with the spreading exponent α, which is different from Tanner's law for Newtonian liquids and those for non-Newtonian liquids on a flat substrate. Furthermore, the line-tension dominated spreading, which could be realized on a spherical substrate for late-stage of spreading when the contact angle becomes low and the curvature of the contact line becomes large, is also investigated.

Formation of conductive copper lines by femtosecond laser irradiation of copper nitride film on plastic substrates

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

Xu, Xiaodong; Yuan, Ningyi, E-mail: nyyuan@cczu.edu.cn; Center for Low-Dimensional Materials, Micro-Nano Devices and Systems, Changzhou University, Changzhou 213164, Jiangsu

2015-05-15

In this paper, we report a simple method to form conductive copper lines by scanning a single-beam femtosecond pulse laser on a plastic substrate covered with copper nitride (Cu{sub 3}N) film. The Cu{sub 3}N films were prepared by DC magnetron sputtering in the presence of an Ar + N{sub 2} atmosphere at 100 °C. The influence of the laser power and scanning speed on the formed copper line width, surface features, and morphology was analyzed by means of optical microscopy, X-ray diffraction, non-contact 3D profilometer, and scanning electron microscopy. The experimental results demonstrate that low laser power and low scanningmore » speed favor the formation of uniform and flat Cu lines. After process optimization, copper lines with a width less than 5 μm were obtained, which provides an attractive application prospect in the field of flexible electronic devices.« less

HIGH FREQUENCY POWER TRANSMISSION LINE FOR CYCLOTRONS AND THE LIKE

DOEpatents

Armstrong, W.J.

1954-04-20

High-frequency power transmission systems, particularly a stacked capacitance alternating power current transmission line wherein maximum utilization of the effective conductios skin of the line conductors is achieved while enabling a low impedance to be obtained are reported. The transmission line consists of a number of flat metal strips with interleaved dielectric strips. The metal dielectric strips are coiled spirally with the axis of the spiral extending along the length of the strips, and the alternating metal strips at the output end have outwardly extending aligned lugs which are directly strapped together and connected to the respective terminals on the load. At the input end of the transmission line, similarly, the alternate metal strips are directly strapped together and connected to an altereating current source. With the arrangement described each metal strip conducts on both sides, so that the metal strips are designed to have a thickness corresponding to twice the depth of the "skin effect" conducting lamina of each conductor at the source frequency.

Piling-to-buckling transition in the drying process of polymer solution drop on substrate having a large contact angle.

PubMed

Kajiya, Tadashi; Nishitani, Eisuke; Yamaue, Tatsuya; Doi, Masao

2006-01-01

We studied the drying process of polymer solution drops placed on a substrate having a large contact angle with the drop. The drying process takes place in three stages. First, the droplet evaporates keeping the contact line fixed. Second, the droplet shrinks uniformly with receding contact line. Finally the contact line is pinned again, and the droplet starts to be deformed. The shape of the final polymer deposit changes from concave dot, to flat dot, and then to concave dot again with the increase of the initial polymer concentration. This shape change is caused by the gradual transition from the solute piling mechanism proposed by Deegan to the crust buckling mechanism proposed by de Gennes and Pauchard.

In the Jungle of Astronomical On--line Data Services

NASA Astrophysics Data System (ADS)

Egret, D.

The author tried to survive in the jungle of astronomical on--line data services. In order to find efficient answers to common scientific data retrieval requests, he had to collect many pieces of information, in order to formulate typical user scenarios, and try them against a number of different data bases, catalogue services, or information systems. He discovered soon how frustrating treasure coffers may be when their keys are not available, but he realized also that nice widgets and gadgets are of no help when the information is not there. And, before long, he knew he would have to navigate through several systems because no one was yet offering a general answer to all his questions. I will present examples of common user scenarios and show how they were tested against a number of services. I will propose some elements of classification which should help the end-user to evaluate how adequate the different services may be for providing satisfying answers to specific queries. For that, many aspects of the user interaction will be considered: documentation, access, query formulation, functionalities, qualification of the data, overall efficiency, etc. I will also suggest possible improvements to the present situation: the first of them being to encourage system managers to increase collaboration between one another, for the benefit of the whole astronomical community. The subjective review I will present, is based on publicly available astronomical on--line services from the U.S. and from Europe, most of which (excepting the newcomers) were described in ``Databases and On-Line Data in Astronomy", (Albrecht & Egret, eds, 1991): this includes databases (such as NED and Simbad ), catalog services ( StarCat , DIRA , XCatScan , etc.), and information systems ( ADS and ESIS ).

A new species of Esagonatopus Olmi (Hymenoptera, Dryinidae) from Central Brazil.

PubMed

Martins, AndrÉ Luis

2018-02-15

Esagonatopus antonioi Martins sp. nov. from Central Brazil is described and illustrated. The new species is characterized by having the head slightly excavated, almost flat, with granulate sculpture; the frontal line complete; the occipital carina absent; the mesosoma reticulate rugose and the scutum without lateral pointed apophyses. An updated key to the Neotropical species of the genus Esagonatopus Olmi is provided.

Solid State Research

DTIC Science & Technology

1998-05-15

2 Bioaerosol fluorescence sensor concept. 2 1-3 Bioaerosol fluorescence sensor detection geometry: (a) signal collection (side view... wavelength light, (b) Strength of output signal along vertical line trace indicated by arrow in (a). 37 5-2 Brick wall pattern revealed by chemical...etchant. 38 5-3 (a) Flat-field illumination of improved laser-annealed CCD at -90°C with 410-nm wavelength light, (b) Strength of output signal along

Ultrastructure Processing of Ordered Polymers

DTIC Science & Technology

1990-01-18

from regenerated cellulose , then from synthetic polymer consisting of chemical raw materials derived from oils and coal. Since then, some scientists have...ordered crystal- line material, crystallite, throughout the fiber, which is composed of microfibrils and fibrils. The small crystallites are regularly...these flat ribbons appears to consist of smaller " microfibrils " of lateral dimension varying from 50-80 A, as described before(Figs. 15 and 16). These

X-Ray Phase Imaging for Breast Cancer Detection

DTIC Science & Technology

2012-09-01

the Gerchberg-Saxton algorithm in the Fresnel diffraction regime, and is much more robust against image noise than the TIE-based method. For details...developed efficient coding with the software modules for the image registration, flat-filed correction , and phase retrievals. In addition, we...X, Liu H. 2010. Performance analysis of the attenuation-partition based iterative phase retrieval algorithm for in-line phase-contrast imaging

Soils, vegetation, and woody debris data from the 2001 Survey Line fire and a comparable unburned site, Tanana Flats region, Alaska

USGS Publications Warehouse

Manies, Kristen L.; Harden, Jennifer W.; Holingsworth, Teresa N.

2014-01-01

This report describes the collection and processing methodologies for samples obtained at two sites within Interior Alaska: (1) a location within the 2001 Survey Line burn, and (2) an unburned location, selected as a control. In 2002 and 2004 U.S. Geological Survey investigators measured soil properties including, but not limited to, bulk density, volumetric water content, carbon content, and nitrogen content from samples obtained from these sites. Stand properties, such as tree density, the amount of woody debris, and understory vegetation, were also measured and are presented in this report.

X-ray spectroscopy of E2 and M3 transitions in Ni-like W

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

Clementson, J.; Beiersdorfer, P.; Gu, M. F.

2010-01-15

The electric quadrupole (E2) and magnetic octupole (M3) ground-state transitions in Ni-like W{sup 46+} have been measured using high-resolution crystal spectroscopy at the LLNL electron-beam ion trap facility. The lines fall in the soft x-ray region near 7.93 A and were originally observed as an unresolved feature in tokamak plasmas. Using flat ammonium dihydrogen phosphate and quartz crystals, the wavelengths, intensities, and polarizations of the two lines have been measured for various electron-beam energies and compared to intensity and polarization calculations performed using the Flexible Atomic Code (FAC).

High-resolution crystal spectrometer for the 10-60 A extreme ultraviolet region

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

Beiersdorfer, P.; Brown, G.V.; Goddard, R.

2004-10-01

A vacuum crystal spectrometer with nominal resolving power approaching 1000 is described for measuring emission lines with wavelength in the extreme ultraviolet region up to 60 A. The instrument utilizes a flat octadecyl hydrogen maleate crystal and a thin-window 1D position-sensitive gas proportional detector. This detector employs a 1-{mu}m-thick 100x8 mm{sup 2} aluminized polyimide window and operates at one atmosphere pressure. The spectrometer has been implemented on the Livermore electron beam ion traps. The performance of the instrument is illustrated in measurements of the newly discovered magnetic field-sensitive line in Ar{sup 8+}.

High-resolution crystal spectrometer for the 10-60 (angstrom) EUV region

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

Beiersdorfer, P; Brown, G V; Goddard, R

2004-02-20

A vacuum crystal spectrometer with nominal resolving power approaching 1000 is described for measuring emission lines with wavelength in the extreme ultraviolet region up to 60 Angstroms. The instrument utilizes a flat octadecyl hydrogen maleate (OHM) crystal and a thin-window 1-D position-sensitive gas proportional detector. This detector employs a 1 {micro}m-thick 100 x8 mm{sup 2} aluminized polyimide window and operates at one atmosphere pressure. The spectrometer has been implemented on the Livermore electron beam ion traps. The performance of the instrument is illustrated in measurements of the newly discovered magnetic field-sensitive line in Ar{sup 8+}.

Wave-optical evaluation of interference fringes and wavefront phase in a hard-x-ray beam totally reflected by mirror optics.

PubMed

Yamauchi, Kazuto; Yamamura, Kazuya; Mimura, Hidekazu; Sano, Yasuhisa; Saito, Akira; Endo, Katsuyoshi; Souvorov, Alexei; Yabashi, Makina; Tamasaku, Kenji; Ishikawa, Tetsuya; Mori, Yuzo

2005-11-10

The intensity flatness and wavefront shape in a coherent hard-x-ray beam totally reflected by flat mirrors that have surface bumps modeled by Gaussian functions were investigated by use of a wave-optical simulation code. Simulated results revealed the necessity for peak-to-valley height accuracy of better than 1 nm at a lateral resolution near 0.1 mm to remove high-contrast interference fringes and appreciable wavefront phase errors. Three mirrors that had different surface qualities were tested at the 1 km-long beam line at the SPring-8/Japan Synchrotron Radiation Research Institute. Interference fringes faded when the surface figure was corrected below the subnanometer level to a spatial resolution close to 0.1 mm, as indicated by the simulated results.

Nanocrystalline copper films are never flat.

PubMed

Zhang, Xiaopu; Han, Jian; Plombon, John J; Sutton, Adrian P; Srolovitz, David J; Boland, John J

2017-07-28

We used scanning tunneling microscopy to study low-angle grain boundaries at the surface of nearly planar copper nanocrystalline (111) films. The presence of grain boundaries and their emergence at the film surface create valleys composed of dissociated edge dislocations and ridges where partial dislocations have recombined. Geometric analysis and simulations indicated that valleys and ridges were created by an out-of-plane grain rotation driven by reduction of grain boundary energy. These results suggest that in general, it is impossible to form flat two-dimensional nanocrystalline films of copper and other metals exhibiting small stacking fault energies and/or large elastic anisotropy, which induce a large anisotropy in the dislocation-line energy. Copyright © 2017 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

Flat-Passband 3 × 3 Interleaving Filter Designed With Optical Directional Couplers in Lattice Structure

NASA Astrophysics Data System (ADS)

Wang, Qi Jie; Zhang, Ying; Soh, Yeng Chai

2005-12-01

This paper presents a novel lattice optical delay-line circuit using 3 × 3 directional couplers to implement three-port optical interleaving filters. It is shown that the proposed circuit can deliver three channels of 2pi/3 phase-shifted interleaving transmission spectra if the coupling ratios of the last two directional couplers are selected appropriately. The other performance requirements of an optical interleaver can be achieved by designing the remaining part of the lattice circuit. A recursive synthesis design algorithm is developed to calculate the design parameters of the lattice circuit that will yield the desired filter response. As illustrative examples, interleavers with maximally flat-top passband transmission and with given transmission performance on passband ripples and passband bandwidth, respectively, are designed to verify the effectiveness of the proposed design scheme.

Solar concentration properties of flat fresnel lenses with large F-numbers

NASA Technical Reports Server (NTRS)

Cosby, R. M.

1978-01-01

The solar concentration performances of flat, line-focusing sun-tracking Fresnel lenses with selected f-numbers between 0.9 and 2.0 were analyzed. Lens transmittance was found to have a weak dependence on f-number, with a 2% increase occuring as the f-number is increased from 0.9 to 2.0. The geometric concentration ratio for perfectly tracking lenses peaked for an f-number near 1.35. Intensity profiles were more uniform over the image extent for large f-number lenses when compared to the f/0.9 lens results. Substantial decreases in geometri concentration ratios were observed for transverse tracking errors equal to or below 1 degree for all f-number lenses. With respect to tracking errors, the solar performance is optimum for f-numbers between 1.25 and 1.5.

Carbon Nanotube Thin Film Transistors for Flat Panel Display Application.

PubMed

Liang, Xuelei; Xia, Jiye; Dong, Guodong; Tian, Boyuan; Peng, Lianmao

2016-12-01

Carbon nanotubes (CNTs) are promising materials for both high performance transistors for high speed computing and thin film transistors for macroelectronics, which can provide more functions at low cost. Among macroelectronics applications, carbon nanotube thin film transistors (CNT-TFT) are expected to be used soon for backplanes in flat panel displays (FPDs) due to their superior performance. In this paper, we review the challenges of CNT-TFT technology for FPD applications. The device performance of state-of-the-art CNT-TFTs are compared with the requirements of TFTs for FPDs. Compatibility of the fabrication processes of CNT-TFTs and current TFT technologies are critically examined. Though CNT-TFT technology is not yet ready for backplane production line of FPDs, the challenges can be overcome by close collaboration between research institutes and FPD manufacturers in the short term.

Improving a high-efficiency, gated spectrometer for x-ray Thomson scattering experiments at the National Ignition Facility.

PubMed

Döppner, T; Kraus, D; Neumayer, P; Bachmann, B; Emig, J; Falcone, R W; Fletcher, L B; Hardy, M; Kalantar, D H; Kritcher, A L; Landen, O L; Ma, T; Saunders, A M; Wood, R D

2016-11-01

We are developing x-ray Thomson scattering for applications in implosion experiments at the National Ignition Facility. In particular we have designed and fielded MACS, a high-efficiency, gated x-ray spectrometer at 7.5-10 keV [T. Döppner et al., Rev. Sci. Instrum. 85, 11D617 (2014)]. Here we report on two new Bragg crystals based on Highly Oriented Pyrolytic Graphite (HOPG), a flat crystal and a dual-section cylindrically curved crystal. We have performed in situ calibration measurements using a brass foil target, and we used the flat HOPG crystal to measure Mo K-shell emission at 18 keV in 2nd order diffraction. Such high photon energy line emission will be required to penetrate and probe ultra-high-density plasmas or plasmas of mid-Z elements.

Direct and indirect reputation formation in nonhuman great apes (Pan paniscus, Pan troglodytes, Gorilla gorilla, Pongo pygmaeus) and human children (Homo sapiens).

PubMed

Herrmann, Esther; Keupp, Stefanie; Hare, Brian; Vaish, Amrisha; Tomasello, Michael

2013-02-01

Humans make decisions about when and with whom to cooperate based on their reputations. People either learn about others by direct interaction or by observing third-party interactions or gossip. An important question is whether other animal species, especially our closest living relatives, the nonhuman great apes, also form reputations of others. In Study 1, chimpanzees, bonobos, orangutans, and 2.5-year-old human children experienced a nice experimenter who tried to give food/toys to the subject and a mean experimenter who interrupted the food/toy giving. In studies 2 and 3, nonhuman great apes and human children could only passively observe a similar interaction, in which a nice experimenter and a mean experimenter interacted with a third party. Orangutans and 2.5-year-old human children preferred to approach the nice experimenter rather than the mean one after having directly experienced their respective behaviors. Orangutans, chimpanzees, and 2.5-year-old human children also took into account experimenter actions toward third parties in forming reputations. These studies show that the human ability to form direct and indirect reputation judgment is already present in young children and shared with at least some of the other great apes. PsycINFO Database Record (c) 2013 APA, all rights reserved

Effect of Roller Profile on Cylindrical Roller Bearing Life Prediction

NASA Technical Reports Server (NTRS)

Poplawski, Joseph V.; Zaretsky, Erwin V.; Peters, Steven M.

2000-01-01

Four roller profiles used in cylindrical roller bearing design and manufacture were analyzed using both a closed form solution and finite element analysis (FEA) for stress and life. The roller profiles analyzed were flat, tapered end, aerospace, and fully crowned loaded against a flat raceway. Four rolling-element bearing life models were chosen for this analysis and compared. These were those of Weibull, Lundberg and Palmgren, Ioannides and Harris, and Zaretsky. The flat roller profile without edge loading has the longest predicted life. However, edge loading can reduce life by as much as 98 percent. The end tapered profile produced the highest lives but not significantly different than the aerospace profile. The fully crowned profile produces the lowest lives. The resultant predicted life at each stress condition not only depends on the life equation used but also on the Weibull slope assumed. For Weibull slopes of 1.5 and 2, both Lundberg-Palmgren and Iaonnides-Harris equations predict lower lives than the ANSI/ABMAJISO standards. Based upon the Hertz stresses for line contact, the accepted load-life exponent of 10/3 results in a maximum Hertz stress-life exponent equal to 6.6. This value is inconsistent with that experienced in the field.

Predictors of fever-related admissions to a paediatric assessment unit, ward and reattendances in a South London emergency department: the CABIN 2 study.

PubMed

Bustinduy, Amaya L; Chis Ster, Irina; Shaw, Rebecca; Irwin, Adam; Thiagarajan, Jaiganesh; Beynon, Rhys; Ladhani, Shamez; Sharland, Mike

2017-01-01

To explore the risk factors for ward and paediatric assessment unit (PAU) admissions from the emergency department (ED). Prospective observational study. Febrile children attending a large tertiary care ED during the winter of 2014-2015. Ward and PAU admissions, National Institute for Health and Care Excellence (NICE) guidelines classification, reattendance to the ED within 28 days and antibiotic use. A total of 1097 children attending the children's ED with fever were analysed. Risk factors for PAU admission were tachycardia (RR=1.1, 95% CI (1 to 1.1)), ill-appearance (RR=2.2, 95% CI (1.2 to 4.2)), abnormal chest findings (RR=2.1, 95% CI (1.2 to 4.3)), categorised as NICE amber (RR 1.7 95% CI (1.2 to 2.5)). There was a 30% discordance between NICE categorisation at triage and statistical internal validation. Predictors of ward admission were a systemic (RR=6.9, 95% CI (2.4 to 19.8)) or gastrointestinal illness (RR=3.8, 95% (1.4 to 10.4)) and categorised as NICE Red (RR=5.9, 95% CI (2.2 to 15.3)). Only 51 children had probable bacterial pneumonia (4.6%), 52 children had a proven urinary tract infection (4.2%), with just 2 (0.2%) positive blood cultures out of 485 (44%) children who received an antibiotic. 15% of all children reattended by 28 days and were more likely to have been categorised as Amber and had investigations on initial visit. Risk factors for PAU and ward admissions are different in this setting with high reattendance rates and very low proportion of confirmed/probable serious bacterial infections. Future studies need to focus on reducing avoidable admissions and antibiotic treatment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Iceless Icy Moons: Is the Nice Model In Trouble?

NASA Astrophysics Data System (ADS)

Dones, Henry C. Luke; Levison, H. F.

2012-05-01

Nimmo and Korycansky (2012; henceforth NK12) stated that if the outer Solar System underwent a Late Heavy Bombardment (LHB) in the Nice model, the mass striking the icy satellites at speeds up to tens of km/s would have vaporized so much ice that moons such as Mimas, Enceladus, and Miranda would have been devolatilized. NK12's possible explanations of this apparent discrepancy with observations include (1) the mass influx was a factor of 10 less than that in the Nice model; (2) the mass distribution of the impactors was top-heavy, so that luck might have saved some of the moons from suffering large, vapor-removing impacts; or (3) the inner moons formed after the LHB. NK12 calculated the mass influx onto the satellites from the lunar impact rate estimated by Gomes et al. (2005) and scaling factors calculated by Zahnle et al. (1998, 2003; also see Barr and Canup 2010). Production of vapor in hypervelocity impacts is calculated from Kraus et al. (2011). Our preliminary results show that there is about an order-of-magnitude uncertainty in the mass striking the satellites during the LHB, with NK12's estimate at the upper end of the range. We will discuss how the mass influx depends on the velocity and mass distributions of the impactors. The Nice model lives. We thank the NASA Lunar Science Institute (http://lunarscience.nasa.gov/) for support. Barr, A.C., Canup, R.M., Nature Geoscience 3, 164-167 (2010). Gomes, R., Levison, H.F., Tsiganis, K., Morbidelli, A., Nature 435, 466-469 (2005). Kraus, R.G., Senft, L.E., Stewart, S.T., Icarus 214, 724-738 (2011). Nimmo, F., Korycansky, D.G., Icarus, in press, http://www.sciencedirect.com/science/article/pii/S0019103512000310 (2012). Zahnle, K., Dones, L., Levison, H.F., Icarus 136, 202-222 (1998). Zahnle, K., Schenk, P., Levison, H.F., Dones, L., Icarus 163, 263-289 (2003).

N-ICE2015: Multi-disciplinary study of the young sea ice system north of Svalbard from winter to summer.

NASA Astrophysics Data System (ADS)

Steen, Harald; Granskog, Mats; Assmy, Philipp; Duarte, Pedro; Hudson, Stephen; Gerland, Sebastian; Spreen, Gunnar; Smedsrud, Lars H.

2016-04-01

The Arctic Ocean is shifting to a new regime with a thinner and smaller sea-ice area cover. Until now, winter sea ice extent has changed less than during summer, as the heat loss to the atmosphere during autumn and winter is large enough form an ice cover in most regions. The insulating snow cover also heavily influences the winter ice growth. Consequently, the older, thicker multi-year sea ice has been replace by a younger and thinner sea. These large changes in the sea ice cover may have dramatic consequences for ecosystems, energy fluxes and ultimately atmospheric circulation and the Northern Hemisphere climate. To study the effects of the changing Arctic the Norwegian Polar Institute, together with national and international partners, launched from January 11 to June 24, 2015 the Norwegian Young Sea ICE cruise 2015 (N-ICE2015). N-ICE2015 was a multi-disciplinary cruise aimed at simultaneously studying the effect of the Arctic Ocean changes in the sea ice, the atmosphere, in radiation, in ecosystems. as well as water chemistry. R/V Lance was frozen into the drift ice north of Svalbard at about N83 E25 and drifted passively southwards with the ice until she was broken loose. When she was loose, R/V Lance was brought back north to a similar starting position. While fast in the ice, she served as a living and working platform for 100 scientist and engineers from 11 countries. One aim of N-ICE2015 is to present a comprehensive data-set on the first year ice dominated system available for the scientific community describing the state and changes of the Arctic sea ice system from freezing to melt. Analyzing the data is progressing and some first results will be presented.

Achievement of NICE quality standards for patients with new presentation of inflammatory arthritis: observations from the National Clinical Audit for Rheumatoid and Early Inflammatory Arthritis.

PubMed

Ledingham, Joanna M; Snowden, Neil; Rivett, Ali; Galloway, James; Ide, Zoe; Firth, Jill; MacPhie, Elizabeth; Kandala, Ngianga; Dennison, Elaine M; Rowe, Ian

2017-02-01

A national audit was performed assessing the early management of suspected inflammatory arthritis by English and Welsh rheumatology units. The aim of this audit was to measure the performance of rheumatology services against National Institute for Health and Care Excellence (NICE) quality standards (QSs) for the management of early inflammatory arthritis benchmarked to regional and national comparators for the first time in the UK. All individuals >16 years of age presenting to rheumatology services in England and Wales with suspected new-onset inflammatory arthritis were included in the audit. Information was collected against six NICE QSs that pertain to early inflammatory arthritis management. We present national data for the 6354 patients recruited from 1 February 2014 to 31 January 2015; 97% of trusts and health boards in England and Wales participated in this audit. Only 17% of patients were referred by their general practitioner within 3 days of first presentation. Specialist rheumatology assessment occurred within 3 weeks of referral in 38% of patients. The target of DMARD initiation within 6 weeks of referral was achieved in 53% of RA patients; 36% were treated with combination DMARDs and 82% with steroids within the first 3 months of specialist care. Fifty-nine per cent of patients received structured education on their arthritis within 1 month of diagnosis. In total, 91% of patients had a treatment target set; the agreed target was achieved within 3 months of specialist review in only 27% of patients. Access to urgent advice via a telephone helpline was reported to be available in 96% of trusts. The audit has highlighted gaps between NICE standards and delivery of care, as well as substantial geographic variability. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

To what extent are national guidelines for the management of urinary incontinence in women adhered? Data from a national audit.

PubMed

Wagg, A; Duckett, J; McClurg, D; Harari, D; Lowe, D

2011-12-01

OBJECTIVE  To assess the degree of adherence to the current National Institute for Health and Clinical Excellence (NICE) guidelines on the management of urinary incontinence (UI) in women. Retrospective survey of consecutive female inpatients and outpatients with UI as part of a national audit. NHS hospital and primary care (PC) trusts. Twenty-five women <65 years old and 25 women ≥ 65 years old from each participating site. All NHS trusts in England, Wales and Northern Ireland were eligible to participate. A web-based data collection form aligned to the NICE guidelines was constructed for the study. All data submitted to the audit were anonymous and access to the web-tool was password-protected for confidentiality. Data were returned by 128 acute and 75 PC trusts on 7846 women. No diagnosis was documented in 6.8% (153/2254) of younger and 28% (571/2011) of older women in hospitals (P < 0.001), and by 8.6% (123/1435) of younger and 21% (380/1786) of older women in PC trusts. In hospitals, 26% (396/1524) of younger women and 15% (182/1231) of older women (P < 0.001) and in PC trusts 8.2% (77/934) of younger and 4.7% (46/975) of older women underwent multichannel cystometry before conservative therapy. Documentation of discussion of causes and treatment of UI occurred in 76% (1717/2254) of younger and 44% (884/2011) of older women in hospitals (P < 0.001) and in 75% (1080/1435) of younger and 53% (948/1786) of older women in PC trusts (P < 0.001). CONCLUSION Older women are less likely to receive NICE compliant management. Adherence varies according to recommendation. There needs to be concentration on evidence-based community provision of care by competent and interested clinicians before the aims of the NICE guidelines are met. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

Impact of investigations in general practice on timeliness of referral for patients subsequently diagnosed with cancer: analysis of national primary care audit data.

PubMed

Rubin, G P; Saunders, C L; Abel, G A; McPhail, S; Lyratzopoulos, G; Neal, R D

2015-02-17

For patients with symptoms of possible cancer who do not fulfil the criteria for urgent referral, initial investigation in primary care has been advocated in the United Kingdom and supported by additional resources. The consequence of this strategy for the timeliness of diagnosis is unknown. We analysed data from the English National Audit of Cancer Diagnosis in Primary Care on patients with lung (1494), colorectal (2111), stomach (246), oesophagus (513), pancreas (327), and ovarian (345) cancer relating to the ordering of investigations by the General Practitioner and their nature. Presenting symptoms were categorised according to National Institute for Health and Care Excellence (NICE) guidance on referral for suspected cancer. We used linear regression to estimate the mean difference in primary-care interval by cancer, after adjustment for age, gender, and the symptomatic presentation category. Primary-care investigations were undertaken in 3198/5036 (64%) of cases. The median primary-care interval was 16 days (IQR 5-45) for patients undergoing investigation and 0 days (IQR 0-10) for those not investigated. Among patients whose symptoms mandated urgent referral to secondary care according to NICE guidelines, between 37% (oesophagus) and 75% (pancreas) were first investigated in primary care. In multivariable linear regression analyses stratified by cancer site, adjustment for age, sex, and NICE referral category explained little of the observed prolongation associated with investigation. For six specified cancers, investigation in primary care was associated with later referral for specialist assessment. This effect was independent of the nature of symptoms. Some patients for whom urgent referral is mandated by NICE guidance are nevertheless investigated before referral. Reducing the intervals between test order, test performance, and reporting can help reduce the prolongation of primary-care intervals associated with investigation use. Alternative models of assessment should be considered.

Impact of investigations in general practice on timeliness of referral for patients subsequently diagnosed with cancer: analysis of national primary care audit data

PubMed Central

Rubin, G P; Saunders, C L; Abel, G A; McPhail, S; Lyratzopoulos, G; Neal, R D

2015-01-01

Background: For patients with symptoms of possible cancer who do not fulfil the criteria for urgent referral, initial investigation in primary care has been advocated in the United Kingdom and supported by additional resources. The consequence of this strategy for the timeliness of diagnosis is unknown. Methods: We analysed data from the English National Audit of Cancer Diagnosis in Primary Care on patients with lung (1494), colorectal (2111), stomach (246), oesophagus (513), pancreas (327), and ovarian (345) cancer relating to the ordering of investigations by the General Practitioner and their nature. Presenting symptoms were categorised according to National Institute for Health and Care Excellence (NICE) guidance on referral for suspected cancer. We used linear regression to estimate the mean difference in primary-care interval by cancer, after adjustment for age, gender, and the symptomatic presentation category. Results: Primary-care investigations were undertaken in 3198/5036 (64%) of cases. The median primary-care interval was 16 days (IQR 5–45) for patients undergoing investigation and 0 days (IQR 0–10) for those not investigated. Among patients whose symptoms mandated urgent referral to secondary care according to NICE guidelines, between 37% (oesophagus) and 75% (pancreas) were first investigated in primary care. In multivariable linear regression analyses stratified by cancer site, adjustment for age, sex, and NICE referral category explained little of the observed prolongation associated with investigation. Interpretation: For six specified cancers, investigation in primary care was associated with later referral for specialist assessment. This effect was independent of the nature of symptoms. Some patients for whom urgent referral is mandated by NICE guidance are nevertheless investigated before referral. Reducing the intervals between test order, test performance, and reporting can help reduce the prolongation of primary-care intervals associated with investigation use. Alternative models of assessment should be considered. PMID:25602963

Effect of dialyzer geometry on granulocyte and complement activation.

PubMed

Schaefer, R M; Heidland, A; Hörl, W H

1987-01-01

During hemodialysis with cuprophan membranes, the complement system as well as leukocytes become activated. In order to clarify the role of dialyzer geometry, the effect of hollow-fiber versus flat-sheet dialyzers and of different surface areas on C3a generation and leukocyte degranulation was investigated. Plasma levels of leukocyte elastase in complex with alpha 1-proteinase inhibitor were significantly increased after 1 h (+55%) and 3 h (+62%) of hemodialysis with flat-sheet dialyzers as compared to hollow-fiber devices. In addition, plasma levels of lactoferrin, released from the specific granules of leukocytes during activation, were significantly higher (+42%) 3 h after the onset of dialysis treatment with flat-sheet than with hollow-fiber dialyzers. With respect to surface area, larger dialyzers tended to cause more release of leukocyte elastase as compared to dialyzers with smaller surface areas, irrespectively of the configuration of the dialyzer used. On the other hand, activation of the complement system, as measured by the generation of C3a-desarg, did not differ with both types of configurations. The same held true for leukopenia, which was almost identical for hollow-fiber and flat-sheet dialyzers. From these findings two lines of evidence emerge: First, not only the type of membrane material used in a dialyzer may influence its biocompatibility, but the geometry of the extracorporeal device also determines the degree of compatibility. Hence, the extent of leukocyte activation correlated with both configuration of the dialyzer and surface area of the membrane.(ABSTRACT TRUNCATED AT 250 WORDS)

Rare earth element fingerprints in Korean coastal bay sediments: Association with provenance discrimination

NASA Astrophysics Data System (ADS)

Kang, Jeongwon; Woo, Han Jun; Jang, Seok; Jeong, Kap-Sik; Jung, Hoi-Soo; Hwang, Ha Gi; Lee, Jun-Ho; Cho, Jin Hyung

2016-09-01

Rare earth elements (REEs: La-Lu) in surface sediments collected from the mouth and middle tidal flats of Gomso Bay, South Korea, in August 2011 and May 2012 were analyzed to investigate the fine-grained sediment provenance. The upper continental crust (UCC)-normalized light REEs (LREEs: La to Nd) were more enriched than the middle REEs (MREEs: Sm to Dy) and heavy REEs (HREEs: Ho to Lu), resulting in large (La/Yb)UCC (1.9 ± 0.4) to (Gd/Yb)UCC (1.4 ± 0.2) ratios. The monthly (La/Yb)UCC values differed between the mouth and middle tidal flats due to deposition of fine-grained sediments that originated from distant rivers (the Geum and Yeongsan) and the Jujin Stream, located on the southern shore of the inner bay. We observed relative reductions in the (La/Yb)UCC value and REE content in the sediments from the mouth of the bay compared with those from Jujin Stream sediments. Confined to the middle tidal flat around the KH Line of Jujin Stream, the sediments, most enriched in LREEs but depleted in Eu, were distributed in August as strong Jujin Stream runs. Here, we suggest that an increase in LREE/HREE and decrease in MREE/LREE ratios can be used as a proxy to identify the Jujin Stream provenance in mixed riverine sediments and to trace Jujin Stream sediments within the Gomso Bay tidal flat, especially in the summer rainy season.

Structure disorder degree of polysilicon thin films grown by different processing: Constant C from Raman spectroscopy

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

Wang, Quan, E-mail: wangq@mail.ujs.edu.cn; State Key Laboratory of Solid Lubrication, Lanzhou Institute of Chemical Physics, Chinese Academy of Sciences, Lanzhou 730000; Zhang, Yanmin

2013-11-14

Flat, low-stress, boron-doped polysilicon thin films were prepared on single crystalline silicon substrates by low pressure chemical vapor deposition. It was found that the polysilicon films with different deposition processing have different microstructure properties. The confinement effect, tensile stresses, defects, and the Fano effect all have a great influence on the line shape of Raman scattering peak. But the effect results are different. The microstructure and the surface layer are two important mechanisms dominating the internal stress in three types of polysilicon thin films. For low-stress polysilicon thin film, the tensile stresses are mainly due to the change of microstructuremore » after thermal annealing. But the tensile stresses in flat polysilicon thin film are induced by the silicon carbide layer at surface. After the thin film doped with boron atoms, the phenomenon of the tensile stresses increasing can be explained by the change of microstructure and the increase in the content of silicon carbide. We also investigated the disorder degree states for three polysilicon thin films by analyzing a constant C. It was found that the disorder degree of low-stress polysilicon thin film larger than that of flat and boron-doped polysilicon thin films due to the phase transformation after annealing. After the flat polysilicon thin film doped with boron atoms, there is no obvious change in the disorder degree and the disorder degree in some regions even decreases.« less

A regional audit of the use of COX-2 selective non-steroidal anti-inflammatory drugs (NSAIDs) in rheumatology clinics in the West Midlands, in relation to NICE guidelines.

PubMed

Price-Forbes, A N; Callaghan, R; Allen, M E; Rowe, I F

2005-07-01

Whilst all non-steroidal anti-inflammatory drugs (NSAIDs) can cause adverse gastrointestinal events, COX-2-selective inhibitors (COX-2) may have improved gastrointestinal safety compared with non-selective NSAIDs (NSNSAIDs). In 2001, the National Institute for Clinical Excellence (NICE) published guidance on the use of the COX-2 agents celecoxib, rofecoxib, meloxicam and etodolac for rheumatoid arthritis (RA) and osteoarthritis (OA). This study aimed to audit the appropriateness of NSAID use in relation to NICE guidance in rheumatology out-patients. Questionnaires were completed for all patients attending clinics in 18 rheumatology units in the West Midlands over a 2-week period. Data collected included patient demographics, NSAID type, indications, duration of use (> or =3 months was considered prolonged), and concomitant prescription of corticosteroids, warfarin and gastroprotective agents. Data were collected on 2846 patients; 1164 (41%) were taking NSAIDs (791 NSNSAIDs, 373 COX-2). Of the 1164 NSAID users, 753 (65%) had a diagnosis of RA or OA (483 NSNSAIDs, 270 COX-2). Overall, 37% of NSAID prescriptions were appropriate. Of the NSNSAID users, 92% had at least one risk factor for adverse gastrointestinal events and were therefore inappropriately treated. Prolonged use (in 89%) and age > or =65 yr (in 23%) were the most frequent risk factors identified. Of the COX-2 users, 97% had one or more risk factors and were appropriately treated. Analysis of the RA/OA subgroup revealed similar findings. Thirty-six per cent were taking NSAIDs appropriately; 97% of NSNSAID use was inappropriate and 97% of COX-2 use was appropriate treatment. In the whole cohort, gastroprotective agents were used in 26% of NSNSAID users, 56% of gastroprotective agents being proton pump inhibitors. Ninety-two per cent of patients attending rheumatology clinics who were taking NSNSAIDs should have been prescribed a COX-2-selective agent in relation to NICE guidance. Duration of use and age > or =65 yr emerged numerically as the most important risk factors. Significant numbers of patients taking NSNSAIDs may be at risk from adverse gastrointestinal events and clinicians may wish to review their prescribing patterns. Conversely, 97% of patients taking COX-2 agents were treated appropriately. Although practice overall conformed poorly with NICE guidance, NSAID prescribing also needs to be considered in the context of recent concerns regarding the cardiovascular risks of COX-2 agents.

Hydrological modelling in sandstone rocks watershed

NASA Astrophysics Data System (ADS)

Ponížilová, Iva; Unucka, Jan

2015-04-01

The contribution is focused on the modelling of surface and subsurface runoff in the Ploučnice basin. The used rainfall-runoff model is HEC-HMS comprising of the method of SCS CN curves and a recession method. The geological subsurface consisting of sandstone is characterised by reduced surface runoff and, on the contrary, it contributes to subsurface runoff. The aim of this paper is comparison of the rate of influence of sandstone on reducing surface runoff. The recession method for subsurface runoff was used to determine the subsurface runoff. The HEC-HMS model allows semi- and fully distributed approaches to schematisation of the watershed and rainfall situations. To determine the volume of runoff the method of SCS CN curves is used, which results depend on hydrological conditions of the soils. The rainfall-runoff model assuming selection of so-called methods of event of the SCS-CN type is used to determine the hydrograph and peak flow rate based on simulation of surface runoff in precipitation exceeding the infiltration capacity of the soil. The recession method is used to solve the baseflow (subsurface) runoff. The method is based on the separation of hydrograph to direct runoff and subsurface or baseflow runoff. The study area for the simulation of runoff using the method of SCS CN curves to determine the hydrological transformation is the Ploučnice basin. The Ploučnice is a hydrologically significant river in the northern part of the Czech Republic, it is a right tributary of the Elbe river with a total basin area of 1.194 km2. The average value of CN curves for the Ploučnice basin is 72. The geological structure of the Ploučnice basin is predominantly formed by Mesozoic sandstone. Despite significant initial loss of rainfall the basin response to the causal rainfall was demonstrated by a rapid rise of the surface runoff from the watershed and reached culmination flow. Basically, only surface runoff occures in the catchment during the initial phase of this extreme event. The increase of the baseflow runoff is slower and remains constant after reaching a certain level. The rise of the baseflow runoff is showed in a descending part of the hydrograph. The recession method in this case shows almost 20 hours delay. Results from the HEC-HMS prove availability of both methods for the runoff modeling in this type of catchment. When simulating extreme short-term rainfall-runoff episodes, the influence of geological subsurface is not significant, but it is manifested. Using more relevant rainfall events would bring more satisfactory results.

Provision of smoking cessation support for pregnant women in England: results from an online survey of NHS stop smoking services for pregnant women

PubMed Central

2014-01-01

Background Smoking during pregnancy is a major public health concern and an NHS priority. In 2010, 26% of UK women smoked immediately before or during their pregnancy and 12% smoked continuously. Smoking cessation support is provided through free at the point of use Stop Smoking Services for Pregnant women (SSSP). However, to date, little is known of how these services provide support across England. The aim of this study was to describe the key elements of support provided through English SSSP. Methods SSSP managers were invited to participate in this survey by email. Data were then collected via an online questionnaire; one survey was completed for each SSSP. Up to four reminder emails were sent over a two month period. Results 86% (121 of 141) of services completed the survey. Responding services were, on average, larger than non-responding services in terms of the number of pregnant women setting quit dates and successfully quitting (p < 0.01). In line with the 2010 NICE guidelines, Stop Smoking in Pregnancy and following Childbirth, one in five SSSP identified pregnant smokers using carbon monoxide (CO) testing and refer via an opt-out pathway. All services offered nicotine replacement therapy (NRT) to pregnant women and 87% of services also offered dual therapy NRT, i.e. combination of a patch and short acting NRT product.. The 2010 NICE guidelines note that services should be flexible and client-centred. Consistent with this, SSSP offer pregnant women a range of support types (median 4) including couple/family, group (open or closed) or one-to-one. These are available in a number of locations (median 5), including in community venues, clinics and women’s homes. Conclusions English Stop Smoking Services offer behavioural support and pharmacotherapy to pregnant women motivated to quit smoking. Interventions provided are generally evidence-based and delivered in a variety of both social and health care settings. PMID:24593130

Effect of isospin diffusion on the production of neutron-rich nuclei in multinucleon transfer reactions

NASA Astrophysics Data System (ADS)

Niu, Fei; Chen, Peng-Hui; Guo, Ya-Fei; Ma, Chun-Wang; Feng, Zhao-Qing

2018-03-01

The isospin dissipation dynamics in multinucleon transfer reactions has been investigated within the dinuclear system model. Production cross sections of neutron-rich isotopes around projectile-like and target-like fragments are estimated in collisions of Ni,6458+208Pb and 78.86,91Kr +198Pt near Coulomb barrier energies. The isospin diffusion in the nucleon transfer process is coupled to the dissipation of relative motion energy and angular momentum of colliding system. The available data of projectile-like fragments via multinucleon transfer reactions are nicely reproduced. It is found that the light projectile-like fragments are produced in the neutron-rich region because of the isospin equilibrium in two colliding nuclei. However, the heavy target-like fragments tend to be formed on the neutron-poor side above the β -stability line. The neutron-rich projectiles move the maximal yields of heavy nuclei to the neutron-rich domain and are available for producing the heavy exotic isotopes, in particular around the neutron shell closure of N =126 .

Predicting lanthanide cluster properties: a comparison with the observed optical spectra of HO 2

NASA Astrophysics Data System (ADS)

Nemukhin, A. V.; Ermilov, A. Yu.; Petrukhina, M. A.; Klotzbücher, W. E.; Smets, J.

1997-10-01

Ab initio pseudopotential calculations for HO and HO 2 have been carried out in order to support an assignment of the bands observed in UV-visible spectra of matrix isolated holmium species. SCF, MCSCF and configuration interaction (CI) procedures have been used with quasirelativistic pseudopotentials to compute the ground and excited state energies of HO and HO 2, together with the dipole transition moments. For HO 2, using a Q = 11 pseudopotential (describing the holmium atom in the 4f 106s 25d 1 electronic state), two transitions from the ground state σg2σu2πu2 to the states with principal excitations σu → πg and π u → σ g∗ are predicted at 499 and 524 nm. These two lines, with predicted close intensities, correlate nicely with the observed features at 498/504 and 558/563nm in the spectrum of matrix-isolated HO 2.

Crizotinib for Untreated Anaplastic Lymphoma Kinase-Positive Non-Small-Cell Lung Cancer: An Evidence Review Group Perspective of a NICE Single Technology Appraisal.

PubMed

Morgan, Philip; Woolacott, Nerys; Biswas, Mousumi; Mebrahtu, Teumzghi; Harden, Melissa; Hodgson, Robert

2017-09-01

As part of the National Institute for Health and Care Excellence (NICE) single technology appraisal process, the manufacturer of crizotinib submitted evidence on the clinical and cost effectiveness of crizotinib in untreated anaplastic lymphoma kinase-positive (ALK-positive) non-small-cell lung cancer (NSCLC). Crizotinib has previously been assessed by NICE for patients with previously treated ALK-positive NSCLC (TA 296). It was not approved in this previous appraisal, but had been made available through the cancer drugs fund. As part of this new appraisal, the company included a price discount patient access scheme (PAS). The Centre for Reviews and Dissemination and Centre for Health Economics Technology Appraisal Group at the University of York was commissioned to act as the independent Evidence Review Group (ERG). This article provides a description of the company's submission and the ERG's review and summarises the resulting NICE guidance issued in August 2016. The main clinical-effectiveness data were derived from a multicentre randomised controlled trial-PROFILE 1014-that compared crizotinib with pemetrexed chemotherapy in combination with carboplatin or cisplatin in patients with untreated non-squamous ALK-positive NSCLC. In the trial, crizotinib demonstrated improvements in progression-free survival (PFS) and overall survival (OS). The company's economic model was a three-state 'area under the curve' Markov model. The base-case incremental cost-effectiveness ratio (ICER) was estimated to be greater than £50,000 per quality-adjusted life-year (QALY) gained (excluding the PAS discount). The ERG assessment of the evidence submitted by the company raised a number of concerns. In terms of the clinical evidence, the OS benefit was highly uncertain due to the cross-over permitted in the trial and the immaturity of the data; only 26% of events had occurred by the data cut-off point. In the economic modelling, the most significant concerns related to the analysis of OS and assumptions made regarding the duration of therapy. The ERG exploratory re-analysis of the OS data relaxed the assumption of proportional hazards made in the company submission, which demonstrated significant uncertainty regarding the OS gains from crizotinib. The ERG reconfigured the economic model so that duration of therapy was based on the area under the curve analysis of the PROFILE 1014 trial, dramatically increasing the cost associated with implementing crizotinib and consequently, substantially increasing the ICER. At the first appraisal meeting, the NICE Appraisal Committee concluded that crizotinib, while clinically effective, was not sufficiently cost effective for use in the UK NHS. Following the consultation, the company offered a revised PAS and conducted extensive re-analysis, resulting in a revised base-case ICER of £47,291 per QALY gained. The NICE Appraisal Committee concluded that crizotinib was likely to be a cost-effective use of NHS resources, despite the uncertainty that persisted around a number of factors, namely the long-term survival benefit of crizotinib. Crizotinib was therefore recommended as an option for untreated ALK-positive advanced NSCLC in adults.

Manipulating line waves in flat graphene for agile terahertz applications

NASA Astrophysics Data System (ADS)

Bisharat, Dia'aaldin J.; Sievenpiper, Daniel F.

2018-05-01

Reducing open waveguides enabled by surface waves, such as surface plasmon polaritons, to a one-dimensional line is attractive due to the potentially enhanced control over light confinement and transport. This was recently shown to be possible by simply interfacing two co-planar surfaces with complementary surface impedances, which support transverse-magnetic and transverse-electric modes, respectively. Attractively, the resultant "line wave" at the interface line features singular field enhancement and robust direction-dependent polarizations. Current implementations, however, are limited to microwave frequencies and have fixed functionality due to the lack of dynamic control. In this article, we examine the potential of using gate-tunable graphene sheets for supporting line waves in the terahertz regime and propose an adequate graphene-metasurface configuration for operation at room temperature and low voltage conditions. In addition, we show the occurrence of quasi-line wave under certain conditions of non-complementary boundaries and qualify the degradation in line wave confinement due to dissipation losses. Furthermore, we show the possibility to alter the orientation of the line wave's spin angular momentum on demand unlike conventional surface waves. Our results on active manipulation of electromagnetic line waves in graphene could be useful for various applications including reconfigurable integrated circuits, modulation, sensing and signal processes.

A Photometric Study of 1134 Kepler

NASA Astrophysics Data System (ADS)

Pilcher, Frederick; Benishek, Vladimir

2018-04-01

Minor planet 1134 Kepler has a synodic rotation period 2.7545 hours and amplitude increasing from 0.12 to 0.18 magnitudes in the interval 2017 Aug. 26 – Nov. 22. Superimposed upon the short rotation period is a 0.45 magnitude fading that we attribute to its movement in the sky from a more polar to a more equatorial line of sight, suggesting a somewhat flat shape for this object.

Numerical study of the interaction between a head fire and a backfire propagating in grassland.

Treesearch

Dominique Morvan; Sofiane Meradji; William Mell

2011-01-01

One of the objectives of this paper was to simulate numerically the interaction between two line fires ignited in a grassland, on a flat terrain, perpendicularly to the wind direction, in such a way that the two fire fronts (a head fire and a backfire) propagated in opposite directions parallel to the wind. The numerical simulations were conducted in 3-0 using the new...

The iMoD display: considerations and challenges in fabricating MOEMS on large area glass substrates

NASA Astrophysics Data System (ADS)

Chui, Clarence; Floyd, Philip D.; Heald, David; Arbuckle, Brian; Lewis, Alan; Kothari, Manish; Cummings, Bill; Palmateer, Lauren; Bos, Jan; Chang, Daniel; Chiang, Jedi; Wang, Li-Ming; Pao, Edmon; Su, Fritz; Huang, Vincent; Lin, Wen-Jian; Tang, Wen-Chung; Yeh, Jia-Jiun; Chan, Chen-Chun; Shu, Fang-Ann; Ju, Yuh-Diing

2007-01-01

QUALCOMM has developed and transferred to manufacturing iMoD displays, a MEMS-based reflective display technology. The iMoD array architecture allows for development at wafer scale, yet easily scales up to enable fabrication on flat-panel display (FPD) lines. In this paper, we will describe the device operation, process flow and fabrication, technology transfer issues, and display performance.

3D Visualizations of Abstract DataSets

DTIC Science & Technology

2010-08-01

contrasts no shadows, drop shadows and drop lines. 15. SUBJECT TERMS 3D displays, 2.5D displays, abstract network visualizations, depth perception , human...altitude perception in airspace management and airspace route planning—simulated reality visualizations that employ altitude and heading as well as...cues employed by display designers for depicting real-world scenes on a flat surface can be applied to create a perception of depth for abstract

Sediment Trapping Pathways and Mechanisms through the Mekong Tidal River and Subaqueous Delta

DTIC Science & Technology

2013-09-30

strive to understand how the delicate balance of ebb and flood sediment fluxes is maintained to create tidal flat and mangrove complexes, and...subaqueous delta on the inner continental shelf, and sediment sinks within vegetated/ mangrove shoreline complexes. Our overall hypothesis is that sediment... Mangrove /Vegetated Intertidal Areas. Along the main stem tidal river and coastal banks may be shorelines lined with vegetation ( mangroves at the

25. VIEW OF THE MACHINE TOOL LAYOUT IN ROOMS 244 ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

25. VIEW OF THE MACHINE TOOL LAYOUT IN ROOMS 244 AND 296. MACHINES WERE USED FOR STAINLESS STEEL FABRICATION (THE J-LINE). THE ORIGINAL DRAWING HAS BEEN ARCHIVED ON MICROFILM. THE DRAWING WAS REPRODUCED AT THE BEST QUALITY POSSIBLE. LETTERS AND NUMBERS IN THE CIRCLES INDICATE FOOTER AND/OR COLUMN LOCATIONS. - Rocky Flats Plant, General Manufacturing, Support, Records-Central Computing, Southern portion of Plant, Golden, Jefferson County, CO

Evaporation-induced flow in an inviscid liquid line at any contact angle

NASA Astrophysics Data System (ADS)

Petsi, A. J.; Burganos, V. N.

2006-04-01

The problem of potential flow inside an evaporating liquid line, shaped as an infinitely long cylindrical segment lying on a flat surface, is considered and an analytical solution is obtained for any contact angle in (0,π) . In this way, microflow details inside linear liquid bodies evaporating on hydrophilic, hydrophobic, and strongly hydrophobic substrates can now be obtained. The mathematical formulation employs the velocity potential and stream function formulations in bipolar coordinates and the solution is obtained using the technique of Fourier transform. Both pinned and depinned contact lines are considered. The solution is applicable to any evaporation mechanism but for illustration purposes numerical results are presented here for the particular case of kinetically controlled evaporation. For hydrophilic substrates, the flow inside the evaporating liquid line is directed towards the edges for pinned contact lines, thus, promoting a coffee stain effect. The opposite flow direction is observed for depinned contact lines. However, for strongly hydrophobic substrates, flow is directed outwards for both pinned and depinned contact lines, but owing to its low magnitude compared to that on hydrophilic substrates, a craterlike colloidal deposit should be expected rather than a ringlike deposit, in agreement with experimental observations.

Evaluation of the effectiveness of an intravenous line and fluid bottle fixation design.

PubMed

Chiou, Piao-Yi; Chien, Chih-Yin; Shiu, Ting-Ru; Lin, Pei-Jiun; Lin, Wan-Yu; Jiang, Yi-Rung

2015-01-01

It's important to improve the stability of intravenous (IV) lines and bottles during patient activity and nursing care. We developed an intravenous line and fluid bottle fixation design (ILFBFD) which includes a bottle retaining clip and line fixation kit. We randomly assigned 60 participants each to the experimental and control groups. Participants were asked to push an IV stand without and with ILFBFD 11 meters on uneven pavement and a sloping floor. The distance the IV bottle moved was recorded. Self-administered questionnaires were used to collect the opinions of the participants. Use of ILFBFD, resulted in less movement in the anteroposterior and left/right directions (differences of 46.98 cm2, t= 12.80, p < 0.000 and 39.24 cm2, t= 8.01, p< 0.000, respectively) compared with not using ILFBFD. The average scores for bottle movement when participants walked on a flat floor, uneven pavement and sloping floor, IV line tangling and dropping, and organization of Liv lines were significantly better in those using than not using ILFBFD. The results can be used in clinical practice to reduce knotting of IV lines, and to enhance the safety and quality of patient care.

Plane-grating flat-field soft x-ray spectrometer

NASA Astrophysics Data System (ADS)

Hague, C. F.; Underwood, J. H.; Avila, A.; Delaunay, R.; Ringuenet, H.; Marsi, M.; Sacchi, M.

2005-02-01

We describe a soft x-ray spectrometer covering the 120-800 eV range. It is intended for resonant inelastic x-ray scattering experiments performed at third generation synchrotron radiation (SR) facilities and has been developed with SOLEIL, the future French national SR source in mind. The Hettrick-Underwood principle is at the heart of the design using a combination of varied line-spacing plane grating and spherical-mirror to provide a flat-field image. It is slitless for optimum acceptance. This means the source size determines the resolving power. A spot size of ⩽5μm is planned at SOLEIL which, according to simulations, should ensure a resolving power ⩾1000 over the whole energy range. A 1024×1024 pixel charge-coupled device (CCD) with a 13μm×13μm pixel size is used. This is an improvement on the use of microchannel-plate detectors, both as concerns efficiency and spatial resolution. Additionally spectral line curvature is avoided by the use of a horizontal focusing mirror concentrating the beam in the nondispersing direction. It allows for readout using a binning mode to reduce the intrinsically large CCD readout noise. Preliminary results taken at beamlines at Elettra (Trieste) and at BESSY (Berlin) are presented.

Geometric Modeling of Construction Communications with Specified Dynamic Properties

NASA Astrophysics Data System (ADS)

Korotkiy, V. A.; Usmanova, E. A.; Khmarova, L. I.

2017-11-01

Among many construction communications the pipelines designed for the organized supply or removal of liquid or loose working bodies are distinguished for their functional purpose. Such communications should have dynamic properties which allow one to reduce losses on friction and vortex formation. From the point of view of geometric modeling, the given dynamic properties of the projected communication mean the required degree of smoothness of its center line. To model the axial line (flat or spatial), it is proposed to use composite curve lines consisting of the curve arcs of the second order or from their quadratic images. The advantage of the proposed method is that the designer gets the model of a given curve not as a set of coordinates of its points but in the form of a matrix of coefficients of the canonical equations for each arc.

Dust and ionized gas in active radio elliptical galaxies

NASA Technical Reports Server (NTRS)

Forbes, D. A.; Sparks, W. B.; Macchetto, F. D.

1990-01-01

The authors present broad and narrow bandwidth imaging of three southern elliptical galaxies which have flat-spectrum active radio cores (NGC 1052, IC 1459 and NGC 6958). All three contain dust and extended low excitation optical line emission, particularly extensive in the case of NGC 1052 which has a large H alpha + (NII) luminosity. Both NGC 1052 and IC 1459 have a spiral morphology in emission-line images. All three display independent strong evidence that a merger or infall event has recently occurred, i.e., extensive and infalling HI gas in NGC 1052, a counter-rotating core in IC 1459 and Malin-Carter shells in NGC 6958. This infall event is the most likely origin for the emission-line gas and dust, and the authors are currently investigating possible excitation mechanisms (Sparks et al. 1990).

Research of X-ray curved crystals analyzer

NASA Astrophysics Data System (ADS)

Xiao, Shali; Xong, Xian-cai; Qian, Jia-yu; Zhong, Xian-xin; Yan, Guo-hong; Liu, Zhong-li; Ding, Yong-kun

2005-08-01

X-ray spectrograph has long been used as a means of diagnosing conditions of laser-produced plasmas, as information concerning both the temperature and density can be extracted from the emitted radiation. For the measurement of X-ray lines in the energy range of 0.6-6 keV, A curved crystal X-ray spectrometer of reflection type elliptical geometry is required. In order to obtain both high resolution and collection efficiency the elliptical geometry is more advantageous than the flat configurations. Elliptical curved crystals spectrograph with a relatively wide spectral range are of particular use for deducing electron temperatures by measurement of the ratios of lines associated with different charge states. Curved crystals analyzer was designed and manufactured for use on an experiment to investigate the properties of laser produced plasmas. The spectrograph has 1350mm focal length and for these measurements, utilized PET, LIF, KAP and MICA crystal bent onto an elliptical substrate. This crystal analyzer covers the Bragg angel range from 30 to 67.5. The analyzer based on elliptically geometrical principle, which has self-focusing characteristics. The experiment was carried out on Shanghai Shengguang-II Facility and aimed to investigate the characteristics of a high density plasma. Experimental results using Curved crystal analyzer are described which show spectrum of Ti, Au laser-plasma. The focusing crystal analyzer clearly gave an increase in sensitivity over a flat crystal. Spectra showing the main resonance line were recorded with X-ray CCD and with laser energies 150J laser wavelength 350nm. The calculated wavelength resolution is about 500-1000.

The characterization of the distant blazar GB6 J1239+0443 from flaring and low activity periods

DOE PAGES

Pacciani, L.; Donnarumma, I.; Denney, K. D.; ...

2012-08-27

In 2008, AGILE and Fermi detected gamma-ray flaring activity from the unidentified EGRET source 3EG J1236+0457, recently associated with a flat spectrum radio quasar (GB6 J1239+0443) at z = 1.762. The optical counterpart of the gamma-ray source underwent a flux enhancement of a factor of 15–30 in six years, and of ~10 in six months. Here, we interpret this flare-up in terms of a transition from an accretion-disc-dominated emission to a synchrotron-jet-dominated one. We analysed a Sloan Digital Sky Survey (SDSS) archival optical spectrum taken during a period of low radio and optical activity of the source. We estimated themore » mass of the central black hole using the width of the C iv emission line. In our work, we have also investigated SDSS archival optical photometric data and ultraviolet GALEX observations to estimate the thermal disc emission contribution of GB6 J1239+0443. This analysis of the gamma-ray data taken during the flaring episodes indicates a flat gamma-ray spectrum, with an extension of up to 15 GeV, with no statistically relevant sign of absorption from the broad-line region, suggesting that the blazar zone is located beyond the broad-line region. Our result is confirmed by the modelling of the broad-band spectral energy distribution (well constrained by the available multiwavelength data) of the flaring activity periods and by the accretion disc luminosity and black hole mass estimated by us using archival data.« less

Faraday rotation from magnesium II absorbers toward polarized background radio sources

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

Farnes, J. S.; O'Sullivan, S. P.; Corrigan, M. E.

2014-11-01

Strong singly ionized magnesium (Mg II) absorption lines in quasar spectra typically serve as a proxy for intervening galaxies along the line of sight. Previous studies have found a correlation between the number of these Mg II absorbers and the Faraday rotation measure (RM) at ≈5 GHz. We cross-match a sample of 35,752 optically identified non-intrinsic Mg II absorption systems with 25,649 polarized background radio sources for which we have measurements of both the spectral index and RM at 1.4 GHz. We use the spectral index to split the resulting sample of 599 sources into flat-spectrum and steep-spectrum subsamples. Wemore » find that our flat-spectrum sample shows significant (∼3.5σ) evidence for a correlation between Mg II absorption and RM at 1.4 GHz, while our steep-spectrum sample shows no such correlation. We argue that such an effect cannot be explained by either luminosity or other observational effects, by evolution in another confounding variable, by wavelength-dependent polarization structure in an active galactic nucleus, by the Galactic foreground, by cosmological expansion, or by partial coverage models. We conclude that our data are most consistent with intervenors directly contributing to the Faraday rotation along the line of sight, and that the intervening systems must therefore have coherent magnetic fields of substantial strength ( B-bar =1.8±0.4 μG). Nevertheless, the weak nature of the correlation will require future high-resolution and broadband radio observations in order to place it on a much firmer statistical footing.« less

Genetics Home Reference: gastrointestinal stromal tumor

MedlinePlus

... Treatment of Gastrointestinal Stromal Tumours (Review of NICE Technology Appraisal Guidance 196) (National Institute for Health and ... Society: Treating Gastrointestinal Stromal Tumor (GIST) Cancer.Net: Gastrointestinal ...

Changing Health Care Professionals' Attitudes Toward Spanking.

PubMed

Burkhart, Kimberly; Knox, Michele; Hunter, Kimberly

2016-10-01

Twenty-two pediatric residents and 31 medical students viewed the Play Nicely program. The Play Nicely program is a multimedia program that teaches health care professionals how to counsel parents to use positive parenting and disciplining strategies in response to early childhood aggression. Health care professionals completed pre- and posttraining questionnaires to assess changes in comfort with counseling, parenting knowledge, and attitudes toward spanking. Results indicated at posttraining that health care professionals were significantly more comfortable with counseling parents, had increased parenting knowledge, and decreased positive attitudes toward spanking. Findings suggest that this program holds promise for educating health care professionals on how to counsel parents on positive parenting strategies and positively change attitudes toward spanking. © The Author(s) 2016.

Atmosphere-Ice-Ocean-Ecosystem Processes in a Thinner Arctic Sea Ice Regime: The Norwegian Young Sea ICE (N-ICE2015) Expedition

NASA Astrophysics Data System (ADS)

Granskog, Mats A.; Fer, Ilker; Rinke, Annette; Steen, Harald

2018-03-01

Arctic sea ice has been in rapid decline the last decade and the Norwegian young sea ICE (N-ICE2015) expedition sought to investigate key processes in a thin Arctic sea ice regime, with emphasis on atmosphere-snow-ice-ocean dynamics and sea ice associated ecosystem. The main findings from a half-year long campaign are collected into this special section spanning the Journal of Geophysical Research: Atmospheres, Journal of Geophysical Research: Oceans, and Journal of Geophysical Research: Biogeosciences and provide a basis for a better understanding of processes in a thin sea ice regime in the high Arctic. All data from the campaign are made freely available to the research community.

Biofabrication of morphology improved cadmium sulfide nanoparticles using Shewanella oneidensis bacterial cells and ionic liquid: For toxicity against brain cancer cell lines.

PubMed

Wang, Li; Chen, Siyuan; Ding, Yiming; Zhu, Qiang; Zhang, Nijia; Yu, Shuqing

2018-01-01

The present work determines the anticancer activity of bio-mediated synthesized cadmium sulfide nanoparticles using the ionic liquid and bacterial cells (Shewanella oneidensis). Bacterial cells have been exposed to be important resources that hold huge potential as ecofriendly, cost-effective, evading toxic of dangerous chemicals and the alternative of conventional physiochemical synthesis. The Shewanella oneidensis is an important kind of metal reducing bacterium, known as its special anaerobic respiratory and sulfate reducing capacity. The crystalline nature, phase purity and surface morphology of biosynthesized cadmium sulfide nanoparticles were analyzed by Fourier transform infrared spectroscopy, X-ray diffraction, Field emission scanning electron microscopy, Energy dispersive spectroscopy and Transmission electron microscopy. The use of imidazolium based ionic liquids as soft templating agent for controlling self-assembly and crystal growth direction of metal sulfide nanoparticles has also advanced as an important method. The microscopic techniques showed that the nanoparticles are designed on the nano form and have an excellent spherical morphology, due to the self-assembled mechanism of ionic liquid assistance. The antitumor efficiency of the cadmium sulfide nanoparticles was investigated against brain cancer cell lines using rat glioma cell lines. The effectively improved nano-crystalline and morphological structure of CdS nanoparticles in the presence of IL exhibit excellent cytotoxicity and dispersion ability on the cell shape is completely spread out showing a nice toxic environment against cancer cells. The cytotoxicity effect of cadmium sulfide nanoparticles was discussed with a diagrammatic representation. Copyright © 2017. Published by Elsevier B.V.

Hair follicle nevus in a 2-year old.

PubMed

Motegi, Sei-ichiro; Amano, Hiroo; Tamura, Atsushi; Ishikawa, Osamu

2008-01-01

We report a 2-year-old boy with an elastic soft, flatly elevated, skin-colored nodule on his nasal ala. Histologic examination revealed numerous small hair follicles in several stages of maturation in the dermis. Serial sections did not show any cartilage or a central epithelial lined cystic structure. Based on clinico-pathologic findings, we diagnosed this lesion as a hair follicle nevus. Hair follicle nevus is quite rare. Histologically, it is very important not to find cartilage or a central epithelial lined cystic structure for distinction from an accessory auricle and from a trichofolliculoma, respectively. Awareness of the clinical and pathologic characterization of hair follicle nevus is an aid to a correct diagnosis.

Technical advances of interventional fluoroscopy and flat panel image receptor.

PubMed

Lin, Pei-Jan Paul

2008-11-01

In the past decade, various radiation reducing devices and control circuits have been implemented on fluoroscopic imaging equipment. Because of the potential for lengthy fluoroscopic procedures in interventional cardiovascular angiography, these devices and control circuits have been developed for the cardiac catheterization laboratories and interventional angiography suites. Additionally, fluoroscopic systems equipped with image intensifiers have benefited from technological advances in x-ray tube, x-ray generator, and spectral shaping filter technologies. The high heat capacity x-ray tube, the medium frequency inverter generator with high performance switching capability, and the patient dose reduction spectral shaping filter had already been implemented on the image intensified fluoroscopy systems. These three underlying technologies together with the automatic dose rate and image quality (ADRIQ) control logic allow patients undergoing cardiovascular angiography procedures to benefit from "lower patient dose" with "high image quality." While photoconductor (or phosphor plate) x-ray detectors and signal capture thin film transistor (TFT) and charge coupled device (CCD) arrays are analog in nature, the advent of the flat panel image receptor allowed for fluoroscopy procedures to become more streamlined. With the analog-to-digital converter built into the data lines, the flat panel image receptor appears to become a digital device. While the transition from image intensified fluoroscopy systems to flat panel image receptor fluoroscopy systems is part of the on-going "digitization of imaging," the value of a flat panel image receptor may have to be evaluated with respect to patient dose, image quality, and clinical application capabilities. The advantage of flat panel image receptors has yet to be fully explored. For instance, the flat panel image receptor has its disadvantages as compared to the image intensifiers; the cost of the equipment is probably the most obvious. On the other hand, due to its wide dynamic range and linearity, lowering of patient dose beyond current practice could be achieved through the calibration process of the flat panel input dose rate being set to, for example, one half or less of current values. In this article various radiation saving devices and control circuits are briefly described. This includes various types of fluoroscopic systems designed to strive for reduction of patient exposure with the application of spectral shaping filters. The main thrust is to understand the ADRIQ control logic, through equipment testing, as it relates to clinical applications, and to show how this ADRIQ control logic "ties" those three technological advancements together to provide low radiation dose to the patient with high quality fluoroscopic images. Finally, rotational angiography with computed tomography (CT) and three dimensional (3-D) images utilizing flat panel technology will be reviewed as they pertain to diagnostic imaging in cardiovascular disease.

The diagnosis and management of pre-invasive breast disease: Flat epithelial atypia – classification, pathologic features and clinical significance

PubMed Central

Schnitt, Stuart J

2003-01-01

Flat epithelial atypia is a descriptive term that encompasses lesions of the breast terminal duct lobular units in which variably dilated acini are lined by one to several layers of epithelial cells, which are usually columnar in shape and which display low-grade cytologic atypia. Observational studies have suggested that at least some of these lesions may represent either a precursor of ductal carcinoma in situ (DCIS) or the earliest morphological manifestation of DCIS. In contrast, the limited available clinical follow-up data suggest that the risk of both local recurrence and progression of these lesions to invasive cancer is extremely low, supporting the notion that categorizing such lesions as 'clinging carcinoma' and managing them as if they were fully developed DCIS will result in overtreatment of many patients. Additional studies are needed to better understand the biological nature and clinical significance of these lesions. PMID:12927037

Flat-panel video resolution LED display system

NASA Astrophysics Data System (ADS)

Wareberg, P. G.; Kennedy, D. I.

The system consists of a 128 x 128 element X-Y addressable LED array fabricated from green-emitting gallium phosphide. The LED array is interfaced with a 128 x 128 matrix TV camera. Associated electronics provides for seven levels of grey scale above zero with a grey scale ratio of square root of 2. Picture elements are on 0.008 inch centers resulting in a resolution of 125 lines-per-inch and a display area of approximately 1 sq. in. The LED array concept lends itself to modular construction, permitting assembly of a flat panel screen of any desired size from 1 x 1 inch building blocks without loss of resolution. A wide range of prospective aerospace applications exist extending from helmet-mounted systems involving small dedicated arrays to multimode cockpit displays constructed as modular screens. High-resolution LED arrays are already used as CRT replacements in military film-marking reconnaissance applications.

Nonlinear shallow ocean-wave soliton interactions on flat beaches.

PubMed

Ablowitz, Mark J; Baldwin, Douglas E

2012-09-01

Ocean waves are complex and often turbulent. While most ocean-wave interactions are essentially linear, sometimes two or more waves interact in a nonlinear way. For example, two or more waves can interact and yield waves that are much taller than the sum of the original wave heights. Most of these shallow-water nonlinear interactions look like an X or a Y or two connected Ys; at other times, several lines appear on each side of the interaction region. It was thought that such nonlinear interactions are rare events: they are not. Here we report that such nonlinear interactions occur every day, close to low tide, on two flat beaches that are about 2000 km apart. These interactions are closely related to the analytic, soliton solutions of a widely studied multidimensional nonlinear wave equation. On a much larger scale, tsunami waves can merge in similar ways.

Improving a high-efficiency, gated spectrometer for x-ray Thomson scattering experiments at the National Ignition Facility

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

Döppner, T., E-mail: doeppner1@llnl.gov; Bachmann, B.; Emig, J.

We are developing x-ray Thomson scattering for applications in implosion experiments at the National Ignition Facility. In particular we have designed and fielded MACS, a high-efficiency, gated x-ray spectrometer at 7.5–10 keV [T. Döppner et al., Rev. Sci. Instrum. 85, 11D617 (2014)]. Here we report on two new Bragg crystals based on Highly Oriented Pyrolytic Graphite (HOPG), a flat crystal and a dual-section cylindrically curved crystal. We have performed in situ calibration measurements using a brass foil target, and we used the flat HOPG crystal to measure Mo K-shell emission at 18 keV in 2nd order diffraction. Such high photonmore » energy line emission will be required to penetrate and probe ultra-high-density plasmas or plasmas of mid-Z elements.« less

Improving a high-efficiency, gated spectrometer for x-ray Thomson scattering experiments at the National Ignition Facility

DOE PAGES

Döppner, T.; Kraus, D.; Neumayer, P.; ...

2016-08-03

We are developing x-ray Thomson scattering for applications in implosion experiments at the National Ignition Facility. In particular we have designed and fielded MACS, a high-efficiency, gated x-ray spectrometer at 7.5-10 keV [T. Döppner et al., Rev. Sci. Instrum. 85, 11D617 (2014)]. Here in this paper we report on two new Bragg crystals based on Highly Oriented Pyrolytic Graphite (HOPG), a flat crystal and a dual-section cylindrically curved crystal. We have performed in situ calibration measurements using a brass foil target, and we used the flat HOPG crystal to measure Mo K-shell emission at 18 keV in 2nd order diffraction.more » Such high photon energy line emission will be required to penetrate and probe ultra-high-density plasmas or plasmas of mid-Z elements.« less

Spatial reflection patterns of iridescent wings of male pierid butterflies: curved scales reflect at a wider angle than flat scales.

PubMed

Pirih, Primož; Wilts, Bodo D; Stavenga, Doekele G

2011-10-01

The males of many pierid butterflies have iridescent wings, which presumably function in intraspecific communication. The iridescence is due to nanostructured ridges of the cover scales. We have studied the iridescence in the males of a few members of Coliadinae, Gonepteryx aspasia, G. cleopatra, G. rhamni, and Colias croceus, and in two members of the Colotis group, Hebomoia glaucippe and Colotis regina. Imaging scatterometry demonstrated that the pigmentary colouration is diffuse whereas the structural colouration creates a directional, line-shaped far-field radiation pattern. Angle-dependent reflectance measurements demonstrated that the directional iridescence distinctly varies among closely related species. The species-dependent scale curvature determines the spatial properties of the wing iridescence. Narrow beam illumination of flat scales results in a narrow far-field iridescence pattern, but curved scales produce broadened patterns. The restricted spatial visibility of iridescence presumably plays a role in intraspecific signalling.

An experimental study of tip shape effects on the flutter of aft-swept, flat-plate wings

NASA Technical Reports Server (NTRS)

Dansberry, Bryan E.; Rivera, Jose A., Jr.; Farmer, Moses G.

1990-01-01

The effects of tip chord orientation on wing flutter are investigated experimentally using six cantilever-mounted, flat-plate wing models. Experimentally determined flutter characteristics of the six models are presented covering both the subsonic and transonic Mach number ranges. While all models have a 60 degree leading edge sweep, a 40.97 degree trailing edge sweep, and a root chord of 34.75 inches, they are subdivided into two series characterized by a higher aspect ratio and a lower aspect ratio. Each series is made up of three models with tip chord orientations which are parallel to the free-stream flow, perpendicular to the model mid-chord line, and perpendicular to the free-stream flow. Although planform characteristics within each series of models are held constant, structural characteristics such as mode shapes and natural frequencies are allowed to vary.

The suppression of pulsar and gamma-ray burst annihilation lines by magnetic photon splitting

NASA Technical Reports Server (NTRS)

Baring, Matthew G.

1993-01-01

Neutron stars, relativistic and compact by nature, show great potential for the copious creation of electron-positron pairs in the magnetospheres; these rapidly cool, thermalize, and then annihilate. It is therefore expected that many neutron sources might display evidence of pair annihilation lines in the 400-500 keV range. It is shown that magnetic photon splitting, which operates effectively at these energies and in the enormous neutron star magnetic fields, can destroy an annihilation feature by absorbing line photons and reprocessing them to lower energies. In so doing, photon splitting creates a soft gamma-ray bump and a broad quasi-power-law contribution to the X-ray continuum, which is too flat to conflict with the observed X-ray paucity in gamma-ray bursts. The destruction of the line occurs in neutron stars with surface fields of 5 x 10 exp 12 G or maybe even less, depending on the size of the emission region.

Electron-density-sensitive Line Ratios of Fe xiii– xvi from Laboratory Sources Compared to CHIANTI

DOE PAGES

Weller, M. E.; Beiersdorfer, P.; Soukhanovskii, V. A.; ...

2018-02-15

We present electron-density-sensitive line ratios for Fe xiii– xvi measured in the spectral wavelength range of 200–440 Å and an electron density range of (1-4) × 10 13 cm -3. The results provide a test at the high-density limit of density-sensitive line ratios useful for astrophysical studies. The measurements were performed on the National Spherical Torus Experiment-Upgrade, where electron densities were measured independently by the laser Thomson scattering diagnostic. Spectra were collected with a flat-field grazing-incidence spectrometer, which provided a spectral resolution of up to 0.3 Å, i.e., high resolution across the broad wavelength range. The response of the instrumentmore » was relatively calibrated using spectroscopic techniques in order to improve accuracy. Lastly, the line ratios are compared to other laboratory sources and the latest version of CHIANTI (8.0.2), and an agreement within 30% is found.« less

How Escherichia coli lands and forms cell clusters on a surface: a new role of surface topography

PubMed Central

Gu, Huan; Chen, Aaron; Song, Xinran; Brasch, Megan E.; Henderson, James H.; Ren, Dacheng

2016-01-01

Bacterial response to surface topography during biofilm formation was studied using 5 μm tall line patterns of poly (dimethylsiloxane) (PDMS). Escherichia coli cells attached on top of protruding line patterns were found to align more perpendicularly to the orientation of line patterns when the pattern narrowed. Consistently, cell cluster formation per unit area on 5 μm wide line patterns was reduced by 14-fold compared to flat PDMS. Contrasting the reduced colony formation, cells attached on narrow patterns were longer and had higher transcriptional activities, suggesting that such unfavorable topography may present a stress to attached cells. Results of mutant studies indicate that flagellar motility is involved in the observed preference in cell orientation on narrow patterns, which was corroborated by the changes in cell rotation pattern before settling on different surface topographies. These findings led to a set of new design principles for creating antifouling topographies, which was validated using 10 μm tall hexagonal patterns. PMID:27412365

Getting the current out

NASA Astrophysics Data System (ADS)

Burger, D. R.

1983-11-01

Progress of a photovoltaic (PV) device from a research concept to a competitive power-generation source requires an increasing concern with current collection. The initial metallization focus is usually on contact resistance, since a good ohmic contact is desirable for accurate device characterization measurements. As the device grows in size, sheet resistance losses become important and a metal grid is usually added to reduce the effective sheet resistance. Later, as size and conversion efficiency continue to increase, grid-line resistance and cell shadowing must be considered simultaneously, because grid-line resistance is inversely related to total grid-line area and cell shadowing is directly related. A PV cell grid design must consider the five power-loss phenomena mentioned above: sheet resistance, contact resistance, grid resistance, bus-bar resistance and cell shadowing. Although cost, reliability and usage are important factors in deciding upon the best metallization system, this paper will focus only upon grid-line design and substrate material problems for flat-plate solar arrays.

Electron-density-sensitive Line Ratios of Fe xiii– xvi from Laboratory Sources Compared to CHIANTI

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

Weller, M. E.; Beiersdorfer, P.; Soukhanovskii, V. A.

We present electron-density-sensitive line ratios for Fe xiii– xvi measured in the spectral wavelength range of 200–440 Å and an electron density range of (1-4) × 10 13 cm -3. The results provide a test at the high-density limit of density-sensitive line ratios useful for astrophysical studies. The measurements were performed on the National Spherical Torus Experiment-Upgrade, where electron densities were measured independently by the laser Thomson scattering diagnostic. Spectra were collected with a flat-field grazing-incidence spectrometer, which provided a spectral resolution of up to 0.3 Å, i.e., high resolution across the broad wavelength range. The response of the instrumentmore » was relatively calibrated using spectroscopic techniques in order to improve accuracy. Lastly, the line ratios are compared to other laboratory sources and the latest version of CHIANTI (8.0.2), and an agreement within 30% is found.« less

Effect of printing parameters on gravure patterning with conductive silver ink

NASA Astrophysics Data System (ADS)

Kim, Seunghwan; Sung, Hyung Jin

2015-04-01

Conductive line patterns were printed on a poly-dimethylsiloxane (PDMS) substrate using a gravure printing method with conductive silver ink. A plate-to-roll gravure print was prepared for this experiment. Gravure plates with fine lines 5-25 μm in width and 0-90° in tilted angles were fabricated using photolithography techniques. The printability, defined as the ratio of the real printed area to the ideal printed area, was measured and analyzed with respect to the process parameters and the line pattern designs. The effect of the process parameters on the fine line patterning was discussed, including the wiping condition, the printing pressure and the printing speed. The printability of the high adhesive substrate was examined by preparing a nanostructured PDMS substrate featuring a forest of 200 nm nanopillars using an anodic aluminum oxide (AAO) template. The patterns printed onto the nanostructured PDMS were compared with those printed on a flat PDMS substrate.

Location of Bare Soil Surface and Soil Line on the RED-NIR Spectral Plane

NASA Astrophysics Data System (ADS)

Koroleva, P. V.; Rukhovich, D. I.; Rukhovich, A. D.; Rukhovich, D. D.; Kulyanitsa, A. L.; Trubnikov, A. V.; Kalinina, N. V.; Simakova, M. S.

2017-12-01

Soil as a separate natural body occupies certain area with its own set of spectral characteristics within the RED-NIR spectral space. This is an ellipse-shaped area, and its semi-major axis is the soil line for a satellite image. The spectral area for a bare soil surface is neighboring to the areas of black carbon, straw, vegetating plants, and missing RED-NIR values. A reliable separation of the bare soil surface within the spectral space is possible with the technology of spectral neighborhood of soil line. The accuracy of this method is 90%. The determination of the bare soil surface using vegetation indices, both relative (NDVI), and perpendicular (PVI), is incorrect; the accuracy of these methods does not exceed 65%, and for most of the survey seasons it may be lower than 50%. The flat part of the "tasseled cap" described as the soil line, is not a synonym for the area of the bare soil surface. The bare soil surface on the RED-NIR plots occupies significantly smaller areas than the area of soil line according to Kauth and Thomas.

Surface characterization of dialyzer polymer membranes by imaging ToF-SIMS and quantitative XPS line scans.

PubMed

Holzweber, Markus; Lippitz, Andreas; Krueger, Katharina; Jankowski, Joachim; Unger, Wolfgang E S

2015-03-24

The surfaces of polymeric dialyzer membranes consisting of polysulfone and polyvinylpyrrolidone were investigated regarding the lateral distribution and quantitative surface composition using time-of-flight secondary-ion-mass-spectrometry and x-ray photoelectron spectroscopy. Knowledge of the distribution and composition on the outer surface region is of utmost importance for understanding the biocompatibility of such dialyzer membranes. Both flat membranes and hollow fiber membranes were studied.

Nuclear Weapons Effects Mitigation Techniques

DTIC Science & Technology

1982-06-01

ELF ) into the ultra-high (UHF) frequeniese, with much of Its energy concentrated In frequenrv ranges (high frequency (IF) into UHF) employed by Army...tactical Communications equipment. It Is of concern because the damage and upset it causes can occur Rt distances from the burst far beyond where...radiation is scattered from all directions, most of’ it comes from direct line-of-sight to the fireball. Therefore, the flat earth cover of an underground

4. DETAIL VIEW (SIDE A) OF HANDMADE STEEL BOX ASSOCIATED ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

4. DETAIL VIEW (SIDE A) OF HANDMADE STEEL BOX ASSOCIATED WITH THE DEPLETED URANIUM ALLOY DEVELOPMENT AND COMPONENT FABRICATION PROCESS. THE BOX WAS USED TO TRANSFER HEATED BLOCKS OF METAL (SHOWN IN THE OPENED DOOR) FROM THE MOLTEN SALT BATH TO THE ROLLER LINES. (4/28/62) - Rocky Flats Plant, Uranium Rolling & Forming Operations, Southeast section of plant, southeast quadrant of intersection of Central Avenue & Eighth Street, Golden, Jefferson County, CO

Processes Controlling Transfer of Fine-Grained Sediment in Tidal Systems Spanning a Range of Fluvial Influence

DTIC Science & Technology

2012-09-30

understand how the delicate balance of ebb and flood sediment fluxes is maintained to create tidal flat and mangrove complexes, and distributary shoals and...and the subaqueous delta on the inner continental shelf, and sediment sinks within vegetated/ mangrove shoreline complexes. Our overall hypothesis...on Mangrove /Vegetated Intertidal Areas. Along the main stem tidal river and in the offshore banks may be shorelines lined with vegetation ( mangroves

Low-Loss Coupler For Microwave Laser-Diode Modulation

NASA Technical Reports Server (NTRS)

Toda, Minoru

1991-01-01

Elimination of series resistor reduces loss of radio-frequency power. Quarter-wavelength matching section connected to transmission line eliminates need for resistor near laser diode and extends frequency response of system. Concept significantly extends relatively flat frequency response of laser diode or similar component, while simplifying design of its package, increasing amplitude of output signal, and reducing dissipation of heat by eliminating resistance. Phase characteristics approximately linear and any digital information transmitted not significantly altered.

Physical Ability-Task Performance Models: Assessing the Risk of Omitted Variable Bias

DTIC Science & Technology

2008-09-15

association was evaluated in a study of simulated job performance in men and women. The study measured four major abilities, Static Strength (SS), Dynamic...ability- performance interface for physical tasks. Methods Sample Participants were active-duty naval personnel (64 men , 38 women) between ages 20...bench with feet flat on the floor. Position was adjusted so the bar was between the shoulder and nipple line. Handles were gripped at a comfortable

Societal views on NICE, cancer drugs fund and value-based pricing criteria for prioritising medicines: a cross-sectional survey of 4118 adults in Great Britain.

PubMed

Linley, Warren G; Hughes, Dyfrig A

2013-08-01

The criteria used by the National Institute for Health and Clinical Excellence (NICE) for accepting higher incremental cost-effectiveness ratios for some medicines over others, and the recent introduction of the Cancer Drugs Fund (CDF) in England, are assumed to reflect societal preferences for National Health Service resource allocation. Robust empirical evidence to this effect is lacking. To explore societal preferences for these and other criteria, including those proposed for rewarding new medicines under the future value-based pricing (VBP) system, we conducted a choice-based experiment in 4118 UK adults via web-based surveys. Preferences were determined by asking respondents to allocate fixed funds between different patient and disease types reflecting nine specific prioritisation criteria. Respondents supported the criteria proposed under the VBP system (for severe diseases, address unmet needs, are innovative--provided they offered substantial health benefits, and have wider societal benefits) but did not support the end-of-life premium or the prioritisation of children or disadvantaged populations as specified by NICE, nor the special funding status for treatments of rare diseases, nor the CDF. Policies introduced on the basis of perceived--and not actual--societal values may lead to inappropriate resource allocation decisions with the potential for significant population health and economic consequences. Copyright © 2012 John Wiley & Sons, Ltd.