Is Textbook Outcome a valuable composite measure for short-term outcomes of gastrointestinal treatments in the Netherlands using hospital information system data? A retrospective cohort study

PubMed Central

Salet, Nèwel; Bremmer, Rolf H; Verhagen, Marc A M T; Ekkelenkamp, Vivian E; Hansen, Bettina E; de Jonge, Pieter J F; de Man, Rob A

2018-01-01

Objective To develop a feasible model for monitoring short-term outcome of clinical care trajectories for hospitals in the Netherlands using data obtained from hospital information systems for identifying hospital variation. Study design Retrospective analysis of collected data from hospital information systems combined with clinical indicator definitions to define and compare short-term outcomes for three gastrointestinal pathways using the concept of Textbook Outcome. Setting 62 Dutch hospitals. Participants 45 848 unique gastrointestinal patients discharged in 2015. Main outcome measure A broad range of clinical outcomes including length of stay, reintervention, readmission and doctor–patient counselling. Results Patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) for gallstone disease (n=4369), colonoscopy for inflammatory bowel disease (IBD; n=19 330) and colonoscopy for colorectal cancer screening (n=22 149) were submitted to five suitable clinical indicators per treatment. The percentage of all patients who met all five criteria was 54%±9% (SD) for ERCP treatment. For IBD this was 47%±7% of the patients, and for colon cancer screening this number was 85%±14%. Conclusion This study shows that reusing data obtained from hospital information systems combined with clinical indicator definitions can be used to express short-term outcomes using the concept of Textbook Outcome without any excess registration. This information can provide meaningful insight into the clinical care trajectory on the level of individual patient care. Furthermore, this concept can be applied to many clinical trajectories within gastroenterology and beyond for monitoring and improving the clinical pathway and outcome for patients. PMID:29496668

Angiographic outcomes following stenting or coronary artery bypass surgery of the left main coronary artery: fifteen-month outcomes from the synergy between PCI with TAXUS express and cardiac surgery left main angiographic substudy (SYNTAX-LE MANS).

PubMed

Morice, Marie-Claude; Feldman, Ted E E; Mack, Michael J; Ståhle, Elisabeth; Holmes, David R; Colombo, Antonio; Morel, Marie-Angèle; van den Brand, Marcel; Serruys, Patrick W; Mohr, Friedrich; Carrié, Didier; Fournial, Gérard; James, Stefan; Leadley, Katrin; Dawkins, Keith D; Kappetein, A Pieter

2011-10-30

The SYNTAX-LE MANS substudy prospectively evaluated 15-month angiographic and clinical outcomes in patients with treated left main (LM) disease. In the SYNTAX trial, 1,800 patients with three-vessel and/or LM disease were randomised to either CABG or PCI; of these, 271 LM patients were prospectively assigned to receive a 15-month angiogram. The primary endpoint for the CABG arm was the ratio of ≥50% to <100% obstructed/occluded grafts bypassing LM lesions to the number placed. The primary endpoint for the PCI arm was the proportion of patients with ≤50% diameter stenosis ('patent' stents) of treated LM lesions. Per protocol, no formal comparison between CABG and PCI arms was intended based on the differing primary endpoints. Available 15-month angiograms were analysed for 114 CABG and 149 PCI patients. At 15 months, 9.9% (26/263) of CABG grafts were 100% occluded and an additional 5.7% (15/263) were ≥50% to <100% occluded. Overall, 27.2% (31/114) of patients had ≥1 obstructed/occluded graft. The 15-month CABG MACCE rate was 8.8% (10/114) and MACCE at 15 months was not significantly associated with graft obstruction/occlusion (p=0.85). In the PCI arm, 92.4% (134/145) of patients had ≤50% diameter LM stenosis at 15 months (89.7% [87/97] distal LM lesions and 97.9% [47/48] non-distal LM lesions). The 15-month PCI MACCE rate was 12.8% (20/156) and this was significantly associated with lack of stent patency at 15 months (p<0.001), mainly due to repeat revascularisation. At 15 months, 15.6% (41/263) of grafts were at least 50% obstructed but this was not significantly associated with MACCE; 92.4% (134/145) of patients had stents that remained patent at 15 months, and stent restenosis was significantly associated with MACCE, predominantly due to revascularisation.

A model for national outcome audit in vascular surgery.

PubMed

Prytherch, D R; Ridler, B M; Beard, J D; Earnshaw, J J

2001-06-01

The aim was to model vascular surgical outcome in a national study using POSSUM scoring. One hundred and twenty-one British and Irish surgeons completed data questionnaires on patients undergoing arterial surgery under their care (mean 12 patients, range 1-49) in May/June 1998. A total of 1480 completed data records were available for logistic regression analysis using P-POSSUM methodology. Information collected included all POSSUM data items plus other factors thought to have a significant bearing on patient outcome: "extra items". The main outcome measures were death and major postoperative complications. The data were checked and inconsistent records were excluded. The remaining 1313 were divided into two sets for analysis. The first "training" set was used to obtain logistic regression models that were applied prospectively to the second "test" dataset. using POSSUM data items alone, it was possible to predict both mortality and morbidity after vascular reconstruction using P-POSSUM analysis. The addition of the "extra items" found significant in regression analysis did not significantly improve the accuracy of prediction. It was possible to predict both mortality and morbidity derived from the preoperative physiology components of the POSSUM data items alone. this study has shown that P-POSSUM methodology can be used to predict outcome after arterial surgery across a range of surgeons in different hospitals and could form the basis of a national outcome audit. It was also possible to obtain accurate models for both mortality and major morbidity from the POSSUM physiology scores alone. Copyright 2001 Harcourt Publishers Limited.

Use of portable devices and confocal Raman spectrometers at different wavelength to obtain the spectral information of the main organic components in tomato (Solanum lycopersicum) fruits

NASA Astrophysics Data System (ADS)

Trebolazabala, Josu; Maguregui, Maite; Morillas, Héctor; de Diego, Alberto; Madariaga, Juan Manuel

2013-03-01

Tomato (Solanum lycopersicum) fruit samples, in two ripening stages, ripe (red) and unripe (green), collected from a cultivar in the North of Spain (Barrika, Basque Country), were analyzed directly, without any sample pretreatment, with two different Raman instruments (portable spectrometer coupled to a micro-videocamera and a confocal Raman microscope), using two different laser excitation wavelengths (514 and 785 nm, only for the confocal microscope). The combined use of these laser excitation wavelengths allows obtaining, in a short period of time, the maximum spectral information about the main organic compounds present in this fruit. The major identified components of unripe tomatoes were cutin and cuticular waxes. On the other hand, the main components on ripe tomatoes were carotenes, polyphenoles and polysaccharides. Among the carotenes, it was possible to distinguish the presence of lycopene from β-carotene with the help of both excitation wavelengths, but specially using the 514 nm one, which revealed specific overtones and combination tones of this type of carotene.

Outcome-Based Educational Planning.

ERIC Educational Resources Information Center

Stephens, Gail M.; Herman, Jerry J.

1984-01-01

Whitmore Lake's (Michigan) outcome-based planning model emphasizes starting the planning process by obtaining consensus on desired outcomes; involves students, teachers, staff, parents, and community in planning; and identifies the responsibilities of students, the home, and the school in helping students achieve the desired outcomes. (MJL)

Use of dimethyldioxirane in the epoxidation of the main constituents of the essential oils obtained from Tagetes lucida, Cymbopogon citratus, Lippia alba and Eucalyptus citriodora.

PubMed

Veloza, Luz A; Orozco, Lina M; Sepúlveda-Arias, Juan C

2011-07-01

Dimethyldioxirane (DMDO), a widely used oxidant in organic synthesis is considered an environmentally friendly oxygen transfer reagent because acetone is the only byproduct formed in its oxidation reactions. This work describes the isolation of the main constituents (terpenes) in the essential oils obtained from Tagetes lucida, Cymbopogon citratus, Lippia alba and Eucalyptus citriodora, their epoxidation with DMDO in acetone solution and the characterization of the resulting epoxides by GC-MS (EI) and NMR. This is one of the first reports involving the application of dioxirane chemistry to essential oils in order to generate modified compounds with potential uses in several areas of medicine and industry.

Prediction of antiepileptic drug treatment outcomes using machine learning

NASA Astrophysics Data System (ADS)

Colic, Sinisa; Wither, Robert G.; Lang, Min; Zhang, Liang; Eubanks, James H.; Bardakjian, Berj L.

2017-02-01

Objective. Antiepileptic drug (AED) treatments produce inconsistent outcomes, often necessitating patients to go through several drug trials until a successful treatment can be found. This study proposes the use of machine learning techniques to predict epilepsy treatment outcomes of commonly used AEDs. Approach. Machine learning algorithms were trained and evaluated using features obtained from intracranial electroencephalogram (iEEG) recordings of the epileptiform discharges observed in Mecp2-deficient mouse model of the Rett Syndrome. Previous work have linked the presence of cross-frequency coupling (I CFC) of the delta (2-5 Hz) rhythm with the fast ripple (400-600 Hz) rhythm in epileptiform discharges. Using the I CFC to label post-treatment outcomes we compared support vector machines (SVMs) and random forest (RF) machine learning classifiers for providing likelihood scores of successful treatment outcomes. Main results. (a) There was heterogeneity in AED treatment outcomes, (b) machine learning techniques could be used to rank the efficacy of AEDs by estimating likelihood scores for successful treatment outcome, (c) I CFC features yielded the most effective a priori identification of appropriate AED treatment, and (d) both classifiers performed comparably. Significance. Machine learning approaches yielded predictions of successful drug treatment outcomes which in turn could reduce the burdens of drug trials and lead to substantial improvements in patient quality of life.

Outcome of elective prostatectomy.

PubMed Central

Neal, D. E.; Ramsden, P. D.; Sharples, L.; Smith, A.; Powell, P. H.; Styles, R. A.; Webb, R. J.

1989-01-01

OBJECTIVES--To determine the symptomatic and urodynamic outcome of elective prostatectomy and to establish whether the outcome is influenced or can be predicted by preoperative urodynamic measurements. DESIGN--Prospective non-randomised study with follow up at a mean of 11 months after operation. Most men were assessed jointly by a urologist and a general practitioner. SETTING--Department of urology in a teaching hospital serving a large district population. PATIENTS--253 Men listed for elective prostatectomy because of symptoms and low urinary flow rates (less than 15 ml/s) and excluding those already on a waiting list or with acute urinary retention, clinically apparent prostatic cancer, and neurological or cerebrovascular disease; 217 (86%) were followed up. INTERVENTION--Elective prostatectomy. MAIN OUTCOME MEASURE--Classification on the basis of relief of symptoms assessed by patients and urologist and general practitioner and of symptom scores obtained by questionnaire. RESULTS--Of the 217 men followed up, 171 (79%) had a satisfactory subjective review and 155 (72%) had a satisfactory review and also low symptom scores. An unsatisfactory outcome was associated with preoperative symptoms of urge incontinence, small prostatic size and resected weight, low voiding pressures, and low urethral resistance. Preoperative maximum urinary flow rates did not predict outcome. Men with poor outcome could be classified into two groups: those with irritative symptoms who were more likely before operation to have had urge incontinence and detrusor instability and men with symptoms of poor urinary flow who were more likely before operation to have had a small prostate, low voiding pressures, and low urethral resistance. In patients in the second group flow rates or voiding pressures improved little after operation. Men with stable detrusors and either low urethral resistance or low voiding pressures were less likely to do well after prostatectomy, but despite these

Use of portable devices and confocal Raman spectrometers at different wavelength to obtain the spectral information of the main organic components in tomato (Solanum lycopersicum) fruits.

PubMed

Trebolazabala, Josu; Maguregui, Maite; Morillas, Héctor; de Diego, Alberto; Madariaga, Juan Manuel

2013-03-15

Tomato (Solanum lycopersicum) fruit samples, in two ripening stages, ripe (red) and unripe (green), collected from a cultivar in the North of Spain (Barrika, Basque Country), were analyzed directly, without any sample pretreatment, with two different Raman instruments (portable spectrometer coupled to a micro-videocamera and a confocal Raman microscope), using two different laser excitation wavelengths (514 and 785 nm, only for the confocal microscope). The combined use of these laser excitation wavelengths allows obtaining, in a short period of time, the maximum spectral information about the main organic compounds present in this fruit. The major identified components of unripe tomatoes were cutin and cuticular waxes. On the other hand, the main components on ripe tomatoes were carotenes, polyphenoles and polysaccharides. Among the carotenes, it was possible to distinguish the presence of lycopene from β-carotene with the help of both excitation wavelengths, but specially using the 514 nm one, which revealed specific overtones and combination tones of this type of carotene. Copyright © 2012 Elsevier B.V. All rights reserved.

Secondary outcome analysis for data from an outcome-dependent sampling design.

PubMed

Pan, Yinghao; Cai, Jianwen; Longnecker, Matthew P; Zhou, Haibo

2018-04-22

Outcome-dependent sampling (ODS) scheme is a cost-effective way to conduct a study. For a study with continuous primary outcome, an ODS scheme can be implemented where the expensive exposure is only measured on a simple random sample and supplemental samples selected from 2 tails of the primary outcome variable. With the tremendous cost invested in collecting the primary exposure information, investigators often would like to use the available data to study the relationship between a secondary outcome and the obtained exposure variable. This is referred as secondary analysis. Secondary analysis in ODS designs can be tricky, as the ODS sample is not a random sample from the general population. In this article, we use the inverse probability weighted and augmented inverse probability weighted estimating equations to analyze the secondary outcome for data obtained from the ODS design. We do not make any parametric assumptions on the primary and secondary outcome and only specify the form of the regression mean models, thus allow an arbitrary error distribution. Our approach is robust to second- and higher-order moment misspecification. It also leads to more precise estimates of the parameters by effectively using all the available participants. Through simulation studies, we show that the proposed estimator is consistent and asymptotically normal. Data from the Collaborative Perinatal Project are analyzed to illustrate our method. Copyright © 2018 John Wiley & Sons, Ltd.

The reproducibility and predictive value on outcome of renal biopsies from expanded criteria donors.

PubMed

Azancot, M Antonieta; Moreso, Francesc; Salcedo, Maite; Cantarell, Carme; Perello, Manel; Torres, Irina B; Montero, Angeles; Trilla, Enric; Sellarés, Joana; Morote, Joan; Seron, Daniel

2014-05-01

Reproducibility and predictive value on outcome are the main criteria to evaluate the utility of histological scores. Here we analyze the reproducibility of donor biopsy assessment by different on-call pathologists and the retrospective evaluation by a single renal pathologist blinded to clinical outcomes. We also evaluate the predictive value on graft outcome of both evaluations. A biopsy was performed in donors with any of the following: age≥55 years, hypertension, diabetes, creatinine>1.5 mg/dl, or stroke. Glomerulosclerosis, interstitial fibrosis, tubular atrophy, intimal thickening, and arteriolar hyalinosis evaluated according to the Banff criteria were added to obtain a chronic score. Biopsies were classified as mild (≥3), intermediate (4-5), or advanced (6-7) damage, and unacceptable (≥8) for transplantation of 127 kidneys biopsied. Weighted κ value between both readings was 0.41 (95% CI: 0.28-0.54). Evaluation of biopsies by the renal pathologist was significantly and independently associated with estimated 12-month glomerular filtration rate and a significant composite outcome variable, including death-censored graft survival and time to reach an estimated glomerular filtration rate<30 ml/min per 1.73 m2. Thus, there was no association between readings of on-call pathologists and outcome. The lack of association between histological scores obtained by the on-call pathologists and graft outcome suggests that a specific training on renal pathology is recommended to optimize the use of kidneys retrieved from expanded criteria donors.

Outcomes of organ donation in brain-dead patient's families: Ethical perspective.

PubMed

Ahmadian, Shamsi; Rahimi, Abolfazl; Khaleghi, Ebrahim

2017-01-01

The families of brain-dead patients have a significant role in the process of decision making for organ donation. Organ donation is a traumatic experience. The ethical responsibility of healthcare systems respecting organ donation is far beyond the phase of decision making for donation. The principles of donation-related ethics require healthcare providers and organ procurement organizations to respect donor families and protect them against any probable harm. Given the difficult and traumatic nature of donation-related experience, understanding the outcomes of donation appears crucial. The aim of this study was to explore the outcomes of organ donation for the families of brain-dead patients. This was a qualitative descriptive study to which a purposeful sample of 19 donor family members were recruited. Data were collected through holding in-depth semi-structured interviews with the participants. Data analysis was performed by following the qualitative content analysis approach developed by Elo and Kyngäs. The main category of the data was "Decision to organ donation: a challenge from conflict to transcendence." This main category consisted of 10 subcategories and 3 general categories. The general categories were "challenging outcomes," "reassuring outcomes," and "transcending outcomes." Ethical considerations: The study was approved by the regional ethical review board. The ethical principles of informed consent, confidentiality, and non-identification were used. Donor families experience different challenges which range from conflict and doubtfulness to confidence, satisfaction, and transcendence. Healthcare providers and organ procurers should not discontinue care and support provision to donor families after obtaining their consent to donate because the post-decision phase is also associated with different complexities and difficulties with which donor families may not be able to cope effectively. In order to help donor families achieve positive outcomes from

Geomagnetic main field modeling using magnetohydrodynamic constraints

NASA Technical Reports Server (NTRS)

Estes, R. H.

1985-01-01

The influence of physical constraints are investigated which may be approximately satisfied by the Earth's liquid core on models of the geomagnetic main field and its secular variation. A previous report describes the methodology used to incorporate nonlinear equations of constraint into the main field model. The application of that methodology to the GSFC 12/83 field model to test the frozen-flux hypothesis and the usefulness of incorporating magnetohydrodynamic constraints for obtaining improved geomagnetic field models is described.

Workplace Violence and Job Outcomes of Newly Licensed Nurses.

PubMed

Chang, Hyoung Eun; Cho, Sung-Hyun

2016-12-01

The purpose of this study was to examine the prevalence of workplace violence toward newly licensed nurses and the relationship between workplace violence and job outcomes. An online survey was conducted of newly licensed registered nurses who had obtained their license in 2012 or 2013 in South Korea and had been working for 5-12 months after first being employed. The sample consisted of 312 nurses working in hospitals or clinics. The Copenhagen Psychosocial Questionnaire II was used to measure violence and nurse job outcomes. Multiple linear and logistic regression analyses were conducted to examine the relationship between violence and job outcomes. Verbal abuse was most prevalent (59.6%), followed by threats of violence (36.9%), physical violence (27.6%), bullying (25.6%), and sexual harassment (22.4%). Approximately three quarters of the nurses had experienced at least one type of violence. The main perpetrators were patients and nurse colleagues, although the distribution of perpetrators varied depending on the type of violence. Bullying had a significant relationship with all four job outcomes (job satisfaction, burnout, commitment to the workplace, and intent to leave), while verbal abuse was associated with all job outcomes except for intent to leave. Violence perpetrated by nurse colleagues had a significant relationship with all four job outcomes, while violence by physicians had a significant inverse relationship with job satisfaction. Workplace violence is experienced by a high percentage of newly licensed nurses, and is associated with their job outcomes. Copyright © 2016. Published by Elsevier B.V.

How to select outcome measurement instruments for outcomes included in a "Core Outcome Set" - a practical guideline.

PubMed

Prinsen, Cecilia A C; Vohra, Sunita; Rose, Michael R; Boers, Maarten; Tugwell, Peter; Clarke, Mike; Williamson, Paula R; Terwee, Caroline B

2016-09-13

In cooperation with the Core Outcome Measures in Effectiveness Trials (COMET) initiative, the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) initiative aimed to develop a guideline on how to select outcome measurement instruments for outcomes (i.e., constructs or domains) included in a "Core Outcome Set" (COS). A COS is an agreed minimum set of outcomes that should be measured and reported in all clinical trials of a specific disease or trial population. Informed by a literature review to identify potentially relevant tasks on outcome measurement instrument selection, a Delphi study was performed among a panel of international experts, representing diverse stakeholders. In three consecutive rounds, panelists were asked to rate the importance of different tasks in the selection of outcome measurement instruments, to justify their choices, and to add other relevant tasks. Consensus was defined as being achieved when 70 % or more of the panelists agreed and when fewer than 15 % of the panelists disagreed. Of the 481 invited experts, 120 agreed to participate of whom 95 (79 %) completed the first Delphi questionnaire. We reached consensus on four main steps in the selection of outcome measurement instruments for COS: Step 1, conceptual considerations; Step 2, finding existing outcome measurement instruments, by means of a systematic review and/or a literature search; Step 3, quality assessment of outcome measurement instruments, by means of the evaluation of the measurement properties and feasibility aspects of outcome measurement instruments; and Step 4, generic recommendations on the selection of outcome measurement instruments for outcomes included in a COS (consensus ranged from 70 to 99 %). This study resulted in a consensus-based guideline on the methods for selecting outcome measurement instruments for outcomes included in a COS. This guideline can be used by COS developers in defining how to measure core outcomes.

Patients' knowledge about the outcomes of thyroid biopsy: a patient survey.

PubMed

Singh Ospina, Naykky; Castaneda-Guarderas, Ana; Ward, Russell; Brito, Juan P; Maraka, Spyridoula; Zeballos Palacios, Claudia; Yost, Kathleen J; Dean, Diana S; Montori, Victor M

2018-06-16

Fine-needle aspiration biopsy of the thyroid is an increasingly common outpatient procedure. Patients are counseled about the indications and risks of this procedure and informed consent is obtained. We aimed to assess the extent to which patients acquired necessary knowledge during this process. Survey study conducted in a thyroid nodule clinic at a referral center. Adult patients who had just undergone a thyroid biopsy were asked to complete a survey, including eight questions regarding the indications and potential outcomes of thyroid biopsy. The main outcome of the study was to assess the patients' knowledge based on the response to each individual survey question. Two-hundred and ninety-seven patients were eligible, of which 196 (66%) completed the survey: most were women (76%), had adequate reading health literacy (95%) and a mean age of 58 years. Although 86% of patients correctly identified evaluation for thyroid cancer as the main indication for their biopsy, 56% were not aware of the likelihood of this diagnosis. Almost all (>90%) of respondents knew that results could be benign or malignant; fewer were aware of non-diagnostic (71%) or indeterminate (68%) outcomes, or of the need for additional diagnostic testing after the biopsy (33%). After undergoing thyroid biopsy, a high proportion of well-educated patients remained unaware of their risk for thyroid cancer, potential outcomes, and downstream consequences of their biopsy. This quality gap raises the possibility that informed consent procedures that meet legal standards may leave patients undergoing thyroid biopsy paradoxically uninformed.

Outcome in pediatric hydrocephalus: a comparison between previously used outcome measures and the hydrocephalus outcome questionnaire.

PubMed

Platenkamp, Marc; Hanlo, Patrick W; Fischer, Kathelijn; Gooskens, Rob H J M

2007-07-01

The objectives of this study were to assess, in a cohort of children with recently treated hydrocephalus, the correlation between scores on the Hydrocephalus Outcome Questionnaire (HOQ) and the children's type of schooling and motor functioning, and to assess the overall outcome of the children. The health status of 142 pediatric patients (85 boys) with previous hydrocephalus, born between 1995 and 1999, was assessed. Outcomes were determined using the HOQ, type of schooling, and motor functioning. Data were obtained from parental interviews and patient medical records. RESULTS. Twelve patients died (8.5%). Responses to the HOQ were obtained from 107 patients (65 boys). The mean age of the patients was 7 years and 9 months +/- 1.42 years (range 6-10 years). The Physical Health score of the HOQ correlated well with the motor functioning score (r = 0.652) as did the Cognitive Health score with the type of schooling (r = 0.672). Fifty-nine percent of the patients were able to attend a school for students with normal intelligence. Disabling motor functioning was found in only 30% of patients. Epilepsy was present in 14%. The results show a good correlation between the type of schooling and the Cognitive HOQ score and between the Physical HOQ score and the motor functioning score. The HOQ is a simple and very useful measurement for determining outcome in pediatric hydrocephalus.

The Impact of Maternal Obesity and Excessive Gestational Weight Gain on Maternal and Infant Outcomes in Maine: Analysis of Pregnancy Risk Assessment Monitoring System Results from 2000 to 2010.

PubMed

Baugh, Nancy; Harris, David E; Aboueissa, AbouEl-Makarim; Sarton, Cheryl; Lichter, Erika

2016-01-01

The objective of this study is to understand the relationships between prepregnancy obesity and excessive gestational weight gain (GWG) and adverse maternal and fetal outcomes. Pregnancy risk assessment monitoring system (PRAMS) data from Maine for 2000-2010 were used to determine associations between demographic, socioeconomic, and health behavioral variables and maternal and infant outcomes. Multivariate logistic regression analysis was performed on the independent variables of age, race, smoking, previous live births, marital status, education, BMI, income, rurality, alcohol use, and GWG. Dependent variables included maternal hypertension, premature birth, birth weight, infant admission to the intensive care unit (ICU), and length of hospital stay of the infant. Excessive prepregnancy BMI and excessive GWG independently predicted maternal hypertension. A high prepregnancy BMI increased the risk of the infant being born prematurely, having a longer hospital stay, and having an excessive birth weight. Excessive GWG predicted a longer infant hospital stay and excessive birth weight. A low pregnancy BMI and a lower than recommended GWG were also associated with poor outcomes: prematurity, low birth weight, and an increased risk of the infant admitted to ICU. These findings support the importance of preconception care that promotes achievement of a healthy weight to enhance optimal reproductive outcomes.

The Impact of Maternal Obesity and Excessive Gestational Weight Gain on Maternal and Infant Outcomes in Maine: Analysis of Pregnancy Risk Assessment Monitoring System Results from 2000 to 2010

PubMed Central

Sarton, Cheryl; Lichter, Erika

2016-01-01

The objective of this study is to understand the relationships between prepregnancy obesity and excessive gestational weight gain (GWG) and adverse maternal and fetal outcomes. Pregnancy risk assessment monitoring system (PRAMS) data from Maine for 2000–2010 were used to determine associations between demographic, socioeconomic, and health behavioral variables and maternal and infant outcomes. Multivariate logistic regression analysis was performed on the independent variables of age, race, smoking, previous live births, marital status, education, BMI, income, rurality, alcohol use, and GWG. Dependent variables included maternal hypertension, premature birth, birth weight, infant admission to the intensive care unit (ICU), and length of hospital stay of the infant. Excessive prepregnancy BMI and excessive GWG independently predicted maternal hypertension. A high prepregnancy BMI increased the risk of the infant being born prematurely, having a longer hospital stay, and having an excessive birth weight. Excessive GWG predicted a longer infant hospital stay and excessive birth weight. A low pregnancy BMI and a lower than recommended GWG were also associated with poor outcomes: prematurity, low birth weight, and an increased risk of the infant admitted to ICU. These findings support the importance of preconception care that promotes achievement of a healthy weight to enhance optimal reproductive outcomes. PMID:27747104

Obtaining Employment after Spinal Cord Injury: Relationship with Pre- and Postinjury Education

ERIC Educational Resources Information Center

Krause, James S.; Reed, Karla S.

2009-01-01

The authors identify the association of educational milestones obtained before and after spinal cord injury (SCI) with postinjury employment (PIE). Survey data were collected from 1,362 adults younger than 65, with traumatic SCI of at least 1 year duration who were not currently attending school. The sole outcome was obtaining PIE--whether the…

Habitable zones around main sequence stars

NASA Technical Reports Server (NTRS)

Kasting, James F.; Whitmire, Daniel P.; Reynolds, Ray T.

1993-01-01

A mechanism for stabilizing climate on the earth and other earthlike planets is described, and the physical processes that define the inner and outer boundaries of the habitable zone (HZ) around the sun and main sequence stars are discussed. Physical constraints on the HZ obtained from Venus and Mars are taken into account. A 1D climate model is used to estimate the width of the HZ and the continuously habitable zone around the sun, and the analysis is extended to other main sequence stars. Whether other stars have planets and where such planets might be located with respect to the HZ is addressed. The implications of the findings for NASA's SETI project are considered.

Outcomes following the main treatment options in patients with a leaking esophagus: a systematic literature review.

PubMed

Persson, S; Rouvelas, I; Irino, T; Lundell, L

2017-12-01

Leakage from the esophagus and gastroesophageal junction can be lethal due to uncontrolled contamination of the mediastinum. The most predominant risk factors for the subsequent clinical outcome are the patients' delay as well as the delay of diagnosis. Two major therapeutic concepts have been advocated: either prompt closure of the leakage by insertion of a self-expandable metal stent (SEMS) or more traditionally, surgical exploration. The objective of this review is to carefully scrutinize the recent literature and assess the outcomes of these two therapeutic alternatives in the management of iatrogenic perforation-spontaneous esophageal rupture as separated from those with anastomotic leak. A systematic web-based search using PubMed and the Cochrane Library was performed, reviewing literature published between January 2005 and December 2015. Eligible studies included all studies that presented data on the outcome of SEMS or surgical exploration in case of esophageal leak (including >3 patients). Only patients older than 15 years of age by the time of admission were included. Articles in other languages but English were excluded. Treatment failure was defined as a need for change in therapeutic strategy due to uncontrolled sepsis and mediastinitis, which usually meant rescue esophagectomy with end esophagostomy, death occurring as a consequence of the leakage or development of an esophagorespiratory fistula and/or other serious life threatening complications. Accordingly, the corresponding success rate is composed of cases where none of the failures above occurred. Regarding SEMS treatment, 201 articles were found, of which 48 were deemed relevant and of these, 17 articles were further analyzed. As for surgical management, 785 articles were retrieved, of which 82 were considered relevant, and 17 were included in the final analysis. It was not possible to specifically extract detailed clinical outcomes in sufficient numbers, when we tried to separately analyze the

Jupiter's Main Ring

NASA Technical Reports Server (NTRS)

1997-01-01

A mosaic of four images taken through the clear filter (610 nanometers) of the solid state imaging (CCD) system aboard NASA's Galileo spacecraft on November 8, 1996, at a resolution of approximately 46 kilometers (km) per picture element (pixel) along the rings; however, because the spacecraft was only about 0.5 degrees above the ring plane, the image is highly foreshortened in the vertical direction. The images were obtained when Galileo was in Jupiter's shadow peering back toward the Sun; the ring was approximately 2,300,000 kilometers (km) away. The arc on the far right of the image is produced by sunlight scattered by small particles comprising Jupiter's upper atmospheric haze. The ring also efficiently scatters light, indicating that much of its brightness is due to particles that are microns or less in diameter. Such small particles are believed to have human-scale lifetimes, i.e., very brief compared to the solar system's age.

Jupiter's ring system is composed of three parts -- a flat main ring, a lenticular halo interior to the main ring, and the gossamer ring, which lies exterior to the main ring. The near and far arms of Jupiter's main ring extend horizontally across the mosaic, joining together at the ring's ansa, on the far left side of the figure. The near arm of the ring appears to be abruptly truncated close to the planet, at the point where it passes into Jupiter's shadow. Some radial structure is barely visible across the ring's ansa. A faint mist of particles can be seen above and below the main rings; this vertically extended 'halo' is unusual in planetary rings, and is probably caused by electromagnetic forces pushing the smallest grains out of the ring plane. Because of shadowing, the halo is not visible close to Jupiter in the lower right part of the mosaic.

Jupiter's main ring is a thin strand of material encircling the planet. The diffuse innermost boundary begins at approximately 123,000 km. The main ring's outer radius is found to be

Measurement of health outcomes.

PubMed

Thavorncharoensap, Montarat

2014-05-01

Health outcomes are one of the most important components of health technology assessments (HTAs). All HTA outcomes should be measured from a relevant sample using a properly designed study and method. A number of recommendations on health outcome measurements are made in this second edition of Thailand's HTA guidelines. In particular the use of final outcomes, rather than surrogate outcomes, in HTAs is stressed. Where surrogate outcomes are used, strong justification and evidence must be provided. Effectiveness is preferred over efficacy. The relative treatment effect (the difference between health outcome that would be experienced by patients receiving the technology and that experienced by the same group were they to receive an alternative technology) should be derived from a systematic review of head-to-head RCTs. Mixed treatment comparison (MTC) should be used only to provide supplementary data that cannot be obtained from a head-to-head comparison. Where no direct comparison evidence exists, indirect comparison and observational study data can be used.

Linking main-belt comets to asteroid families

NASA Astrophysics Data System (ADS)

Novakovic, B.; Hsieh, H. H.; Cellino, A.

2012-09-01

Here we present our results obtained by applying different methods in order to establish a firm link between the main-belt comets (MBCs) and colisionally-formed asteroid families (AFs), i.e, to possibly find additional line of evidence supporting the hypothesis that MBCs may be preferentially found among the members of young AFs.

Aftershock patterns and main shock faulting

USGS Publications Warehouse

Mendoza, C.; Hartzell, S.H.

1988-01-01

We have compared aftershock patterns following several moderate to large earthquakes with the corresponding distributions of coseismic slip obtained from previous analyses of the recorded strong ground motion and teleseismic waveforms. Our results are consistent with a hypothesis of aftershock occurrence that requires a secondary redistribution of stress following primary failure on the earthquake fault. Aftershocks followng earthquakes examined in this study occur mostly outside of or near the edges of the source areas indicated by the patterns of main shock slip. The spatial distribution of aftershocks reflects either a continuation of slip in the outer regions of the areas of maximum coseismic displacement or the activation of subsidiary faults within the volume surrounding the boundaries of main shock rupture. -from Authors

[Cleaning and disinfection in nursing homes. Data on quality of structure, process and outcome in nursing homes in Frankfurt am Main, Germany, 2011].

PubMed

Heudorf, U; Gasteyer, S; Samoiski, Y; Voigt, K

2012-08-01

Due to the Infectious Disease Prevention Act, public health services in Germany are obliged to check the infection prevention in hospitals and other medical facilities as well as in nursing homes. In Frankfurt/Main, Germany, standardized control visits have been performed for many years. In 2011 focus was laid on cleaning and disinfection of surfaces. All 41 nursing homes were checked according to a standardized checklist covering quality of structure (i.e. staffing, hygiene concept), quality of process (observation of the cleaning processes in the homes) and quality of output, which was monitored by checking the cleaning of fluorescent marks which had been applied some days before and should have been removed via cleaning in the following days before the final check. In more than two thirds of the homes, cleaning personnel were salaried, in one third external personnel were hired. Of the homes 85% provided service clothing and all of them offered protective clothing. All homes had established hygiene and cleaning concepts, however, in 15% of the homes concepts for the handling of Norovirus and in 30% concepts for the handling of Clostridium difficile were missing. Regarding process quality only half of the processes observed, i.e. cleaning of hand contact surfaces, such as handrails, washing areas and bins, were correct. Only 44% of the cleaning controls were correct with enormous differences between the homes (0-100%). The correlation between quality of process and quality of output was significant. There was good quality of structure in the homes but regarding quality of process and outcome there was great need for improvement. This was especially due to faults in communication and coordination between cleaning personnel and nursing personnel. Quality outcome was neither associated with the number of the places for residents nor with staffing. Thus, not only quality of structure but also quality of process and outcome should be checked by the public health

Carbon nanofibers obtained from electrospinning process

NASA Astrophysics Data System (ADS)

Bovi de Oliveira, Juliana; Müller Guerrini, Lília; Sizuka Oishi, Silvia; Rogerio de Oliveira Hein, Luis; dos Santos Conejo, Luíza; Cerqueira Rezende, Mirabel; Cocchieri Botelho, Edson

2018-02-01

In recent years, reinforcements consisting of carbon nanostructures, such as carbon nanotubes, fullerenes, graphenes, and carbon nanofibers have received significant attention due mainly to their chemical inertness and good mechanical, electrical and thermal properties. Since carbon nanofibers comprise a continuous reinforcing with high specific surface area, associated with the fact that they can be obtained at a low cost and in a large amount, they have shown to be advantageous compared to traditional carbon nanotubes. The main objective of this work is the processing of carbon nanofibers, using polyacrylonitrile (PAN) as a precursor, obtained by the electrospinning process via polymer solution, with subsequent use for airspace applications as reinforcement in polymer composites. In this work, firstly PAN nanofibers were produced by electrospinning with diameters in the range of (375 ± 85) nm, using a dimethylformamide solution. Using a furnace, the PAN nanofiber was converted into carbon nanofiber. Morphologies and structures of PAN and carbon nanofibers were investigated by scanning electron microscopy, Raman Spectroscopy, thermogravimetric analyses and differential scanning calorimeter. The resulting residual weight after carbonization was approximately 38% in weight, with a diameters reduction of 50%, and the same showed a carbon yield of 25%. From the analysis of the crystalline structure of the carbonized material, it was found that the material presented a disordered structure.

Reconnaissance of radioactive rocks of Maine

USGS Publications Warehouse

Nelson, John M.; Narten, Perry F.

1951-01-01

The state of Maine was traversed with car-mounted Geiger-Mueller equipment in the late summer of 1948 and the radioactivity of approximately 4,600 miles of road was logged. All samples were analyzed, both in the field by comparing the radioactivity of each sample to the radioactivity of a stranded measured with a simple scaling modification of a portable counter, and in the Geological Survey’s Trace Elements Section Washington Laboratory. Differences between both types of analyses were negligible. The maximum equivalent uranium content of the most radioactive rocks thus analyzed was 0.008 percent. A 1,400-square-mile abnormally radioactive province in southwestern Maine was outlined. The outcrop data obtained from car traversing are evaluated statistically. Cumulative frequency distribution curves are drawn to show the distribution of outcrops at various levels of radioactivity, and straight-line extensions are made to show to maximum probable grade for various rock types and areas in Maine. A maximum grade of 0.055 percent equivalent uranium is thus predicted for the entire state. This prediction necessarily is a broad generalization because large areas of Main are inaccessible for car traversing. A concept of evaluation of an area for possible mineral deposits is proposed on the basis of lithology, and observed and indicated ranges in grade.

Technical and technological solution for vegetal bio-stimulants obtaining

NASA Astrophysics Data System (ADS)

Anghelache, D. G.; Diaconescu, I.; Pătraşcu, R.

2017-08-01

The paper presents a modern technology for bio fertilizers resulted from waste plant mass after harvesting crops Experimental products were obtained rich in nutrients, but unstable in terms of existing microorganisms. Therefore, they conducted further studies to obtaining bio fungicide herb, so in all investigations undertaken so far in the laboratory, were able to conclude that the introduction of medicinal plant extracts with fungicidal effect into the bio fertilizers obtained by degradation of plant material post-harvest can get various bio-stimulants with nourishing effect upon the plants. Following this technology the paper’s objective is to identify a flux scheme for experimental equipment which can produce as final outcome this type of bio-stimulant. Also, in this work, this equipment will be chosen and will be designed following and obeying to the request of every step of the above technology.

Comparison of outcomes obtained in murine local lymph node assays using CBA/J or CBA/Ca mice.

PubMed

Maeda, Yosuke; Hirosaki, Haruka; Yakata, Naoaki; Takeyoshi, Masahiro

2016-08-01

CBA/J and CBA/Ca mice are the recommended strains for local lymph node assays (LLNAs). Here, we report quantitative and qualitative comparisons between both mouse strains to provide useful information for the strain selection of sensitization testing. LLNA was conducted, in accordance with Organisation for Economic Co-operation and Development Test Guideline No. 429, with CBA/J and CBA/Ca mice using five chemicals including typical contact sensitizers and non-sensitizers: 2,4-dinitrochlorobenzene (DNCB), isoeugenol, α-hexylcinnamic aldehyde (HCA), propylene glycol (PG), and hexane; then outcomes were compared based on the raw data (disintegrations per minute, DPM), stimulation index (SI) values, EC3 values and positive/negative decisions. Although a significant difference was noted between DPM values derived from each strain of mice, SI values exhibited no considerable difference. The EC3 values for DNCB in CBA/J and CBA/Ca mice were 0.04 and 0.03, those for isoeugenol were 1.4 and 0.9, and those for HCA were 7.7 and 6.0, respectively. All EC values derived from each test system were almost equivalent and were within the range of acceptance criteria of the ICCVAM performance standard for LLNA. Positive/negative outcomes for all test chemicals were consistent. In conclusion, no considerable differences were observed in the final outcomes derived from CBA/J and CBA/Ca mice in LLNA. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Clinical outcome and surgical strategies for late post-traumatic kyphosis after failed thoracolumbar fracture operation

PubMed Central

Li, Suyun; Li, Zhi; Hua, Wenbin; Wang, Kun; Li, Shuai; Zhang, Yunkun; Ye, Zhewei; Shao, Zengwu; Wu, Xinghuo; Yang, Cao

2017-01-01

Abstract Rationale: Thoracic-lumbar vertebral fracture is very common in clinic, and late post-traumatic kyphosis is the main cause closely related to the patients’ life quality, which has evocated extensive concern for the surgical treatment of the disease. This study aimed to analyze the clinical outcomes and surgical strategies for late post-traumatic kyphosis after failed thoracolumbar fracture operation. Patient concerns: All patients presented back pain with kyphotic apex vertebrae between T12 and L3. According to Frankel classification grading system, among them, 3 patients were classified as grade D, with the ability to live independently. Diagnoses: A systematic review of 12 case series of post-traumatic kyphosis after failed thoracolumbar fracture operation was involved. Interventions: Wedge osteotomy was performed as indicated—posterior closing osteotomy correction in 5 patients and anterior open-posterior close correction in 7 patients.Postoperatively, thoracolumbar x-rays were obtained to evaluate the correction of kyphotic deformity, visual analog scales (VAS) and Frankel grading system were used for access the clinical outcomes. Outcomes: All the patients were followed up, with the average period of 38.5 months (range 24–56 months). The Kyphotic Cobb angle was improved from preoperative (28.65 ± 11.41) to postoperative (1.14 ± 2.79), with the correction rate of 96.02%. There was 1 case of intraoperative dural tear, without complications such as death, neurological injury, and wound infection. According to Frankel grading system, no patient suffered deteriorated neurological symptoms after surgery, and 2 patients (2/3) experienced significant relief after surgery. The main VAS score of back pain was improved from preoperative (4.41 ± 1.08) to postoperative (1.5 ± 0.91) at final follow-up, with an improvement rate of 65.89%. Lessons: Surgical treatment of late post-traumatic kyphosis after failed thoracolumbar fracture

Stroke Location Is an Independent Predictor of Cognitive Outcome.

PubMed

Munsch, Fanny; Sagnier, Sharmila; Asselineau, Julien; Bigourdan, Antoine; Guttmann, Charles R; Debruxelles, Sabrina; Poli, Mathilde; Renou, Pauline; Perez, Paul; Dousset, Vincent; Sibon, Igor; Tourdias, Thomas

2016-01-01

On top of functional outcome, accurate prediction of cognitive outcome for stroke patients is an unmet need with major implications for clinical management. We investigated whether stroke location may contribute independent prognostic value to multifactorial predictive models of functional and cognitive outcomes. Four hundred twenty-eight consecutive patients with ischemic stroke were prospectively assessed with magnetic resonance imaging at 24 to 72 hours and at 3 months for functional outcome using the modified Rankin Scale and cognitive outcome using the Montreal Cognitive Assessment (MoCA). Statistical maps of functional and cognitive eloquent regions were derived from the first 215 patients (development sample) using voxel-based lesion-symptom mapping. We used multivariate logistic regression models to study the influence of stroke location (number of eloquent voxels from voxel-based lesion-symptom mapping maps), age, initial National Institutes of Health Stroke Scale and stroke volume on modified Rankin Scale and MoCA. The second part of our cohort was used as an independent replication sample. In univariate analyses, stroke location, age, initial National Institutes of Health Stroke Scale, and stroke volume were all predictive of poor modified Rankin Scale and MoCA. In multivariable analyses, stroke location remained the strongest independent predictor of MoCA and significantly improved the prediction compared with using only age, initial National Institutes of Health Stroke Scale, and stroke volume (area under the curve increased from 0.697-0.771; difference=0.073; 95% confidence interval, 0.008-0.155). In contrast, stroke location did not persist as independent predictor of modified Rankin Scale that was mainly driven by initial National Institutes of Health Stroke Scale (area under the curve going from 0.840 to 0.835). Similar results were obtained in the replication sample. Stroke location is an independent predictor of cognitive outcome (MoCA) at 3

Long-term outcomes of coronary artery bypass grafting versus stent-PCI for unprotected left main disease: a meta-analysis.

PubMed

De Rosa, Salvatore; Polimeni, Alberto; Sabatino, Jolanda; Indolfi, Ciro

2017-09-06

Coronary artery bypass graft (CABG) surgery has traditionally represented the standard of care for left main coronary artery (LMCA) disease. However, percutaneous coronary intervention with stent implantation (PCI) has more recently emerged as a valuable alternative. The long-time awaited results of the largest randomized trials on the long-term impact of PCI versus CABG in LMCA disease, the newly published NOBLE and EXCEL studies, revealed contrasting results. Thus, aim of the present meta-analysis was to review the most robust evidence from randomized comparisons of CABG versus PCI for revascularization of LMCA. Randomized studies comparing long-term clinical outcomes of CABG or Stent-PCI for the treatment of LMCA disease were searched for in PubMed, the Chochrane Library and Scopus electronic databases. A total of 5 randomized studies were selected, including 4499 patients. No significant difference between CABG and PCI was found in the primary analysis on the composite endpoint of death, stroke and myocardial infarction (OR = 1·06 95% CI 0·80-1·40; p = 0·70). Similarly, no differences were observed between CABG and PCI for all-cause death (OR = 1·03 95% CI 0·81-1·32; p = 0·81). Although not statistically significant, a lower rate of stroke was registered in the PCI arm (OR = 0·86; p = 0·67), while a lower rate of myocardial infarction was found in the CABG arm (OR = 1·43; p = 0·17). On the contrary, a significantly higher rate of repeat revascularization was registered in the PCI arm (OR = 1·76 95% CI 1·45-2·13; p < 0·001). The present meta-analysis, the most comprehensive and updated to date, including 5 randomized studies and 4499 patients, demonstrates no difference between Stent-PCI and CABG for the treatment of LMCA disease in the composite endpoint of death, stroke and myocardial infarction. Hence, a large part of patients with unprotected left main coronary artery disease can be managed equally well by means of both

Main Clinical Outcomes of Feldspathic Porcelain and Glass-Ceramic Laminate Veneers: A Systematic Review and Meta-Analysis of Survival and Complication Rates.

PubMed

Morimoto, Susana; Albanesi, Rafael Borges; Sesma, Newton; Agra, Carlos Martins; Braga, Mariana Minatel

2016-01-01

The aim of this study was to perform a systematic review and meta-analysis based on clinical trials that evaluated the main outcomes of glass-ceramic and feldspathic porcelain laminate veneers. A systematic search was carried out in Cochrane and PubMed databases. From the selected studies, the survival rates for porcelain and glass-ceramic veneers were extracted, as were complication rates of clinical outcomes: debonding, fracture/chipping, secondary caries, endodontic problems, severe marginal discoloration, and influence of incisal coverage and enamel/dentin preparation. The Cochran Q test and the I(2) statistic were used to evaluate heterogeneity. Out of the 899 articles initially identified, 13 were included for analysis. Metaregression analysis showed that the types of ceramics and follow-up periods had no influence on failure rate. The estimated overall cumulative survival rate was 89% (95% CI: 84% to 94%) in a median follow-up period of 9 years. The estimated survival for glass-ceramic was 94% (95% CI: 87% to 100%), and for feldspathic porcelain veneers, 87% (95% CI: 82% to 93%). The meta-analysis showed rates for the following events: debonding: 2% (95% CI: 1% to 4%); fracture/chipping: 4% (95% CI: 3% to 6%); secondary caries: 1% (95% CI: 0% to 3%); severe marginal discoloration: 2% (95% CI: 1% to 10%); endodontic problems: 2% (95% CI: 1% to 3%); and incisal coverage odds ratio: 1.25 (95% CI: 0.33 to 4.73). It was not possible to perform meta-analysis of the influence of enamel/dentin preparation on failure rates. Glass-ceramic and porcelain laminate veneers have high survival rates. Fracture/ chipping was the most frequent complication, providing evidence that ceramic veneers are a safe treatment option that preserve tooth structure.

[Patient-reported and patient-weighted outcomes in ophthalmology].

PubMed

Scheibler, F; Finger, R P; Grosselfinger, R; Dintsios, C-M

2010-03-01

Considering patients' values and preferences in comparative effectiveness research (CER) is one of the main challenges in ophthalmology (value-based medicine). This article defines core terms in CER. The concept of patient-relevant (or patient-important) outcomes is distinguished from patient-reported outcomes (PRO) by means of examples in the field of ophthalmology. In order to be able to give a consistant recommendation if an intervention leads to conflicting results for different outcomes (trade-off), a ranking of outcomes will be necessary. Examples of studies in glaucoma patients are provided that demonstrate the possibilities of ranking of outcomes based on patient preferences.

Left main coronary artery stenosis: severity evaluation and implications for management.

PubMed

Habibi, Susan E; Shah, Rahman; Berzingi, Chalak O; Melchior, Ryan; Sumption, Kevin F; Jovin, Ion S

2017-03-01

The significant stenosis of the left main coronary artery is associated with poor outcomes and is considered a strong indication for revascularization. However, deciding whether the stenosis is significant can sometimes be challenging, especially when the degree of stenosis is intermediate, and can necessitate additional tests and imaging modalities. Areas covered: We did a literature search using keywords like 'left main', 'imaging', 'intravascular ultrasound', 'fractional flow reserve', 'computed tomographic angiography' and 'magnetic resonance imaging'. The most commonly used methods for better characterizing intermediate left main coronary stenoses are intravascular ultrasound and fractional flow reserve, while optical coherence tomography is the newer technique that provides better images, but for which not as much data is available. The noninvasive techniques are coronary computed tomographic angiography and, to a lesser degree, coronary magnetic resonance imaging. Expert commentary: Accurately determining the severity of left main coronary stenosis can mean the difference between a major intervention and conservative therapy. The reviewed newer imaging modalities give us greater confidence that patients with left main stenosis are assigned to the right treatment modality.

Blood Pressure Response to Main Renal Artery and Combined Main Renal Artery Plus Branch Renal Denervation in Patients With Resistant Hypertension.

PubMed

Fengler, Karl; Ewen, Sebastian; Höllriegel, Robert; Rommel, Karl-Philipp; Kulenthiran, Saaraaken; Lauder, Lucas; Cremers, Bodo; Schuler, Gerhard; Linke, Axel; Böhm, Michael; Mahfoud, Felix; Lurz, Philipp

2017-08-10

Single-electrode ablation of the main renal artery for renal sympathetic denervation showed mixed blood pressure (BP)-lowering effects. Further improvement of the technique seems crucial to optimize effectiveness of the procedure. Because sympathetic nerve fibers are closer to the lumen in the distal part of the renal artery, treatment of the distal main artery and its branches has been shown to reduce variability in treatment effects in preclinical studies and a recent randomized trial. Whether this optimized technique improves clinical outcomes remains uncertain. We report a 2-center experience of main renal artery and combined main renal artery plus branches renal denervation in patients with resistant hypertension using a multielectrode catheter. Twenty-five patients with therapy-resistant hypertension underwent renal sympathetic denervation with combined main renal artery and renal branch ablation and were compared to matched controls undergoing an ablation of the main renal artery only. BP change was assessed by ambulatory measurement at baseline and after 3 months. At baseline, BP was balanced between the groups. After 3 months, BP changed significantly in the combined ablation group (systolic/diastolic 24-hour mean and daytime mean BP -8.5±9.8/-7.0±10.7 and -9.4±9.8/-7.1±13.5 mm Hg, P <0.001/0.003 and <0.001/0.016, respectively), but not in patients with main artery treatment (-3.5±11.1/-2.0±7.6 and -2.8±10.9/-1.8±7.7 mm Hg, P =0.19/0.20 and 0.19/0.24, respectively). Systolic daytime BP was significantly more reduced in patients with combined ablation than in patients with main artery ablation ( P =0.033). Combined ablation of the main renal artery and branches appears to improve BP-lowering efficacy and should be further investigated. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Impact of lesion morphology and associated procedures for left main coronary stenting on angiographic outcome after intervention: sub-analysis of Heart Research Group of Kanazawa, HERZ, Study.

PubMed

Kawashiri, Masa-aki; Sakata, Kenji; Uchiyama, Katsuharru; Konno, Tetsuo; Namura, Masanobu; Mizuno, Sumio; Tatami, Ryozo; Kanaya, Honin; Nitta, Yutaka; Michishita, Ichiro; Hirase, Hiroaki; Ueda, Kosei; Aoyama, Takashi; Okeie, Kazuyasu; Haraki, Tatsuo; Mori, Kiyoo; Araki, Tsutomu; Minamoto, Masaharu; Oiwake, Hisanori; Ino, Hidekazu; Hayashi, Kenshi; Yamagishi, Masakazu

2014-04-01

Whether the lesion morphology and associated interventional procedures for the left main coronary artery disease (LMCA) could affect clinical outcome is still controversial. Therefore, we examined the impact of lesion morphology and associated procedures on clinical and angiographic outcomes of stenting for the LMCA. Among 7,660 patients with coronary intervention registered, we analyzed early angiographic results of 228 patients (179 men, mean age 69.4 years) concerned with LMCA lesions. In 121 out of 228 patients having long-term angiographic results, we examined the occurrence of major adverse coronary events (MACE) particularly in terms of the presence of acute coronary syndrome (ACS), the kind of stents, bear metal or drug eluting, the lesion morphology and associated procedures. Early angiographic success rate of LMCA stenting was 100 %, and clinical success rate was 94.3 %. During follow-up period for 3 years, MACE was observed in 17 patients. Under these conditions, multiple stenting (p < 0.01) and complicated procedures such as such as Y-stent, T-stent and crush stent (p < 0.01) were listed as risks for MACE, although there was no statistical difference in kinds of stent. Multivariate analysis demonstrated the significant disadvantage of complicated procedures using the bear metal stent on the occurrence of MACE (p < 0.01). These results demonstrate that the complicated procedures have great impact on clinical and angiographic outcomes after stenting for LMCA lesions, and suggest the simple procedure with a single stent for LMCA lesions in the present cohort. Whether the presence of ACS can affect the prognosis should further be sought.

Research investigation of helicopter main rotor/tail rotor interaction noise

NASA Technical Reports Server (NTRS)

Fitzgerald, J.; Kohlhepp, F.

1988-01-01

Acoustic measurements were obtained in a Langley 14 x 22 foot Subsonic Wind Tunnel to study the aeroacoustic interaction of 1/5th scale main rotor, tail rotor, and fuselage models. An extensive aeroacoustic data base was acquired for main rotor, tail rotor, fuselage aerodynamic interaction for moderate forward speed flight conditions. The details of the rotor models, experimental design and procedure, aerodynamic and acoustic data acquisition and reduction are presented. The model was initially operated in trim for selected fuselage angle of attack, main rotor tip-path-plane angle, and main rotor thrust combinations. The effects of repositioning the tail rotor in the main rotor wake and the corresponding tail rotor countertorque requirements were determined. Each rotor was subsequently tested in isolation at the thrust and angle of attack combinations for trim. The acoustic data indicated that the noise was primarily dominated by the main rotor, especially for moderate speed main rotor blade-vortex interaction conditions. The tail rotor noise increased when the main rotor was removed indicating that tail rotor inflow was improved with the main rotor present.

Transcultural adaptation and new proposal for the nursing outcome, Physical condition (2004)

PubMed Central

Navarrete, Jessica Rojas; Pérez, Paloma Echevarría; Costa, César Leal

2018-01-01

ABSTRACT Objectives: cross-culturally adapt to the Spanish context and make a new proposal for the nursing outcome, Physical Condition (2004), of the Nursing Outcomes Classification (NOC) for its precise use in clinical practice. Method: a cross-cultural adaptation study and a proposal for the nursing outcome, Physical Condition, was conducted and supported by the opinion of 26 experts. The data was obtained through an electronic form, and a quantitative analysis was conducted, using the SPSS software. Results: the version adapted to the Spanish context was obtained and the proposal of the outcome, Physical Condition, received agreement from 26 experts, with a mean score greater than 7.6 for adequacy of the outcome definition and its indicators, and 8.5 for the relevance of the indicators. Conclusions: the version adapted to the Spanish context and a new proposal for Physical Condition were obtained. The results obtained indicate a high level of adequacy and relevance, an instrument of great utility in the clinic, and research was obtained to evaluate the interventions directed to the improvement of the physical condition. PMID:29791669

Aquarius main structure configuration

NASA Astrophysics Data System (ADS)

Eremenko, A.

The Aquarius/SAC-D Observatory is a joint US-Argentine mission to map the salinity at the ocean surface. This information is critical to improving our understanding of two major components of Earth's climate system - the water cycle and ocean circulation. By measuring ocean salinity from space, the Aquarius/SAC-D Mission will provide new insights into how the massive natural exchange of freshwater between the ocean, atmosphere and sea ice influences ocean circulation, weather and climate. Aquarius is the primary instrument on the SAC-D spacecraft. It consists of a Passive Microwave Radiometer to detect the surface emission that is used to obtain salinity and an Active Scatterometer to measure the ocean waves that affect the precision of the salinity measurement. The Aquarius Primary Structure houses instrument electronics, feed assemblies, and supports a deployable boom with a 2.5 m Reflector, and provides the structural interface to the SAC-D Spacecraft. The key challenge for the Aquarius main structure configuration is to satisfy the needs of component accommodations, ensuring that the instrument can meet all operational, pointing, environmental, and launch vehicle requirements. This paper describes the evolution of the Aquarius main structure configuration, the challenges of balancing the conflicting requirements, and the major configuration driving decisions and compromises.

Aquarius Main Structure Configuration

NASA Technical Reports Server (NTRS)

Eremenko, Alexander

2012-01-01

The Aquarius/SAC-D Observatory is a joint US-Argentine mission to map the salinity at the ocean surface. This information is critical to improving our understanding of two major components of Earth's climate system - the water cycle and ocean circulation. By measuring ocean salinity from space, the Aquarius/SAC-D Mission will provide new insights into how the massive natural exchange of freshwater between the ocean, atmosphere and sea ice influences ocean circulation, weather and climate. Aquarius is the primary instrument on the SAC-D spacecraft. It consists of a Passive Microwave Radiometer to detect the surface emission that is used to obtain salinity and an Active Scatterometer to measure the ocean waves that affect the precision of the salinity measurement. The Aquarius Primary Structure houses instrument electronics, feed assemblies, and supports a deployable boom with a 2.5 m Reflector, and provides the structural interface to the SAC-D Spacecraft. The key challenge for the Aquarius main structure configuration is to satisfy the needs of component accommodations, ensuring that the instrument can meet all operational, pointing, environmental, and launch vehicle requirements. This paper describes the evolution of the Aquarius main structure configuration, the challenges of balancing the conflicting requirements, and the major configuration driving decisions and compromises.

Ecological Correlates of Children's Subjective School Outcomes.

ERIC Educational Resources Information Center

Marjoribanks, Kevin

1981-01-01

Path analytic techniques examined relations between children's subjective school outcomes and measures of their family and school learning environments. A home interview assessed parents' orientations to education and children's perceptions of schools were obtained. Children's perceptions have links with school-related outcomes even when family…

Five pediatric cases of ictal fear with variable outcomes.

PubMed

Akiyama, Mari; Kobayashi, Katsuhiro; Inoue, Takushi; Akiyama, Tomoyuki; Yoshinaga, Harumi

2014-10-01

Ictal fear is an uncommon condition in which fear manifests as the main feature of epileptic seizures. The literature has suggested that ictal fear is generally associated with poor seizure outcomes. We wanted to clarify the variability in seizure outcome of children with ictal fear. We identified five pediatric patients with ictal fear who were followed up on at Okayama University Hospital between January 2003 and December 2012. We retrospectively reviewed their clinical records and EEG findings. The onset age of epilepsy ranged from 8 months to 9 years and 10 months. The common ictal symptoms were sudden fright, clinging to someone nearby, and subsequent impairment of consciousness, which were often accompanied by complex visual hallucinations and psychosis-like complaints. Ictal fear, in four patients, was perceived as a nonepileptic disorder by their parents. Ictal electroencephalograms (EEG) of ictal fear were obtained in all patients. Three showed frontal onset, while the other two showed centrotemporal or occipital onsets. Two patients were seizure free at last follow-up, while seizures persisted in the other three. A patient with seizure onset during infancy had a favorable outcome, which was considered to be compatible with benign partial epilepsy with affective symptoms. Ictal fear is not always associated with a symptomatic cause or a poor seizure outcome. It is quite important to make a correct diagnosis of ictal fear as early as possible to optimize treatment. Copyright © 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Long-Term Asymmetric Hearing Affects Cochlear Implantation Outcomes Differently in Adults with Pre- and Postlingual Hearing Loss

PubMed Central

Boisvert, Isabelle; McMahon, Catherine M.; Dowell, Richard C.; Lyxell, Björn

2015-01-01

In many countries, a single cochlear implant is offered as a treatment for a bilateral hearing loss. In cases where there is asymmetry in the amount of sound deprivation between the ears, there is a dilemma in choosing which ear should be implanted. In many clinics, the choice of ear has been guided by an assumption that the reorganisation of the auditory pathways caused by longer duration of deafness in one ear is associated with poorer implantation outcomes for that ear. This assumption, however, is mainly derived from studies of early childhood deafness. This study compared outcomes following implantation of the better or poorer ear in cases of long-term hearing asymmetries. Audiological records of 146 adults with bilateral hearing loss using a single hearing aid were reviewed. The unaided ear had 15 to 72 years of unaided severe to profound hearing loss before unilateral cochlear implantation. 98 received the implant in their long-term sound-deprived ear. A multiple regression analysis was conducted to assess the relative contribution of potential predictors to speech recognition performance after implantation. Duration of bilateral significant hearing loss and the presence of a prelingual hearing loss explained the majority of variance in speech recognition performance following cochlear implantation. For participants with postlingual hearing loss, similar outcomes were obtained by implanting either ear. With prelingual hearing loss, poorer outcomes were obtained when implanting the long-term sound-deprived ear, but the duration of the sound deprivation in the implanted ear did not reliably predict outcomes. Contrary to an apparent clinical consensus, duration of sound deprivation in one ear has limited value in predicting speech recognition outcomes of cochlear implantation in that ear. Outcomes of cochlear implantation are more closely related to the period of time for which the brain is deprived of auditory stimulation from both ears. PMID:26043227

Decompressive Craniectomy for Traumatic Brain Injury: The Role of Cranioplasty and Hydrocephalus on Outcome.

PubMed

Nasi, Davide; Dobran, Mauro; Di Rienzo, Alessandro; di Somma, Lucia; Gladi, Maurizio; Moriconi, Elisa; Scerrati, Massimo; Iacoangeli, Maurizio

2018-05-14

After severe traumatic brain injury (sTBI) associated with uncontrollable high intracranial pressure (ICP), today the main challenge for neurosurgeons remains to identify who may obtain benefit from decompressive craniectomy (DC) and which factors after DC influence the prognosis of these patients. The aim of this paper was to identify the pre- and postoperative determinants of outcome after DC. This retrospective study included all patients undergoing DC for sTBI from 2003 to 2011. The 6-month outcome, assessed using the Glasgow Outcome Scale (GOS), was dichotomized into favorable (GOS scores 4 and 5) and unfavorable (GOS scores 1-3) outcome. Predictors of outcome were identified by uni- and multivariate analysis. There were 190 patients who underwent DC for sTBI in this study. Sixty patients (31.6%) died within 30 days after DC. Independent prognostic factors for survival after 30 days were Glasgow Coma Scale score at admission greater than 5 (P = 0.002) and bilateral pupil reactivity (P < 0.0001). Thirty days after DC, 67 patients (51.5%) out of 130 had unfavorable outcome (GOS scores 1-3) and 63 patients (49.5%) presented favorable outcome (GOS scores 4 and 5). The independent preoperative prognostic factors for poor outcome were age over 65 years (P < 0.0001) and bilateral absence of pupil reactivity (P = 0.0165). After DC, onset of postoperative hydrocephalus and delayed cranioplasty (3 months after DC) was associated with unfavorable outcome at multivariate analysis (P = 0.002 and P < 0.0001, respectively). In our study, the development of hydrocephalus after DC for sTBI and delayed cranial reconstruction were associated with unfavorable outcome. Copyright © 2018 Elsevier Inc. All rights reserved.

Short-term outcome of retrograde tibiotalocalcaneal arthrodesis with a curved intramedullary nail.

PubMed

Mückley, Thomas; Klos, Kajetan; Drechsel, Thomas; Beimel, Claudia; Gras, Florian; Hofmann, Gunther O

2011-01-01

The aim of this study was to investigate the potential clinical benefit of tibiotalocalcaneal arthrodesis (TTCA) with an intramedullary nail with a valgus curve, two compression options, and angle-stable locking. Patients who had undergone TTCA at two tertiary hospitals were eligible. Patients who had undergone TTCA before the beginning of the study were evaluated retrospectively, then all following patients were examined prospectively. There were 59 TTCAs; 55 patients were available for analysis. Twenty-eight were evaluated retrospectively, 27 prospectively. Main Outcome Measures were an SF-36, Mazur-, and AOFAS ankle-hindfoot rating scores and radiographic examination. Bony union was obtained in 53 patients. Fifty-one patients were satisfied with the outcome. Fifty-one patients had marked subjective improvement in mobility. The mean AOFAS score of the 55 patients at the latest followup was 66.8 (range, 38 to 86). The mean Mazzur score was 68.0 (range, 30 to 83). In the prospective group, the scores were significantly improved: AOFAS score by an average of 39.6 points (p<0.001); Mazur score by an average of 43 points (p<0.001); SF-36 physical component summary score (p<0.001) and mental component summary score also improved (p<0.048). Radiology showed good hindfoot alignment. The complication rate was 25%. Compared with the literature, the data obtained in this study show a good outcome and a high rate of bony union, with comparable complication rates. Patient satisfaction was good. However, the patients still had limitations. The clinical benefit of the nail used was confirmed.

Hst Measurements Of Main Belt Comet 300163

NASA Astrophysics Data System (ADS)

Jewitt, David; Weaver, H.; Agarwal, J.; Mutchler, M.; Larson, S.

2012-10-01

Asteroid 300163 (semimajor axis 3.05 AU, eccentricity 0.20, inclination 3 deg., Tisserand parameter 3.20) is a source of dust, giving it the dual cometary designation P/2006 VW139. It satisfies the definition of a main-belt comet (MBC) by having the orbital character of a main-belt asteroid but the diffuse appearance of a comet. We obtained Hubble Space Telescope observations of this object in December 2011 in order to study the morphology of the ejected dust at the highest angular resolution and to determine the cause of the mass loss from the nucleus. One of the two HST observing epochs was carefully timed to coincide with the Earth's crossing of the orbital plane (out of plane angle 0.01 deg.) to obtain a measure of the vertical velocity dispersion free from the effects of projection. We find an extraordinarily thin dust sheet and infer a sub-meter per second dust ejection velocity. Observations at the second epoch show a change in the near-nucleus dust morphology that indicates continuing ejection (i.e. the dust emission is not impulsive). We use the low velocity ejection, coupled with the absence of an observable coma, to help constrain the possible source mechanisms for the dust.

Acoustic barriers obtained from industrial wastes.

PubMed

Garcia-Valles, M; Avila, G; Martinez, S; Terradas, R; Nogués, J M

2008-07-01

Acoustic pollution is an environmental problem that is becoming increasingly more important in our society. Likewise, the accumulation of generated waste and the need for waste management are also becoming more and more pressing. In this study we describe a new material--called PROUSO--obtained from industrial wastes. PROUSO has a variety of commercial and engineering, as well as building, applications. The main raw materials used for this environmentally friendly material come from slag from the aluminium recycling process, dust from the marble industry, foundry sands, and recycled expanded polystyrene from recycled packaging. Some natural materials, such as plastic clays, are also used. To obtain PROUSO we used a conventional ceramic process, forming new mineral phases and incorporating polluted elements into the structure. Its physical properties make PROUSO an excellent acoustic and thermal insulation material. It absorbs 95% of the sound in the frequency band of the 500 Hz. Its compressive strength makes it ideal for use in ceramic wall building.

A photoelectric lightcurve survey of small main belt asteroids

NASA Technical Reports Server (NTRS)

Binzel, R. P.; Mulholland, J. D.

1983-01-01

A survey to obtain photoelectric lightcurves of small main-belt asteroids was conducted from November 1981 to April 1982 using the 0.91- and 2.1-m telescopes at the University of Texas McDonald Observatory. A total of 18 main-belt asteroids having estimated dimaters under 30 km were observed with over half of these being smaller than 15 km. Rotational periods were determined or estimated from multiple nights of observation for nearly all of these yielding a sample of 17 small main-belt asteroids which is believed to be free of observational selection effects. All but two of these objects were investigated for very short periods in the range of 1 min to 2 hr using power spectrum analysis of a continuous set of integrations. No evidence for such short periods was seen in this sample. Rotationally averaged B(1,0) magnitudes were determined for most of the surveyed asteroids, allowing diameter estimates to be made. Imposing the suspected selection effects of photogaphic photometry on the results of this survey gives excellent agreement with the results from that technique. This shows that the inability of photographic photometry to obtain results for many asteroids is indeed due to the rotational parameter of those asteroids.

Higher HDL cholesterol is associated with better cognitive function: the Maine-Syracuse study.

PubMed

Crichton, Georgina E; Elias, Merrill F; Davey, Adam; Sullivan, Kevin J; Robbins, Michael A

2014-11-01

Few studies have examined associations between different subcategories of cholesterol and cognitive function. We examined relationships between total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), triglyceride levels and cognitive performance in the Maine-Syracuse Longitudinal Study, a community-based study of cardiovascular risk factors. Cross-sectional analyses were undertaken on data from 540 participants, aged 60 to 98 years, free of dementia and stroke. TC, HDL, LDL, and triglyceride levels were obtained. Cognitive function was assessed using a thorough neuropsychological test battery, including domains of cognitive function indexed by multiple cognitive tests. The cognitive outcomes studied were as follows: Visual-Spatial Memory and Organization, Verbal and Working Memory, Scanning and Tracking, Abstract Reasoning, a Global Composite score, and the Mini-Mental State Examination (MMSE). Significant positive associations were observed between HDL-cholesterol and the Global Composite score, Working Memory, and the MMSE after adjustment for demographic and cardiovascular risk factors. Participants with desirable levels of HDL (≥60 mg/dL) had the highest scores on all cognitive outcomes. There were no significant associations observed between TC, LDL, or triglyceride concentrations and cognition. In older individuals, HDL-cholesterol was related to a composite of Working Memory tests and for general measures of cognitive ability when adjusted for cardiovascular variables. We speculate that persons over 60 are survivors and thus less likely to show cognitive deficit in relation to TC, LDL-cholesterol, and triglycerides. Longitudinal studies are needed to examine relations between specific cognitive abilities and the different subcategories of cholesterol.

Predicting couple therapy outcomes based on speech acoustic features

PubMed Central

Nasir, Md; Baucom, Brian Robert; Narayanan, Shrikanth

2017-01-01

Automated assessment and prediction of marital outcome in couples therapy is a challenging task but promises to be a potentially useful tool for clinical psychologists. Computational approaches for inferring therapy outcomes using observable behavioral information obtained from conversations between spouses offer objective means for understanding relationship dynamics. In this work, we explore whether the acoustics of the spoken interactions of clinically distressed spouses provide information towards assessment of therapy outcomes. The therapy outcome prediction task in this work includes detecting whether there was a relationship improvement or not (posed as a binary classification) as well as discerning varying levels of improvement or decline in the relationship status (posed as a multiclass recognition task). We use each interlocutor’s acoustic speech signal characteristics such as vocal intonation and intensity, both independently and in relation to one another, as cues for predicting the therapy outcome. We also compare prediction performance with one obtained via standardized behavioral codes characterizing the relationship dynamics provided by human experts as features for automated classification. Our experiments, using data from a longitudinal clinical study of couples in distressed relations, showed that predictions of relationship outcomes obtained directly from vocal acoustics are comparable or superior to those obtained using human-rated behavioral codes as prediction features. In addition, combining direct signal-derived features with manually coded behavioral features improved the prediction performance in most cases, indicating the complementarity of relevant information captured by humans and machine algorithms. Additionally, considering the vocal properties of the interlocutors in relation to one another, rather than in isolation, showed to be important for improving the automatic prediction. This finding supports the notion that behavioral

Heart-lung transplantation: pediatric indications and outcomes

PubMed Central

2014-01-01

As indications for heart-lung transplant (HLT) have changed to some degree in the past 30 years, this treatment is being used less frequently in children due to more advanced care of severe heart and lung disease. This is fortunate as the outcomes for HLT are poor compared to other solid organ transplants and this is mainly due to the poorer outcome of the lung graft. PMID:25132980

Organizational Climate, Services, and Outcomes in Child Welfare Systems

ERIC Educational Resources Information Center

Glisson, Charles; Green, Philip

2011-01-01

Objective: This study examines the association of organizational climate, casework services, and youth outcomes in child welfare systems. Building on preliminary findings linking organizational climate to youth outcomes over a 3-year follow-up period, the current study extends the follow-up period to 7 years and tests main, moderating and…

Maternal nutrition and birth outcomes.

PubMed

Abu-Saad, Kathleen; Fraser, Drora

2010-01-01

In this review, the authors summarize current knowledge on maternal nutritional requirements during pregnancy, with a focus on the nutrients that have been most commonly investigated in association with birth outcomes. Data sourcing and extraction included searches of the primary resources establishing maternal nutrient requirements during pregnancy (e.g., Dietary Reference Intakes), and searches of Medline for "maternal nutrition"/[specific nutrient of interest] and "birth/pregnancy outcomes," focusing mainly on the less extensively reviewed evidence from observational studies of maternal dietary intake and birth outcomes. The authors used a conceptual framework which took both primary and secondary factors (e.g., baseline maternal nutritional status, socioeconomic status of the study populations, timing and methods of assessing maternal nutritional variables) into account when interpreting study findings. The authors conclude that maternal nutrition is a modifiable risk factor of public health importance that can be integrated into efforts to prevent adverse birth outcomes, particularly among economically developing/low-income populations.

Does pulse oximeter use impact health outcomes? A systematic review

PubMed Central

English, Mike; Shepperd, Sasha

2016-01-01

Objective Do newborns, children and adolescents up to 19 years have lower mortality rates, lower morbidity and shorter length of stay in health facilities where pulse oximeters are used to inform diagnosis and treatment (excluding surgical care) compared with health facilities where pulse oximeters are not used? Design Studies were obtained for this systematic literature review by systematically searching the Database of Abstracts of Reviews of Effects, Cochrane, Medion, PubMed, Web of Science, Embase, Global Health, CINAHL, WHO Global Health Library, international health organisation and NGO websites, and study references. Patients Children 0–19 years presenting for the first time to hospitals, emergency departments or primary care facilities. Interventions Included studies compared outcomes where pulse oximeters were used for diagnosis and/or management, with outcomes where pulse oximeters were not used. Main outcome measures: mortality, morbidity, length of stay, and treatment and management changes. Results The evidence is low quality and hypoxaemia definitions varied across studies, but the evidence suggests pulse oximeter use with children can reduce mortality rates (when combined with improved oxygen administration) and length of emergency department stay, increase admission of children with previously unrecognised hypoxaemia, and change physicians’ decisions on illness severity, diagnosis and treatment. Pulse oximeter use generally increased resource utilisation. Conclusions As international organisations are investing in programmes to increase pulse oximeter use in low-income settings, more research is needed on the optimal use of pulse oximeters (eg, appropriate oxygen saturation thresholds), and how pulse oximeter use affects referral and admission rates, length of stay, resource utilisation and health outcomes. PMID:26699537

Patient-reported allergies cause inferior outcomes after total knee arthroplasty.

PubMed

Hinarejos, Pedro; Ferrer, Tulia; Leal, Joan; Torres-Claramunt, Raul; Sánchez-Soler, Juan; Monllau, Joan Carles

2016-10-01

The main objective of this study was to analyse the outcomes after total knee arthroplasty (TKA) of a group of patients with at least one self-reported allergy and a group of patients without reported allergies. We hypothesized there is a significant negative influence on clinical outcome scores after TKA in patients with self-reported allergies. Four-hundred and seventy-five patients who had undergone TKA were analysed preoperatively and 1 year after surgery. The WOMAC, KSS and SF-36 scores were obtained. The patients' Yesavage depression questionnaire score was also recorded. The scores of the 330 (69.5 %) patients without self-reported allergies were compared to the scores of the 145 (30.5 %) patients with at least one self-reported allergy in the medical record. Preoperative scores were similar in both groups. The WOMAC post-operative scores (23.6 vs 20.4; p = 0.037) and the KSS-Knee score (91.1 vs 87.6; p = 0.027) were worse in the group of patients with self-reported allergies than in the group without allergies. The scores from the Yesavage depression questionnaire and in the SF-36 were similar in both groups. Patients with at least one self-reported allergy have worse post-operative outcomes in terms of the WOMAC and KSS-Knee scores after TKA than patients without allergies. These poor outcomes do not seem to be related to depression. Therefore, more research is needed to explain them. Reported allergies could be considered a prognostic factor and used when counselling TKA patients. I.

Outcome selection and role of patient reported outcomes in contemporary cardiovascular trials: systematic review

PubMed Central

Malhotra, Aneil; Banning, Adrian P; Jenkinson, Crispin

2010-01-01

Objectives To systematically assess the type of outcomes selected and the prevalence of patient reported outcomes in contemporary cardiovascular trials and to quantify any misuse or underuse of patient reported outcomes using a specially developed tool that would allow estimation of the relevance of such outcomes to clinical decision making. Design Systematic review. Data sources Medline and Embase. Study selection Randomised controlled trials of the treatment for or prevention of cardiovascular disease published in 10 leading general medical and cardiology journals from January 2005 to December 2008. Results Primary outcomes were patient important (death, morbidity, or patient reported outcomes) in only 93 of 413 trials (23%, SE 2%), whereas another 92 (22%, SE 2%) combined these outcomes with other less important ones into a composite. Sixty five trials (16%; SE 2%) used at least one instrument to measure patient reported outcomes, mostly in trials where such information would have been important or crucial for clinical decision making (52 trials). Patient reported outcomes were judged to be of little incremental value to a large number of, mostly explanatory, cardiovascular trials (152 trials). However, many trials in which patient reported outcomes would have been important or crucial for clinical decision making did not report such outcomes (122 of 174 trials, 70%). These included several trials that primarily aimed to improve symptoms or functional status, trials that tested interventions with a considerable potential for causing harm (mainly bleeding) that were not meaningfully measured, and trials with composite outcomes that were dominated by outcomes of questionable importance to patients. Conclusions Despite a continued rise in the reporting of patient reported outcomes with no evidence for their misuse in more recent cardiovascular trials, they seem to be still underused once their relevance to clinical decision making has been taken into account. This

Priorities for Cardiovascular Outcomes Research: A Report of the National Heart, Lung, and Blood Institute's Centers for Cardiovascular Outcomes Research Working Group.

PubMed

Khazanie, Prateeti; Krumholz, Harlan M; Kiefe, Catarina I; Kressin, Nancy R; Wells, Barbara; Wang, Tracy Y; Peterson, Eric D

2017-07-01

The Centers for Cardiovascular Outcomes Research (CCORs) held a meeting to review how cardiovascular outcomes research had evolved in the decade since the National Heart, Lung, and Blood Institute 2004 working group report and to consider future directions. The conference involved representatives from governmental agencies, outcomes research thought leaders, and public and private healthcare partners. The main purposes of this meeting were to (1) advance collaborative high-yield, high-impact outcomes research; (2) identify priorities and barriers to important cardiovascular outcomes research; and (3) define future needs for the field. This report highlights the key topics covered during the meeting, including an examination of the recent history of outcomes research, an evaluation of the current academic climate, and a vision for the future of cardiovascular outcomes research. © 2017 American Heart Association, Inc.

Speech Therapy Telepractice for Vocal Cord Dysfunction (VCD): MaineCare (Medicaid) Cost Savings

PubMed Central

Towey, Michael P.

2012-01-01

This Brief Communication represents an analysis of the cost savings to MaineCare (also referred to as Medicaid) directly attributable to service provided via speech therapy telepractice. Seven female (primarily adolescent) MaineCare patients consecutively referred to Waldo County General Hospital (WCGH) with suspected diagnosis of Vocal Cord Dysfunction (VCD) were treated by speech therapy telepractice. Outcome data demonstrated a first month cost savings of $2376.72. The analysis additionally projected thousands of dollars of potential savings each month in reduced medical costs for this patient group as a result of successful treatment via speech therapy telepractice. The study suggests that without access to speech therapy telepractice for patients with VCD, the medical costs to MaineCare will be ongoing and significant. PMID:25945195

A Participative Approach to Evaluation of Graduates' Professional Outcomes

ERIC Educational Resources Information Center

Clerici, Renata; Castiglioni, Maria; Grion, Valentina; Zago, Giuseppe; Da Re, Lorenza

2014-01-01

This work discusses the professional outcomes of University of Padova graduates in academic year 2007/08. Its aim was to carry out an overall assessment of higher education professional outcomes, involving all the main actors of the learning process, students, teachers and tutors, in a perspective of participatory evaluation, to improve teaching…

Pulmonary Vascular Input Impedance is a Combined Measure of Pulmonary Vascular Resistance and Stiffness and Predicts Clinical Outcomes Better than PVR Alone in Pediatric Patients with Pulmonary Hypertension

PubMed Central

Hunter, Kendall S.; Lee, Po-Feng; Lanning, Craig J.; Ivy, D. Dunbar; Kirby, K. Scott; Claussen, Lori R.; Chan, K. Chen; Shandas, Robin

2011-01-01

Background Pulmonary vascular resistance (PVR) is the current standard for evaluating reactivity in children with pulmonary arterial hypertension (PAH). However, PVR measures only the mean component of right ventricular afterload and neglects pulsatile effects. We recently developed and validated an method to measure pulmonary vascular input impedance, which revealed excellent correlation between the zero-harmonic impedance value and PVR, and suggested a correlation between higher harmonic impedance values and pulmonary vascular stiffness (PVS). Here we show that input impedance can be measured routinely and easily in the catheterization laboratory, that impedance provides PVR and PVS from a single measurement, and that impedance is a better predictor of disease outcomes compared to PVR. Methods Pressure and velocity waveforms within the main PA were measured during right-heart catheterization of patients with normal PA hemodynamics (n=14) and those with PAH undergoing reactivity evaluation (49 subjects; 95 conditions). A correction factor needed to transform velocity into flow was obtained by calibrating against cardiac output. Input impedance was obtained off-line by dividing Fourier-transformed pressure and flow waveforms. Results Exceptional correlation was found between the indexed zero harmonic of impedance and indexed PVR (y=1.095·x+1.381, R2=0.9620). Additionally, the modulus sum of the first two harmonics of impedance was found to best correlate with indexed pulse pressure over stroke volume (PP/SV) (y=13.39·x-0.8058, R2=0.7962). Amongst a subset of PAH patients (n=25), cumulative logistic regression between outcomes to total indexed impedance was better (RL2=0.4012) than between outcomes and indexed PVR (RL2=0.3131). Conclusions Input impedance can be consistently and easily obtained from PW Doppler and a single catheter pressure measurement, provides comprehensive characterization of the main components of RV afterload, and better predicts patient

Forward Neutron Production at the Fermilab Main Injector

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

Nigmanov, T.S.; /Michigan U.; Rajaram, D.

2010-10-01

We have measured cross sections for forward neutron production from a variety of targets using proton beams from the Fermilab Main Injector. Measurements were performed for proton beam momenta of 58 GeV/c, 84 GeV/c, and 120 GeV/c. The cross section dependence on the atomic weight (A) of the targets was found to vary as A{sup a} where a is 0.46 {+-} 0.06 for a beam momentum of 58 GeV/c and 0.54 {+-} 0.05 for 120 GeV/c. The cross sections show reasonable agreement with FLUKA and DPMJET Monte Carlos. Comparisons have also been made with the LAQGSM Monte Carlo. The MIPPmore » (Main Injector Particle Production) experiment (FNAL E907) [1] acquired data in the Meson Center beam line at Fermilab. The primary purposes of the experiment were to investigate scaling laws in hadron fragmentation [2], to obtain hadron production data for the NuMI (Neutrinos at the Main Injector [3]) target to be used for calculating neutrino fluxes, and to obtain inclusive pion, neutron, and photon production data to facilitate proton radiography [4]. While there is considerable data available on inclusive charged particle production [5], there is little data on neutron production. In this article we present results for forward neutron production using proton beams of 58 GeV/c, 84 GeV/c, and 120 GeV/c on hydrogen, beryllium, carbon, bismuth, and uranium targets, and compare these data with predictions from Monte Carlo simulations.« less

The Relationship between Parent Expectations and Postschool Outcomes of Adolescents with Disabilities

ERIC Educational Resources Information Center

Doren, Bonnie; Gau, Jeff M.; Lindstrom, Lauren E.

2012-01-01

A secondary analysis was conducted of the National Longitudinal Transition Study-2 to examine (a) main effects of parents' school and postschool outcome expectations on the actual outcomes achieved, (b) demographic moderators, and (c) adolescent autonomy as a mediator of parent expectations and outcomes. Parent expectations were found to…

The Main Topics at the Oncoplastic Breast Surgery Course and Expert Panel.

PubMed

Emiroğlu, Mustafa; Kuru, Bekir; Gülçelik, Mehmet Ali; Atahan, M Kemal; Sezer, Atakan Y; Karaali, Cem; Güllüoğlu, Bahadır

2017-01-01

The Oncoplastic and Reconstructive Breast Surgery course was held in Izmir by the Izmir Breast Diseases Federation in collaboration with the Breast Diseases Federation of Turkey. The techniques of oncoplasty, the application details and experience in this subject were shared. In this text, the main topics and outcomes are briefly summarised. These evaluations can be considered highly valuable on both local and regional scales.

Contaminated sediments database for the Gulf of Maine

USGS Publications Warehouse

Buchholtz ten Brink, Marilyn R.; Manheim, F.T.; Mecray, E.L.; Hastings, M.E.; Currence, J.M.; Farrington, J.W.; Jones, S.H.; Larsen, P.F.; Tripp, B.W.; Wallace, G.T.; Ward, L.G.; Fredette, T.J.; Liebman, M.L.; Smith Leo, W.

2002-01-01

Bottom sediments in the Gulf of Maine and its estuaries have accumulated pollutants of many types, including metals and organic compounds of agricultural, industrial, and household derivation. Much analytical and descriptive data has been obtained on these sediments over the past decades, but only a small effort had been made, prior to this project, to compile and edit the published and unpublished data in forms suitable for a variety of users. The Contaminated Sediments Database for the Gulf of Maine provides a compilation and synthesis of existing data to help establish the environmental status of our coastal sediments and the transport paths and fate of contaminants in this region. This information, in turn, forms one of the essential bases for developing successful remediation and resource management policies.

Urinary tract infection and adverse outcome of pregnancy.

PubMed

Dimetry, Shaira R; El-Tokhy, Hanan M; Abdo, Nagla M; Ebrahim, Moustafa A; Eissa, Mohammed

2007-01-01

Urinary tract infections (UTIs) during pregnancy are among the commonest health problems world wide, specially in developing countries, including Egypt. It has several adverse outcomes not only on the mother but also on the fetus as well.. The aim of this study is to determine the incidence of UTIs during pregnancy, study the main risk factors associated with such infections and find the impact of these infections on some pregnancy outcomes namely the gestational age and birth weight. A follow-up study on 249 pregnant women attending the ante natal care clinic at Zagazig university hospital. They were recruited over a period from 1st of September to 30th of or November, 2005. The outcome could be recorded for 201 of them. Data were collected through a pretested questionnaire, repeated urine analyses and recording of outcome of pregnancy. The study revealed that the incidence of UTIs during pregnancy was 31.3%. The commonest organisms were Klebsiella and E-coli. Several socio-demographic characteristics were found significantly associated with UTIs, age being 30 years and more, illiterates and low educational level, low socio-economic level and those with unsatisfactory personal hygiene and those using underwear clothes other than cotton. Significant associations with UTIs were also found in multigravidae 4th and more, those having more than one child and those who previously suffered UTIs. The only predicting variable with UTIs was low socio-economic level. The study revealed that the probability of delivering premature infants and low birth weights was significantly higher among those who experienced UTIs during pregnancy. Multivariate analysis revealed that UTI was one of the main contributors to pre-mature deliveries. Urinary tract infections with pregnancy still constitute a big problem with high incidence. It has a great impact on pregnancy outcome mainly pre-mature labor. So, the study recommends health education about personal hygiene, repeated urine

LOX/Methane Main Engine Igniter Tests and Modeling

NASA Technical Reports Server (NTRS)

Breisacher, Kevin J.; Ajmani, Kumund

2008-01-01

The LOX/methane propellant combination is being considered for the Lunar Surface Access Module ascent main engine propulsion system. The proposed switch from the hypergolic propellants used in the Apollo lunar ascent engine to LOX/methane propellants requires the development of igniters capable of highly reliable performance in a lunar surface environment. An ignition test program was conducted that used an in-house designed LOX/methane spark torch igniter. The testing occurred in Cell 21 of the Research Combustion Laboratory to utilize its altitude capability to simulate a space vacuum environment. Approximately 750 ignition test were performed to evaluate the effects of methane purity, igniter body temperature, spark energy level and frequency, mixture ratio, flowrate, and igniter geometry on the ability to obtain successful ignitions. Ignitions were obtained down to an igniter body temperature of approximately 260 R with a 10 torr back-pressure. The data obtained is also being used to anchor a CFD based igniter model.

Pulmonary vascular input impedance is a combined measure of pulmonary vascular resistance and stiffness and predicts clinical outcomes better than pulmonary vascular resistance alone in pediatric patients with pulmonary hypertension.

PubMed

Hunter, Kendall S; Lee, Po-Feng; Lanning, Craig J; Ivy, D Dunbar; Kirby, K Scott; Claussen, Lori R; Chan, K Chen; Shandas, Robin

2008-01-01

Pulmonary vascular resistance (PVR) is the current standard for evaluating reactivity in children with pulmonary arterial hypertension (PAH). However, PVR measures only the mean component of right ventricular afterload and neglects pulsatile effects. We recently developed and validated a method to measure pulmonary vascular input impedance, which revealed excellent correlation between the zero harmonic impedance value and PVR and suggested a correlation between higher-harmonic impedance values and pulmonary vascular stiffness. Here we show that input impedance can be measured routinely and easily in the catheterization laboratory, that impedance provides PVR and pulmonary vascular stiffness from a single measurement, and that impedance is a better predictor of disease outcomes compared with PVR. Pressure and velocity waveforms within the main pulmonary artery were measured during right heart catheterization of patients with normal pulmonary artery hemodynamics (n = 14) and those with PAH undergoing reactivity evaluation (49 subjects, 95 conditions). A correction factor needed to transform velocity into flow was obtained by calibrating against cardiac output. Input impedance was obtained off-line by dividing Fourier-transformed pressure and flow waveforms. Exceptional correlation was found between the indexed zero harmonic of impedance and indexed PVR (y = 1.095x + 1.381, R2 = 0.9620). In addition, the modulus sum of the first 2 harmonics of impedance was found to best correlate with indexed pulse pressure over stroke volume (y = 13.39x - 0.8058, R2 = 0.7962). Among a subset of patients with PAH (n = 25), cumulative logistic regression between outcomes to total indexed impedance was better (R(L)2 = 0.4012) than between outcomes and indexed PVR (R(L)2 = 0.3131). Input impedance can be consistently and easily obtained from pulse-wave Doppler and a single catheter pressure measurement, provides comprehensive characterization of the main components of RV afterload, and

The King's Outcome Scale for Childhood Head Injury and Injury Severity and Outcome Measures in Children with Traumatic Brain Injury

ERIC Educational Resources Information Center

Calvert, Sophie; Miller, Helen E.; Curran, Andrew; Hameed, Biju; McCarter, Renee; Edwards, Richard J.; Hunt, Linda; Sharples, Peta Mary

2008-01-01

The aim of this study was to relate discharge King's Outcome Scale for Childhood Head Injury (KOSCHI) category to injury severity and detailed outcome measures obtained in the first year post-traumatic brain injury (TBI). We used a prospective cohort study. Eighty-one children with TBI were studied: 29 had severe, 15 moderate, and 37 mild TBI. The…

Capillary electrophoretic determination of main components of natural dyes with MS detection.

PubMed

Surowiec, Izabella; Pawelec, Katarzyna; Rezeli, Melinda; Kilar, Ferenc; Trojanowicz, Marek

2008-07-01

CE with UV-Vis and MS detections was investigated as a technique for detection of main components of selected natural dyes of plant and insect origin. The BGE giving the best separation of the investigated flavonoids and anthraquinoids, suitable for MS detection consisted of 40 mM ammonium acetate solution of pH 9.5 with 40% ACN. LODs obtained with MS detection were even one order of magnitude lower than the ones obtained with UV-Vis detection. Application of MS detection enabled determination of eleven dye compounds from three different chemical groups in 15 min. and proved to be more satisfactory than diode-array detection in the electrophoretic analysis of main classes of natural dyes both in terms of selectivity and sensitivity of analysis.

Potential Utility of the SYNTAX Score 2 in Patients Undergoing Left Main Angioplasty

PubMed Central

Madeira, Sérgio; Raposo, Luís; Brito, João; Rodrigues, Ricardo; Gonçalves, Pedro; Teles, Rui; Gabriel, Henrique; Machado, Francisco; Almeida, Manuel; Mendes, Miguel

2016-01-01

Background The revascularization strategy of the left main disease is determinant for clinical outcomes. Objective We sought to 1) validate and compare the performance of the SYNTAX Score 1 and 2 for predicting major cardiovascular events at 4 years in patients who underwent unprotected left main angioplasty and 2) evaluate the long-term outcome according to the SYNTAX score 2-recommended revascularization strategy. Methods We retrospectively studied 132 patients from a single-centre registry who underwent unprotected left main angioplasty between March 1999 and December 2010. Discrimination and calibration of both models were assessed by ROC curve analysis, calibration curves and the Hosmer-Lemeshow test. Results Total event rate was 26.5% at 4 years.The AUC for the SYNTAX Score 1 and SYNTAX Score 2 for percutaneous coronary intervention, was 0.61 (95% CI: 0.49-0.73) and 0.67 (95% CI: 0.57-0.78), respectively. Despite a good overall adjustment for both models, the SYNTAX Score 2 tended to underpredict risk. In the 47 patients (36%) who should have undergone surgery according to the SYNTAX Score 2, event rate was numerically higher (30% vs. 25%; p=0.54), and for those with a higher difference between the two SYNTAX Score 2 scores (Percutaneous coronary intervention vs. Coronary artery by-pass graft risk estimation greater than 5.7%), event rate was almost double (40% vs. 22%; p=0.2). Conclusion The SYNTAX Score 2 may allow a better and individualized risk stratification of patients who need revascularization of an unprotected left main coronary artery. Prospective studies are needed for further validation. PMID:27007223

Ramadan, Fasting and Educational Outcomes

ERIC Educational Resources Information Center

Oosterbeek, Hessel; van der Klaauw, Bas

2013-01-01

Using a difference-in-differences framework, we estimate the impact of Ramadan on educational outcomes of Muslim students living in a non-Muslim country. For identification we exploit that the number of Ramadan weeks during the course that we study, varies from year to year, ranging from zero to four. Our main finding is that Ramadan observance…

75 FR 27863 - Savings Bank of Maine, MHC and Savings Bank of Maine, Gardiner, Maine; Approval of Conversion...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-18

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision [AC-38: OTS Nos. 06947 and H 4709] Savings Bank of Maine, MHC and Savings Bank of Maine, Gardiner, Maine; Approval of Conversion Application Notice is hereby given that on May 7, 2010, the Office of Thrift Supervision approved the application of...

Should surgical outcomes be published?

PubMed

Chou, Evelyn; Abboudi, Hamid; Shamim Khan, Mohammed; Dasgupta, Prokar; Ahmed, Kamran

2015-04-01

Despite publishing surgical outcomes being a positive step forwards in the progression of England's healthcare system, it has no doubt been faced with criticism and reservations. This review article aims to discuss the pros and cons of publishing individual surgical outcomes, as well as the challenges faced. Publishing outcomes requires data from a number of sources such as national clinical audits, hospital episode statistics, patient-reported outcomes, registers and information from revalidation. As yet, eight surgical specialties have begun publishing their data, including cardiac (coronary artery bypass graft, valve and aortic surgery), endocrine (thyroidectomy, lobectomy, isthmusectomy), orthopaedic (hip and knee replacement), urological (full and partial nephrectomies, nephroureterectomy), colorectal (bowel tumour removal), upper gastrointestinal (stomach cancer and oesophageal cancer removal, bariatric surgery), ear, nose and throat surgery (larynx, oral cavity, oropharynx, hypopharynx and salivary gland cancer removal), as well as vascular surgery (abdominal aortic aneurysm, carotid endarterectomy). However, not all procedures have been addressed. Despite the controversy surrounding the topic of publishing surgical outcomes, the advantages of reporting outcomes outweigh the disadvantages, and these challenges can be overcome, to create a more reliable, trustworthy and transparent NHS. Perhaps one of the main challenges has been the difficulty in collecting large amounts of clinically significant data able to quantify the performance of surgeons. © The Royal Society of Medicine.

18. MAIN FLOOR HOLDING TANKS Main floor, looking at ...

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

18. MAIN FLOOR - HOLDING TANKS Main floor, looking at holding tanks against the west wall, from which sluice gates are seen protruding. Right foreground-wooden holding tanks. Note narrow wooden flumes through which fish were sluiced into holding and brining tanks. - Hovden Cannery, 886 Cannery Row, Monterey, Monterey County, CA

Impact of locus of control on clinical outcomes in renal dialysis.

PubMed

Dec, Elaine

2006-01-01

This study focused on the relationship between patients' locus of control and their ability to improve selected clinical outcomes related to kidney dialysis. The main hypothesis of this study stated that patients who viewed themselves as having control over their situation would be more successful at improving targeted clinical outcomes than those who believed someone other than themselves had control over their situation. The study found that interventions aimed at increasing awareness of who has control and reducing the aspect of chance had a more significant positive impact on outcomes than did pure cognitive or educational interventions geared mainly toward emotional issues or educational deficits. Interventions that work with the dominant locus of control to increase awareness of where control lies appeared to be more effective in assisting the patients to improve their targeted clinical outcomes rather than are interventions to change the locus of control between internal and powerful others (external).

Developing a core outcome set for chronic rhinosinusitis: a systematic review of outcomes utilised in the current literature.

PubMed

Soni-Jaiswal, Archana; Lakhani, Raj; Hopkins, Claire

2017-07-11

A core outcome set (COS) is an agreed standardised collection of outcomes that should be measured and reported by all trials for a specific clinical area, in this case chronic rhinosinusitis. These are not restrictive and researchers may continue to explore other outcomes alongside these that they feel are relevant to their intervention. The aim of this systematic review was to identify the need for a COS for chronic rhinosinusitis. A sensitive search strategy was used to identify all published Cochrane systematic reviews and randomised control trials of intervention for adult patients with chronic rhinosinusitis. Two independent authors reviewed these to obtain a list of outcomes and outcome measures reported by each clinical trial. Sixty-nine randomised control trials and eight Cochrane systematic reviews were included in this study. They reported 68 individual outcomes and outcome measures, with an average of four to ten outcomes per clinical trial. These outcomes were mapped to 23 subcategories belonging to eight core categories. The key finding of this review was the heterogeneity of outcomes reported and measured by clinical trials of patients with chronic rhinosinusitis, precluding meaningful meta-analysis of data. This review supports the need for development of a COS, to be used in future trials on adult patients with chronic rhinosinusitis.

29. MAIN CONTROL ROOM, PANELS WEST OF MAIN CONTROL AREA, ...

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

29. MAIN CONTROL ROOM, PANELS WEST OF MAIN CONTROL AREA, LOOKING SOUTH (LOCATION Q) - Shippingport Atomic Power Station, On Ohio River, 25 miles Northwest of Pittsburgh, Shippingport, Beaver County, PA

28. MAIN CONTROL ROOM, PANELS WEST OF MAIN CONTROL AREA, ...

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

28. MAIN CONTROL ROOM, PANELS WEST OF MAIN CONTROL AREA, LOOKING NORTH (LOCATION Q) - Shippingport Atomic Power Station, On Ohio River, 25 miles Northwest of Pittsburgh, Shippingport, Beaver County, PA

125. Pre1911. Crew on main deck, starboard side at main ...

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

125. Pre-1911. Crew on main deck, starboard side at main hatch, looking aft. Note dark object in center of photo that may be original main deck capstan. Fred Heick collection. (K9.9571) - Ship BALCLUTHA, 2905 Hyde Street Pier, San Francisco, San Francisco County, CA

22. View showing main anchor arm, as viewed from main ...

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

22. View showing main anchor arm, as viewed from main cantilever arm looking south. Note upper chord eyebar arrangement. - Williamstown-Marietta Bridge, Spanning Ohio River between Williamstown & Marietta, Williamstown, Wood County, WV

Hundred lightcurves of sub-km main-belt asteroids

NASA Astrophysics Data System (ADS)

Yoshida, F.; Souami, D.; Bouquillon, S.; Nakamura, T.; Dermawan, B.; Yagi, M.; Souchay, J.

2014-07-01

We observed a single sky field near opposition and near the ecliptic plane using the Subaru telescope equipped with the Suprime-Cam. Taking advantage of the wide field of view (FOV) for the Suprime-Cam, the plan was to obtain 100 lightcurves of asteroids at the same time. The total observing time interval was about 8 hours on September 2, 2002, with 2-min exposures. We detected 147 moving objects in the single FOV (34'×27') on the Suprime-Cam (see Figure). Of those, 112 detections corresponded to different objects. We used the R filter during almost the entire observing run, but we took a few images with the B filter at the beginning, the middle, and the end of the run. We classified main-belt asteroids into S- and C-complexes with the B-R color of the object (Yoshida & Nakamura 2007). Although we carefully avoided regions of bright stars, the sky in the images taken by Suprime-Cam were actually crowded with faint objects. Therefore, the asteroids overlapped with background stars very often. Thus, it was very difficult to get lightcurves with high accuracy. We modified the GAIA-GBOT (Ground Based Optical Tracking) PIPELINE to measure the position and brightness of each object (Bouquillon et al. 2012). Once the objects were identified and their positions measured in pixel coordinates, the pipeline proceeded to the astrometric calibration and then to the photometric calibrations with the Guide Star Catalog II (Lasker et al. 2008). The pipeline produced time series of photometry for each object. The average brightness of each lightcurve ranged between 19--24 mag. We then estimated the rotational period from the lightcurve of each object. In our presentation, we will show the spin-period distribution of sub- km main-belt asteroids and compare it with that of large main-belt asteroids obtained from the lightcurve catalogue.

[Main characteristics of current biomedical research, in Chile].

PubMed

Valdés S, Gloria; Armas M, Rodolfo; Reyes B, Humberto

2012-04-01

Biomedical research is a fundamental tool for the development of a country, requiring human and financial resources. To define some current characteristics of biomedical research, in Chile. Data on entities funding bio-medical research, participant institutions, and the number of active investigators for the period 2007-2009 were obtained from institutional sources; publications indexed in PubMed for 2008-2009 were analysed. Most financial resources invested in biomedical research projects (approximately US$ 19 million per year) came from the "Comisión Nacional de Investigación Científica y Tecnológica" (CONICYT), a state institution with 3 independent Funds administering competitive grant applications open annually to institutional or independent investigators in Chile. Other sources and universities raised the total amount to US$ 26 million. Since 2007 to 2009, 408 investigators participated in projects funded by CONICYT. The main participant institutions were Universidad de Chile and Pontificia Universidad Católica de Chile, both adding up to 84% of all funded projects. Independently, in 2009,160 research projects -mainly multi centric clinical trials- received approximately US$ 24 million from foreign pharmaceutical companies. Publications listed in PubMed were classified as "clinical research" (n = 879, including public health) or "basic biomedical research" (n = 312). Biomedical research in Chile is mainly supported by state funds and university resources, but clinical trials also obtained an almost equivalent amount from foreign resources. Investigators are predominantly located in two universities. A small number of MD-PhD programs are aimed to train and incorporate new scientists. Only a few new Medical Schools participate in biomedical research. A National Registry of biomedical research projects, including the clinical trials, is required among other initiatives to stimulate research in biomedical sciences in Chile.

Space Shuttle main engine nozzle-steerhorn dynamics

NASA Technical Reports Server (NTRS)

Kiefling, L.

1981-01-01

On two occasions during the Space Shuttle main engine development, the LH2 feedline (called the steerhorn, because of its shape) failed during the cutoff transient. A dynamic test was undertaken, and an analytical model was developed and correlated to the dynamic test. Detailed models of the tube bundle were required to obtain the equivalent shell coefficients. All-shell models of the nozzle wall were found better than beam-shell models. The most difficult part of the structure to simulate was the felt-metal pad between the feedline and its mount, which introduced nonlinear stiffness and damping and led to the use of separate low amplitude and high amplitude models. The total structure was found to have 400 modes in the frequency range of interest, 0 to 500 Hz. Good test analysis correlation was obtained and a modified feedline configuration was found to demonstrate a 40% reduction of response stress from the original configuration.

Quasi-periodic latitudinal shift of Saturn's main auroral emission

NASA Astrophysics Data System (ADS)

Roussos, E.; Palmaerts, B.; Grodent, D. C.; Radioti, K.; Krupp, N.; Yao, Z.

2017-12-01

The main component of the ultraviolet auroral emissions at Saturn consists in a ring of emission around each pole of the planet. This main ring of emission has been revealed to oscillate by a few degrees in the prenoon-premidnight direction with a period of 10.8h. This auroral oscillation is thought to be induced by a rotating external magnetospheric current system associated with the planetary period oscillations. Here we report, by means of auroral imaging sequences obtained with the Ultraviolet Imaging Spectrograph (UVIS) on board the Cassini spacecraft, the first direct observation of an additional motion of the main emission superimposed to this oscillation. The whole main emission ring exhibits step-like displacements in latitude mainly towards dayside, decoupled from the 10.8h oscillation. These latitude shifts recur around every hour, which is a typical short periodicity at Saturn previously identified in the aurora intensity, in the charged particle fluxes and in the magnetic field. This unique observation directly demonstrates what has been inferred from past in-situ and remote measurements: the 1-hour periodicities reveal a global and fundamental magnetospheric oscillation mode that acts independently of the local magnetospheric conditions. However, the magnetospheric mechanism responsible for these 1-hour auroral shifts is still unknown. It is possible that Alfvén waves inducing hourly magnetic fluctuations might also modify the place where the field-aligned electrons precipitate in the ionosphere and produce the main emission.

Association Between In Vitro Susceptibility to Natamycin and Voriconazole and Clinical Outcomes in Fungal Keratitis

PubMed Central

Sun, Catherine Q.; Lalitha, Prajna; Prajna, N. Venkatesh; Karpagam, Rajarathinam; Geetha, Manoharan; O’Brien, Kieran S.; Oldenburg, Catherine E.; Ray, Kathryn J.; McLeod, Stephen D.; Acharya, Nisha R.; Lietman, Thomas M.

2014-01-01

Purpose To assess the association between minimum inhibitory concentration (MIC) and clinical outcomes in a fungal keratitis clinical trial. Design Experimental study using data from a randomized comparative trial. Participants Of the 323 patients enrolled in the trial, we were able to obtain MIC values from 221 patients with monocular fungal keratitis. Methods The Mycotic Ulcer Treatment Trial I (MUTT I) was a randomized, double-masked clinical trial comparing clinical outcomes of monotherapy with topical natamycin versus voriconazole for the treatment of fungal keratitis. Speciation and determination of MIC to natamycin and voriconazole were performed according to Clinical and Laboratory Standards Institute guidelines. The relationship between MIC and clinical outcome was assessed. Main Outcome Measures The primary outcome was 3-month best spectacle-corrected visual acuity. Secondary outcomes included 3-month infiltrate/scar size, corneal perforation and/or therapeutic penetrating keratoplasty (TPK), and time to re-epithelialization. Results A 2-fold increase in MIC was associated with a larger 3-month infiltrate/scar size (0.21 mm, 95% confidence interval [CI] 0.10–0.31, P <0.001) and increased odds of perforation (odds ratio [OR] 1.32, 95% CI 1.04–1.69, P=0.02). No correlation was found between MIC and 3-month visual acuity. For natamycin-treated cases, an association was found between higher natamycin MIC with larger 3-month infiltrate/scar size (0.29 mm, 95% CI 0.15–0.43, P<0.001) and increased perforations (OR 2.41, 95% CI 1.46–3.97, P<0.001). Among voriconazole-treated cases, the voriconazole MIC did not correlate with any of the measured outcomes in the study. Conclusion Decreased susceptibility to natamycin was associated with increased infiltrate/scar size and increased odds of perforation. There was no association between susceptibility to voriconazole and outcome. PMID:24746358

Influence of peer review on the reporting of primary outcome(s) and statistical analyses of randomised trials.

PubMed

Hopewell, Sally; Witt, Claudia M; Linde, Klaus; Icke, Katja; Adedire, Olubusola; Kirtley, Shona; Altman, Douglas G

2018-01-11

Selective reporting of outcomes in clinical trials is a serious problem. We aimed to investigate the influence of the peer review process within biomedical journals on reporting of primary outcome(s) and statistical analyses within reports of randomised trials. Each month, PubMed (May 2014 to April 2015) was searched to identify primary reports of randomised trials published in six high-impact general and 12 high-impact specialty journals. The corresponding author of each trial was invited to complete an online survey asking authors about changes made to their manuscript as part of the peer review process. Our main outcomes were to assess: (1) the nature and extent of changes as part of the peer review process, in relation to reporting of the primary outcome(s) and/or primary statistical analysis; (2) how often authors followed these requests; and (3) whether this was related to specific journal or trial characteristics. Of 893 corresponding authors who were invited to take part in the online survey 258 (29%) responded. The majority of trials were multicentre (n = 191; 74%); median sample size 325 (IQR 138 to 1010). The primary outcome was clearly defined in 92% (n = 238), of which the direction of treatment effect was statistically significant in 49%. The majority responded (1-10 Likert scale) they were satisfied with the overall handling (mean 8.6, SD 1.5) and quality of peer review (mean 8.5, SD 1.5) of their manuscript. Only 3% (n = 8) said that the editor or peer reviewers had asked them to change or clarify the trial's primary outcome. However, 27% (n = 69) reported they were asked to change or clarify the statistical analysis of the primary outcome; most had fulfilled the request, the main motivation being to improve the statistical methods (n = 38; 55%) or avoid rejection (n = 30; 44%). Overall, there was little association between authors being asked to make this change and the type of journal, intervention, significance of the

Adverse outcome pathways: a concise introduction for toxicologists

PubMed Central

Vergauwen, Lucia; Hengstler, Jan G.; Angrish, Michelle; Whelan, Maurice

2018-01-01

Adverse outcome pathways are designed to provide a clear-cut mechanistic representation of critical toxicological effects that propagate over different layers of biological organization from the initial interaction of a chemical with a molecular target to an adverse outcome at the individual or population level. Adverse outcome pathways are currently gaining momentum, especially in view of their many potential applications as pragmatic tools in the fields of human toxicology, ecotoxicology and risk assessment. A number of guidance documents, issued by the Organization for Economic Cooperation and Development, as well as landmark papers, outlining best practices to develop, assess and use adverse outcome pathways, have been published in the last few years. The present paper provides a synopsis of the main principles related to the adverse outcome pathway framework for the toxicologist less familiar with this area, followed by two case studies relevant for human toxicology and ecotoxicology. PMID:28660287

Outcome of cataract surgery at one year in Kenya, the Philippines and Bangladesh.

PubMed

Lindfield, R; Kuper, H; Polack, S; Eusebio, C; Mathenge, W; Wadud, Z; Rashid, A M; Foster, A

2009-07-01

To assess the change in vision following cataract surgery in Kenya, Bangladesh and the Philippines and to identify causes and predictors of poor outcome. Cases were identified through surveys, outreach and clinics. They underwent preoperative visual acuity measurement and ophthalmic examination. Cases were re-examined 8-15 months after cataract surgery. Information on age, gender, poverty and literacy was collected at baseline. 452 eyes of 346 people underwent surgery. 124 (27%) eyes had an adverse outcome. In Kenya and the Philippines, the main cause of adverse outcome was refractive error (37% and 49% respectively of all adverse outcomes) then comorbid ocular disease (26% and 27%). In Bangladesh, this was comorbid disease (58%) then surgical complications (21%). There was no significant association between adverse outcome and gender, age, literacy, poverty or preoperative visual acuity. Adverse outcomes following cataract surgery were frequent in the three countries. Main causes were refractive error and preoperative comorbidities. Many patients are not attaining the outcomes available with modern surgery. Focus should be on correcting refractive error, through operative techniques or postoperative refraction, and on a system for assessing comorbidities and communicating risk to patients. These are only achievable with a commitment to ongoing surgical audit.

DEFINING THE RELEVANT OUTCOME MEASURES IN MEDICAL DEVICE ASSESSMENTS: AN ANALYSIS OF THE DEFINITION PROCESS IN HEALTH TECHNOLOGY ASSESSMENT.

PubMed

Jacobs, Esther; Antoine, Sunya-Lee; Prediger, Barbara; Neugebauer, Edmund; Eikermann, Michaela

2017-01-01

Defining relevant outcome measures for clinical trials on medical devices (MD) is complex, as there is a large variety of potentially relevant outcomes. The chosen outcomes vary widely across clinical trials making the assessment in evidence syntheses very challenging. The objective is to provide an overview on the current common procedures of health technology assessment (HTA) institutions in defining outcome measures in MD trials. In 2012-14, the Web pages of 126 institutions involved in HTA were searched for methodological manuals written in English or German that describe methods for the predefinition process of outcome measures. Additionally, the institutions were contacted by email. Relevant information was extracted. All process steps were performed independently by two reviewers. Twenty-four manuals and ten responses from the email request were included in the analysis. Overall, 88.5 percent of the institutions describe the type of outcomes that should be considered in detail and 84.6 percent agree that the main focus should be on patient relevant outcomes. Specifically related to MD, information could be obtained in 26 percent of the included manuals and email responses. Eleven percent of the institutions report a particular consideration of MD related outcomes. This detailed analysis on common procedures of HTA institutions in the context of defining relevant outcome measures for the assessment of MD shows that standardized procedures for MD from the perspective of HTA institutions are not widespread. This leads to the question if a homogenous approach should be implemented in the field of HTA on MD.

Update on Outcome Measure Development for Large Vessel Vasculitis: Report from OMERACT 12

PubMed Central

Aydin, Sibel Zehra; Direskeneli, Haner; Sreih, Antoine; Alibaz-Oner, Fatma; Gul, Ahmet; Kamali, Sevil; Hatemi, Gulen; Kermani, Tanaz; Mackie, Sarah L.; Mahr, Alfred; Meara, Alexa; Milman, Nataliya; Nugent, Heidi; Robson, Joanna; Tomasson, Gunnar; Merkel, Peter A.

2015-01-01

Objective The rarity of large vessel vasculitis (LVV) is a major factor limiting randomized controlled trials in LVV, resulting in treatment choices in these diseases that are guided mainly by observational studies and expert opinion. Further complicating trials in LVV is the absence of validated and meaningful outcome measures. The Outcome Measures in Rheumatology (OMERACT) vasculitis working group initiated the Large Vessel Vasculitis task force in 2009 to develop data-driven, validated outcome tools for clinical investigation in LVV. This report summarizes the progress that has been made on a disease activity assessment tool and patient-reported outcomes in LVV as well as the group’s research agenda. Methods The OMERACT LVV task force brought an international group of investigators and patient research partners together to work collaboratively on developing outcome tools. The group initially focused on disease activity assessment tools in LVV. Following a systematic literature review, an international Delphi exercise was conducted to obtain expert opinion on principles and domains for disease assessment. The OMERACT vasculitis working group’s LVV task force is also conducting qualitative research with patients, including interviews, focus groups, and engaging patients as research partners, all to ensure that the approach to disease assessment includes measures of patients’ perspectives and that patients have input into the research agenda and process. Results The preliminary results of both the Delphi exercise and the qualitative interviews were discussed at the OMERACT 12 (2014) meeting and the completion of the analyses will produce an initial set of domains and instruments to form the basis of next steps in the research agenda. Conclusion The research agenda continues to evolve, with the ultimate goal of developing an OMERACT-endorsed core set of outcome measures for use in clinical trials of LVV. PMID:26077399

Outcomes, and factors affecting outcomes, following shoulder hemiarthroplasty for proximal humeral fracture repair.

PubMed

Liu, Jie; Li, Shao-Hua; Cai, Zheng-Dong; Lou, Lie-Ming; Wu, Xing; Zhu, Yu-Chang; Wu, Wei-Ping

2011-09-01

Hemiarthroplasty has been applied to treat proximal humeral fracture with variable outcomes. The purpose of this retrospective study was to assess factors affecting outcome in patients following hemiarthroplasty for proximal humeral fracture (PHF) repair. Patients with proximal humeral fractures treated over a 6-year period were included. Indications for hemiarthroplasty were severe three-part fractures associated with osteoporosis; four-part fractures with or without dislocation; splitting of the humeral head, or >45% collapse of the humeral head. Surgery outcome and postoperative complications were main outcome measures in this study. Thirty-three of 47 patients were included in the final analysis (mean age 64.3 years, range 43-82). Mean postoperative follow-up was 44.4 (range 36-57) months. Postoperative complications (shoulder dislocation, mild shoulder subluxation, heterotopic ossification) occurred in seven patients. Healing of the greater and lesser tubercles was abnormal or poor in 18 patients. These patients had significantly higher pain scores (4.0 ± 1.1 vs. 2.2 ± 1.1) and significantly lower capacities for active lifting (79.3 ± 9.6 vs. 121.7 ± 24.3), external rotation (20.7 ± 3.7 vs. 39.2 ± 10.3), and Neer scores (79.2 ± 5.7 vs. 90.6 ± 3.6) versus patients who exhibited complete healing (all P < 0.001). Patient age, type of surgical approach, and fracture type were not major influencers of outcome. In conclusion, the healing of the greater and lesser tubercles is the major determinant of outcome following hemiarthroplasty for PHF repair.

Jupiter's Main Ring/Ring Halo

NASA Technical Reports Server (NTRS)

1997-01-01

A mosaic of four images taken through the clear filter (610 nanometers) of the solid state imaging (CCD) system aboard NASA's Galileo spacecraft on November 8, 1996, at a resolution of approximately 46 kilometers (28.5 miles) per picture element (pixel) along Jupiter's rings. Because the spacecraft was only about 0.5 degrees above the ring plane, the image is highly foreshortened in the vertical direction. The images were obtained when Galileo was in Jupiter's shadow, peering back toward the Sun; the ring was approximately 2.3 million kilometers (1.4 million miles) away. The arc on the far right of the image is produced when sunlight is scattered by small particles comprising Jupiter's upper atmospheric haze. The ring also efficiently scatters light, indicating that much of its brightness is due to particles that are microns or less in diameter. Such small particles are believed to have human-scale lifetimes, i.e., very brief compared to the solar system's age.

Jupiter's ring system is composed of three parts - - a flat main ring, a lenticular halo interior to the main ring, and the gossamer ring, outside the main ring. The near and far arms of Jupiter's main ring extend horizontally across the mosaic, joining together at the ring's ansa, on the figure's far left side. The near arm of the ring appears to be abruptly truncated close to the planet, at the point where it passes into Jupiter's shadow. Some radial structure is barely visible across the ring's ansa (top image). A faint mist of particles can be seen above and below the main rings. This vertically extended 'halo' is unusual in planetary rings, and is probably caused by electromagnetic forces pushing the smallest grains out of the ring plane. Because of shadowing, the halo is not visible close to Jupiter in the lower right part of the mosaic. To accentuate faint features in the bottom image of the ring halo, different brightnesses are shown through color. Brightest features are white or yellow and the

Predictors of Hearing-Aid Outcomes

PubMed Central

Johannesen, Peter T.; Pérez-González, Patricia; Blanco, José L.; Kalluri, Sridhar; Edwards, Brent

2017-01-01

Over 360 million people worldwide suffer from disabling hearing loss. Most of them can be treated with hearing aids. Unfortunately, performance with hearing aids and the benefit obtained from using them vary widely across users. Here, we investigate the reasons for such variability. Sixty-eight hearing-aid users or candidates were fitted bilaterally with nonlinear hearing aids using standard procedures. Treatment outcome was assessed by measuring aided speech intelligibility in a time-reversed two-talker background and self-reported improvement in hearing ability. Statistical predictive models of these outcomes were obtained using linear combinations of 19 predictors, including demographic and audiological data, indicators of cochlear mechanical dysfunction and auditory temporal processing skills, hearing-aid settings, working memory capacity, and pretreatment self-perceived hearing ability. Aided intelligibility tended to be better for younger hearing-aid users with good unaided intelligibility in quiet and with good temporal processing abilities. Intelligibility tended to improve by increasing amplification for low-intensity sounds and by using more linear amplification for high-intensity sounds. Self-reported improvement in hearing ability was hard to predict but tended to be smaller for users with better working memory capacity. Indicators of cochlear mechanical dysfunction, alone or in combination with hearing settings, did not affect outcome predictions. The results may be useful for improving hearing aids and setting patients’ expectations. PMID:28929903

Intimate partner violence among Egyptian pregnant women: incidence, risk factors, and adverse maternal and fetal outcomes.

PubMed

Ibrahim, Z M; Sayed Ahmed, W A; El-Hamid, S A; Hagras, A M

2015-01-01

To assess incidence and risk factors of intimate partner violence (IPV) during pregnancy among a sample of women from Egypt and to evaluate its impact on maternal and fetal adverse health outcomes. After obtaining ethical approval, a total of 1,857 women aged 18 - 43 years completed the study and were investigated using an interview questionnaire. The questionnaire contains five main items: demographic characteristics of women, intimate partner characteristics, assessment of IPV during current pregnancy, and assessment of maternal as well as fetal/neonatal adverse outcomes. Women were also examined to detect signs of violence and identify injuries. Exposure to IPV during pregnancy was reported among 44.1% of the studied women. Emotional violence was the most common form. Women exposed to violence were of younger age, higher parity, and lower educational level. Their partners were older, less educated, and more likely to be addicted to drugs and alcohol. Women were also found to have significantly higher incidence of adverse pregnancy outcomes (miscarriage, preterm labor, and premature rupture of membrane), and fetal/neonatal adverse outcomes (fetal distress, fetal death, and low birth weight). A total of 297 cases had been exposed to physical violence (15.9%) vs 32.6% and 10% exposed to emotional and sexual violence, respectively. The most common form of physical violence was kicking. Violence during pregnancy is prevalent among Egyptian women. Exposure to violence was a significant risk factor for multiple adverse maternal and fetal health outcomes.

[Encopresis--predictive factors and outcome].

PubMed

Mehler-Wex, Claudia; Scheuerpflug, Peter; Peschke, Nicole; Roth, Michael; Reitzle, Karl; Warnke, Andreas

2005-10-01

comparison of diagnostic, clinical and therapeutic features and their predictive value for the outcome of encopresis in children and adolescents. 85 children and adolescents (aged 9.6 +/- 3.2 years) with severe encopresis (ICD 10: F98.1) were investigated during inpatient treatment and 35 of them again 5.5 +/- 1.8 years later. Mentally retarded patients were excluded. Inpatient therapy consisted of treating constipation and/or stool regulation by means of laxatives, behavioural approaches, and the specific therapy of comorbid psychiatric disorders. During inpatient treatment 22% of the patients experienced total remission, 8% an unchanged persistence of symptoms. Of the 35 patients studied at follow-up 5.5 years later, 40% were symptom-free. As main result, prognostic outcome depended significantly on sufficient treatment of obstipation. Another important factor was the specific therapeutic approach to psychiatric comorbidity, especially to ADHD. The outcome for patients with comorbid ICD 10: F43 was significantly better than for the other patients. Those who were symptom-free at discharge had significantly better long-term outcomes. Decisive to the success of encopresis treatment were the stool regulation and the specific therapy of associated psychiatric illnesses, in particular of ADHD. Inpatient treatment revealed significantly better long-term outcomes where total remission had been achieved by the time of discharge from hospital.

Methods for obtaining and determination of squalene from natural sources.

PubMed

Popa, Ovidiu; Băbeanu, Narcisa Elena; Popa, Ioana; Niță, Sultana; Dinu-Pârvu, Cristina Elena

2015-01-01

Squalene is a natural dehydrotriterpenic hydrocarbon (C30H50) with six double bonds, known as an intermediate in the biosynthesis of phytosterol or cholesterol in plants or animals. We have briefly reviewed the natural sources for squalene and focused on the main methods and techniques to obtain and to determine it. Some of its applications in different fields of human activity are also mentioned.

Methods for Obtaining and Determination of Squalene from Natural Sources

PubMed Central

Popa, Ovidiu; Băbeanu, Narcisa Elena; Niță, Sultana; Dinu-Pârvu, Cristina Elena

2015-01-01

Squalene is a natural dehydrotriterpenic hydrocarbon (C30H50) with six double bonds, known as an intermediate in the biosynthesis of phytosterol or cholesterol in plants or animals. We have briefly reviewed the natural sources for squalene and focused on the main methods and techniques to obtain and to determine it. Some of its applications in different fields of human activity are also mentioned. PMID:25695064

Initial home health outcomes under prospective payment.

PubMed

Schlenker, Robert E; Powell, Martha C; Goodrich, Glenn K

2005-02-01

To assess initial changes in home health patient outcomes under Medicare's home health Prospective Payment System (PPS), implemented by the Centers for Medicare and Medicaid Services (CMS) in October 2000. Pre-PPS and early PPS data were obtained from CMS Outcome and Assessment Information Set (OASIS) and Medicare claims files. Regression analysis was applied to national random samples (n=164,810) to estimate pre-PPS/PPS outcome and visit-per-episode changes. Outcome episodes were constructed from OASIS data and linked with Medicare claims data on visits. Outcome changes (risk adjusted) were mixed and generally modest. Favorable changes included higher improvement rates under PPS for functioning and dyspnea, higher community discharge rates, and lower hospitalization and emergent care rates. Most stabilization (nonworsening) outcome rates also increased. However, improvement rates were lower under PPS for wounds, incontinence, and cognitive and emotional/behavioral outcomes. Total visits per episode (case-mix adjusted) declined 16.6 percent although therapy visits increased by 8.4 percent. The outcome and visit results suggest improved system efficiency under PPS (fewer visits, similar outcomes). However, declines in several improvement rates merit ongoing monitoring, as do subsequent (posthome health) hospitalization and emergent care use. Since only the early PPS period was examined, longer-term analyses are needed.

The Effect of Principal's Leadership Style on School Environment and Outcome

ERIC Educational Resources Information Center

Al-Safran, Eissa; Brown, David; Wiseman, Alexander

2014-01-01

The main objective of this study was to investigate the effect of principal's leadership style on school outcome. This study focused on the indirect relationship between the leadership style and the school environment. An additional objective was to investigate the impact of culture on leadership style as related to school environment and outcome.…

Securing recruitment and obtaining informed consent in minority ethnic groups in the UK.

PubMed

Lloyd, Cathy E; Johnson, Mark R D; Mughal, Shanaz; Sturt, Jackie A; Collins, Gary S; Roy, Tapash; Bibi, Rukhsana; Barnett, Anthony H

2008-03-30

Previous health research has often explicitly excluded individuals from minority ethnic backgrounds due to perceived cultural and communication difficulties, including studies where there might be language/literacy problems in obtaining informed consent. This study addressed these difficulties by developing audio-recorded methods of obtaining informed consent and recording data. This report outlines 1) our experiences with securing recruitment to a qualitative study investigating alternative methods of data collection, and 2) the development of a standardised process for obtaining informed consent from individuals from minority ethnic backgrounds whose main language does not have an agreed written form. Two researchers from South Asian backgrounds recruited adults with Type 2 diabetes whose main language was spoken and not written, to attend a series of focus groups. A screening tool was used at recruitment in order to assess literacy skills in potential participants. Informed consent was obtained using audio-recordings of the patient information and recording patients' verbal consent. Participants' perceptions of this method of obtaining consent were recorded. Recruitment rates were improved by using telephone compared to face-to-face methods. The screening tool was found to be acceptable by all potential participants. Audio-recorded methods of obtaining informed consent were easy to implement and accepted by all participants. Attrition rates differed according to ethnic group. Snowballing techniques only partly improved participation rates. Audio-recorded methods of obtaining informed consent are an acceptable alternative to written consent in study populations where literacy skills are variable. Further exploration of issues relating to attrition is required, and a range of methods may be necessary in order to maximise response and participation rates.

Composite outcomes in randomized clinical trials: arguments for and against.

PubMed

Ross, Sue

2007-02-01

Composite outcomes that combine a number of individual outcomes (such as types of morbidity) are frequently used as primary outcomes in obstetrical trials. The main argument for their use is to ensure that trials can answer important clinical questions in a timely fashion, without needing huge sample sizes. Arguments against their use are that composite outcomes may be difficult to use and interpret, leading to errors in sample size estimation, possible contradictory trial results, and difficulty in interpreting findings. Such problems may reduce the credibility of the research, and may impact on the implementation of findings. Composite outcomes are an attractive solution to help to overcome the problem of limited available resources for clinical trials. However, future studies should carefully consider both the advantages and disadvantages before using composite outcomes. Rigorous development and reporting of composite outcomes is essential if the research is to be useful.

Improving the Outcomes of Organs Obtained From Controlled Donation After Circulatory Death Donors Using Abdominal Normothermic Regional Perfusion.

PubMed

Miñambres, E; Suberviola, B; Dominguez-Gil, B; Rodrigo, E; Ruiz-San Millan, J C; Rodríguez-San Juan, J C; Ballesteros, M A

2017-08-01

The use of donation after circulatory death (DCD) has increased significantly during the past decade. However, warm ischemia results in a greater risk for transplantation. Indeed, controlled DCD (cDCD) was associated with inferior outcomes compared with donation after brain death. The use of abdominal normothermic regional perfusion (nRP) to restore blood flow before organ recovery in cDCD has been proposed as better than rapid recovery to reverse the effect of ischemia and improve recipients' outcome. Here, the first Spanish series using abdominal nRP as an in situ conditioning method is reported. A specific methodology to avoid restoring circulation to the brain after death determination is described. Twenty-seven cDCD donors underwent abdominal nRP during at least 60 min. Thirty-seven kidneys, 11 livers, six bilateral lungs, and one pancreas were transplanted. The 1-year death-censored kidney survival was 91%, and delayed graft function rate was 27%. The 1-year liver survival rate was 90.1% with no cases of ischemic cholangiopathy. Transplanted lungs and pancreas exhibited primary function. The use of nRP may represent an advance to increase the number and quality of grafts in cDCD. Poor results in cDCD livers could be reversed with nRP. Concerns about restoring brain circulation after death are easily solved. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Technology and outcomes assessment in lung transplantation.

PubMed

Yusen, Roger D

2009-01-15

Lung transplantation offers the hope of prolonged survival and significant improvement in quality of life to patients that have advanced lung diseases. However, the medical literature lacks strong positive evidence and shows conflicting information regarding survival and quality of life outcomes related to lung transplantation. Decisions about the use of lung transplantation require an assessment of trade-offs: do the potential health and quality of life benefits outweigh the potential risks and harms? No amount of theoretical reasoning can resolve this question; empiric data are needed. Rational analyses of these trade-offs require valid measurements of the benefits and harms to the patients in all relevant domains that affect survival and quality of life. Lung transplant systems and registries mainly focus outcomes assessment on patient survival on the waiting list and after transplantation. Improved analytic approaches allow comparisons of the survival effects of lung transplantation versus continued waiting. Lung transplant entities do not routinely collect quality of life data. However, the medical community and the public want to know how lung transplantation affects quality of life. Given the huge stakes for the patients, the providers, and the healthcare systems, key stakeholders need to further support quality of life assessment in patients with advanced lung disease that enter into the lung transplant systems. Studies of lung transplantation and its related technologies should assess patients with tools that integrate both survival and quality of life information. Higher quality information obtained will lead to improved knowledge and more informed decision making.

The Fossilized Size Distribution of the Main Asteroid Belt

NASA Astrophysics Data System (ADS)

Bottke, W. F.; Durda, D.; Nesvorny, D.; Jedicke, R.; Morbidelli, A.

2004-05-01

The main asteroid belt evolved into its current state via two processes: dynamical depletion and collisional evolution. During the planet formation epoch, the primordial main belt (PMB) contained several Earth masses of material, enough to allow the asteroids to accrete on relatively short timescales (e.g., Weidenschilling 1977). The present-day main belt, however, only contains 5e-4 Earth masses of material (Petit et al. 2002). To explain this mass loss, we suggest the PMB evolved in the following manner: Planetesimals and planetary embryos accreted (and differentiated) in the PMB during the first few Myr of the solar system. Gravitational perturbations from these embryos dynamically stirred the main belt, enough to initiate fragmentation. When Jupiter reached its full size, some 10 Myr after the solar system's birth, its perturbations, together with those of the embryos, dynamically depleted the main belt region of > 99% of its bodies. Much of this material was sent to high (e,i) orbits, where it continued to pummel the surviving main belt bodies at high impact velocities for more than 100 Myr. While some differentiated bodies in the PMB were disrupted, most were instead scattered; only small fragments from this population remain. This period of comminution and dynamical evolution in the PMB created, among other things, the main belt's wavy size-frequency distribution, such that it can be considered a "fossil" from this violent early epoch. From this time forward, however, relatively little collisional evolution has taken place in the main belt, consistent with the surprising paucity of prominent asteroid families. We will show that the constraints provided by asteroid families and the shape of the main belt size distribution are essential to obtaining a unique solution from our model's initial conditions. We also use our model results to solve for the asteroid disruption scaling law Q*D, a critical function needed in all planet formation codes that include

Student Outcomes: Annual Summary Report.

ERIC Educational Resources Information Center

Prince George's Community Coll., Largo, MD. Office of Institutional Research.

Each year a study is conducted at Prince George's Community College (PGCC) to update student outcomes data using quantifiable measures of student achievement. Data for the 1989 study were obtained from the college's student information system, the University of Maryland (UM) system, and surveys of all 825 fiscal year 1988 graduates and 118 of…

Developing from child to adult: Risk factors for poor psychosocial outcome in adolescents and young adults with epilepsy.

PubMed

Geerlings, R P J; Aldenkamp, A P; Gottmer-Welschen, L M C; de With, P H N; Zinger, S; van Staa, A L; de Louw, A J A

2015-10-01

Childhood-onset epilepsy during the years of transition to adulthood may affect normal social, physical, and mental development, frequently leading to psychosocial and health-related problems in the long term. This study aimed to describe the main characteristics of patients in transition and to identify risk factors for poor psychosocial outcome in adolescents and young adults with epilepsy. Patients with epilepsy, 15-25years of age, who visited the Kempenhaeghe Epilepsy Transition Clinic from March 2012 to December 2014 were included (n=138). Predefined risk scores for medical, educational/occupational status, and independence/separation/identity were obtained, along with individual risk profile scores for poor psychosocial outcome. Multivariate linear regression analysis and discriminant analysis were used to identify variables associated with an increased risk of poor long-term psychosocial outcome. Demographic, epilepsy-related, and psychosocial variables associated with a high risk of poor long-term outcome were lower intelligence, higher seizure frequency, ongoing seizures, and an unsupportive and unstable family environment. Using the aforementioned factors in combination, we were able to correctly classify the majority (55.1%) of the patients regarding their risk of poor psychosocial outcome. Our analysis may allow early identification of patients at high risk of prevention, preferably at pretransition age. The combination of a chronic refractory epilepsy and an unstable family environment constitutes a higher risk of transition problems and poor outcome in adulthood. As a consequence, early interventions should be put into place to protect youth at risk of poor transition outcome. Copyright © 2015 Elsevier Inc. All rights reserved.

Health-related quality of life after upper extremity injuries and predictors for suboptimal outcome.

PubMed

de Putter, C E; Selles, R W; Haagsma, J A; Polinder, S; Panneman, M J M; Hovius, S E R; Burdorf, A; van Beeck, E F

2014-11-01

The purpose of this study was to examine the impact of upper extremity injuries (UEIs) on health-related quality of life (HRQoL) in adult patients compared with victims of other types of injuries and with the general population, in order to establish recovery patterns of different types of UEIs and determine predictors for suboptimal outcome in the long term. Data were obtained from the Dutch Injury Surveillance System, from the National Hospital Discharge Registry, and from a patient follow-up survey. A total of 608 patients (aged ≥18 years) with an UEI were included. The main outcome measure was HRQoL measured at 2.5, 5, 9 and 24 months after UEI according to the EuroQol-5D (EQ-5D). The predictors for the suboptimal outcome were examined by multivariate linear regression analyses. For non-hospitalized UEI patients, a substantial loss in HRQoL was observed after 2.5 months which improved to the level of the general population norms by 24 months. For hospitalized UEI patients, HRQoL improved from 2.5 to 24 months but remained far below population norms. The more proximal UEI had a lower HRQoL and a slower recovery of HRQoL than distal injuries. At all time points, the proportion of UEI patients with limitations on the health domains self-care, usual activities and complaints of pain and/or discomfort was higher than in the group of all injuries. Female gender, higher age, low educational level, co-morbidity, shoulder or upper arm injury, multiple injuries and hospitalization are independent predictors for long-term loss in HRQoL. The impact of UEI exceeds the health consequences of the group with all injuries, for both non-hospitalized and hospitalized patients. The presence of UEI substantially reduces HRQoL in the short and long term, mainly due to limitations on the health domains self-care, usual activities and complaints of pain and/or discomfort. The impact of UEIs on HRQoL exceeds the health consequences of the group with all injuries. Proximal UEIs had a

CAA modeling of helicopter main rotor in hover

NASA Astrophysics Data System (ADS)

Kusyumov, Alexander N.; Mikhailov, Sergey A.; Batrakov, Andrey S.; Kusyumov, Sergey A.; Barakos, George

In this work rotor aeroacoustics in hover is considered. Farfield observers are used and the nearfield flow parameters are obtained using the in house HMB and commercial Fluent CFD codes (identical hexa-grids are used for both solvers). Farfield noise at a remote observer position is calculated at post processing stage using FW-H solver implemented in Fluent and HMB. The main rotor of the UH-1H helicopter is considered as a test case for comparison to experimental data. The sound pressure level is estimated for different rotor blade collectives and observation angles.

The V-band Empirical Mass-luminosity Relation for Main Sequence Stars

NASA Astrophysics Data System (ADS)

Xia, Fang; Fu, Yan-Ning

2010-07-01

Stellar mass is an indispensable parameter in the studies of stellar physics and stellar dynamics. On the one hand, the most reliable way to determine the stellar dynamical mass is via orbital determinations of binaries. On the other hand, however, most stellar masses have to be estimated by using the mass luminosity relation (MLR). Therefore, it is important to obtain the empirical MLR through fitting the data of stellar dynamical mass and luminosity. The effect of metallicity can make this relation disperse in the V-band, but studies show that this is mainly limited to the case when the stellar mass is less than 0.6M⊙ Recently, many relevant data have been accumulated for main sequence stars with larger masses, which make it possible to significantly improve the corresponding MLR. Using a fitting method which can reasonably assign weights to the observational data including two quantities with different dimensions, we obtain a V-band MLR based on the dynamical masses and luminosities of 203 main sequence stars. In comparison with the previous work, the improved MLR is statistically significant, and the relative error of mass estimation reaches about 5%. Therefore, our MLR is useful not only in the studies of statistical nature, but also in the studies of concrete stellar systems, such as the long-term dynamical study and the short-term positioning study of a specific multiple star system.

The V Band Empirical Mass-Luminosity Relation for Main Sequence Stars

NASA Astrophysics Data System (ADS)

Xia, F.; Fu, Y. N.

2010-01-01

Stellar mass is an indispensable parameter in the studies of stellar physics and stellar dynamics. On the one hand, the most reliable way to determine the stellar dynamical mass is via orbital determination of binaries. On the other hand, however, most stellar masses have to be estimated by using the mass-luminosity relation (MLR). Therefore, it is important to obtain the empirical MLR through fitting the data of stellar dynamical mass and luminosity. The effect of metallicity can make this relation disperse in the V-band, but studies show that this is mainly limited to the case when the stellar mass is less than 0.6M⊙. Recently, many relevant data have been accumulated for main sequence stars with larger mass, which make it possible to significantly improve the corresponding MLR. Using a fitting method which can reasonably assign weight to the observational data including two quantities with different dimensions, we obtain a V-band MLR based on the dynamical masses and luminosities of 203 main sequence stars. Compared with the previous work, the improved MLR is statistically significant, and the relative error of mass estimation reaches about 5%. Therefore, our MLR is useful not only in studies of statistical nature, but also in studies of concrete stellar systems, such as the long-term dynamical study and the short-term positioning study of a specific multiple star system.

Outcome of ICSI with motile testicular spermatozoa obtained through microscopically assisted testicular sperm extraction in relation to the ovarian response.

PubMed

Erdem, E; Karacan, M; Usta, A; Arvas, A; Cebi, Z; Camlibel, T

2017-05-01

To determine the relationship between AFC, basal FSH level, woman's age, the number of oocytes retrieved and the outcome of ICSI with testicular spermatozoa obtained with microscopically assisted testicular sperm extraction. In this retrospective cohort study, a total of 340 couples who underwent ICSI treatment with testicular sperm were enrolled. Women aged?40years and the first cycles of couples were included. ICSI was performed with motile testicular spermatozoa obtained from 89 men with obstructive azoospermia and 251 men with nonobstructive azoospermia. GnRH-antagonist protocol was used for ovulation induction. Simple linear regression was carried out to analyze relationship between the AFC, basal FSH, woman's age, the number of oocytes, and the live birth rate (LBR). Receiver operator characteristic curves (ROC) were formed to detect cut-off values below which LBR was significantly decreased. ROC curve analysis demonstrated that the cut-off level of the number of oocytes retrieved to predict the LBR was 7. According to this cut-off level, all patients were divided into two groups. Women with retrieved<7 oocytes were included in Group 1 and women with retrieved?7 oocytes were included in Group 2. The mean age of men was 35.1±4.9years. The mean age, mean FSH level and mean AFC of women were 32.1±4.9years, 6.9±2.7 IU/L, 7.6±3.4, respectively. Significant correlations were found between AFC, the number of oocytes retrieved, and the LBR per ICSI cycle with testicular spermatozoa. The LBR was significantly lower in women with AFC<8 than those with AFC?8. Independently, the LBR was significantly lower in cycles with<7 oocytes retrieved compared to those with ?7. Embryo transfer was not achieved in 37 cycles with<7 oocytes (37/167, 22.1%) and 18 cycles with?7 (18/173, 10.4%) because of the absence of transfer-quality embryos (P=0.005). The LBRs were the lowest in cycles with one or two oocytes available (8.3 and 8.3%, respectively), but these rates were not

Prediction of processing tomato peeling outcomes

USDA-ARS?s Scientific Manuscript database

Peeling outcomes of processing tomatoes were predicted using multivariate analysis of Magnetic Resonance (MR) images. Tomatoes were obtained from a whole-peel production line. Each fruit was imaged using a 7 Tesla MR system, and a multivariate data set was created from 28 different images. After ...

Quality Markers in Cardiology. Main Markers to Measure Quality of Results (Outcomes) and Quality Measures Related to Better Results in Clinical Practice (Performance Metrics). INCARDIO (Indicadores de Calidad en Unidades Asistenciales del Área del Corazón): A SEC/SECTCV Consensus Position Paper.

PubMed

López-Sendón, José; González-Juanatey, José Ramón; Pinto, Fausto; Cuenca Castillo, José; Badimón, Lina; Dalmau, Regina; González Torrecilla, Esteban; López-Mínguez, José Ramón; Maceira, Alicia M; Pascual-Figal, Domingo; Pomar Moya-Prats, José Luis; Sionis, Alessandro; Zamorano, José Luis

2015-11-01

Cardiology practice requires complex organization that impacts overall outcomes and may differ substantially among hospitals and communities. The aim of this consensus document is to define quality markers in cardiology, including markers to measure the quality of results (outcomes metrics) and quality measures related to better results in clinical practice (performance metrics). The document is mainly intended for the Spanish health care system and may serve as a basis for similar documents in other countries. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Generalizability of EXCEL and NOBLE results to a large registry population with unprotected left main coronary artery disease.

PubMed

Lee, Pil Hyung; Kang, Se Hun; Han, Seungbong; Ahn, Jung-Min; Bae, Jae Seok; Lee, Cheol Hyun; Kang, Soo-Jin; Lee, Seung-Whan; Kim, Young-Hak; Lee, Cheol Whan; Park, Seong-Wook; Park, Duk-Woo; Park, Seung-Jung

2017-12-01

The aim of this study was to determine how trial-based findings of EXCEL and NOBLE might be interpreted and generalizable in 'real-world' settings with comparison of data from the large-scaled, all-comer Interventional Research Incorporation Society-Left MAIN Revascularization (IRIS-MAIN) registry. We compared baseline clinical and procedural characteristics and also determined how the relative treatment effect of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) was different in EXCEL and NOBLE, compared with those of the multicenter, IRIS-MAIN registry (n=2481). The primary outcome for between-study comparison was a composite of death, myocardial infarction (MI), or stroke. There were between-study differences in patient risk profiles (age, BMI, diabetes, and clinical presentation), lesion complexities, and procedural characteristics (stent type, the use of off-pump surgery, and radial artery); the proportion of diabetes and acute coronary syndrome was particularly lower in NOBLE than in other studies. Although there was interstudy heterogeneity for the protocol definition of MI, the risks for serious composite outcome of death, MI, or stroke were similar between PCI and CABG in EXCEL [hazard ratio (HR): 1.00; 95% confidence interval (CI): 0.79-1.26; P=0.98] and in the matched cohort of IRIS-MAIN (HR: 1.08; 95%CI: 0.85-1.38; P=0.53), whereas it was significantly higher after PCI than after CABG in NOBLE (HR: 1.47; 95%CI: 1.06-2.05; P=0.02), which was driven by more common MI and stroke after PCI. In the comparison of a large-sized, all-comer registry, the EXCEL trial might represent better generalizability with respect to baseline characteristics and observed clinical outcomes compared with the NOBLE trial.

[Using neural networks based template matching method to obtain redshifts of normal galaxies].

PubMed

Xu, Xin; Luo, A-li; Wu, Fu-chao; Zhao, Yong-heng

2005-06-01

Galaxies can be divided into two classes: normal galaxy (NG) and active galaxy (AG). In order to determine NG redshifts, an automatic effective method is proposed in this paper, which consists of the following three main steps: (1) From the template of normal galaxy, the two sets of samples are simulated, one with the redshift of 0.0-0.3, the other of 0.3-0.5, then the PCA is used to extract the main components, and train samples are projected to the main component subspace to obtain characteristic spectra. (2) The characteristic spectra are used to train a Probabilistic Neural Network to obtain a Bayes classifier. (3) An unknown real NG spectrum is first inputted to this Bayes classifier to determine the possible range of redshift, then the template matching is invoked to locate the redshift value within the estimated range. Compared with the traditional template matching technique with an unconstrained range, our proposed method not only halves the computational load, but also increases the estimation accuracy. As a result, the proposed method is particularly useful for automatic spectrum processing produced from a large-scale sky survey project.

Main meal quality in Brazil and United Kingdom: Similarities and differences.

PubMed

Gorgulho, Bartira Mendes; Pot, Gerda Karolien; Sarti, Flavia Mori; Marchioni, Dirce Maria

2017-04-01

Consumption of fast food and ready-to-eat meals has been positively associated with obesity. In the UK, ready-made meals are more often consumed than in Brazil, a country in which nutrition transition is relatively low. This study aimed to compare the nutritional quality of the main meal consumed by adults in Brazil and UK. Food record data was obtained from representative samples from UK and Brazil databases. The Main Meal Quality Index (MMQI) was applied to estimate the quality of the main meal consumed in Brazil and UK. Differences in food groups consumed in the main meal in Brazil and UK were observed using classification decision tree. Meals with higher average energy content were lunch for Brazil, and dinner for the UK. On average, the Brazilian main meal had better nutritional quality (4.42 times higher), independently of sex, age, family income, nutritional status and energy consumed, with higher scores of fiber, carbohydrate, total fat, saturated fat and energy density. However, UK's main meal included more fruits and vegetables. Food preparations combined with rice and beans were classified as Brazilian main meal, while combinations with fast food items, as fried potatoes, sandwiches and sugary beverages, were classified as UK main meals. In Brazil, the main meal quality was lower among women and obese individuals, presenting significant positive association with age, and negative association with energy intake and family income; while in UK, only age was positively associated with MMQI. Although main meals in Brazil had higher nutritional quality compared to the UK, main meals consumed in both countries need nutritional improvement. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Randomized Controlled Trial to Compare 2 Scalable Interventions for Lower Urinary Tract Symptom Prevention: Main Outcomes of the TULIP Study.

PubMed

Sampselle, Carolyn M; Newman, Diane K; Miller, Janis M; Kirk, Keri; DiCamillo, Mary Ann; Wagner, Todd H; Raghunathan, Trivellor E; Diokno, Ananias C

2017-06-01

We compared 2-year urinary incontinence and urgency scores of older women who attended a 2-hour bladder health class vs those who viewed a 20-minute abbreviated class video for the purpose of urinary incontinence prevention. A randomized, 2-arm, parallel design study was done to test the superiority of the 20-minute video over the 2-hour class. Outcomes at baseline, and 3, 12 and 24 months were the scores on questions 1 to 3 of ICIQ-SF (International Consultation on Incontinence Short Form) as the primary outcome and on IUSS (Indevus Urgency Severity Scale). Intent to treat analysis was done to compare the change from baseline in each intervention group across time and also with each other. Multiple imputation was used for missing data. A total of 647 women participated in the study. Mean age was 63 years and approximately 28% of the participants were African American, primarily from an urban setting. The 2 arms were balanced on body mass index at baseline, age, race/ethnicity, education, employment status, income and marital status. No differences in primary or secondary outcomes were demonstrated between the 2 groups from baseline to the 3, 12 or 24-month visits. The absence of significant differences in the outcome measures of ICIQ-SF and IUSS between the 2-hour class and the 20-minute video groups demonstrates that the 2 interventions were comparable. As urinary incontinence and urgency tend to rise annually in older women, instruction in bladder health self-care provided through either the 2-hour class or the 20-minute video format is a useful intervention to prevent urinary incontinence in older women. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

[Gender-specific differences of the early postoperative and oncosurgical long-term outcome in rectal cancer-data obtained in a prospective multicenter observational study].

PubMed

Katzenstein, J; Steinert, R; Ptok, H; Otto, R; Gastinger, I; Lippert, H; Meyer, F

2018-04-11

Gender-specific aspects have been increasingly considered in clinical medicine, also in oncological surgery. To analyze gender-specific differences of early postoperative and oncological outcomes after rectal cancer resection based on data obtained in a prospective multicenter observational study. As part of the multicenter prospective observational study "Quality assurance in primary rectal cancer", data on tumor site, exogenic and endogenic risk factors, neoadjuvant treatment, surgical procedures, tumor stage, intraoperative and postoperative complications of patients with the histological diagnosis of rectal cancer were registered. Data from the years 2005-2006 and 2010-2011 were investigated with respect to gender-specific differences of postoperative morbidity, hospital mortality, local recurrency rate, disease-free and overall survival by univariable and multivariable analyses. Overall, data from 10,657 patients were evaluated: 60.9% of the patients were male, who were significantly younger (p < 0.001). Men had a significantly higher rate of alcohol (p < 0.001) and nicotine abuse (p < 0.001) as well as a trend to a higher body mass index (BMI) compared with women. Although, there was no significant difference in the distribution of various tumor stages comparing men and women, neoadjuvant radiochemotherapy was used significantly more often in male patients (p < 0.001). In addition, male patients underwent an abdominoperineal rectum exstirpation more often, whereas creation of an enterostoma and Hartmann's procedure were more frequently used in women (p < 0.001 each). Multivariate analysis revealed that male patients developed a higher overall morbidity (odds ratio, OR: 1.5; p < 0.001) during both study periods and from 2010-2011 a higher hospital mortality (OR: 1.8; p < 0.001). After a median follow-up period of 36 months, gender did not have a significant impact on overall survival, disease-free survival or on the local

One-year Outcomes in Patients with ST-segment Elevation Myocardial Infarction Caused by Unprotected Left Main Coronary Artery Occlusion Treated by Primary Percutaneous Coronary Intervention.

PubMed

Liu, Hai-Wei; Han, Ya-Ling; Jin, Quan-Min; Wang, Xiao-Zeng; Ma, Ying-Yan; Wang, Geng; Wang, Bin; Xu, Kai; Li, Yi; Chen, Shao-Liang

2018-06-20

Very few data have been reported for ST-segment elevation myocardial infarction (STEMI) caused by unprotected left main coronary artery (ULMCA) occlusion, and very little is known about the results of this subgroup of patients who underwent primary percutaneous coronary intervention (PCI). The aim of this study was to determine the clinical features and outcomes of patients with STEMI who underwent primary PCI for acute ULMCA occlusion. From January 2000 to February 2014, 372 patients with STEMI caused by ULMCA acute occlusion (ULMCA-STEMI) who underwent primary PCI at one of two centers were enrolled. The 230 patients with non-ST-segment elevation MI (NSTEMI) caused by ULMCA lesion (ULMCA-NSTEMI) who underwent emergency PCI were designated the control group. The main indexes were the major adverse cardiac events (MACEs) in-hospital, at 1 month, and at 1 year. Compared to the NSTEMI patients, the patients with STEMI had significantly higher rates of Killip class≥III (21.2% vs. 3.5%, χ 2 = 36.253, P < 0.001) and cardiac arrest (8.3% vs. 3.5%, χ 2 = 5.529, P = 0.019). For both groups, the proportions of one-year cardiac death in the patients with a post-procedure thrombolysis in myocardial infarction (TIMI) flow grade<3 were significantly higher than those in the patients with a TIMI flow grade of 3 (STEMI group: 51.7% [15/29] vs. 4.1% [14/343], P < 0.001; NSTEMI group: 33.3% [3/9] vs. 13.6% [3/221], P = 0.001; respectively]. Landmark analysis showed that the patients in STEMI group were associated with higher risks of MACE (16.7% vs. 9.1%, P = 0.009) and cardiac death (5.4% vs. 1.3%, P = 0.011) compared with NSTEMI patients at 1 month. Meanwhile, in patients with ULMCA, the landmark analysis for incidences of MACE and cardiac death was similar between the STEMI and NSTEMI (all P = 0.72) in the intervals of 1-12 months. However, patients who were diagnosed with STEMI or NSTEMI had no significant difference in reinfarction (all P > 0.05) and TVR (all P > 0.05) in

Privileging Practice: Facing the Challenge of Integrated Working for Outcomes for Children

ERIC Educational Resources Information Center

Canavan, John; Coen, Liam; Dolan, Pat; Whyte, Liam

2009-01-01

Integrated working for outcomes is complex and challenging in theory and practice. Yet, outcomes and integrated working are central to the policy goals for children and families in Ireland. In this article, the authors present two main arguments: first, that reflective practice offers a useful general methodology for engaging with the theoretical…

Survivorship and functional outcomes of patellofemoral arthroplasty: a systematic review.

PubMed

van der List, J P; Chawla, H; Zuiderbaan, H A; Pearle, A D

2017-08-01

Historically poor results of survivorship and functional outcomes of patellofemoral arthroplasty (PFA) have been reported in the setting of isolated patellofemoral osteoarthritis. More recently, however, fairly good results of PFA were reported, but the current status of PFA outcomes is unknown. Therefore, a systematic review was performed to assess overall PFA survivorship and functional outcomes. A search was performed using PubMed, Embase and Cochrane systems, and the registries were searched. Twenty-three cohort studies and one registry reported survivorship using Kaplan-Meier curve, while 51 cohort studies reported functional outcomes of PFA. Twelve studies were level II studies, while 45 studies were level III or IV studies. Heterogeneity was mainly seen in type of prosthesis and year the cohort started. Nine hundred revisions in 9619 PFAs were reported yielding 5-, 10-, 15- and 20-year PFA survivorships of 91.7, 83.3, 74.9 and 66.6 %, respectively, and an annual revision rate of 2.18. Functional outcomes were reported in 2587 PFAs with an overall score of 82.2 % of the maximum score. KSS and Knee Function Score were 87.5 and 81.6 %, respectively. This systematic review showed that fairly good results of PFA survivorship and functional outcomes were reported at short- and midterm follow-up in the setting of isolated patellofemoral osteoarthritis. Heterogeneity existed mainly in prosthesis design and year the cohort started. These results provide a clear overview of the current status of PFA in the setting of isolated patellofemoral osteoarthritis. IV.

Flood of April and May 2008 in Northern Maine

USGS Publications Warehouse

Lombard, Pamela J.

2010-01-01

Severe flooding occurred in Aroostook and Penobscot Counties in northern Maine between April 28 and May 1, 2008, and was most extreme in the town of Fort Kent. Peak streamflows in northern Aroostook County were the result of a persistent heavy snowpack that caused high streamflows when it quickly melted during the third week of April 2008. Snowmelt was followed by from two to four inches of rainfall over a 2-day period in northern Maine. Peak water-surface elevations resulting from the flood were obtained from 13 continuous-record streamgages and 63 surveyed high-water marks in Aroostook and Penobscot Counties. Peak streamflows were obtained from 20 sites on 15 streams through stage/discharge rating curves or hydraulic flow models. Peak water-surface elevations and streamflows were the highest ever recorded at seven continuous-record streamgages, which had between 25 and 84 years of record in northern Aroostook County. The annual exceedance probability (the percent chance of exceeding the streamflow recorded during the April/May 2008 flood during any given year) at six streamgages in northern Maine was equal to or less than 1 percent. Data from flood-insurance studies published by the Federal Emergency Management Agency were available for five of the locations analyzed for the April/May 2008 flood and were compared to streamflows and observed peak water-surface elevations from the 2008 flood. Water-surface elevations that would be expected given the observed flow as applied to the effective flood insurance studies ranged from between 1 and 4 feet from the water-surface elevations observed during the 2008 flood. Differences were likely the result of up to 30 years of additional data for the calculation of recurrence intervals and the fact that hydraulic models used for the models had not previously been calibrated to a flood of this magnitude.

Outcome modelling strategies in epidemiology: traditional methods and basic alternatives

PubMed Central

Greenland, Sander; Daniel, Rhian; Pearce, Neil

2016-01-01

Abstract Controlling for too many potential confounders can lead to or aggravate problems of data sparsity or multicollinearity, particularly when the number of covariates is large in relation to the study size. As a result, methods to reduce the number of modelled covariates are often deployed. We review several traditional modelling strategies, including stepwise regression and the ‘change-in-estimate’ (CIE) approach to deciding which potential confounders to include in an outcome-regression model for estimating effects of a targeted exposure. We discuss their shortcomings, and then provide some basic alternatives and refinements that do not require special macros or programming. Throughout, we assume the main goal is to derive the most accurate effect estimates obtainable from the data and commercial software. Allowing that most users must stay within standard software packages, this goal can be roughly approximated using basic methods to assess, and thereby minimize, mean squared error (MSE). PMID:27097747

Analysis of a spaceborne mirror on a main plate with isostatic mounts

NASA Astrophysics Data System (ADS)

Chan, Chia-Yen; Lien, Chun-Chieh; Huang, Po-Hsuan; Chang, Shenq-Tsong; Huang, Ting-Ming

2014-09-01

The paper is aimed at obtaining the deformation results and optical aberration configurations of a spaceborne mirror made of ZERODUR® glass on a main plate with three isostatic mounts for a space Cassegrain telescope. On the rear side of the main plate four screws will be locked to fix the focal plane assembly. The locking modes for the four screws will be simulated as push and pull motions in the Z axis for simplification. The finite element analysis and Zernike polynomial fitting are applied to the whole integrated optomechanical analysis process. Under the analysis, three isostatic mounts are bonded to the neutral plane of the mirror. The deformation results and optical aberration configurations under six types of push and pull motions as well as self-weight loading have been obtained. In addition, the comparison between the results under push and pull motions with 0.01 mm and 0.1 mm displacements in Z axis will be attained.

Dichotomisation using a distributional approach when the outcome is skewed.

PubMed

Sauzet, Odile; Ofuya, Mercy; Peacock, Janet L

2015-04-24

Dichotomisation of continuous outcomes has been rightly criticised by statisticians because of the loss of information incurred. However to communicate a comparison of risks, dichotomised outcomes may be necessary. Peacock et al. developed a distributional approach to the dichotomisation of normally distributed outcomes allowing the presentation of a comparison of proportions with a measure of precision which reflects the comparison of means. Many common health outcomes are skewed so that the distributional method for the dichotomisation of continuous outcomes may not apply. We present a methodology to obtain dichotomised outcomes for skewed variables illustrated with data from several observational studies. We also report the results of a simulation study which tests the robustness of the method to deviation from normality and assess the validity of the newly developed method. The review showed that the pattern of dichotomisation was varying between outcomes. Birthweight, Blood pressure and BMI can either be transformed to normal so that normal distributional estimates for a comparison of proportions can be obtained or better, the skew-normal method can be used. For gestational age, no satisfactory transformation is available and only the skew-normal method is reliable. The normal distributional method is reliable also when there are small deviations from normality. The distributional method with its applicability for common skewed data allows researchers to provide both continuous and dichotomised estimates without losing information or precision. This will have the effect of providing a practical understanding of the difference in means in terms of proportions.

Clinical outcomes research in gynecologic oncology.

PubMed

Melamed, Alexander; Rauh-Hain, J Alejandro; Schorge, John O

2017-09-01

Clinical outcomes research seeks to understand the real-world manifestations of clinical care. In particular, outcomes research seeks to reveal the effects of pharmaceutical, procedural, and structural aspects of healthcare on patient outcomes, including mortality, disease control, toxicity, cost, and quality of life. Although outcomes research can utilize interventional study designs, insightful use of observational data is a defining feature of this field. Many questions in gynecologic oncology are not amenable to investigation in randomized clinical trials due to cost, feasibility, or ethical concerns. When a randomized trial is not practical or has not yet been conducted, well-designed observational studies have the potential to provide the best available evidence about the effects of clinical care. Such studies may use surveys, medical records, disease registries, and a variety of administrative data sources. Even when a randomized trial has been conducted, observational studies can be used to estimate the real-world effect of an intervention, which may differ from the results obtained in the controlled setting of a clinical trial. This article reviews the goals, methodologies, data sources, and limitations of clinical outcomes research, with a focus on gynecologic oncology. Copyright © 2017. Published by Elsevier Inc.

Maternal and fetal outcome of pregnancy complicated by HELLP syndrome.

PubMed

Gasem, Turki; Al Jama, Fathia E; Burshaid, Sameera; Rahman, Jessica; Al Suleiman, Suleiman A; Rahman, Mohammad S

2009-12-01

The study evaluated the maternal and fetal outcome in 64 pregnancies complicated by HELLP syndrome. A retrospective analysis of the medical records was performed of patients with HELLP syndrome managed at this tertiary Obstetric unit between January 1996 and December 2005, who were admitted for preeclamsia/eclampsia and had documented evidence of hemolysis, elevated liver enzymes and low platelet count. Maternal and neonatal complications were recorded and analyzed. The incidence of HELLP syndrome in the study was 8.3%. Mean gestational age at delivery was 32.4 +/- 4.2 weeks and mean birth weight was 1851 +/- 810 g. Forty-two percent of the patients had deliveries <32 weeks and 28% IUGR. Respiratory distress syndrome was the main indication for NICU admissions (33.9%). The PNM rate was 20%. Maternal morbidity rate was 34%. The most common maternal complications were abruptio placentae (36.4%) and DIC (31.8%). There was no maternal death. Once the diagnosis of HELLP syndrome is confirmed, the management depends on several obstetric and maternal variables like gestational age, severity of laboratory abnormalities and fetal status. As soon as the maternal condition is stabilized and fetal assessment is obtained, prompt delivery of the fetus is indicated. It is not yet established whether expectant management in preterm pregnancies with HELLP syndrome would improve perinatal outcome.

Propensity for obtaining alcohol through shoulder tapping.

PubMed

Toomey, Traci L; Fabian, Lindsey E A; Erickson, Darin J; Lenk, Kathleen M

2007-07-01

Underage youth often obtain alcohol from adults who illegally provide the alcohol. One method for obtaining alcohol from adults is shoulder tapping, where youth approach an adult outside an alcohol establishment and ask the adult to purchase alcohol for them. The goal of this study was to assess what percentage of the general and youth-targeted adult population approached outside of a convenience/liquor store will agree to purchase and then provide alcohol to individuals who appear under age 21. We conducted 2 waves of pseudo-underage shoulder tap request attempts, using requesters who were age 21 or older but appeared 18 to 20 years old. In both waves, requests were conducted at randomly selected liquor and convenience stores, requesters explained that the reason they were asking the adult was because they did not have their identification with them, and requesters asked the adults to purchase a 6-pack of beer. During wave 1, we conducted 102 attempts, with the requester approaching the first adult entering the store alone. During wave 2, we conducted 102 attempts where the requester approached the first casually dressed male entering the store alone who appeared to be 21 to 30 years old. During wave 1, 8% of the general sample of approached adults provided alcohol to the pseudo-underage requesters. The odds of adults providing alcohol in urban areas were 9.4 times greater than in suburban areas. During wave 2, 19% of the approached young men provided alcohol to the requesters. No requester, request attempt, establishment, or community characteristics were associated with request attempt outcomes during wave 2. A small percentage of the general population of adults will agree to provide alcohol to underage youth when approached outside an alcohol establishment. The likelihood of underage youth obtaining alcohol through shoulder tapping increases substantially if the youth approach young men.

Therapist perception of treatment outcome: Evaluating treatment outcomes among youth with antisocial behavior problems.

PubMed

Crandal, Brent R; Foster, Sharon L; Chapman, Jason E; Cunningham, Phillippe B; Brennan, Patricia A; Whitmore, Elizabeth A

2015-06-01

Effective evaluation of treatment requires the use of measurement tools producing reliable scores that can be used to make valid decisions about the outcomes of interest. Therapist-rated treatment outcome scores that are obtained within the context of empirically supported treatments (ESTs) could provide clinicians and researchers with data that are easily accessible and complimentary to existing instrumentation. We examined the psychometric properties of scores from the Therapist Perception of Treatment Outcome: Youth Antisocial Behavior (TPTO:YAB), an instrument developed to assess therapist judgments of treatment success among families participating in an EST, Multisystemic Therapy (MST), for youth with antisocial behavior problems. Data were drawn from a longitudinal study of MST. The initial 20-item TPTO:YAB was completed by therapists of 111 families at midtreatment and 163 families at treatment termination. Rasch model dimensionality analyses provided evidence for 2 dimensions reflecting youth- and caregiver-related aspects of treatment outcome, although a bifactor analyses suggested that these dimensions reflected a single more general construct. Rasch analyses were also used to assess item and rating scale characteristics and refine the number of items. These analyses suggested items performed similarly across time and that scores reflect treatment outcome in similar ways at mid and posttreatment. Multilevel and zero-order analyses provided evidence for the validity of TPTO:YAB scores. TPTO:YAB scores were moderately correlated with scores of youth and caregiver behaviors targeted in treatment, adding support to its use as a treatment outcome measurement instrument. (c) 2015 APA, all rights reserved).

Treatment Outcomes for Extensively Drug-Resistant Tuberculosis and HIV Co-infection

PubMed Central

Padayatchi, Nesri; Kvasnovsky, Charlotte; Werner, Lise; Master, Iqbal; Horsburgh, C. Robert

2013-01-01

High mortality rates have been reported for patients co-infected with extensively drug-resistant tuberculosis (XDR-TB) and HIV, but treatment outcomes have not been reported. We report treatment outcomes for adult XDR TB patients in KwaZulu-Natal Province, South Africa. Initial data were obtained retrospectively, and outcomes were obtained prospectively during 24 months of treatment. A total of 114 XDR TB patients were treated (median 6 drugs, range 3–9 drugs); 82 (73%) were HIV positive and 50 (61%) were receiving antiretroviral therapy. After receiving treatment for 24 months, 48 (42%) of 114 patients died, 25 (22%) were cured or successfully completed treatment, 19 (17%) withdrew from the study, and 22 (19%) showed treatment failure. A higher number of deaths occurred among HIV-positive patients not receiving antiretroviral therapy and among patients who did not show sputum culture conversion. Culture conversion was a major predictor of survival but was poorly predictive (51%) of successful treatment outcome. PMID:23622055

Similarities amid the difference: caregiving burden and adaptation outcomes in dyads of parents and their children with and without cerebral palsy.

PubMed

Carona, C; Crespo, C; Canavarro, M C

2013-03-01

This study had two main objectives: first, to examine the direct and indirect effects, via social support, of caregiving burden on the adaptation outcomes of children/adolescents with cerebral palsy and their parents; and second, to assess the invariance of such models in clinical vs. healthy subsamples. Participants were 210 dyads of children/adolescents and one of their parents (total N=420), divided in 93 dyads of children/adolescents with cerebral palsy and 117 dyads of children/adolescents with no medical diagnosis. Data on caregiving burden, social support and adaptation outcomes were obtained through self-report questionnaires. Caregiving burden was linked to parents and their children's psychological maladjustment and quality of life both directly (except for children's quality of life) and indirectly through social support. Findings were invariant across clinical and healthy subsamples. Caregiving burden may influence adaptation outcomes of children/adolescents with CP and their parents both directly and via their social support perceptions. These patterns are similar to those observed in typically developing children/adolescents. Copyright © 2012 Elsevier Ltd. All rights reserved.

Organisational stressors, coping, and outcomes in competitive sport.

PubMed

Arnold, Rachel; Fletcher, David; Daniels, Kevin

2017-04-01

Organisational stressors are associated with positive and negative outcomes in extant literature; however, little is known about which demands predict which outcomes. Extant theory and literature also suggests that coping style may influence an individual's resilience or vulnerability to stressors and, subsequently, their psychological responses and outcomes. The purpose of this study was, therefore, to examine the main effects of organisational stressors and coping styles on various outcomes (e.g., positive and negative affect, performance satisfaction). Sport performers (n = 414) completed measures of organisational stressors, coping styles, positive and negative affect, and performance satisfaction. Multiple regression analyses revealed positive relationships of both goals and development stressors (duration and intensity) and team and culture stressors (frequency and intensity) on negative affect. Furthermore, problem-focused coping was positively related to positive affect, and emotion-focused coping was positively related to negative affect. This study furthers theoretical knowledge regarding the associations that both organisational stressors (and their dimensions) and coping styles can have with various outcomes, and practical understanding regarding the optimal design of stress management interventions.

Time and outcome framing in intertemporal tradeoffs.

PubMed

Scholten, Marc; Read, Daniel

2013-07-01

A robust anomaly in intertemporal choice is the delay-speedup asymmetry: Receipts are discounted more, and payments are discounted less, when delayed than when expedited over the same interval. We developed 2 versions of the tradeoff model (Scholten & Read, 2010) to address such situations, in which an outcome is expected at a given time but then its timing is changed. The outcome framing model generalizes the approach taken by the hyperbolic discounting model (Loewenstein & Prelec, 1992): Not obtaining a positive outcome when expected is a worse than expected state, to which people are over-responsive, or hypersensitive, and not incurring a negative outcome when expected is a better than expected state, to which people are under-responsive, or hyposensitive. The time framing model takes a new approach: Delaying a positive outcome or speeding up a negative one involves a loss of time to which people are hypersensitive, and speeding up a positive outcome or delaying a negative one involves a gain of time to which people are hyposensitive. We compare the models on their quantitative predictions of indifference data from matching and preference data from choice. The time framing model systematically outperforms the outcome framing model. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Factors predicting work outcome in Japanese patients with schizophrenia: role of multiple functioning levels.

PubMed

Sumiyoshi, Chika; Harvey, Philip D; Takaki, Manabu; Okahisa, Yuko; Sato, Taku; Sora, Ichiro; Nuechterlein, Keith H; Subotnik, Kenneth L; Sumiyoshi, Tomiki

2015-09-01

Functional outcomes in individuals with schizophrenia suggest recovery of cognitive, everyday, and social functioning. Specifically improvement of work status is considered to be most important for their independent living and self-efficacy. The main purposes of the present study were 1) to identify which outcome factors predict occupational functioning, quantified as work hours, and 2) to provide cut-offs on the scales for those factors to attain better work status. Forty-five Japanese patients with schizophrenia and 111 healthy controls entered the study. Cognition, capacity for everyday activities, and social functioning were assessed by the Japanese versions of the MATRICS Cognitive Consensus Battery (MCCB), the UCSD Performance-based Skills Assessment-Brief (UPSA-B), and the Social Functioning Scale Individuals' version modified for the MATRICS-PASS (Modified SFS for PASS), respectively. Potential factors for work outcome were estimated by multiple linear regression analyses (predicting work hours directly) and a multiple logistic regression analyses (predicting dichotomized work status based on work hours). ROC curve analyses were performed to determine cut-off points for differentiating between the better- and poor work status. The results showed that a cognitive component, comprising visual/verbal learning and emotional management, and a social functioning component, comprising independent living and vocational functioning, were potential factors for predicting work hours/status. Cut-off points obtained in ROC analyses indicated that 60-70% achievements on the measures of those factors were expected to maintain the better work status. Our findings suggest that improvement on specific aspects of cognitive and social functioning are important for work outcome in patients with schizophrenia.

Intraoperative ultrasound guidance in breast-conserving surgery shows superiority in oncological outcome, long-term cosmetic and patient-reported outcomes: Final outcomes of a randomized controlled trial (COBALT).

PubMed

Volders, J H; Haloua, M H; Krekel, N M A; Negenborn, V L; Kolk, R H E; Lopes Cardozo, A M F; Bosch, A M; de Widt-Levert, L M; van der Veen, H; Rijna, H; Taets van Amerongen, A H M; Jóźwiak, K; Meijer, S; van den Tol, M P

2017-04-01

The multicenter randomized controlled COBALT trial demonstrated that ultrasound-guided breast-conserving surgery (USS) results in a significant reduction of margin involvement (3.1% vs. 13%) and excision volumes compared to palpation-guided surgery (PGS). The aim of the present study was to determine long term oncological and patient-reported outcomes including quality of life (QoL), together with their progress over time. 134 patients with T1-T2 breast cancer were randomized to USS (N = 65) or PGS (N = 69). Cosmetic outcomes were assessed with the Breast Cancer Conservative Treatment cosmetic results (BCCT.core) software, panel-evaluation and patient self-evaluation on a 4-point Likert-scale. QoL was measured using the EORTC QLQ-C30/-BR23 questionnaire. No locoregional recurrences were reported after mean follow-up of 41 months. Seven patients (5%) developed distant metastatic disease (USS 6.3%, PGS 4.4%, p = 0.466), of whom six died of disease (95.5% overall survival). USS achieved better cosmetic outcomes compared to PGS, with poor outcomes of 11% and 21% respectively, a result mainly attributable to mastectomies due to involved margins following PGS. There was no difference after 1 and 3 years in cosmetic outcome. Dissatisfied patients included those with larger excision volumes, additional local therapies and worse QoL. Patients with poor/fair cosmetic outcomes scored significantly lower on aspects of QoL, including breast-symptoms, body image and sexual enjoyment. By significantly reducing positive margin status and lowering resection volumes, USS improves the rate of good cosmetic outcomes and increases patient-satisfaction. Considering the large impact of cosmetic outcome on QoL, USS has great potential to improve QoL following breast-conserving therapy. Copyright © 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Structure of Cu/Ni Nanowires Obtained by Matrix Synthesis

NASA Astrophysics Data System (ADS)

Zhigalina, O. M.; Doludenko, I. M.; Khmelenin, D. N.; Zagorskiy, D. L.; Bedin, S. A.; Ivanov, I. M.

2018-05-01

The structure of layered Cu/Ni nanowires obtained by template synthesis in 100-nm channels of track membranes has been investigated by transmission and scanning electron microscopy. The phase composition and main structural features of individual nanowires are determined. It is shown that nanowires consist of alternating Ni ( Fm3m) and Cu ( Fm3m) layers with grains up to 100 nm in size. It is found that nanowires contain also copper oxide crystallites up to 20 nm in size. The elemental composition of individual layers and their mutual arrangement are determined.

Early Head CT Findings Are Associated With Outcomes After Pediatric Out-of-Hospital Cardiac Arrest

PubMed Central

Starling, Rebecca M.; Shekdar, Karuna; Licht, Dan; Nadkarni, Vinay M.; Berg, Robert A.; Topjian, Alexis A.

2015-01-01

Objectives Head CT after out-of-hospital cardiac arrest is often obtained to evaluate intracranial pathology. Among children admitted to the PICU following pediatric out-of-hospital cardiac arrest, we hypothesized that loss of gray-white matter differentiation and basilar cistern and sulcal effacement are associated with mortality and unfavorable neurologic outcome. Design Retrospective, cohort study. Setting Single, tertiary-care center PICU. Patients Seventy-eight patients less than 18 years old who survived out-of-hospital cardiac arrest to PICU admission and had a head CT within 24 hours of return of spontaneous circulation were evaluated from July 2005 through May 2012. Interventions None. Measurements and Main Results Median time to head CT from return of spontaneous circulation was 3.3 hours (1.0, 6.0). Median patient age was 2.3 years (0.4, 9.5). Thirty-nine patients (50%) survived, of whom 29 (74%) had favorable neurologic outcome. Nonsurvivors were more likely than survivors to have 1) loss of gray-white matter differentiation (Hounsfield unit ratios, 0.96 [0.88, 1.07] vs 1.1 [1.07, 1.2]; p < 0.001), 2) basilar cistern effacement (93% vs 7%; p = 0.001; positive predictive value, 94%; negative predictive value, 59%), and 3) sulcal effacement (100% vs 0%; p ≤ 0.001; positive predictive value, 100%; negative predictive value, 68%). All patients with poor gray-white matter differentiation or sulcal effacement had unfavorable neurologic outcomes. Only one patient with basilar cistern effacement had favorable outcome. Conclusions Loss of gray-white matter differentiation and basilar cistern effacement and sulcal effacement are associated with poor outcome after pediatric out-of-hospital cardiac arrest. Select patients may have favorable outcomes despite these findings. PMID:25844694

Outcome dependency alters the neural substrates of impression formation

PubMed Central

Ames, Daniel L.; Fiske, Susan T.

2015-01-01

How do people maintain consistent impressions of other people when other people are often inconsistent? The present research addresses this question by combining recent neuroscientific insights with ecologically meaningful behavioral methods. Participants formed impressions of real people whom they met in a personally involving situation. fMRI and supporting behavioral data revealed that outcome dependency (i.e., depending on another person for a desired outcome) alters previously identified neural dynamics of impression formation. Consistent with past research, a functional localizer identified a region of dorsomedial PFC previously linked to social impression formation. In the main task, this ROI revealed the predicted patterns of activity across outcome dependency conditions: greater BOLD response when information confirmed (vs. violated) social expectations if participants were outcome-independent and the reverse pattern if participants were outcome-dependent. We suggest that, although social perceivers often discount expectancy-disconfirming information as noise, being dependent on another person for a desired outcome focuses impression-formation processing on the most diagnostic information, rather than on the most tractable information. PMID:23850465

Applying for ethical approval for research: the main issues.

PubMed

Gelling, Leslie

2016-01-13

The need to obtain research ethical approval is common to all research involving human participants. This approval must be obtained before research participants can be approached and before data collection can begin. The process of ethical review is one way that research participants can be confident that possible risks have been considered, minimised and deemed acceptable. This article outlines some of the main issues researchers should consider when planning an application for research ethical approval by answering the following six questions: 'Do I need research ethical approval?', 'How many applications will I need to make?', 'Where should I apply for research ethical approval?', 'What do I need to include in my application?', 'What do research ethics committees look for?' and 'What other approvals might I need?' Answering these questions will enable researchers to navigate the ethical review process.

The main peculiarities of the processes of the deformation and destruction of lunar soil

NASA Technical Reports Server (NTRS)

Leonovich, A. K.; Gromov, V. V.; Dmitriyev, A. D.; Penetrigov, V. N.; Senevov, P. S.; Shvarev, V. V.

1977-01-01

The main results of study of the physical and mechanical properties of lunar soil, obtained by laboratory study of samples returned from the moon by Luna 16 and Luna 20, as well as by operation of the self-propelled Lunokhod 1 and Lunokhod 2 on the surface of the moon, are analyzed in the report. All studies were carried out by single methods and by means of unified instruments, allowing a confident comparison of the results obtained. The investigations conducted allowed the following values of the main physical-mechanical properties of lunar soil to be determined: in the natural condition the solid density corresponds to the porosity of 0.8; the modal value of the carrying capacity is 0.4 kg/square cm; adhesion is 0.04 to 0.06 kg/square cm; and the internal angle of friction is 20 to 25 degree. The main mechanisms of deformation and destruction of the soil are analyzed in the report, and the relationships between the mechanical properties and physical parameters of the soil are presented.

Long term outcomes of new generation drug eluting stents versus coronary artery bypass grafting for multivessel and/or left main coronary artery disease. A Bayesian network meta-analysis of randomized controlled trials.

PubMed

Mina, George S; Watti, Hussam; Soliman, Demiana; Shewale, Anand; Atkins, Jessica; Reddy, Pratap; Dominic, Paari

2018-01-05

Most data guiding revascularization of multivessel disease (MVD) and/or left main disease (LMD) favor coronary artery bypass grafting (CABG) over percutaneous coronary intervention (PCI). However, those data are based on trials comparing CABG to bare metal stents (BMS) or old generation drug eluting stents (OG-DES). Hence, it is essential to outcomes of CABG to those of new generation drug eluting stents (NG-DES). We searched PUBMED and Cochrane database for trials evaluating revascularization of MVD and/or LMD with CABG and/or PCI. A Bayesian network meta-analysis was performed to calculate odds ratios (OR) and 95% credible intervals (CrI). Primary outcome was major adverse cardiovascular events (MACE) at 3-5 years. Secondary outcomes were mortality, cerebrovascular accidents (CVA), myocardial infarction (MI) and repeat revascularization. We included 10 trials with a total of 9287 patients. CABG was associated with lower MACE when compared to BMS or OG-DES. However, MACE was not significantly different between CABG and NG-DES (OR 0.79, CrI 0.45-1.40). Moreover, there were no significant differences between CABG and NG-DES in mortality (OR 0.78, CrI 0.45-1.37), CVA (OR 0.93 CrI 0.35-2.2) or MI (OR 0.6, CrI 0.17-2.0). On the other hand, CABG was associated with lower repeat revascularization (OR 0.55, CrI 0.36-0.84). Our study suggests that NG-DES is an acceptable alternative to CABG in patients with MVD and/or LMD. However, repeat revascularization remains to be lower with CABG than with PCI. Copyright © 2018. Published by Elsevier Inc.

International variation in the definition of ‘main condition’ in ICD-coded health data

PubMed Central

Quan, H.; Moskal, L.; Forster, A.J.; Brien, S.; Walker, R.; Romano, P.S.; Sundararajan, V.; Burnand, B.; Henriksson, G.; Steinum, O.; Droesler, S.; Pincus, H.A.; Ghali, W.A.

2014-01-01

Hospital-based medical records are abstracted to create International Classification of Disease (ICD) coded discharge health data in many countries. The ‘main condition’ is not defined in a consistent manner internationally. Some countries employ a ‘reason for admission’ rule as the basis for the main condition, while other countries employ a ‘resource use’ rule. A few countries have recently transitioned from one of these approaches to the other. The definition of ‘main condition’ in such ICD data matters when it is used to define a disease cohort to assign diagnosis-related groups and to perform risk adjustment. We propose a method of harmonizing the international definition to enable researchers and international organizations using ICD-coded health data to aggregate or compare hospital care and outcomes across countries in a consistent manner. Inter-observer reliability of alternative harmonization approaches should be evaluated before finalizing the definition and adopting it worldwide. PMID:24990594

Automatically identifying health outcome information in MEDLINE records.

PubMed

Demner-Fushman, Dina; Few, Barbara; Hauser, Susan E; Thoma, George

2006-01-01

Understanding the effect of a given intervention on the patient's health outcome is one of the key elements in providing optimal patient care. This study presents a methodology for automatic identification of outcomes-related information in medical text and evaluates its potential in satisfying clinical information needs related to health care outcomes. An annotation scheme based on an evidence-based medicine model for critical appraisal of evidence was developed and used to annotate 633 MEDLINE citations. Textual, structural, and meta-information features essential to outcome identification were learned from the created collection and used to develop an automatic system. Accuracy of automatic outcome identification was assessed in an intrinsic evaluation and in an extrinsic evaluation, in which ranking of MEDLINE search results obtained using PubMed Clinical Queries relied on identified outcome statements. The accuracy and positive predictive value of outcome identification were calculated. Effectiveness of the outcome-based ranking was measured using mean average precision and precision at rank 10. Automatic outcome identification achieved 88% to 93% accuracy. The positive predictive value of individual sentences identified as outcomes ranged from 30% to 37%. Outcome-based ranking improved retrieval accuracy, tripling mean average precision and achieving 389% improvement in precision at rank 10. Preliminary results in outcome-based document ranking show potential validity of the evidence-based medicine-model approach in timely delivery of information critical to clinical decision support at the point of service.

Fish consumption and prenatal methylmercury exposure: cognitive and behavioral outcomes in the main cohort at 17 years from the Seychelles child development study.

PubMed

Davidson, Philip W; Cory-Slechta, Deborah A; Thurston, Sally W; Huang, Li-Shan; Shamlaye, Conrad F; Gunzler, Douglas; Watson, Gene; van Wijngaarden, Edwin; Zareba, Grazyna; Klein, Jonathan D; Clarkson, Thomas W; Strain, J J; Myers, Gary J

2011-12-01

People worldwide depend upon daily fish consumption as a major source of protein and other nutrients. Fish are high in nutrients essential for normal brain development, but they also contain methylmercury (MeHg), a neurotoxicant. Our studies in a population consuming fish daily have indicated no consistent pattern of adverse associations between prenatal MeHg and children's development. For some endpoints we found performance improved with increasing prenatal exposure to MeHg. Follow up studies indicate this association is related to the beneficial nutrients present in fish. To determine if the absence of adverse outcomes and the presence of beneficial associations between prenatal MeHg and developmental outcomes previously reported persists into adolescence. This study was conducted on the Main Cohort of the Seychelles Child Development Study (SCDS). We examined the association between prenatal MeHg exposure and subjects' performance at 17 years of age on 27 endpoints. The test battery included the Wisconsin Card Sorting Test (WCST), the California Verbal Learning Test (CVLT), the Woodcock-Johnson (W-J-II) Achievement Test, subtests of the Cambridge Neuropsychological Test Automated Battery (CANTAB), and measures of problematic behaviors. Analyses for all endpoints were adjusted for postnatal MeHg, sex, socioeconomic status, maternal IQ, and child's age at testing and the child's IQ was added for problematic behavioral endpoints. Mean prenatal MeHg exposure was 6.9 ppm. There was no association between prenatal MeHg and 21 endpoints. Increasing prenatal MeHg was associated with better scores on four endpoints (higher W-J-II math calculation scores, reduced numbers of trials on the Intra-Extradimensional Shift Set of the CANTAB), fewer reports of substance use and incidents of and referrals for problematic behaviors in school. Increasing prenatal MeHg was adversely associated with one level of referrals to a school counselor. At age 17 years there was no consistent

Fish Consumption and Prenatal Methylmercury Exposure: Cognitive and Behavioral Outcomes in the Main Cohort at 17 Years from the Seychelles Child Development Study

PubMed Central

Davidson, Philip W.; Cory-Slechta, Deborah A.; Thurston, Sally W.; Huang, Li-Shan; Shamlaye, Conrad F.; Gunzler, Douglas; Watson, Gene; van Wijngaarden, Edwin; Zareba, Grazyna; Klein, Jonathan D.; Clarkson, Thomas W.; Strain, J.J.; Myers, Gary J.

2011-01-01

Introduction People worldwide depend upon daily fish consumption as a major source of protein and other nutrients. Fish are high in nutrients essential for normal brain development, but they also contain methylmercury (MeHg), a neurotoxicant. Our studies in a population consuming fish daily have indicated no consistent pattern of adverse associations between prenatal MeHg and children’s development. For some endpoints we found performance improved with increasing prenatal exposure to MeHg. Follow up studies indicate this association is related to the beneficial nutrients present in fish. Objectives To determine if the absence of adverse outcomes and the presence of beneficial associations between prenatal MeHg and developmental outcomes previously reported persists into adolescence. Methods This study was conducted on the Main Cohort of the Seychelles Child Development Study (SCDS). We examined the association between prenatal MeHg exposure and subjects’ performance at 17 years of age on 27 endpoints. The test battery included the Wisconsin Card Sorting Test (WCST), the California Verbal Learning Test (CVLT), the Woodcock-Johnson (W-J-II) Achievement Test, subtests of the Cambridge Neuropsychological Test Automated Battery (CANTAB), and measures of problematic behaviors. Analyses for all endpoints were adjusted for postnatal MeHg, sex, socioeconomic status, maternal IQ, and child’s age at testing and the child’s IQ was added for problematic behavioral endpoints. Results Mean prenatal MeHg exposure was 6.9 ppm. There was no association between prenatal MeHg and 21 endpoints. Increasing prenatal MeHg was associated with better scores on four endpoints (higher W-J-II math calculation scores, reduced numbers of trials on the Intra-Extradimensional Shift Set of the CANTAB, fewer reports of substance use and incidents of and referrals for problematic behaviors in school. Increasing prenatal MeHg was adversely associated with one level of referrals to a school

Does antioxidant properties of the main component of essential oil reflect its antioxidant properties? The comparison of antioxidant properties of essential oils and their main components.

PubMed

Dawidowicz, Andrzej L; Olszowy, Małgorzata

2014-01-01

This study discusses the similarities and differences between the antioxidant activities of some essential oils: thyme (Thymus vulgaris), basil (Ocimum basilicum), peppermint (Mentha piperita), clove (Caryophyllus aromaticus), summer savory (Satureja hortensis), sage (Salvia hispanica) and lemon (Citrus limon (L.) Burm.) and of their main components (thymol or estragole or menthol or eugenol or carvacrol or camphor or limonene) estimated by using 2,2'-Diphenyl-1-picrylhydrazyl, 2,2'-azinobis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt and β-carotene bleaching assays. The obtained data show that the antioxidant properties of essential oil do not always depend on the antioxidant activity of its main component, and that they can be modulated by their other components. The conclusions concerning the interaction of essential oil components depend on the type of method applied for assessing the antioxidant activity. When comparing the antioxidant properties of essential oils and their main components, the concepts of synergism, antagonism and additivity are very relevant.

International variation in the definition of 'main condition' in ICD-coded health data.

PubMed

Quan, H; Moskal, L; Forster, A J; Brien, S; Walker, R; Romano, P S; Sundararajan, V; Burnand, B; Henriksson, G; Steinum, O; Droesler, S; Pincus, H A; Ghali, W A

2014-10-01

Hospital-based medical records are abstracted to create International Classification of Disease (ICD) coded discharge health data in many countries. The 'main condition' is not defined in a consistent manner internationally. Some countries employ a 'reason for admission' rule as the basis for the main condition, while other countries employ a 'resource use' rule. A few countries have recently transitioned from one of these approaches to the other. The definition of 'main condition' in such ICD data matters when it is used to define a disease cohort to assign diagnosis-related groups and to perform risk adjustment. We propose a method of harmonizing the international definition to enable researchers and international organizations using ICD-coded health data to aggregate or compare hospital care and outcomes across countries in a consistent manner. Inter-observer reliability of alternative harmonization approaches should be evaluated before finalizing the definition and adopting it worldwide. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Clinical outcome and surgical strategies for late post-traumatic kyphosis after failed thoracolumbar fracture operation: Case report and literature review.

PubMed

Li, Suyun; Li, Zhi; Hua, Wenbin; Wang, Kun; Li, Shuai; Zhang, Yunkun; Ye, Zhewei; Shao, Zengwu; Wu, Xinghuo; Yang, Cao

2017-12-01

Thoracic-lumbar vertebral fracture is very common in clinic, and late post-traumatic kyphosis is the main cause closely related to the patients' life quality, which has evocated extensive concern for the surgical treatment of the disease. This study aimed to analyze the clinical outcomes and surgical strategies for late post-traumatic kyphosis after failed thoracolumbar fracture operation. All patients presented back pain with kyphotic apex vertebrae between T12 and L3. According to Frankel classification grading system, among them, 3 patients were classified as grade D, with the ability to live independently. A systematic review of 12 case series of post-traumatic kyphosis after failed thoracolumbar fracture operation was involved. Wedge osteotomy was performed as indicated-posterior closing osteotomy correction in 5 patients and anterior open-posterior close correction in 7 patients.Postoperatively, thoracolumbar x-rays were obtained to evaluate the correction of kyphotic deformity, visual analog scales (VAS) and Frankel grading system were used for access the clinical outcomes. All the patients were followed up, with the average period of 38.5 months (range 24-56 months). The Kyphotic Cobb angle was improved from preoperative (28.65 ± 11.41) to postoperative (1.14 ± 2.79), with the correction rate of 96.02%. There was 1 case of intraoperative dural tear, without complications such as death, neurological injury, and wound infection. According to Frankel grading system, no patient suffered deteriorated neurological symptoms after surgery, and 2 patients (2/3) experienced significant relief after surgery. The main VAS score of back pain was improved from preoperative (4.41 ± 1.08) to postoperative (1.5 ± 0.91) at final follow-up, with an improvement rate of 65.89%. Surgical treatment of late post-traumatic kyphosis after failed thoracolumbar fracture operation can obtain good radiologic and clinical outcomes by kyphosis correction, decompression

Maine's forests 2008

Treesearch

George L. McCaskill; William H. McWilliams; Charles J. Barnett; Brett J. Butler; Mark A. Hatfield; Cassandra M. Kurtz; Randall S. Morin; W. Keith Moser; Charles H. Perry; Christopher W. Woodall

2011-01-01

The second annual inventory of Maine's forests was completed in 2008 after more than 3,160 forested plots were measured. Forest land occupies almost 17.7 million acres, which represents 82 percent of the total land area of Maine. The dominant forest-type groups are maple/beech/yellow birch, spruce/fir, white/red/jack pine, and aspen/white birch. Statewide volume...

Generating Outcome Measurements: Achievement and Attitudes. A Guide to Educational Outcome Measurements and Their Uses. Seminar No. 3.

ERIC Educational Resources Information Center

Mushkin, Selma J.; Billings, Bradley B.

This guide is essentially designed as a teaching aid for those who would inform planners, officials of educational ministries, school administrators, principals, and teachers about educational outcome measurements. In outline and graphic form, the guide presents topics for discussion in a seminar dealing with how to obtain information on…

Small main-belt asteroid spectroscopic survey: Initial results

NASA Technical Reports Server (NTRS)

Xu, Shui; Binzel, Richard P.; Burbine, Thomas H.; Bus, Schelte J.

1995-01-01

The spectral characterization of small asteroids is important for understanding the evolution of their compositional and mineralogical properties. We report the results of a CCD spectroscopic survey of small main-belt asteroids which we call the Small Main-belt Asteroid Spectroscopic Survey (SMASS). Spectra of 316 asteroids were obtained, with wavelength coverage ranging from 4000 to 10000 A (0.4 to 1 micrometers). More than half of the objects in our survey have diameters less than 20 km. Survey results include the identification of the first object resembling ordinary chondrite meteorites among the main-belt asteroids (Binzel, R. P., et al, 1993) and observations of more than 20 asteroids showing basaltic achondrite spectral absorption features that strongly link Vesta as the parent body for the basaltic achondrite meteorites (Binzel, R. P., and S. Xu 1993). A potential Mars-crossing asteroid analog to ordinary chondrite meteorites (H chondrites), 2078 Nanking, is reported here. Through a principal component analysis, we have assigned classifications to the members of our sample. The majority of the small main-belt asteroids belong to S and C classes, similar to large asteroids. Our analysis shows that two new classes are justified which we label as J and O. Small asteroids display more diversity in spectral absorption features than the larger ones, which may indicate a greater variation of compositions in the small asteroid population. We found a few candidates for olivine-rich asteroids within the S class. Although the total number of olivine-rich candidates is relatively small, we present evidence suggesting that such objects are more prevalent at smaller sizes.

Causal illusions in children when the outcome is frequent

PubMed Central

2017-01-01

Causal illusions occur when people perceive a causal relation between two events that are actually unrelated. One factor that has been shown to promote these mistaken beliefs is the outcome probability. Thus, people tend to overestimate the strength of a causal relation when the potential consequence (i.e. the outcome) occurs with a high probability (outcome-density bias). Given that children and adults differ in several important features involved in causal judgment, including prior knowledge and basic cognitive skills, developmental studies can be considered an outstanding approach to detect and further explore the psychological processes and mechanisms underlying this bias. However, the outcome density bias has been mainly explored in adulthood, and no previous evidence for this bias has been reported in children. Thus, the purpose of this study was to extend outcome-density bias research to childhood. In two experiments, children between 6 and 8 years old were exposed to two similar setups, both showing a non-contingent relation between the potential cause and the outcome. These two scenarios differed only in the probability of the outcome, which could either be high or low. Children judged the relation between the two events to be stronger in the high probability of the outcome setting, revealing that, like adults, they develop causal illusions when the outcome is frequent. PMID:28898294

Psychological distress and in vitro fertilization outcome

PubMed Central

Pasch, Lauri A.; Gregorich, Steven E.; Katz, Patricia K.; Millstein, Susan G.; Nachtigall, Robert D.; Bleil, Maria E.; Adler, Nancy E.

2016-01-01

Objective To examine whether psychological distress predicts IVF treatment outcome as well as whether IVF treatment outcome predicts subsequent psychological distress. Design Prospective cohort study over an 18-month period. Setting Five community and academic fertility practices. Patients Two hundred and two women who initiated their first IVF cycle. Interventions Women completed interviews and questionnaires at baseline and at 4, 10, and 18 months follow-up. Main Outcome Measures IVF cycle outcome and psychological distress. Results Using a binary logistic model including covariates (woman’s age, ethnicity, income, education, parity, duration of infertility, and time interval), pre-treatment depression and anxiety were not significant predictors of the outcome of the first IVF cycle. Using linear regression models including covariates (woman’s age, income, education, parity, duration of infertility, assessment point, time since last treatment cycle, and pre-IVF depression or anxiety), experiencing failed IVF was associated with higher post-IVF depression and anxiety. Conclusions IVF failure predicts subsequent psychological distress, but pre-IVF psychological distress does not predict IVF failure. Instead of focusing efforts on psychological interventions specifically aimed at improving the chance of pregnancy, these findings suggest that attention be paid to helping patients prepare for and cope with treatment and treatment failure. PMID:22698636

Maine Forests 2013

Treesearch

George L. McCaskill; Thomas Albright; Charles J. Barnett; Brett J. Butler; Susan J. Crocker; Cassandra M. Kurtz; William H. McWilliams; Patrick D. Miles; Randall S. Morin; Mark D. Nelson; Richard H. Widmann; Christopher W. Woodall

2016-01-01

The third 5-year annualized inventory of Maine's forests was completed in 2013 after more than 3170 forested plots were measured. Maine contains more than 17.6 million acres of forest land, an area that has been quite stable since 1960, covering more than 82 percent of the total land area. The number of live trees greater than 1 inch in diameter are approaching 24...

Laboratory Diagnosis of Invasive Aspergillosis: From Diagnosis to Prediction of Outcome

PubMed Central

Barton, Richard C.

2013-01-01

Invasive aspergillosis (IA), an infection caused by fungi in the genus Aspergillus, is seen in patients with immunological deficits, particularly acute leukaemia and stem cell transplantation, and has been associated with high rates of mortality in previous years. Diagnosing IA has long been problematic owing to the inability to culture the main causal agent A. fumigatus from blood. Microscopic examination and culture of respiratory tract specimens have lacked sensitivity, and biopsy tissue for histopathological examination is rarely obtainable. Thus, for many years there has been a great interest in nonculture-based techniques such as the detection of galactomannan, β-D-glucan, and DNA by PCR-based methods. Recent meta-analyses suggest that these approaches have broadly similar performance parameters in terms of sensitivity and specificity to diagnose IA. Improvements have been made in our understanding of the limitations of antigen assays and the standardisation of PCR-based DNA detection. Thus, in more recent years, the debate has focussed on how these assays can be incorporated into diagnostic strategies to maximise improvements in outcome whilst limiting unnecessary use of antifungal therapy. Furthermore, there is a current interest in applying these tests to monitor the effectiveness of therapy after diagnosis and predict clinical outcomes. The search for improved markers for the early and sensitive diagnosis of IA continues to be a challenge. PMID:24278780

The Influence of Sitting Time and Physical Activity on Health Outcomes in Public Housing Residents

PubMed Central

Leach, Heather J.; Mama, Scherezade K.; Soltero, Erica G.; Lee, Rebecca E.

2015-01-01

Objectives Examine differences between levels of physical activity and sitting time for residents of public housing developments located in high vs low income neighborhoods, and whether physical activity or sitting time had a greater influence on health outcomes. Design Secondary data analysis from the Healthful Options Using Streets and Transportation in Our Neighborhoods (HOUSTON) project. Setting Public housing developments located in Houston, TX. Participants African American, adult males and females. Main Outcome Measures Self-reported PA and time spent sitting on weekdays were measured using the International Physical Activity Questionnaire (IPAQ) short form. Participants completed measures of BMI (kg/m2), % body fat (%BF) and resting blood pressure to assess health outcomes. Neighborhood income was defined as the median household income at the census block group level, obtained from the 2006–2010 American Community Survey. Results All participants (N=216) had an annual household income of ≤$19,350, and neighborhood income ranged from $9,226 to $57,618. Participants reported an average of 4342.2 ± 4828.3 MET-min/wk of physical activity, and 4.5 ± 3.2 hours of sitting per weekday. Time spent sitting was associated with BMI (β=.50, t=2.4, P=.018), %BF (β=.87, t=3.6, P=.000), and diastolic blood pressure (β=.62, t=2.1, P=.041). Physical activity was not significantly associated with any health outcomes. Conclusion Our findings indicate that public housing residents’ health statuses are vulnerable to sedentary behaviors regardless of the affluence of the neighborhood surrounding the housing development. PMID:25065081

Predicting Child Outcomes from Preschool Quality in Portugal

ERIC Educational Resources Information Center

Abreu-Lima, Isabel M. P.; Leal, Teresa B.; Cadima, Joana; Gamelas, Ana Madalena

2013-01-01

The main purpose of this study is to analyze whether quality of preschool classrooms relates to 4- and 5-year-old children developmental outcomes. The study was conducted in 60 classrooms in Porto Metropolitan Area, Portugal. Children (N = 215) were evaluated in the literacy, math, and behavior domains. Preschool quality was assessed through…

Measurement of CPAS Main Parachute Rate of Descent

NASA Technical Reports Server (NTRS)

Ray, Eric S.

2011-01-01

The Crew Exploration Vehicle Parachute Assembly System (CPAS) is being designed to land the Orion Crew Module (CM) at a safe rate of descent at splashdown. Flight test performance must be measured to a high degree of accuracy to ensure this requirement is met with the most efficient design possible. Although the design includes three CPAS Main parachutes, the requirement is that the system must not exceed 33 ft/s under two Main parachutes, should one of the Main parachutes fail. Therefore, several tests were conducted with clusters of two Mains. All of the steady-state rate of descent data are normalized to standard sea level conditions and checked against the limit. As the Orion design gains weight, the system is approaching this limit to within measurement precision. Parachute "breathing," cluster interactions, and atmospheric anomalies can cause the rate of descent to vary widely and lead to challenges in characterizing parachute terminal performance. An early test had contradictory rate of descent results from optical trajectory and Differential Global Positioning Systems (DGPS). A thorough analysis of the data sources and error propagation was conducted to determine the uncertainty in the trajectory. It was discovered that the Time Space Position Information (TSPI) from the optical tracking provided accurate position data. However, the velocity from TPSI must be computed via numerical differentiation, which is prone to large error. DGPS obtains position through pseudo-range calculations from multiple satellites and velocity through Doppler shift of the carrier frequency. Because the velocity from DGPS is a direct measurement, it is more accurate than TSPI velocity. To remedy the situation, a commercial off-the-shelf product that combines GPS and an Inertial Measurement Unit (IMU) was purchased to significantly improve rate of descent measurements. This had the added benefit of solving GPS dropouts during aircraft extraction. Statistical probability

Ethical leadership outcomes in nursing.

PubMed

Barkhordari-Sharifabad, Maasoumeh; Ashktorab, Tahereh; Atashzadeh-Shoorideh, Foroozan

2017-01-01

Leadership style adopted by nursing managers is a key element in progress and development of nursing and quality of healthcare services received by the patients. In this regard, the role of ethical leadership is of utmost importance. The objective of the study was to elaborate on the ethical leadership and its role in professional progress and growth of nurses in the light of work condition in health providing institutes. The study was carried out as a qualitative study following conventional content analysis method. In total, 14 nursing faculty members and nursing managers at different levels were selected through purposive sampling method. Semi-structured interviews were used for data gathering. The data were analyzed using latent content analysis and constant comparison analysis. Ethical considerations: This study was conducted in accordance with ethical issues in research with human participants and national rules and regulations related to informed consent and confidentiality. The study was approved by the Committee of Ethics in Research at the Shahid Beheshti University of Medical Sciences in Tehran, Iran, under the code: sbmu.rec.1393.695 on 15 February 2015. Five subcategories were obtained based on the analysis, which constituted two main categories including "all-inclusive satisfaction" and "productivity." Nursing leaders highlighted the point that their ethical behavior creates "inner satisfaction of the leader," "employees' job satisfaction," and "patients' satisfaction." Improvement of productivity was another outcome of ethical behavior of the leaders. This kind of behavior resulted in "providing better services" and "inspiring ethical behavior in the employees." It has great influence on progress and growth of the nursing profession. By creating an ethical climate, ethical leadership leads to positive and effective outcomes-for the patients as well as for the nurses and the leaders-and professional progress and development of the nursing profession

Measuring voice outcomes: state of the science review.

PubMed

Carding, Pau N; Wilson, J A; MacKenzie, K; Deary, I J

2009-08-01

Researchers evaluating voice disorder interventions currently have a plethora of voice outcome measurement tools from which to choose. Faced with such a wide choice, it would be beneficial to establish a clear rationale to guide selection. This article reviews the published literature on the three main areas of voice outcome assessment: (1) perceptual rating of voice quality, (2) acoustic measurement of the speech signal and (3) patient self-reporting of voice problems. We analysed the published reliability, validity, sensitivity to change and utility of the common outcome measurement tools in each area. From the data, we suggest that routine voice outcome measurement should include (1) an expert rating of voice quality (using the Grade-Roughness-Breathiness-Asthenia-Strain rating scale) and (2) a short self-reporting tool (either the Vocal Performance Questionnaire or the Vocal Handicap Index 10). These measures have high validity, the best reported reliability to date, good sensitivity to change data and excellent utility ratings. However, their application and administration require attention to detail. Acoustic measurement has arguable validity and poor reliability data at the present time. Other areas of voice outcome measurement (e.g. stroboscopy and aerodynamic phonatory measurements) require similarly detailed research and analysis.

Association between funding, risk of bias, and outcome of randomised controlled trials in oral and maxillofacial surgery.

PubMed

Oomens, M A E M; Lazzari, S; Heymans, M W; Forouzanfar, T

2016-01-01

The influence of funding on the main outcome of a random control trial (RCT) is important, as it could potentially lead to bias towards industry, and results that are too optimistic. We investigated the association between funding, the published outcome, and the risk of bias in trials in oral and maxillofacial surgery (OMFS) published from January 2000 to May 2013 listed in PubMed. The methods used were scored using the risk of bias items given in a Delphi List. Sources of funding were recorded and categorised five ways: not funded, funded by industry, not funded by industry, supported by industry, and source of funds not clear. A total of 390 RCT met the inclusion criteria, and there was a correlation between funding and favourable main outcomes, although this was not significant. There was no correlation between the risk of bias and favourable results of the main outcome of a trial, or between the risk of bias and the reported source of funding in post-hoc analysis. We were unable to show a significant correlation between funding and a higher likelihood of a favourable result for the primary outcome in RCT in OMFS. We also failed to show a significant correlation between the risk of bias of a trial and its main outcome. In contrast, the source of funding proved to affect the risk of bias of a trial significantly, although not in post-hoc analysis. Funded trials were better organised, and so had a lower risk of bias. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

The real radical generator other than main-product hydroperoxide in lipid autoxidation.

PubMed

Morita, Makio; Tokita, Masako

2006-01-01

The theory of initiation in lipid autoxidation, which deals with the supply of radicals to the chain reaction, has not been substantively advanced for several decades. Most researchers have long assumed a mechanism of initiation in which main-product hydroperoxide is centrally responsible for autocatalytic radical generation. However, this paper, in which we investigate autoxidizing methyl linoleate, presents decisive evidence against such an assumption: Autoxidation-accelerating activity under mild conditions was not found in the chromatographically separated main-product hydroperoxide fraction but was found in other fractions; and highly active substances with structures containing a peroxide-linked dimer with two hydroperoxy groups were actually obtained.

Space Transportation Main Engine

NASA Technical Reports Server (NTRS)

Monk, Jan C.

1992-01-01

The topics are presented in viewgraph form and include the following: Space Transportation Main Engine (STME) definition, design philosophy, robust design, maximum design condition, casting vs. machined and welded forgings, operability considerations, high reliability design philosophy, engine reliability enhancement, low cost design philosophy, engine systems requirements, STME schematic, fuel turbopump, liquid oxygen turbopump, main injector, and gas generator. The major engine components of the STME and the Space Shuttle Main Engine are compared.

The forests of Maine: 2003

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William H. McWilliams; Brett J. Butler; Laurence E. Caldwell; Douglas M. Griffith; Michael L. Hoppus; Kenneth M. Laustsen; Andrew J. Lister; Tonya W. Lister; Jacob W. Metzler; Randall S. Morin; Steven A. Sader; Lucretia B. Stewart; James R. Steinman; James, A. Westfall; David A. Williams; Andrew Whitman; Christopher W. Woodall; Christopher W. Woodall

2005-01-01

In 1999, the Maine Forest Service and USDA Forest Service's Forest Inventory and Analysis program implemented a new system for inventorying and monitoring Maine's forests. The effects of the spruce budworm epidemic continue to affect the composition, structure, and distribution of Maine's forested ecosystems. The area of forest land in Maine has remained...

Role of subdural electrocorticography in prediction of long-term seizure outcome in epilepsy surgery

PubMed Central

Juhász, Csaba; Shah, Aashit; Sood, Sandeep; Chugani, Harry T.

2009-01-01

Since prediction of long-term seizure outcome using preoperative diagnostic modalities remains suboptimal in epilepsy surgery, we evaluated whether interictal spike frequency measures obtained from extraoperative subdural electrocorticography (ECoG) recording could predict long-term seizure outcome. This study included 61 young patients (age 0.4–23.0 years), who underwent extraoperative ECoG recording prior to cortical resection for alleviation of uncontrolled focal seizures. Patient age, frequency of preoperative seizures, neuroimaging findings, ictal and interictal ECoG measures were preoperatively obtained. The seizure outcome was prospectively measured [follow-up period: 2.5–6.4 years (mean 4.6 years)]. Univariate and multivariate logistic regression analyses determined how well preoperative demographic and diagnostic measures predicted long-term seizure outcome. Following the initial cortical resection, Engel Class I, II, III and IV outcomes were noted in 35, 6, 12 and 7 patients, respectively. One child died due to disseminated intravascular coagulation associated with pseudomonas sepsis 2 days after surgery. Univariate regression analyses revealed that incomplete removal of seizure onset zone, higher interictal spike-frequency in the preserved cortex and incomplete removal of cortical abnormalities on neuroimaging were associated with a greater risk of failing to obtain Class I outcome. Multivariate logistic regression analysis revealed that incomplete removal of seizure onset zone was the only independent predictor of failure to obtain Class I outcome. The goodness of regression model fit and the predictive ability of regression model were greatest in the full regression model incorporating both ictal and interictal measures [R2 0.44; Area under the receiver operating characteristic (ROC) curve: 0.81], slightly smaller in the reduced model incorporating ictal but not interictal measures (R2 0.40; Area under the ROC curve: 0.79) and slightly smaller

Protocol for the development of a core domain set for hidradenitis suppurativa trial outcomes.

PubMed

Thorlacius, Linnea; Ingram, John R; Garg, Amit; Villumsen, Bente; Esmann, Solveig; Kirby, Joslyn S; Gottlieb, Alice B; Merola, Joseph F; Dellavalle, Robert; Christensen, Robin; Jemec, Gregor B E

2017-02-20

Randomised controlled trials (RCTs) should have well-defined primary and secondary outcomes to answer questions generated by the main hypotheses. However, for the chronic, inflammatory skin disease hidradenitis suppurativa (HS), the reported outcome measures are numerous and diverse. A recent systematic review found a total of 30 outcome measure instruments in 12 RCTs. This use of a broad range of outcome measures can increase difficulties in interpretation and comparison of results and may potentially obstruct appropriate evidence synthesis by causing reporting bias. One strategy for dealing with these problems is to develop a core outcome set (COS). A COS is a list of outcomes that are meant as mandatory and should be measured and reported in all clinical trials. The aim of this study is to develop a COS for the management of HS. An international steering group of researchers, clinicians and a patient research partner will guide the COS development. 6 stakeholder groups are involved: patients, dermatologists, surgeons, nurses, industry representatives and drug regulatory authorities. A 1:1 ratio of patients:healthcare professionals is aimed for. The initial list of candidate items will be obtained by combining three data sets: (1) a systematic review of the literature, (2) US and Danish qualitative interview studies involving patients with HS and (3) an online healthcare professional (HCP) item generation survey. To reach consensus on the COS, 4 anonymous online Delphi rounds are then planned together with 2 face-to-face consensus meetings (1 in Europe and 1 in the USA) to ensure global representation. The study will be performed according to the Helsinki declaration. All results from the study, including inconclusive or negative results, will be published in peer-reviewed indexed journals. The study will involve different stakeholder groups to ensure that the developed COS will be suitable and well accepted. Published by the BMJ Publishing Group Limited. For

Student Outcomes: Investigating Competency-Based Curriculum in Adult Basic Education. Research Report No. 5.

ERIC Educational Resources Information Center

Hazell, Pat

The outcomes attained by Australian adults enrolled in competency-based Certificate in Adult Foundation Education (CAFE) courses were examined. Special attention was paid to the outcomes achieved by students in the two lowest of the CAFE program's four levels. The main data sources were as follows: literature review; enrollment data from the…

Adherence to antibiotic treatment guidelines and outcomes in the hospitalized elderly with different types of pneumonia.

PubMed

Rossio, Raffaella; Franchi, Carlotta; Ardoino, Ilaria; Djade, Codjo D; Tettamanti, Mauro; Pasina, Luca; Salerno, Francesco; Marengoni, Alessandra; Corrao, Salvatore; Marcucci, Maura; Peyvandi, Flora; Biganzoli, Elia M; Nobili, Alessandro; Mannucci, Pier Mannuccio

2015-06-01

Few studies evaluated the clinical outcomes of Community Acquired Pneumonia (CAP), Hospital-Acquired Pneumonia (HAP) and Health Care-Associated Pneumonia (HCAP) in relation to the adherence of antibiotic treatment to the guidelines of the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) in hospitalized elderly people (65 years or older). Data were obtained from REPOSI, a prospective registry held in 87 Italian internal medicine and geriatric wards. Patients with a diagnosis of pneumonia (ICD-9 480-487) or prescribed with an antibiotic for pneumonia as indication were selected. The empirical antibiotic regimen was defined to be adherent to guidelines if concordant with the treatment regimens recommended by IDSA/ATS for CAP, HAP, and HCAP. Outcomes were assessed by logistic regression models. A diagnosis of pneumonia was made in 317 patients. Only 38.8% of them received an empirical antibiotic regimen that was adherent to guidelines. However, no significant association was found between adherence to guidelines and outcomes. Having HAP, older age, and higher CIRS severity index were the main factors associated with in-hospital mortality. The adherence to antibiotic treatment guidelines was poor, particularly for HAP and HCAP, suggesting the need for more adherence to the optimal management of antibiotics in the elderly with pneumonia. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Main-belt Asteroids in the K2 Uranus Field

NASA Astrophysics Data System (ADS)

Molnár, L.; Pál, A.; Sárneczky, K.; Szabó, R.; Vinkó, J.; Szabó, Gy. M.; Kiss, Cs.; Hanyecz, O.; Marton, G.; Kiss, L. L.

2018-02-01

We present the K2 light curves of a large sample of untargeted main-belt asteroids (MBAs) detected with the Kepler Space Telescope. The asteroids were observed within the Uranus superstamp, a relatively large, continuous field with a low stellar background designed to cover the planet Uranus and its moons during Campaign 8 of the K2 mission. The superstamp offered the possibility of obtaining precise, uninterrupted light curves of a large number of MBAs and thus determining unambiguous rotation rates for them. We obtained photometry for 608 MBAs, and were able to determine or estimate rotation rates for 90 targets, of which 86 had no known values before. In an additional 16 targets we detected incomplete cycles and/or eclipse-like events. We found the median rotation rate to be significantly longer than that of the ground-based observations, indicating that the latter are biased toward shorter rotation rates. Our study highlights the need and benefits of further continuous photometry of asteroids.

The main factor affecting the competitiveness of Contractor Company

NASA Astrophysics Data System (ADS)

Nurisra; Malahayati, Nurul; Mahmuddin

2018-05-01

Contractor companies must have the competitive advantage to compete in maintaining the survival of the company. Problems arise because quite a lot of advantages can be used and these advantages must be used appropriately to produce competitiveness for the company to continue to compete and to win the competition. This study aims to determine the main factors affecting the competitiveness of medium-class contractors in Banda Aceh. Data collection was obtained through questionnaires distributed to 31 middle-class contractors in Banda Aceh. Data processing and analysis is done by using descriptive analysis. Based on the result of descriptive analysis, it can be concluded that the most important competitiveness factor with a mean score value 4.52 is the relationship, and the factor that has the highest mean score value is the relationship with the government of 4.97, while the result of the ranking analysis is obtained 25 factor that is critical to the competitiveness of medium-class contractors in Banda Aceh.

33 CFR 334.30 - Gulf of Maine off Pemaquid Point, Maine; naval sonobuoy test area.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., Maine; naval sonobuoy test area. 334.30 Section 334.30 Navigation and Navigable Waters CORPS OF....30 Gulf of Maine off Pemaquid Point, Maine; naval sonobuoy test area. (a) The area. The test area or... enforced by the Commanding Officer, U.S. Naval Air Station, Brunswick, Maine, or such agencies as he may...

33 CFR 334.30 - Gulf of Maine off Pemaquid Point, Maine; naval sonobuoy test area.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., Maine; naval sonobuoy test area. 334.30 Section 334.30 Navigation and Navigable Waters CORPS OF....30 Gulf of Maine off Pemaquid Point, Maine; naval sonobuoy test area. (a) The area. The test area or... enforced by the Commanding Officer, U.S. Naval Air Station, Brunswick, Maine, or such agencies as he may...

33 CFR 334.30 - Gulf of Maine off Pemaquid Point, Maine; naval sonobuoy test area.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., Maine; naval sonobuoy test area. 334.30 Section 334.30 Navigation and Navigable Waters CORPS OF....30 Gulf of Maine off Pemaquid Point, Maine; naval sonobuoy test area. (a) The area. The test area or... enforced by the Commanding Officer, U.S. Naval Air Station, Brunswick, Maine, or such agencies as he may...

33 CFR 334.30 - Gulf of Maine off Pemaquid Point, Maine; naval sonobuoy test area.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., Maine; naval sonobuoy test area. 334.30 Section 334.30 Navigation and Navigable Waters CORPS OF....30 Gulf of Maine off Pemaquid Point, Maine; naval sonobuoy test area. (a) The area. The test area or... enforced by the Commanding Officer, U.S. Naval Air Station, Brunswick, Maine, or such agencies as he may...

33 CFR 334.30 - Gulf of Maine off Pemaquid Point, Maine; naval sonobuoy test area.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., Maine; naval sonobuoy test area. 334.30 Section 334.30 Navigation and Navigable Waters CORPS OF....30 Gulf of Maine off Pemaquid Point, Maine; naval sonobuoy test area. (a) The area. The test area or... enforced by the Commanding Officer, U.S. Naval Air Station, Brunswick, Maine, or such agencies as he may...

Role of serum immunoglobulins for predicting sarcoidosis outcome: A cohort study.

PubMed

Belhomme, Nicolas; Jouneau, Stéphane; Bouzillé, Guillaume; Decaux, Olivier; Lederlin, Mathieu; Guillot, Stéphanie; Perlat, Antoinette; Jégo, Patrick

2018-01-01

Sarcoidosis is a systemic granulomatous disease which carries variable outcomes. Serum protein electrophoresis is an easily accessible and routinely performed examination at diagnosis, in order to search for hypergammaglobulinemia, which is frequently found, and to rule out other granulomatous diseases such as common variable immunodeficiency. We aimed to assess the impact of baseline immunoglobulin level on the outcome of sarcoidosis. We conducted a retrospective cohort-study, at Rennes University Hospital, in which all newly diagnosed patients for whom a serum protein electrophoresis had been performed at baseline were enrolled, from 2006 to 2014. The main outcome was the need for corticosteroid treatment within 2 years from diagnosis, the secondary outcome was the occurrence of relapse among treated patients. Eighty patients were included in the study, and 41.25% of them exhibited an elevated globulins rate. In univariate analysis, an elevated ACE level >70 U/l, Afro-Caribbean origin, and extra-pulmonary involvement, were associated with the need for corticosteroid treatment. In multivariate analysis, only ACE elevation (OR = 1.03, IC95% 1.01-1.05, p = 0.009) and extra-pulmonary involvement (OR = 5.8, IC95% 1.4-24, p = 0.015) were significant. Immunoglobulin level was not associated with the main outcome. Regarding the secondary outcome, none of the studied features were predictive of relapse among the 34 treated patients followed for two years. There was no relation between the immunoglobulin level at diagnosis and the evolution of sarcoidosis. An elevated ACE level and the presence of initial extra-pulmonary involvement were both associated with a more severe course of the disease necessitating a corticosteroid treatment.

Nucleus Characterization of Main-Belt Comet P/Garradd

NASA Astrophysics Data System (ADS)

Hsieh, Henry H.; Kaluna, Heather; Meech, Karen J.

2012-02-01

We seek SOAR time to physically characterize the nucleus of main- belt comet (MBC) P/2008 R1 (Garradd). Our primary objectives include determination of P/Garradd's rotation period, shape, and colors. MBCs are mysterious objects that exhibit cometary activity yet are dynamically indistinguishable from main-belt asteroids. Studying these apparently icy objects so close to the Sun is important for understanding the distribution of volatile material in our solar system as well as the origin of Earth's water. Five MBCs are currently known: only two have well-characterized nuclei, while the others have only been partially characterized. With so little known about this population, it is crucial to obtain the best possible physical characterizations for as many of the few currently known MBCs as possible. This information will aid us in developing a global understanding of the population's characteristics, such as the level of diversity as well as any commonalities. This will then help answer larger scientific questions such as how abundant MBCs may be and what they can tell us about the past and present distribution of ice in the inner solar system.

Automated Quantitative Spectral Classification of Stars in Areas of the main Meridional Section of the Galaxy

NASA Astrophysics Data System (ADS)

Shvelidze, T. D.; Malyuto, V. D.

Quantitative spectral classification of F, G and K stars with the 70-cm telescope of the Ambastumani Astrophysical Observatory in areas of the main meridional section of the Galaxy, and for which proper motion data are available, has been performed. Fundamental parameters have been obtained for 333 stars in four areas. Space densities of stars of different spectral types, the stellar luminosity function and the relationships between the kinematics and metallicity of stars have been studied. The results have confirmed and completed the conclusions made on the basis of some previous spectroscopic and photometric surveys. Many plates have been obtained for other important directions in the sky: the Kapteyn areas, the Galactic anticentre and the main meridional section of the Galaxy. The data can be treated with the same quantitative method applied here. This method may also be applied to other available and future spectroscopic data of similar resolution, notably that obtained with large format CCD detectors on Schmidt-type telescopes.

Intermediate outcomes in randomized clinical trials: an introduction

PubMed Central

2013-01-01

Background Intermediate outcomes are common and typically on the causal pathway to the final outcome. Some examples include noncompliance, missing data, and truncation by death like pregnancy (e.g. when the trial intervention is given to non-pregnant women and the final outcome is preeclampsia, defined only on pregnant women). The intention-to-treat approach does not account properly for them, and more appropriate alternative approaches like principal stratification are not yet widely known. The purposes of this study are to inform researchers that the intention-to-treat approach unfortunately does not fit all problems we face in experimental research, to introduce the principal stratification approach for dealing with intermediate outcomes, and to illustrate its application to a trial of long term calcium supplementation in women at high risk of preeclampsia. Methods Principal stratification and related concepts are introduced. Two ways for estimating causal effects are discussed and their application is illustrated using the calcium trial, where noncompliance and pregnancy are considered as intermediate outcomes, and preeclampsia is the main final outcome. Results The limitations of traditional approaches and methods for dealing with intermediate outcomes are demonstrated. The steps, assumptions and required calculations involved in the application of the principal stratification approach are discussed in detail in the case of our calcium trial. Conclusions The intention-to-treat approach is a very sound one but unfortunately it does not fit all problems we find in randomized clinical trials; this is particularly the case for intermediate outcomes, where alternative approaches like principal stratification should be considered. PMID:23510143

Preparation of a Ammonia-Treated Lac Dye and Structure Elucidation of Its Main Component.

PubMed

Nishizaki, Yuzo; Ishizuki, Kyoko; Akiyama, Hiroshi; Tada, Atsuko; Sugimoto, Naoki; Sato, Kyoko

2016-01-01

Lac dye and cochineal extract contain laccaic acids and carminic acid as the main pigments, respectively. Both laccaic acids and carminic acid are anthraquinone derivatives. 4-Aminocarminic acid (acid-stable carmine), an illegal colorant, has been detected in several processed foods. 4-Aminocarminic acid is obtained by heating cochineal extract (carminic acid) in ammonia solution. We attempted to prepare ammonia-treated lac dye and to identify the structures of the main pigment components. Ammonia-treated lac dye showed acid stability similar to that of 4-aminocarminic acid. The structures of the main pigments in ammonia-treated lac dye were analyzed using LC/MS. One of the main pigments was isolated and identified as 4-aminolaccaic acid C using various NMR techniques, including 2D-INADEQUATE. These results indicated that ammonia-treatment of lac dye results in the generation of 4-aminolaccaic acids.

Alternative large-scale conservation visions for northern Maine: interviews with decision leaders in Maine

Treesearch

Elizabeth Dennis Baldwin; Laura S. Kenefic; Will F. LaPage

2007-01-01

Based on confidential interviews with 21 decision leaders in Maine, Elizabeth Baldwin, Laura Kenefic, and Will LaPage examine the complexity of the conflicts over alternate visions for large-scale conservation in Maine. Exploring models that may be useful for policymakers grappling with competing values for Maine's forests, they present four alternatives: national...

[Difference between perinatal mortality in multiple pregnancies obtained spontaneously versus assisted reproduction].

PubMed

del Rayo Rivas-Ortiz, Yazmín; Hernández-Herrera, Ricardo Jorge

2010-06-01

Recently assisted reproduction techniques are more common, which increases multiple pregnancies and adverse perinatal outcomes. Some authors report increased mortality in multiple pregnancies products obtained by techniques of assisted reproduction vs. conceived spontaneously, although other authors found no significant difference. To evaluate mortality rate of multiple pregnancies comparing those obtained by assisted reproduction vs. spontaneous conception. Retrospective, observational and comparative study. We included pregnant women with 3 or more products that went to the Unidad Médica de Alta Especialidad No. 23, IMSS, in Monterrey, NL (Mexico), between 2002-2008. We compared the number of complicated pregnancies and dead products obtained by a technique of assisted reproduction vs. spontaneous. 68 multiple pregnancies were included. On average, spontaneously conceived fetuses had more weeks of gestation and more birth weight than those achieved by assisted reproduction techniques (p = ns). 20.5% (14/68) of multiple pregnancies had one or more fatal events: 10/40 (25%) by assisted reproduction techniques vs. 4/28 (14%) of spontaneous multiple pregnancies (p = 0.22). 21/134 (16%) of the products conceived by assisted reproduction techniques and 6/88 (7%) of spontaneous (p < 0.03) died. 60% of all multiple pregnancies were obtained by a technique of assisted reproduction and 21% of the cases had one or more fatal events (11% more in pregnancies achieved by assisted reproduction techniques). 12% of the products of multiple pregnancies died (9% more in those obtained by a technique of assisted reproduction).

Effects of aerodynamic interaction between main and tail rotors on helicopter hover performance and noise

NASA Technical Reports Server (NTRS)

Menger, R. P.; Wood, T. L.; Brieger, J. T.

1983-01-01

A model test was conducted to determine the effects of aerodynamic interaction between main rotor, tail rotor, and vertical fin on helicopter performance and noise in hover out of ground effect. The experimental data were obtained from hover tests performed with a .151 scale Model 222 main rotor, tail rotor and vertical fin. Of primary interest was the effect of location of the tail rotor with respect to the main rotor. Penalties on main rotor power due to interaction with the tail rotor ranged up to 3% depending upon tail rotor location and orientation. Penalties on tail rotor power due to fin blockage alone ranged up to 10% for pusher tail rotors and up to 50% for tractor tail rotors. The main rotor wake had only a second order effect on these tail rotor/fin interactions. Design charts are presented showing the penalties on main rotor power as a function of the relative location of the tail rotor.

Main types of optical beams giving predominant contributions to the light backscatter for the irregular hexagonal columns

NASA Astrophysics Data System (ADS)

Shishko, Victor A.; Konoshonkin, Alexander V.; Kustova, Natalia V.; Borovoi, Anatoli G.

2017-11-01

This work presents the estimation of contribution of the main types of optical beams to the light backscatter for randomly oriented hexagonal ice column, the right dihedral angle of which was distorted within the range of 0° (regular particle) to 10°. Calculations were obtained within the physical optics approximation. The wavelength was 532 nm and the refractive index was 1.3116. The results showed that the total contribution of the main types of optical beams to the total backscattering cross section reach the value of 85% at small distortion angle of the hexagonal column and at substantial distortion angle the total contribution of the main types of optical beams decrease up to 55% of the total backscattering cross section. The obtained conclusions can significantly reduce the calculation time in the case when there is no need for high accuracy of the calculation.

A comparison of pregnancy outcomes in Ghanaian women with varying dietary diversity: a prospective cohort study protocol

PubMed Central

Saaka, Mahama; Siassi, Fereydoun; Qorbani, Mostafa; Yavari, Parvaneh; Danquah, Ina; Sotoudeh, Gity

2016-01-01

Introduction Poor dietary intake during pregnancy can have negative repercussions on the mother and fetus. This study therefore aims to explore the dietary diversity (DD) of pregnant women and its associations with pregnancy outcomes among women in Northern Ghana. The main outcome variables to be measured are gestational weight gain and birth weight. Methods and analysis A prospective cohort study design will be used and 600 pregnant women in their first trimester will be systematically recruited at health facilities and followed until delivery. In three follow-up visits after recruitment, information on sociodemographic and general characteristics, physical activity (International Physical Activity Questionnaire (IPAQ) short form, dietary intake (24-hour food recall), anthropometry and pregnancy outcomes will be collected. DD will be measured three times using the minimum DD-women (MDD-W) indicator and the mean of the three values overall will be used to determine low (<5 food groups) and high (≥5 food groups) DD. Data will be analysed using SPSS. Comparisons between groups (categorical data) will be made using the χ2 test for proportions, and t-tests and ANOVA will be performed on continuous variables. Regression analysis will be used to identify independent outcome predictors while controlling for possible confounding factors. The results may help to identify differences in DD between healthy and unhealthy pregnancy outcomes. Ethics and dissemination The study protocol has been approved by the ethics committee of Tehran University of Medical Sciences and the ethical review committee of the Tamale Teaching Hospital. Written informed consent will be obtained from all subjects. The results will be published in due course. PMID:27655259

Multimodal predictor of neurodevelopmental outcome in newborns with hypoxic-ischaemic encephalopathy.

PubMed

Temko, Andriy; Doyle, Orla; Murray, Deirdre; Lightbody, Gordon; Boylan, Geraldine; Marnane, William

2015-08-01

Automated multimodal prediction of outcome in newborns with hypoxic-ischaemic encephalopathy is investigated in this work. Routine clinical measures and 1h EEG and ECG recordings 24h after birth were obtained from 38 newborns with different grades of HIE. Each newborn was reassessed at 24 months to establish their neurodevelopmental outcome. A set of multimodal features is extracted from the clinical, heart rate and EEG measures and is fed into a support vector machine classifier. The performance is reported with the statistically most unbiased leave-one-patient-out performance assessment routine. A subset of informative features, whose rankings are consistent across all patients, is identified. The best performance is obtained using a subset of 9 EEG, 2h and 1 clinical feature, leading to an area under the ROC curve of 87% and accuracy of 84% which compares favourably to the EEG-based clinical outcome prediction, previously reported on the same data. The work presents a promising step towards the use of multimodal data in building an objective decision support tool for clinical prediction of neurodevelopmental outcome in newborns with hypoxic-ischaemic encephalopathy. Copyright © 2015 Elsevier Ltd. All rights reserved.

Funding source and primary outcome changes in clinical trials registered on ClinicalTrials.gov are associated with the reporting of a statistically significant primary outcome: a cross-sectional study.

PubMed

Ramagopalan, Sreeram V; Skingsley, Andrew P; Handunnetthi, Lahiru; Magnus, Daniel; Klingel, Michelle; Pakpoor, Julia; Goldacre, Ben

2015-01-01

We and others have shown a significant proportion of interventional trials registered on ClinicalTrials.gov have their primary outcomes altered after the listed study start and completion dates. The objectives of this study were to investigate whether changes made to primary outcomes are associated with the likelihood of reporting a statistically significant primary outcome on ClinicalTrials.gov. A cross-sectional analysis of all interventional clinical trials registered on ClinicalTrials.gov as of 20 November 2014 was performed. The main outcome was any change made to the initially listed primary outcome and the time of the change in relation to the trial start and end date. 13,238 completed interventional trials were registered with ClinicalTrials.gov that also had study results posted on the website. 2555 (19.3%) had one or more statistically significant primary outcomes. Statistical analysis showed that registration year, funding source and primary outcome change after trial completion were associated with reporting a statistically significant primary outcome .  Funding source and primary outcome change after trial completion are associated with a statistically significant primary outcome report on clinicaltrials.gov.

Modeling and Predicting Hearing Aid Outcome

PubMed Central

Humes, Larry E.

2003-01-01

Following a brief tutorial on the application of factor analysis to hearing aid outcome measures, three studies of hearing aid outcome measures in elderly adults are presented and analyzed. Two of the studies were completed at Indiana University (IU-1 and IU-2), and one was a collaborative multisite study by the Veterans Administration and the National Institute of Deafness and other Communication Disorders (NIDCD/VA). IU-1 measured hearing aid outcome in 173 elderly wearers of single-channel, linear, in-the-ear hearing aids with output-limiting compression, whereas IU-2 obtained the same extensive set of outcome measures from 53 elderly wearers of two-channel, wide-dynamic-range compression, in-the-canal hearing aids. In the NIDCD/VA study, 333 to 338 participants wore three single-channel circuits in succession, with each circuit housed within an in-the-ear shell. The three circuits included in that study and in this analysis were: (1) linear with peak clipping, (2) linear with output-limiting compression, and (3) single-channel, wide-dynamic-range compression. Evaluation of the many outcome measures completed in each study using principal components factor analysis revealed that from three (both IU studies) to five (NIDCD/VA study) principal components captured the individual differences in hearing aid outcome. This was independent of hearing aid type (in-the-ear or in-the-canal) and circuitry. Subsequent multiple regression analyses of individual differences in performance along each dimension of hearing aid outcome revealed that these individual differences could be accounted for reasonably well by various prefit variables for some dimensions of outcome, but not others. In general, measures of speech recognition performance were well accounted for by prefit measures, with the best predictors being hearing loss, cognitive performance, and age. Measures of hearing aid usage were less well accounted for by prefit measures, with the most accurate predictor of

Some Factors Effected Student's Calculus Learning Outcome

ERIC Educational Resources Information Center

Rajagukguk, Wamington

2016-01-01

The purpose of this study is to determine the factors effected calculus learning outcome of the student. This study was conducted with 176 respondents, which were selected randomly. The data were obtained by questionnaire, and then analyzed by using multiple regressions, and correlation, at level of a = 0.05. The findings showed there is the…

Neurological outcomes after hematopoietic stem cell transplantation for cerebral X-linked adrenoleukodystrophy, late onset metachromatic leukodystrophy and Hurler syndrome.

PubMed

Saute, Jonas Alex Morales; Souza, Carolina Fischinger Moura de; Poswar, Fabiano de Oliveira; Donis, Karina Carvalho; Campos, Lillian Gonçalves; Deyl, Adriana Vanessa Santini; Burin, Maira Graeff; Vargas, Carmen Regla; Matte, Ursula da Silveira; Giugliani, Roberto; Saraiva-Pereira, Maria Luiza; Vedolin, Leonardo Modesti; Gregianin, Lauro José; Jardim, Laura Bannach

2016-12-01

To describe survival and neurological outcomes after HSCT for these disorders. Seven CALD, 2 MLD and 2 MPS-IH patients underwent HSCT between 2007 and 2014. Neurological examinations, magnetic resonance imaging, molecular and biochemical studies were obtained at baseline and repeated when appropriated. Favorable outcomes were obtained with 4/5 related and 3/6 unrelated donors. Two patients died from procedure-related complications. Nine transplanted patients were alive after a median of 3.7 years: neurological stabilization was obtained in 5/6 CALD, 1/2 MLD, and one MPS-IH patient. Brain lesions of the MPS-IH patient were reduced four years after HSCT. Good outcomes were obtained when HSCT was performed before adulthood, early in the clinical course, and/or from a related donor.

Plasma Glycoproteomics Reveals Sepsis Outcomes Linked to Distinct Proteins in Common Pathways

PubMed Central

DeLeon-Pennell, Kristine Y.; Nguyen, Nguyen T.; de Castro Brás, Lisandra E.; Flynn, Elizabeth R.; Cannon, Presley L.; Griswold, Michael E.; Jin, Yu-Fang; Puskarich, Michael A.; Jones, Alan E.; Lindsey, Merry L.

2015-01-01

Objective Sepsis remains a predominant cause of mortality in the ICU, yet strategies to increase survival have proved largely unsuccessful. This study aimed to identify proteins linked to sepsis outcomes using a glycoproteomic approach to target extracellular proteins that trigger downstream pathways and direct patient outcomes. Design Plasma was obtained from the LacTATEs cohort. N-linked plasma glycopeptides were quantified by solid-phase extraction coupled with mass spectrometry. Glycopeptides were assigned to proteins using RefSeq and visualized in a heat map. Protein differences were validated by immunoblotting, and proteins were mapped for biological processes using Database for Annotation, Visualization and Integrated Discovery and for functional pathways using Kyoto Encyclopedia of Genes and Genomes databases. Setting Hospitalized care. Measurements and Main Results A total of 501 glycopeptides corresponding to 234 proteins were identified. Of these, 66 glycopeptides were unique to the survivor group and corresponded to 54 proteins, 60 were unique to the nonsurvivor group and corresponded to 43 proteins, and 375 were common responses between groups and corresponded to 137 proteins. Immunoblotting showed that nonsurvivors had increased total kininogen; decreased total cathepsin-L1, vascular cell adhesion molecule, periostin, and neutrophil gelatinase–associated lipocalin; and a two-fold decrease in glycosylated clusterin (all p < 0.05). Kyoto Encyclopedia of Genes and Genomes analysis identified six enriched pathways. Interestingly, survivors relied on the extrinsic pathway of the complement and coagulation cascade, whereas nonsurvivors relied on the intrinsic pathway. Conclusion This study identifies proteins linked to patient outcomes and provides insight into unexplored mechanisms that can be investigated for the identification of novel therapeutic targets. (Crit Care Med 2015; XX:00–00) PMID:26086942

Thermoelectric generator based on composites obtained by sintering of detonation nanodiamonds

NASA Astrophysics Data System (ADS)

Eidelman, E. D.; Meilakhs, A. P.; Semak, B. V.; Shakhov, F. M.

2017-11-01

A model of a thermoelectric generator is proposed, in which composite materials obtained by sintering diamond nanoparticles are used as the main component. To increase the useful conversion of heat into electric current, it is proposed to use the effect of electron drag by ballistic phonons. To reduce the ineffective heat spread, it is proposed to use the effect of thermal resistance of the boundaries between the graphite-like and diamond-like phases of the composite. An experimental confirmation of the existence of an optimal volume ratio between graphite-like and diamond-like phases of the composite is predicted and obtained. The highest achieved value of thermoelectric coefficient in the actual structure is 80 µV K-1 (which means 20 times increase compared to that of composites not of the optimal structure), with a thermal conductivity of 50 W m-1 K-1. These results were obtained with constant electrical conductivity. The combined influence of these two effects in case of the ideal composite structure should result in an increase of the thermoelectric efficiency parameter by three orders of magnitude.

Main Propulsion Test Article (MPTA)

NASA Technical Reports Server (NTRS)

Snoddy, Cynthia

2010-01-01

Scope: The Main Propulsion Test Article integrated the main propulsion subsystem with the clustered Space Shuttle Main Engines, the External Tank and associated GSE. The test program consisted of cryogenic tanking tests and short- and long duration static firings including gimbaling and throttling. The test program was conducted on the S1-C test stand (Position B-2) at the National Space Technology Laboratories (NSTL)/Stennis Space Center. 3 tanking tests and 20 hot fire tests conducted between December 21 1 1977 and December 17, 1980 Configuration: The main propulsion test article consisted of the three space shuttle main engines, flightweight external tank, flightweight aft fuselage, interface section and a boilerplate mid/fwd fuselage truss structure.

Cancer of the colorectum in Maine, 1995-1998: determinants of stage at diagnosis in a rural state.

PubMed

Parsons, Margaret A; Askland, Kathleen D

2007-01-01

Despite screening for colorectal cancer, mortality in the United States remains substantial. In northern New England, little is known about predictors of stage at diagnosis, an important determinant of survival and mortality. The objective of this study was to identify predictors of late stage at diagnosis for colorectal cancer in a rural state with a predominantly white population and a large Franco-American minority. Incident cases from 1995-1998 were obtained from the Maine Cancer Registry. Individual-level variables (age, sex, race, French ethnicity by surname, and payer) and contextual/town-level variables (socioeconomic status, population density, Franco ancestry proportion, distance to health care, and weather) were modeled with multiple logistic regression for late stage. Increasing distance to primary care provider was associated with late stage for colorectal cancer. Compared to patients aged > or =85 years, those aged 65-84 years were less likely to be diagnosed late, while those aged 35-49 years were more likely--although not significantly--to have late stage at diagnosis. Associations were not found with socioeconomic variables. The finding regarding distance to primary care may be consistent with studies showing that rurality and distance to care predict reduced utilization of health care services and worse health outcomes. The finding regarding age has implications for the education of younger high-risk patients and their physicians. The absence of positive findings with regard to socioeconomic variables may stem from the uniquely mixed sociodemographic profiles in rural and urban regions of Maine. Further research should refine these and other contextual measures to elucidate effects on rural health and should further evaluate the utility of assigning French ethnicity by surname in order to identify health disparities.

Predictors of outcome in residential cognitive and interpersonal treatment for social phobia: do cognitive and social dysfunction moderate treatment outcome?

PubMed

Borge, Finn-Magnus; Hoffart, Asle; Sexton, Harold

2010-09-01

The predictors of residential cognitive (RCT) and residential interpersonal Treatment (RIPT) for social phobia were explored. (1) Sotsky et al. (1991) found differential effects of CT and IPT for depression, suggesting that the level of cognitive or social dysfunction predicted differential outcome. We examined whether an analogous effect could be demonstrated in 10 weeks of residential treatment of 80 social phobia subjects. (2) We also included expectations, age of onset, severity of illness, concurrent anxiety, mood, avoidant personality disorder, and body dysmorphic disorder as predictors in this exploratory study. Main outcome was the social phobia subscale of Social Phobia and Anxiety Inventory (SPAI SP). DSM-IV axis I and II interviews were completed. (1) Sotsky et al. (1991) findings were not reproduced. However, RIPT subjects with poor general functioning were less improved following treatment. Subjects with concurrent agoraphobia responded better with RCT than subjects without agoraphobia. (2) Age of onset and expectations were the most powerful predictors of post treatment outcome. Some patient characteristics appear to impact outcome with RIPT and RCT differentially. The findings are discussed. (c) 2010 Elsevier Ltd. All rights reserved.

Nonlinear rotordynamics analysis. [Space Shuttle Main Engine turbopumps

NASA Technical Reports Server (NTRS)

Noah, Sherif T.

1991-01-01

Effective analysis tools were developed for predicting the nonlinear rotordynamic behavior of the Space Shuttle Main Engine (SSME) turbopumps under steady and transient operating conditions. Using these methods, preliminary parametric studies were conducted on both generic and actual HPOTP (high pressure oxygen turbopump) models. In particular, a novel modified harmonic balance/alternating Fourier transform (HB/AFT) method was developed and used to conduct a preliminary study of the effects of fluid, bearing and seal forces on the unbalanced response of a multi-disk rotor in the presence of bearing clearances. The method makes it possible to determine periodic, sub-, super-synchronous and chaotic responses of a rotor system. The method also yields information about the stability of the obtained response, thus allowing bifurcation analyses. This provides a more effective capability for predicting the response under transient conditions by searching in proximity of resonance peaks. Preliminary results were also obtained for the nonlinear transient response of an actual HPOTP model using an efficient, newly developed numerical method based on convolution integration. Currently, the HB/AFT is being extended for determining the aperiodic response of nonlinear systems. Initial results show the method to be promising.

Teaching Main Idea Comprehension.

ERIC Educational Resources Information Center

Baumann, James F., Ed.

Intended to help classroom teachers, curriculum developers, and researchers, this book provides current information on theoretical and instructional aspects of main idea comprehension. Titles and authors are as follows: "The Confused World of Main Idea" (James W. Cunningham and David W. Moore); "The Comprehension of Important…

The effect of the presence and characteristics of an outlying group on exposure-outcome associations.

PubMed

Coenen, Pieter; Mathiassen, Svend Erik; Kingma, Idsart; Boot, Cécile R L; Bongers, Paulien M; van Dieën, Jaap H

2015-01-01

Physical exposures (eg, lifting or bending) are believed to be risk factors for low-back pain (LBP), but the literature is inconsistent. Exposure and LBP prevalence differ considerably between occupations, and exposure-outcome associations could be severely modified by the presence of particular occupational groups. We aimed to investigate the influence of such outlying groups on the properties of associations between exposure and LBP. Lifting and trunk flexion were observed for 371 of 1131 workers within 19 groups. LBP was obtained from all workers during three follow-up years. Both exposure variables were associated with LBP (P<0.01) in this parent dataset. By removing the 19 groups one-by-one and performing logistic regressions analysis on the 18 remaining groups, we demonstrated that one group, mainly road workers, with outlying exposures and LBP prevalence substantially affected the exposure-outcome association in the total population. In order to further examine this phenomenon, we assessed, by simulation, the influence of realistic sizes (n=4, 8, 16, 32, 64, 128), mean exposures (e=2000, 3000, 4000 lifts and e=30, 40, 50% trunk flexion time) and LBP prevalences (p=70, 80, 90, 100%) of the outlying group on the strength and certainty of the eventual relationship between exposure and LBP. For each combination of n, e and p, 3000 virtual studies were constructed, including the simulated group together with the other 18 original groups from the parent data-set. Average odds ratios (OR), 95% confidence limits, and power (P<0.05) were calculated across these 3000 studies as measures of the properties of each virtual study design. OR were attenuated more towards 1 and power decreased with smaller values of n, e, and p in the outlying group. Changes in group size and prevalence had a larger influence on OR and power than changes in mean exposure. The size and characteristics of a single group with high exposure and outcome prevalence can strongly influence both the

Literature review on monitoring technologies and their outcomes in independently living elderly people.

PubMed

Peetoom, Kirsten K B; Lexis, Monique A S; Joore, Manuela; Dirksen, Carmen D; De Witte, Luc P

2015-07-01

To obtain insight into what kind of monitoring technologies exist to monitor activity in-home, what the characteristics and aims of applying these technologies are, what kind of research has been conducted on their effects and what kind of outcomes are reported. A systematic document search was conducted within the scientific databases Pubmed, Embase, Cochrane, PsycINFO and Cinahl, complemented by Google Scholar. Documents were included in this review if they reported on monitoring technologies that detect activities of daily living (ADL) or significant events, e.g. falls, of elderly people in-home, with the aim of prolonging independent living. Five main types of monitoring technologies were identified: PIR motion sensors, body-worn sensors, pressure sensors, video monitoring and sound recognition. In addition, multicomponent technologies and smart home technologies were identified. Research into the use of monitoring technologies is widespread, but in its infancy, consisting mainly of small-scale studies and including few longitudinal studies. Monitoring technology is a promising field, with applications to the long-term care of elderly persons. However, monitoring technologies have to be brought to the next level, with longitudinal studies that evaluate their (cost-) effectiveness to demonstrate the potential to prolong independent living of elderly persons. [Box: see text].

Real-world data of 197 patients treated with ulipristal acetate for uterine fibroids: PREMYA study French population main outcomes.

PubMed

Fernandez, H; Descamps, P; Koskas, M; Lopès, P; Brun, J L; Darai, E; Agostini, A

2017-09-01

To characterize and describe treatment with ulipristal acetate (UPA) in a preoperative setting and to evaluate the safety, effectiveness, and Health Related Quality of Life (HRQoL) outcomes in a French population treated according to standard clinical practice. Multicentre, prospective, non-interventional study (PREMYA) of patients diagnosed with moderate to severe symptoms of uterine fibroids and undergoing a preoperative treatment with UPA 5mg (Esmya ® ). Patients were followed for a total of 15months (3months UPA treatment and 12months after). Data were collected approximatively every 3months according to centre usual visit schedule. A total of 206 women were enrolled in France, of whom 197 were found to be eligible for data analysis. Physicians' assessments of patients' overall symptomatic changes, as measured on the Clinical Global Impression-Improvement (CGI-I) scale, indicated that 83.7% of patients were improved at end of treatment (month 3). On the patients' treatment benefit scale (PTBS), 94.7% of patients reported an improvement. These 2 measurements, pain and quality of life, remained improved after treatment cessation and during the entire period of follow-up. Only 58.4% of patients underwent surgery within the timeframe of the study follow-up of which the majority were of a conservative/minimal invasive nature. Many patients did not undergo surgery during the planned 12months follow-up period after treatment whereas all patients had an indication of surgery. All measurements of treatment outcome were markedly improved by 3 months of UPA 5mg treatment. NCT01635452. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Maine's Employability Skills Program

ERIC Educational Resources Information Center

McMahon, John M.; Wolffe, Karen E.; Wolfe, Judy; Brooker, Carrie

2013-01-01

This Practice Report describes the development and implementation of the "Maine Employability Skills Program," a model employment program developed by the Maine Division for the Blind and Visually Impaired (DBVI). The program was designed to support the efforts of the chronically unemployed or underemployed. These consumers were either…

Long-term outcomes following laparoscopic adjustable gastric banding: postoperative psychological sequelae predict outcome at 5-year follow-up.

PubMed

Scholtz, Samantha; Bidlake, Louise; Morgan, John; Fiennes, Alberic; El-Etar, Ashraf; Lacey, John Hubert; McCluskey, Sara

2007-09-01

NICE guidelines state that patients with psychological contra-indications should not be considered for bariatric surgery, including Laparoscopic Adjustable Gastric Banding (LAGB) surgery as treatment of morbid obesity, although no consistent correlation between psychiatric illness and long-term outcome in LAGB has been established. This is to our knowledge the first study to evaluate long-term outcomes in LAGB for a full range of DSM-IV defined psychiatric and eating disorders, and forms part of a research portfolio developed by the authors aimed at defining psychological predictors of bariatric surgery in the short-, medium- and long-term. Case notes of 37 subjects operated on between April 1997 and June 2000, who had undergone structured clinical interview during pre-surgical assessment to yield diagnoses of mental and eating disorders according to DSM-IV criteria were analyzed according to a set of operationally defined criteria. Statistical analysis was carried out to compare those with a poor outcome and those considered to have a good outcome in terms of psychiatric profile. In this group of mainly female, Caucasian subjects, ranging in age from 27 to 60 years, one-third were diagnosed with a mental disorder according to DSM-IV criteria. The development of postoperative DSM-IV defined binge eating disorder (BED) or depression strongly predicted poor surgical outcome, but pre-surgical psychiatric factors alone did not. Although pre-surgical psychiatric assessment alone cannot predict outcome, an absence of preoperative psychiatric illness should not reassure surgeons who should be mindful of postoperative psychiatric sequelae, particularly BED. The importance of providing an integrated biopsychosocial model of care in bariatric teams is highlighted.

Impairments in action-outcome learning in schizophrenia.

PubMed

Morris, Richard W; Cyrzon, Chad; Green, Melissa J; Le Pelley, Mike E; Balleine, Bernard W

2018-03-03

Learning the causal relation between actions and their outcomes (AO learning) is critical for goal-directed behavior when actions are guided by desire for the outcome. This can be contrasted with habits that are acquired by reinforcement and primed by prevailing stimuli, in which causal learning plays no part. Recently, we demonstrated that goal-directed actions are impaired in schizophrenia; however, whether this deficit exists alongside impairments in habit or reinforcement learning is unknown. The present study distinguished deficits in causal learning from reinforcement learning in schizophrenia. We tested people with schizophrenia (SZ, n = 25) and healthy adults (HA, n = 25) in a vending machine task. Participants learned two action-outcome contingencies (e.g., push left to get a chocolate M&M, push right to get a cracker), and they also learned one contingency was degraded by delivery of noncontingent outcomes (e.g., free M&Ms), as well as changes in value by outcome devaluation. Both groups learned the best action to obtain rewards; however, SZ did not distinguish the more causal action when one AO contingency was degraded. Moreover, action selection in SZ was insensitive to changes in outcome value unless feedback was provided, and this was related to the deficit in AO learning. The failure to encode the causal relation between action and outcome in schizophrenia occurred without any apparent deficit in reinforcement learning. This implies that poor goal-directed behavior in schizophrenia cannot be explained by a more primary deficit in reward learning such as insensitivity to reward value or reward prediction errors.

Role of Subdural Electrocorticography in Prediction of Long-Term Seizure Outcome in Epilepsy Surgery

ERIC Educational Resources Information Center

Asano, Eishi; Juhasz, Csaba; Shah, Aashit; Sood, Sandeep; Chugani, Harry T.

2009-01-01

Since prediction of long-term seizure outcome using preoperative diagnostic modalities remains suboptimal in epilepsy surgery, we evaluated whether interictal spike frequency measures obtained from extraoperative subdural electrocorticography (ECoG) recording could predict long-term seizure outcome. This study included 61 young patients (age…

Review and Outcome of Prolonged Cardiopulmonary Resuscitation

PubMed Central

Youness, Houssein; Al Halabi, Tarek; Hussein, Hussein; Awab, Ahmed; Jones, Kellie; Keddissi, Jean

2016-01-01

The maximal duration of cardiopulmonary resuscitation (CPR) is unknown. We report a case of prolonged CPR. We have then reviewed all published cases with CPR duration equal to or more than 20 minutes. The objective was to determine the survival rate, the neurological outcome, and the characteristics of the survivors. Measurements and Main Results. The CPR data for 82 patients was reviewed. The median duration of CPR was 75 minutes. Patients mean age was 43 ± 21 years with no significant comorbidities. The main causes of the cardiac arrests were myocardial infarction (29%), hypothermia (21%), and pulmonary emboli (12%). 74% of the arrests were witnessed, with a mean latency to CPR of 2 ± 6 minutes and good quality chest compression provided in 96% of the cases. Adjunct therapy included extracorporeal membrane oxygenation (18%), thrombolysis (15.8%), and rewarming for hypothermia (19.5%). 83% were alive at 1 year, with full neurological recovery reported in 63 patients. Conclusion. Patients undergoing prolonged CPR can survive with good outcome. Young age, myocardial infarction, and potentially reversible causes of cardiac arrest such as hypothermia and pulmonary emboli predict a favorable result, especially when the arrest is witnessed and followed by prompt and good resuscitative efforts. PMID:26885387

Diabetes and obesity are the main metabolic drivers of peripheral neuropathy.

PubMed

Callaghan, Brian C; Gao, LeiLi; Li, Yufeng; Zhou, Xianghai; Reynolds, Evan; Banerjee, Mousumi; Pop-Busui, Rodica; Feldman, Eva L; Ji, Linong

2018-04-01

To determine the associations between individual metabolic syndrome (MetS) components and peripheral neuropathy in a large population-based cohort from Pinggu, China. A cross-sectional, randomly selected, population-based survey of participants from Pinggu, China was performed. Metabolic phenotyping and neuropathy outcomes were performed by trained personnel. Glycemic status was defined according to the American Diabetes Association criteria, and the MetS using modified consensus criteria (body mass index instead of waist circumference). The primary peripheral neuropathy outcome was the Michigan Neuropathy Screening Instrument (MNSI) examination. Secondary outcomes were the MNSI questionnaire and monofilament testing. Multivariable models were used to assess for associations between individual MetS components and peripheral neuropathy. Tree-based methods were used to construct a classifier for peripheral neuropathy using demographics and MetS components. The mean (SD) age of the 4002 participants was 51.6 (11.8) and 51.0% were male; 37.2% of the population had normoglycemia, 44.0% prediabetes, and 18.9% diabetes. The prevalence of peripheral neuropathy increased with worsening glycemic status (3.25% in normoglycemia, 6.29% in prediabetes, and 15.12% in diabetes, P < 0.0001). Diabetes (odds ratio [OR] 2.60, 95% CI 1.77-3.80) and weight (OR 1.09, 95% CI 1.02-1.18) were significantly associated with peripheral neuropathy. Age, diabetes, and weight were the primary splitters in the classification tree for peripheral neuropathy. Similar to previous studies, diabetes and obesity are the main metabolic drivers of peripheral neuropathy. The consistency of these results reinforces the urgent need for effective interventions that target these metabolic factors to prevent and/or treat peripheral neuropathy.

Fat and neurosurgery: does obesity affect outcome after intracranial surgery?

PubMed

Schultheiss, Kim E; Jang, Yeon Gyoe; Yanowitch, Rachel N; Tolentino, Jocelyn; Curry, Daniel J; Lüders, Jürgen; Asgarzadie-Gadim, Farbod; Macdonald, R Loch

2009-02-01

Obesity has been linked to increased morbidity and mortality after some surgical procedures. The purpose of this study was to determine whether obesity affects outcome after general neurosurgery and subarachnoid hemorrhage (SAH). Three data sets were analyzed, including a retrospective review of 404 patients undergoing cranial and spinal neurosurgical procedures, a prospective collection of 100 patients with aneurysmal SAH, and data from 3567 patients with aneurysmal SAH who were entered into randomized clinical trials of tirilazad. For each data set, outcome was assessed by mortality, postoperative morbidity, and Glasgow Outcome Scale score. Prognostic factors, including body weight and body mass index, were tested for their effect on these outcomes using multivariable logistic regression. For patients undergoing general cranial and spinal neurosurgery, independent predictors of morbidity and mortality were age, American Society of Anesthesia class, disseminated malignancy, emergency surgery, and increased duration of surgery. For patients with SAH, score on the Glasgow Outcome Scale was associated with age and admission Glasgow Coma Scale score. In the tirilazad data set, multiple factors were associated with score on the Glasgow Outcome Scale, but, as with the other 2 data sets, body weight had no relationship to outcome. Obesity may have less effect on the outcome of patients with mainly cranial neurosurgical disease and aneurysmal SAH than it does on patients undergoing other types of surgery.

Preoperative anemia and postoperative outcomes after hepatectomy

PubMed Central

Tohme, Samer; Varley, Patrick R.; Landsittel, Douglas P.; Chidi, Alexis P.; Tsung, Allan

2015-01-01

Background Preoperative anaemia is associated with adverse outcomes after surgery but outcomes after liver surgery specifically are not well established. We aimed to analyze the incidence of and effects of preoperative anemia on morbidity and mortality in patients undergoing liver resection. Methods All elective hepatectomies performed for the period 2005–2012 recorded in the American College of Surgeons' National Surgical Quality Improvement Program (ACS-NSQIP) database were evaluated. We obtained anonymized data for 30-day mortality and major morbidity (one or more major complication), demographics, and preoperative and perioperative risk factors. We used multivariable logistic regression models to assess the adjusted effect of anemia, which was defined as (hematocrit <39% in men, <36% in women), on postoperative outcomes. Results We obtained data for 12,987 patients, of whom 4260 (32.8%) had preoperative anemia. Patients with preoperative anemia experienced higher postoperative major morbidity and mortality rates compared to those without anemia. After adjustment for predefined variables, preoperative anemia was an independent risk factor for postoperative major morbidity (adjusted OR 1.21, 1.09–1.33). After adjustment, there was no significant difference in postoperative mortality for patients with or without preoperative anemia (adjusted OR 0.88, 0.66–1.16). Conclusion Preoperative anemia is independently associated with an increased risk of major morbidity in patients undergoing hepatectomy. Therefore, it is crucial to readdress preoperative blood management in anemic patients prior to hepatectomy. PMID:27017165

Microbiologic Data in Acute Cholecystitis: Ten Years' Experience from Bile Cultures Obtained during Percutaneous Cholecystostomy.

PubMed

Nitzan, Orna; Brodsky, Yuri; Edelstein, Hana; Hershko, Dan; Saliba, Walid; Keness, Yoram; Peretz, Avi; Chazan, Bibiana

2017-04-01

The aim of the study was to describe the microbiology and susceptibility patterns in acute cholecystitis by examining bile culture results from patients who underwent percutaneous cholecystostomy and examine concordance with empiric treatment. A total of 124 patients with acute cholecystitis underwent percutaneous cholecystostomy between 2003 and 2012 at Emek Medical Center, Israel. Data on bile and blood culture results, isolate susceptibility, and clinical outcomes were retrieved from patient files. Bile cultures obtained from 116 patients were positive in 70 (60.3%) patients. Blood cultures obtained from 77 patients were positive in 23 (31.1%). Escherichia coli was the most common isolate in 28.6% of bile cultures and 43.5% of blood cultures. The concordance between empiric treatment coverage and culture isolate susceptibility was 67.6%. In most discordant cases, the isolates were Enterobacter spp. (40.9%) and Enterococcus spp. (31.8%). Overall, the in-hospital mortality rate was 7%: 2% in patients with concordant treatment compared with 14% in patients with discordant treatment (p = 0.09). Empiric antibiotic regimens were adequate in only two-thirds of patients. There might be a trend for poorer outcome in patients treated with inadequate antibiotic agents, emphasizing the importance of tailoring antibiotic treatment.

77 FR 36298 - In the Matter of Maine Yankee Atomic Power Company; Maine Yankee Atomic Power Station...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-18

... the Matter of Maine Yankee Atomic Power Company; Maine Yankee Atomic Power Station; Confirmatory Order... Regulatory Commission (NRC or the Commission) issued a Confirmatory Order to Maine Yankee Atomic Power...: (301) 492-3342; Email: [email protected] . I Maine Yankee Atomic Power Company (Maine Yankee or the...

Prediction of antiepileptic drug treatment outcomes using machine learning.

PubMed

Colic, Sinisa; Wither, Robert G; Lang, Min; Zhang, Liang; Eubanks, James H; Bardakjian, Berj L

2017-02-01

Antiepileptic drug (AED) treatments produce inconsistent outcomes, often necessitating patients to go through several drug trials until a successful treatment can be found. This study proposes the use of machine learning techniques to predict epilepsy treatment outcomes of commonly used AEDs. Machine learning algorithms were trained and evaluated using features obtained from intracranial electroencephalogram (iEEG) recordings of the epileptiform discharges observed in Mecp2-deficient mouse model of the Rett Syndrome. Previous work have linked the presence of cross-frequency coupling (I CFC ) of the delta (2-5 Hz) rhythm with the fast ripple (400-600 Hz) rhythm in epileptiform discharges. Using the I CFC to label post-treatment outcomes we compared support vector machines (SVMs) and random forest (RF) machine learning classifiers for providing likelihood scores of successful treatment outcomes. (a) There was heterogeneity in AED treatment outcomes, (b) machine learning techniques could be used to rank the efficacy of AEDs by estimating likelihood scores for successful treatment outcome, (c) I CFC features yielded the most effective a priori identification of appropriate AED treatment, and (d) both classifiers performed comparably. Machine learning approaches yielded predictions of successful drug treatment outcomes which in turn could reduce the burdens of drug trials and lead to substantial improvements in patient quality of life.

Development of the Main Wing Structure of a High Altitude Long Endurance UAV

NASA Astrophysics Data System (ADS)

Park, Sang Wook; Shin, Jeong Woo; Kim, Tae-Uk

2018-04-01

To enhance the flight endurance of a HALE UAV, the main wing of the UAV should have a high aspect ratio and low structural weight. Since a main wing constructed with the thin walled and slender components needed for low structural weight can suffer catastrophic failure during flight, it is important to develop a light-weight airframe without sacrificing structural integrity. In this paper, the design of the main wing of the HALE UAV was conducted using spars which were composed of a carbon-epoxy cylindrical tube and bulkheads to achieve both the weight reduction and structural integrity. The spars were sized using numerical analysis considering non-linear deformation under bending moment. Static strength testing of the wing was conducted under the most critical load condition. Then, the experimental results obtained for the wing were compared to the analytical result from the non-linear finite-element analysis. It was found that the developed main wing reduced its structural weight without any failure under the ultimate load condition of the static strength testing.

Impact of cooking and home food preparation interventions among adults: outcomes and implications for future programs

PubMed Central

Reicks, Marla; Trofholz, Amanda C.; Stang, Jamie S; Laska, Melissa N.

2014-01-01

Objective Cooking programs are growing in popularity; however an extensive review has not examined overall impact. Therefore, this study reviewed previous research on cooking/home food preparation interventions and diet and health-related outcomes among adults and identified implications for practice and research. Design Literature review and descriptive summative method. Main outcome measures Dietary intake, knowledge/skills, cooking attitudes and self-efficacy/confidence, health outcomes. Analysis Articles evaluating effectiveness of interventions that included cooking/home food preparation as the primary aim (January 1980 through December 2011) were identified via OVID MEDLINE, Agricola and Web of Science databases. Studies grouped according to design and outcomes were reviewed for validity using an established coding system. Results were summarized for several outcome categories. Results Of 28 studies identified, 12 included a control group with six as non-randomized and six as randomized controlled trials. Evaluation was done post-intervention for five studies, pre- and post-intervention for 23 and beyond post-intervention for 15. Qualitative and quantitative measures suggested a positive influence on main outcomes. However, non-rigorous study designs, varying study populations, and use of non-validated assessment tools limited stronger conclusions. Conclusions and Implications Well-designed studies are needed that rigorously evaluate long-term impact on cooking behavior, dietary intake, obesity and other health outcomes. PMID:24703245

33 CFR 334.10 - Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area. 334.10 Section 334.10 Navigation and Navigable Waters CORPS... REGULATIONS § 334.10 Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area. (a) The danger...

33 CFR 334.10 - Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area. 334.10 Section 334.10 Navigation and Navigable Waters CORPS... REGULATIONS § 334.10 Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area. (a) The danger...

33 CFR 334.10 - Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area. 334.10 Section 334.10 Navigation and Navigable Waters CORPS... REGULATIONS § 334.10 Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area. (a) The danger...

33 CFR 334.10 - Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area. 334.10 Section 334.10 Navigation and Navigable Waters CORPS... REGULATIONS § 334.10 Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area. (a) The danger...

Key-Vertebral Screws Strategy for Main Thoracic Curve Correction in Patients With Adolescent Idiopathic Scoliosis.

PubMed

Li, Jingfeng; Cheung, Kenneth M C; Samartzis, Dino; Ganal-Antonio, Anne K B; Zhu, Xiaodong; Li, Ming; Luk, Keith D K

2016-10-01

The following study was a prospective radiographic and retrospective clinical data assessment of adolescent idiopathic scoliosis (AIS) patients who had undergone a key-vertebral screws strategy (KVSS) at a single institution, with a minimum of 2 years' follow-up. The aim of the study was to introduce the KVSS for the operative treatment of AIS of the main thoracic curve, and to address the role of the fulcrum-bending radiograph (FBR) in predicting the outcome of surgical management by this method. The application of multilevel pedicle screws for the main thoracic curve in AIS patients is popular in an effort to provide spinal stability, enhance fusion outcome, and provide optimal curve correction. However, with the application of pedicle screw also comes a potential risk for soft tissue and neural injury and increased health care costs. It remains unknown whether limited screw placement can provide proper curve correction without compromising patient outcome. A total of 17 consecutive patients with AIS extending to the main thoracic spine, who had undergone posterior fusion and fixation by the KVSS, a procedure in which screws are placed at important strategic points in the spine (ie, bilaterally at the upper and lower end segments of the fusion block, apical vertebra on the convex side, adjacent cephalad, and caudal screw placement on the concave side), at a single institution, with a minimum of 2 year' follow-up, were included. The assessment of preoperative standing posteroanterior and sagittal, FBR, and postoperative standing posteroanterior and sagittal plain radiographs were assessed in all patients. The flexibility of the curve as well as the fulcrum-bending correction index (FBCI) were calculated for all patients. Postoperatively, radiographs were assessed at the immediate (ie, 1 wk) and last follow-up. Clinical assessment entailed evaluation of patient demographics and the presence of any intraoperative or postoperative complications. The mean age at the

Massive pre-main-sequence stars in M17

NASA Astrophysics Data System (ADS)

Ramírez-Tannus, M. C.; Kaper, L.; de Koter, A.; Tramper, F.; Bik, A.; Ellerbroek, L. E.; Ochsendorf, B. B.; Ramírez-Agudelo, O. H.; Sana, H.

2017-08-01

The formation process of massive stars is still poorly understood. Massive young stellar objects (mYSOs) are deeply embedded in their parental clouds; these objects are rare, and thus typically distant, and their reddened spectra usually preclude the determination of their photospheric parameters. M17 is one of the best-studied H II regions in the sky, is relatively nearby, and hosts a young stellar population. We have obtained optical to near-infrared spectra of previously identified candidate mYSOs and a few OB stars in this region with X-shooter on the ESO Very Large Telescope. The large wavelength coverage enables a detailed spectroscopic analysis of the photospheres and circumstellar disks of these candidate mYSOs. We confirm the pre-main-sequence (PMS) nature of six of the stars and characterise the O stars. The PMS stars have radii that are consistent with being contracting towards the main sequence and are surrounded by a remnant accretion disk. The observed infrared excess and the double-peaked emission lines provide an opportunity to measure structured velocity profiles in the disks. We compare the observed properties of this unique sample of young massive stars with evolutionary tracks of massive protostars and propose that these mYSOs near the western edge of the H II region are on their way to become main-sequence stars ( 6-20 M⊙) after having undergone high mass accretion rates (Ṁacc 10-4-10-3M⊙yr-1). Their spin distribution upon arrival at the zero age main-sequence is consistent with that observed for young B stars, assuming conservation of angular momentum and homologous contraction. Based on observations collected at the European Southern Observatory at Paranal, Chile (ESO programmes 60.A-9404(A), 085.D-0741, 089.C-0874(A), and 091.C-0934(B)).The full normalised X-shooter spectra are available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (http://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/604/A78

Parental Book Reading and Social-Emotional Outcomes for Head Start Children in Foster Care.

PubMed

Lee, Kyunghee; Lee, Jung-Sook

2016-01-01

This study examines the associations between parental book reading and social-emotional outcomes for Head Start children in foster care. Despite no main Head Start impact on parental book reading, subgroup effects were found. Foster parents in Head Start provided more book reading for children with disabilities but less for children with low preacademic scores. Head Start enhanced social-emotional outcomes for children in foster care. The positive impacts of Head Start on children's social-emotional outcomes were greater when parents read books frequently. Head Start should include more foster families and provided parenting skills to enhance social-emotional outcomes for children in foster care.

Postoperative costs associated with outcomes after cardiac surgery with extracorporeal circulation: role of antithrombin levels.

PubMed

Muedra, Vicente; Llau, Juan V; Llagunes, José; Paniagua, Pilar; Veiras, Sonia; Fernández-López, Antonio R; Diago, Carmen; Hidalgo, Francisco; Gil, Jesús; Valiño, Cristina; Moret, Enric; Gómez, Laura; Pajares, Azucena; de Prada, Blanca

2013-04-01

To study the impact on postoperative costs of a patient's antithrombin levels associated with outcomes after cardiac surgery with extracorporeal circulation. An analytic decision model was designed to estimate costs and clinical outcomes after cardiac surgery in a typical patient with low antithrombin levels (<63.7%) compared with a patient with normal antithrombin levels (≥63.7%). The data used in the model were obtained from a literature review and subsequently validated by a panel of experts in cardiothoracic anesthesiology. Multi-institutional (14 Spanish hospitals). Consultant anesthesiologists. A sensitivity analysis of extreme scenarios was carried out to assess the impact of the major variables in the model results. The average cost per patient was €18,772 for a typical patient with low antithrombin levels and €13,881 for a typical patient with normal antithrombin levels. The difference in cost was due mainly to the longer hospital stay of a patient with low antithrombin levels compared with a patient with normal levels (13 v 10 days, respectively, representing a €4,596 higher cost) rather than to costs related to the management of postoperative complications (€215, mostly owing to transfusions). Sensitivity analysis showed a high variability range of approximately ±55% of the base case cost between the minimum and maximum scenarios, with the hospital stay contributing more significantly to the variation. Based on this analytic decision model, there could be a marked increase in the postoperative costs of patients with low antithrombin activity levels at the end of cardiac surgery, mainly ascribed to a longer hospitalization. Copyright © 2013 Elsevier Inc. All rights reserved.

Epidemiology, transmission, diagnosis, and outcome of Hepatitis C virus infection.

PubMed

Moosavy, Seyed Hamid; Davoodian, Parivash; Nazarnezhad, Mirza Ali; Nejatizaheh, Abdolazim; Eftekhar, Ebrahim; Mahboobi, Hamidreza

2017-10-01

Hepatitis C infection is one of the main causes of chronic liver disorders worldwide. Nearly three percent (3%) of the world population has an HCV infection. Prevalence of HCV infection was higher in some groups such as injected drug users (IDUs) and HIV positive populations. Acute hepatitis has proven asymptomatic in most cases, and delay of diagnosis might lead to late onset of hepatocellular carcinoma and cirrhosis. Some host characteristics such as age, gender, body mass index, and viral properties are associated with HCV outcome hepatitis. Although disease progression is typically slow, some risk factors such as alcohol abuse and coinfection of patients with HBV and HIV can worsen the disease. On the other hand, viral overload is one of the main causes of prediction of HCV infection outcome. Prevalence of HCV infection will increase if we do not consider means of transmission, virus behaviors, and immunologic responses. Rapid diagnostic tests can help us to create preventive strategies among undeveloped villages and prisoners. Screening and training of the high-risk population such as IV drug users, dialysis patients, and hemophiliacs must be one of main HCV preventive programs. The present review is intended to help health policymakers to design suitable preventive and management programs.

Sexual Outcomes and Satisfaction with Hysterectomy: Influence of Patient Education

PubMed Central

Bradford, Andrea; Meston, Cindy

2010-01-01

Introduction Many women experience improved sexual function after hysterectomy. However, a sizeable minority of women report worsened sexual function after the surgery, and concerns about the effect of surgery on sexual function are common among women planning to undergo hysterectomy. Aim The present study examined the role of education about the potential sexual consequences of hysterectomy in predicting self-reported outcomes and satisfaction with the procedure. Methods We conducted a cross-sectional survey of 204 women who had undergone simple hysterectomy in the preceding 3–12 months. Participants volunteered in response to a Web-based advertisement. Main Outcome Measures Participants indicated their current sexual function using the Female Sexual Function Index (FSFI), and reported positive and negative sexual outcomes experienced after hysterectomy using a checklist. Participants also completed questionnaire items regarding satisfaction with hysterectomy and education from their physicians about sexual risks and benefits prior to surgery. Results Current sexual function scores were related to self-reports of positive and negative sexual outcomes following hysterectomy and overall satisfaction with hysterectomy. Education from a physician about possible adverse sexual outcomes was largely unrelated to self-reports of having experienced those outcomes. However, education about possible negative sexual outcomes predicted overall satisfaction with hysterectomy when controlling for self-reports of positive and negative sexual outcomes. Conclusion Education about potential negative sexual outcomes after surgery may enhance satisfaction with hysterectomy, independent of whether negative sexual outcomes were experienced. Including a discussion of potential sexual changes after surgery may enhance the benefits of presurgical counseling prior to hysterectomy. PMID:17087803

Maine Ingredients

ERIC Educational Resources Information Center

Waters, John K.

2009-01-01

This article features Maine Learning Technology Initiative (MLTI), the nation's first-ever statewide 1-to-1 laptop program which marks its seventh birthday by expanding into high schools, providing an occasion to celebrate--and to examine the components of its success. The plan to put laptops into the hands of every teacher and student in grades 7…

Prevalence, risk factors and outcome of childhood abuse reported by female university students in jeddah.

PubMed

Ibrahim, Nahla K; Jalali, Ekram A; Al-Ahmadi, Jawaher R; Al-Bar, Adnan A

2008-01-01

Child abuse constitutes all forms of physical and /or emotional ill treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child's health, survival, development or dignity in the context of a relationship of responsibility, trust or power. The objective of the study was to determine the prevalence, types, main predictors and outcome of child abuse, retrospectively reported by female university students in Jeddah. A cross sectional study was conducted and the Standardized Arabic Version of Child Abuse Screening Tool for Young Adult (18-24 years old) was used. Ethical standards of confidentiality and freedom to participate were followed. Multistage stratified random sample was used with selection of 1,897 females. About two-thirds (68.3 %) of students reported exposure to some form of child abuse. Physical and emotional forms were recalled by 45.1 % & 50.6 % of students, respectively, while, 2.9 % reported exposure to forced contact sexual assault. Parents and siblings were the commonest perpetrators of both physical & emotional abuse, while other relatives and extra-familial persons were the main offenders of sexual violence. The predictors of exposure to three forms of abuse together were: existence of parent who hit the other (aOR= 2.54; 95 % CI: 1.88-3.42), non-university graduated mother (aOR =1.83; p main outcomes of exposure to physical abuse were poor educational performance (aOR = 4.26; 95 % C.I.: 1.7-10.5), becoming suicidal prone (aOR =2.68; pobtaining violent behavior. Conclusion and Recommended:Child abuse represents a public health problem, and there is a strong influence of familial risk factors in its occurrence. Programs for prevention of child abuse and for treating and rehabilitating victims are urgently

Organizational climate, services, and outcomes in child welfare systems.

PubMed

Glisson, Charles; Green, Philip

2011-08-01

This study examines the association of organizational climate, casework services, and youth outcomes in child welfare systems. Building on preliminary findings linking organizational climate to youth outcomes over a 3-year follow-up period, the current study extends the follow-up period to 7 years and tests main, moderating and mediating effects of organizational climate and casework services on outcomes. The study applies hierarchical linear models (HLMs) analyses to all 5 waves of the National Survey of Child and Adolescent Well-being (NSCAW) with a US nationwide sample of 1,678 maltreated youth aged 4-16 years and 1,696 caseworkers from 88 child welfare systems. Organizational climate is assessed on 2 dimensions, Engagement and Stress, with scales from the well established measure, Organizational Social Context (OSC); youth outcomes are measured as problems in psychosocial functioning with the Child Behavior Checklist (CBCL); and casework services are assessed with original scales developed for the study and completed by the maltreated youths' primary caregivers and caseworkers. Maltreated youth served by child welfare systems with more engaged organizational climates have significantly better outcomes. Moreover, the quantity and quality of casework services neither mediate nor interact with the effects of organizational climate on youth outcomes. Organizational climate is associated with youth outcomes in child welfare systems, but a better understanding is needed of the mechanisms that link organizational climate to outcomes. In addition, there is a need for evidence-based organizational interventions that can improve the organizational climates and effectiveness of child welfare systems. Copyright © 2011 Elsevier Ltd. All rights reserved.

The Timing of Surgery for Hip Fracture and its Effects on Outcomes

PubMed Central

Orosz, Gretchen M.; Magaziner, Jay; Hannan, Edward L.; Morrison, R. Sean; Koval, Kenneth; Gilbert, Marvin; McLaughlin, Maryann; Halm, Ethan A.; Wang, Jason J.; Litke, Ann; Silberzweig, Stacey B.; Siu, Albert L.

2006-01-01

Context Previous studies of surgical timing in patients with hip fracture have yielded conflicting findings on mortality and have not focused on functional outcomes. Objectives We examine the impact of surgical timing on function and other outcomes. Design Prospective cohort study. Additional analyses involved a) matching cases of early and late surgery with propensity scores, and b) analysis of a restricted cohort that excluded patients who might not be candidates for early surgery Setting Four hospitals in the New York metropolitan area. Participants 1206 patients age ≥50 admitted with hip fracture over 29 months. Intervention Timing of surgery from hospital arrival. Main Outcome Measures Information collected from medical records and from interviews with patients or proxies during hospital stay. Follow-up information obtained on function (using the Functional Independence Measure) and survival. Results Of the patients treated with surgery (n=1178), 33.8% had surgery within 24 hours. Earlier surgery was not associated with improved mortality (hazard ratio = 0.75; 95% CI 0.52, 1.08) or improved locomotion (difference of −0.04 points, 95% CI −0.48, 0.39). Earlier surgery was associated with fewer days of severe pain (difference of −0.22 days, 95% CI −0.41, −0.03) and shorter length of stay by 1.94 days (p<0.001). Analyses with propensity scores or with a restricted cohort yielded similar results except that early surgery was also associated with reduced major complications in the restricted cohort (p=0.041). Conclusions Early surgery was not associated with improved function or mortality, but it was associated with reduced pain, length of stay and probably major complications. Additional research is needed on whether functional outcomes may be improved. In the meantime, patients with hip fracture with stable medical problems should be treated with early surgery given that adverse events are unlikely and that pain, length of stay, and possibly

25 CFR 162.539 - Must I obtain a WEEL before obtaining a WSR lease?

Code of Federal Regulations, 2014 CFR

2014-04-01

... AND PERMITS Wind and Solar Resource Leases Wsr Leases § 162.539 Must I obtain a WEEL before obtaining... direct result of energy resource information gathered from a WEEL activity, obtaining a WEEL is not a...

25 CFR 162.539 - Must I obtain a WEEL before obtaining a WSR lease?

Code of Federal Regulations, 2013 CFR

2013-04-01

... AND PERMITS Wind and Solar Resource Leases Wsr Leases § 162.539 Must I obtain a WEEL before obtaining... direct result of energy resource information gathered from a WEEL activity, obtaining a WEEL is not a...

Measuring Student Satisfaction from the Student Outcomes Survey. Technical Paper

ERIC Educational Resources Information Center

Fieger, Peter

2012-01-01

The Student Outcomes Survey is an annual national survey of vocational education and training (VET) students. Since 1995, participants have been asked to rate their satisfaction with different aspects of their training, grouped under three main themes: teaching, assessment, and generic skills and learning experiences. While the composition of the…

Long-term renal outcome in patients with malignant hypertension: a retrospective cohort study

PubMed Central

2012-01-01

Background Malignant hypertension is frequently complicated by renal insufficiency. Although the survival of this hypertensive emergency has improved, recent data on renal outcome and its predictors are lacking. We assessed renal outcome and its predictors in patients with malignant hypertension. Methods Retrospective analysis of patients admitted with malignant hypertension in Amsterdam, the Netherlands between August 1992–January 2010. Follow-up data on vital status, renal function and blood pressure (BP) were obtained from the outpatient department and from general practitioners. The primary composite endpoint was end-stage renal disease (ESRD) defined as the start of kidney replacement therapy (KRT) or ≥ 50% decline of estimated glomerular filtration rate (eGFR). The secondary endpoint was all cause mortality. Results A total of 120 patients admitted with malignant hypertension were included. After a median follow-up period of 67 months (IQR 28 to 108 months) the primary endpoint was reached by 37 (31%) patients, whereas 18 patients (15%) reached the secondary endpoint. Twenty-nine (24%) patients started KRT and 8 patients (7%) had an eGFR decline ≥ 50%. After the acute phase (> 3 months after admission), initial serum creatinine and follow-up BP were the main predictors of future ESRD with hazard ratios of 6.1 (95% CI, 2.2–17) for patients with initial serum creatinine ≥ 175 μmol /L and 4.3 (95% CI, 1.4–14) for patients with uncontrolled hypertension. Conclusions Progressive renal function decline leading to ESRD remains a major threat to patients with malignant hypertension. BP control during follow-up was an important modifiable predictor of renal outcome. PMID:22846257

When Service-Learning Is Not a "Border-Crossing" Experience: Outcomes of a Graduate Spanish Online Course

ERIC Educational Resources Information Center

Carracelas-Juncal, Carmen

2013-01-01

Research on Spanish service-learning has focused mainly on the outcomes of service-learning for undergraduate students learning Spanish as a second language. This article examines the role of service-learning in a graduate online course for practicing Spanish teachers and the outcomes of the service-learning experience for three participants who…

Spiritual transcendence as a predictor of psychosocial outcome from an outpatient substance abuse program.

PubMed

Piedmont, Ralph L

2004-09-01

Does the Spiritual Transcendence Scale (STS; R. L. Piedmont, 1999) predict psychosocial outcomes from an outpatient substance abuse program? Self-report data on symptoms, personality, and coping resources were obtained for 73 consecutive admissions (57 men and 16 women; ages 19-66 years) at intake and again from the 56 (47 men and 9 women) who completed treatment. Controlling for relevant demographic variables, pretreatment STS scores were significantly related to self-ratings at posttreatment. The STS predicted treatment outcomes over and above the contribution of the five-factor model of personality. Significant partial correlations between pretreatment STS scores and therapist ratings of treatment outcome were also obtained. Spiritual Transcendence, especially the facets of Universality and Connectedness, appears to play a significant role in substance abuse recovery. (c) 2004 APA

Perceived Neighborhood Violence, Parenting Styles, and Developmental Outcomes among Spanish Adolescents

ERIC Educational Resources Information Center

Gracia, Enrique; Fuentes, Maria C.; Garcia, Fernando; Lila, Marisol

2012-01-01

This article analyzed perceptions of neighborhood violence of Spanish adolescents (N = 1,015) from authoritative, authoritarian, indulgent, and neglectful families, and its association with three sets of developmental outcomes (psychological, behavioral, and academic). Tests of main and interactive effects were conducted to answer research…

Consequences of ADHD medication use for children's outcomes.

PubMed

Dalsgaard, Søren; Nielsen, Helena Skyt; Simonsen, Marianne

2014-09-01

This paper estimates effects of early ADHD medication use on key human capital outcomes for children diagnosed with ADHD while using rarely available register based data on diagnoses and prescription drug purchases. Our main identification strategy exploits plausible exogenous assignment of children to hospitals with specialist physicians, while our analysis of health outcomes also allows for an individual level panel data strategy. We find that the behavior of specialist physicians varies considerably across hospitals and that the prescribing behavior does affect the probability that a given child is treated. Results show that children diagnosed with ADHD in pharmacological treatment have fewer hospital contacts if treated and that treatment to some extent protects against criminal behavior. Copyright © 2014 Elsevier B.V. All rights reserved.

Unexpected but Incidental Positive Outcomes Predict Real-World Gambling.

PubMed

Otto, A Ross; Fleming, Stephen M; Glimcher, Paul W

2016-03-01

Positive mood can affect a person's tendency to gamble, possibly because positive mood fosters unrealistic optimism. At the same time, unexpected positive outcomes, often called prediction errors, influence mood. However, a linkage between positive prediction errors-the difference between expected and obtained outcomes-and consequent risk taking has yet to be demonstrated. Using a large data set of New York City lottery gambling and a model inspired by computational accounts of reward learning, we found that people gamble more when incidental outcomes in the environment (e.g., local sporting events and sunshine) are better than expected. When local sports teams performed better than expected, or a sunny day followed a streak of cloudy days, residents gambled more. The observed relationship between prediction errors and gambling was ubiquitous across the city's socioeconomically diverse neighborhoods and was specific to sports and weather events occurring locally in New York City. Our results suggest that unexpected but incidental positive outcomes influence risk taking. © The Author(s) 2016.

A multilevel examination of affective job insecurity climate on safety outcomes.

PubMed

Jiang, Lixin; Probst, Tahira M

2016-07-01

Previous research has established a causal link between individual perceptions of job insecurity and safety outcomes. However, whether job insecurity climate is associated with safety outcomes has not been studied. The purpose of the current study was to explore the main and cross-level interaction effects of affective job insecurity climate on safety outcomes, including behavioral safety compliance, reporting attitudes, workplace injuries, experienced safety events, unreported safety events, and accident underreporting, beyond individual affective job insecurity. With 171 employees nested in 40 workgroups, multilevel analyses revealed that the negative impacts of individual affective job insecurity on safety outcomes are exacerbated when they occur in a climate of high affective job insecurity. These results are interpreted in light of safety management efforts and suggest that efforts to create a secure climate within one's workgroup may reap safety-related benefits. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Obtaining evidence for use by healthcare payers on the success of chronic obstructive pulmonary disease management.

PubMed

Mapel, D; Pearson, M

2002-08-01

Healthcare payers make decisions on funding for treatments for diseases, such as chronic obstructive pulmonary disease (COPD), on a population level, so require evidence of treatment success in appropriate populations, using usual routine care as the comparison for alternative management approaches. Such health outcomes evidence can be obtained from a number of sources. The 'gold standard' method for obtaining evidence of treatment success is usually taken as the randomized controlled prospective clinical trial. Yet the value of such studies in providing evidence for decision-makers can be questioned due to the restricted entry criteria limiting the ability to generalize to real life populations, narrow focus on individual parameters, use of placebo for comparison rather than usual therapy and unrealistic intense monitoring of patients. Evidence obtained from retrospective and observational studies can supplement that from randomized clinical trials, providing that care is taken to guard against bias and confounders. However, very large numbers of patients must be investigated if small differences between drugs and treatment approaches are to be detected. Administrative databases from healthcare systems provide an opportunity to obtain observational data on large numbers of patients. Such databases have shown that high healthcare costs in patients with COPD are associated with co-morbid conditions and current smoking status. Analysis of an administrative database has also shown that elderly patients with COPD who received inhaled corticosteroids within 90 days of discharge from hospital had 24% fewer repeat hospitalizations for COPD and were 29% less likely to die during the 1-year follow-up period. In conclusion, there are a number of sources of meaningful evidence of the health outcomes arising from different therapeutic approaches that should be of value to healthcare payers making decisions on resource allocation.

Short-term forecasting of turbidity in trunk main networks.

PubMed

Meyers, Gregory; Kapelan, Zoran; Keedwell, Edward

2017-11-01

Water discolouration is an increasingly important and expensive issue due to rising customer expectations, tighter regulatory demands and ageing Water Distribution Systems (WDSs) in the UK and abroad. This paper presents a new turbidity forecasting methodology capable of aiding operational staff and enabling proactive management strategies. The turbidity forecasting methodology developed here is completely data-driven and does not require hydraulic or water quality network model that is expensive to build and maintain. The methodology is tested and verified on a real trunk main network with observed turbidity measurement data. Results obtained show that the methodology can detect if discolouration material is mobilised, estimate if sufficient turbidity will be generated to exceed a preselected threshold and approximate how long the material will take to reach the downstream meter. Classification based forecasts of turbidity can be reliably made up to 5 h ahead although at the expense of increased false alarm rates. The methodology presented here could be used as an early warning system that can enable a multitude of cost beneficial proactive management strategies to be implemented as an alternative to expensive trunk mains cleaning programs. Copyright © 2017 Elsevier Ltd. All rights reserved.

76 FR 42716 - Effects of Ischemia Reperfusion Injury on Outcomes in Kidney Transplantation; Public Workshop

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-19

...] Effects of Ischemia Reperfusion Injury on Outcomes in Kidney Transplantation; Public Workshop AGENCY: Food... outcomes in kidney transplantation. This public workshop is intended to obtain information from health care... for the prophylaxis and/or treatment of delayed graft function (DGF) and related conditions in kidney...

Research on the electromagnetic radiation characteristics of the gas main switch of a capacitive intense electron-beam accelerator

NASA Astrophysics Data System (ADS)

Qiu, Yongfeng; Liu, Jinliang; Yang, Jianhua; Cheng, Xinbing; Li, Guolin

2017-11-01

Strong electromagnetic fields are radiated during the operation of the intense electron-beam accelerator (IEBA), which may lead to the nearby electronic devices out of order. In this paper, the research on the electromagnetic radiation characteristic of the gas main switch of a capacitive IEBA is carried out by the methods of theory analysis and experiment investigation. It is obtained that the gas main switch is the dominating radiation resource. In the absence of electromagnetic shielding for the gas main switch, when the pulse forming line of the IEBA is charged to 700 kV, the radiation field with amplitude of 3280 V/m, dominant frequency of 84 MHz and high frequency 100 MHz is obtained at a distance of 10 meters away from the gas main switch. The experimental results of the radiation field agree with the theoretical calculations. We analyze the achievements of several research groups and find that there is a relationship between the rise time (T) of the transient current of the gas main switch and the dominant frequency (F) of the radiation field, namely, F*T=1. Contrast experiment is carried out with a metal shield cover for the gas main switch. Experimental results show that for the shielded setup the radiation field reduces to 115 V/m, the dominant frequency increases to 86.5 MHz at a distance of 10 away meters from the gas main switch. These conclusions are beneficial for further research on the electromagnetic radiation and protection of the IEBA.

A Study of Foreign Language Learning Outcomes Assessment in U.S. Undergraduate Education

ERIC Educational Resources Information Center

Ricardo-Osorio, Jose G.

2008-01-01

This article reports on findings obtained from an online survey answered by 97 foreign language department chairs. The Web survey was pilot tested for validity and reliability and obtained a Cronbach's reliability coefficient of .80. The results suggest that student learning outcomes assessment in American undergraduate foreign language education…

Outcome of limbic encephalitis with VGKC-complex antibodies: relation to antigenic specificity.

PubMed

Malter, M P; Frisch, C; Schoene-Bake, J C; Helmstaedter, C; Wandinger, K P; Stoecker, W; Urbach, H; Surges, R; Elger, C E; Vincent, A V; Bien, C G

2014-09-01

In limbic encephalitis (LE) with antibodies (Abs) to the voltage-gated potassium channel complex (VGKC), the Abs are mainly directed to the VGKC-complex proteins, leucine-rich, glioma inactivated 1 protein (LGI1) or contactin-associated protein-like 2 (CASPR-2) or neither. Here, we relate the outcomes of VGKC-LE patients to the presence of Abs to LGI1, CASPR-2 or neither antigen (LGI1/CASPR-2-Ab(-)). Clinical, neuropsychology and MRI data were obtained from patient records for all LE patients from the Bonn Epilepsy Centre positive for VGKC-Abs by radioimmunoprecipitation assay between 2002 and 2011. Eighteen VGKC-LE patients were identified: nine patients (50 %) had LGI1-Abs, three (16 %) had CASPR-2-Abs; and six (33 %) were negative for both LGI1- and CASPR-2-Abs. At first assessment, the groups did not differ clinically or radiologically, but faciobrachial dystonic seizures were only observed in two LGI1-Ab(+) patients. All patients received monthly intravenous methylprednisolone (MP) pulses. At the most recent follow up (median 26 months), thirteen (72 %) were seizure-free, and seizure-freedom rates did not differ between the Ab groups. Hippocampal atrophy had developed in 7/9 LGI1-Ab(+) patients, but in none of the CASPR-2-Ab(+) or LGI/CASPR-2-Ab(-) patients (p = 0.003). While all subgroups improved, memory scores only normalized in six patients (33 %) and LGI1-Ab(+) patients were left with significantly poorer memory than the other two subgroups. Most VGKC-LE patients become seizure-free with pulsed monthly MP, but memory outcome is less favourable. Hippocampal atrophy and poor memory recovery is common in patients with LGI1-Abs and suggests permanent functional damage. More intense immunotherapies could improve outcomes in LGI1-Ab(+)-LE.

Outcome regimes of binary raindrop collisions

NASA Astrophysics Data System (ADS)

Testik, Firat Y.

2009-11-01

This study delineates the physical conditions that are responsible for the occurrence of main outcome regimes (i.e., bounce, coalescence, and breakup) for binary drop collisions with a precipitation microphysics perspective. Physical considerations based on the collision kinetic energy and the surface energies of the colliding drops lead to the development of a theoretical regime diagram for the drop/raindrop collision outcomes in the We- p plane ( We — Weber number, p — raindrop diameter ratio). This theoretical regime diagram is supported by laboratory experimental observations of drop collisions using high-speed imaging. Results of this fundamental study bring in new insights into the quantitative understanding of drop dynamics, applications of which extend beyond precipitation microphysics. In particular, results of this drop collision study are expected to give impetus to the physics-based dynamic modeling of the drop size distributions that is essential for various typical modern engineering applications, including numerical modeling of evolution of raindrop size distribution in rain shaft.

Complications of Non-Operating Room Procedures: Outcomes From the National Anesthesia Clinical Outcomes Registry.

PubMed

Chang, Beverly; Kaye, Alan D; Diaz, James H; Westlake, Benjamin; Dutton, Richard P; Urman, Richard D

2015-04-07

This study examines the impact of procedural locations and types of anesthetics on patient outcomes in non-operating room anesthesia (NORA) locations. The National Anesthesia Clinical Outcomes Registry database was examined to compare OR to NORA anesthetic complications and patient demographics. The National Anesthesia Clinical Outcomes Registry database was examined for all patient procedures from 2010 to 2013. A total of 12,252,846 cases were analyzed, with 205 practices contributing information, representing 1494 facilities and 7767 physician providers. Cases were separated on the basis of procedure location, OR, or NORA. Subgroup analysis examined outcomes from specific subspecialties. Non-OR anesthesia procedures were performed on a higher percentage of patients older than 50 years (61.92% versus 55.56%, P < 0.0001). Monitored anesthesia care (MAC) (20.15%) and sedation (2.05%) were more common in NORA locations. The most common minor complications were postoperative nausea and vomiting (1.06%), inadequate pain control (1.01%), and hemodynamic instability (0.62%). The most common major complications were serious hemodynamic instability (0.10%) and upgrade of care (0.10%). There was a greater incidence of complications in cardiology and radiology locations. Overall mortality was higher in OR versus NORA (0.04% versus 0.02%, P < 0.0001). Subcategory analysis showed increased incidence of death in cardiology and radiology locations (0.05%). Non-OR anesthesia procedures have lower morbidity and mortality rates than OR procedures, contrary to some previously published studies. However, the increased complication rates in both the cardiology and radiology locations may need to be the target of future safety investigations. Providers must ensure proper monitoring of patients, and NORA locations need to be held to the same standard of care as the main operating room. Further studies need to identify at-risk patients and procedures that may predispose patients to

Sex-specific predictors of inpatient rehabilitation outcomes after traumatic brain injury

PubMed Central

Chan, Vincy; Mollayeva, Tatyana; Ottenbacher, Kenneth J.; Colantonio, Angela

2016-01-01

Objective To identify sex-specific predictors of inpatient rehabilitation outcomes among patients with a traumatic brain injury (TBI) from a population based perspective. Design Retrospective cohort study Setting Ontario, Canada Participants Patients in inpatient rehabilitation for a TBI within one year of acute care discharge between 2008/09 and 2011/12 (N=1,730, 70% male, 30% female). Interventions None Main Outcome Measures Inpatient rehabilitation length of stay, total Functional Independence Measure (FIM™) score, and motor and cognitive FIM™ ratings at discharge. Results Sex, as a covariate in multivariable linear regression models, was not a significant predictor of rehabilitation outcomes. While many of the predictors examined were similar across males and females, sex-specific multivariable models identified some predictors of rehabilitation outcome that are specific for males and females; mechanism of injury (p<.0001) was a significant predictor of functional outcome only among females while comorbidities (p<.0001) was a significant predictor for males only. Conclusions Predictors of outcomes after inpatient rehabilitation differed by sex, providing evidence for a sex-specific approach in planning and resource allocation for inpatient rehabilitation services for patients with TBI. PMID:26836952

How to ask: older adults' preferred tools in health outcome prioritization.

PubMed

Case, Siobhan M; Fried, Terri R; O'Leary, John

2013-04-01

To assess older adults' attitudes toward eliciting health outcome priorities. This observational cohort study of 356 community-living adults age ≥65 included three tools: (1) Health Outcomes: ranking four outcomes (survival, function, freedom from pain, and freedom from other symptoms); (2) Now vs. Later: rating importance of current versus future quality of life; (3) Attitude Scale: agreement with statements about health outcomes and current versus future health. Whereas 41% preferred Health Outcomes, 40% preferred the Attitude Scale. Only 7-12% rated any tool as very hard or hard. In bivariate analysis, participants of non-white race and with lower education, health literacy, and functional status were significantly more likely to rate at least one of the tools as easy (p < .05). Across all tools, 17% of participants believed tools would change care. The main reason for thinking there would be no change was satisfaction with existing care (62%). There is variability in how older persons wish to be asked about health outcome priorities. Few find this task difficult, and difficulty was not greater among participants with lower health literacy, education, or health status. By offering different tools, healthcare providers can help patients clarify their health outcome priorities. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

How to ask: Older adults’ preferred tools in health outcome prioritization

PubMed Central

Case, Siobhan M.; Fried, Terri R.; O’Leary, John

2012-01-01

OBJECTIVE To assess older adults’ attitudes toward eliciting health outcome priorities. METHODS This observational cohort study of 356 community-living adults age ≥ 65 included three tools: 1) Health Outcomes: ranking four outcomes (survival, function, freedom from pain, and freedom from other symptoms); 2) Now vs. Later: rating importance of current versus future quality of life; 3) Attitude Scale: agreement with statements about health outcomes and current versus future health. RESULTS Whereas 41% preferred Health Outcomes, 40% preferred the Attitude Scale. Only 7–12% rated any tool as very hard or hard. In bivariate analysis, participants of non-white race and with lower education, health literacy, and functional status were significantly more likely to rate at least one of the tools as easy (p<0.05). Across all tools, 17% of participants believed tools would change care. The main reason for thinking there would be no change was satisfaction with existing care (62%). CONCLUSIONS There is variability in how older persons wish to be asked about health outcome priorities. Few find this task difficult, and difficulty was not greater among participants with lower health literacy, education, or health status. PRACTICE IMPLICATIONS By offering different tools, healthcare providers can help patients clarify their health outcome priorities. PMID:23218242

High throughput estimation of functional cell activities reveals disease mechanisms and predicts relevant clinical outcomes

PubMed Central

Hidalgo, Marta R.; Cubuk, Cankut; Amadoz, Alicia; Salavert, Francisco; Carbonell-Caballero, José; Dopazo, Joaquin

2017-01-01

Understanding the aspects of the cell functionality that account for disease or drug action mechanisms is a main challenge for precision medicine. Here we propose a new method that models cell signaling using biological knowledge on signal transduction. The method recodes individual gene expression values (and/or gene mutations) into accurate measurements of changes in the activity of signaling circuits, which ultimately constitute high-throughput estimations of cell functionalities caused by gene activity within the pathway. Moreover, such estimations can be obtained either at cohort-level, in case/control comparisons, or personalized for individual patients. The accuracy of the method is demonstrated in an extensive analysis involving 5640 patients from 12 different cancer types. Circuit activity measurements not only have a high diagnostic value but also can be related to relevant disease outcomes such as survival, and can be used to assess therapeutic interventions. PMID:28042959

Influence of pansharpening techniques in obtaining accurate vegetation thematic maps

NASA Astrophysics Data System (ADS)

Ibarrola-Ulzurrun, Edurne; Gonzalo-Martin, Consuelo; Marcello-Ruiz, Javier

2016-10-01

In last decades, there have been a decline in natural resources, becoming important to develop reliable methodologies for their management. The appearance of very high resolution sensors has offered a practical and cost-effective means for a good environmental management. In this context, improvements are needed for obtaining higher quality of the information available in order to get reliable classified images. Thus, pansharpening enhances the spatial resolution of the multispectral band by incorporating information from the panchromatic image. The main goal in the study is to implement pixel and object-based classification techniques applied to the fused imagery using different pansharpening algorithms and the evaluation of thematic maps generated that serve to obtain accurate information for the conservation of natural resources. A vulnerable heterogenic ecosystem from Canary Islands (Spain) was chosen, Teide National Park, and Worldview-2 high resolution imagery was employed. The classes considered of interest were set by the National Park conservation managers. 7 pansharpening techniques (GS, FIHS, HCS, MTF based, Wavelet `à trous' and Weighted Wavelet `à trous' through Fractal Dimension Maps) were chosen in order to improve the data quality with the goal to analyze the vegetation classes. Next, different classification algorithms were applied at pixel-based and object-based approach, moreover, an accuracy assessment of the different thematic maps obtained were performed. The highest classification accuracy was obtained applying Support Vector Machine classifier at object-based approach in the Weighted Wavelet `à trous' through Fractal Dimension Maps fused image. Finally, highlight the difficulty of the classification in Teide ecosystem due to the heterogeneity and the small size of the species. Thus, it is important to obtain accurate thematic maps for further studies in the management and conservation of natural resources.

Optical properties of hydroxyapatite obtained by mechanical alloying

NASA Astrophysics Data System (ADS)

Silva, C. C.; Thomazini, D.; Pinheiro, A. G.; Lanciotti, F.; Sasaki, J. M.; Góes, J. C.; Sombra, A. S. B.

2002-09-01

Calcium phosphate based bioceramics, mainly in the form of hydroxyapatite (HA), have been in use in medicine and dentistry for the last 20 years. Applications include coatings of orthopaedic and dental implants, alveolar ridge augmentation, maxillofacial surgery, otolaryngology, and scaffolds for bone growth and as powders in total hip and knee surgery. These materials exhibit several problems of handling and fabrication, which can be overcome by mixing with a suitable binder. In this paper, mechanical alloying has been used successfully to produce nanocrystalline powders of HA using five different experimental procedures. The milled HA were studied by X-ray powder diffraction, infrared and Raman scattering spectroscopy. For four different procedures, HA was obtained after a couple of hours of milling (on an average, 20 h of milling depending on the reaction procedure). The XRD patterns indicate that the grain size is within the range of 29-103 nm. This milling process, used to produce HA, presents the advantage that melting is not necessary and the powder obtained is nanocrystalline with extraordinary mechanical properties. The material can be compacted and transformed in solid ceramic samples. The high efficiency of the process opens a way to produce commercial amount of nanocrystalline HA. Due to the nanocrystalline character of this powder, their mechanical properties have changed and for this reason a pressure of 1 GPa is enough to shape the sample into any geometry.

Statistical results on restorative dentistry experiments: effect of the interaction between main variables

PubMed Central

CAVALCANTI, Andrea Nóbrega; MARCHI, Giselle Maria; AMBROSANO, Gláucia Maria Bovi

2010-01-01

Statistical analysis interpretation is a critical field in scientific research. When there is more than one main variable being studied in a research, the effect of the interaction between those variables is fundamental on experiments discussion. However, some doubts can occur when the p-value of the interaction is greater than the significance level. Objective To determine the most adequate interpretation for factorial experiments with p-values of the interaction nearly higher than the significance level. Materials and methods The p-values of the interactions found in two restorative dentistry experiments (0.053 and 0.068) were interpreted in two distinct ways: considering the interaction as not significant and as significant. Results Different findings were observed between the two analyses, and studies results became more coherent when the significant interaction was used. Conclusion The p-value of the interaction between main variables must be analyzed with caution because it can change the outcomes of research studies. Researchers are strongly advised to interpret carefully the results of their statistical analysis in order to discuss the findings of their experiments properly. PMID:20857003

Women's awareness of liberalization of abortion law and knowledge of place for obtaining services in Nepal.

PubMed

Thapa, Shyam; Sharma, Sharad K

2015-03-01

In Nepal, following the liberalization of the abortion law, expansion and scaling up of services proceeded in parallel with efforts to create awareness of the legalization status of abortion and provide women with information about where services are available. This article assesses the effectiveness of these programmatic interventions in the early years of the country's abortion program. Data from a 2006 national survey are analyzed with 2 outcome measures-awareness of the legal status of abortion and knowledge of places to obtain abortion services among women ages 15 to 44 years. The variations in the outcomes are analyzed by ecological-development subregion, residence, education, household wealth quintile, age, and number of living children. Bivariate and multivariate logistic regression techniques are used. Overall 32.3% (95% confidence interval = 31.4% to 33.2%) of the respondents were aware of the legal status of abortion and 56.5% (95% confidence interval = 55.5% to 57.4%) knew of a place where they could obtain an abortion. Both outcome measures showed considerable variations by the covariates. Women with secondary or higher level of education had the highest odds ratio of being aware of the law and having knowledge of a source for abortion services. Ecological-development subregions showed the second highest levels of odds ratios. Significant disparities among the population subgroups existed in the diffusion of awareness of the legal status of abortion and having knowledge of a place for abortion services in Nepal. The results point to which population subgroups to focus on and also serve as a baseline for assessing future progress in the diffusion process. © 2012 APJPH.

The virtual morphology and the main movements of the human neck simulations used for car crash studies

NASA Astrophysics Data System (ADS)

Ciunel, St.; Tica, B.

2016-08-01

The paper presents the studies made on a similar biomechanical system composed by neck, head and thorax bones. The models were defined in a CAD environment which includes Adams algorithm for dynamic simulations. The virtual models and the entire morphology were obtained starting with CT images made on a living human subject. The main movements analyzed were: axial rotation (left-right), lateral bending (left-right) and flexion- extension movement. After simulation was obtained the entire biomechanical behavior based on data tables or diagrams. That virtual model composed by neck and head can be included in complex system (as a car system) and supposed to several impact simulations (virtual crash tests). Also, our research team built main components of a testing device for dummy car crash neck-head system using anatomical data.

Obtaining Parts

Science.gov Websites

The Cosmic Connection Parts for the Berkeley Detector Suppliers: Scintillator Eljen Technology 1 obtain the components needed to build the Berkeley Detector. These companies have helped previous the last update. He estimates that the cost to build a detector varies from $1500 to $2700 depending

Functional outcomes of conservatively treated clavicle fractures

PubMed Central

Bajuri, Mohd Yazid; Maidin, S; Rauf, A; Baharuddin, M; Harjeet, S

2011-01-01

OBJECTIVE: The main aim of the study was to analyze the outcomes of clavicle fractures in adults treated non-surgically and to evaluate the clinical effects of displacement, fracture patterns, fracture location, fracture comminution, shortening and fracture union on shoulder function. METHODS: Seventy clavicle fractures were non-surgically treated in the Orthopedics Department at the Tuanku Ja'afar General Hospital, a tertiary care hospital in Seremban, Malaysia, an average of six months after injury. The clavicle fractures were treated conservatively with an arm sling and a figure-eight splint for three weeks. No attempt was made to reduce displaced fractures, and the patients were allowed immediate free-shoulder mobilization, as tolerated. They were prospectively evaluated clinically and radiographically. Shoulder function was evaluated using the Constant scoring technique. RESULTS: There were statistically significant functional outcome impairments in non-surgically treated clavicle fractures that correlated with the fracture type (comminution), the fracture displacement (21 mm or more), shortening (15 mm or more) and the fracture union (malunion). CONCLUSION: This article reveals the need for surgical intervention to treat clavicle fractures and improve shoulder functional outcomes. PMID:21655759

33 CFR 334.20 - Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. 334.20 Section 334.20 Navigation and Navigable Waters... REGULATIONS § 334.20 Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. (a) The...

33 CFR 334.20 - Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. 334.20 Section 334.20 Navigation and Navigable Waters... REGULATIONS § 334.20 Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. (a) The...

33 CFR 334.20 - Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. 334.20 Section 334.20 Navigation and Navigable Waters... REGULATIONS § 334.20 Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. (a) The...

33 CFR 334.20 - Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. 334.20 Section 334.20 Navigation and Navigable Waters... REGULATIONS § 334.20 Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. (a) The...

33 CFR 334.20 - Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. 334.20 Section 334.20 Navigation and Navigable Waters... REGULATIONS § 334.20 Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. (a) The...

Consciousness Indexing and Outcome Prediction with Resting-State EEG in Severe Disorders of Consciousness.

PubMed

Stefan, Sabina; Schorr, Barbara; Lopez-Rolon, Alex; Kolassa, Iris-Tatjana; Shock, Jonathan P; Rosenfelder, Martin; Heck, Suzette; Bender, Andreas

2018-04-17

We applied the following methods to resting-state EEG data from patients with disorders of consciousness (DOC) for consciousness indexing and outcome prediction: microstates, entropy (i.e. approximate, permutation), power in alpha and delta frequency bands, and connectivity (i.e. weighted symbolic mutual information, symbolic transfer entropy, complex network analysis). Patients with unresponsive wakefulness syndrome (UWS) and patients in a minimally conscious state (MCS) were classified into these two categories by fitting and testing a generalised linear model. We aimed subsequently to develop an automated system for outcome prediction in severe DOC by selecting an optimal subset of features using sequential floating forward selection (SFFS). The two outcome categories were defined as UWS or dead, and MCS or emerged from MCS. Percentage of time spent in microstate D in the alpha frequency band performed best at distinguishing MCS from UWS patients. The average clustering coefficient obtained from thresholding beta coherence performed best at predicting outcome. The optimal subset of features selected with SFFS consisted of the frequency of microstate A in the 2-20 Hz frequency band, path length obtained from thresholding alpha coherence, and average path length obtained from thresholding alpha coherence. Combining these features seemed to afford high prediction power. Python and MATLAB toolboxes for the above calculations are freely available under the GNU public license for non-commercial use ( https://qeeg.wordpress.com ).

A core outcome set for clinical trials in acute diarrhoea.

PubMed

Karas, Jacek; Ashkenazi, Shai; Guarino, Alfredo; Lo Vecchio, Andrea; Shamir, Raanan; Vandenplas, Yvan; Szajewska, Hania

2015-04-01

Core outcome sets are the baseline for what should be measured in clinical research and, thus, should serve as a guide for what should be collected and reported. The Consensus Group on Outcome Measures Made in Pediatric Enteral Nutrition Clinical Trials, established in 2012, agreed that consensus on a core set of outcomes with agreed-upon definitions that should be measured and reported in clinical trials was needed. To achieve this goal, six working groups (WGs) were setup, including WG on acute diarrhoea, whose main goal was to develop a core outcome set for trials in acute diarrhoea. The first step identified how published outcomes related to acute diarrhoea were reported. The second focused on the methodology for determining which outcomes to measure in clinical trials. The third employed a two-phase questionnaire study using the Delphi technique to define clinically important outcomes to clinicians and parents. For therapeutic studies, the five most important outcome measures were diarrhoea duration, degree of dehydration, need for hospitalisation (or duration of hospitalisation for inpatients), the proportion of patients recovered by 48 h and adverse effects. The prophylactic core outcome set included prevention of diarrhoea, prevention of dehydration, prevention of hospitalisation and adverse effects. The outcome sets for therapy and prevention can be recommended for use in future trials of patients with gastroenteritis. Their envisioned goal is to decrease study heterogeneity and to ease the comparability of studies. WG's next step is to determine how to measure the outcomes included in the core set. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Post-Inpatient Brain Injury Rehabilitation Outcomes: Report from the National OutcomeInfo Database.

PubMed

Malec, James F; Kean, Jacob

2016-07-15

This study examined outcomes for intensive residential and outpatient/community-based post-inpatient brain injury rehabilitation (PBIR) programs compared with supported living programs. The goal of supported living programs was stable functioning (no change). Data were obtained for a large cohort of adults with acquired brain injury (ABI) from the OutcomeInfo national database, a web-based database system developed through National Institutes of Health (NIH) Small Business Technology Transfer (STTR) funding for monitoring progress and outcomes in PBIR programs primarily with the Mayo-Portland Adaptability Inventory (MPAI-4). Rasch-derived MPAI-4 measures for cases from 2008 to 2014 from 9 provider organizations offering programs in 23 facilities throughout the United States were examined. Controlling for age at injury, time in program, and time since injury on admission (chronicity), both intensive residential (n = 205) and outpatient/community-based (n = 2781) programs resulted in significant (approximately 1 standard deviation [SD]) functional improvement on the MPAI-4 Total Score compared with supported living (n = 101) programs (F = 18.184, p < 0.001). Intensive outpatient/community-based programs showed greater improvements on MPAI-4 Ability (F = 14.135, p < 0.001), Adjustment (F = 12.939, p < 0.001), and Participation (F = 16.679, p < 0.001) indices than supported living programs; whereas, intensive residential programs showed improvement primarily in Adjustment and Participation. Age at injury and time in program had small effects on outcome; the effect of chronicity was small to moderate. Examination of more chronic cases (>1 year post-injury) showed significant, but smaller (approximately 0.5 SD) change on the MPAI-4 relative to supported living programs (F = 17.562, p < 0.001). Results indicate that intensive residential and outpatient/community-based PIBR programs result in substantial positive

Post-Inpatient Brain Injury Rehabilitation Outcomes: Report from the National OutcomeInfo Database

PubMed Central

Kean, Jacob

2016-01-01

Abstract This study examined outcomes for intensive residential and outpatient/community-based post-inpatient brain injury rehabilitation (PBIR) programs compared with supported living programs. The goal of supported living programs was stable functioning (no change). Data were obtained for a large cohort of adults with acquired brain injury (ABI) from the OutcomeInfo national database, a web-based database system developed through National Institutes of Health (NIH) Small Business Technology Transfer (STTR) funding for monitoring progress and outcomes in PBIR programs primarily with the Mayo-Portland Adaptability Inventory (MPAI-4). Rasch-derived MPAI-4 measures for cases from 2008 to 2014 from 9 provider organizations offering programs in 23 facilities throughout the United States were examined. Controlling for age at injury, time in program, and time since injury on admission (chronicity), both intensive residential (n = 205) and outpatient/community-based (n = 2781) programs resulted in significant (approximately 1 standard deviation [SD]) functional improvement on the MPAI-4 Total Score compared with supported living (n = 101) programs (F = 18.184, p < 0.001). Intensive outpatient/community-based programs showed greater improvements on MPAI-4 Ability (F = 14.135, p < 0.001), Adjustment (F = 12.939, p < 0.001), and Participation (F = 16.679, p < 0.001) indices than supported living programs; whereas, intensive residential programs showed improvement primarily in Adjustment and Participation. Age at injury and time in program had small effects on outcome; the effect of chronicity was small to moderate. Examination of more chronic cases (>1 year post-injury) showed significant, but smaller (approximately 0.5 SD) change on the MPAI-4 relative to supported living programs (F = 17.562, p < 0.001). Results indicate that intensive residential and outpatient/community-based PIBR programs result in substantial positive

Water vapor over Europe obtained from remote sensors and compared with a hydrostatic NWP model

NASA Astrophysics Data System (ADS)

Johnsen, K.-P.; Kidder, S. Q.

Due to its high-variability water vapor is a crucial parameter in short-term numerical weather prediction. Integrated water vapor (IWV) data obtained from a network of groundbased Global Positioning System (GPS) receivers mainly over Germany and passive microwave measurements of the Advanced Microwave Sounding Unit (AMSU-A) are compared with the high-resolution regional weather forecast model HRM of the Deutscher Wetterdienst (DWD). Time series of the IWV at 74 GPS stations obtained during the first complete year of the GFZ/GPS network between May 2000 and April 2001 are applied together with colocated forecasts of the HRM model. The low bias (0.08 kg/m 2) between the HRM model and the GPS data can mainly be explained by the bias between the ECMWF analysis data used to initilize the HRM model and the GPS data. The IWV standard deviation between the HRM model and the GPS data during that time is about 2.47 kg/ m2. GPS stations equipped with surface pressure sensors show about 0.29 kg/ m2 lower standard deviation compared with GPS stations with interpolated surface pressure from synoptic stations. The NOAA/NESDIS Total Precipitable Water algorithm is applied to obtain the IWV and to validate the model above the sea. While the mean IWV obtained from the HRM model is about 2.1 kg/ m2 larger than from the AMSU-A data, the standard deviations are 2.46 kg/ m2 (NOAA-15) and 2.29 kg/ m2 (NOAA-16) similar to the IWV standard deviation between HRM and GPS data.

Service system integration, access to services, and housing outcomes in a program for homeless persons with severe mental illness.

PubMed

Rosenheck, R; Morrissey, J; Lam, J; Calloway, M; Johnsen, M; Goldman, H; Randolph, F; Blasinsky, M; Fontana, A; Calsyn, R; Teague, G

1998-11-01

This study evaluated the hypothesis that greater integration and coordination between agencies within service systems is associated with greater accessibility of services and improved client housing outcomes. As part of the Access to Community Care and Effective Services and Supports program, data were obtained on baseline client characteristics, service use, and 3-month and 12-month outcomes from 1832 clients seen at 18 sites during the first year of program operation. Data on interorganizational relationships were obtained from structured interviews with key informants from relevant organizations in each community (n = 32-82 at each site). Complete follow-up data were obtained from 1340 clients (73%). After control for baseline characteristics, service system integration was associated with superior housing outcomes at 12 months, and this relationship was mediated through greater access to housing agencies. Service system integration is related to improved access to housing services and better housing outcomes among homeless people with mental illness.

Deep-vein thrombosis prevention in orthopaedic patients: affecting outcomes through interdisciplinary education.

PubMed

Hohlt, T

2000-01-01

Deep-vein thrombosis (DVT) is a serious problem that affects millions of people annually. Prophylaxis against DVT following major orthopaedic surgery can save lives and health care dollars. Proper application of the prophylactic regimen by nursing and the interdisciplinary team can be a major key in affecting the outcome of the orthopaedic patient. To obtain successful outcomes, the educational needs of each individual in the interdisciplinary team must be met. Also, being aware of each physician's practice patterns, implementing their individual preferences, and ensuring that all equipment is available and used in a consistent manner will enhance the desired outcome.

Investing in a Surgical Outcomes Auditing System

PubMed Central

Bermudez, Luis; Trost, Kristen; Ayala, Ruben

2013-01-01

Background. Humanitarian surgical organizations consider both quantity of patients receiving care and quality of the care provided as a measure of success. However, organizational efficacy is often judged by the percent of resources spent towards direct intervention/surgery, which may discourage investment in an outcomes monitoring system. Operation Smile's established Global Standards of Care mandate minimum patient followup and quality of care. Purpose. To determine whether investment of resources in an outcomes monitoring system is necessary and effectively measures success. Methods. This paper analyzes the quantity and completeness of data collected over the past four years and compares it against changes in personnel and resources assigned to the program. Operation Smile began investing in multiple resources to obtain the missing data necessary to potentially implement a global Surgical Outcomes Auditing System. Existing personnel resources were restructured to focus on postoperative program implementation, data acquisition and compilation, and training materials used to educate local foundation and international employees. Results. An increase in the number of postoperative forms and amount of data being submitted to headquarters occurred. Conclusions. Humanitarian surgical organizations would benefit from investment in a surgical outcomes monitoring system in order to demonstrate success and to ameliorate quality of care. PMID:23401763

Infective endocarditis; report from a main referral teaching hospital in Iran

PubMed Central

Heydari, Behrooz; Karimzadeh, Iman; Khalili, Hossein; Shojaei, Esfandiar; Ebrahimi, Abdolrasool

2017-01-01

Background/Objective: The aim of the present preliminary study was to assess the demographic, clinical, paraclinical, microbiological, echocardiographic, and therapeutic profile as well as in-hospital outcome of patients with infective endocarditis at a referral center for various infectious diseases in Iran. Methods: Required demographic, clinical, plausible complications and paraclinical data were collected from patients’ medical charts. Echocardiographic findings were obtained by performing transthoracic and/or transesophageal echocardiography as clinically indicated. In addition, details of management modalities and in-hospital outcome of patients were recorded. Results: During a 3-year period, 55 patients with definite or possible diagnosis of Infective endocarditis were admitted to the ward. Twenty one (38.2%) patients were injection drug users. Staphylococcus aureus and S.epidermidis were the most commonly isolated microorganisms. Management modalities of Infective endocarditis included antimicrobial therapy alone (48 cases) and the combination of antimicrobial therapy and surgery (7 cases). Conclusion: The rate of negative blood culture in our cohort is high. S. aureus and S.epidermidis were the most commonly isolated microorganisms from positive blood cultures. Congestive heart failure was the most frequent infective endocarditis complication as well as indication for surgery. In-hospital mortality rate of patients was unexpectedly low. PMID:28496492

Pregnancy with epilepsy: obstetric and neonatal outcome of a controlled study

PubMed Central

Mawer, G.; Briggs, M.; Baker, G.A.; Bromley, R.; Coyle, H.; Eatock, J.; Kerr, L; Kini, U.; Kuzmyshcheva, L.; Lucas, S.B.; Wyatt, L.; Clayton-Smith, J.

2010-01-01

Purpose to determine the influence of epilepsy and its treatment on pregnancy and its outcome. Design controlled, observational study. Setting National Health Service maternity hospitals in Liverpool and Manchester regions. Population 277 women with epilepsy (WWE) and 315 control women. Methods WWE were recruited from antenatal clinics. Controls were matched for age and parity but not gestational age. Information was obtained by interview and from clinical records. Main Outcome Measures: obstetric complications, mode of delivery, condition of newborn. Results Distribution of epilepsy syndromes was similar to previous surveys. Most WWE (67%) received monotherapy with carbamazepine, sodium valproate or lamotrigine. Half WWE had no seizures during pregnancy but 34% had tonic clonic seizures. Seizure related injuries were infrequent. Pregnancies with obstetric complications were increased in women with treated epilepsy (WWTE 45%, controls 33%; p = 0.01). Most had normal vaginal delivery (WWTE 63%, controls 61%; p = 0.65). Low birth weight was not increased (WWTE 6.2%, controls 5.2%; p = 0.69). There were more major congenital malformations (MCM) (WWTE 6.6%, controls 2.1%; p = 0.02) and fetal/infant deaths (WWTE 2.2%, controls 0.3%; p = 0.09). Amongst monotherapies MCM prevalence was highest with valproate (11.3%; p = 0.005). Lamotrigine (5.4%; p = 0.23) and carbamazepine (3.0%; p = 0.65) were closer to controls (2.1%). There was no association between MCM and dose of folic acid preconception. Conclusion MCM were more prevalent in the babies of WWTE particularly amongst those receiving sodium valproate. PMID:20036166

Medical Rapid Response in Psychiatry: Reasons for Activation and Immediate Outcome.

PubMed

Manu, Peter; Loewenstein, Kristy; Girshman, Yankel J; Bhatia, Padam; Barnes, Maira; Whelan, Joseph; Solderitch, Victoria A; Rogozea, Liliana; McManus, Marybeth

2015-12-01

Rapid response teams are used to improve the recognition of acute deteriorations in medical and surgical settings. They are activated by abnormal physiological parameters, symptoms or clinical concern, and are believed to decrease hospital mortality rates. We evaluated the reasons for activation and the outcome of rapid response interventions in a 222-bed psychiatric hospital in New York City using data obtained at the time of all activations from January through November, 2012. The primary outcome was the admission rate to a medical or surgical unit for each of the main reasons for activation. The 169 activations were initiated by nursing staff (78.7 %) and psychiatrists (13 %) for acute changes in condition (64.5 %), abnormal physiological parameters (27.2 %) and non-specified concern (8.3 %). The most common reasons for activation were chest pain (14.2 %), fluctuating level of consciousness (9.5 %), hypertension (9.5 %), syncope or fall (8.9 %), hypotension (8.3 %), dyspnea (7.7 %) and seizures (5.9 %). The rapid response team transferred 127 (75.2 %) patients to the Emergency Department and 46 (27.2 %) were admitted to a medical or surgical unit. The admission rates were statistically similar for acute changes in condition, abnormal physiological parameters, and clinicians' concern. In conclusion, a majority of rapid response activations in a self-standing psychiatric hospital were initiated by nursing staff for changes in condition, rather than for policy-specified abnormal physiological parameters. The findings suggest that a rapid response system may empower psychiatric nurses to use their clinical skills to identify patients requiring urgent transfer to a general hospital.

Model potentials for main group elements Li through Rn

NASA Astrophysics Data System (ADS)

Sakai, Yoshiko; Miyoshi, Eisaku; Klobukowski, Mariusz; Huzinaga, Sigeru

1997-05-01

Model potential (MP) parameters and valence basis sets were systematically determined for the main group elements Li through Rn. For alkali and alkaline-earth metal atoms, the outermost core (n-1)p electrons were treated explicitly together with the ns valence electrons. For the remaining atoms, only the valence ns and np electrons were treated explicitly. The major relativistic effects at the level of Cowan and Griffin's quasi-relativistic Hartree-Fock method (QRHF) were incorporated in the MPs for all atoms heavier than Kr. The valence orbitals thus obtained have inner nodal structure. The reliability of the MP method was tested in calculations for X-, X, and X+ (X=Br, I, and At) at the SCF level and the results were compared with the corresponding values given by the numerical HF (or QRHF) calculations. Calculations that include electron correlation were done for X-, X, and X+ (X=Cl and Br) at the SDCI level and for As2 at the CASSCF and MRSDCI levels. These results were compared with those of all-electron (AE) calculations using the well-tempered basis sets. Close agreement between the MP and AE results was obtained at all levels of the treatment.

Outcomes from a School-Randomized Controlled Trial of Steps to Respect: A Bullying Prevention Program

ERIC Educational Resources Information Center

Brown, Eric C.; Low, Sabina; Smith, Brian H.; Haggerty, Kevin P.

2011-01-01

This study reports the outcomes of a randomized controlled trial of Steps to Respect: A Bullying Prevention Program conducted in 33 California elementary schools. Schools were matched on school demographic characteristics and assigned randomly to intervention or waitlisted control conditions. Outcome measures were obtained from (a) all school…

Energy Survey of Machine Tools: Separating Power Information of the Main Transmission System During Machining Process

NASA Astrophysics Data System (ADS)

Liu, Shuang; Liu, Fei; Hu, Shaohua; Yin, Zhenbiao

The major power information of the main transmission system in machine tools (MTSMT) during machining process includes effective output power (i.e. cutting power), input power and power loss from the mechanical transmission system, and the main motor power loss. These information are easy to obtain in the lab but difficult to evaluate in a manufacturing process. To solve this problem, a separation method is proposed here to extract the MTSMT power information during machining process. In this method, the energy flow and the mathematical models of major power information of MTSMT during the machining process are set up first. Based on the mathematical models and the basic data tables obtained from experiments, the above mentioned power information during machining process can be separated just by measuring the real time total input power of the spindle motor. The operation program of this method is also given.

An Assessment of Flap and Main Landing Gear Noise Abatement Concepts

NASA Technical Reports Server (NTRS)

Khorrami, Mehdi R.; Humphreys, William M., Jr.; Lockard, David P.

2015-01-01

A detailed assessment of the acoustic performance of several noise reduction concepts for aircraft flaps and landing gear is presented. Consideration is given to the best performing concepts within the suite of technologies that were evaluated in the NASA Langley Research Center 14- by 22-Foot Subsonic Tunnel using an 18 percent scale, semi-span, high-fidelity Gulfstream aircraft model as a test bed. Microphone array measurements were obtained with the model in a landing configuration (flap deflected 39 degrees and the main landing gear deployed or retracted). The effectiveness of each concept over the range of pitch angles, speeds, and directivity angles tested is presented. Comparison of the acoustic spectra, obtained from integration of the beamform maps between the untreated baseline and treated configurations, clearly demonstrates that the flap and gear concepts maintain noise reduction benefits over the entire range of the directivity angles tested.

Relationship between LAAM-methadone preference and treatment outcomes.

PubMed

White, Jason M; Danz, Cath; Kneebone, Joanne; La Vincente, Sophie F; Newcombe, David A L; Ali, Robert L

2002-05-01

Studies of relative LAAM-methadone preference have indicated that a significant proportion of patients prefer levo-alpha-acetylmethadol (LAAM). The present study was designed to determine whether this preference is associated with better treatment outcomes. Sixty-two stable methadone patients participated in a randomised crossover clinical trial. They received LAAM (alternate days) and methadone (daily) for 3 months each, followed by a further 6-month period during which they were free to choose between the drugs. LAAM maintenance was associated with a lower rate of heroin use than methadone maintenance based on analysis of morphine concentration in hair and equivalent health outcomes. The majority of subjects showed a preference for LAAM (n=27, 69.2%) rather than methadone (n=12, 30.8%). The main reasons given for the LAAM preference were that it produced less withdrawal (39.3%), fewer side effects (28.5%), less craving for heroin (17.9%), and entailed fewer pick-up days (14.3%). Those who chose LAAM had lower levels of heroin use during LAAM maintenance, significantly better outcomes on two sub-scales of the SF-36 (Vitality and Mental Health), and reported that they felt more normal and that they were 'held' better when on LAAM. For those who chose methadone, there were no differences in outcomes between the LAAM and methadone maintenance periods. Preference for LAAM is associated with treatment outcomes as good or better than those with methadone.

Outcome of horizontal strabismus surgery and parents' satisfaction.

PubMed

Sharma, Ananda K; Thapa, Madhu; Shrestha, Gulshan B; Sitaula, Sanjeeta; Shrestha, Gauri S

2014-01-01

A clinical audit of strabismus surgery in children in terms of functional and cosmetic outcomes helps improve the quality of services in pediatric ophthalmology. To evaluate the outcome of strabismus surgery and assess the satisfaction of the patients' parents with respect to the surgery outcome. A study of an interventional series of cases that included 60 strabismic subjects was carried out. The bilateral strabismus surgery under general anesthesia was performed on all subjects using the fornix approach. The parents' understanding about strabismus and the cosmetic outcome was assessed through a set of interview questionnaires. The main outcome measures were the amount of deviation, the parents' knowledge about strabismus and their satisfaction after the intervention. Of the 60 subjects, 32 (53.3%) were esotropic and 28 (46.7%) exotropic. The male to female ratio was 1:1. The mean age with standard deviation was 16.6±8.5 years,with a range of 3 to 35 years. The pre- operative mean esotropia with standard deviation was 48.2±14.8 pd, with a range of 22 to 114 pd). The pre-operative mean exotropia was 57.8±14.2 pd, with a range of 25 to 90 pd). In 93.47% of the subjects, the ocular deviation after surgery reduced significantly (p=less than 0.00). After the strabismus surgery, orthophoria was achieved in 15 (25%) subjects, and with excellent cosmetics. After surgery, gross binocular single vision was attained in 39.3% of the exotropes and in 17.9% of the esotropes. Only 30% of the parents were aware about the strabismus and the treatment modalities. Nearly 90% of the parents were satisfied with the cosmetic outcome. Horizontal and bilateral strabismus has good surgical outcome with improved cosmetic acceptance. © NEPjOPH.

Measuring outcomes in adult spinal deformity surgery: a systematic review to identify current strengths, weaknesses and gaps in patient-reported outcome measures.

PubMed

Faraj, Sayf S A; van Hooff, Miranda L; Holewijn, Roderick M; Polly, David W; Haanstra, Tsjitske M; de Kleuver, Marinus

2017-08-01

Adult spinal deformity (ASD) causes severe disability, reduces overall quality of life, and results in a substantial societal burden of disease. As healthcare is becoming more value based, and to facilitate global benchmarking, it is critical to identify and standardize patient-reported outcome measures (PROMs). This study aims to identify the current strengths, weaknesses, and gaps in PROMs used for ASD. Studies were included following a systematic search in multiple bibliographic databases between 2000 and 2015. PROMs were extracted and linked to the outcome domains of WHO's International Classification of Functioning and Health (ICF) framework. Subsequently, the clinimetric quality of identified PROMs was evaluated. The literature search identified 144 papers that met the inclusion criteria, and nine frequently used PROMs were identified. These covered 29 ICF outcome domains, which could be grouped into three of the four main ICF chapters: body function (n = 7), activity and participation (n = 19), environmental factors (n = 3), and body structure (n = 0). A low quantity (n = 3) of papers was identified that studied the clinimetric quality of PROMs. The Scoliosis Research Society (SRS)-22 has the highest level of clinimetric quality for ASD. Outcome domains related to mobility and pain were well represented. We identified a gap in current outcome measures regarding neurological and pulmonary function. In addition, no outcome domains were measured in the ICF chapter body structure. These results will serve as a foundation for the process of seeking international consensus on a standard set of outcome domains, accompanied PROMs and contributing factors to be used in future clinical trials and spine registries.

Comprehensive chlorophyll composition in the main edible seaweeds.

PubMed

Chen, Kewei; Ríos, José Julián; Pérez-Gálvez, Antonio; Roca, María

2017-08-01

Natural chlorophylls present in seaweeds have been studied regarding their biological activities and health benefit effects. However, detailed studies regarding characterization of the complete chlorophyll profile either qualitatively and quantitatively are scarce. This work deals with the comprehensive spectrometric study of the chlorophyll derivatives present in the five main coloured edible seaweeds. The novel complete MS 2 characterization of five chlorophyll derivatives: chlorophyll c 2 , chlorophyll c 1 , purpurin-18 a, pheophytin d and phytyl-purpurin-18 a has allowed to obtain fragmentation patterns associated with their different structural features. New chlorophyll derivatives have been identified and quantified by first time in red, green and brown seaweeds, including some oxidative structures. Quantitative data of the chlorophyll content comes to achieve significant information for food composition databases in bioactive compounds. Copyright © 2017 Elsevier Ltd. All rights reserved.

33 CFR 334.10 - Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Gulf of Maine off Seal Island... REGULATIONS § 334.10 Gulf of Maine off Seal Island, Maine; naval aircraft bombing target area. (a) The danger zone. A circular area with a radius of 1.5 nautical miles, having its center just easterly of Seal...

Leaf Phenological Characters of Main Tree Species in Urban Forest of Shenyang

PubMed Central

Xu, Sheng; Xu, Wenduo; Chen, Wei; He, Xingyuan; Huang, Yanqing; Wen, Hua

2014-01-01

Background Plant leaves, as the main photosynthetic organs and the high energy converters among primary producers in terrestrial ecosystems, have attracted significant research attention. Leaf lifespan is an adaptive characteristic formed by plants to obtain the maximum carbon in the long-term adaption process. It determines important functional and structural characteristics exhibited in the environmental adaptation of plants. However, the leaf lifespan and leaf characteristics of urban forests were not studied up to now. Methods By using statistic, linear regression methods and correlation analysis, leaf phenological characters of main tree species in urban forest of Shenyang were observed for five years to obtain the leafing phenology (including leafing start time, end time, and duration), defoliating phenology (including defoliation start time, end time, and duration), and the leaf lifespan of the main tree species. Moreover, the relationships between temperature and leafing phenology, defoliating phenology, and leaf lifespan were analyzed. Findings The timing of leafing differed greatly among species. The early leafing species would have relatively early end of leafing; the longer it took to the end of leafing would have a later time of completed leafing. The timing of defoliation among different species varied significantly, the early defoliation species would have relatively longer duration of defoliation. If the mean temperature rise for 1°C in spring, the time of leafing would experience 5 days earlier in spring. If the mean temperature decline for 1°C, the time of defoliation would experience 3 days delay in autumn. Interpretation There is significant correlation between leaf longevity and the time of leafing and defoliation. According to correlation analysis and regression analysis, there is significant correlation between temperature and leafing and defoliation phenology. Early leafing species would have a longer life span and consequently have

Leaf phenological characters of main tree species in urban forest of Shenyang.

PubMed

Xu, Sheng; Xu, Wenduo; Chen, Wei; He, Xingyuan; Huang, Yanqing; Wen, Hua

2014-01-01

Plant leaves, as the main photosynthetic organs and the high energy converters among primary producers in terrestrial ecosystems, have attracted significant research attention. Leaf lifespan is an adaptive characteristic formed by plants to obtain the maximum carbon in the long-term adaption process. It determines important functional and structural characteristics exhibited in the environmental adaptation of plants. However, the leaf lifespan and leaf characteristics of urban forests were not studied up to now. By using statistic, linear regression methods and correlation analysis, leaf phenological characters of main tree species in urban forest of Shenyang were observed for five years to obtain the leafing phenology (including leafing start time, end time, and duration), defoliating phenology (including defoliation start time, end time, and duration), and the leaf lifespan of the main tree species. Moreover, the relationships between temperature and leafing phenology, defoliating phenology, and leaf lifespan were analyzed. The timing of leafing differed greatly among species. The early leafing species would have relatively early end of leafing; the longer it took to the end of leafing would have a later time of completed leafing. The timing of defoliation among different species varied significantly, the early defoliation species would have relatively longer duration of defoliation. If the mean temperature rise for 1°C in spring, the time of leafing would experience 5 days earlier in spring. If the mean temperature decline for 1°C, the time of defoliation would experience 3 days delay in autumn. There is significant correlation between leaf longevity and the time of leafing and defoliation. According to correlation analysis and regression analysis, there is significant correlation between temperature and leafing and defoliation phenology. Early leafing species would have a longer life span and consequently have advantage on carbon accumulation compared with

The Use of Portfolios to Foster Professionalism: Attributes, Outcomes, and Recommendations

ERIC Educational Resources Information Center

Franco, Renato Soleiman; Franco, Camila Ament Giuliani dos Santos; Pestana, Olívia; Severo, Milton; Ferreira, Maria Amélia

2017-01-01

The main objective of this research was to review the characteristics of portfolios and their outcomes for teaching professionalism to undergraduate medical students. A systematic review on the use of portfolios in teaching professionalism to medical students identified 1,257 papers. Of these, 11 articles met all inclusion criteria. According to…

IMPROVEMENT OF WATER MAIN INSPECTION TECHNOLOGY

EPA Science Inventory

This document is a handout of a slide presentation that addresses improvement of water main inspection technology. The slide presentation addresses the need for improved inspection technology (e.g., 237,000 main breaks/yr); the limits on main break prevention; and, the adverse ...

Small Main-Belt Asteroid Lightcurve Survey

NASA Technical Reports Server (NTRS)

Binzel, Richard P.; Xu, Shui; Bus, Schelte J.; Bowell, Edward

1992-01-01

The Small Main-Belt Asteroid Lightcurve Survey is the first to measure main-belt asteroid lightcurve properties for bodies with diameters smaller than 5 km. Attention is given to CCD lightcurves for 32 small main-belt asteroids. The objects of this sample have a mean rotational frequency which is faster than that of larger main-belt asteroids. All lightcurves were investigated for nonperiodic variations ascribable to free precession; no conclusive detection of this phenomenon has been made, however.

Characterisation of Aronia powders obtained by different drying processes.

PubMed

Horszwald, Anna; Julien, Heritier; Andlauer, Wilfried

2013-12-01

Nowadays, food industry is facing challenges connected with the preservation of the highest possible quality of fruit products obtained after processing. Attention has been drawn to Aronia fruits due to numerous health promoting properties of their products. However, processing of Aronia, like other berries, leads to difficulties that stem from the preparation process, as well as changes in the composition of bioactive compounds. Consequently, in this study, Aronia commercial juice was subjected to different drying techniques: spray drying, freeze drying and vacuum drying with the temperature range of 40-80 °C. All powders obtained had a high content of total polyphenols. Powders gained by spray drying had the highest values which corresponded to a high content of total flavonoids, total monomeric anthocyanins, cyaniding-3-glucoside and total proanthocyanidins. Analysis of the results exhibited a correlation between selected bioactive compounds and their antioxidant capacity. In conclusion, drying techniques have an impact on selected quality parameters, and different drying techniques cause changes in the content of bioactives analysed. Spray drying can be recommended for preservation of bioactives in Aronia products. Powder quality depends mainly on the process applied and parameters chosen. Therefore, Aronia powders production should be adapted to the requirements and design of the final product. Copyright © 2013 Elsevier Ltd. All rights reserved.

Employment Outcomes of Vocational Rehabilitation Clients with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Alverson, Charlotte Y.; Yamamoto, Scott H.

2017-01-01

Research has consistently documented poor employment outcomes for young adults with autism spectrum disorder (ASD). Vocational rehabilitation (VR) services provide substantial federal and state commitments to individuals with disabilities to obtain and maintain employment. To date, little research has examined the relationship between VR services…

Searching for δ Scuti-type pulsation and characterising northern pre-main-sequence field stars

NASA Astrophysics Data System (ADS)

Díaz-Fraile, D.; Rodríguez, E.; Amado, P. J.

2014-08-01

Context. Pre-main-sequence (PMS) stars are objects evolving from the birthline to the zero-age main sequence (ZAMS). Given a mass range near the ZAMS, the temperatures and luminosities of PMS and main-sequence stars are very similar. Moreover, their evolutionary tracks intersect one another causing some ambiguity in the determination of their evolutionary status. In this context, the detection and study of pulsations in PMS stars is crucial for differentiating between both types of stars by obtaining information of their interiors via asteroseismic techniques. Aims: A photometric variability study of a sample of northern field stars, which previously classified as either PMS or Herbig Ae/Be objects, has been undertaken with the purpose of detecting δ Scuti-type pulsations. Determination of physical parameters for these stars has also been carried out to locate them on the Hertzsprung-Russell diagram and check the instability strip for this type of pulsators. Methods: Multichannel photomultiplier and CCD time series photometry in the uvby Strömgren and BVI Johnson bands were obtained during four consecutive years from 2007 to 2010. The light curves have been analysed, and a variability criterion has been established. Among the objects classified as variable stars, we have selected those which present periodicities above 4 d-1, which was established as the lowest limit for δ Scuti-type pulsations in this investigation. Finally, these variable stars have been placed in a colour-magnitude diagram using the physical parameters derived with the collected uvbyβ Strömgren-Crawford photometry. Results: Five PMS δ Scuti- and three probable β Cephei-type stars have been detected. Two additional PMS δ Scuti stars are also confirmed in this work. Moreover, three new δ Scuti- and two γ Doradus-type stars have been detected among the main-sequence objects used as comparison or check stars.

Contributions of Therapist Characteristics and Stability to Intensive In-home Therapy Youth Outcomes

PubMed Central

Greeson, Johanna K. P.; Guo, Shenyang; Barth, Richard P.; Hurley, Sarah; Sisson, Jocelyn

2014-01-01

Objective This study examines the influence of therapist and youth characteristics on post-discharge outcomes from intensive in-home therapy. Method Data for 1,416 youth and 412 therapists were obtained from a behavioral health services provider. The Huber–White method was used to account for nested data; ordered logistic regression was employed to assess outcomes. Results Therapist gender and employment stability were significantly associated with youth outcomes. The likelihood of an undesirable outcome was significantly less for cases with female therapists. Conclusion Findings underscore the need for additional study concerning the impact of therapist characteristics and stability on youth outcomes, and to improve the understanding of the relationship between the two. Future studies in these areas would advance social work practice in family-based treatment programs. PMID:24944505

Conceptual framework for outcomes research studies of hepatitis C: an analytical review

PubMed Central

Sbarigia, Urbano; Denee, Tom R; Turner, Norris G; Wan, George J; Morrison, Alan; Kaufman, Anna S; Rice, Gary; Dusheiko, Geoffrey M

2016-01-01

Hepatitis C virus infection is one of the main causes of chronic liver disease worldwide. Until recently, the standard antiviral regimen for hepatitis C was a combination of an interferon derivative and ribavirin, but a plethora of new antiviral drugs is becoming available. While these new drugs have shown great efficacy in clinical trials, observational studies are needed to determine their effectiveness in clinical practice. Previous observational studies have shown that multiple factors, besides the drug regimen, affect patient outcomes in clinical practice. Here, we provide an analytical review of published outcomes studies of the management of hepatitis C virus infection. A conceptual framework defines the relationships between four categories of variables: health care system structure, patient characteristics, process-of-care, and patient outcomes. This framework can provide a starting point for outcomes studies addressing the use and effectiveness of new antiviral drug treatments. PMID:27313473

A data base and analysis program for shuttle main engine dynamic pressure measurements

NASA Technical Reports Server (NTRS)

Coffin, T.

1986-01-01

A dynamic pressure data base management system is described for measurements obtained from space shuttle main engine (SSME) hot firing tests. The data were provided in terms of engine power level and rms pressure time histories, and power spectra of the dynamic pressure measurements at selected times during each test. Test measurements and engine locations are defined along with a discussion of data acquisition and reduction procedures. A description of the data base management analysis system is provided and subroutines developed for obtaining selected measurement means, variances, ranges and other statistics of interest are discussed. A summary of pressure spectra obtained at SSME rated power level is provided for reference. Application of the singular value decomposition technique to spectrum interpolation is discussed and isoplots of interpolated spectra are presented to indicate measurement trends with engine power level. Program listings of the data base management and spectrum interpolation software are given. Appendices are included to document all data base measurements.

Changes in Body Composition in Anorexia Nervosa: Predictors of Recovery and Treatment Outcome.

PubMed

Agüera, Zaida; Romero, Xandra; Arcelus, Jon; Sánchez, Isabel; Riesco, Nadine; Jiménez-Murcia, Susana; González-Gómez, Jana; Granero, Roser; Custal, Nuria; Montserrat-Gil de Bernabé, Monica; Tárrega, Salomé; Baños, Rosa M; Botella, Cristina; de la Torre, Rafael; Fernández-García, José C; Fernández-Real, José M; Frühbeck, Gema; Gómez-Ambrosi, Javier; Tinahones, Francisco J; Crujeiras, Ana B; Casanueva, Felipe F; Menchón, José M; Fernández-Aranda, Fernando

2015-01-01

The restoration of body composition (BC) parameters is considered to be one of the most important goals in the treatment of patients with anorexia nervosa (AN). However, little is known about differences between AN diagnostic subtypes [restricting (AN-R) and binge/purging (AN-BP)] and weekly changes in BC during refeeding treatment. Therefore, the main objectives of our study were twofold: 1) to assess the changes in BC throughout nutritional treatment in an AN sample and 2) to analyze predictors of BC changes during treatment, as well as predictors of treatment outcome. The whole sample comprised 261 participants [118 adult females with AN (70 AN-R vs. 48 AN-BP), and 143 healthy controls]. BC was measured weekly during 15 weeks of day-hospital treatment using bioelectrical impedance analysis (BIA). Assessment measures also included the Eating Disorders Inventory-2, as well as a number of other clinical indices. Overall, the results showed that AN-R and AN-BP patients statistically differed in all BC measures at admission. However, no significant time×group interaction was found for almost all BC parameters. Significant time×group interactions were only found for basal metabolic rate (p = .041) and body mass index (BMI) (p = .035). Multiple regression models showed that the best predictors of pre-post changes in BC parameters (namely fat-free mass, muscular mass, total body water and BMI) were the baseline values of BC parameters. Stepwise predictive logistic regressions showed that only BMI and age were significantly associated with outcome, but not with the percentage of body fat. In conclusion, these data suggest that although AN patients tended to restore all BC parameters during nutritional treatment, only AN-BP patients obtained the same fat mass values as healthy controls. Put succinctly, the best predictors of changes in BC were baseline BC values, which did not, however, seem to influence treatment outcome.

Evaluation of a mid-career investigator career development award: Assessing the ability of OppNet K18 awardees to obtain NIH follow-on research funding.

PubMed

Pomeroy-Carter, Cassidy A; Williams, Sharon R; Han, Xueying; Elwood, William N; Zuckerman, Brian L

2018-01-01

The National Institutes of Health (NIH) K18 award mechanism provides funded opportunities for established investigators to gain knowledge in fields outside of their primary disciplines, but outcomes associated with these awards have not been evaluated to date. NIH's Basic Behavioral and Social Sciences Opportunity Network (OppNet) is one of the few initiatives that has used this award mechanism. We explored how the unique features of K18 awards affect the ability of recipients to obtain follow-on NIH research funding. We compared outcomes (ability to obtain follow-on funding and interval between receipt of the primary award and receipt of the first follow-on award) associated with OppNet K18 awards to findings from evaluations of other NIH career development (K) awards, which usually target early-career investigators. We hypothesized that K18 award recipients might be (1) more successful than are other K award recipients in obtaining follow-on NIH research funding due to their career experience or (2) less successful due to the competing demands of other projects. By analyzing follow-on NIH research awards and interview data, we found that OppNet K18 award recipients were at least as successful as were other K award recipients in obtaining follow-on funding and may have been more successful by certain measures. K18 awards produce their outcomes with a lower investment per investigator than do other K awards, suggesting continued or enhanced use of the mechanism.

Evaluation of a mid-career investigator career development award: Assessing the ability of OppNet K18 awardees to obtain NIH follow-on research funding

PubMed Central

Williams, Sharon R.; Han, Xueying; Elwood, William N.; Zuckerman, Brian L.

2018-01-01

The National Institutes of Health (NIH) K18 award mechanism provides funded opportunities for established investigators to gain knowledge in fields outside of their primary disciplines, but outcomes associated with these awards have not been evaluated to date. NIH’s Basic Behavioral and Social Sciences Opportunity Network (OppNet) is one of the few initiatives that has used this award mechanism. We explored how the unique features of K18 awards affect the ability of recipients to obtain follow-on NIH research funding. We compared outcomes (ability to obtain follow-on funding and interval between receipt of the primary award and receipt of the first follow-on award) associated with OppNet K18 awards to findings from evaluations of other NIH career development (K) awards, which usually target early-career investigators. We hypothesized that K18 award recipients might be (1) more successful than are other K award recipients in obtaining follow-on NIH research funding due to their career experience or (2) less successful due to the competing demands of other projects. By analyzing follow-on NIH research awards and interview data, we found that OppNet K18 award recipients were at least as successful as were other K award recipients in obtaining follow-on funding and may have been more successful by certain measures. K18 awards produce their outcomes with a lower investment per investigator than do other K awards, suggesting continued or enhanced use of the mechanism. PMID:29438411

Developer handbook for Section 210 of PURPA for Maine

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

O'Connell, J.

The essential element of the Public Utility Regulatory Policies Act of 1978 (PURPA) for developers is a reordering by Congress of the relationship between electric utilities and small power producers. The goal of PURPA is to encourage development of alternative sources of electricity by helping small power production become economically viable. The strategy adopted by Congress for encouraging development has two main components. First, the utility must purchase the power produced by a project meeting certain definitional requirements; and second, the utility must pay a price for the power, determined in accordance with guidelines set out in the FERC regulations.more » This handbook is designed to explain to developers in Maine the requirements of PURPA, including: who may qualify for treatment as a facility that may invoke the mandates of PURPA; the impact of PURPA on the state; the role of the state utility commission and the impact of state laws on the developer. Thus, the primary goal of the handbook is to provide potential small producers with a working understanding of their status and rights vis a vis the state utility commissions and electric utilities, and to aid the potential developer in obtaining the information needed to stimulate further research and development.« less

Case Mix Difference Can Affect Evaluation of Outcome of Treatment for Colorectal Cancer.

PubMed

Ljungman, David; Kodeda, Karl; Derwinger, Kristoffer

2015-07-01

To explore the potential effects of patient selection, for example by organization, on survival as outcome parameter in colorectal cancer treatment. The main cohort was identified in a Hospital-based registry and outcome data of all 2,717 patients operated on for colorectal cancer between 2000-2011 were evaluated. A simulation of different center settings was performed using several potential selection criteria, including emergency cases, referral surgery and palliative resection, and used for comparison of outcome data. Overall survival and cancer-specific survival can be significantly affected in both short-term (30-/90-day) mortality and long-term survival by factors of organizational level. Survival data as an outcome parameter can be affected by the composition of the patient cohort and thus reflect possible selection bias for example due to organization, referral patterns and practice customs. This potential bias should be acknowledged when making inter-hospital comparisons of outcome. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Cellulose fibers obtained by organosolv process from date palm rachis (Phoenix dactylifera L.)

NASA Astrophysics Data System (ADS)

Ammar, H.; Abid, M.; Abid, S.

2012-02-01

In this preliminary study, the chemical composition of Tunisian DPR was established and discussed. The main characteristic of this agri-residue was its high lignin content in comparison with that of alfa plant. CIMV process was used to selectively separate cellulose fibres, hemicelluloses and lignin at atmospheric pressure. The obtained unbleached pulp was analysed in accordance with Kappa index and degree of polymerisation and then bleached by treating successively with peroxyacids and hydrogen peroxide in basic media.

Comparative effectiveness studies to improve clinical outcomes in end stage renal disease: the DEcIDE patient outcomes in end stage renal disease study

PubMed Central

2012-01-01

Background Evidence is lacking to inform providers’ and patients’ decisions about many common treatment strategies for patients with end stage renal disease (ESRD). Methods/design The DEcIDE Patient Outcomes in ESRD Study is funded by the United States (US) Agency for Health Care Research and Quality to study the comparative effectiveness of: 1) antihypertensive therapies, 2) early versus later initiation of dialysis, and 3) intravenous iron therapies on clinical outcomes in patients with ESRD. Ongoing studies utilize four existing, nationally representative cohorts of patients with ESRD, including (1) the Choices for Healthy Outcomes in Caring for ESRD study (1041 incident dialysis patients recruited from October 1995 to June 1999 with complete outcome ascertainment through 2009), (2) the Dialysis Clinic Inc (45,124 incident dialysis patients initiating and receiving their care from 2003–2010 with complete outcome ascertainment through 2010), (3) the United States Renal Data System (333,308 incident dialysis patients from 2006–2009 with complete outcome ascertainment through 2010), and (4) the Cleveland Clinic Foundation Chronic Kidney Disease Registry (53,399 patients with chronic kidney disease with outcome ascertainment from 2005 through 2009). We ascertain patient reported outcomes (i.e., health-related quality of life), morbidity, and mortality using clinical and administrative data, and data obtained from national death indices. We use advanced statistical methods (e.g., propensity scoring and marginal structural modeling) to account for potential biases of our study designs. All data are de-identified for analyses. The conduct of studies and dissemination of findings are guided by input from Stakeholders in the ESRD community. Discussion The DEcIDE Patient Outcomes in ESRD Study will provide needed evidence regarding the effectiveness of common treatments employed for dialysis patients. Carefully planned dissemination strategies to the ESRD

Correlation and evaluation of inplane stability characteristics for an advanced bearingless main rotor

NASA Technical Reports Server (NTRS)

Weller, W. H.

1983-01-01

A program of experimental and analytical research was performed to demonstrate the degree of correlation achieved between measured and computed rotor inplane stability characteristics. The experimental data were obtained from hover and wind tunnel tests of a scaled bearingless main rotor model. Both isolated rotor and free-hub conditions were tested. Test parameters included blade built-in cone and sweep angles; rotor inplane structural stiffness and damping; pitch link stiffness and location; and fuselage damping, inertia, and natural frequency. Analytical results for many test conditions were obtained. In addition, the analytical and experimental results were examined to ascertain the effects of the test parameters on rotor ground and air resonance stability. The results from this program are presented herein in tabular and graphical form.

Maine CITE: Technology Collaboration through Distance Learning.

ERIC Educational Resources Information Center

Stockford, David Noble; And Others

This paper describes the Maine Consumer Information and Technology Training Exchange (Maine CITE) project designed to increase the availability and use of assistive-technology to Maine people with disabilities. Maine CITE is a 3-year project supported by the Maine Department of Education, Division of Special Education, with a grant from the…

Indicators and standards of quality for the Schoodic Peninsula section of Acadia National Park, Maine

Treesearch

James Bacon; Robert Manning; Steven Lawson; William Valliere; Daniel Laven

2003-01-01

A multi-year research initiative was undertaken to inform park planning and management efforts at the Schoodic Peninsula Section of Acadia National Park, Maine. This research focused on developing information that will enable formulation of indicators and standards of quality. The first phase of research in the summer of 2000 obtained descriptive information on visitor...

Modern classification and outcome predictors of surgery in patients with brain arteriovenous malformations.

PubMed

Tayebi Meybodi, Ali; Lawton, Michael T

2018-02-23

Brain arteriovenous malformations (bAVM) are challenging lesions. Part of this challenge stems from the infinite diversity of these lesions regarding shape, location, anatomy, and physiology. This diversity has called on a variety of treatment modalities for these lesions, of which microsurgical resection prevails as the mainstay of treatment. As such, outcome prediction and managing strategy mainly rely on unraveling the nature of these complex tangles and ways each lesion responds to various therapeutic modalities. This strategy needs the ability to decipher each lesion through accurate and efficient categorization. Therefore, classification schemes are essential parts of treatment planning and outcome prediction. This article summarizes different surgical classification schemes and outcome predictors proposed for bAVMs.

Ethnic Gaps in Educational Attainment and Labor-Market Outcomes: Evidence from France

ERIC Educational Resources Information Center

Langevin, Gabin; Masclet, David; Moizeau, Fabien; Peterle, Emmanuel

2017-01-01

We use data from the "Trajectoires et Origines" survey to analyze ethnic gaps in education and labor-market outcomes between second-generation immigrants and their French-native counterparts. Our three main findings underscore the importance of family background in explaining lifelong ethnic inequalities. First, second-generation…

Long-term outcomes of pars plana vitrectomy without internal limiting membrane peeling for optic disc pit maculopathy.

PubMed

Avci, R; Yilmaz, S; Inan, U U; Kaderli, B; Kurt, M; Yalcinbayir, O; Yildiz, M; Yucel, A

2013-12-01

To evaluate the results of surgical treatment of maculopathy secondary to congenital optic pit anomaly with pars plana vitrectomy (PPV), endolaser to the temporal edge of the optic disc and C3F8 tamponade without internal limiting membrane (ILM) peeling. Thirteen eyes of 12 patients with serous macular detachment and/or macular retinoschisis secondary to congenital optic disc pit (ODP) were included in the study. All eyes underwent PPV, posterior hyaloid removal, endolaser photocoagulation on the temporal margin of the optic disc and 12% C3F8 gas tamponade. Anatomic success and functional outcome determined retrospectively by optical coherence tomography and measurement of best corrected visual acuity (BCVA), respectively were the main outcome parameters. Two lines or more improvement in BCVA was obtained in 11 eyes and 6 of these eyes had 20/40 or better BCVA at the final visit. Subretinal or intraretinal fluid was completely resorbed postoperatively in 12 eyes but a little intraretinal fluid persisted in one eye at the 16-month follow-up. Better visual improvement was observed in patients treated by earlier surgical intervention. PPV, C3F8 gas tamponade and endolaser to the optic disc margin without ILM peeling may yield favourable results in the treatment of ODP maculopathy.

Submillimeter Imaging of Dust Around Main Sequence Stars

NASA Technical Reports Server (NTRS)

Jewitt, David

1998-01-01

circumstellar dust disks were obtained at 850 gm in 1997/8. These images show extended, asymmetric emission, but have a signal-to-noise ratio too low to permit disk mapping to large projected distances. Our images of beta Pic, in particular, are in agreement with those obtained by Holland et al., and appear to confirm the blob-structure reported first by these authors. We have not yet been able to confirm that the structure is intrinsic to the disk, since beta Pic is at -50 degree declination, and suitable observing opportunities from northern latitudes are comparatively rare (even at the +20 degree latitude of JCMT). It is possible, for instance, that the main 850 micro-m blob is merely a galaxy or other high-z source projected onto the beta Pic mid-plane.

The influence of body mass index to in-vitro fertilisation treatment outcome, risk of miscarriage and pregnancy outcome.

PubMed

Thum, M Y; El-Sheikhah, A; Faris, R; Parikh, J; Wren, M; Ogunyemi, T; Gafar, A; Abdalla, H

2007-10-01

The aim of this work was to evaluate the effects of extreme body mass index (BMI) on assisted reproductive treatment outcome and pregnancy outcome. This is a descriptive cohort study that evaluated 8,145 consecutive in-vitro fertilisation/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) cycles in which BMI were known, from July 1997 to June 2005 in an inner London major fertility clinic. The data were collected prospectively and analysed retrospectively on women undergoing IVF/ICSI and ET. Patients' weight and height were established prior to treatment. IVF/ICSI treatment was then started using either a long or an antagonist protocol. Patients were divided into five groups: Group A (BMI < 19); Group B (BMI between 19 and 25.9); Group C (BMI between 26 and 30.9); Group D (BMI between 31 and 35.9); Group E (BMI > 36). The main outcomes measured were number of eggs collected, fertilisation rate, number of embryos available for transfer, pregnancy rate (PR), live-birth rate (LBR) and miscarriage rate (MR). The results showed no significant difference in the average number of days taking follicle stimulating hormone (FSH) for ovarian stimulation, the average amount of gonadotrophin used for stimulation, number of eggs collected and fertilisation rate. The pregnancy rate, miscarriage rate and the live-birth rate were not statistically different between all groups. However, in group E the miscarriage rate was significantly higher and the LBR was statistically lower compared with group B. We concluded that extreme BMI did not affect the super-ovulation outcome fertilisation rate and pregnancy rate. Women with a BMI > 35 had a higher miscarriage rate and hence a lower live-birth rate, but a reasonable pregnancy and live-birth rate can be achieved. For women with a BMI < 20 there was no difference in assisted reproduction treatment (ART) outcome and pregnancy outcome when compared with women with a normal BMI. This information should be used to advise patients

76 FR 32266 - Maine Northern Railway Company-Trackage Rights Exemption-Montreal, Maine & Atlantic Railway, Ltd.

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-03

... written trackage rights agreement, Montreal, Maine & Atlantic Railway, Ltd. (MMA) has agreed to grant... milepost 109 on MMA's Millinocket Subdivision) and Brownville Junction, Me. (at or about milepost 104.84 on the Mattawamkeag Subdivision of the Eastern Maine Railway (EMR)), including MMA's Brownville Junction...

Positive interaction of social comparison and personal responsibility for outcomes.

PubMed

Grygolec, Jaroslaw; Coricelli, Giorgio; Rustichini, Aldo

2012-01-01

We formulate and test a model that allows sharp separation between two different ways in which environment affects evaluation of outcomes, by comparing social vs. private and personal responsibility vs. chance. In the experiment, subjects chose between two lotteries, one low-risk and one high-risk. They could then observe the outcomes. By varying the environment between private (they could observe the outcome of the chosen lottery and the outcome of the lottery they had not chosen) and social (they could observe the outcome of the lottery chosen by another subject) we can differentiate the response and brain activity following the feedback in social and private settings. The evidence suggests that envy and pride are significant motives driving decisions and outcomes evaluation, stronger than private emotions like regret and rejoice, with ventral striatum playing a key role. When we focus on the outcome evaluation stage we demonstrate that BOLD signal in ventral striatum is increasing in the difference between obtained and counterfactual payoffs. For a given difference in payoffs, striatal responses are more pronounced in social than in private environment. Moreover, a positive interaction (complementarity) between social comparison and personal responsibility is reflected in the pattern of activity in the ventral striatum. At decision stage we observe getting ahead of the Joneses effect in ventral striatum with subjective value of risk larger in social than in private environment.

Positive Interaction of Social Comparison and Personal Responsibility for Outcomes

PubMed Central

Grygolec, Jaroslaw; Coricelli, Giorgio; Rustichini, Aldo

2012-01-01

We formulate and test a model that allows sharp separation between two different ways in which environment affects evaluation of outcomes, by comparing social vs. private and personal responsibility vs. chance. In the experiment, subjects chose between two lotteries, one low-risk and one high-risk. They could then observe the outcomes. By varying the environment between private (they could observe the outcome of the chosen lottery and the outcome of the lottery they had not chosen) and social (they could observe the outcome of the lottery chosen by another subject) we can differentiate the response and brain activity following the feedback in social and private settings. The evidence suggests that envy and pride are significant motives driving decisions and outcomes evaluation, stronger than private emotions like regret and rejoice, with ventral striatum playing a key role. When we focus on the outcome evaluation stage we demonstrate that BOLD signal in ventral striatum is increasing in the difference between obtained and counterfactual payoffs. For a given difference in payoffs, striatal responses are more pronounced in social than in private environment. Moreover, a positive interaction (complementarity) between social comparison and personal responsibility is reflected in the pattern of activity in the ventral striatum. At decision stage we observe getting ahead of the Joneses effect in ventral striatum with subjective value of risk larger in social than in private environment. PMID:22371706

Maternal care and birth outcomes among ethnic minority women in Finland

PubMed Central

Malin, Maili; Gissler, Mika

2009-01-01

Background Care during pregnancy and labour is of great importance in every culture. Studies show that people of migrant origin have barriers to obtaining accessible and good quality care compared to people in the host society. The aim of this study is to compare the access to and use of maternity services, and their outcomes among ethnic minority women having a singleton birth in Finland. Methods The study is based on data from the Finnish Medical Birth Register in 1999–2001 linked with the information of Statistics Finland on woman's country of birth, citizenship and mother tongue. Our study data included 6,532 women of foreign origin (3.9% of all singletons) giving singleton birth in Finland during 1999–2001 (compared to 158,469 Finnish origin singletons). Results Most women have migrated during the last fifteen years, mainly from Russia, Baltic countries, Somalia and East Europe. Migrant origin women participated substantially in prenatal care. Interventions performed or needed during pregnancy and childbirth varied between ethnic groups. Women of African and Somali origin had most health problems resulted in the highest perinatal mortality rates. Women from East Europe, the Middle East, North Africa and Somalia had a significant risk of low birth weight and small for gestational age newborns. Most premature newborns were found among women from the Middle East, North Africa and South Asia. Primiparous women from Africa, Somalia and Latin America and Caribbean had most caesarean sections while newborns of Latin American origin had more interventions after birth. Conclusion Despite good general coverage of maternal care among migrant origin women, there were clear variations in the type of treatment given to them or needed by them. African origin women had the most health problems during pregnancy and childbirth and the worst perinatal outcomes indicating the urgent need of targeted preventive and special care. These study results do not confirm either

Intensivist-reported Facilitators and Barriers to Discussing Post-Discharge Outcomes with Intensive Care Unit Surrogates. A Qualitative Study

PubMed Central

Davis, Wesley E.; Needham, Dale M.; White, Douglas B.; Eakin, Michelle N.

2016-01-01

Rationale: Intensive care unit (ICU) patients’ expected post-discharge outcomes are rarely discussed in family meetings despite this information being centrally important to patients and their families. Objectives: To characterize intensivist-identified barriers and facilitators to discussing post-discharge outcomes with surrogates of ICU patients. Methods: Qualitative study conducted via one-on-one, semistructured telephone interviews with 23 intensivists from 20 hospitals with accreditation council for graduate medical education–accredited critical care medicine programs in 16 states. A limited application of grounded theory methods was used to code transcribed interviews and identify themes and illustrative quotes. Measurements and Main Results: Intensivists reported tension between their professional responsibility to discuss likely functional outcomes versus uncertainty about their ability to predict those outcomes for an individual patient. They cited three main barriers as limiting their ability to conduct conversations about post-discharge outcomes with ICU surrogates: (1) incorrectly optimistic expectations for recovery among ICU surrogates, (2) having little or no contact with their patients after ICU discharge, and (3) minimal confidence applying existing outcomes research to individual patients. Despite these barriers, experience talking to ICU surrogates, seeing ICU survivors in the outpatient setting, and trusted research on functional outcomes were identified as important facilitators to discussing likely patient outcomes with surrogates. Intensivists generally welcomed questions from surrogates about post-discharge outcomes as opportunities to initiate conversations about prognosis and patient values. Conclusions: In this sample of intensivists from 20 academic hospitals, experience conducting conversations with surrogates and interactions with ICU survivors as outpatients were identified as facilitating discussion of expected post

Relationship between Smoking and Outcomes after Cubital Tunnel Release.

PubMed

Crosby, Nicholas E; Nosrati, Naveed N; Merrell, Greg; Hasting, Hill

2018-04-01

Several studies have drawn a connection between cigarette smoking and cubital tunnel syndrome. One comparison article demonstrated worse outcomes in smokers treated with transmuscular transposition of the ulnar nerve. However, very little is known about the effect that smoking might have on patients who undergo ulnar nerve decompression at the elbow. The purpose of this study is to evaluate the effect of smoking preoperatively on outcomes in patients treated with ulnar nerve decompression. This study used a survey developed from the comparison article with additional questions based on outcome measures from supportive literature. Postoperative improvement was probed, including sensation, strength, and pain scores. A thorough smoking history was obtained. The study spanned a 10-year period. A total of 1,366 surveys were mailed to former patients, and 247 surveys with adequate information were returned. No significant difference was seen in demographics or comorbidities. Patients who smoked preoperatively were found to more likely relate symptoms of pain. Postoperatively, nonsmoking patients generally reported more favorable improvement, though these findings were not statistically significant. This study finds no statistically significant effect of smoking on outcomes after ulnar nerve decompression. Finally, among smokers, there were no differences in outcomes between simple decompression and transposition.

Alpha-canonical form representation of the open loop dynamics of the Space Shuttle main engine

NASA Technical Reports Server (NTRS)

Duyar, Almet; Eldem, Vasfi; Merrill, Walter C.; Guo, Ten-Huei

1991-01-01

A parameter and structure estimation technique for multivariable systems is used to obtain a state space representation of open loop dynamics of the space shuttle main engine in alpha-canonical form. The parameterization being used is both minimal and unique. The simplified linear model may be used for fault detection studies and control system design and development.

Investigating Relationships between Features of Learning Designs and Student Learning Outcomes

ERIC Educational Resources Information Center

McNaught, Carmel; Lam, Paul; Cheng, Kin Fai

2012-01-01

This article reports a study of eLearning in 21 courses in Hong Kong universities that had a blended design of face-to-face classes combined with online learning. The main focus of the study was to examine possible relationships between features of online learning designs and student learning outcomes. Data-collection strategies included expert…

Sublimation-Driven Activity in Main-Belt Comet 313p/Gibbs

NASA Astrophysics Data System (ADS)

Hsieh, Henry H.; Hainaut, Olivier; Novaković, Bojan; Bolin, Bryce; Denneau, Larry; Fitzsimmons, Alan; Haghighipour, Nader; Kleyna, Jan; Kokotanekova, Rosita; Lacerda, Pedro; Meech, Karen J.; Micheli, Marco; Moskovitz, Nick; Schunova, Eva; Snodgrass, Colin; Wainscoat, Richard J.; Wasserman, Lawrence; Waszczak, Adam

2015-02-01

We present an observational and dynamical study of newly discovered main-belt comet 313P/Gibbs. We find that the object is clearly active both in observations obtained in 2014 and in precovery observations obtained in 2003 by the Sloan Digital Sky Survey, strongly suggesting that its activity is sublimation-driven. This conclusion is supported by a photometric analysis showing an increase in the total brightness of the comet over the 2014 observing period, and dust modeling results showing that the dust emission persists over at least three months during both active periods, where we find start dates for emission no later than 2003 July 24 ± 10 for the 2003 active period and 2014 July 28 ± 10 for the 2014 active period. From serendipitous observations by the Subaru Telescope in 2004 when the object was apparently inactive, we estimate that the nucleus has an absolute R-band magnitude of HR = 17.1 ± 0.3, corresponding to an effective nucleus radius of re ∼ 1.00 ± 0.15 km. The object’s faintness at that time means we cannot rule out the presence of activity, and so this computed radius should be considered an upper limit. We find that 313P’s orbit is intrinsically chaotic, having a Lyapunov time of Tl = 12,000 yr and being located near two three-body mean-motion resonances with Jupiter and Saturn, 11J-1S-5A and 10J+12S-7A, yet appears stable over >50 Myr in an apparent example of stable chaos. We furthermore find that 313P is the second main-belt comet, after P/2012 T1 (PANSTARRS), to belong to the ∼155 Myr old Lixiaohua asteroid family.

SUBLIMATION-DRIVEN ACTIVITY IN MAIN-BELT COMET 313P/GIBBS

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

Hsieh, Henry H.; Hainaut, Olivier; Novaković, Bojan

2015-02-10

We present an observational and dynamical study of newly discovered main-belt comet 313P/Gibbs. We find that the object is clearly active both in observations obtained in 2014 and in precovery observations obtained in 2003 by the Sloan Digital Sky Survey, strongly suggesting that its activity is sublimation-driven. This conclusion is supported by a photometric analysis showing an increase in the total brightness of the comet over the 2014 observing period, and dust modeling results showing that the dust emission persists over at least three months during both active periods, where we find start dates for emission no later than 2003more » July 24 ± 10 for the 2003 active period and 2014 July 28 ± 10 for the 2014 active period. From serendipitous observations by the Subaru Telescope in 2004 when the object was apparently inactive, we estimate that the nucleus has an absolute R-band magnitude of H{sub R} = 17.1 ± 0.3, corresponding to an effective nucleus radius of r{sub e} ∼ 1.00 ± 0.15 km. The object’s faintness at that time means we cannot rule out the presence of activity, and so this computed radius should be considered an upper limit. We find that 313P’s orbit is intrinsically chaotic, having a Lyapunov time of T{sub l} = 12,000 yr and being located near two three-body mean-motion resonances with Jupiter and Saturn, 11J-1S-5A and 10J+12S-7A, yet appears stable over >50 Myr in an apparent example of stable chaos. We furthermore find that 313P is the second main-belt comet, after P/2012 T1 (PANSTARRS), to belong to the ∼155 Myr old Lixiaohua asteroid family.« less

Learning to Obtain Reward, but Not Avoid Punishment, Is Affected by Presence of PTSD Symptoms in Male Veterans: Empirical Data and Computational Model

PubMed Central

Myers, Catherine E.; Moustafa, Ahmed A.; Sheynin, Jony; VanMeenen, Kirsten M.; Gilbertson, Mark W.; Orr, Scott P.; Beck, Kevin D.; Pang, Kevin C. H.; Servatius, Richard J.

2013-01-01

Post-traumatic stress disorder (PTSD) symptoms include behavioral avoidance which is acquired and tends to increase with time. This avoidance may represent a general learning bias; indeed, individuals with PTSD are often faster than controls on acquiring conditioned responses based on physiologically-aversive feedback. However, it is not clear whether this learning bias extends to cognitive feedback, or to learning from both reward and punishment. Here, male veterans with self-reported current, severe PTSD symptoms (PTSS group) or with few or no PTSD symptoms (control group) completed a probabilistic classification task that included both reward-based and punishment-based trials, where feedback could take the form of reward, punishment, or an ambiguous “no-feedback” outcome that could signal either successful avoidance of punishment or failure to obtain reward. The PTSS group outperformed the control group in total points obtained; the PTSS group specifically performed better than the control group on reward-based trials, with no difference on punishment-based trials. To better understand possible mechanisms underlying observed performance, we used a reinforcement learning model of the task, and applied maximum likelihood estimation techniques to derive estimated parameters describing individual participants’ behavior. Estimations of the reinforcement value of the no-feedback outcome were significantly greater in the control group than the PTSS group, suggesting that the control group was more likely to value this outcome as positively reinforcing (i.e., signaling successful avoidance of punishment). This is consistent with the control group’s generally poorer performance on reward trials, where reward feedback was to be obtained in preference to the no-feedback outcome. Differences in the interpretation of ambiguous feedback may contribute to the facilitated reinforcement learning often observed in PTSD patients, and may in turn provide new insight into

Differentiated Effects of Community Schooling on Cognitive and Social-Emotional Learning Outcomes

ERIC Educational Resources Information Center

Heers, Marieke; Ghysels, Joris; Groot, Wim; van den Brink, Henriëtte Maassen

2015-01-01

Community schools are becoming increasingly popular. They aim to enhance children's educational performance by offering extended educational and social services. As community schools mainly focus on disadvantaged children, this study evaluates the effects of community schooling on the educational outcomes of these pupils. We focus on care pupils…

Preliminary crystallographic analysis of avian infectious bronchitis virus main protease

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

Li, Jun; Shen, Wei; Liao, Ming, E-mail: mliao@scau.edu.cn

The avian infectious bronchitis virus main protease has been crystallized; crystals diffract to 2.7 Å resolution. Infectious bronchitis virus (IBV) is the prototype of the genus Coronavirus. It causes a highly contagious disease which affects the respiratory, reproductive, neurological and renal systems of chickens, resulting great economic losses in the poultry industry worldwide. The coronavirus (CoV) main protease (M{sup pro}), which plays a pivotal role in viral gene expression and replication through a highly complex cascade involving the proteolytic processing of replicase polyproteins, is an attractive target for antiviral drug design. In this study, IBV M{sup pro} was overexpressed inmore » Escherichia coli. Crystals suitable for X-ray crystallography have been obtained using microseeding techniques and belong to space group P6{sub 1}22. X-ray diffraction data were collected in-house to 2.7 Å resolution from a single crystal. The unit-cell parameters were a = b = 119.1, c = 270.7 Å, α = β = 90, γ = 120°. Three molecules were predicted to be present in the asymmetric unit from a calculated self-rotation function.« less

Trajectories of Peer-Nominated Aggression: Risk Status, Predictors and Outcomes.

ERIC Educational Resources Information Center

van Lier, Pol A.C.; Crijnen, Alfons A.M.

2005-01-01

Developmental trajectories of peer-nominated aggression, risk factors at baseline, and outcomes were studied. Peer nominations of aggression were obtained annually from grades 1 to 3. Three developmental trajectories were identified: an early-onset/increasers trajectory with high levels of peer-nominated aggression at elementary school entry and…

14 CFR 119.47 - Maintaining a principal base of operations, main operations base, and main maintenance base...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Maintaining a principal base of operations, main operations base, and main maintenance base; change of address. 119.47 Section 119.47 Aeronautics... Under Part 121 or Part 135 of This Chapter § 119.47 Maintaining a principal base of operations, main...

14 CFR 119.47 - Maintaining a principal base of operations, main operations base, and main maintenance base...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Maintaining a principal base of operations, main operations base, and main maintenance base; change of address. 119.47 Section 119.47 Aeronautics... Under Part 121 or Part 135 of This Chapter § 119.47 Maintaining a principal base of operations, main...

14 CFR 119.47 - Maintaining a principal base of operations, main operations base, and main maintenance base...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Maintaining a principal base of operations, main operations base, and main maintenance base; change of address. 119.47 Section 119.47 Aeronautics... Under Part 121 or Part 135 of This Chapter § 119.47 Maintaining a principal base of operations, main...

14 CFR 119.47 - Maintaining a principal base of operations, main operations base, and main maintenance base...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Maintaining a principal base of operations, main operations base, and main maintenance base; change of address. 119.47 Section 119.47 Aeronautics... Under Part 121 or Part 135 of This Chapter § 119.47 Maintaining a principal base of operations, main...

Maine's annual inventory: state perspectives

Treesearch

Kenneth M. Laustsen

2000-01-01

In 1999, Maine became the first northeastern state to begin implementing the USDA Forest Service's annual inventory system as directed by PL 105- 185, the Agricultural Research, Extension, and Education Reform Act of 1998. The Maine Forest Service, in collaboration with Forest Inventory and Analysis program of the Northeastern Research Station of the USDA Forest...

Melancholic and atypical depression as predictor and moderator of outcome in cognitive behavior therapy and pharmacotherapy for adult depression.

PubMed

Cuijpers, Pim; Weitz, Erica; Lamers, Femke; Penninx, Brenda W; Twisk, Jos; DeRubeis, Robert J; Dimidjian, Sona; Dunlop, Boadie W; Jarrett, Robin B; Segal, Zindel V; Hollon, Steven D

2017-03-01

Melancholic and atypical depression are widely thought to moderate or predict outcome of pharmacological and psychological treatments of adult depression, but that has not yet been established. This study uses the data from four earlier trials comparing cognitive behavior therapy (CBT) versus antidepressant medications (ADMs; and pill placebo when available) to examine the extent to which melancholic and atypical depression moderate or predict outcome in an "individual patient data" meta-analysis. We conducted a systematic search for studies directly comparing CBT versus ADM, contacted the researchers, integrated the resulting datasets from these studies into one big dataset, and selected the studies that included melancholic or atypical depressive subtyping according to DSM-IV criteria at baseline (n = 4, with 805 patients). After multiple imputation of missing data at posttest, mixed models were used to conduct the main analyses. In none of the analyses was melancholic or atypical depression found to significantly moderate outcome (indicating a better or worse outcome of these patients in CBT compared to ADM; i.e., an interaction), predict outcome independent of treatment group (i.e., a main effect), or predict outcome within a given modality. The outcome differences between patients with melancholia or atypical depression versus those without were consistently very small (all effect sizes g < 0.10). We found no indication that melancholic or atypical depressions are significant or relevant moderators or predictors of outcome of CBT and ADM. © 2016 Wiley Periodicals, Inc.

Quality of non-mydriatic digital fundus photography obtained by nurse practitioners in the emergency department: the FOTO-ED study

PubMed Central

Lamirel, Cédric; Bruce, Beau B.; Wright, David W.; Delaney, Kevin P.; Newman, Nancy J.; Biousse, Valérie

2011-01-01

Objective Non-mydriatic fundus photography by non-ophthalmic trained personnel has recently been shown to be a potential alternative to direct ophthalmoscopy in the emergency department (ED). We evaluated the reliability of a novel quality rating scale and applied this scale to non-mydriatic fundus photographs taken during routine ED patient encounters to determine factors associated with diminished photograph quality. Design Prospective, cross-sectional Participants 350 patients enrolled in the Fundus photography vs. Ophthalmoscopy Trials Outcomes in the Emergency Department (FOTO-ED) study were photographed by nurse practitioners after <30 minutes of training followed by supervision. Methods Photographs of both eyes were graded for quality on two occasions by two neuro-ophthalmologists. Four regions were independently evaluated for quality: optic disc, macula, superior and inferior vascular arcades. Quality as a function of the number of photographs taken was evaluated by Kaplan-Meier analysis. Mixed effects ordinal logistic regression was used to evaluate for predictors of image quality while accounting for the repeated measures design. Main Outcome Measure Overall photographic quality (1–5 scale, 5 best). Results We evaluated 1734 photographs. Inter- and intra-observer agreements between neuro-ophthalmologists were very good (weighted kappa:0.84–0.87). Quality of the optic disc area was better than those of other retinal areas (p<0.002). Kaplan-Meier analysis showed that if a high-quality photograph of an eye was not obtained by the third attempt it was unlikely that one would be obtained at all. A 10 second increase in the inter-photograph interval before a total of forty seconds increased the odds of a one unit higher quality rating by 1.81 times (95%CI: 1.68–1.98), and a ten year increase in age decreased the odds by 0.76 times (95%CI: 0.69–0.85). Black patients had 0.42 times (95%CI: 0.28–0.63) the odds of a one unit higher quality rating compared

A Main Sequence For Quasars

NASA Astrophysics Data System (ADS)

Marziani, Paola; Sulentic, J. W.; Dultzin, D.; Negrete, A.; del Olmo, A.; Martínez-Carballo, M. A.; Stirpe, G. M.; D'Onofrio, M.; Perea, J.

2016-10-01

The 4D eigenvector 1 parameter space defined by Sulentic et al. may be seen as a surrogate H-R diagram for quasars. As in the stellar H-R diagram, a source sequence can be easily identified. In the case of quasars, the main sequence appears to be mainly driven by Eddington ratio. A transition Eddington ratio may in part explain the striking observational differences between quasars at opposite ends of the main sequence. The eigenvector-1 approach opens the door towards properly contextualized models of quasar physics, geometry and kinematics. We review some of the progress that has been made over the past 15 years, and point out still unsolved issues.

Does Race-Ethnicity Moderate the Relationship between CPAP Adherence and Functional Outcomes of Sleep in US Veterans with Obstructive Sleep Apnea Syndrome?

PubMed Central

Wallace, Douglas M.; Wohlgemuth, William K.

2014-01-01

Background: Little is known about the association of race-ethnicity and the relationship of continuous positive airway pressure (CPAP) adherence with functional outcomes of sleep in American samples with obstructive sleep apnea syndrome (OSAS). This retrospective study examines whether race-ethnicity moderates the relationship between CPAP adherence and functional outcomes of sleep in OSAS. Methods: Over 4 months, consecutive OSAS patients had CPAP data downloads and completed questionnaires (demographics, Functional Outcomes of Sleep Questionnaire [FOSQ], Epworth Sleepiness Scale [ESS], Insomnia Severity Index [ISI]) at the Miami VA sleep center. Medical diagnoses and polysomnography data were obtained from medical record. CPAP adherence was measured as mean daily hours of use. Hierarchical regression modeling was used to explore the differential impact of race-ethnicity and CPAP adherence on functional outcomes of sleep. Results: Two hundred twenty-seven veterans (93% male, age 59 ± 11 years) were included; 142 (63%) participants self-reported as white or Hispanic, and 85 participants (37%) as black. Hierarchical regression analyses failed to show main effects for race-ethnicity or CPAP use and FOSQ scores; however, the interaction of race-ethnicity with CPAP adherence was significantly associated with the total FOSQ (p = 0.04), Social (p = 0.02), and Intimacy (p = 0.01) subscale scores. For blacks, in adjusted analyses, CPAP adherence was positively associated with Social and Intimacy FOSQ subscales; however, no significant relationship was noted between CPAP use and FOSQ scores in whites/Hispanics. Conclusions: Race-ethnicity may moderate the relationship between CPAP adherence and some functional outcomes of sleep; however, further studies are needed. Citation: Wallace DM, Wohlgemuth WK. Does race-ethnicity moderate the relationship between CPAP adherence and functional outcomes of sleep in US veterans with obstructive sleep apnea syndrome? J Clin Sleep Med

Maine: Early Head Start Initiatives

ERIC Educational Resources Information Center

Center for Law and Social Policy, Inc. (CLASP), 2012

2012-01-01

Maine has two initiatives that build on Early Head Start (EHS). The first initiative, Fund for a Healthy Maine, has since 2001 provided tobacco settlement money to existing Head Start and EHS programs to expand the number of children who receive full-day, full-year services. Local programs have the option of using these funds for EHS, depending on…

Maine Agricultural Foods. Project SEED.

ERIC Educational Resources Information Center

Beaulieu, Peter; Ossenfort, Pat

This paper describes an activity-based program that teaches students in grades 4-12 about the importance of Maine agriculture in their lives. Specifically, the goal is to increase student awareness of how the foods they eat are planted, harvested, and processed. The emphasis is on crops grown in Maine such as potatoes, broccoli, peas, blueberries,…

Serum tenascin-C predicts severity and outcome of acute intracerebral hemorrhage.

PubMed

Wang, Lin-Guo; Huangfu, Xue-Qin; Tao, Bo; Zhong, Guan-Jin; Le, Zhou-Di

2018-06-01

Tenascin-C is a matricellular protein related to brain injury. We studied serum tenascin-C in acute intracerebral hemorrhage (ICH) and examined the associations with severity and outcome following the acute event. Tenascin-C samples were obtained from 162 patients with acute hemorrhagic stroke and 162 healthy controls. Poor 90-day functional outcome was defined as modified Rankin Scale score > 2. Early neurological deterioration (END) and hematoma growth (HG) were recorded at 24 h. Patients had higher tenascin-C levels than controls. Tenascin-C levels were positively correlated with hematoma volume or National Institutes of Health Stroke Scale score at baseline. Elevated tenascin-C levels were independently associated with END, HG, 90-day mortality and poor functional outcome. Moreover, tenascin-C levels significantly predicted END, HG and 90-day outcomes under receiver operating characteristic curves. An increase in serum tenascin-C level is associated with an adverse outcome in ICH patients, supporting the potential role of serum tenascin-C as a prognostic biomarker for hemorrhagic stroke. Copyright © 2018 Elsevier B.V. All rights reserved.

Urinary metabolomics study on the anti-inflammation effects of flavonoids obtained from Glycyrrhiza.

PubMed

Wei, Mengying; Ma, Yinghui; Liu, Yuanyuan; Zhou, Yuan; Men, Lihui; Yue, Kexin; Pi, Zifeng; Liu, Zhiqiang; Liu, Zhongying

2018-06-01

Rheumatoid arthritis (RA) is a chronic disease with pain, swelling, and limitation in the motion and function of multiple joints thus leading to high disability. Previous studies have shown that flavonoids and saponins are the most abundant and active constituents in Glycyrrhiza, which possess a wide range of pharmacological effects such as anti-inflammatory, antioxidant and anti-bacteria. But the mechanisms of those actions are not entirely clear. In order to clarify the mechanisms of those actions, the pharmacodynamical assessments of extraction of water-soluble components and flavonoids and saponins obtained from Glycyrrhiza were investigated. Combining the pharmacodynamical researches, we found that flavonoids obtained from Glycyrrhiza had more significant therapeutic effects on acute inflammation, chronic inflammation and inflammatory pain than that of extraction of water-soluble components and saponins obtained from Glycyrrhiza. The results indicated that flavonoids are the main medicinal ingredients in Glycyrrhiza. In order to further investigate the mechanism of the action of flavonoids in Glycyrrhiza on treating RA, a urine metabolomics method based on ultra high-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS) was established to observe the metabolic variations in adjuvant-induced arthritis (AIA) rats and investigate the therapeutic effect of flavonoids in Glycyrrhiza on RA. As a result, twenty potential biomarkers were found by comparison with the model group (MG) and flavonoid treated group (FG). We associated these compounds with related metabolic pathways, the results showed that these biomarkers were mainly associated with purine metabolism, taurine and hypotaurine metabolism, tryptophan metabolism, phenylalanine metabolism, tricarboxylic acid cycle (TCA cycle), pantothenate and coenzyme A (CoA) biosynthesis. The results about the pharmacodynamics and metabolomics provided a theoretical basis

Resource Allocation and Resident Outcomes In Nursing Homes: Comparisons between the Best and Worst1

PubMed Central

Anderson, Ruth A.; Hsieh, Pi-Ching; Su, Hui-Fang

2005-01-01

The purpose of this study was to identify patterns of resource allocation that related to resident outcomes in nursing homes. Data on structure, staffing levels, salaries, cost, casemix, and resident outcomes were obtained from state-level, administrative databases on 494 nursing homes. We identified two sets of comparison groups and showed that the group of homes with the greatest percentage of improvement in resident outcomes had higher levels of RN staffing and higher costs. However, comparison groups based on best/worst average outcomes did not differ in resource allocation patterns. Additional analysis demonstrated that when controlling for RN staffing, resident outcomes in high and low cost homes did not differ. The results suggest that, although RN staffing is more expensive, it is key to improving resident outcomes. PMID:9679807

Visual acuity outcomes in eyes with flat corneas after PRK.

PubMed

Varssano, David; Waisbourd, Michael; Minkev, Liza; Sela, Tzahi; Neudorfer, Meira; Binder, Perry S

2013-06-01

To evaluate the impact of corneal curvatures less than 35 diopters (D) after photorefractive keratectomy (PRK) on visual acuity outcomes. Visual acuity outcomes of 5,410 eyes that underwent PRK from January 2006 to November 2010 were retrospectively analyzed for the impact of postoperative corneal curvatures on visual outcomes. All procedures were performed on a single platform (Allegretto 200Hz excimer laser; Alcon Laboratories, Inc., Irvine, CA). Main outcome measures were postoperative corrected distance visual acuity (CDVA) and loss of CDVA. Corneas with a measured or a calculated postoperative flat meridian less than 35 D and those with a measured postoperative steep meridian less than 35 D had worse postoperative CDVA than corneas with meridians of either 35 D or more (P ≤ .021). However, the preoperative CDVA was worse in the flatter curvatures in all comparisons performed (P ≤ .024). Consequently, the measured or calculated meridian curvature had no effect on CDVA loss (P ≥ .074). Postoperative corneal keratometry values (flat and steep meridians) less than 35 D did not have a predictive effect on the risk of losing visual acuity following myopic PRK performed on the Allegretto 200Hz excimer laser. Copyright 2013, SLACK Incorporated.

Association Between Onset-to-Door Time and Clinical Outcomes After Ischemic Stroke.

PubMed

Matsuo, Ryu; Yamaguchi, Yuko; Matsushita, Tomonaga; Hata, Jun; Kiyuna, Fumi; Fukuda, Kenji; Wakisaka, Yoshinobu; Kuroda, Junya; Ago, Tetsuro; Kitazono, Takanari; Kamouchi, Masahiro

2017-11-01

The role of early hospital arrival in improving poststroke clinical outcomes in patients without reperfusion treatment remains unclear. This study aimed to determine whether early hospital arrival was associated with favorable outcomes in patients without reperfusion treatment or with minor stroke. This multicenter, hospital-based study included 6780 consecutive patients (aged, 69.9±12.2 years; 63.9% men) with ischemic stroke who were prospectively registered in Fukuoka, Japan, between July 2007 and December 2014. Onset-to-door time was categorized as T 0-1 , ≤1 hour; T 1-2 , >1 and ≤2 hours; T 2-3 , >2 and ≤3 hours; T 3-6 , >3 and ≤6 hours; T 6-12 , >6 and ≤12 hours; T 12-24 , >12 and ≤24 hours; and T 24- , >24 hours. The main outcomes were neurological improvement (decrease in National Institutes of Health Stroke Scale score of ≥4 during hospitalization or 0 at discharge) and good functional outcome (3-month modified Rankin Scale score of 0-1). Associations between onset-to-door time and main outcomes were evaluated after adjusting for potential confounders using logistic regression analysis. Odds ratios (95% confidence intervals) increased significantly with shorter onset-to-door times within 6 hours, for both neurological improvement ( T 0- 1 , 2.79 [2.28-3.42]; T 1-2 , 2.49 [2.02-3.07]; T 2-3 , 1.52 [1.21-1.92]; T 3-6 , 1.72 [1.44-2.05], with reference to T 24- ) and good functional outcome ( T 0-1 , 2.68 [2.05-3.49], T 1-2 2.10 [1.60-2.77], T 2-3 1.53 [1.15-2.03], T 3-6 1.31 [1.05-1.64], with reference to T 24- ), even after adjusting for potential confounding factors including reperfusion treatment and basal National Institutes of Health Stroke Scale. These associations were maintained in 6216 patients without reperfusion treatment and in 4793 patients with minor stroke (National Institutes of Health Stroke Scale ≤4 on hospital arrival). Early hospital arrival within 6 hours after stroke onset is associated with favorable outcomes after

The information needs of women diagnosed with Polycystic Ovarian Syndrome – implications for treatment and health outcomes

PubMed Central

Avery, Jodie C; Braunack-Mayer, Annette J

2007-01-01

Background This paper reports the findings of an exploratory study about the information women diagnosed with Polycystic Ovarian Syndrome (PCOS) want to know about their condition and the consequences of this information for future treatment and health outcomes. Methods In-depth qualitative interviews regarding their information needs were undertaken with ten South Australian women diagnosed with PCOS. These women were aged 28–38 years and at differing stages of their fertility experience. The time since diagnosis ranged from 1–17 years. The main outcome measures sought were the identification of the information needs of women diagnosed with Polycystic Ovarian Syndrome (PCOS) during different periods of their lives; how and where they obtain this information, and the consequences of this information for future treatment and health outcomes. Results The women with PCOS in this study preferentially used the Internet for their information needs, as it had the advantages of convenience, privacy and accessibility, when compared with traditional mechanisms of information provision. Conclusion Giving a name to a collection of symptoms may bring relief and provide recognition that there really is a problem. However, with a diagnosis comes the need to have questions answered. A diagnosis of a chronic condition such as PCOS necessitates decision-making regarding possible treatment strategies and lifestyle choices. Information is needed in order to participate in shared decision making. The Internet proved to be a most versatile and beneficial source of information source for women with PCOS, if its limitations are taken into consideration. PMID:17578583

The Era of the Large Databases: Outcomes After Gastroesophageal Surgery According to NSQIP, NIS, and NCDB Databases. Systematic Literature Review.

PubMed

Batista Rodríguez, Gabriela; Balla, Andrea; Fernández-Ananín, Sonia; Balagué, Carmen; Targarona, Eduard M

2018-05-01

The term big data refers to databases that include large amounts of information used in various areas of knowledge. Currently, there are large databases that allow the evaluation of postoperative evolution, such as the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS), and the National Cancer Database (NCDB). The aim of this review was to evaluate the clinical impact of information obtained from these registries regarding gastroesophageal surgery. A systematic review using the Meta-analysis of Observational Studies in Epidemiology guidelines was performed. The research was carried out using the PubMed database identifying 251 articles. All outcomes related to gastroesophageal surgery were analyzed. A total of 34 articles published between January 2007 and July 2017 were included, for a total of 345 697 patients. Studies were analyzed and divided according to the type of surgery and main theme in (1) esophageal surgery and (2) gastric surgery. The information provided by these databases is an effective way to obtain levels of evidence not obtainable by conventional methods. Furthermore, this information is useful for the external validation of previous studies, to establish benchmarks that allow comparisons between centers and have a positive impact on the quality of care.

Health and Occupational Outcomes Among Injured, Nonstandard Shift Workers.

PubMed

Wong, Imelda S; Smith, Peter M; Mustard, Cameron A; Gignac, Monique A M

2015-11-01

This study compares health and occupational outcomes following a work-related injury for nonstandard and day-shift workers. National Population Health Survey data were used to explore outcomes 2 years post-work injury. Retrospective-matched cohort analyses examined main effects and interactions of shift schedule and work injury with changes in health, shift schedule, and labor force status. Models were adjusted for respondent characteristics, baseline health status, and occupational strength requirements. Injured nonstandard shift workers reported lower health utility index scores, compared with uninjured and injured daytime workers and uninjured nonstandard-shift workers. No significant interactions between shift and injury were found with schedule change and leaving the labor force. Injured nonstandard-shift workers are as likely to remain employed as other groups, but may be vulnerable in terms of diminished health.

Long term outcome after poliomyelitis in different health and social conditions

PubMed Central

Rekand, T; Korv, J; Farbu, E; Roose, M; Gilhus, N; Langeland, N; Aarli, J

2003-01-01

Objective: To examine and compare the long term outcome after polio in an east European and a west European country with different access to rehabilitation and with different medical and social conditions. Design and Setting: The patients who were acutely hospitalised for polio 1950–54 in the University Hospital in Bergen, Norway and 1958 in the University Hospital in Tartu, Estonia received the mailed questionnaire in the period between January 1998 and December 1998. Patients: Patient files concerning 334 patients hospitalised in Tartu and 243 patients hospitalised in Bergen were obtained; of these 128 Estonian and 148 Norwegian patients were re-examined. Main results: Despite more pronounced disability in the acute stage, significantly more Norwegian patients were working full time and part time in 1998 (p<0.0001) and also through the period 1958–1998. In both countries, 30% of patients had manual work and 18% changed profession during their career. Low income (below 50% of national average) was reported by 73% of Estonian and 35% of Norwegian patients (p<0.0001). Except for the odds ratio for muscular pain of 1.89 (95%CI =1.14 to 3.14) for Norwegian patients, new symptoms indicating late progression did not differ. Norwegian patients were more independent with significantly less need for assistance in housekeeping (p=0.02), whereas the use of orthopaedic devices did not differ. Conclusions: The long term outcome after polio is different in eastern and western Europe. Access to continuous rehabilitation seems to maintain physical independence in polio patients, improves their ability to earn their own income, and lessens the need for disability pensions. PMID:12700222

High infrared radiance glass-ceramics obtained from fly ash and titanium slag.

PubMed

Wang, Shuming; Liang, Kaiming

2007-11-01

A new glass-ceramic was synthesized by crystal growth from a homogenous glass obtained by melting a mixture of fly ash collected from a power plant in Hebei province of China, titanium slag collected from a titanium factory in Sichuan province of China, and MgCO(3) as an additive. According to the measurement results of differential thermal analysis, a thermal treatment of nucleating at 850 degrees C for 2h and crystallizing at 985 degrees C for 1.5h was used to obtain the crystallized glass. X-ray diffraction and scanning electron microscopy measurements showed that the main crystalline phase of this material was iron-ion substituted cordierite, (Mg,Fe)(2)Al(4)Si(5)O(18), which is homogeneously dispersed within the parent glass matrix. The infrared radiance and thermal expansion coefficient of this material have been examined, and the results demonstrate that this glass-ceramic material has potential for application in a wide range of infrared heating and drying materials.

Antitumoral materials with regenerative function obtained using a layer-by-layer technique

PubMed Central

Ficai, Denisa; Sonmez, Maria; Albu, Madalina Georgiana; Mihaiescu, Dan Eduard; Ficai, Anton; Bleotu, Coralia

2015-01-01

A layer-by layer technique was successfully used to obtain collagen/hydroxyapatite-magnetite-cisplatin (COLL/HAn-Fe3O4-CisPt, n=1–7) composite materials with a variable content of hydroxyapatite intended for use in the treatment of bone cancer. The main advantages of this system are the possibility of controlling the rate of delivery of cytostatic agents, the presence of collagen and hydroxyapatite to ensure more rapid healing of the injured bone tissue, and the potential for magnetite to be a passive antitumoral component that can be activated when an appropriate external electromagnetic field is applied. In vitro cytotoxicity assays performed on the COLL/HAn-Fe3O4-CisPt materials obtained using a layer-by layer method confirmed their antitumoral activity. Samples with a higher content of hydroxyapatite had more antitumoral activity because of their better absorption of cisplatin and consequently a higher amount of cisplatin being present in the matrices. PMID:25767374

Patient-reported outcome measures in arthroplasty registries

PubMed Central

Eresian Chenok, Kate; Bohm, Eric; Lübbeke, Anne; Denissen, Geke; Dunn, Jennifer; Lyman, Stephen; Franklin, Patricia; Dunbar, Michael; Overgaard, Søren; Garellick, Göran; Dawson, Jill

2016-01-01

The International Society of Arthroplasty Registries (ISAR) Steering Committee established the Patient-Reported Outcome Measures (PROMs) Working Group to convene, evaluate, and advise on best practices in the selection, administration, and interpretation of PROMs and to support the adoption and use of PROMs for hip and knee arthroplasty in registries worldwide. The 2 main types of PROMs include generic (general health) PROMs, which provide a measure of general health for any health state, and specific PROMs, which focus on specific symptoms, diseases, organs, body regions, or body functions. The establishment of a PROM instrument requires the fulfillment of methodological standards and rigorous testing to ensure that it is valid, reliable, responsive, and acceptable to the intended population. A survey of the 41 ISAR member registries showed that 8 registries administered a PROMs program that covered all elective hip or knee arthroplasty patients and 6 registries collected PROMs for sample populations; 1 other registry had planned but had not started collection of PROMs. The most common generic instruments used were the EuroQol 5 dimension health outcome survey (EQ-5D) and the Short Form 12 health survey (SF-12) or the similar Veterans RAND 12-item health survey (VR-12). The most common specific PROMs were the Hip disability and Osteoarthritis Outcome Score (HOOS), the Knee injury and Osteoarthritis Outcome Score (KOOS), the Oxford Hip Score (OHS), the Oxford Knee Score (OKS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC), and the University of California at Los Angeles Activity Score (UCLA). PMID:27168175

The Effects of Service-Delivery Model and Purchase Price on Hearing-Aid Outcomes in Older Adults: A Randomized Double-Blind Placebo-Controlled Clinical Trial.

PubMed

Humes, Larry E; Rogers, Sara E; Quigley, Tera M; Main, Anna K; Kinney, Dana L; Herring, Christine

2017-03-01

The objectives of this study were to determine efficacy of hearing aids in older adults using audiology best practices, to evaluate the efficacy of an alternative over-the-counter (OTC) intervention, and to examine the influence of purchase price on outcomes for both service-delivery models. The design of this study was a single-site, prospective, double-blind placebo-controlled randomized trial with three parallel branches: (a) audiology best practices (AB), (b) consumer decides OTC model (CD), and (c) placebo devices (P). Outcome measures were obtained after a typical 6-week trial period with follow-up 4-week AB-based trial for those initially assigned to CD and P groups. Older adults from the general community were recruited via newspaper and community flyers to participate at a university research clinic. Participants were adults, ages 55-79 years, with mild-to-moderate hearing loss. There were 188 eligible participants: 163 enrolled as a volunteer sample, and 154 completed the intervention. All participants received the same high-end digital mini-behind-the-ear hearing aids fitted bilaterally. AB and P groups received best-practice services from audiologists; differing mainly in use of appropriate (AB) or placebo (P) hearing aid settings. CD participants self-selected their own pre-programmed hearing aids via an OTC model. Primary outcome measure was a 66-item self-report, Profile of Hearing Aid Benefit (Cox & Gilmore, 1990). Secondary outcome measure was the Connected Speech Test (Cox, Alexander, & Gilmore, 1987) benefit. Additional measures of hearing-aid benefit, satisfaction, and usage were also obtained. Per-protocol analyses were performed. AB service-delivery model was found to be efficacious for most of the outcome measures, with moderate or large effect sizes (Cohen's d). CD service-delivery model was efficacious, with similar effect sizes. However, CD group had a significantly (p < .05) lower satisfaction and percentage (CD: 55%; AB: 81%; P: 36

International Postgraduate Students' Cross-Cultural Adaptation in Malaysia: Antecedents and Outcomes

ERIC Educational Resources Information Center

Shafaei, Azadeh; Razak, Nordin Abd

2016-01-01

This study develops and empirically tests a conceptual model capturing the factors impacting students' cross-cultural adaptation and the outcomes resulting from such adaption. Data were obtained from a sample of international postgraduate students from six Malaysian public universities using a structured questionnaire. Structural equation…

An intervention to improve program implementation: findings from a two-year cluster randomized trial of Assets-Getting To Outcomes

PubMed Central

2013-01-01

Background Studies have shown that communities have not always been able to implement evidence-based prevention programs with quality and achieve outcomes demonstrated by prevention science. Implementation support interventions are needed to bridge this gap between science and practice. The purpose of this article is to present two-year outcomes from an evaluation of the Assets Getting To Outcomes (AGTO) intervention in 12 Maine communities engaged in promoting Developmental Assets, a positive youth development approach to prevention. AGTO is an implementation support intervention that consists of: a manual of text and tools; face-to-face training, and onsite technical assistance, focused on activities shown to be associated with obtaining positive results across any prevention program. Methods This study uses a nested and cross-sectional, cluster randomized controlled design. Participants were coalition members and program staff from 12 communities in Maine. Each coalition nominated up to five prevention programs to participate. At random, six coalitions and their respective 30 programs received the two-year AGTO intervention and the other six maintained routine operations. The study assessed prevention practitioner capacity (efficacy and behaviors), practitioner exposure to and use of AGTO, practitioner perceptions of AGTO, and prevention program performance. Capacity of coalition members and performance of their programs were compared between the two groups across the baseline, one-, and two-year time points. Results We found no significant differences between AGTO and control group’s prevention capacity. However, within the AGTO group, significant differences were found between those with greater exposure to and use of AGTO. Programs that received the highest number of technical assistance hours showed the most program improvement. Conclusions This study is the first of its kind to show that use of an implementation support intervention-AGTO -yielded

Interdisciplinary ICU Cardiac Arrest Debriefing Improves Survival Outcomes

PubMed Central

Wolfe, Heather; Zebuhr, Carleen; Topjian, Alexis A.; Nishisaki, Akira; Niles, Dana E.; Meaney, Peter A.; Boyle, Lori; Giordano, Rita T.; Davis, Daniela; Priestley, Margaret; Apkon, Michael; Berg, Robert A.; Nadkarni, Vinay M.; Sutton, Robert M.

2014-01-01

Objective In-hospital cardiac arrest is an important public health problem. High-quality resuscitation improves survival but is difficult to achieve. Our objective is to evaluate the effectiveness of a novel, interdisciplinary, postevent quantitative debriefing program to improve survival outcomes after in-hospital pediatric chest compression events. Design, Setting, and Patients Single-center prospective interventional study of children who received chest compressions between December 2008 and June 2012 in the ICU. Interventions Structured, quantitative, audiovisual, interdisciplinary debriefing of chest compression events with front-line providers. Measurements and Main Results Primary outcome was survival to hospital discharge. Secondary outcomes included survival of event (return of spontaneous circulation for ≥ 20 min) and favorable neurologic outcome. Primary resuscitation quality outcome was a composite variable, termed “excellent cardiopulmonary resuscitation,” prospectively defined as a chest compression depth ≥ 38 mm, rate ≥ 100/min, ≤ 10% of chest compressions with leaning, and a chest compression fraction > 90% during a given 30-second epoch. Quantitative data were available only for patients who are 8 years old or older. There were 119 chest compression events (60 control and 59 interventional). The intervention was associated with a trend toward improved survival to hospital discharge on both univariate analysis (52% vs 33%, p = 0.054) and after controlling for confounders (adjusted odds ratio, 2.5; 95% CI, 0.91–6.8; p = 0.075), and it significantly increased survival with favorable neurologic outcome on both univariate (50% vs 29%, p = 0.036) and multivariable analyses (adjusted odds ratio, 2.75; 95% CI, 1.01–7.5; p = 0.047). Cardiopulmonary resuscitation epochs for patients who are 8 years old or older during the debriefing period were 5.6 times more likely to meet targets of excellent cardiopulmonary resuscitation (95% CI, 2.9–10

Treatment outcome in adults with chronic fatigue syndrome: a prospective study in England based on the CFS/ME National Outcomes Database.

PubMed

Crawley, E; Collin, S M; White, P D; Rimes, K; Sterne, J A C; May, M T

2013-06-01

Chronic fatigue syndrome (CFS) is relatively common and disabling. Over 8000 patients attend adult services each year, yet little is known about the outcome of patients attending NHS services. Investigate the outcome of patients with CFS and what factors predict outcome. Longitudinal patient cohort. We used data from six CFS/ME (myalgic encephalomyelitis) specialist services to measure changes in fatigue (Chalder Fatigue Scale), physical function (SF-36), anxiety and depression (Hospital Anxiety and Depression Scale) and pain (visual analogue pain rating scale) between clinical assessment and 8-20 months of follow-up. We used multivariable linear regression to investigate baseline factors associated with outcomes at follow-up. Baseline data obtained at clinical assessment were available for 1643 patients, of whom 834 (51%) had complete follow-up data. There were improvements in fatigue [mean difference from assessment to outcome: -6.8; 95% confidence interval (CI) -7.4 to -6.2; P < 0.001]; physical function (4.4; 95% CI 3.0-5.8; P < 0.001), anxiety (-0.6; 95% CI -0.9 to -0.3; P < 0.001), depression (-1.6; 95% CI -1.9 to -1.4; P < 0.001) and pain (-5.3; 95% CI -7.0 to -3.6; P < 0.001). Worse fatigue, physical function and pain at clinical assessment predicted a worse outcome for fatigue at follow-up. Older age, increased pain and physical function at assessment were associated with poorer physical function at follow-up. Patients who attend NHS specialist CFS/ME services can expect similar improvements in fatigue, anxiety and depression to participants receiving cognitive behavioural therapy and graded exercise therapy in a recent trial, but are likely to experience less improvement in physical function. Outcomes were predicted by fatigue, disability and pain at assessment.

Marine Occupations Conference (Southern Maine Vocational Technical Institute, South Portland, Maine, April 5, 1974). Maine Sea Grant Bulletin 9.

ERIC Educational Resources Information Center

Coggins, Phyllis, Ed.; And Others

This collection of speeches, presented as the 1974 Marine Occupations Conference in South Portland, Maine, provides an overview of information regarding availability and kinds of careers in, as well as the educational requirements for, marine occupations. Also reviewed are the problems of developing marine resources, such as those involving…

Whey-derived valuable products obtained by microbial fermentation.

PubMed

Pescuma, Micaela; de Valdez, Graciela Font; Mozzi, Fernanda

2015-08-01

Whey, the main by-product of the cheese industry, is considered as an important pollutant due to its high chemical and biological oxygen demand. Whey, often considered as waste, has high nutritional value and can be used to obtain value-added products, although some of them need expensive enzymatic synthesis. An economical alternative to transform whey into valuable products is through bacterial or yeast fermentations and by accumulation during algae growth. Fermentative processes can be applied either to produce individual compounds or to formulate new foods and beverages. In the first case, a considerable amount of research has been directed to obtain biofuels able to replace those derived from petrol. In addition, the possibility of replacing petrol-derived plastics by biodegradable polymers synthesized during bacterial fermentation of whey has been sought. Further, the ability of different organisms to produce metabolites commonly used in the food and pharmaceutical industries (i.e., lactic acid, lactobionic acid, polysaccharides, etc.) using whey as growth substrate has been studied. On the other hand, new low-cost functional whey-based foods and beverages leveraging the high nutritional quality of whey have been formulated, highlighting the health-promoting effects of fermented whey-derived products. This review aims to gather the multiple uses of whey as sustainable raw material for the production of individual compounds, foods, and beverages by microbial fermentation. This is the first work to give an overview on the microbial transformation of whey as raw material into a large repertoire of industrially relevant foods and products.

Revascularization for Left Main and Multivessel Coronary Artery Disease: Current Status and Future Prospects after the EXCEL and NOBLE Trials

PubMed Central

2018-01-01

Revascularization of severe left main and multivessel coronary artery disease has been shown to improve survival in both stable ischemic heart disease and acute coronary syndrome. While revascularization with coronary artery bypass surgery for these disease entities carries class I recommendation in most current guidelines, recent trials has shown potential comparable survival and cardiovascular outcomes between percutaneous and surgical interventions in patients with less complex coronary anatomy. Despite the conflicting results observed in the most recent left main revascularization trials, Everolimus-Eluting Stents or Bypass Surgery for Left Main Coronary Artery Disease (EXCEL) and Nordic-Baltic-British left main revascularization (NOBLE), both treatment strategies remain important for the management of left main disease (LMD) and multivessel disease (MVD) reflecting on the importance of heart team discussion. This review is focused on revascularization of LMD and MVD in patients who are not presenting with ST-segment elevation myocardial infarction, encompassing the evidence from historic and contemporary trials which shaped up current practices. This review discusses the heart team approach to guide decision making, including special populations that are not represented in clinical trials. PMID:29856140

Revascularization for Left Main and Multivessel Coronary Artery Disease: Current Status and Future Prospects after the EXCEL and NOBLE Trials.

PubMed

Al-Hijji, Mohammed; El Sabbagh, Abdallah; Holmes, David R

2018-06-01

Revascularization of severe left main and multivessel coronary artery disease has been shown to improve survival in both stable ischemic heart disease and acute coronary syndrome. While revascularization with coronary artery bypass surgery for these disease entities carries class I recommendation in most current guidelines, recent trials has shown potential comparable survival and cardiovascular outcomes between percutaneous and surgical interventions in patients with less complex coronary anatomy. Despite the conflicting results observed in the most recent left main revascularization trials, Everolimus-Eluting Stents or Bypass Surgery for Left Main Coronary Artery Disease (EXCEL) and Nordic-Baltic-British left main revascularization (NOBLE), both treatment strategies remain important for the management of left main disease (LMD) and multivessel disease (MVD) reflecting on the importance of heart team discussion. This review is focused on revascularization of LMD and MVD in patients who are not presenting with ST-segment elevation myocardial infarction, encompassing the evidence from historic and contemporary trials which shaped up current practices. This review discusses the heart team approach to guide decision making, including special populations that are not represented in clinical trials. Copyright © 2018. The Korean Society of Cardiology.

Clinical outcomes of symptomatic arterioportal fistulas after transcatheter arterial embolization

PubMed Central

Hirakawa, Masakazu; Nishie, Akihiro; Asayama, Yoshiki; Ishigami, Kousei; Ushijima, Yasuhiro; Fujita, Nobuhiro; Honda, Hiroshi

2013-01-01

AIM: To evaluate the complications and clinical outcomes of transcatheter arterial embolization (TAE) for symptoms related to severe arterioportal fistulas (APFs). METHODS: Six patients (3 males, 3 females; mean age, 63.8 years; age range, 60-71 years) with chronic liver disease and severe APFs due to percutaneous intrahepatic treatment (n = 5) and portal vein (PV) tumor thrombosis of hepatocellular carcinoma (n = 1) underwent TAE for symptoms related to severe APFs [refractory ascites (n = 4), hemorrhoidal hemorrhage (n = 1), and hepatic encephalopathy (n = 1)]. Control of symptoms related to APFs and complications were evaluated during the follow-up period (range, 4-57 mo). RESULTS: In all patients, celiac angiography revealed immediate retrograde visualization of the main PV before TAE, indicating severe APF. Selective TAE for the hepatic arteries was performed using metallic coils (MC, n = 4) and both MCs and n-butyl cyanoacrylate (n = 2). Three patients underwent repeated TAEs for residual APFs and ascites. Four patients developed PV thrombosis after TAE. During the follow-up period after TAE, APF obliteration and symptomatic improvement were obtained in all patients. CONCLUSION: Although TAE for severe APFs may sometimes be complicated by PV thrombosis, TAE can be an effective treatment to improve clinical symptoms related to severe APFs. PMID:23494252

Main Sources, Socio-Demographic and Anthropometric Correlates of Salt Intake in Austria

PubMed Central

Hasenegger, Verena; Rust, Petra; Purtscher, Anna Elisabeth; Erler, Judith; Ekmekcioglu, Cem

2018-01-01

Excessive salt intake is known to increase blood pressure and cardiovascular risk. Nevertheless, salt intake exceeds the recommendations in most countries. To face this problem, it is important to identify high consumers as well as the main contributors of salt intake. Overall, data of 2018 adults between 18 and 64 years were analysed to determine the main sources, socio-demographic and anthropometric correlates of salt intake. Dietary intake was assessed from 24-h-recalls, information on socio-demographic characteristics was obtained using a questionnaire and anthropometric data were measured. Salt intake was significantly higher in males than in females. There was a significant positive association between salt intake and body mass index. No significant differences in salt intake were observed for other variables including affluence, educational level, smoking status and physical activity. The main contributor to salt intake were condiments including table salt (32.6%), followed by cereals and cereal products (27.0%), meat and meat products (16.1%) and dairy products (14.0%). These results highlight that specific population groups need to be targeted by public health initiatives and that a reduction in salt intake can only be achieved in tandem with the food producers by the reduction of salt in processed foods. PMID:29509671

Child development at 5 years of age predicted mathematics ability and schooling outcomes in Malawian adolescents.

PubMed

Gandhi, Mihir; Teivaanmaki, Tiina; Maleta, Kenneth; Duan, Xiaolian; Ashorn, Per; Cheung, Yin Bun

2013-01-01

This study aimed to examine the association between child development at 5 years of age and mathematics ability and schooling outcomes at 12 years of age in Malawian children. A prospective cohort study looking at 609 rural Malawian children. Outcome measures were percentage of correctly answered mathematics questions, highest school grade completed and number of times repeating school grades at 12 years of age. A child development summary score obtained at 5 years of age was the main exposure variable. Regression analyses were used to estimate the association and adjust for confounders. Sensitivity analysis was performed by handling losses to follow-up with multiple imputation (MI) method. The summary score was positively associated with percentage of correctly answered mathematics questions (p = 0.057; p = 0.031 MI) and with highest school grade completed (p = 0.096; p = 0.070 MI), and negatively associated with number of times repeating school grades (p = 0.834; p = 0.339 MI). Fine motor score at 5 years was independently associated with the mathematic score (p = 0.032; p = 0.011 MI). The association between child development and mathematics ability did not depend on school attendance. Child development at 5 years of age showed signs of positive association with mathematics ability and possibly with highest school grade completed at 12 years of age. © 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.

Health Outcomes of Sexual-Minority Youth in Canada: An Overview

PubMed Central

Blais, Martin; Bergeron, Félix-Antoine; Duford, Julie; Boislard, Marie-Aude; Hébert, Martine

2016-01-01

Objectives The objectives of this review are to (1) document health outcomes among sexual-minority youth (SMY) in Canada; and (2) identify sexual-minority-specific risk and protective factors Data Sources We conducted a review of Canadian data published after 2005 on the mental, physical and sexual health outcomes of SMY using relevant keywords. A total of 19 empirical studies and 2 research reports was included. Data Synthesis The study reviewed included 53 to 30 588 respondents (total = 81 567). SMY counted for 15.86% of the total sample. Overall, SMY in Canada show negative health outcomes in proportions varying from 7% to 69.4%, the most common issues being psychological distress and maladjustment. SMY are more likely than their heterosexual peers to report psychological distress/malfunctioning, suicidality, substance misuse, condomless intercourse, pregnancy involvement. Main SMY-specific risk factors were family rejection of one’s minority sexual orientation, homophobic bullying and victimization, and internalized homophobia. Among the few protective factors that were reported, school and family connectedness, school safety, parental support and sports involvement decreased the odds of negative health outcomes. Conclusions Canadian data show that SMY are more likely to experience negative health outcomes than their heterosexual peers. These results are consistent with data from around the world. Recommendations for research and intervention are discussed. PMID:28111592

Blastocyst development rate impacts outcome in cryopreserved blastocyst transfer cycles

PubMed Central

Levens, Eric D.; Whitcomb, Brian W.; Hennessy, Sasha; James, Aidita N.; Yauger, Belinda J.; Larsen, Frederick W.

2008-01-01

Structured Abstract Objective To assess cycle outcome among day 5 and day 6 cryopreserved frozen-thawed blastocyst embryo transfers (FBET). Design Retrospective cohort study. Setting Military-based ART center. Patients One hundred seventy-two non-donor, programmed cryopreserved embryo cycles. Interventions Fully expanded blastocysts on day 5 were cryopreserved on day 5 and those achieving this state on day 6 were cryopreserved on day 6. Leuprolide acetate was given for ovulation inhibition and endometrial supplementation was by oral and vaginal estradiol. Progesterone in oil was administered and blastocyst transfer occurred in the morning of the 6th day of progesterone. Main Outcome Measures Implantation, pregnancy and live birth rates. Results Fresh and frozen cycle characteristics were similar between groups. Day 5 FBET had significantly higher implantation rates (32.2% vs. 19.2%; p=0.01) which remained significant even when adjusting for co-variates (OR: 1.91; 95%CI: 1.00, 3.67). Live birth rates trended towards improvement after adjusting for co-variates (OR: 1.18; 95%CI: 0.61, 2.30). Conclusions Cryopreserved day 5 blastocysts have higher implantation rates and trend toward improved pregnancy outcomes compared to cryopreserved day 6 blastocysts. This suggests that embryo development rate may, in part, predict implantation and subsequent FBET outcomes although embryos not achieving the blastocyst stage until day 6 still demonstrate acceptable outcomes. PMID:18178191

Effect of Clinical and Attitudinal Characteristics on Obtaining Comprehensive Medication Reviews.

PubMed

Farris, Karen B; Salgado, Teresa M; Aneese, Nadia; Marshall, Vincent D; Pendergast, Jane F; Frank, Jessica; Chrischilles, Elizabeth A; Doucette, William R

2016-04-01

Comprehensive medication reviews (CMRs) consist of in-depth reviews of patients' medications to identify effectiveness or safety problems and often generate cost savings for individuals. Despite their advantages, CMRs are not widely obtained. Previous studies found that older age, female sex, and experience of side effects were associated with obtaining a medication review. To quantify the association between attitudinal and clinical factors with intention and predict future behavior to obtain a CMR among Medicare Part D beneficiaries. A sample of Medicare Part D beneficiaries from 1 health care plan (n = 660) completed a 14-item survey over the telephone assessing factors that were hypothesized to affect their intention and behavior to obtain a CMR. The survey collected medication use history and health care information with the medication user self-evaluation tool, health status, adherence, intention to obtain a CMR, and demographic characteristics. Subjects subsequently were informed that they could obtain a CMR from their pharmacies. Claims data were obtained that indicated which subjects received a CMR. Two dependent variables were predicted: intention to schedule a CMR using a multivariate linear regression model and receipt of a CMR using a logistic regression and including intention as a predictor variable. The mean age of participants was 76.6 (SD = 7.61) years; 71% were female; and participants took an average of 5.2 (SD = 3.18) medications. The intention to have a CMR was 2.85 (SD = 1.41) on a 5-point scale, and 5.6% of the participants actually had a CMR. Worrying about medications doing more harm than good, number of pharmacies where participants obtained their medications from, number of medications, and number of medical conditions predicted intention to obtain a CMR. Patients who perceived their health status to be poorer compared with others their age were more likely to have a CMR. Intention to obtain a CMR was not associated with receipt of a CMR

Risk factors for unfavorable outcome of pulmonary tuberculosis in adults in Taipei, Taiwan.

PubMed

Yen, Yung-Feng; Yen, Muh-Yong; Shih, Hsiu-Chen; Deng, Chung-Yeh

2012-05-01

This study was undertaken to identify factors associated with unfavorable outcomes in patients with pulmonary tuberculosis (PTB) in Taipei, Taiwan in 2007-2008. Taiwanese adults with culture-positive PTB diagnosed in Taipei during the study period were included in this retrospective cohort study. Unfavorable outcomes were classified as treatment default, death, treatment failure, or transfer. Of 1616 eligible patients, 22.6% (365) had unfavorable outcomes, mainly death. After controlling for patient sociodemographic factors, clinical findings, and underlying disease, independent risk factors for unfavorable outcomes included advanced age, unemployment, end-stage renal disease requiring dialysis, malignancy, acid-fast bacilius smear-positivity, multidrug-resistant TB, and notification from ordinary ward or intensive care unit. In contrast, patients receiving directly observed treatment, and with a high school or higher education were significantly less likely to have unfavorable outcomes. This study advanced our understanding by revealing that a high school or higher education might lower the risk of an unfavorable outcome. Our results also confirmed the risk factors for unfavorable outcomes shown in previous research. Future TB control programmes in Taiwan should target particularly high-risk patients including those who had lower educational levels. Copyright © 2012 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

Acute left main coronary artery occlusion

PubMed Central

Burgazli, K. Mehmet; Bilgin, Mehmet; Soydan, Nedim; Chasan, Ridvan; Erdogan, Ali

2013-01-01

The treatment of an acute left main coronary artery occlusion still poses a challenge. In this case report we present a 50-year-old patient with an acute occlusion of the left main artery. After a successful angioplasty without “stenting” due to the complexity of the stenosis the patient underwent a successful bypass surgery. We discuss the therapeutic options of acute left main occlusion regarding medical, interventional and surgical options. PMID:24353543

Preparation of potato starch microfibers obtained by electro wet spinning

NASA Astrophysics Data System (ADS)

Cárdenas, W.; Gómez-Pachon, E. Y.; Muñoz, E.; Vera-Graziano, R.

2016-07-01

Starch is one of the most abundant biopolymer in nature. It has been primarily used as a thickener in the food industry. Starch is found in greater amounts in the potato tubers, which is one of the largest food productions in the region of Boyacá-Colombia. Thus, potatoes are a viable source of starch. The main objective of this study is the preparation and characterization of native starch's microfiber by electro wet-spinning technique. The parameters that were changed for each treatment were as follows: the amount of potential applied to the solution, the distance between the needle and the collector and the rate of injection of the solution in order to determine the physical and chemical properties of the membranes, conformed by potatoes starch microfiber. Diverse instrumental analysis techniques were applied. They were: Scanning Electron Microscopy (SEM) to determine the morphologies and diameters of microfibers, Fourier Transform Infrared Spectroscopy (FTIR) to determine the chemical changes, Thermogravimetric Analysis (TGA) and Differential Calorimetry Scanning (DSC) to obtain the thermal transitions and the temperatures of useful. The microfibers were analysed in order to determine their structural properties and thus define the range of application. In conclusion, potatoes starch microfibers were obtained with average diameters of 15, 17, 23 and 25 micrometres, besides the fibers presented a degradation temperature of 304 °C, indicating that fibers are available with diameters of small scale, with good thermal properties. This study will enable the implementation of the microfibers to obtain bio packaging for food products and other applications.

The Impact of College Quality on Early Labor Market Outcomes in China

ERIC Educational Resources Information Center

Yu, Li

2014-01-01

This study aims to explore the impact of college quality on early labor market outcomes in China, including the fresh college graduates' initial employment status and starting wages for students who graduated in 2011. The main data source is the College Student Labor Market (CSLM) survey conducted by Tsinghua University. Distinguished from…

Outcome based education enacted: teachers' tensions in balancing between student learning and bureaucracy.

PubMed

Barman, Linda; Silén, Charlotte; Bolander Laksov, Klara

2014-12-01

This paper reports on how teachers within health sciences education translate outcome-based education (OBE) into practice when they design courses. The study is an empirical contribution to the debate about outcome- and competency-based approaches in health sciences education. A qualitative method was used to study how teachers from 14 different study programmes designed courses before and after OBE was implemented. Using an interpretative approach, analysis of documents and interviews was carried out. The findings show that teachers enacted OBE either to design for more competency-oriented teaching-learning, or to further detail knowledge and thus move towards reductionism. Teachers mainly understood the outcome-based framework as useful to support students' learning, although the demand for accountability created tension and became a bureaucratic hindrance to design for development of professional competence. The paper shows variations of how teachers enacted the same outcome-based framework for instructional design. These differences can add a richer understanding of how outcome- or competency-based approaches relate to teaching-learning at a course level.

Outcome Prediction in Mathematical Models of Immune Response to Infection.

PubMed

Mai, Manuel; Wang, Kun; Huber, Greg; Kirby, Michael; Shattuck, Mark D; O'Hern, Corey S

2015-01-01

Clinicians need to predict patient outcomes with high accuracy as early as possible after disease inception. In this manuscript, we show that patient-to-patient variability sets a fundamental limit on outcome prediction accuracy for a general class of mathematical models for the immune response to infection. However, accuracy can be increased at the expense of delayed prognosis. We investigate several systems of ordinary differential equations (ODEs) that model the host immune response to a pathogen load. Advantages of systems of ODEs for investigating the immune response to infection include the ability to collect data on large numbers of 'virtual patients', each with a given set of model parameters, and obtain many time points during the course of the infection. We implement patient-to-patient variability v in the ODE models by randomly selecting the model parameters from distributions with coefficients of variation v that are centered on physiological values. We use logistic regression with one-versus-all classification to predict the discrete steady-state outcomes of the system. We find that the prediction algorithm achieves near 100% accuracy for v = 0, and the accuracy decreases with increasing v for all ODE models studied. The fact that multiple steady-state outcomes can be obtained for a given initial condition, i.e. the basins of attraction overlap in the space of initial conditions, limits the prediction accuracy for v > 0. Increasing the elapsed time of the variables used to train and test the classifier, increases the prediction accuracy, while adding explicit external noise to the ODE models decreases the prediction accuracy. Our results quantify the competition between early prognosis and high prediction accuracy that is frequently encountered by clinicians.

Depression Predicts Functional Outcome in Geriatric Inpatient Rehabilitation.

PubMed

Shahab, Saba; Nicolici, Diana-Felicia; Tang, Alva; Katz, Paul; Mah, Linda

2017-03-01

To evaluate the effect of depression on functional recovery in geriatric patients who have completed an inpatient rehabilitation program. Prospective cohort study. Inpatient rehabilitation unit of a university-affiliated geriatric hospital. Convenience sample of patients (N=65; mean age, 81.6y; 25 men) admitted to rehabilitation over a 10-month period. Patients >60 years of age who were proficient in English and capable of providing informed consent were eligible to participate in the study. Depression was assessed using both the Geriatric Depression Scale-short form (GDS-15) and the Patient Health Questionnaire (9-item screen for depression) (PHQ-9). Measures of well-established predictors of rehabilitation outcome, which may interact with depression, were also obtained, and multiple regression linear modeling was used to evaluate the relation between depression and functional outcome over and above the contribution of these other factors. FIM (Functional Independence Measure) at discharge from the rehabilitation program. Depression, as assessed by the GDS-15, but not the PHQ-9, was predictive of functional outcome (standardized beta=-.151, P=.030) after controlling for other significant predictors, which included baseline disability, pain, cognition, and educational level. Participation in recreational, but not physio- or occupational, therapy additionally contributed to a small amount of variance in the functional outcome. Our findings suggest that self-report of depression is an independent predictor of functional outcome in high-tolerance, short-duration geriatric rehabilitation. Routine assessment of depressive symptoms in older adults using an instrument (eg, GDS-15) may help identify those at risk for poorer outcomes in rehabilitation. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Voting in Maine.

ERIC Educational Resources Information Center

Stewart, Carolyn; Cook, Mary

The first item in this packet is a pamphlet on how to vote and the election process. The pamphlet includes comprehensive information at a reading level that can be understood by many adults who have not graduated from high school. The pamphlet was designed by volunteer tutors of adult literacy students in Maine. The tutors researched information,…

SELENE Translunar Trajectory Reconfiguration Plan Provided for the Case of Main Engine Anomaly

NASA Technical Reports Server (NTRS)

Kawakatsu, Yasuhiro

2007-01-01

In this paper, the reconfiguration of translunar trajectory in case of main engine anomaly is investigated. The objectives of the trajectory design are to reduce the excessive velocity at the Lunar encounter as well as to reduce the total required Delta-v to complete the sequence. 3-impulse Hohmann transfer based trajectory is adopted and possible trajectories are categorized under 2-body approximation. The solutions obtained are applied to more sophisticated models (3-body approximation and 4-body) and yields feasible trajectory.

Determinants of Child Outcomes in a Cohort of Children in the Free Pre-School Year in Ireland, 2012/2013

ERIC Educational Resources Information Center

McKeown, Kieran; Haase, Trutz; Pratschke, Jonathan

2015-01-01

The study analyses determinants of child outcomes in a cohort of children who participated in the Free Pre-School Year. Child outcomes are measured through a before-and-after assessment of children using the Early Development Instrument. The sample comprises 448 children in 70 early years centres. There are three main findings. First, children…

Strategies for obtaining unpublished drug trial data: a qualitative interview study

PubMed Central

2013-01-01

Background Authors of systematic reviews have difficulty obtaining unpublished data for their reviews. This project aimed to provide an in-depth description of the experiences of authors in searching for and gaining access to unpublished data for their systematic reviews, and to give guidance on best practices for identifying, obtaining and using unpublished data. Methods This is a qualitative study analyzing in-depth interviews with authors of systematic reviews who have published Cochrane reviews or published systematic reviews outside of The Cochrane Library. We included participants who 1) were the first or senior author of a published systematic review of a drug intervention, 2) had expertise in conducting systematic reviews, searching for data, and assessing methodological biases, and 3) were able to participate in an interview in English. We used non-random sampling techniques to identify potential participants. Eighteen Cochrane authors were contacted and 16 agreed to be interviewed (89% response rate). Twenty-four non-Cochrane authors were contacted and 16 were interviewed (67% response rate). Results Respondents had different understandings of what was meant by unpublished data, including specific outcomes and methodological details. Contacting study authors was the most common method used to obtain unpublished data and the value of regulatory agencies as a data source was underappreciated. Using the data obtained was time consuming and labor intensive. Respondents described the collaboration with other colleagues and/or students required to organize, manage and use the data in their reviews, generally developing and using templates, spreadsheets and computer programs for data extraction and analysis. Respondents had a shared belief that data should be accessible but some had concerns about sharing their own data. Respondents believed that obtaining unpublished data for reviews has important public health implications. There was widespread support for

The yeast Saccharomyces cerevisiae- the main character in beer brewing.

PubMed

Lodolo, Elizabeth J; Kock, Johan L F; Axcell, Barry C; Brooks, Martin

2008-11-01

Historically, mankind and yeast developed a relationship that led to the discovery of fermented beverages. Numerous inventions have led to improved technologies and capabilities to optimize fermentation technology on an industrial scale. The role of brewing yeast in the beer-making process is reviewed and its importance as the main character is highlighted. On considering the various outcomes of functions in a brewery, it has been found that these functions are focused on supporting the supply of yeast requirements for fermentation and ultimately to maintain the integrity of the product. The functions/processes include: nutrient supply to the yeast (raw material supply for brewhouse wort production); utilities (supply of water, heat and cooling); quality assurance practices (hygiene practices, microbiological integrity measures and other specifications); plant automation (vessels, pipes, pumps, valves, sensors, stirrers and centrifuges); filtration and packaging (product preservation until consumption); distribution (consumer supply); and marketing (consumer awareness). Considering this value chain of beer production and the 'bottle neck' during production, the spotlight falls on fermentation, the age-old process where yeast transforms wort into beer.

Childhood Sporting Activities and Adult Labour-Market Outcomes

PubMed Central

Cabane, Charlotte; Clark, Andrew E.

2017-01-01

We here ask whether childhood sport participation is positively correlated with adult labour-market outcomes. There are many potential channels for this effect, although, as usual, identifying a causal relationship is difficult. We appeal to two widely-separated waves of Add Health data to map out the correlation between childhood sports and a number of adult labour-market outcomes. We show that different types of childhood sports are associated with both managerial responsibilities and autonomy at work when adult. We take the endogeneity of sport seriously, and appeal to a variety of techniques, including the use of data on siblings, in order to obtain estimates that are as close to unbiased as possible. Last, we compare the effect of sporting activities to that of other leisure activities.* PMID:28798886

Retransplantation in Late Hepatic Artery Thrombosis: Graft Access and Transplant Outcome.

PubMed

Buchholz, Bettina M; Khan, Shakeeb; David, Miruna D; Gunson, Bridget K; Isaac, John R; Roberts, Keith J; Muiesan, Paolo; Mirza, Darius F; Tripathi, Dhiraj; Perera, M Thamara P R

2017-08-01

Definitive treatment for late hepatic artery thrombosis (L-HAT) is retransplantation (re-LT); however, the L-HAT-associated disease burden is poorly represented in allocation models. Graft access and transplant outcome of the re-LT experience between 2005 and 2016 was reviewed with specific focus on the L-HAT cohort in this single-center retrospective study. Ninety-nine (5.7%) of 1725 liver transplantations were re-LT with HAT as the main indication (n = 43; 43%) distributed into early (n = 25) and late (n = 18) episodes. Model for end-stage liver disease as well as United Kingdom model for end-stage liver disease did not accurately reflect high disease burden of graft failure associated infections such as hepatic abscesses and biliary sepsis in L-HAT. Hence, re-LT candidates with L-HAT received low prioritization and waited longest until the allocation of an acceptable graft (median, 103 days; interquartile range, 28-291 days), allowing for progression of biliary sepsis. Balance of risk score and 3-month mortality score prognosticated good transplant outcome in L-HAT but, contrary to the prediction, the factual 1-year patient survival after re-LT was significantly inferior in L-HAT compared to early HAT, early non-HAT and late non-HAT (65% vs 82%, 92% and 95%) which was mainly caused by sepsis and multiorgan failure driving 3-month mortality (28% vs 11%, 16% and 0%). Access to a second graft after a median waitlist time of 6 weeks achieved the best short- and long-term outcome in re-LT for L-HAT (3-month mortality, 13%; 1-year survival, 77%). Inequity in graft access and peritransplant sepsis are fundamental obstacles for successful re-LT in L-HAT. Offering a graft for those in need at the best window of opportunity could facilitate earlier engrafting with improved outcomes.

Predictive value of 3-month lumbar discectomy outcomes in the NeuroPoint-SD Registry.

PubMed

Whitmore, Robert G; Curran, Jill N; Ali, Zarina S; Mummaneni, Praveen V; Shaffrey, Christopher I; Heary, Robert F; Kaiser, Michael G; Asher, Anthony L; Malhotra, Neil R; Cheng, Joseph S; Hurlbert, John; Smith, Justin S; Magge, Subu N; Steinmetz, Michael P; Resnick, Daniel K; Ghogawala, Zoher

2015-10-01

The authors have established a multicenter registry to assess the efficacy and costs of common lumbar spinal procedures using prospectively collected outcomes. Collection of these data requires an extensive commitment of resources from each site. The aim of this study was to determine whether outcomes data from shorter-interval follow-up could be used to accurately estimate long-term outcome following lumbar discectomy. An observational prospective cohort study was completed at 13 academic and community sites. Patients undergoing single-level lumbar discectomy for treatment of disc herniation were included. SF-36 and Oswestry Disability Index (ODI) data were obtained preoperatively and at 1, 3, 6, and 12 months postoperatively. Quality-adjusted life year (QALY) data were calculated using SF-6D utility scores. Correlations among outcomes at each follow-up time point were tested using the Spearman rank correlation test. One hundred forty-eight patients were enrolled over 1 year. Their mean age was 46 years (49% female). Eleven patients (7.4%) required a reoperation by 1 year postoperatively. The overall 1-year follow-up rate was 80.4%. Lumbar discectomy was associated with significant improvements in ODI and SF-36 scores (p < 0.0001) and with a gain of 0.246 QALYs over the 1-year study period. The greatest gain occurred between baseline and 3-month follow-up and was significantly greater than improvements obtained between 3 and 6 months or 6 months and 1 year(p < 0.001). Correlations between 3-month, 6-month, and 1-year outcomes were similar, suggesting that 3-month data may be used to accurately estimate 1-year outcomes for patients who do not require a reoperation. Patients who underwent reoperation had worse outcomes scores and nonsignificant correlations at all time points. This national spine registry demonstrated successful collection of high-quality outcomes data for spinal procedures in actual practice. Three-month outcome data may be used to accurately

Isolators Including Main Spring Linear Guide Systems

NASA Technical Reports Server (NTRS)

Goold, Ryan (Inventor); Buchele, Paul (Inventor); Hindle, Timothy (Inventor); Ruebsamen, Dale Thomas (Inventor)

2017-01-01

Embodiments of isolators, such as three parameter isolators, including a main spring linear guide system are provided. In one embodiment, the isolator includes first and second opposing end portions, a main spring mechanically coupled between the first and second end portions, and a linear guide system extending from the first end portion, across the main spring, and toward the second end portion. The linear guide system expands and contracts in conjunction with deflection of the main spring along the working axis, while restricting displacement and rotation of the main spring along first and second axes orthogonal to the working axis.

Kinetic Analysis of the Main Temperature Stage of Fast Pyrolysis

NASA Astrophysics Data System (ADS)

Yang, Xiaoxiao; Zhao, Yuying; Xu, Lanshu; Li, Rui

2017-10-01

Kinetics of the thermal decomposition of eucalyptus chips was evaluated using a high-rate thermogravimetric analyzer (BL-TGA) designed by our research group. The experiments were carried out under non-isothermal condition in order to determine the fast pyrolysis behavior of the main temperature stage (350-540ºC) at heating rates of 60, 120, 180, and 360ºC min-1. The Coats-Redfern integral method and four different reaction mechanism models were adopted to calculate the kinetic parameters including apparent activation energy and pre-exponential factor, and the Flynn-Wall-Ozawa method was employed to testify apparent activation energy. The results showed that estimation value was consistent with the values obtained by linear fitting equations, and the best-fit model for fast pyrolysis was found.

Effects of oral contraceptives and metformin on the outcome of in vitro maturation in infertile women with polycystic ovary syndrome.

PubMed

Zhao, Jun-Zhao; Lin, Jin-Ju; Yang, Hai-Yan; Zhang, Wei; Huang, Xue-Feng; Huang, Yin-Ping

2010-02-01

Abstract Objective: To evaluate the effects of oral contraceptives and metformin on the outcome of in vitro maturation (IVM) in infertile women with polycystic ovary syndrome (PCOS). This is a retrospective study of 108 women with PCOS, subject to 152 cycles of IVM treatment. The study was held at the Reproductive Medicine Center of the First Affiliated Hospital of Wenzhou Medical College, People's Republic of China. Before entering IVM treatment, 54 patients who received oral contraceptive pill (marvelon, 0.15 mg desogestrel, and 0.03 mg ethinylestradiol), one tablet every day, and metformin 500 mg twice or three times per day were defined as the pretreated group, and another 64 patients who were not administered any drugs as the control group. The main outcome measures were the rates of oocyte maturation, fertilization, cleavage, miscarriage, clinical pregnancy, and live birth. There were no significant differences between the two groups in the rates of oocyte maturation, fertilization, cleavage, and clinical pregnancy (p > 0.05). A significantly lower miscarriage rate was obtained in the pretreated group than in the control group (16.13% vs 4.0%, p < 0.01). The live birth rate per embryo transfer seemed to be higher in the pretreated group than in the control group (37.70% vs 30.38%, p = 0.363), but was not statistically significant. Pretreatment with oral contraceptives and metformin improved the outcome of IVM related to the miscarriage rate and possibly also live birth rate.

Antimicrobial activity and composition profile of grape (Vitis vinifera) pomace extracts obtained by supercritical fluids.

PubMed

Oliveira, Daniela A; Salvador, Ana Augusta; Smânia, Artur; Smânia, Elza F A; Maraschin, Marcelo; Ferreira, Sandra R S

2013-04-10

The possibility of increasing the aggregated value of the huge amount of residues generated by wineries around the world foment studies using the grape pomace - the residue from the wine production, composed by seed, skin and stems - to obtain functional ingredients. Nowadays, consumers in general prefer natural and safe products mainly for food and cosmetic fields, where the supercritical fluid extraction is of great importance due to the purity of the extracts provided. Therefore, the objective of this work is to evaluate the global extraction yield, the antimicrobial activity and the composition profile of Merlot and Syrah grape pomace extracts obtained by supercritical CO2 (SC-CO2) and CO2 added with co-solvent at pressures up to 300 bar and temperatures of 50 and 60 °C. The results were compared with the ones obtained by Soxhlet and by ultrasound-assisted leaching extraction methods. The main components from the extracts, identified by HPLC, were gallic acid, p-OH-benzoic acid, vanillic acid and epicatechin. The antibacterial and antifungal activities of the extracts were evaluated using four strains of bacteria (Staphylococcus aureus, Bacillus cereus, Escherichia coli and Pseudomonas aeruginosa) and three fungi strains (Candida albicans, Candida parapsilosis, Candida krusei). Despite lower extraction yield results, the supercritical fluid extracts presented the highest antimicrobial effectiveness compared to the other grape pomace extracts due to the presence of antimicrobial active compounds. Syrah extracts were less efficient against the microorganisms tested and Merlot extracts were more active against Gram-positive bacteria. Copyright © 2012 Elsevier B.V. All rights reserved.

30 CFR 75.302 - Main mine fans.

Code of Federal Regulations, 2012 CFR

2012-07-01

... ventilated by one or more main mine fans. Booster fans shall not be installed underground to assist main mine fans except in anthracite mines. In anthracite mines, booster fans installed in the main air current or...

30 CFR 75.302 - Main mine fans.

Code of Federal Regulations, 2011 CFR

2011-07-01

... ventilated by one or more main mine fans. Booster fans shall not be installed underground to assist main mine fans except in anthracite mines. In anthracite mines, booster fans installed in the main air current or...

30 CFR 75.302 - Main mine fans.

Code of Federal Regulations, 2014 CFR

2014-07-01

... ventilated by one or more main mine fans. Booster fans shall not be installed underground to assist main mine fans except in anthracite mines. In anthracite mines, booster fans installed in the main air current or...

30 CFR 75.302 - Main mine fans.

Code of Federal Regulations, 2013 CFR

2013-07-01

... ventilated by one or more main mine fans. Booster fans shall not be installed underground to assist main mine fans except in anthracite mines. In anthracite mines, booster fans installed in the main air current or...

30 CFR 75.302 - Main mine fans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... ventilated by one or more main mine fans. Booster fans shall not be installed underground to assist main mine fans except in anthracite mines. In anthracite mines, booster fans installed in the main air current or...

EPA Partners with Maine DEP to Provide Technical Assistance Support, Improve Environmental and Public Health in Maine

EPA Pesticide Factsheets

The US Environmental Protection Agency (EPA) Region 1 is collaborating with the Maine Department of Environmental Protection (ME DEP) to provide free technical assistance for municipalities and businesses in Maine.

Outcome Based Budgeting: Connecting Budget Development, Allocation and Outcomes.

ERIC Educational Resources Information Center

Anderes, Thomas

This plan for outcome-based budgeting (OBB) is the result of growing demands for increased fiscal accountability, measurable outcomes, strengthened assessment processes, and more meaningful performance indicators as mandated by many State and Federal legislators. OBB focuses on linking funding with outputs and outcomes. Higher education…

Liquid crystal polymers: evidence of hairpin defects in nematic main chains, comparison with side chain polymers

NASA Astrophysics Data System (ADS)

Li, M. H.; Brûlet, A.; Keller, P.; Cotton, J. P.

1996-09-01

This article describes the conformation of two species of liquid crystalline polymers as revealed by small angle neutron scattering. The results obtained with side chain polymers are recalled. The procedure used to analyze the scattering data of main chains in the nematic phase is reported in this paper. It permits a demonstration of the existence of hairpins. Comparison of both polymer species shows that in the isotropic phase, the two polymers adopt a random coil conformation. In the nematic phase, the conformations are very different; the side chains behave as a melt of penetrable random coils whereas the main chains behave as a nematic phase of non penetrable cylinders.

Tree Height and DBH Growth Model Establishment of Main Tree Species in Wuling Mountain Small Watershed

NASA Astrophysics Data System (ADS)

Luo, Jia; Zhang, Min; Zhou, Xiaoling; Chen, Jianhua; Tian, Yuxin

2018-01-01

Taken 4 main tree species in the Wuling mountain small watershed as research objects, 57 typical sample plots were set up according to the stand type, site conditions and community structure. 311 goal diameter-class sample trees were selected according to diameter-class groups of different tree-height grades, and the optimal fitting models of tree height and DBH growth of main tree species were obtained by stem analysis using Richard, Logistic, Korf, Mitscherlich, Schumacher, Weibull theoretical growth equations, and the correlation coefficient of all optimal fitting models reached above 0.9. Through the evaluation and test, the optimal fitting models possessed rather good fitting precision and forecast dependability.

Short-Term Treatment Outcomes and Dropout Risk in Men and Women with Eating Disorders.

PubMed

Agüera, Zaida; Sánchez, Isabel; Granero, Roser; Riesco, Nadine; Steward, Trevor; Martín-Romera, Virginia; Jiménez-Murcia, Susana; Romero, Xandra; Caroleo, Mariarita; Segura-García, Cristina; Menchon, José Manuel; Fernández-Aranda, Fernando

2017-07-01

This study compared treatment outcomes between men and women with eating disorders (EDs) and analysed clinical predictors of treatment outcome. Our sample consisted of 131 male and 131 female ED patients who underwent cognitive behavioural therapy treatment. ED severity, personality and psychopathology were assessed using standard instruments. We found that the risk of dropout was higher for men with bulimia nervosa (BN) than for women with BN and that men with BN and other specified feeding and EDs were more likely to obtain full remission in comparison with their female counterparts. Predictive models of treatment outcome indicated that higher scores in novelty seeking were a shared factor associated with higher risk of dropout and not obtaining full remission for both men and women with ED. However, only in men, younger age and lower scores in reward dependence predicted higher dropout. Contrastingly, higher persistence scores were predictors of full remission. This study reinforces the effectiveness of using outpatient cognitive behavioural therapy as treatment as usual for men with ED. Nonetheless, placing greater emphasis on strategies targeting gender-specific issues could enhance outcomes. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Women's perceptions of everyday occupations: outcomes of the Redesigning Daily Occupations (ReDO) programme.

PubMed

Eklund, Mona; Erlandsson, Lena-Karin

2014-09-01

The aim was to (i) assess the outcomes of the 16-week Redesigning Daily Occupations (ReDO) programme for women on sick leave due to stress-related disorders, in terms of occupational value, satisfaction with everyday occupations, and participation level; (ii) investigate the relationships between those outcomes and return-to-work rate. A total of 42 women receiving ReDO and 42 receiving care as usual (CAU) were included in a matched-control study with measurements before and after the rehabilitation. Seventy-eight participated on both occasions. They completed self-report questionnaires regarding the aforementioned outcomes. Return-to-work data were obtained from the registers of the Social Insurance Offices. Increases in concrete, symbolic, and self-reward values were found in both groups, but no statistically significant difference between the groups was demonstrated. The ReDO group improved more than the CAU group, however, on satisfaction with everyday occupations and participation level. Occupational value, but not satisfaction with everyday occupations, was related to return to work. Everyday occupations were shown to be relevant outcomes after work rehabilitation. They could play an important role in future development of profession-specific evidence of occupational therapy. Further support was obtained for viewing occupational value and satisfaction with everyday occupations as theoretically distinct phenomena.

Primary Care Outcomes Questionnaire: psychometric testing of a new instrument.

PubMed

Murphy, Mairead; Hollinghurst, Sandra; Cowlishaw, Sean; Salisbury, Chris

2018-06-01

Patients attend primary care for many reasons and to achieve a range of possible outcomes. There is currently no Patient Reported Outcome Measure (PROM) designed to capture these diverse outcomes, and trials of interventions in primary care may thus fail to detect beneficial effects. This study describes the psychometric testing of the Primary Care Outcomes Questionnaire (PCOQ), which was designed to capture a broad range of outcomes relevant to primary care. Questionnaires were administered in primary care in South West England. Patients completed the PCOQ in GP waiting rooms before a consultation, and a second questionnaire, including the PCOQ and seven comparator PROMs, after 1 week. Psychometric testing included exploratory factor analysis on the PCOQ, internal consistency, correlation coefficients between domain scores and comparator measures, and repeated measures effect sizes indicating change across 1 week. In total, 602 patients completed the PCOQ at baseline, and 264 (44%) returned the follow-up questionnaire. Exploratory factor analysis suggested four dimensions underlying the PCOQ items: health and wellbeing, health knowledge and self-care, confidence in health provision, and confidence in health plan. Each dimension was internally consistent and correlated as expected with comparator PROMs, providing evidence of construct validity. Patients reporting an improvement in their main problem exhibited small to moderate improvements in relevant domain scores on the PCOQ. The PCOQ was acceptable, feasible, showed strong psychometric properties, and was responsive to change. It is a promising new tool for assessment of outcomes of primary care interventions from a patient perspective. © British Journal of General Practice 2018.

Recent advances of basic materials to obtain electrospun polymeric nanofibers for medical applications

NASA Astrophysics Data System (ADS)

Manea, L. R.; Hristian, L.; Leon, A. L.; Popa, A.

2016-08-01

The most important applications of electrospun polymeric nanofibers are by far those from biomedical field. From the biological point of view, almost all the human tissues and organs consist of nanofibroas structures. The examples include the bone, dentine, cartilage, tendons and skin. All these are characterized through different fibrous structures, hierarchically organized at nanometer scale. Electrospinning represents one of the nanotechnologies that permit to obtain such structures for cell cultures, besides other technologies, such as selfassembling and phase separation technologies. The basic materials used to produce electrospun nanofibers can be natural or synthetic, having polymeric, ceramic or composite nature. These materials are selected depending of the nature and structure of the tissue meant to be regenerated, namely: for the regeneration of smooth tissues regeneration one needs to process through electrospinning polymeric basic materials, while in order to obtain the supports for the regeneration of hard tissues one must mainly use ceramic materials or composite structures that permit imbedding the bioactive substances in distinctive zones of the matrix. This work presents recent studies concerning basic materials used to obtain electrospun polymeric nanofibers, and real possibilities to produce and implement these nanofibers in medical bioengineering applications.

Performance and Vibratory Loads Data From a Wind-Tunnel Test of a Model Helicopter Main-Rotor Blade With a Paddle-Type Tip

NASA Technical Reports Server (NTRS)

Yeager, William T., Jr.; Noonan, Kevin W.; Singleton, Jeffrey D.; Wilbur, Matthew L.; Mirick, Paul H.

1997-01-01

An investigation was conducted in the Langley Transonic Dynamics Tunnel to obtain data to permit evaluation of paddle-type tip technology for possible use in future U.S. advanced rotor designs. Data was obtained for both a baseline main-rotor blade and a main-rotor blade with a paddle-type tip. The baseline and paddle-type tip blades were compared with regard to rotor performance, oscillatory pitch-link loads, and 4-per-rev vertical fixed-system loads. Data was obtained in hover and forward flight over a nominal range of advance ratios from 0.15 to 0.425. Results indicate that the paddle-type tip offers no performance improvements in either hover or forward flight. Pitch-link oscillatory loads for the paddle-type tip are higher than for the baseline blade, whereas 4-per-rev vertical fixed-system loads are generally lower.

A flight investigation of blade-section aerodynamics for a helicopter main rotor having 10-64C airfoil sections

NASA Technical Reports Server (NTRS)

Morris, C. E. K., Jr.

1981-01-01

Pressure data at 90 percent blade radius were obtained for a helicopter main rotor with 10-64C blade sections during flight. Concurrent measurements ere made of vehicle flight state, performance and some rotor loads. The test envelope included hover, level flight from about 65 to 162 knots, climb and descent, and collective fixed maneuvers. Good agreement is shown between some sets of airfoil pressure distributions obtained in flight and those from two-dimensional wind-tunnel tests or theoretical calculations.

Psychological contract breach and outcomes: Combining meta-analysis and structural equation models.

PubMed

Topa Cantisano, Gabriela; Morales Domínguez, J Francisco; Depolo, Marco

2008-08-01

In this study, meta-analytic procedures were used to examine the relationships between psychological contract perceived breach and certain outcome variables, such as organizational commitment, job satisfaction and organizational citizenship behaviours (OCB). Our review of the literature generated 41 independent samples in which perceived breach was used as a predictor of these personal and organizational outcomes. A medium effect size (ES) for desirable outcomes (job satisfaction, organizational commitment, organizational trust, OCB and performance) was obtained (r=-.35). For undesirable outcomes (neglect in role duties and intention to leave), ES were also medium (r=.31). When comparing attitudinal (job satisfaction, organizational commitment, organizational trust) and behavioural outcomes (OCB, neglect in role duties and performance), a stronger ES was found for attitudinal (r=-.24) than for behavioural outcomes (r=-.11). Potential moderator variables were examined, and it was found that they explained only a percentage of variability of primary studies. Structural equation analysis of the pooled meta-analytical correlation matrix indicated that the relationships of perceived breach with satisfaction, OCB, intention to leave and performance are fully mediated by organizational trust and commitment. Results are discussed in order to suggest theoretical and empirical implications.

Basal progesterone level as the main determinant of progesterone elevation on the day of hCG triggering in controlled ovarian stimulation cycles.

PubMed

Papaleo, Enrico; Corti, Laura; Vanni, Valeria Stella; Pagliardini, Luca; Ottolina, Jessica; De Michele, Francesca; La Marca, Antonio; Viganò, Paola; Candiani, Massimo

2014-07-01

Modest increases of serum progesterone at human chorionic gonadotrophin (hCG) administration in controlled ovarian hyperstimulation (COH) cycles have been shown to have a negative impact on pregnancy outcomes. The aim of this study was to identify early predictors of progesterone elevation at hCG. Pregnancy outcome of 303 consecutive patients undergoing COH and fresh day-3 embryo transfer was analysed. Considering the non-linear relationship between progesterone at hCG triggering and pregnancy outcomes, partial area under the curve (pAUC) analysis was used to implement marker identification potential of receiver operating characteristic (ROC) curve analysis. Multivariate logistic analysis was then performed to identify predictors of progesterone rise. Pregnancy outcomes could be predicted by pAUC analysis (pAUC = 0.58, 95 % CI 0.51-0.66, p = 0.02) and a significant detrimental cut-off could be calculated (progesterone at hCG > 1.35 ng/ml). Total dose of rFSH administered, E2 level at hCG but mostly basal progesterone level (OR = 12.21, 95 % CI 1.82-81.70) were predictors of progesterone rise above the cut-off. Basal progesterone is shown to be the main prognostic factor for progesterone elevation. This observation should be taken into consideration in the clinical management of IVF/ICSI cycles to improve pregnancy outcomes.

The Effects of Service-Delivery Model and Purchase Price on Hearing-Aid Outcomes in Older Adults: A Randomized Double-Blind Placebo-Controlled Clinical Trial

PubMed Central

Rogers, Sara E.; Quigley, Tera M.; Main, Anna K.; Kinney, Dana L.; Herring, Christine

2017-01-01

Objectives The objectives of this study were to determine efficacy of hearing aids in older adults using audiology best practices, to evaluate the efficacy of an alternative over-the-counter (OTC) intervention, and to examine the influence of purchase price on outcomes for both service-delivery models. Design The design of this study was a single-site, prospective, double-blind placebo-controlled randomized trial with three parallel branches: (a) audiology best practices (AB), (b) consumer decides OTC model (CD), and (c) placebo devices (P). Outcome measures were obtained after a typical 6-week trial period with follow-up 4-week AB-based trial for those initially assigned to CD and P groups. Setting Older adults from the general community were recruited via newspaper and community flyers to participate at a university research clinic. Participants Participants were adults, ages 55–79 years, with mild-to-moderate hearing loss. There were 188 eligible participants: 163 enrolled as a volunteer sample, and 154 completed the intervention. Intervention(s) All participants received the same high-end digital mini-behind-the-ear hearing aids fitted bilaterally. AB and P groups received best-practice services from audiologists; differing mainly in use of appropriate (AB) or placebo (P) hearing aid settings. CD participants self-selected their own pre-programmed hearing aids via an OTC model. Primary and Secondary Outcome Measures Primary outcome measure was a 66-item self-report, Profile of Hearing Aid Benefit (Cox & Gilmore, 1990). Secondary outcome measure was the Connected Speech Test (Cox, Alexander, & Gilmore, 1987) benefit. Additional measures of hearing-aid benefit, satisfaction, and usage were also obtained. Results Per-protocol analyses were performed. AB service-delivery model was found to be efficacious for most of the outcome measures, with moderate or large effect sizes (Cohen's d). CD service-delivery model was efficacious, with similar effect sizes. However

Change in Irrational Beliefs and the Outcome of Rational-Emotive Psychotherapy.

ERIC Educational Resources Information Center

Smith, Timothy W.

1983-01-01

Examined correlations between pre- to posttreatment changes in beliefs and changes in treatment-outcome measures within the context of a previous study of rational-emotive therapy. Obtained reliable correlations between changes in beliefs and changes in emotional distress. This relationship occurred in control conditions as well as in treatment…

Does It Pay to Be a Sexist? The Relationship between Modern Sexism and Career Outcomes

ERIC Educational Resources Information Center

Watkins, Marla Baskerville; Kaplan, Seth; Brief, Author P.; Shull, Amanda; Dietz, Joerg; Mansfield, Marie-Therese; Cohen, Robin

2006-01-01

In this study, we examined the consequences of harboring "modern sexist" beliefs on the career outcomes of both men and women. We argued that individuals endorsing these beliefs disproportionately rely on men (versus women) for work-related advice and, in turn, obtain more promotions than do their less sexist counterparts. Results obtained from a…

Countrywide analysis of perinatal outcome.

PubMed

Stembera, Z; Kravka, A; Mandys, F

1988-01-01

The computer laboratory of the Research Institute for the Care of Mother and Child in Prague performs annually a countrywide analysis of perinatal outcome in order to obtain a background for the preparation of the optimal strategy for improving perinatal care in CSR in the future. The total as well as weight specific perinatal mortality rate further sub-divided into early neonatal death rate and late fetal death rate and differentiated according to the birthweight, was correlated with the incidence of different factors influencing the perinatal mortality rate both countrywide and for each of the eight provinces of CSR. This way a correlation was found between some of the mentioned perinatal outcomes and e.g. instrumental equipment of obstetrical departments and neonatal intensive care units, frequency of caesarean sections, or transport of LBW newborns in incubators or "in utero" etc. The results of this analysis have proved that there still remain in some provinces opportunity for further decrease in perinatal mortality due to the incomplete observance of the two intervention strategies "Risk approach" and "New technology" which were introduced in the whole country during the last 10 years.

Influence of safety motivation and climate on safety behaviour and outcomes: evidence from the Saudi Arabian construction industry.

PubMed

Panuwatwanich, Kriengsak; Al-Haadir, Saeed; Stewart, Rodney A

2017-03-01

Over the last three decades, safety literature has focused on safety climate and its role in forecasting injuries and accidents. However, research findings regarding the relationships between safety climate and other key outcome constructs are somewhat inconsistent. Recent safety climate literature suggests that examining the role of safety motivation may help provide a better explanation of such relationships. The research presented in this article aimed to empirically analyse the relationships among safety motivation, safety climate, safety behaviour and safety outcomes within the context of the Saudi Arabian construction industry. A conceptual model was developed to examine the relationships among four main constructs: safety motivation, safety climate, safety behaviour and safety outcomes. Based on the survey data collected in Saudi Arabia from site engineers and project managers (n = 295), statistical analyses were carried out, including confirmatory and exploratory factor analysis, and structural equation modelling to assess the model and test the hypotheses. The main results indicated that safety motivation could positively influence safety behaviour through safety climate, which plays a mediating role for this mechanism. The results also confirmed that safety behaviour could predict safety outcomes within the context of the Saudi Arabian construction industry.

Clinical and radiographic outcomes of thoracic and lumbar pedicle subtraction osteotomy for fixed sagittal imbalance.

PubMed

Yang, Benson P; Ondra, Stephen L; Chen, Larry A; Jung, Hee Soo; Koski, Tyler R; Salehi, Sean A

2006-07-01

The authors conducted a study to evaluate the radiographically documented and functional outcomes obtained in patients who underwent pedicle subtraction osteotomy (PSO). They also compared outcomes after classification of cases into thoracic and lumbar PSO subgroups. The authors analyzed data obtained in 35 consecutive PSO-treated patients with sagittal imbalance. One surgeon performed all surgeries. The minimal follow-up period was 2 years. Events during the perioperative course and complications were noted. Standing long-film radiographs of the spine were obtained and measurements were made preoperatively, immediately postoperatively, and at most recent follow-up examination. The modified Prolo Scale and the 22-item Scoliosis Research Society (SRS-22) Outcomes Questionnaire were administered. Early complications after PSO included neurological injury, wound-related problems, and nosocomial infections. Late complications were limited to pseudarthrosis and attendant instrumentation failure. Early and late complication rates ranged from 10 to 30% for both thoracic and lumbar PSO cohorts. Lumbar PSO was associated with improvements in local, segmental, and global measures of sagittal balance, whereas thoracic PSO was only associated with local improvement. Most patients rated their functional status as fair to good according to the modified Prolo Scale and reported, according to the SRS-22 Outcomes Questionnaire, that they were satisfied with the overall treatment of their back condition. The ability to perform a PSO at both lumbar and thoracic levels is a powerful asset for the spine surgeon treating spinal deformity. In the present study radiographic and clinical outcomes were superior when PSO was used to treat lumbar deformity rather than thoracic deformity because of several anatomical and technical obstacles that hindered the thoracic procedure. Nevertheless, the thoracic PSO proved a useful addition with which to produce regional improvement in sagittal

[Microdialysis cerebral. Main application of this technique].

PubMed

Blanco-Lezcano, L; Pavón-Fuentes, N; Blanco-Lezcano, V

Microdialysis cerebral technique has been widely employed in order to study the neurotransmitter release. This technique present numerous advantages such as: allow to work with sample in vivo from animals freely moving, by means of microdialysis can be infused simultaneously different drugs in different points implanted probes in several coordinates; also allow carry out pharmacokinetics studies that show correlation with behavior patter as well as to study metabolic changes, which is not possible when this determination are carry out in tissue, in post mortem stadio. In the present work is carry out a review about the main results obtaining in the sensitization and abstinence to several drug study and approach to biochemical characteristics to Parkinson s disease (PD) by means of microdialysis technique. In relation to sensibilization studies, the temporal changes in different behavior pattern that modify after amphetamine administration have been studied. Microdialysis study allowed correlationate dopamine concentration with behavior pattern above mentioned. In relation with PD, dopamine concentration after systemic and central (intracerebral) administration of levodopa and another dopaminergic drugs have been studied in different nucleus of basal ganglia as well as its respectively behavior correlates.

Evaluation of spent coffee obtained from the most common coffeemakers as a source of hydrophilic bioactive compounds.

PubMed

Bravo, Jimena; Juániz, Isabel; Monente, Carmen; Caemmerer, Bettina; Kroh, Lothar W; De Peña, M Paz; Cid, Concepción

2012-12-26

The main hydrophilic antioxidant compounds (3-, 4-, and 5-monocaffeoylquinic and 3,4-, 3,5-, and 4,5-dicaffeoylquinic acids, caffeine, and browned compounds, including melanoidins) and the antioxidant capacity (Folin-Ciocalteu, ABTS, DPPH, Fremy's salt, and TEMPO) were evaluated in Arabica and Robusta spent coffee obtained from the preparation of coffee brews with the most common coffeemakers (filter, espresso, plunger, and mocha). All spent coffee grounds, with the exception of those from the mocha coffeemaker, had relevant amounts of total caffeoylquinic acids (6.22-13.24 mg/g of spent coffee), mainly dicaffeoylquinic acids (3.31-5.79 mg/g of spent coffee), which were 4-7-fold higher than in their respective coffee brews. Caffeine ranged from 3.59 to 8.09 mg/g of spent coffee. The antioxidant capacities of the aqueous spent coffee extracts were 46.0-102.3% (filter), 59.2-85.6% (espresso), and <42% (plunger) in comparison to their respective coffee brews. This study obtained spent coffee extracts with antioxidant properties that can be used as a good source of hydrophilic bioactive compounds.

Severe Neonatal Anaemia, MRI Findings and Neurodevelopmental Outcome.

PubMed

Zonnenberg, Inge A; Vermeulen, R Jeroen; Rohaan, Maartje W; van Weissenbruch, Mirjam M; Groenendaal, Floris; de Vries, Linda S

2016-01-01

Severe neonatal anaemia can impair cerebral oxygen supply. Data on long-term outcomes following severe neonatal anaemia are scarce. Clinical data and neurodevelopmental outcome of 49 (near) term infants with haemoglobin concentration after birth <6.0 mmol/l were retrospectively collected and analysed. In a subgroup of 28 patients, amplitude-integrated EEG was available and in 25 infants cerebral MRI was obtained. Infants were followed up at 14-35 months of age and assessed with the Griffiths Scale of Mental Development or Bayley Scale of Infant Development. Eighteen patients (37%) died during the neonatal period. In 25 patients MRI was performed. A predominant pattern of injury on MRI was seen in the basal ganglia and thalami in 7 patients (28%), whereas some form of white matter injury was present in 16 (64%) and a combination in 3 (12%). Follow-up data were available for 26 patients (84% of survivors). Formal assessment of neurodevelopmental outcome was performed in 20 of 31 (65%) infants who survived (median age: 19 months, range: 14-35). Sixteen infants (80%) had a developmental quotient appropriate for age in the first 2 years after birth. On motor outcome, 1 patient (5%) scored below average (Z-score -1.10). One patient developed cerebral palsy. Early neurodevelopmental outcome in surviving patients with severe neonatal anaemia was within the normal range in the majority of the survivors. MRI showed mild-to-moderate white matter injury in two thirds of the infants. Prospectively collected data with a longer follow-up period are needed. © 2016 The Author(s) Published by S. Karger AG, Basel.

Hazard and outcome of retreated choledochal cyst patients.

PubMed

Chijiiwa, K

1993-01-01

Thirty-nine patients initially treated for choledochal cyst (25: cyst-enterostomy for 15 type I and 10 type IV A, 13: cyst excision for 8 type I and 5 type IV A, 1: sphincterotomy for type III) have been completely followed up for a mean period of 17 years to examine the effect of surgical management on their lives. Eighteen of 25 cases with cyst-enterostomy (72%) needed retreatment due to the complications but one could not be retreated because of the presence of advanced bile duct carcinoma. Fourteen of 17 cases were retreated with cyst excision, of whom 12 showed an excellent outcome but other two were suffering from cholangitis and hepatolithiasis. The remaining 3 patients retreated with PTCS or cyst-enterostomy showed a poor outcome. Of 13 patients who had undergone cyst excision with hepatico-jejunostomy as the first choice, 12 showed a good outcome but one needed retreatment due to the anastomotic stenosis and hepatolithiasis. Thus, excision of cyst should be the surgical management for choledochal cyst. However, it should be noted that three of 27 patients treated initially or secondarily with cyst excision showed unsatisfactory results mainly due to the anastomotic stenosis. The results demonstrate that hepaticojejunostomy with a wide opening stoma is necessary to prevent postoperative morbidity.

Outcomes of fetuses with small head circumference on second-trimester ultrasonography.

PubMed

Deloison, Benjamin; Chalouhi, Gihad E; Bernard, Jean-Pierre; Ville, Yves; Salomon, Laurent J

2012-09-01

We examined the outcomes of pregnancies in which the fetal head circumference (HC) was below the 5(th) centile at the routine second-trimester scan. We retrospectively analysed outcomes of 18,377 women according to HC Z scores at second-trimester ultrasound examination between 2001 and 2008. We collected all major malformations, intrauterine deaths and other abnormal outcomes. Six hundred seventy-four fetuses (3.7%) had an HC below the 5(th) centile. Twenty-one major malformations were noted, consisting mainly of neurological abnormalities (3.1%). There were seven intra uterine fetal death (1.3%). Of all the fetuses, 26% were lost to follow-up. Outcome and neurological development was normal in 467 cases, based on neonatal examination and/or parent or general practitioner reports. Major abnormalities were noted in respectively 26.2%, 3.0% and 1.1% of fetuses with Z scores < -2.5, -2.5 to -2.0, and -2 to -1.645, compared with 0.3% of fetuses with normal HC (p < 10(-4)). A head circumference below the 5(th) centile at second-trimester scan is associated with various abnormalities, especially neurological disorders. The outcome was worse when the HC was smaller. An HC Z score below -2.5 was strongly associated with neurological and chromosomal abnormalities. Conversely, an HC Z score below -1.645 but above -2, excluding cases with prenatally diagnosed malformations, seems to be reassuring for favorable neonatal outcome. © 2012 John Wiley & Sons, Ltd.

Combining clinical variables to optimize prediction of antidepressant treatment outcomes.

PubMed

Iniesta, Raquel; Malki, Karim; Maier, Wolfgang; Rietschel, Marcella; Mors, Ole; Hauser, Joanna; Henigsberg, Neven; Dernovsek, Mojca Zvezdana; Souery, Daniel; Stahl, Daniel; Dobson, Richard; Aitchison, Katherine J; Farmer, Anne; Lewis, Cathryn M; McGuffin, Peter; Uher, Rudolf

2016-07-01

The outcome of treatment with antidepressants varies markedly across people with the same diagnosis. A clinically significant prediction of outcomes could spare the frustration of trial and error approach and improve the outcomes of major depressive disorder through individualized treatment selection. It is likely that a combination of multiple predictors is needed to achieve such prediction. We used elastic net regularized regression to optimize prediction of symptom improvement and remission during treatment with escitalopram or nortriptyline and to identify contributing predictors from a range of demographic and clinical variables in 793 adults with major depressive disorder. A combination of demographic and clinical variables, with strong contributions from symptoms of depressed mood, reduced interest, decreased activity, indecisiveness, pessimism and anxiety significantly predicted treatment outcomes, explaining 5-10% of variance in symptom improvement with escitalopram. Similar combinations of variables predicted remission with area under the curve 0.72, explaining approximately 15% of variance (pseudo R(2)) in who achieves remission, with strong contributions from body mass index, appetite, interest-activity symptom dimension and anxious-somatizing depression subtype. Escitalopram-specific outcome prediction was more accurate than generic outcome prediction, and reached effect sizes that were near or above a previously established benchmark for clinical significance. Outcome prediction on the nortriptyline arm did not significantly differ from chance. These results suggest that easily obtained demographic and clinical variables can predict therapeutic response to escitalopram with clinically meaningful accuracy, suggesting a potential for individualized prescription of this antidepressant drug. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Effects of Admission and Treatment Strategies of DWI Courts on Offender Outcomes

PubMed Central

Sloan, Frank A.; Chepke, Lindsey M.; Davis, Dontrell V.; Acquah, Kofi; Zold-Kilbourne, Phyllis

2013-01-01

Purpose The purpose of this study is to classify DWI courts on the basis of the mix of difficult cases participating in the court (casemix severity) and the amount of involvement between the court and participant (service intensity). Using our classification typology, we assess how casemix severity and service intensity are associated with program outcomes. We expected that holding other factors constant, greater service intensity would improve program outcomes while a relatively severe casemix would result in worse program outcomes. Methods The study used data from 8 DWI courts, 7 from Michigan and 1 from North Carolina. Using a 2-way classification system based on court casemix severity and program intensity, we selected participants in 1 of the courts, and alternatively 2 courts as reference groups. Reference group courts had relatively severe casemixes and high service intensity. We used propensity score matching to match participants in the other courts to participants in the reference group court programs. Program outcome measures were the probabilities of participants’: failing to complete the court’s program; increasing educational attainment; participants improving employment from time of program enrollment; and re-arrest. Results For most outcomes, our main finding was that higher service intensity is associated with better outcomes for court participants, as anticipated, but a court’s casemix severity was unrelated to study outcomes. Conclusions Our results imply that devoting more resources to increasing duration of treatment is productive in terms of better outcomes, irrespective of the mix of participants in the court’s program PMID:23416679

Euthanasia requests, procedures and outcomes for 100 Belgian patients suffering from psychiatric disorders: a retrospective, descriptive study

PubMed Central

Thienpont, Lieve; Verhofstadt, Monica; Van Loon, Tony; Distelmans, Wim; Audenaert, Kurt; De Deyn, Peter P

2015-01-01

Objectives To identify patterns in euthanasia requests and practices relating to psychiatric patients; to generate recommendations for future research. Design Retrospective analysis of data obtained through medical file review. Setting Outpatient psychiatric clinical setting in the Dutch-speaking region of Belgium, between October 2007 and December 2011; follow-up at the end of December 2012. Participants 100 consecutive psychiatric patients requesting euthanasia based on psychological suffering associated with psychiatric disorders (77 women, 23 men; mean age 47 years; age range 21–80 years). Main outcome measures Patient sociodemographic characteristics; diagnoses; decisions on euthanasia requests; circumstances of euthanasia procedures; patient outcomes at follow-up. Results Most patients had been referred for psychiatric counselling by their physician (n=55) or by LEIF (Life End Information Forum) (n=36). 90 patients had >1 disorder; the most frequent diagnoses were depression (n=58) and personality disorder (n=50). 38 patients required further testing and/or treatment, including 13 specifically tested for autism spectrum disorder (ASD); 12 received an ASD diagnosis (all Asperger syndrome). In total, 48 of the euthanasia requests were accepted and 35 were carried out. Of the 13 remaining patients whose requests were accepted, 8 postponed or cancelled the procedure, because simply having this option gave them enough peace of mind to continue living. In December 2012, 43 patients had died, including 35 by euthanasia; others died by suicide (6), palliative sedation (1) and anorexia nervosa (1). Conclusions Depression and personality disorders are the most common diagnoses in psychiatric patients requesting euthanasia, with Asperger syndrome representing a neglected disease burden. Further research is needed, especially prospective quantitative and qualitative studies, to obtain a better understanding of patients with psychiatric disorders who request

Fetomaternal outcome of pregnancy with Mitral stenosis

PubMed Central

Ahmed, Nazia; Kausar, Hafeeza; Ali, Lubna; Rakhshinda

2015-01-01

Objective: To evaluate the frequency of fetomaternal outcome of pregnancy with Mitral stenosis admitted in Civil Hospital Karachi. Methods: It was a two years descriptive study done in the Department of Obstetrics and Gynaecology Civil Hospital Karachi. All pregnant women with a known or newly diagnosed Mitral stenosis on echocardiography were included in the study. History was taken regarding age, parity, gestational age (calculated by ultrasound) and complaints. Mode of delivery and Maternal mortality noted. Foetal outcome was analyzed by birth weight and Apgar score. Results: A total of 101 patients meeting the inclusion criteria were enrolled in the study. The ages of the women ranged between 20-29 years (69%) and 81% were multigravidas. Vaginal delivery occurred in 67 (66.3%) women and 78.3% were term pregnancies. Preterm deliveries were 21.8% and 27.7% newborns were low birth weight. APGAR score <7 was found in 14.9% of neonates and 9 babies had intrauterine death. Low ejection fraction<55% was diagnosed in 20(13.9%) women and Maternal mortality was found in two cases. Conclusion: Heart disease in pregnancy is associated with significant morbidity, it should be carefully managed in a tertiary care hospital to obtain optimum maternal and foetal outcome. PMID:26150860

A dynamic quality assessment tool for laparoscopic hysterectomy to measure surgical outcomes.

PubMed

Driessen, Sara R C; Van Zwet, Erik W; Haazebroek, Pascal; Sandberg, Evelien M; Blikkendaal, Mathijs D; Twijnstra, Andries R H; Jansen, Frank Willem

2016-12-01

The current health care system has an urgent need for tools to measure quality. A wide range of quality indicators have been developed in an attempt to differentiate between high-quality and low-quality health care processes. However, one of the main issues of currently used indicators is the lack of case-mix correction and improvement possibilities. Case-mix is defined as specific (patient) characteristics that are known to potentially affect (surgical) outcome. If these characteristics are not taken into consideration, comparisons of outcome among health care providers may not be valid. The objective of the study was to develop and test a quality assessment tool for laparoscopic hysterectomy, which can serve as a new outcome quality indicator. This is a prospective, international, multicenter implementation study. A web-based application was developed with 3 main goals: (1) to measure the surgeon's performance using 3 primary outcomes (blood loss, operative time, and complications); (2) to provide immediate individual feedback using cumulative observed-minus-expected graphs; and (3) to detect consistently suboptimal performance after correcting for case-mix characteristics. All gynecologists who perform laparoscopic hysterectomies were requested to register their procedures in the application. A patient safety risk factor checklist was used by the surgeon for reflection. Thereafter a prospective implementation study was performed, and the application was tested using a survey that included the System Usability Scale. A total of 2066 laparoscopic hysterectomies were registered by 81 gynecologists. Mean operative time was 100 ± 39 minutes, blood loss 127 ± 163 mL, and the complication rate 6.1%. The overall survey response rate was 75%, and the mean System Usability Scale was 76.5 ± 13.6, which indicates that the application was good to excellent. The majority of surgeons reported that the application made them more aware of their performance, the outcomes, and

Main image file tape description

USGS Publications Warehouse

Warriner, Howard W.

1980-01-01

This Main Image File Tape document defines the data content and file structure of the Main Image File Tape (MIFT) produced by the EROS Data Center (EDC). This document also defines an INQUIRY tape, which is just a subset of the MIFT. The format of the INQUIRY tape is identical to the MIFT except for two records; therefore, with the exception of these two records (described elsewhere in this document), every remark made about the MIFT is true for the INQUIRY tape.

48 CFR 53.107 - Obtaining forms.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 2 2012-10-01 2012-10-01 false Obtaining forms. 53.107 Section 53.107 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION (CONTINUED) CLAUSES AND FORMS FORMS General 53.107 Obtaining forms. (a) Executive agencies shall obtain standard and...

48 CFR 53.107 - Obtaining forms.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 2 2013-10-01 2013-10-01 false Obtaining forms. 53.107 Section 53.107 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION (CONTINUED) CLAUSES AND FORMS FORMS General 53.107 Obtaining forms. (a) Executive agencies shall obtain standard and...

48 CFR 53.107 - Obtaining forms.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Obtaining forms. 53.107 Section 53.107 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION (CONTINUED) CLAUSES AND FORMS FORMS General 53.107 Obtaining forms. (a) Executive agencies shall obtain standard and...

48 CFR 53.107 - Obtaining forms.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 2 2011-10-01 2011-10-01 false Obtaining forms. 53.107 Section 53.107 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION (CONTINUED) CLAUSES AND FORMS FORMS General 53.107 Obtaining forms. (a) Executive agencies shall obtain standard and...

48 CFR 53.107 - Obtaining forms.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 2 2014-10-01 2014-10-01 false Obtaining forms. 53.107 Section 53.107 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION (CONTINUED) CLAUSES AND FORMS FORMS General 53.107 Obtaining forms. (a) Executive agencies shall obtain standard and...

HOUSEHOLD NUCLEATION, DEPENDENCY AND CHILD HEALTH OUTCOMES IN GHANA.

PubMed

Annim, Samuel Kobina; Awusabo-Asare, Kofi; Amo-Adjei, Joshua

2015-09-01

This study uses three key anthropometric measures of nutritional status among children (stunting, wasting and underweight) to explore the dual effects of household composition and dependency on nutritional outcomes of under-five children in Ghana. The objective is to examine changes in household living arrangements of under-five children to explore the interaction of dependency and nucleation on child health outcomes. The concept of nucleation refers to the changing structure and composition of household living arrangements, from highly extended with its associated socioeconomic system of production and reproduction, social behaviour and values, towards single-family households - especially the nuclear family, containing a husband and wife and their children alone. A negative relationship between levels of dependency, as measured by the number of children in the household, and child health outcomes is premised on the grounds that high dependency depletes resources, both tangible and intangible, to the disadvantage of young children. Data were drawn from the last four rounds of the Ghana Demographic and Health Surveys (GDHSs), from 1993 to 2008, for the first objective - to explore changes in household composition. For the second objective, the study used data from the 2008 GDHS. The results show that, over time, households in Ghana have been changing towards nucleation. The main finding is that in households with the same number of dependent children, in nucleated households children under age 5 have better health outcomes compared with children under age 5 in non-nucleated households. The results also indicate that the effect of dependency on child health outcomes is mediated by household nucleation and wealth status and that, as such, high levels of dependency do not necessarily translate into negative health outcomes for children under age 5, based on anthropometric measures.

Space Shuttle Main Engine structural analysis and data reduction/evaluation. Volume 5: Main Injector LOX Inlet analysis

NASA Technical Reports Server (NTRS)

Violett, Rebeca S.

1989-01-01

The analysis performed on the Main Injector LOX Inlet Assembly located on the Space Shuttle Main Engine is summarized. An ANSYS finite element model of the inlet assemably was built and executed. Static stress analysis was also performed.

Application of Matrix Outcome Mapping to Constructively Align Program Outcomes and Course Outcomes in Higher Education

ERIC Educational Resources Information Center

Mazouz, Abdelkader; Crane, Keenan

2013-01-01

Establishing a link between Course Learning Outcomes (LOs) and Program Outcomes (POs) while assessing the course contents and delivery are among the most challenging issues in Higher Education. In the present study two forms were generated based on specific Course Learning Outcomes identified in the syllabus at the beginning of the teaching term:…

Learning outcomes through the cooperative learning team assisted individualization on research methodology’ course

NASA Astrophysics Data System (ADS)

Pakpahan, N. F. D. B.

2018-01-01

All articles must contain an abstract. The research methodology is a subject in which the materials must be understood by the students who will take the thesis. Implementation of learning should create the conditions for active learning, interactive and effective are called Team Assisted Individualization (TAI) cooperative learning. The purpose of this study: 1) improving student learning outcomes at the course research methodology on TAI cooperative learning. 2) improvement of teaching activities. 3) improvement of learning activities. This study is a classroom action research conducted at the Department of Civil Engineering Universitas Negeri Surabaya. The research subjects were 30 students and lecturer of courses. Student results are complete in the first cycle by 20 students (67%) and did not complete 10 students (33%). In the second cycle students who complete being 26 students (87%) and did not complete 4 students (13%). There is an increase in learning outcomes by 20%. Results of teaching activities in the first cycle obtained the value of 3.15 with the criteria enough well. In the second cycle obtained the value of 4.22 with good criterion. The results of learning activities in the first cycle obtained the value of 3.05 with enough criterion. In the second cycle was obtained 3.95 with good criterion.

Primary Outcomes for Resuscitation Science Studies

PubMed Central

Becker, Lance B.; Aufderheide, Tom P.; Geocadin, Romergryko G.; Callaway, Clifton W.; Lazar, Ronald M.; Donnino, Michael W.; Nadkarni, Vinay M.; Abella, Benjamin S.; Adrie, Christophe; Berg, Robert A.; Merchant, Raina M.; O'Connor, Robert E.; Meltzer, David O.; Holm, Margo B.; Longstreth, William T.; Halperin, Henry R.

2013-01-01

Background and Purpose The guidelines presented in this consensus statement are intended to serve researchers, clinicians, reviewers, and regulators in the selection of the most appropriate primary outcome for a clinical trial of cardiac arrest therapies. The American Heart Association guidelines for the treatment of cardiac arrest depend on high-quality clinical trials, which depend on the selection of a meaningful primary outcome. Because this selection process has been the subject of much controversy, a consensus conference was convened with national and international experts, the National Institutes of Health, and the US Food and Drug Administration. Methods The Research Working Group of the American Heart Association Emergency Cardiovascular Care Committee nominated subject leaders, conference attendees, and writing group members on the basis of their expertise in clinical trials and a diverse perspective of cardiovascular and neurological outcomes (see the online-only Data Supplement). Approval was obtained from the Emergency Cardiovascular Care Committee and the American Heart Association Manuscript Oversight Committee. Preconference position papers were circulated for review; the conference was held; and postconference consensus documents were circulated for review and comments were invited from experts, conference attendees, and writing group members. Discussions focused on (1) when after cardiac arrest the measurement time point should occur; (2) what cardiovascular, neurological, and other physiology should be assessed; and (3) the costs associated with various end points. The final document underwent extensive revision and peer review by the Emergency Cardiovascular Care Committee, the American Heart Association Science Advisory and Coordinating Committee, and oversight committees. Results There was consensus that no single primary outcome is appropriate for all studies of cardiac arrest. The best outcome measure is the pairing of a time point and

Recommendations for Self-Report Outcome Measures in Vulvodynia Clinical Trials.

PubMed

Pukall, Caroline F; Bergeron, Sophie; Brown, Candace; Bachmann, Gloria; Wesselmann, Ursula

2017-08-01

Vulvodynia (idiopathic chronic vulvar pain) is a prevalent condition associated with significant and negative impacts in many areas of function. Despite the increased research interest in vulvodynia in recent years, recommendations for outcome measures for use in clinical trials are missing. The purpose of this paper, therefore, was to provide recommendations for outcome measures for vulvodynia clinical trials so that consistent measures are used across trials to facilitate between-study comparisons and the conduct of large multicenter trials, and to improve measurement of the multiple dimensions of vulvodynia. Given that provoked vestibulodynia (PVD)-characterized by provoked pain localized to the vaginal opening-is the most common subtype of vulvodynia and the current main focus of clinical trials, this paper focused on recommended outcome measures in PVD clinical trials. The framework used to guide the selection of outcome measures was based on the one proposed by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT). The IMMPACT framework provided a well-suited guideline for outcome measure recommendations in PVD clinical trials. However, given the provoked presentation of PVD and the significant impact it has on sexuality, modifications to some of the IMMPACT recommendations were made and specific additional measures were suggested. Measures that are specific to vulvovaginal pain are ideal for adoption in PVD clinical trials, and many such measures currently exist that allow the relevant IMMPACT domains to be captured.

47 CFR 80.859 - Main power supply.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Main power supply. 80.859 Section 80.859... power supply. (a) The main power supply must simultaneously energize the radiotelephone transmitter at... main power supply at the radiotelephone input terminals must not deviate from its rated potential by...

47 CFR 80.859 - Main power supply.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 5 2011-10-01 2011-10-01 false Main power supply. 80.859 Section 80.859... power supply. (a) The main power supply must simultaneously energize the radiotelephone transmitter at... main power supply at the radiotelephone input terminals must not deviate from its rated potential by...

Using Propensity Score Methods to Approximate Factorial Experimental Designs to Analyze the Relationship between Two Variables and an Outcome

ERIC Educational Resources Information Center

Dong, Nianbo

2015-01-01

Researchers have become increasingly interested in programs' main and interaction effects of two variables (A and B, e.g., two treatment variables or one treatment variable and one moderator) on outcomes. A challenge for estimating main and interaction effects is to eliminate selection bias across A-by-B groups. I introduce Rubin's causal model to…

Surgical Outcomes of Urinary Tract Deep Infiltrating Endometriosis.

PubMed

Darwish, Basma; Stochino-Loi, Emanuela; Pasquier, Geoffroy; Dugardin, Fabrice; Defortescu, Guillaume; Abo, Carole; Roman, Horace

To report the outcomes of surgical management of urinary tract endometriosis. Retrospective study based on prospectively recorded data (NCT02294825) (Canadian Task Force classification II-3). University tertiary referral center. Eighty-one women treated for urinary tract endometriosis between July 2009 and December 2015 were included, including 39 with bladder endometriosis, 31 with ureteral endometriosis, and 11 with both ureteral and bladder endometriosis. Owing to bilateral ureteral localization in 8 women, 50 different ureteral procedures were recorded. Procedures performed included resection of bladder endometriosis nodules, advanced ureterolysis, ureteral resection followed by end-to-end anastomosis, and ureteroneocystostomy. The main outcome measure was the outcome of the surgical management of urinary tract endometriosis. Fifty women presented with deep infiltrating endometriosis (DIE) of the bladder and underwent either full-thickness excision of the nodule (70%) or excision of the bladder wall without opening of the bladder (30%). Ureteral lesions were treated by ureterolysis in 78% of the patients and by primary segmental resection in 22%. No patient required nephrectomy. Histological analysis revealed intrinsic ureteral endometriosis in 54.5% of cases. Clavien-Dindo grade III complications were present in 16% of the patients who underwent surgery for ureteral nodules and in 8% of those who underwent surgery for bladder endometriosis. Overall delayed postoperative outcomes were favorable regarding urinary symptoms and fertility. Patients were followed up for a minimum of 12 months and a maximum of 7 years postoperatively, with no recorded recurrences. Surgical outcomes of urinary tract endometriosis are generally satisfactory; however, the risk of postoperative complications should be taken into consideration. Therefore, all such procedures should be managed by an experienced multidisciplinary team. Copyright © 2017 AAGL. Published by Elsevier Inc

46 CFR 108.401 - Fire main system.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Fire main system. 108.401 Section 108.401 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS DESIGN AND EQUIPMENT Fire Extinguishing Systems § 108.401 Fire main system. Each unit must have a fire main system. ...

46 CFR 108.401 - Fire main system.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Fire main system. 108.401 Section 108.401 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS DESIGN AND EQUIPMENT Fire Extinguishing Systems § 108.401 Fire main system. Each unit must have a fire main system. ...

46 CFR 108.401 - Fire main system.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Fire main system. 108.401 Section 108.401 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS DESIGN AND EQUIPMENT Fire Extinguishing Systems § 108.401 Fire main system. Each unit must have a fire main system. ...

46 CFR 108.401 - Fire main system.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Fire main system. 108.401 Section 108.401 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS DESIGN AND EQUIPMENT Fire Extinguishing Systems § 108.401 Fire main system. Each unit must have a fire main system. ...

46 CFR 108.401 - Fire main system.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Fire main system. 108.401 Section 108.401 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS DESIGN AND EQUIPMENT Fire Extinguishing Systems § 108.401 Fire main system. Each unit must have a fire main system. ...

30 CFR 57.8525 - Main fan maintenance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Main fan maintenance. 57.8525 Section 57.8525 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE... Underground Only § 57.8525 Main fan maintenance. Main fans shall be maintained according to either the...

Investigations for the improvement of space shuttle main engine electron beam welding equipment

NASA Technical Reports Server (NTRS)

Smock, R. A.; Taylor, R. A.; Wall, W. A., Jr.

1977-01-01

Progress made in the testing, evaluation, and correction of MSFC's 7.5 kW electron beam welder in support of space shuttle main engine component welding is summarized. The objective of this project was to locate and correct the deficiencies in the welder. Some 17 areas were deficient in the 7.5 kW ERI welding system and the associated corrective action was taken to improve its operational performance. An overall improvement of 20 times the original reliability was obtained at full rated capacity after the modifications were made.

Emulsifying and Foaming Properties of Different Protein Fractions Obtained from a Novel Lupin Variety AluProt-CGNA(®) (Lupinus luteus).

PubMed

Burgos-Díaz, César; Piornos, José A; Wandersleben, Traudy; Ogura, Takahiro; Hernández, Xaviera; Rubilar, Mónica

2016-07-01

The use of vegetable proteins as food ingredient is becoming increasingly important due to their high versatility and environmental acceptability. This work describes a chemical characterization and techno-functional properties (emulsifying and foaming properties) of 3 protein fractions obtained from a protein-rich novel lupin variety, AluProt-CGNA(®) . This nongenetically modified variety have a great protein content in dehulled seeds (60.6 g protein/100 g, dry matter), which is higher than soybean and other lupin varieties. A simple procedure was utilized to obtain 3 different fractions by using alkali solubilization and isoelectric precipitation. Fractions 1 and 3 were mainly composed of protein and polysaccharides (NNE), whereas fraction 2 was mainly composed by protein (97%, w/w). Fraction 3 presented interesting and potential foaming properties in comparison to the other fractions evaluated in the study. Besides, its solubility, foaming and emulsifying capacity were practically not affected by pH variations. The 3 fractions also presented good emulsion stability, reaching values above a 95%. SDS-PAGE showed that fractions 1 and 2 contained mainly conglutin α, β, and δ, but in different ratios, whereas fraction 3 contained mainly conglutin γ and albumins. The results of this work will provide better understanding for the utilization of each protein fractions as potential ingredients in food industry. © 2016 Institute of Food Technologists®

Skipped Stage Modeling and Testing of the CPAS Main Parachutes

NASA Technical Reports Server (NTRS)

Varela, Jose G.; Ray, Eric S.

2013-01-01

The Capsule Parachute Assembly System (CPAS) has undergone the transition from modeling a skipped stage event using a simulation that treats a cluster of parachutes as a single composite canopy to the capability of simulating each parachute individually. This capability along with data obtained from skipped stage flight tests has been crucial in modeling the behavior of a skipping canopy as well as the crowding effect on non-skipping ("lagging") neighbors. For the finite mass inflation of CPAS Main parachutes, the cluster is assumed to inflate nominally through the nominal fill time, at which point the skipping parachute continues inflating. This sub-phase modeling method was used to reconstruct three flight tests involving skipped stages. Best fit inflation parameters were determined for both the skipping and lagging canopies.

47 CFR 80.963 - Main power supply.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Main power supply. 80.963 Section 80.963... MARITIME SERVICES Radiotelephone Installation Required for Vessels on the Great Lakes § 80.963 Main power supply. (a) A main power supply must be available at all times while the vessel is subject to the...

47 CFR 80.963 - Main power supply.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 5 2011-10-01 2011-10-01 false Main power supply. 80.963 Section 80.963... MARITIME SERVICES Radiotelephone Installation Required for Vessels on the Great Lakes § 80.963 Main power supply. (a) A main power supply must be available at all times while the vessel is subject to the...

47 CFR 80.915 - Main power supply.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Main power supply. 80.915 Section 80.915... supply. (a) There must be readily available for use under normal load conditions a main power supply... required receiver. Under this load condition the potential of the main power supply at the power input...

47 CFR 80.915 - Main power supply.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 5 2011-10-01 2011-10-01 false Main power supply. 80.915 Section 80.915... supply. (a) There must be readily available for use under normal load conditions a main power supply... required receiver. Under this load condition the potential of the main power supply at the power input...

14 CFR 27.547 - Main rotor structure.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Main rotor structure. 27.547 Section 27.547... structure. (a) Each main rotor assembly (including rotor hubs and blades) must be designed as prescribed in this section. (b) [Reserved] (c) The main rotor structure must be designed to withstand the following...

14 CFR 23.753 - Main float design.