40 CFR 72.44 - Phase II repowering extensions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) PERMITS REGULATION Acid Rain Compliance Plan and Compliance Options § 72.44 Phase II repowering... the requirements of paragraph (a)(1)(i) of this section may include in the unit's Phase II Acid Rain... authority shall issue the Acid Rain portion of the operating permit including: (A) The approved repowering...

40 CFR 72.44 - Phase II repowering extensions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) PERMITS REGULATION Acid Rain Compliance Plan and Compliance Options § 72.44 Phase II repowering... the requirements of paragraph (a)(1)(i) of this section may include in the unit's Phase II Acid Rain... authority shall issue the Acid Rain portion of the operating permit including: (A) The approved repowering...

40 CFR 72.44 - Phase II repowering extensions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) PERMITS REGULATION Acid Rain Compliance Plan and Compliance Options § 72.44 Phase II repowering... the requirements of paragraph (a)(1)(i) of this section may include in the unit's Phase II Acid Rain... authority shall issue the Acid Rain portion of the operating permit including: (A) The approved repowering...

A Freely-Available Authoring System for Browser-Based CALL with Speech Recognition

ERIC Educational Resources Information Center

O'Brien, Myles

2017-01-01

A system for authoring browser-based CALL material incorporating Google speech recognition has been developed and made freely available for download. The system provides a teacher with a simple way to set up CALL material, including an optional image, sound or video, which will elicit spoken (and/or typed) answers from the user and check them…

Standardised surveillance of Clostridium difficile infection in European acute care hospitals: a pilot study, 2013.

PubMed

van Dorp, Sofie M; Kinross, Pete; Gastmeier, Petra; Behnke, Michael; Kola, Axel; Delmée, Michel; Pavelkovich, Anastasia; Mentula, Silja; Barbut, Frédéric; Hajdu, Agnes; Ingebretsen, André; Pituch, Hanna; Macovei, Ioana S; Jovanović, Milica; Wiuff, Camilla; Schmid, Daniela; Olsen, Katharina Ep; Wilcox, Mark H; Suetens, Carl; Kuijper, Ed J

2016-07-21

Clostridium difficile infection (CDI) remains poorly controlled in many European countries, of which several have not yet implemented national CDI surveillance. In 2013, experts from the European CDI Surveillance Network project and from the European Centre for Disease Prevention and Control developed a protocol with three options of CDI surveillance for acute care hospitals: a 'minimal' option (aggregated hospital data), a 'light' option (including patient data for CDI cases) and an 'enhanced' option (including microbiological data on the first 10 CDI episodes per hospital). A total of 37 hospitals in 14 European countries tested these options for a three-month period (between 13 May and 1 November 2013). All 37 hospitals successfully completed the minimal surveillance option (for 1,152 patients). Clinical data were submitted for 94% (1,078/1,152) of the patients in the light option; information on CDI origin and outcome was complete for 94% (1,016/1,078) and 98% (294/300) of the patients in the light and enhanced options, respectively. The workload of the options was 1.1, 2.0 and 3.0 person-days per 10,000 hospital discharges, respectively. Enhanced surveillance was tested and was successful in 32 of the hospitals, showing that C. difficile PCR ribotype 027 was predominant (30% (79/267)). This study showed that standardised multicountry surveillance, with the option of integrating clinical and molecular data, is a feasible strategy for monitoring CDI in Europe. This article is copyright of The Authors, 2016.

Psychotherapy for Suicidal Clients.

ERIC Educational Resources Information Center

Lester, David

1994-01-01

Reviews various systems of psychotherapy for suitability for suicidal clients. Discusses psychoanalysis, cognitive therapy, primal therapy, transactional analysis, Gestalt therapy, reality therapy, person-centered therapy, existential analysis, and Jungian analysis in light of available treatment options. Includes 36 citations. (Author/CRR)

78 FR 25770 - Options Price Reporting Authority; Order Approving an Amendment to the Plan for Reporting of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-02

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-69453; File No. SR-OPRA-2012-07] Options Price Reporting Authority; Order Approving an Amendment to the Plan for Reporting of Consolidated Options Last Sale Reports and Quotation Information To Amend Section 3.5 of the OPRA Plan April 25, 2013. I. Introduction On December 21, 2012, the Options...

Pneumocystis jirovecii Pneumonia in the Non-HIV-Infected Population.

PubMed

Avino, Laura J; Naylor, Shane M; Roecker, Andrew M

2016-08-01

Summarize data on the pathophysiology, treatment, and prevention options for non-AIDS immunocompromised patients who have Pneumocystis jirovecii pneumonia (PJP); review the epidemiology of patients presenting with PJP; and discuss the first and second-line pharmacological options for treatment and prophylaxis of PJP in this population. MEDLINE (1989-February 2016) searched. Terms searched included combinations of Pneumocystis jirovecii, Pneumocystis carinii, non-HIV, infected, patients, prevention, prophylaxis, Bactrim, treatment, AIDS, opportunistic, immunocompromised, cancer, and pathophysiology Articles included had the most relevant information on PJP pathophysiology, and first-/second-line treatment and prophylactic options. Inclusion criteria were met and evaluated with 43 sources. P jirovecii has a complicated life-cycle; it seeks to find compromised immune systems in order to replicate, causing life-threatening complications. With immunosuppressive medications coming to market for immunomodulating diseases, PJP has become a prevalent opportunistic infection in the non-HIV population. CD4+ lymphocyte count <200 cells/µL is the primary risk factor for PJP presentation in these patients. With data from clinical trials, trimethoprim/sulfamethoxazole (TMP/SMX) has become the primary treatment and prophylaxis of PJP in the non-HIV population, although second-line options are available. PJP is a health problem that may result in an increased concern as more immunomodulating medications to treat various disease states are developed. Patients on these drugs or those with immunosuppressive diseases should have their CD4+ count monitored. Health care providers should continue to use TMP/SMX as the primary option in non-HIV, immunocompromised patients for treatment and prophylaxis of PJP. © The Author(s) 2016.

The Easy Way to Create Computer Slide Shows.

ERIC Educational Resources Information Center

Anderson, Mary Alice

1995-01-01

Discusses techniques for creating computer slide shows. Topics include memory; format; color use; HyperCard and CD-ROM; font styles and sizes; graphs and graphics; the slide show option; special effects; and tips for effective presentation. (Author/AEF)

Providing inbuilt economic resilience options : an obligation of comprehensive cancer care.

PubMed

Cross, Eva Reitschuler; Emanuel, Linda

2008-12-15

For many, a cancer death in the family is the immediately obvious part of what is actually a double devastation. Overwhelming financial damage also results for many families, from the cost of medical care and from the loss of earning power by the patient and family. For some families, the consequences may be multigenerational and can affect the health of the survivors. Although this situation is not limited to cancer, the authors argue that oncology can take a lead in attending to these consequences of cancer as an integral part of its commitment to comprehensive cancer care. They make this case for both the national and the international settings. They also articulate and illustrate the notion of inbuilt options for economic resilience (IERs), which the authors suggest the medical industry, and its cancer care sectors in particular, should be providing to all patients and their families if they are at risk for damaging financial losses. After describing key features to IER, the authors illustrate it with 1 type of approach for households of the terminally ill: hospice care with provision of supplementary training and certification to the family caregiver. Such programming could generate a low-technology, semiskilled healthcare service economy as trained family caregivers provide support to other households in need, thereby both providing a recovery option for themselves and reduced economic devastation to the households which, by receiving the services, can stay in the workforce. Finally, the authors call for invigorated research on the economic impact of cancer on families and for the modeling, demonstration, and study of options for economic resilience, including IER programs.

Acquisition Management for System of Systems: Affordability through Effective Portfolio Management

DTIC Science & Technology

2013-04-01

the management of strategic “ portfolios of systems” in military acquisitions; this includes application of Real Options (RO) theory and metrics such...Affordability Through Effective Portfolio Management Navindran Davendralingam and Daniel DeLaurentis Purdue University Published April 1, 2013...Systems: Affordability Through Effective Portfolio Management 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d

Navy Nuclear-Powered Surface Ships: Background, Issues, and Options for Congress

DTIC Science & Technology

2008-10-03

the use of nuclear power to a wider array of Navy surface ships, including the Navy’s planned CG(X) cruiser. Section 1012 of the FY2008 Defense...wider array of Navy surface ships, starting with the Navy’s planned CG(X) cruiser. Section 1012 of the FY2008 Defense Authorization Act (H.R. 4986...CG(X) Cruiser Program: Background, Oversight Issues, and Options for Congress, by Ronald O’Rourke. 8 For more on the Navy’s 313-ship plan , see CRS

Kent State University's sustainable transportation initiative : final report.

DOT National Transportation Integrated Search

2008-01-01

This past year the author embarked on a study of sustainable transportation options in and around Kent State Universitys campus, including much of the city of Kent itself. Kents most recent Comprehensive Plan attempted to develop a model for th...

Economic Benefits of Improved Water Quality: Public Perceptions of Option and Preservation Values

NASA Astrophysics Data System (ADS)

Bouwes, Nicolaas W., Sr.

The primary objective of this book is to report the authors‧ research approach to the estimation of benefits of water quality improvements in the South Platte River of northeastern Colorado. Benefits included a “consumer surplus” from enhanced enjoyment of water-based recreation, an “option value” of assured choice of future recreation use, and a “preservation value” of the ecosystem and its bequest to future generations. Concepts such as preservation and option value benefits have been often mentioned but seldom estimated in natural resources research. The authors have met their objective by providing the reader with a detailed description of their research without being tedious.

77 FR 56243 - Options Price Reporting Authority; Notice of Filing and Immediate Effectiveness of Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-12

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-67791; File No. SR-OPRA-2012-05] Options Price Reporting Authority; Notice of Filing and Immediate Effectiveness of Proposed Amendment to the Plan for...'') \\1\\ and Rule 608 thereunder,\\2\\ notice is hereby given that on August 27, 2012, the Options Price...

78 FR 51240 - Self-Regulatory Organizations; BATS Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-20

... Change To Eliminate Rules Related to CYCLE Routing August 14, 2013. Pursuant to Section 19(b)(1) of the... that authorize the CYCLE Routing option, effective as of September 3, 2013. The text of the proposed... authorize the CYCLE Routing option on the Exchange's equities platform (``BATS Equities'') and options...

Electric Power System Technology Options for Lunar Surface Missions

NASA Technical Reports Server (NTRS)

Kerslake, Thomas W.

2005-01-01

In 2004, the President announced a 'Vision for Space Exploration' that is bold and forward-thinking, yet practical and responsible. The vision explores answers to longstanding questions of importance to science and society and will develop revolutionary technologies and capabilities for the future, while maintaining good stewardship of taxpayer dollars. One crucial technology area enabling all space exploration is electric power systems. In this paper, the author evaluates surface power technology options in order to identify leading candidate technologies that will accomplish lunar design reference mission three (LDRM-3). LDRM-3 mission consists of multiple, 90-day missions to the lunar South Pole with 4-person crews starting in the year 2020. Top-level power requirements included a nominal 50 kW continuous habitat power over a 5-year lifetime with back-up or redundant emergency power provisions and a nominal 2-kW, 2-person unpressurized rover. To help direct NASA's technology investment strategy, this lunar surface power technology evaluation assessed many figures of merit including: current technology readiness levels (TRLs), potential to advance to TRL 6 by 2014, effectiveness of the technology to meet the mission requirements in the specified time, mass, stowed volume, deployed area, complexity, required special ground facilities, safety, reliability/redundancy, strength of industrial base, applicability to other LDRM-3 elements, extensibility to Mars missions, costs, and risks. For the 50-kW habitat module, dozens of nuclear, radioisotope and solar power technologies were down-selected to a nuclear fission heat source with Brayton, Stirling or thermoelectric power conversion options. Preferred energy storage technologies included lithium-ion battery and Proton Exchange Membrane (PEM) Regenerative Fuel Cells (RFC). Several AC and DC power management and distribution architectures and component technologies were defined consistent with the preferred habitat power generation technology option and the overall lunar surface mission. For rover power, more than 20 technology options were down-selected to radioisotope Stirling, liquid lithium-ion battery, PEM RFC, or primary fuel cell options. The author discusses various conclusions that can be drawn from the findings of this surface power technologies evaluation.

Parenting.

ERIC Educational Resources Information Center

Spock, Benjamin; And Others

Various aspects of child-rearing are covered in this transcript of a program broadcast in the National Public Radio weekly series, "Options in Education." Authors of current popular books on parenting are interviewed. Benjamin Spock discusses changes (including sex role revisions) in his "Baby and Child Care" since the 1946…

Nontraditional Degree Options for Nurses: A Model Program

ERIC Educational Resources Information Center

Walston, Sydney C.

1978-01-01

The Institute for Personal and Career Development of Central Michigan University offers external degree programs for adult learners using nontraditional study. The competency-based programs described include credit given for the educational background and relevant career-life experiences of registered nurses in Michigan. (Author/LBH)

75 FR 22416 - Statement of Organization, Functions, and Delegations of Authority

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-28

... Document Management System; (13) develops and distributes leadership reports, including the Secretary's 90... principal advisor to the Director, CDC, on internal and external affairs of CDC; (2) convenes key leadership for assessment, management, mitigation options, and resolution of issues and initiatives affecting CDC...

78 FR 4505 - Options Price Reporting Authority; Notice of Filing of Proposed Amendment to the Plan for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-22

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-68655; File No. SR-OPRA-2012-07] Options Price Reporting Authority; Notice of Filing of Proposed Amendment to the Plan for Reporting of Consolidated Options Last Sale Reports and Quotation Information To Amend Section 3.5 of the OPRA Plan January 15, 2013. Pursuant to Section 11A of the...

The role of service readiness and health care facility factors in attrition from Option B+ in Haiti: a joint examination of electronic medical records and service provision assessment survey data.

PubMed

Lipira, Lauren; Kemp, Christopher; Domercant, Jean Wysler; Honoré, Jean Guy; Francois, Kesner; Puttkammer, Nancy

2018-01-01

Option B+ is a strategy wherein pregnant or breastfeeding women with HIV are enrolled in lifelong antiretroviral therapy (ART) for prevention of mother-to-child transmission (PMTCT) of HIV. In Haiti, attrition from Option B+ is problematic and variable across health care facilities. This study explores service readiness and other facility factors as predictors of Option B+ attrition in Haiti. This analysis used longitudinal data from 2012 to 2014 from the iSanté electronic medical record system and cross-sectional data from Haiti's 2013 Service Provision Assessment. Predictors included Service Availability and Readiness Assessment (SARA) measures for antenatal care (ANC), PMTCT, HIV care services and ART services; general facility characteristics and patient-level factors. Multivariable Cox proportional hazards models modelled the time to first attrition. Analysis of data from 3147 women at 63 health care facilities showed no significant relationships between SARA measures and attrition. Having integrated ANC/PMTCT care and HIV-related training were significant protective factors. Being a public-sector facility, having a greater number of quality improvement activities and training in ANC were significant risk factors. Several facility-level factors were associated with Option B+ attrition. Future research is needed to explore unmeasured facility factors, clarify causal relationships, and incorporate community-level factors into the analysis of Option B+ attrition. © The Author(s) 2018. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Towards more sustainable management of European food waste: Methodological approach and numerical application.

PubMed

Manfredi, Simone; Cristobal, Jorge

2016-09-01

Trying to respond to the latest policy needs, the work presented in this article aims at developing a life-cycle based framework methodology to quantitatively evaluate the environmental and economic sustainability of European food waste management options. The methodology is structured into six steps aimed at defining boundaries and scope of the evaluation, evaluating environmental and economic impacts and identifying best performing options. The methodology is able to accommodate additional assessment criteria, for example the social dimension of sustainability, thus moving towards a comprehensive sustainability assessment framework. A numerical case study is also developed to provide an example of application of the proposed methodology to an average European context. Different options for food waste treatment are compared, including landfilling, composting, anaerobic digestion and incineration. The environmental dimension is evaluated with the software EASETECH, while the economic assessment is conducted based on different indicators expressing the costs associated with food waste management. Results show that the proposed methodology allows for a straightforward identification of the most sustainable options for food waste, thus can provide factual support to decision/policy making. However, it was also observed that results markedly depend on a number of user-defined assumptions, for example on the choice of the indicators to express the environmental and economic performance. © The Author(s) 2016.

The optimal treatment for stage 2-3 Goutallier rotator cuff tears: A systematic review of the literature.

PubMed

Hollman, Freek; Wolterbeek, Nienke; Flikweert, Petra E; Yang, Kiem G Auw

2018-06-01

Fatty infiltration is an important prognostic factor for cuff healing after rotator cuff repair. Treatment options for stage 2-3 Goutallier rotator cuff tears vary widely and there is lack of decent comparative studies. The objective of this study was 1) to give an overview of the treatment options of stage 2-3 Goutallier rotator cuff tears and their clinical outcome and 2) to give a recommendation of the optimal treatment within this specific subgroup. We searched the databases of Medline, Embase, Cochrane library, NHS Centre for Reviews and Dissemination, PEDro from inception to December 12th, 2016. Two authors, F.H. and N.W., selected the studies after consensus. Data was extracted by one author (F.H.) and checked for completeness by a second author (N.W.). Our primary outcome was physical function, measured by shoulder-specific patient reported outcomes. Secondary outcomes were cuff integrity after rotator cuff repair, shoulder pain, general health, quality of life, activity level and adverse events. For the first research question 28 prospective as well as retrospective studies were included. For the clinical outcome of these treatments three randomized controlled trials were included. Despite the high reported retear rate, rotator cuff repair has comparable results (clinical improvement) as partial repair and isolated bicepstenotomy or tenodesis. These findings suggest that the additional effect of rotator cuff repair compared to the less extensive treatment options like isolated bicepstenotomy or tenodesis should be studied, as these might form a good alternative treatment based on this systematic review. Level IV; systematic review.

Managing the side effects of multiple sclerosis therapy: pharmacotherapy options for patients.

PubMed

Rommer, Paulus S; Zettl, Uwe K

2018-04-01

Multiple sclerosis (MS) is an immune-mediated and neurodegenerative disease with an unpredictable outcome. Immune-modulatory treatment aims at decreasing long-term disability. With the increasing number of treatment options, it is essential to fully digest the possible side effects of the available therapeutics and to monitor patients is essential. Areas covered: All approved disease-modifying drugs (DMD) for MS are discussed in this review. Mode of action, adverse effects, reported risks for infections and malignancies, and pregnancy related issues are discussed in the review. The authors also provide suggestions for monitoring therapy. For all approved DMDs the pivotal studies have been included for possible side effects, as well as reports by health authorities. For this manuscript, PubMed was checked for reports on side effects for various drugs. Expert opinion: Treatment options in MS are manifold, each carrying different risks. The safety-risk profile for approved agents is favorable. Knowing and monitoring these possible side effects is essential to minimize risks associated with treatment. Presently, the long-term experience for some of these therapies is missing and this must be addressed.

76 FR 56832 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-14

... entire universe of U.S. options disseminated by the Options Price Reporting Authority (OPRA). The... unique market data to the public. It was believed that this authority would expand the amount of data...

Stafford Technical Center: Designing a Future for Architects and Builders

ERIC Educational Resources Information Center

Lucci, William, Jr.

2005-01-01

In this article, the author describes Stafford Technical Center's Engineering Technology Academy (ETA), in which students pursue a variety of educational and career options for anything connected to construction technologies--including drafting and design, architecture, and even work in historic preservation. In addition to technical skills,…

Developing a healthcare law library.

PubMed

Sconyers, J M

1998-01-01

Legal materials are expensive, bulky, and extremely time sensitive. Selecting the appropriate means of ensuring easy access to easily-retrievable, timely legal materials is of extreme importance to any lawyer. The author gives an overview of the various means of retrieving necessary research, including the strengths and weaknesses of each of the various options.

12 CFR 390.203 - What definitions apply to this subpart?

Code of Federal Regulations, 2014 CFR

2014-01-01

... not include securities issued by an investment company registered under the Investment Company Act of..., other than a put, call, straddle, option, or privilege: (i) That is traded on one or more national... behalf of the account, regardless of whether this authority has been exercised. Investment company plan...

12 CFR 390.203 - What definitions apply to this subpart?

Code of Federal Regulations, 2013 CFR

2013-01-01

... not include securities issued by an investment company registered under the Investment Company Act of..., other than a put, call, straddle, option, or privilege: (i) That is traded on one or more national... behalf of the account, regardless of whether this authority has been exercised. Investment company plan...

Coursework in Cognition by Mathematics Undergraduates: A Seven Year Review.

ERIC Educational Resources Information Center

Nelson, David

2000-01-01

It has become increasingly possible for mathematics students to include a limited number of approved optional, non-traditional modules in their programs. Surveys coursework in four non-specialist modules over a seven-year period, and examines work in the area of mathematical cognition. (Contains 16 references.) (Author/ASK)

Verbalizing Facial Memory: Criterion Effects in Verbal Overshadowing

ERIC Educational Resources Information Center

Clare, Joseph; Lewandowsky, Stephan

2004-01-01

This article investigated the role of the recognition criterion in the verbal overshadowing effect (VOE). In 3 experiments, people witnessed an event, verbally described a perpetrator, and then attempted identification. The authors found in Experiment 1, which included a "not present" response option and both perpetrator-present (PP) and…

Parental Participation and Partnership in Pre-school Provision.

ERIC Educational Resources Information Center

Foot, Hugh; Howe, Christine; Cheyne, Bill; Terras, Melody; Rattray, Catherine

2002-01-01

Investigated parents' and staff opinions about parental participation in their child's preschool, including perceived available options for partnership. Found that parental needs for participation were largely satisfied by the opportunities offered in the play group sector but not in local authority and private nurseries. Found three areas in…

Rational Suicide and the Crisis of Terminal Illness.

ERIC Educational Resources Information Center

Lokhandwala, Tasneem M.; Westefeld, John S.

1998-01-01

Whether or not suicide may be considered a rational choice for clients with terminal illness is controversial. Rational suicide and the literature and statistics pertaining to suicide and terminal illness are reviewed. Implications of accepting rational suicide as a treatment option, including moral and ethical issues, are addressed. (Author/EMK)

Corporate-Academic Partnerships: Creating a Win-Win in the Classroom

ERIC Educational Resources Information Center

Deeter-Schmelz, Dawn Reneé

2015-01-01

For instructors seeking ways to provide sales students with experiential learning projects designed to develop and enhance skills in an authentic environment, corporate-academic partnerships offer a viable option. The author describes a unique and innovative corporate-academic integrated project, including course content, role plays, and corporate…

Nanomaterial interactions with biomembranes: Bridging the gap between soft matter models and biological context.

PubMed

Werner, Marco; Auth, Thorsten; Beales, Paul A; Fleury, Jean Baptiste; Höök, Fredrik; Kress, Holger; Van Lehn, Reid C; Müller, Marcus; Petrov, Eugene P; Sarkisov, Lev; Sommer, Jens-Uwe; Baulin, Vladimir A

2018-04-03

Synthetic polymers, nanoparticles, and carbon-based materials have great potential in applications including drug delivery, gene transfection, in vitro and in vivo imaging, and the alteration of biological function. Nature and humans use different design strategies to create nanomaterials: biological objects have emerged from billions of years of evolution and from adaptation to their environment resulting in high levels of structural complexity; in contrast, synthetic nanomaterials result from minimalistic but controlled design options limited by the authors' current understanding of the biological world. This conceptual mismatch makes it challenging to create synthetic nanomaterials that possess desired functions in biological media. In many biologically relevant applications, nanomaterials must enter the cell interior to perform their functions. An essential transport barrier is the cell-protecting plasma membrane and hence the understanding of its interaction with nanomaterials is a fundamental task in biotechnology. The authors present open questions in the field of nanomaterial interactions with biological membranes, including: how physical mechanisms and molecular forces acting at the nanoscale restrict or inspire design options; which levels of complexity to include next in computational and experimental models to describe how nanomaterials cross barriers via passive or active processes; and how the biological media and protein corona interfere with nanomaterial functionality. In this Perspective, the authors address these questions with the aim of offering guidelines for the development of next-generation nanomaterials that function in biological media.

Pharmacological management of narcolepsy with and without cataplexy.

PubMed

Kallweit, Ulf; Bassetti, Claudio L

2017-06-01

Narcolepsy is an orphan neurological disease and presents with sleep-wake, motoric, neuropsychiatric and metabolic symptoms. Narcolepsy with cataplexy is most commonly caused by an immune-mediated process including genetic and environmental factors, resulting in the selective loss of hypocretin-producing neurons. Narcolepsy has a major impact on workableness and quality of life. Areas covered: This review provides an overview of the temporal available treatment options for narcolepsy (type 1 and 2) in adults, including authorization status by regulatory agencies. First- and second-line options are discussed as well as combination therapies. In addition, treatment options for frequent coexisting co-morbidities and different phenotypes of narcolepsy are presented. Finally, this review considers potential future management strategies. Non-pharmacological approaches are important in the management of narcolepsy but will not be covered in this review. Expert opinion: Concise evaluation of symptoms and type of narcolepsy, coexisting co-morbidities and patients´ distinct needs is mandatory in order to identify a suitable, individual pharmacological treatment. First-line options include Modafinil/Armodafinil (for excessive daytime sleepiness, EDS), Sodium Oxybate (for EDS and/with cataplexy), Pitolisant (for EDS and cataplexy) and Venlafaxine (for cataplexy (off-label) and co-morbid depression). New symptomatic and causal treatment most probably will be completed by hypocretin-replacement and immune-modifying strategies.

For the last time: stock options are an expense.

PubMed

Bodie, Zvi; Kaplan, Robert S; Merton, Robert C

2003-03-01

Should stock options be recorded as an expense on a company's income statement and balance sheet, or should they remain where they are, relegated to footnotes? The extraordinary boom in share prices during the Internet bubble made critics of option expensing look like spoilsports. But since the crash, the debate has returned with a vengeance. And no wonder: The authors believe the case for expensing options is overwhelming. In this article, Nobel Iaureate Robert Merton, one of the inventors of the Black-Scholes option-pricing model; his coauthor on the classic textbook Finance, Zvi Bodie; and Robert Kaplan, creator of the Balanced Scorecard, examine and dismiss the principal claims put forward by those who continue to oppose options expensing. They demonstrate that stock-option grants do indeed have real cash-flow implications that need to be reported. They show that effective ways certainly exist to quantify those implications. They detail the distortions that relegating stock-option accounting to footnotes creates. And they show why reporting option costs should in no way hamper young companies in their efforts to provide incentives. Options are indeed a powerful incentive, the authors agree, and failing to record a transaction that creates such powerful effects is economically indefensible. Worse, it encourages companies to favor options over alternative incentive systems. It is not the proper role of accounting standards, the authors argue, to distort executive and employee compensation by subsidizing one particular form of compensation and no other. Companies should choose compensation methods according to their economic benefits--not the way they are reported.

Implementing autonomous clinical nurse specialist prescriptive authority: a competency-based transition model.

PubMed

Klein, Tracy Ann

2012-01-01

The purpose of this study was to identify and implement a competency-based regulatory model that transitions clinical nurse specialists (CNSs) to autonomous prescriptive authority pursuant to change in state law. Prescriptive authority for CNSs may be optional or restricted under current state law. Implementation of the APRN Consensus Model includes full prescriptive authority for all advanced practice registered nurses. Clinical nurse specialists face barriers to establishing their prescribing authority when laws or practice change. Identification of transition models will assist CNSs who need to add prescriptive authority to their scope of practice. Identification and implementation of a competency-based transition model for expansion of CNS prescriptive authority. By January 1, 2012, 9 CNSs in the state exemplar have completed a practicum and been granted full prescriptive authority including scheduled drug prescribing. No complaints or board actions resulted from the transition to autonomous prescribing. Transition to prescribing may be facilitated through competency-based outcomes including practicum hours as appropriate to the individual CNS nursing specialty. Outcomes from this model can be used to develop and further validate educational and credentialing policies to reduce barriers for CNSs requiring prescriptive authority in other states.

Metastasis to the Glans Penis: An Unusual Site of Rectal Cancer Recurrence.

PubMed

Nunes, Beatriz; Matias, Margarida; Alves, António; Jorge, Marília

2015-01-01

Secondary malignancy of the penis is a rare clinical condition, often associated with disseminated genitourinary malignancies. The prognosis is poor and the treatment options include penectomy, local surgical excision, radiation therapy, chemotherapy and supportive therapy. Neither of these therapeutic options lead to superior treatment outcomes in the literature. The authors report the case of a 66 year-old man with a metastasis to the glans penis from a rectal adenocarcinoma, diagnosed two years after radical treatment for primary disease. The patient underwent palliative treatment with radiotherapy and chemotherapy, remaining asymptomatic and disease-free at one year follow-up. Close follow-up of patients with history of rectal adenocarcinoma is very important. Radiochemotherapy is a feasible and effective therapeutic option for penile metastasis, addressing both disease control and symptomatic improvement.

Nonlethal weapons as force options for the Army

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

Alexander, J.B.

This paper suggests that future challenges to US national security will be very different from those previously experienced. In a number of foreseeable circumstances, conventional military force will be inappropriate. The National Command Authority, and other appropriate levels of command, need expanded options available to meet threats for which the application of massive lethal force is counterproductive or inadvisable. It is proposed that nonlethal concepts be developed that provide additional options for military leaders and politicians. Included in this initiative should be exploration of policy, strategy, doctrine, and training issues as well as the development of selected technologies and weapons.more » In addition, civilian law enforcement agencies have similar requirements for less-than-lethal systems. This may be an excellent example for a joint technology development venture.« less

SUPPORT Tools for evidence-informed health Policymaking (STP) 7: Finding systematic reviews

PubMed Central

2009-01-01

This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. Systematic reviews are increasingly seen as a key source of information in policymaking, particularly in terms of assisting with descriptions of the impacts of options. Relative to single studies they offer a number of advantages related to understanding impacts and are also seen as a key source of information for clarifying problems and providing complementary perspectives on options. Systematic reviews can be undertaken to place problems in comparative perspective and to describe the likely harms of an option. They also assist with understanding the meanings that individuals or groups attach to a problem, how and why options work, and stakeholder views and experiences related to particular options. A number of constraints have hindered the wider use of systematic reviews in policymaking. These include a lack of awareness of their value and a mismatch between the terms employed by policymakers, when attempting to retrieve systematic reviews, and the terms used by the original authors of those reviews. Mismatches between the types of information that policymakers are seeking, and the way in which authors fail to highlight (or make obvious) such information within systematic reviews have also proved problematic. In this article, we suggest three questions that can be used to guide those searching for systematic reviews, particularly reviews about the impacts of options being considered. These are: 1. Is a systematic review really what is needed? 2. What databases and search strategies can be used to find relevant systematic reviews? 3. What alternatives are available when no relevant review can be found? PMID:20018114

Pragmatic characteristics of patient-reported outcome measures are important for use in clinical practice.

PubMed

Kroenke, Kurt; Monahan, Patrick O; Kean, Jacob

2015-09-01

Measures for assessing patient-reported outcomes (PROs) that may have initially been developed for research are increasingly being recommended for use in clinical practice as well. Although psychometric rigor is essential, this article focuses on pragmatic characteristics of PROs that may enhance uptake into clinical practice. Three sources were drawn on in identifying pragmatic criteria for PROs: (1) selected literature review including recommendations by other expert groups; (2) key features of several model public domain PROs; and (3) the authors' experience in developing practical PROs. Eight characteristics of a practical PRO include: (1) actionability (i.e., scores guide diagnostic or therapeutic actions/decision making); (2) appropriateness for the relevant clinical setting; (3) universality (i.e., for screening, severity assessment, and monitoring across multiple conditions); (4) self-administration; (5) item features (number of items and bundling issues); (6) response options (option number and dimensions, uniform vs. varying options, time frame, intervals between options); (7) scoring (simplicity and interpretability); and (8) accessibility (nonproprietary, downloadable, available in different languages and for vulnerable groups, and incorporated into electronic health records). Balancing psychometric and pragmatic factors in the development of PROs is important for accelerating the incorporation of PROs into clinical practice. Published by Elsevier Inc.

New Author Choice for Open Access

NASA Astrophysics Data System (ADS)

2007-04-01

AGU journals now offer authors the opportunity to make their articles open for others to read for free. Authors choosing this option pay a fee based on article length and number of figures; these charges are designed to offset the potential loss of subscription income. This new option, called Author Choice, provides •Unlimited access to the article for all readers from the moment of publication. • Permission to deposit the PDF version in institutional repositories so long as the repository accepts AGU copyright permissions. • Continued copyright protection to prevent unauthorized uses of the author's work.

Australian Family Research Conference Proceedings (Canberra, Australia, November 23-25, 1983). Volume IV: Policies and Families.

ERIC Educational Resources Information Center

Institute of Family Studies, Melbourne (Australia).

Fourth in a series of volumes containing the proceedings of the 1983 Australian Family Research Conference, this publication deals with policies and families in Australia. Papers and authors included are: "Improving Social Security Programs: Some Options and Barriers" (Andrew Burbidge), "Single Parent Families and Social Policies:…

Commission on Teacher Credentialing Approves 8 ELL-Related Credential Options

ERIC Educational Resources Information Center

Frost, Jeff; Cadiero-Kaplan, Karen; Kuhlman, Natalie

2011-01-01

On September 30, 2010, the California Commission on Teacher Credentialing (CTC) voted unanimously to approve a set of eight recommendations for authorization to teach English language learners. These recommendations approved by the CTC had been in development for almost two years and they focused on several issues, including: (1) a specific focus…

Phylogenetic diversity, functional trait diversity and extinction: avoiding tipping points and worst-case losses.

PubMed

Faith, Daniel P

2015-02-19

The phylogenetic diversity measure, ('PD'), measures the relative feature diversity of different subsets of taxa from a phylogeny. At the level of feature diversity, PD supports the broad goal of biodiversity conservation to maintain living variation and option values. PD calculations at the level of lineages and features include those integrating probabilities of extinction, providing estimates of expected PD. This approach has known advantages over the evolutionarily distinct and globally endangered (EDGE) methods. Expected PD methods also have limitations. An alternative notion of expected diversity, expected functional trait diversity, relies on an alternative non-phylogenetic model and allows inferences of diversity at the level of functional traits. Expected PD also faces challenges in helping to address phylogenetic tipping points and worst-case PD losses. Expected PD may not choose conservation options that best avoid worst-case losses of long branches from the tree of life. We can expand the range of useful calculations based on expected PD, including methods for identifying phylogenetic key biodiversity areas. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Assessing climate change beliefs: Response effects of question wording and response alternatives.

PubMed

Greenhill, Murni; Leviston, Zoe; Leonard, Rosemary; Walker, Iain

2014-11-01

To date, there is no 'gold standard' on how to best measure public climate change beliefs. We report a study (N = 897) testing four measures of climate change causation beliefs, drawn from four sources: the CSIRO, Griffith University, the Gallup poll, and the Newspoll. We found that question wording influences the outcome of beliefs reported. Questions that did not allow respondents to choose the option of believing in an equal mix of natural and anthropogenic climate change obtained different results to those that included the option. Age and belief groups were found to be important predictors of how consistent people were in reporting their beliefs. Response consistency gave some support to past findings suggesting climate change beliefs reflect something deeper in the individual belief system. Each belief question was assessed against five criterion variables commonly used in climate change literature. Implications for future studies are discussed. © The Author(s) 2013.

Open access to scientific articles: a review of benefits and challenges.

PubMed

Björk, Bo-Christer

2017-03-01

The Internet has fundamentally changed the publishing of scholarly peer reviewed journals, and the way readers find and access articles. Digital access is nowadays the norm, in particular for researchers. The Internet has enabled a totally new business model, Open Access (OA), in which an article is openly available in full text for anyone with Internet access. This article reviews the different options to achieve this, whether by journals changing their revenue structures from subscription to publishing charges, or authors utilizing a number of options for posting OA versions of article manuscripts in repositories. It also discusses the regrettable emergence of "predatory" publishers, who spam academics, and make money by promising them rapid publication with only the semblance of peer review. The situation is further discussed from the viewpoints of different stakeholders, including academics as authors and readers, practicing physicians and the general public.

Intensive Care Management of Thoracic Aortic Surgical Patients, Including Thoracic and Infradiaphragmatic Endovascular Repair (EVAR/TEVAR).

PubMed

Cole, Sheela Pai

2015-12-01

The patient with thoracic aortic disease can present for open or endovascular repair. Thoracic endovascular aortic repair (TEVAR) has emerged as a minimally invasive option for a multitude of aortic pathology, including dissections, aneurysms, traumatic injuries, and ulcers. Postoperative management of these patients depends on the extent of procedure, whether it was open or endovascular, and, finally, on the preoperative comorbidities present. While procedural success has catapulted TEVAR to popularity, midterm results have been mixed. Additionally, periprocedural complications such as paraplegia and renal failure remain a significant morbidity in these patients. © The Author(s) 2015.

77 FR 15833 - Options Price Reporting Authority; Notice of Filing and Immediate Effectiveness of Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-16

... Reporting of Consolidated Options Last Sale Reports and Quotation Information To Amend OPRA's Fee Schedule... of Consolidated Options Last Sale Reports and Quotation Information (``OPRA Plan'').\\3\\ The proposed... sale and quotation information on options that are traded on the participant exchanges. The nine...

A pilot study of a chiropractic intervention for management of chronic myofascial temporomandibular disorder

PubMed Central

DeVocht, James W.; Goertz, Christine M.; Hondras, Maria A.; Long, Cynthia R.; Schaeffer, Wally; Thomann, Lauren; Spector, Michael; Stanford, Clark M.

2014-01-01

Background Temporomandibular pain has multiple etiologies and a range of therapeutic options. In this pilot study, the authors assessed the feasibility of conducting a larger trial to evaluate chiropractic treatment of temporomandibular disorders (TMDs). Methods The authors assigned 80 participants randomly into one of the following four groups, all of which included a comprehensive self-care program: reversible interocclusal splint therapy (RIST), Activator Method Chiropractic Technique (AMCT) (Activator Methods International, Phoenix), sham AMCT and self-care only. They made assessments at baseline and at month 2 and month 6, including use of the Research Diagnostic Criteria for Temporomandibular Disorders. Results The authors screened 721 potential participants and enrolled 80 people; 52 participants completed the six-month assessment. The adjusted mean change in current pain over six months, as assessed on the 11-point numerical rating scale, was 2.0 (95 percent confidence interval, 1.1-3.0) for RIST, 1.7 (0.9-2.5) for self-care only, 1.5 (0.7-2.4) for AMCT and 1.6 (0.7-2.5) for sham AMCT. The authors also assessed bothersomeness and functionality. Conclusions The authors found the study design and methodology to be manageable. They gained substantial knowledge to aid in conducting a larger study. AMCT, RIST and self-care should be evaluated in a future comparative effectiveness study. Practical Implications. This pilot study was a necessary step to prepare for a larger study that will provide clinicians with information that should be helpful when discussing treatment options for patients with TMD. PMID:24080932

41 CFR 302-3.405 - If my agency authorizes a TCS, do I have the option of electing payment of per diem expenses...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false If my agency authorizes...? 302-3.405 Section 302-3.405 Public Contracts and Property Management Federal Travel Regulation System... Change Of Station § 302-3.405 If my agency authorizes a TCS, do I have the option of electing payment of...

Vessel co-option is common in human lung metastases and mediates resistance to anti-angiogenic therapy in preclinical lung metastasis models.

PubMed

Bridgeman, Victoria L; Vermeulen, Peter B; Foo, Shane; Bilecz, Agnes; Daley, Frances; Kostaras, Eleftherios; Nathan, Mark R; Wan, Elaine; Frentzas, Sophia; Schweiger, Thomas; Hegedus, Balazs; Hoetzenecker, Konrad; Renyi-Vamos, Ferenc; Kuczynski, Elizabeth A; Vasudev, Naveen S; Larkin, James; Gore, Martin; Dvorak, Harold F; Paku, Sandor; Kerbel, Robert S; Dome, Balazs; Reynolds, Andrew R

2017-02-01

Anti-angiogenic therapies have shown limited efficacy in the clinical management of metastatic disease, including lung metastases. Moreover, the mechanisms via which tumours resist anti-angiogenic therapies are poorly understood. Importantly, rather than utilizing angiogenesis, some metastases may instead incorporate pre-existing vessels from surrounding tissue (vessel co-option). As anti-angiogenic therapies were designed to target only new blood vessel growth, vessel co-option has been proposed as a mechanism that could drive resistance to anti-angiogenic therapy. However, vessel co-option has not been extensively studied in lung metastases, and its potential to mediate resistance to anti-angiogenic therapy in lung metastases is not established. Here, we examined the mechanism of tumour vascularization in 164 human lung metastasis specimens (composed of breast, colorectal and renal cancer lung metastasis cases). We identified four distinct histopathological growth patterns (HGPs) of lung metastasis (alveolar, interstitial, perivascular cuffing, and pushing), each of which vascularized via a different mechanism. In the alveolar HGP, cancer cells invaded the alveolar air spaces, facilitating the co-option of alveolar capillaries. In the interstitial HGP, cancer cells invaded the alveolar walls to co-opt alveolar capillaries. In the perivascular cuffing HGP, cancer cells grew by co-opting larger vessels of the lung. Only in the pushing HGP did the tumours vascularize by angiogenesis. Importantly, vessel co-option occurred with high frequency, being present in >80% of the cases examined. Moreover, we provide evidence that vessel co-option mediates resistance to the anti-angiogenic drug sunitinib in preclinical lung metastasis models. Assuming that our interpretation of the data is correct, we conclude that vessel co-option in lung metastases occurs through at least three distinct mechanisms, that vessel co-option occurs frequently in lung metastases, and that vessel co-option could mediate resistance to anti-angiogenic therapy in lung metastases. Novel therapies designed to target both angiogenesis and vessel co-option are therefore warranted. © 2016 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland. © 2016 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.

Options for Online Undergraduate Courses in Biology at American Colleges and Universities.

PubMed

Varty, Alison K

I aimed to document the online undergraduate course supply in biology to evaluate how well biology educators are serving the diverse and growing population of online students. I documented online biology course offerings in the 2015-2016 academic year at 96 American colleges and universities. I quantified differences in variety, extent, and availability of courses offered by different kinds of academic institutions and characterized 149 online biology courses offered. Although there was no relationship between an institution's enrollment size and any measure of its online biology offerings, I found significantly more online biology course options at 2-year public compared with 4-year public and 4-year private schools. Courses offered for nonmajors, including students pursuing healthcare-related degrees, were three times as common as those intended for biology majors, who were more likely to be offered hybrid courses with face-to-face laboratories. These data indicate some deficiencies in online biology course options; options for students majoring in biology are limited at all types of institutions examined with a minority of 4-year institutions having any online options in biology. Significant investment of institutional resources in faculty training and technological support are necessary to develop online biology courses that will benefit a larger student population. © 2016 A. K. Varty. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Novel pharmacological approaches for the treatment of acne vulgaris.

PubMed

Valente Duarte de Sousa, Isabel Cristina

2014-10-01

Acne vulgaris is the most common skin disease worldwide; yet, current treatment options, although effective, are associated with unwanted side effects, chronicity, relapses and recurrences. The adequate control of the four pathogenic mechanisms, involved in the appearance of acne lesions, is paramount to treatment success. The authors discuss and evaluate the pathogenic pathways related to the mechanisms of action of novel molecules, which are currently under investigation for the treatment of acne vulgaris. The manuscript is based on comprehensive searches made through PubMed, GoogleScholar and ClinicalTrial.gov, using different combination of key words, which include acne vulgaris, pathogenesis, treatment, sebogenesis and Propionibacterium acnes. In the near future, more effective treatments with fewer side effects are expected. The use of topical antiandrogens, acetylcholine inhibitors and PPAR modulators seem to be promising options for controlling sebum production. Retinoic acid metabolism-blocking agents and IL-1α inhibitors have the potential to become legitimate alternative options to retinoid therapy in the management of infundibular dyskeratosis. Indeed, the authors believe that there will likely be a decline in the use of antibiotics for controlling P. acnes colonization and targeting the inflammation cascade.

Industry-Related Day Care: Trends and Options.

ERIC Educational Resources Information Center

Verzaro-Lawrence, Marce; And Others

1982-01-01

Examines current needs and trends of child care options in the United States, and discusses industrial responses to providing day care services. The advantages and disadvantages of industry-related day care and options available are also discussed. (Author/DB)

College-Bound Digest. Valuable Information from Prominent Educators for All College-Bound Students.

ERIC Educational Resources Information Center

Who's Who among American High School Students, Northbrook, IL.

Information for students, counselors, and parents to help in the evaluation of options and opportunities available for most college-bound students is presented in 17 articles. Titles and authors include the following: "Getting the Most from Your High School Counselor" (James Warfield); "The Use of the SAT at Selective Colleges"…

77 FR 53231 - Final Environmental Impact Statement for the Odessa Subarea Special Study-Columbia Basin Project...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-31

... scope of the action alternative which include acreage, water supply, and general site locations would... authorized boundary with a surface water supply as part of continued phased development of the CBP. The... alternative impacts considered in the Draft EIS. Two water supply options are being considered that would use...

Insider Views of the CLIL Class through Teacher Self-Observation-Introspection

ERIC Educational Resources Information Center

Coonan, Carmel Mary

2007-01-01

This paper aims to highlight some of the issues that are appearing in full force now that the Content and Language Integrated Learning (CLIL) option is being ever more taken into consideration by schools and education authorities throughout Europe. The reasons for the interest in CLIL-based learning are various, including the support given to this…

75 FR 3765 - Options Price Reporting Authority; Notice of Filing and Immediate Effectiveness of Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-22

... Reporting Authority; Notice of Filing and Immediate Effectiveness of Proposed Amendment To Revise the Plan... (``Commission'') an amendment to the Plan for Reporting of Consolidated Options Last Sale Reports and Quotation Information (``OPRA Plan'').\\3\\ The proposed amendment would revise the OPRA Plan for the sole purpose of...

Psychological Distance between Categories in the Likert Scale: Comparing Different Numbers of Options

ERIC Educational Resources Information Center

Wakita, Takafumi; Ueshima, Natsumi; Noguchi, Hiroyuki

2012-01-01

This study examined whether the number of options in the Likert scale influences the psychological distance between categories. The most important assumption when using the Likert scale is that the psychological distance between options is equal. The authors proposed a new algorithm for calculating the scale values of options by applying item…

Initiating decision-making in neurology consultations: 'recommending' versus 'option-listing' and the implications for medical authority.

PubMed

Toerien, Merran; Shaw, Rebecca; Reuber, Markus

2013-07-01

This article compares two practices for initiating treatment decision-making, evident in audio-recorded consultations between a neurologist and 13 patients in two hospital clinics in the UK. We call these 'recommending' and 'option-listing'. The former entails making a proposal to do something; the latter entails the construction of a list of options. Using conversation analysis (CA), we illustrate each, showing that the distinction between these two practices matters to participants. Our analysis centres on two distinctions between the practices: epistemic differences and differences in the slots each creates for the patient's response. Considering the implications of our findings for understanding medical authority, we argue that option-listing - relative to recommending - is a practice whereby clinicians work to relinquish a little of their authority. This article contributes, then, to a growing body of CA work that offers a more nuanced, tempered account of medical authority than is typically portrayed in the sociological literature. We argue that future CA studies should map out the range of ways - in addition to recommending - in which treatment decision-making is initiated by clinicians. This will allow for further evidence-based contributions to debates on the related concepts of patient participation, choice, shared decision-making and medical authority. © 2013 The Authors. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

77 FR 54636 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-05

...)(A)(xxxii) to mean a ``long'' and ``short'' position in different call option series, different put...)(xxxii) (renumbered as 4210(f)(2)(A)(xxvii)) that defines an OTC option as an over-the-counter option...

Authorities for Military Operations Against Terrorist Groups: The State of the Debate and Options for Congress

DTIC Science & Technology

2016-01-01

in the Istanbul airport, and the two lone- wolf attacks in the United States—in Orlando, Flor- ida, and San Bernardino, California—were both at least...questions that have dogged the 2001 authorization in recent years would remain. A third option would be for Congress to pass the counter-ISIL

Silent Echoes: A Young Author Rewrites the Rules to Transitioning

ERIC Educational Resources Information Center

Stephens, Aaron Notarianni

2008-01-01

This article describes Sarah, a young woman with autism from Frederick, Maryland, who made a choice to forgo traditional employment options for people with disabilities and to pursue the seemingly improbable option of becoming an author. Becoming a successful writer can be a dubious prospect for people without disabilities. And yet with talent,…

Aneurysms of the petrous internal carotid artery: anatomy, origins, and treatment.

PubMed

Liu, James K; Gottfried, Oren N; Amini, Amin; Couldwell, William T

2004-11-15

Aneurysms arising in the petrous segment of the internal carotid artery (ICA) are rare. Although the causes of petrous ICA aneurysms remain unclear, traumatic, infectious, and congenital origins have been implicated in their development. These lesions can be detected incidentally on routine neuroimaging. Patients can also present with a wide spectrum of signs and symptoms, including cranial nerve palsies, Horner syndrome, pulsatile tinnitus, epistaxis, and otorrhagia. The treatment of petrous ICA aneurysms remains challenging. Treatment options include close observation, endovascular therapies, and surgical trapping with or without revascularization. Management dilemmas exist, particularly for incidental lesions found in asymptomatic patients. The authors review the literature and discuss the anatomy of the petrous ICA as well as the pathophysiological features of aneurysms arising in this region, and they propose a management paradigm with current treatment options.

Effects of Help Options in a Multimedia Listening Environment on L2 Vocabulary Acquisition

ERIC Educational Resources Information Center

Mohsen, Mohammed Ali

2016-01-01

Several types of help options have been incorporated into reading and listening comprehension activities to aid second language (L2) vocabulary acquisition. Textbook authors, teachers, and sometimes even students may pick and choose which help options they wish to use. In this paper, I investigate the effects of two help options in a multimedia…

Group practices explore EDI options.

PubMed

McCormack, J

1999-04-01

Although physician groups have been relatively slow to take advantage of electronic commerce, more are discovering the benefits. Once group practice administrators get beyond their initial trepidation and realize that EDI is efficient, many are pleased with the results. And some are automating other transactions, including verifying patient eligibility for insurance coverage, gaining insurance authorization for referrals to specialists and checking the status of claims.

How can primary care providers manage pediatric obesity in the real world?

PubMed

Hopkins, Kristy F; Decristofaro, Claire; Elliott, Lydia

2011-06-01

To provide information regarding evidence-based interventions and clinical practice guidelines as a basis for a clinical toolkit utilizing a step management approach for the primary care provider in managing childhood obesity. Evidence-based literature including original clinical trials, literature reviews, and clinical practice guidelines. Interventions can be stratified based on initial screening of children and adolescents so that selection of treatment options is optimized. For all treatments, lifestyle modifications include attention to diet and activity level. Levels of initial success, as well as maintenance of target body mass index, may be related to the intensity and duration of interventions; involvement of family may increase success rates. For failed lifestyle interventions, or for patients with extreme obesity and/or certain comorbidities, pharmacologic or surgical options should be considered. Many intensive programs have shown success, but the resources required for these approaches may be unavailable to the typical community provider and family. However, using current guidelines, the primary care provider can initiate and manage ongoing interventions in pediatric obesity. A toolkit for primary care implementation and maintenance interventions is provided. ©2011 The Author(s) Journal compilation ©2011 American Academy of Nurse Practitioners.

Phase II drugs currently being investigated for the treatment of hypogonadism.

PubMed

Udedibia, Emeka; Kaminetsky, Jed

2014-12-01

Hypogonadism is the most common endocrine disorder, which affects men of all age groups. Recent shifts in public awareness, increased screening and recognition of symptoms and updated diagnostic criteria have led to an increase in men diagnosed as hypogonadal, including middle-aged and older men who previously would have been considered eugonadal. The increase in testosterone replacement therapy (TRT) has paralleled an increase in advancements of treatment options. Although current therapies are highly efficacious for many men, there remains a need for newer therapies that are more cost-effective, preserve ease of use and administration, mitigate undesirable effects and closely mimic physiological levels of testosterone. In this review, the authors discuss current TRTs and therapies in development for the treatment of hypogonadism. The focus is on therapies under Phase II investigation or those who have recently completed Phase II study. With several new therapies in development, the authors expect advancements in achieving treatment benchmarks that meet the needs of the individual symptomatic hypogonadal male. Increased public awareness of hypogonadism and TRT has led to a welcomed expansion in the choice of TRT options. These include new delivery systems, formulations, routes of administration and non-testosterone modalities.

Prizes for innovation of new medicines and vaccines.

PubMed

Love, James; Hubbard, Tim

2009-01-01

This article argues that prizes can help stimulate medical innovation, control costs and ensure greater access to new medicines and vaccines. The authors explore four increasingly ambitious prize options to reward medical innovation, each addressing flaws in the current patent system. The first option promotes innovation through a large prize fund linked to the impact on health outcomes; the second option rewards the sharing of knowledge, data, and technology with open source dividends; the third option awards prizes for interim benchmarks and discrete technical problems; and the final option removes the exclusive right to use patented inventions in upstream research in favor of prizes. The authors conclude that a system of prizes to reward drug development would break the link between R&D incentives and product prices, and that such a reform is needed to improve innovation and access to new medicines and vaccines.

A Smorgasbord of Assessment Options

ERIC Educational Resources Information Center

Bacon, Kathy A.

2010-01-01

The wealth of assessment options that exists offers teachers and students a "menu" of selections. Just as matching appetite needs with appropriate food selection is fundamental to a successful dining experience, matching assessment options to targeted achievement needs is crucial to an effective assessment experience. The author uses a…

Sports Venue Security: Public Policy Options for Sear 4-5 Events

DTIC Science & Technology

2014-06-01

NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS Approved for public release; distribution is unlimited SPORTS VENUE...Thesis 4. TITLE AND SUBTITLE SPORTS VENUE SECURITY: PUBLIC POLICY OPTIONS FOR SEAR 4–5 EVENTS 5. FUNDING NUMBERS 6. AUTHOR(S) James M. Gehring...DISTRIBUTION CODE 13. ABSTRACT (maximum 200 words) Although the United States made considerable advances in improving sport venue security

Dopamine Modulates Option Generation for Behavior.

PubMed

Ang, Yuen-Siang; Manohar, Sanjay; Plant, Olivia; Kienast, Annika; Le Heron, Campbell; Muhammed, Kinan; Hu, Michele; Husain, Masud

2018-05-21

Animals make innumerable decisions every day, each of which involves evaluating potential options for action. But how are options generated? Although much is now known about decision making when a fixed set of potential options is provided, surprisingly little progress has been made on self-generated options. Some researchers have proposed that such abilities might be modulated by dopamine. Here, we used a new measure of option generation that is quantitative, objective, and culture fair to investigate how humans generate different behavioral options. Participants were asked to draw as many different paths (options) as they could between two points within a fixed time. Healthy individuals (n = 96) exhibited a trade-off between uniqueness (how individually different their options were) and fluency (number of options), generating either many similar or few unique options. To assess influence of dopamine, we first examined patients with Parkinson's disease (n = 35) ON and OFF their dopaminergic medication and compared them to elderly healthy controls (n = 34). Then we conducted a double-blind, placebo-controlled crossover study of the D2 agonist cabergoline in healthy older people (n = 29). Across both studies, dopamine increased fluency but diminished overall uniqueness of options generated, due to the effect of fluency trading off with uniqueness. Crucially, however, when this trade-off was corrected for, dopamine was found to increase uniqueness for any given fluency. Three carefully designed control studies showed that performance on our option-generation task was not related to executing movements, planning actions, or selecting between generated options. These findings show that dopamine plays an important role in modulating option generation. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Nystagmus and oscillopsia.

PubMed

Straube, A; Bronstein, A; Straumann, D

2012-01-01

The ocular motor system consists of several subsystems, including the vestibular ocular nystagmus saccade system, the pursuit system, the fixation and gaze-holding system and the vergence system. All these subsystems aid the stabilization of the images on the retina during eye and head movements and any kind of disturbance of one of the systems can cause instability of the eyes (e.g. nystagmus) or an inadequate eye movement causing a mismatch between head and eye movement (e.g. bilateral vestibular failure). In both situations, the subjects experience a movement of the world (oscillopsia) which is quite disturbing. New insights into the patho-physiology of some of the ocular motor disorders have helped to establish new treatment options, in particular in downbeat nystagmus, upbeat nystagmus, periodic alternating nystagmus, acquired pendular nystagmus and paroxysmal vestibular episodes/attacks. The discussed patho-physiology of these disorders and the current literature on treatment options are discussed and practical treatment recommendations are given in the paper. © 2011 The Author(s). European Journal of Neurology © 2011 EFNS.

S3 Guideline for the treatment of psoriasis vulgaris, update - Short version part 1 - Systemic treatment.

PubMed

Nast, Alexander; Amelunxen, Lasse; Augustin, Matthias; Boehncke, Wolf-Henning; Dressler, Corinna; Gaskins, Matthew; Härle, Peter; Hoffstadt, Bernd; Klaus, Joachim; Koza, Joachim; Mrowietz, Ulrich; Ockenfels, Hans-Michael; Philipp, Sandra; Reich, Kristian; Rosenbach, Thomas; Rzany, Berthold; Schlaeger, Martin; Schmid-Ott, Gerhard; Sebastian, Michael; von Kiedrowski, Ralph; Weberschock, Tobias

2018-05-01

The German guideline for the treatment of psoriasis vulgaris was updated using GRADE methodology. The guideline is based on a systematic literature review completed on December 1, 2016, and on a formal consensus and approval process. The first section of this short version of the guideline covers systemic treatment options considered relevant by the expert panel and approved in Germany at the time of the consensus conference (acitretin, adalimumab, apremilast, cyclosporine, etanercept, fumaric acid esters, infliximab, methotrexate, secukinumab and ustekinumab). Detailed information is provided on the management and monitoring of the included treatment options. © 2018 The Authors | Journal compilation © Blackwell Verlag GmbH, Berlin.

78 FR 38843 - Single Application Option

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-28

... Application Option AGENCY: U.S. Copyright Office, Library of Congress. ACTION: Interim final rule. SUMMARY: The U.S. Copyright Office is amending its regulations on an interim basis in order to establish a new... an additional option for individual authors/claimants registering a single (one) work that is not a...

Counseling and choosing between infant-feeding options: overall limits and local interpretations by health care providers and women living with HIV in resource-poor countries (Burkina Faso, Cambodia, Cameroon).

PubMed

Desclaux, Alice; Alfieri, Chiara

2009-09-01

As part of prevention of HIV mother-to-child transmission (PMTCT) strategies, HIV-positive women are asked to choose between two options regarding infant feeding: replacement feeding or exclusive breastfeeding with early weaning. Health services must offer women counseling, guidance, and support to enable them to make an informed choice. This article aims to shed light on the content of counseling and its adaptation to local situations, including women's perceptions, in three resource-poor countries with different infant feeding patterns (Burkina Faso, Cambodia, and Cameroon). The qualitative study included observations in health facilities and interviews with HIV-positive mothers and health workers. The results show that counseling practices vary, including prescriptive counseling proposing only one option to all women, an option based on the mother's economic level assessed by health care providers, and the choice between options. While health workers consider economic aspects first, women mostly consider social aspects related to the risk of being stigmatized as a "bad mother'" or as HIV-positive. Overall trends identify some limits to counseling effectiveness when considering women's perceptions and needs, such as: the content of information provided by health care providers, duration and timing of counseling, discrepancies between information provided during counseling and from the health system, and ranking of preventive options by health workers. Women's agency for feeding choices is related to local practices and local authorities' abilities to provide more or less comprehensive counseling based on the organization of the health and aid system. Local practices also depend on institutions' interpretations of international recommendations based on public health considerations regarding standard of care and women's and the health system's respective responsibilities. Beyond structural constraints that hinder the adoption of preventive infant feeding patterns, addressing these issues may help improve counseling practices.

Including Recently Arrived English Learners in State Accountability Systems: An Empirical Illustration of Models. WCER Working Paper No. 2017-1

ERIC Educational Resources Information Center

Cook, H. Gary; Sahakyan, Narek; Linquanti, Robert

2017-01-01

The authors develop model analyses based on a U.S. Department of Education guide to illustrate procedures a State could use to compare and contrast school-level overall and English Learner accountability determinations for proficiency in reading/language arts under the options allowed by the Every Student Succeeds Act. As a technical reference,…

Survey of Microcleaning Methods for Application to Army Coal-Fired Plants

DTIC Science & Technology

1989-02-01

Authority (TVA) has successfully reduced its cost of controlling SOX by combining postcombustion flue gas desulfurization equipment with precombustion coal...effective way of meeting the new standards for SOl Several options are available, in- cluding flue gas desulfurization , fluidized bed combustors, and...are available, including flue gas desulfurization , fluidized bed combustors, and precombustion cleaning. This report (Cont’d.) 20 DISTRIBUTION

Call of the wild: the negative tendency in the nature religions of American youth.

PubMed

Kramp, Joseph M

2015-02-01

The author argues that the paucity of options for sanctioned rebellion in contemporary American society drive an ever-increasing number of idealistic youth in search of isolation in nature, where they construct what the author here calls "nature religions." These worldviews focus on purification of falsehood, ritualized through enduring extreme physical pain, social isolation, and extreme weather conditions in hopes of experiencing reality more authentically. The author argues that unemployment, limited vocational options, and the homogenization of American society are among the major catalysts for this ever-expanding breed of seekers, each of whom struggles with a negative tendency (a theoretical term created by Erik Erikson). Furthermore, the author argues that the emphasis in the nature religions on connection to nature is constructed to compensate for the lack of community and sense of human connectedness in contemporary American society. A representative case study from Jon Krakauer's (Into the wild; Doubleday, New York, 1996) Into the Wild is presented to illuminate and justify the argument made by the author for more institutionally housed options for sanctioned, licit rebellion to manage the negative tendency.

Radiotherapy in Gorlin Syndrome: Can It Be Safe and Effective in Adult Patients?

PubMed

Baker, Sarah; Joseph, Kurian; Tai, Patricia

2016-01-01

Gorlin syndrome, also known as nevoid basal cell carcinoma syndrome, is a rare autosomal dominant disorder with multiple manifestations including early onset of cutaneous basal cell carcinomas (BCCs). Radiotherapy has traditionally been contraindicated due to reports of BCC induction. We describe here a patient treated successfully with radiotherapy with no tumour induction at 57 months of follow-up. A comprehensive literature review of radiotherapy outcomes in patients with Gorlin syndrome suggests radiotherapy may be a feasible treatment option for adult patients with treatment refractory lesions or surgical contraindication. © The Author(s) 2015.

Crude oil options market found to be efficient

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

Not Available

1992-08-17

This paper reports that the U.S. crude oil options market operates efficiently and does not overreact. The authors, with the JFK School of Government, studied the crude oil options market under a Department of Energy grant. The current market was created in November 1986 when the New York Mercantile Exchange introduced an options contract for delivery of West Texas intermediate crude futures. it has grown greatly since then.

Use of stereotactic intensity-modulated radiotherapy in thyroid-related ophthalmopathy. Case report.

PubMed

Espinoza, Salvador; Saboori, Mehran; Forman, Scott; Moorthy, Chitti R; Benzil, Deborah L

2004-11-01

Thyroid-related ophthalmopathy (TRO), a debilitating condition involving a range of visual and orbital symptoms, occurs in up to 40% of patients with Graves disease. The goals of treatment include correcting thyroid dysfunction, relieving ocular pain, preserving vision, and improving cosmetic appearance. Options for therapy include symptomatic treatment, glucocorticoid medication, radiation therapy, and surgery. Traditional radiation treatment uses small opposed bilateral fields consisting of retrobulbar volumes and customized blocks to shield periorbital structures. The combination of intensity-modulated radiotherapy (IMRT) and stereotactic technology facilitates the administration of radiation to patients suffering from TRO and provides greater safety and efficacy than traditional treatment. The authors present the case of a patient with severe TRO whose symptoms resolved rapidly after treatment with stereotactic IMRT. The outcome in this case supports stereotactic IMRT as an effective treatment option for patients with TRO who also undergo radiation therapy.

Breaking the Mold: A Review of Mucormycosis and Current Pharmacological Treatment Options.

PubMed

Riley, Treavor T; Muzny, Christina A; Swiatlo, Edwin; Legendre, Davey P

2016-09-01

To review the current literature for the pathogenesis of mucormycosis, discuss diagnostic strategies, and evaluate the efficacy of polyenes, triazoles, and echinocandins as pharmacological treatment options. An electronic literature search was conducted in PubMed using the MESH terms Rhizopus, zygomycetes, zygomycosis, Mucorales and mucormycosis, with search terms amphotericin B, micafungin, anidulafungin, caspofungin, extended infusion amphotericin B, liposomal amphotericin B, combination therapy, triazole, posaconazole, isavuconazole, diagnosis, and clinical manifestations. Studies written in the English language from January 1960 to March 2016 were considered for this review article. All search results were reviewed, and the relevance of each article was determined by the authors independently. Mucormycosis is a rare invasive fungal infection with an exceedingly high mortality and few therapeutic options. It has a distinct predilection for invasion of endothelial cells in the vascular system, which is likely important in dissemination of disease from a primary focus of infection. Six distinct clinical syndromes can occur in susceptible hosts, including rhino-orbital-cerebral, pulmonary, gastrointestinal, cutaneous, widely disseminated, and miscellaneous infection. Diagnosis of mucormycosis is typically difficult to make based on imaging studies, sputum culture, bronchoalveolar lavage culture, or needle aspirate. Surgical debridement prior to dissemination of infection improves clinical outcomes. Surgery combined with early, high-dose systemic antifungal therapy yields greater than a 1.5-fold increase in survival rates. The Mucorales are inherently resistant to most widely used antifungal agents. Amphotericin B is appropriate for empirical therapy, whereas posaconazole and isavuconazole are best reserved for de-escalation, refractory cases, or patients intolerant to amphotericin B. © The Author(s) 2016.

78 FR 78422 - Order Granting Application by Financial Industry Regulatory Authority, Inc. for Exemption...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-26

... U.S.C. 78s(b). FINRA Rule 2360 (Options) and FINRA Rule 2359 (Position and Exercise Limits; Liquidations) incorporate by reference comparable position and exercise limit rules of the options exchanges. Specifically: (i) FINRA Rule 2360(b)(3)(B) incorporates position limits for index options established by the...

Adversity magnifies the importance of social information in decision-making.

PubMed

Pérez-Escudero, Alfonso; de Polavieja, Gonzalo G

2017-11-01

Decision-making theories explain animal behaviour, including human behaviour, as a response to estimations about the environment. In the case of collective behaviour, they have given quantitative predictions of how animals follow the majority option. However, they have so far failed to explain that in some species and contexts social cohesion increases when conditions become more adverse (i.e. individuals choose the majority option with higher probability when the estimated quality of all available options decreases). We have found that this failure is due to modelling simplifications that aided analysis, like low levels of stochasticity or the assumption that only one choice is the correct one. We provide a more general but simple geometric framework to describe optimal or suboptimal decisions in collectives that gives insight into three different mechanisms behind this effect. The three mechanisms have in common that the private information acts as a gain factor to social information: a decrease in the privately estimated quality of all available options increases the impact of social information, even when social information itself remains unchanged. This increase in the importance of social information makes it more likely that agents will follow the majority option. We show that these results quantitatively explain collective behaviour in fish and experiments of social influence in humans. © 2017 The Authors.

Summary of Propagation Cases of the Second AIAA Sonic Boom Prediction Workshop

NASA Technical Reports Server (NTRS)

Rallabhandi, Sriram; Loubeau, Alexandra

2017-01-01

A summary is provided for the propagation portion of the second AIAA Sonic Boom Workshop held January 8, 2017 in conjunction with the AIAA SciTech 2017 conference. Near-field pressure waveforms for two cases were supplied and ground signatures at multiple azimuthal angles as well as their corresponding loudness metrics were requested from 10 participants, representing 3 countries. Each case had some required runs, as well as some optional runs. The required cases included atmospheric profiles with measured data including winds, using Radiosonde balloon data at multiple geographically spread locations, while the optional cases included temperature and pressure profiles from the US Standard atmosphere. The humidity profiles provided for the optional cases were taken from ANSI guidance, as the authors were unaware of an accepted standard at the time the cases were released to the participants. Participants provided ground signatures along with the requested data, including some loudness metrics using their best practices, which included lossy as well as lossless schemes. All the participants' submissions, for each case, are compared and discussed. Noise or loudness measures are calculated and detailed comparisons and statistical analyses are performed and presented. It has been observed that the variation in the loudness measures and spread between participants' submissions increased as the computation proceeded from under-track locations towards the lateral cut-off. Lessons learned during this workshop are discussed and recommendations are made for potential improvements and possible subsequent workshops as we collectively attempt to refine our analysis methods.

Depression and Anxiety During Pregnancy: Evaluating the Literature in Support of Clinical Risk-Benefit Decision-Making.

PubMed

Dalke, Katharine Baratz; Wenzel, Amy; Kim, Deborah R

2016-06-01

Depression and anxiety during pregnancy are common, and patients and providers are faced with complex decisions regarding various treatment modalities. A structured discussion of the risks and benefits of options with the patient and her support team is recommended to facilitate the decision-making process. This clinically focused review, with emphasis on the last 3 years of published study data, evaluates the major risk categories of medication treatments, namely pregnancy loss, physical malformations, growth impairment, behavioral teratogenicity, and neonatal toxicity. Nonpharmacological treatment options, including neuromodulation and psychotherapy, are also briefly reviewed. Specific recommendations, drawn from the literature and the authors' clinical experience, are also offered to help guide the clinician in decision-making.

75 FR 41247 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-15

... Rule Change to List and Trade Options on the Sprott Physical Gold Trust July 8, 2010. Pursuant to... Exchange Commission (``SEC'' or ``Commission'') authorized ISE to list and trade options on the SPDR Gold... list and trade options on the Sprott Physical Gold Trust. \\5\\ See Securities Exchange Act Release No...

SpecTAD

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

Zamora, Richard; Voter, Arthur; Uberuaga, Bla

2017-10-23

The SpecTAD software represents a refactoring of the Temperature Accelerated Dynamics (TAD2) code authored by Arthur F. Voter and Blas P. Uberuaga (LA-CC-02-05). SpecTAD extends the capabilities of TAD2, by providing algorithms for both temporal and spatial parallelism. The novel algorithms for temporal parallelism include both speculation and replication based techniques. SpecTAD also offers the optional capability to dynamically link to the open-source LAMMPS package.

Navy LPD-17 Amphibious Ship Procurement: Background, Issues, and Options for Congress

DTIC Science & Technology

2009-04-07

and Options for Congress 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f...disrupting the optimal construction sequence and application of lessons learned for follow-on vessels in these programs...statements among others, although not necessarily in the order shown below: • “I am deeply concerned about Northrop Grumman Ship Systems’ ( NGSS

Navy LPD-17 Amphibious Ship Procurement: Background, Issues, and Options for Congress

DTIC Science & Technology

2010-07-01

Background, Issues, and Options for Congress 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK...performed out of sequence and significant rework has been required, disrupting the optimal construction sequence and application of lessons learned...deeply concerned about Northrop Grumman Ship Systems’ ( NGSS ) ability to recover in the aftermath of Hurricane Katrina, particularly in regard to

Navy LPD-17 Amphibious Ship Procurement: Background, Issues, and Options for Congress

DTIC Science & Technology

2010-06-10

Background, Issues, and Options for Congress 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK...out of sequence and significant rework has been required, disrupting the optimal construction sequence and application of lessons learned for...concerned about Northrop Grumman Ship Systems’ ( NGSS ) ability to recover in the aftermath of Hurricane Katrina, particularly in regard to construction

Navy LPD-17 Amphibious Ship Procurement: Background, Issues, and Options for Congress

DTIC Science & Technology

2010-03-29

and Options for Congress 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f...performed out of sequence and significant rework has been required, disrupting the optimal construction sequence and application of lessons learned...deeply concerned about Northrop Grumman Ship Systems’ ( NGSS ) ability to recover in the aftermath of Hurricane Katrina, particularly in regard to

New options for vascularized bone reconstruction in the upper extremity.

PubMed

Houdek, Matthew T; Wagner, Eric R; Wyles, Cody C; Nanos, George P; Moran, Steven L

2015-02-01

Originally described in the 1970s, vascularized bone grafting has become a critical component in the treatment of bony defects and non-unions. Although well established in the lower extremity, recent years have seen many novel techniques described to treat a variety of challenging upper extremity pathologies. Here the authors review the use of different techniques of vascularized bone grafts for the upper extremity bone pathologies. The vascularized fibula remains the gold standard for the treatment of large bone defects of the humerus and forearm, while also playing a role in carpal reconstruction; however, two other important options for larger defects include the vascularized scapula graft and the Capanna technique. Smaller upper extremity bone defects and non-unions can be treated with the medial femoral condyle (MFC) free flap or a vascularized rib transfer. In carpal non-unions, both pedicled distal radius flaps and free MFC flaps are viable options. Finally, in skeletally immature patients, vascularized fibular head epiphyseal transfer can provide growth potential in addition to skeletal reconstruction.

Multicriteria mapping of stakeholder preferences in regulating nanotechnology.

PubMed

Hansen, Steffen Foss

2010-08-01

In order to facilitate stakeholder discussions on how to regulate nanotechnology, the opensource program multicriteria mapping (MCM) was used to structure 26 interviews with stakeholders in the USA. MCM offers a systematic part quantitative, part qualitative approach to clarify why some regulatory options (bans, moratoriums, voluntary measures, etc.) were deemed to be acceptable/unacceptable by various stakeholders and which criteria stakeholders used to evaluate the different regulatory options. Adopting an incremental approach and implementing a new regulatory framework was evaluated as the best options whereas a complete ban and no additional regulation of nanotechnology were found to be the least favorable. Criteria applied differed substantially among stakeholders and included social, ethical, regulatory, environmental, and health issues. Opinions on future regulation seem far less polarized than expected and it seems that stakeholders would welcome a combination of voluntary measures, an incremental approach and forming of a new regulatory framework. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s11051-010-0006-3) contains supplementary material, which is available to authorized users.

75 FR 69058 - Request for Comment on a Proposal to Exempt, Pursuant to the Authority in Section 4(c) of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-10

... categorical Section 4(c) exemption to permit options and futures on shares of all or some precious metal commodity-based ETFs to be traded and cleared as options on securities and security futures, respectively... options and futures on shares of precious metal commodity- based ETFs. The Commission believes that...

75 FR 19619 - Request for Comment on a Proposal To Exempt, Pursuant to the Authority in Section 4(c) of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-15

... clearing of certain contracts called ``options'' and other contracts called ``security futures'' on each of... amend all orders issued exempting the trading and clearing of options and futures on gold and silver... manner.'' \\11\\ Permitting Options and Security Futures on Gold and Silver Products to trade on national...

Sustainability assessment of electrokinetic bioremediation compared with alternative remediation options for a petroleum release site.

PubMed

Gill, R T; Thornton, S F; Harbottle, M J; Smith, J W N

2016-12-15

Sustainable management practices can be applied to the remediation of contaminated land to maximise the economic, environmental and social benefits of the process. The Sustainable Remediation Forum UK (SuRF-UK) have developed a framework to support the implementation of sustainable practices within contaminated land management and decision making. This study applies the framework, including qualitative (Tier 1) and semi-quantitative (Tier 2) sustainability assessments, to a complex site where the principal contaminant source is unleaded gasoline, giving rise to a dissolved phase BTEX and MTBE plume. The pathway is groundwater migration through a chalk aquifer and the receptor is a water supply borehole. A hydraulic containment system (HCS) has been installed to manage the MTBE plume migration. The options considered to remediate the MTBE source include monitored natural attenuation (MNA), air sparging/soil vapour extraction (AS/SVE), pump and treat (PT) and electrokinetic-enhanced bioremediation (EK-BIO). A sustainability indictor set from the SuRF-UK framework, including priority indicator categories selected during a stakeholder engagement workshop, was used to frame the assessments. At Tier 1 the options are ranked based on qualitative supporting information, whereas in Tier 2 a multi-criteria analysis is applied. Furthermore, the multi-criteria analysis was refined for scenarios where photovoltaics (PVs) are included and amendments are excluded from the EK-BIO option. Overall, the analysis identified AS/SVE and EK-BIO as more sustainable remediation options at this site than either PT or MNA. The wider implications of this study include: (1) an appraisal of the management decision from each Tier of the assessment with the aim to highlight areas for time and cost savings for similar assessments in the future; (2) the observation that EK-BIO performed well against key indicator categories compared to the other intensive treatments; and (3) introducing methods to improve the sustainability of the EK-BIO treatment design (such as PVs) did not have a significant effect in this instance. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Agreement Attraction and Impasse Aversion: Reasons for Selecting a Poor Deal Over No Deal at All.

PubMed

Tuncel, Ece; Mislin, Alexandra; Kesebir, Selin; Pinkley, Robin L

2016-03-01

In the present studies, we examined the positive value of agreement and the negative value of impasse. Participants chose to give up real value and sacrifice economic efficiency in order to attain an agreement outcome and avoid an impasse outcome. A personally disadvantageous option was selected significantly more often when it was labeled "Agreement" rather than "Option A," and a personally advantageous option was avoided significantly more often when it was labeled "Impasse" rather than "Option B." In a face-to-face negotiation, a substantial proportion of individuals reached an agreement that was inferior to their best alternative to agreement. We showed that the appeal of agreement and the aversion to impasse both contribute to this effect, yet the aversion to impasse is the stronger of the two motivations. These findings have important implications for negotiators. © The Author(s) 2016.

Synthetic Biology and the U.S. Biotechnology Regulatory System: Challenges and Options

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

Carter, Sarah R.; Rodemeyer, Michael; Garfinkel, Michele S.

Synthetic Biology and the U.S. Biotechnology Regulatory System: Challenges and Options Sarah R. Carter, Ph.D., J. Craig Venter Institute; Michael Rodemeyer, J.D., University of Virginia; Michele S. Garfinkel, Ph.D., EMBO; Robert M. Friedman, Ph.D., J. Craig Venter Institute In recent years, a range of genetic engineering techniques referred to as “synthetic biology” has significantly expanded the tool kit available to scientists and engineers, providing them with far greater capabilities to engineer organisms than previous techniques allowed. The field of synthetic biology includes the relatively new ability to synthesize long pieces of DNA from chemicals, as well as improved methods formore » genetic manipulation and design of genetic pathways to achieve more precise control of biological systems. These advances will help usher in a new generation of genetically engineered microbes, plants, and animals. The JCVI Policy Center team, along with researchers at the University of Virginia and EMBO, examined how well the current U.S. regulatory system for genetically engineered products will handle the near-term introduction of organisms engineered using synthetic biology. In particular, the focus was on those organisms intended to be used or grown directly in the environment, outside of a contained facility. The study concludes that the U.S. regulatory agencies have adequate legal authority to address most, but not all, potential environmental, health and safety concerns posed by these organisms. Such near-term products are likely to represent incremental changes rather than a marked departure from previous genetically engineered organisms. However, the study also identified two key challenges for the regulatory system, which are detailed in the report. First, USDA’s authority over genetically engineered plants depends on the use of an older engineering technique that is no longer necessary for many applications. The shift to synthetic biology and other newer genetic engineering techniques will leave many engineered plants without any pre-market regulatory review. Second, the number and diversity of engineered microbes for commercial use will increase in the near future, challenging EPA’s resources, expertise, and perhaps authority to regulate them. For each of these challenges, the report sets out a series of options, including an analysis of the advantages and disadvantages of each option from a variety of perspectives, for policy makers to consider. Policy responses will depend on the trade-offs chosen among competing considerations. This report, funded by the Department of Energy with additional funds from the Alfred P. Sloan Foundation, is the result of a two-year process that included interviews, commissioned background papers, discussions, and two workshops that sought input from a wide range of experts, including U.S. federal agency regulators, legal and science policy experts, representatives from the biotechnology indus¬try, and non-governmental organiza¬tions. This cross-section of views informed this report, but the conclusions are solely those of the authors. An Executive Summary, full Report, and background papers are available at: http://www.jcvi.org/cms/research/projects/synthetic-biology-and-the-us-biotechnology-regulatory-system/overview/« less

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

Hightower, Marion Michael; Baca, Michael J.; VanderMey, Carissa

In June 2016, the Department of Energy's (DOE's) Office of Energy Efficiency and Renewable Energy (EERE) in collaboration with the Renewable Energy Branch for the Hawaii State Energy Office (HSEO), the Hawaii Community Development Authority (HCDA), the United States Navy (Navy), and Sandia National Laboratories (Sandia) established a project to 1) assess the current functionality of the energy infrastructure at the Kalaeloa Community Development District, and 2) evaluate options to use both existing and new distributed and renewable energy generation and storage resources within advanced microgrid frameworks to cost-effectively enhance energy security and reliability for critical stakeholder needs during bothmore » short-term and extended electric power outages. This report discusses the results of a stakeholder workshop and associated site visits conducted by Sandia in October 2016 to identify major Kalaeloa stakeholder and tenant energy issues, concerns, and priorities. The report also documents information on the performance and cost benefits of a range of possible energy system improvement options including traditional electric grid upgrade approaches, advanced microgrid upgrades, and combined grid/microgrid improvements. The costs and benefits of the different improvement options are presented, comparing options to see how well they address the energy system reliability, sustainability, and resiliency priorities identified by the Kalaeloa stakeholders.« less

A Computer Program for Flow-Log Analysis of Single Holes (FLASH)

USGS Publications Warehouse

Day-Lewis, F. D.; Johnson, C.D.; Paillet, Frederick L.; Halford, K.J.

2011-01-01

A new computer program, FLASH (Flow-Log Analysis of Single Holes), is presented for the analysis of borehole vertical flow logs. The code is based on an analytical solution for steady-state multilayer radial flow to a borehole. The code includes options for (1) discrete fractures and (2) multilayer aquifers. Given vertical flow profiles collected under both ambient and stressed (pumping or injection) conditions, the user can estimate fracture (or layer) transmissivities and far-field hydraulic heads. FLASH is coded in Microsoft Excel with Visual Basic for Applications routines. The code supports manual and automated model calibration. ?? 2011, The Author(s). Ground Water ?? 2011, National Ground Water Association.

Project identification for methane reduction options

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

Kerr, T.

1996-12-31

This paper discusses efforts directed at reduction in emission of methane to the atmosphere. Methane is a potent greenhouse gas, which on a 20 year timeframe may present a similar problem to carbon dioxide. In addition, methane causes additional problems in the form of smog and its longer atmospheric lifetime. The author discusses strategies for reducing methane emission from several major sources. This includes landfill methane recovery, coalbed methane recovery, livestock methane reduction - in the form of ruminant methane reduction and manure methane recovery. The author presents examples of projects which have implemented these ideas, the economics of themore » projects, and additional gains which come from the projects.« less

The potential role of taxes and subsidies on food in the prevention of obesity in Europe.

PubMed

González-Zapata, Laura Inés; Alvarez-Dardet, Carlos; Millstone, Erik; Clemente-Gómez, Vicente; Holdsworth, Michelle; Ortiz-Moncada, Rocio; Lobstein, Tim; Sarri, Katerina; De Marchi, Bruna; Horvath, Katalin Z

2010-08-01

Obesity implies costs not only for the individual but also for society. The authors explore the opinions of stakeholders on the potential of taxes or subsidies, as measures for tackling obesity in Europe. Structured interviews were conducted using Multicriteria Mapping, a computer-based, decision-support tool, with 189 interviewees drawn from 21 different stakeholder categories across nine members of the EU interviews, to appraise 20 predefined policy options aimed at reducing obesity, including 'taxing obesity-promoting foods' and 'subsidising healthy foods.' A four-step approach involved selecting options, defining criteria, scoring options quantitatively and weighting criteria to provide overall rankings of options. Interviews were recorded and transcribed to yield qualitative data. Compared with other policy options appraised, taxation and subsidies were not favourably received, mainly because they were considered difficult to implement. Overall, trade unions rated both options more favourably than all other stakeholder groups. As anticipated, both options received their lowest scores from representatives of the farming, food processing and advertising industries. Nutritional/obesity advisory experts and public sector caterers gave the most positive ratings to subsidies overall. Along with public health professionals, large commercial retailers were most in favour of taxation. Taxation and subsidies were poorly appraised compared with other policy measures, with stakeholders expressing reservations mainly focussed on the practicalities and cost of introducing such measures. Although applying taxes/subsidies could be useful to combat obesity, the study suggests that most stakeholders still need to be convinced of their viability and acceptability when compared with other measures.

Power Management and Distribution Trades Studies for a Deep-Space Mission Scientific Spacecraft

NASA Technical Reports Server (NTRS)

Kimnach, Greg L.; Soltis, James V.

2004-01-01

As part of NASA's Project Prometheus, the Nuclear Systems Program, NASA GRC performed trade studies on the various Power Management and Distribution (PMAD) options for a deep-space scientific spacecraft which would have a nominal electrical power requirement of 100 kWe. These options included AC (1000Hz and 1500Hz and DC primary distribution at various voltages. The distribution system efficiency, reliability, mass, thermal, corona, space radiation levels and technology readiness of devices and components were considered. The final proposed system consisted of two independent power distribution channels, sourced by two 3-phase, 110 kVA alternators nominally operating at half-rated power. Each alternator nominally supplies 50kWe to one half of the ion thrusters and science modules but is capable of supplying the total power re3quirements in the event of loss of one alternator. This paper is an introduction to the methodology for the trades done to arrive at the proposed PMAD architecture. Any opinions expressed are those of the author(s) and do not necessarily reflect the views of Project Prometheus.

Power Management and Distribution Trades Studies for a Deep-space Mission Scientific Spacecraft

NASA Astrophysics Data System (ADS)

Kimnach, Greg L.; Soltis, James V.

2004-02-01

As part of NASA's Project Prometheus, the Nuclear Systems Program, NASA GRC performed trade studies on the various Power Management and Distribution (PMAD) options for a deep-space scientific spacecraft, which would have a nominal electrical power requirement of 100 kWe. These options included AC (1000Hz and 1500Hz) and DC primary distribution at various voltages. The distribution system efficiency, reliability, mass, thermal, corona, space radiation levels, and technology readiness of devices and components were considered. The final proposed system consisted of two independent power distribution channels, sourced by two 3-phase, 110 kVA alternators nominally operating at half-rated power. Each alternator nominally supplies 50 kWe to one-half of the ion thrusters and science modules, but is capable of supplying the total power requirements in the event of loss of one alternator. This paper is an introduction to the methodology for the trades done to arrive at the proposed PMAD architecture. Any opinions expressed are those of the author(s) and do not necessarily reflect the views of Project Prometheus.

Navy CG(X) Cruiser Program: Background, Oversight Issues, and Options for Congress

DTIC Science & Technology

2009-04-10

Options for Congress 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f. WORK...Sees Lessons in Shipbuilding Program Failures,” GovernmentExecutive.com, September 24, 2008) quoted Admiral Gary Roughead, the Chief of Naval...question is whether the schedule for procuring CG(X)s is properly aligned with foreign-country ballistic missile development programs. A 2005 defense

Navy LPD-17 Amphibious Ship Procurement: Background, Issues, and Options for Congress

DTIC Science & Technology

2009-06-04

and Options for Congress 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f...context of the best balance of the force overall. “While we agree on requirements—and the Navy and Marine Corps are pretty aligned on that—we have to...sequence and application of lessons learned for follow-on vessels in these programs

Navy CG(X) Cruiser Program: Background, Oversight Issues, and Options for Congress

DTIC Science & Technology

2009-09-18

and Options for Congress 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f...October 27, 2008. Another press report (Katherine McIntire Peters, “Navy’s Top Officer Sees Lessons in Shipbuilding Program Failures... aligned with foreign-country ballistic missile development programs. A 2005 defense trade press report, for example, states that “navy officials

The value of demand response in Florida

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

Stoll, Brady; Buechler, Elizabeth; Hale, Elaine

Many electrical loads may be operated flexibly to provide grid services, including peaking capacity, reserves, and load shifting. The authors model 14 demand end uses in Florida and analyze their operational impacts and overall value for a wide range of solar penetrations and grid flexibility options. They find demand response is able to reduce production costs, reduce the number of low-load hours for traditional generators, reduce starting of gas generators, and reduce curtailment.

Common Adult Skin and Soft Tissue Lesions

PubMed Central

Trost, Jeffrey G.; Applebaum, Danielle S.; Orengo, Ida

2016-01-01

A strong foundational knowledge of dermatologic disease is crucial for a successful practice in plastic surgery. A plastic surgeon should be able to identify and appreciate common dermatologic diseases that may require medical and/or surgical evaluation and management. In this article, the authors describe epidermal/dermal, infectious, pigmented, and malignant cutaneous lesions that are commonly encountered in practice. Descriptions include the epidemiology, pathogenesis, clinical course, and management options for each type of lesion. PMID:27478418

Navy Littoral Combat Ship (LCS) Program: Background, Issues, and Options for Congress

DTIC Science & Technology

2012-04-06

response, including the time for reviewing instructions, searching existing data sources , gathering and maintaining the data needed, and completing and... Source : Prepared by CRS based on FY2013 Navy budget submission and congressional reports on annual defense authorization and appropriations acts...Dynamics LCS Design (Bottom) Source : Source : U.S. Navy file photo accessed by CRS at http://www.navy.mil/list_all.asp?id=57917 on January 6, 2010

The value of demand response in Florida

DOE PAGES

Stoll, Brady; Buechler, Elizabeth; Hale, Elaine

2017-11-10

Many electrical loads may be operated flexibly to provide grid services, including peaking capacity, reserves, and load shifting. The authors model 14 demand end uses in Florida and analyze their operational impacts and overall value for a wide range of solar penetrations and grid flexibility options. They find demand response is able to reduce production costs, reduce the number of low-load hours for traditional generators, reduce starting of gas generators, and reduce curtailment.

78 FR 62722 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Order Granting...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-22

... proposed rule change is intended to apply to any OCC Cleared OTC Option.\\7\\ \\5\\ See Securities Exchange Act... standardized index option.\\38\\ FINRA Rule 2330(b)(5)(A)(i)(b) generally requires only those members that are... FINRA, as is the case for all conventional options.\\40\\ \\37\\ Id. \\38\\ Id. See also FINRA Rule 2360(b)(5...

US Policy Options in Syria: An Argument for Diplomacy

DTIC Science & Technology

2013-03-01

student academic research paper are those of the author and do not reflect the official policy or position of the Department of the Army...2013 2. REPORT TYPE STRATEGY RESEARCH PROJECT .33 3. DATES COVERED (From - To) 4. TITLE AND SUBTITLE US POLICY OPTIONS IN SYRIA: AN...STRATEGY RESEARCH PROJECT US POLICY OPTIONS IN SYRIA: AN ARGUMENT FOR DIPLOMACY by Lieutenant Colonel Geoffrey A

Comprehensive National Cybersecurity Initiative: Legal Authorities and Policy Considerations

DTIC Science & Technology

2009-03-10

Separation of Powers in National Security Matters....................................................................... 10 Congressional Constraints on Executive Action ........................................................................... 15 Policy Considerations and Congressional Options........................................................................ 17 Conclusion..................................................................................................................................... 18 Author Contact

PROXiMATE: a database of mutant protein-protein complex thermodynamics and kinetics.

PubMed

Jemimah, Sherlyn; Yugandhar, K; Michael Gromiha, M

2017-09-01

We have developed PROXiMATE, a database of thermodynamic data for more than 6000 missense mutations in 174 heterodimeric protein-protein complexes, supplemented with interaction network data from STRING database, solvent accessibility, sequence, structural and functional information, experimental conditions and literature information. Additional features include complex structure visualization, search and display options, download options and a provision for users to upload their data. The database is freely available at http://www.iitm.ac.in/bioinfo/PROXiMATE/ . The website is implemented in Python, and supports recent versions of major browsers such as IE10, Firefox, Chrome and Opera. gromiha@iitm.ac.in. Supplementary data are available at Bioinformatics online. © The Author (2017). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Interventional Therapy for Upper Extremity Deep Vein Thrombosis

PubMed Central

Carlon, Timothy A.; Sudheendra, Deepak

2017-01-01

Approximately 10% of all deep vein thromboses occur in the upper extremity, and that number is increasing due to the use of peripherally inserted central catheters. Sequelae of upper extremity deep vein thrombosis (UEDVT) are similar to those for lower extremity deep vein thrombosis (LEDVT) and include postthrombotic syndrome and pulmonary embolism. In addition to systemic anticoagulation, there are multiple interventional treatment options for UEDVT with the potential to reduce the incidence of these sequelae. To date, there have been no randomized trials to define the optimal management strategy for patients presenting with UEDVT, so many conclusions are drawn from smaller, single-center studies or from LEDVT research. In this article, the authors describe the evidence for the currently available treatment options and an approach to a patient with acute UEDVT. PMID:28265130

Navy LPD-17 Amphibious Ship Procurement: Background, Issues, and Options for Congress

DTIC Science & Technology

2010-08-02

and Options for Congress 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f...has been required, disrupting the optimal construction sequence and application of lessons learned for follow-on vessels in these programs... NGSS ) ability to recover in the aftermath of Hurricane Katrina, particularly in regard to construction of LPD 17 Class vessels.” • “I am equally

Navy LPD-17 Amphibious Ship Procurement: Background, Issues, and Options for Congress

DTIC Science & Technology

2010-07-07

and Options for Congress 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f...has been required, disrupting the optimal construction sequence and application of lessons learned for follow-on vessels in these programs... NGSS ) ability to recover in the aftermath of Hurricane Katrina, particularly in regard to construction of LPD 17 Class vessels.” • “I am equally

Navy LPD-17 Amphibious Ship Procurement: Background, Issues, and Options for Congress

DTIC Science & Technology

2010-10-04

Issues, and Options for Congress 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f...rework has been required, disrupting the optimal construction sequence and application of lessons learned for follow-on vessels in these programs...Systems’ ( NGSS ) ability to recover in the aftermath of Hurricane Katrina, particularly in regard to construction of LPD 17 Class vessels.” • “I am

Navy LPD-17 Amphibious Ship Procurement: Background, Issues, and Options for Congress

DTIC Science & Technology

2009-07-20

and Options for Congress 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f...overall. “While we agree on requirements—and the Navy and Marine Corps are pretty aligned on that—we have to balance the capability and the capacity...sequence and significant rework has been required, disrupting the optimal construction sequence and application of lessons learned for follow-on

Navy CG(X) Cruiser Program: Background, Oversight Issues, and Options for Congress

DTIC Science & Technology

2009-11-20

and Options for Congress 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f. WORK...Another press report (Katherine McIntire Peters, “Navy’s Top Officer Sees Lessons in Shipbuilding Program Failures,” GovernmentExecutive.com, September...whether the schedule for procuring CG(X)s is properly aligned with foreign-country ballistic missile development programs. A 2005 defense trade

Navy CG(X) Cruiser Program: Background, Oversight Issues, and Options for Congress

DTIC Science & Technology

2009-06-04

Options for Congress 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f. WORK UNIT...Inside the Navy, October 27, 2008. Another press report (Katherine McIntire Peters, “Navy’s Top Officer Sees Lessons in Shipbuilding Program...X)s could change.38 A related question is whether the schedule for procuring CG(X)s is properly aligned with foreign-country ballistic missile

Navy CG(X) Cruiser Program: Background, Oversight Issues, and Options for Congress

DTIC Science & Technology

2009-12-22

and Options for Congress 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f. WORK...press report (Katherine McIntire Peters, “Navy’s Top Officer Sees Lessons in Shipbuilding Program Failures,” GovernmentExecutive.com, September 24, 2008...changes would have led to a bigger problem—a future surface combatant force that was both unaffordable and poorly aligned with projected mission needs

Navy CG(X) Cruiser Program: Background, Oversight Issues, and Options for Congress

DTIC Science & Technology

2009-10-21

and Options for Congress 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f. WORK...Navy’s Top Officer Sees Lessons in Shipbuilding Program Failures,” GovernmentExecutive.com, September 24, 2008) quoted Admiral Gary Roughead, the...related question is whether the schedule for procuring CG(X)s is properly aligned with foreign-country ballistic missile development programs. A 2005

Navy LPD-17 Amphibious Ship Procurement: Background, Issues, and Options for Congress

DTIC Science & Technology

2010-10-15

Issues, And Options For Congress 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f...19 has been required, disrupting the optimal construction sequence and application of lessons learned for follow-on vessels in these programs. In...although not necessarily in the order shown below: • “I am deeply concerned about Northrop Grumman Ship Systems’ ( NGSS ) ability to recover in the

Navy LPD-17 Amphibious Ship Procurement: Background, Issues, and Options for Congress

DTIC Science & Technology

2009-12-22

Issues, and Options for Congress 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f...balance of the force overall. “While we agree on requirements—and the Navy and Marine Corps are pretty aligned on that—we have to balance the...and significant rework has been required, disrupting the optimal construction sequence and application of lessons learned for follow-on vessels in

Navy LPD-17 Amphibious Ship Procurement: Background, Issues, and Options for Congress

DTIC Science & Technology

2011-04-20

and Options for Congress 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f...construction sequence and application of lessons learned for follow-on vessels in these programs. In the LPD 17 program, the Navy’s reliance on an immature...deeply concerned about Northrop Grumman Ship Systems’ ( NGSS ) ability to recover in the aftermath of Hurricane Katrina, particularly in regard to

Navy CG(X) Cruiser Program: Background, Oversight Issues, and Options for Congress

DTIC Science & Technology

2009-07-17

Options for Congress 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f. WORK...McIntire Peters, “Navy’s Top Officer Sees Lessons in Shipbuilding Program Failures,” GovernmentExecutive.com, September 24, 2008) quoted Admiral Gary...defined, the total required number of CG(X)s could change.38 A related question is whether the schedule for procuring CG(X)s is properly aligned

Clarifying the disagreements on various reuse options: Repair, recondition, refurbish and remanufacture.

PubMed

Gharfalkar, Mangesh; Ali, Zulfiqur; Hillier, Graham

2016-10-01

Earth's natural resources are finite. To be environmentally sustainable, it may not only be necessary to use them 'efficiently' but also 'effectively'. While we consider 'repair', 'recondition', 'refurbish' and 'remanufacture' to be 'reuse' options, not all researchers agree. Also, there is lack of clarity between the different options that are likely to be challenging for both; the policy makers who formulate policies aimed to encourage 'reuse' of 'waste' products and for decision makers to initiate appropriate action for recovering 'reusable resources' from 'waste streams'. This dichotomy could result into more 'waste' to landfill. A systematic analysis of peer reviewed literature is conducted to understand inconsistencies and/or lack of clarity that exist between the definitions or descriptions of identified `reuse' options. This article proposes a 'hierarchy of reuse options' that plots the relative positions of identified 'reuse' options vis-à-vis five variables, namely work content, energy requirement, cost, performance and warranty. Recommendations are made on how to incentivise original equipment manufacturers (OEMs) to 'remanufacture'. Finally, an alternative 'Type II Resource Effective Close-loop Model' is suggested and a conceptual 'Type II/2 Model of Resource Flows' that is restricted to the use of environmentally benign and renewable resources is introduced. These suggestions are likely to help decision makers to prioritise between 'reuse' options, drive resource effectiveness and also environmental sustainability. © The Author(s) 2016.

To create a cleanroom controlled environment using a mobile air decontamination unit for the preparation of antineoplastic drugs.

PubMed

Lecordier, Julien; Plivard, Claire; Gardeux, Michel; Daouadi, Karim; Lahet, Jean-Jacques

2016-02-01

To use a mobile air decontamination unit (MADU) for a microbial destruction and decreased particle burden making a cleanroom controlled environment in a Centralized Chemotherapy Preparation Unit (CCPU). Good manufacturing practices (GMP) in France specify that the ambient air in the vicinity of a class III biosafety cabinet (isolator) complies with air cleanliness ISO 8 level in CCPU. This guideline has a significant impact because implementing a dedicated air handling unit (AHU) brings some engineering constraints and generates substantial additional costs. Authors have previously studied some technical and economical aspects to evaluate the feasibility of the MADU option. Using a MADU was the chosen option. Qualification of the CCPU showed that results were in compliance with the French GMP. After one year of use, the efficiency of the MADU was confirmed. According to these results, using a MADU constitutes a beneficial option for CCPU previously equipped with an isolator when compared to renovation work involving a standard built-in AHU. © The Author(s) 2014.

Original research: Giving sexual assault survivors time to decide: an exploration of the use and effects of the nonreport option.

PubMed

Heffron, Laurie Cook; Busch-Armendariz, Noël Bridget; Vohra, Shetal S; Johnson, Regina Jones; Camp, Victoria

2014-03-01

Forensic nurses, sexual assault nurse examiners (SANEs), and victim advocates have long recognized the trauma of sexual assault crimes and the significance of survivors' decisions around reporting these crimes to law enforcement agencies. Until recently, survivors who didn't report the crime were not entitled to a free medical forensic examination. In a significant policy shift, the Violence Against Women and Department of Justice Reauthorization Act of 2005 provided an additional decision option with regard to the medical examination for survivors of sexual assault. This provision, referred to here as the nonreport option, was established to offer survivors a full range of reporting options and to ensure exemplary health care, with evidence collection as an important secondary goal. This study sought to examine the implementation of the nonreport option in Texas; explore its impact on SANEs, survivors, and the criminal justice system; and identify strengths and challenges of the nonreport process. A mixed-method approach was used that included qualitative interviews with 79 professionals who regularly respond to sexual assault crimes, a Web-based survey questionnaire of such professionals that yielded 131 completed surveys, and a review of existing data. The step-by-step process involved in a nonreport case was described, and findings in three descriptive areas emerged: confidentiality processes, storage and shipment of evidence, and the use of the nonreport option. Beneficial effects of the nonreport option were identified in five areas: the role of SANEs, the impact on survivors, collaborative relationships, collateral crimes, and anonymous reporting strategies. Seven areas of remaining dilemmas were also identified. Findings indicate that the nonreport option has had a considerable positive impact on SANEs, survivors of sexual assault, and the criminal justice system. But challenges remain if this option is to be fully utilized in the future; further research is warranted. The authors also present recommendations to improve health care delivery.

48 CFR 536.213-371 - Bids that include options.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Bids that include options... Contracting for Construction 536.213-371 Bids that include options. (a) Subject to the limitations in paragraph (c) of this section, you may include options in contracts if it is in the Government's interest...

Upper Extremity Amputations and Prosthetics

PubMed Central

Ovadia, Steven A.; Askari, Morad

2015-01-01

Upper extremity amputations are most frequently indicated by severe traumatic injuries. The location of the injury will determine the level of amputation. Preservation of extremity length is often a goal. The amputation site will have important implications on the functional status of the patient and options for prosthetic reconstruction. Advances in amputation techniques and prosthetic reconstructions promote improved quality of life. In this article, the authors review the principles of upper extremity amputation, including techniques, amputation sites, and prosthetic reconstructions. PMID:25685104

Current methods of burn reconstruction.

PubMed

Orgill, Dennis P; Ogawa, Rei

2013-05-01

After reading this article, the participant should be able to: 1. Explain the present challenges in reconstructive burn surgery. 2. Describe the most appropriate treatment methods and techniques for specific burn injury types, including skin grafts, dermal substitutes, and a variety of flap options. 3. Identify the appropriate use, advantages, and disadvantages of specific flaps in the treatment of burn injuries, including local, regional, superthin, prefabricated, prelaminated, and free flaps. Victims of thermal burns often form heavy scars and develop contractures around joints, inhibiting movement. As burns can occur in all cutaneous areas of the body, a wide range of reconstructive options have been utilized. Each method has advantages and disadvantages that must be considered by both patients and surgeons. The authors reviewed the literature for burn reconstruction and focused their discussion on areas that have been recently developed. They reviewed the mechanism of burn injury and discussed how this relates to the pathophysiology of the burn injury. Surgeons now have a wide array of plastic surgical techniques that can be used to treat burn victims. These range from skin grafts and local flaps to free flaps, prefabricated flaps, superthin flaps, and dermal scaffolds. Recent advances in burn reconstruction provide methods to decrease scar tissue and joint contractures. In the future, the authors hope that further developments in burn treatment will foster the development of new technologies that will allow site-specific reconstruction with minimal donor-site morbidity.

Efficacy of indefinite chronic oral antimicrobial suppression for prosthetic joint infection in the elderly: a comparative study.

PubMed

Prendki, V; Sergent, P; Barrelet, A; Oziol, E; Beretti, E; Berlioz-Thibal, M; Bouchand, F; Dauchy, F A; Forestier, E; Gavazzi, G; Ronde-Oustau, C; Stirnemann, J; Dinh, A

2017-07-01

During prosthetic joint infection (PJI), surgical management is sometimes impossible and indefinite chronic oral antimicrobial suppression (ICOAS) may be the only option. The outcomes of elderly patients who benefited from ICOAS with strictly palliative intent were evaluated. A national retrospective cohort study was performed in France, involving patients aged >75 years with a PJI who were managed with planned life-long ICOAS from 2009 to 2014. Patients who experienced an event were compared to those who did not. An event was defined as a composite outcome in patients undergoing ICOAS, including local or systemic progression of the infection, death, or discontinuation of antimicrobial therapy because of an adverse drug reaction. Twenty-one patients were included, with a median age of 85 years (interquartile range 81-88 years). Eight of the 21 patients experienced an event: one had an adverse drug reaction, three had systemic progression of sepsis, and two had local progression. Two of the 21 patients died. No death was related to ICOAS or infection. There was no significant difference between the population with an event and the population free of an event with regard to demographic, clinical, and microbiological characteristics (p>0.05). ICOAS appeared to be an effective and safe option in this cohort. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Consumer preferences for teledermoscopy screening to detect melanoma early.

PubMed

Spinks, Jean; Janda, Monika; Soyer, H Peter; Whitty, Jennifer A

2016-01-01

'Store and forward' teledermoscopy is a technology with potential advantages for melanoma screening. Any large-scale implementation of this technology is dependent on consumer acceptance. To investigate preferences for melanoma screening options compared with skin self-examination in adults considered to be at increased risk of developing skin cancer. A discrete choice experiment was completed by 35 consumers, all of whom had prior experience with the use of teledermoscopy, in Queensland, Australia. Participants made 12 choices between screening alternatives described by seven attributes including monetary cost. A mixed logit model was used to estimate the relative weights that consumers place on different aspects of screening, along with the marginal willingness to pay for teledermoscopy as opposed to screening at a clinic. Overall, participants preferred screening/diagnosis by a health professional rather than skin self-examination. Key drivers of screening choice were for results to be reviewed by a dermatologist; a higher detection rate; fewer non-cancerous moles being removed in relation to every skin cancer detected; and less time spent away from usual activities. On average, participants were willing to pay AUD110 to have teledermoscopy with dermatologist review available to them as a screening option. Consumers preferentially value aspects of care that are more feasible with a teledermoscopy screening model, as compared with other skin cancer screening and diagnosis options. This study adds to previous literature in the area which has relied on the use of consumer satisfaction scales to assess the acceptability of teledermoscopy. © The Author(s) 2015.

The Transition from Optional to Required Subjects.

ERIC Educational Resources Information Center

O'Grady, William; And Others

1989-01-01

Proposes that the optional subject phenomenon in early child language arises because children have not yet acquired the morphological elements (primarily modal and tense) necessary to distinguish subject-taking verbs (e.g., finite verbs) from their non-subject-taking counterparts (e.g., infinitives). (Author/CB)

Supervised Multi-Authority Scheme with Blind Signature for IoT with Attribute Based Encryption

NASA Astrophysics Data System (ADS)

Nissenbaum, O. V.; Ponomarov, K. Y.; Zaharov, A. A.

2018-04-01

This article proposes a three-side cryptographic scheme for verifying device attributes with a Supervisor and a Certification Authority (CA) for attribute-based encryption. Two options are suggested: using a message authentication code and using a digital signature. The first version is suitable for networks with one CA, and the second one for networks with several CAs, including dynamic systems. Also, the addition of this scheme with a blind signature is proposed to preserve the confidentiality of the device attributes from the CA. The introduction gives a definition and a brief historical overview of attribute-based encryption (ABE), addresses the use of ABE in the Internet of Things.

A Qualitative Study on Factors that Influence Turkish Medical Students' Decisions to Become Family Physicians After the Health Transformation Programme.

PubMed

Tanriover, Ozlem; Hidiroglu, Seyhan; Akan, Hulya; Ay, Pinar; Erdogan, Yalcin; Karavus, Melda; Vitrinel, Ayca; Hayran, Osman

2014-06-01

In Turkey, general practitioners were authorized to work as family physicians without specialization, within the scope of the Health Transformation Programme, due to inadequate number of family medicine specialists since 2004. With this new implementation Family Medicine specialty became a less preferable option for medical students. The study was to investigate the perspectives of medical students and understand the issues to choose Family Medicine specialty as a career option. This qualitative study was performed with 48 final year medical students using a convenience sample from two medical universities. Three main categories emerged from the data viewing Family Medicine 'as a specialty', 'as an employment', and finally 'as a system'. Very few students stated that Family Medicine would be their choice for specialty. Family Medicine does not seem to be an attractive option in career planning by medical students. Several factors that may constrain students from choosing Family Medicine include: not perceiving Family Medicine as a field of expertise, and the adverse conditions at work which may originate from duality in the system.

Copyright Management for Scholarship

ERIC Educational Resources Information Center

Petersen, Rodney J.

2004-01-01

This article describes the author's experience working with copyright and teachers' level of awareness or unawareness of the basics about copyright. The article is divided into sections on the following topics: Rewards for Authors; Hypothetical Scenarios; Options for Managing Authors' Rights; and Emerging Principles for Scholarly Communications.…

75 FR 69334 - International Product and Price Changes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-12

... the following product features and classification changes: Permit Imprint To provide additional payment options for customers we are authorizing permit imprint as a new postage payment option for GXG... (GSS) and pay for postage with a permit imprint through an advance deposit account. The commercial base...

14 CFR 21.289 - Major repairs, rebuilding and alteration.

Code of Federal Regulations, 2010 CFR

2010-01-01

... TRANSPORTATION AIRCRAFT CERTIFICATION PROCEDURES FOR PRODUCTS AND PARTS Delegation Option Authorization Procedures § 21.289 Major repairs, rebuilding and alteration. For types covered by a delegation option... any employee to execute and sign FAA Form 337 and make required log book entries if that employee— (1...

The Chinese brain drain and policy options.

PubMed

Chang, P; Deng, Z

1992-01-01

The authors discuss the growing problem caused by the increasing reluctance of Chinese receiving higher education overseas to return to China following completion of their studies. They note that the Tiananmen incident of June 1989 exacerbated this problem. The policy options open to the Chinese government are reviewed.

42 CFR 436.201 - Individuals included in optional groups.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Individuals included in optional groups. 436.201... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS ELIGIBILITY IN GUAM, PUERTO RICO, AND THE VIRGIN ISLANDS Options for Coverage as Categorically Needy § 436.201 Individuals included in optional groups. (a) The...

Web Applications for Patient Communication.

PubMed

Lewis, Kristopher; Reicher, Murray A

2016-12-01

Communication between imaging professionals and patients can help achieve many goals, including improved patient understanding of imaging-related diagnostic and treatment options, better compliance with appropriate imaging screening procedures, and improved efficiency of service. The explosive growth of out-of-pocket consumer spending on health care has heightened health care shopping, thus making patient communication an important goal of any imaging practice or health care organization. Furthermore, the Merit-Based Incentive Payment System introduced by CMS will publicly disclose physicians' quality ratings, which are in part dependent on patient engagement. The authors summarize the rationale for web communication with patients, the range of content that should be considered, and the technology options. The aim is to help imaging providers develop organized patient communication strategic and implementation plans. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Experiences with the in vivo and in vitro comet assay in regulatory testing.

PubMed

Frötschl, Roland

2015-01-01

The in vivo comet assay has recently been implemented into regulatory genotoxicity testing of pharmaceuticals with inclusion into the ICH S2R1 guidance. Regulatory genotoxicity testing aims to detect DNA alterations in form of gene mutations, larger scale chromosomal damage and recombination and aneuploidy. The ICH S2R1 guideline offers two options of standard batteries of tests for the detection of these endpoints. Both options start with an AMES assay and option 1 includes an in vitro mammalian cell assay and an in vivo micronucleus assay in rodent, whereas option 2 includes an in vivo micronucleus assay in bone marrow in rodent and a second in vivo assay in a second tissue with a second endpoint. The test recommended as second in vivo test is the comet assay in rat liver. The in vivo comet assay is considered as mature enough to ensure reliable detection of relevant in vivo genotoxicants in combination with the micronucleus test in bone marrow and the AMES assay. Although lots of research papers have been published using the in vitro comet assay, the in vitro version has not been implemented into official regulatory testing guidelines. A survey of the years 1999-2014 revealed 27 in vivo comet assays submitted to BfArM with market authorisation procedures, European and national advice procedures and clinical trial applications. In three procedures, in vitro comet assays had been submitted within the genetic toxicology packages. © The Author 2014. Published by Oxford University Press on behalf of the Mutagenesis Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

A Perspective for Assertiveness Training for Blacks

ERIC Educational Resources Information Center

Minor, Billy Joe

1978-01-01

This article discussess assertiveness in the Black-White encounter. The author delineates the assertive options available to Blacks, distortions in interpretation of assertive messages, and strategies for more effective and efficient assertions. (Author)

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

PubMed Central

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

2017-01-01

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

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

PubMed

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

2017-04-01

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

Optimisation of the Management of Higher Activity Waste in the UK - 13537

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

Walsh, Ciara; Buckley, Matthew

2013-07-01

The Upstream Optioneering project was created in the Nuclear Decommissioning Authority (UK) to support the development and implementation of significant opportunities to optimise activities across all the phases of the Higher Activity Waste management life cycle (i.e. retrieval, characterisation, conditioning, packaging, storage, transport and disposal). The objective of the Upstream Optioneering project is to work in conjunction with other functions within NDA and the waste producers to identify and deliver solutions to optimise the management of higher activity waste. Historically, optimisation may have occurred on aspects of the waste life cycle (considered here to include retrieval, conditioning, treatment, packaging, interimmore » storage, transport to final end state, which may be geological disposal). By considering the waste life cycle as a whole, critical analysis of assumed constraints may lead to cost savings for the UK Tax Payer. For example, it may be possible to challenge the requirements for packaging wastes for disposal to deliver an optimised waste life cycle. It is likely that the challenges faced in the UK are shared in other countries. It is therefore likely that the opportunities identified may also apply elsewhere, with the potential for sharing information to enable value to be shared. (authors)« less

Vaccine supply, demand, and policy: a primer.

PubMed

Muzumdar, Jagannath M; Cline, Richard R

2009-01-01

To provide an overview of supply and demand issues in the vaccine industry and the policy options that have been implemented to resolve these issues. Medline, Policy File, and International Pharmaceutical Abstracts were searched to locate academic journal articles. Other sources reviewed included texts on the topics of vaccine history and policy, government agency reports, and reports from independent think tanks. Keywords included vaccines, immunizations, supply, demand, and policy. Search criteria were limited to English language and human studies. Articles pertaining to vaccine demand, supply, and public policy were selected and reviewed for inclusion. By the authors. Vaccines are biologic medications, therefore making their development and production more difficult and costly compared with "small-molecule" drugs. Research and development costs for vaccines can exceed $800 million, and development may require 10 years or more. Strict manufacturing regulations and facility upgrades add to these costs. Policy options to increase and stabilize the supply of vaccines include those aimed at increasing supply, such as government subsidies for basic vaccine research, liability protection for manufacturers, and fast-track approval for new vaccines. Options to increase vaccine demand include advance purchase commitments, government stockpiles, and government financing for select populations. High development costs and multiple barriers to entry have led to a decline in the number of vaccine manufacturers. Although a number of vaccine policies have met with mixed success in increasing the supply of and demand for vaccines, a variety of concerns remain, including developing vaccines for complex pathogens and increasing immunization rates with available vaccines. New policy innovations such as advance market commitments and Medicare Part D vaccine coverage have been implemented and may aid in resolving some of the problems in the vaccine industry.

Organizational Design within University Extension Units: Some Concepts, Options, and Guidelines

ERIC Educational Resources Information Center

Baker, Harold R.

1976-01-01

Drawing on the behavioral sciences, the author outlines alternative modes of structuring and organizing an extension unit. The advantages and disadvantages of several organizational design options, the purposes and management of the temporary task force, and some general guidelines for making organizational design decisions are discussed.…

75 FR 23833 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-04

... date and is contingent upon the Commission's approval of The Options Clearing Corporation's (``OCC... objectives. ISE has analyzed its capacity and represents that it and the Options Price Reporting Authority have the necessary systems capacity to handle the additional traffic associated with the listing and...

17 CFR 30.12 - Direct foreign order transmittal.

Code of Federal Regulations, 2010 CFR

2010-04-01

... customers defined. For the purposes of this section, an “authorized customer” of a futures commission merchant shall mean any foreign futures or foreign options customer, as defined in § 30.1(c), or its... account of the futures commission merchant's foreign futures and options customer omnibus account; and (2...

17 CFR 30.12 - Direct foreign order transmittal.

Code of Federal Regulations, 2014 CFR

2014-04-01

... customers defined. For the purposes of this section, an “authorized customer” of a futures commission merchant shall mean any foreign futures or foreign options customer, as defined in § 30.1(c), or its... account of the futures commission merchant's foreign futures and options customer omnibus account; and (2...

17 CFR 30.12 - Direct foreign order transmittal.

Code of Federal Regulations, 2011 CFR

2011-04-01

... customers defined. For the purposes of this section, an “authorized customer” of a futures commission merchant shall mean any foreign futures or foreign options customer, as defined in § 30.1(c), or its... account of the futures commission merchant's foreign futures and options customer omnibus account; and (2...

17 CFR 30.12 - Direct foreign order transmittal.

Code of Federal Regulations, 2013 CFR

2013-04-01

... customers defined. For the purposes of this section, an “authorized customer” of a futures commission merchant shall mean any foreign futures or foreign options customer, as defined in § 30.1(c), or its... account of the futures commission merchant's foreign futures and options customer omnibus account; and (2...

17 CFR 30.12 - Direct foreign order transmittal.

Code of Federal Regulations, 2012 CFR

2012-04-01

... customers defined. For the purposes of this section, an “authorized customer” of a futures commission merchant shall mean any foreign futures or foreign options customer, as defined in § 30.1(c), or its... account of the futures commission merchant's foreign futures and options customer omnibus account; and (2...

Labour circulation and the urban labour process.

PubMed

Standing, G

1986-01-01

The author investigates aspects of labor circulation, which he defines as "temporary movement between geographical areas for work or in search of work....[He attempts to determine] what roles have been played by labour circulation in the development of urban-industrial labour forces in the transition to industrial capitalism." Factors considered include the exploitation and oppression of labor migrants; the industrial-urban labor reserve; urban socioeconomic stratification and discrimination by age, sex, or race; the division of labor; and policy options. excerpt

42 CFR 435.201 - Individuals included in optional groups.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Individuals included in optional groups. 435.201... Individuals included in optional groups. (a) The agency may choose to cover as optional categorically needy any group or groups of the following individuals who are not receiving cash assistance and who meet...

Medicaid program; self-directed personal assistance services program State Plan option (cash and counseling). Final rule.

PubMed

2008-10-03

This final rule provides guidance to States that want to administer self-directed personal assistance services through their State Plans, as authorized by the Deficit Reduction Act of 2005. The State plan option allows beneficiaries, through an approved self-directed services plan and budget, to purchase personal assistance services. The rule also provides guidance to ensure beneficiary health and welfare and financial accountability of the State Plan option.

The impact of lecture attendance and other variables on how medical students evaluate faculty in a preclinical program.

PubMed

Martin, Stanley I; Way, David P; Verbeck, Nicole; Nagel, Rollin; Davis, John A; Vandre, Dale D

2013-07-01

High-quality audiovisual recording technology enables medical students to listen to didactic lectures without actually attending them. The authors wondered whether in-person attendance affects how students evaluate lecturers. This is a retrospective review of faculty evaluations completed by first- and second-year medical students at the Ohio State University College of Medicine during 2009-2010. Lecture-capture technology was used to record all lectures. Attendance at lectures was optional; however, all students were required to complete lecturer evaluation forms. Students rated overall instruction using a five-option response scale. They also reported their attendance. The authors used analysis of variance to compare the lecturer ratings of attendees versus nonattendees. The authors included additional independent variables-year of student, student grade/rank in class, and lecturer degree-in the analysis. The authors analyzed 12,092 evaluations of 220 lecturers received from 358 students. The average number of evaluations per lecturer was 55. Seventy-four percent (n = 8,968 evaluations) of students attended the lectures they evaluated, whereas 26% (n = 3,124 evaluations) viewed them online. Mean lecturer ratings from attendees was 3.85 compared with 3.80 by nonattendees (P ≤ .05; effect size: 0.055). Student's class grade and year, plus lecturer degree, also affected students' evaluations of lecturers (effect sizes: 0.055-0.3). Students' attendance at lectures, year, and class grade, as well as lecturer degree, affect students' evaluation of lecturers. This finding has ramifications on how student evaluations should be collected, interpreted, and used in promotion and tenure decisions in this evolving medical education environment.

Co-option of Liver Vessels and Not Sprouting Angiogenesis Drives Acquired Sorafenib Resistance in Hepatocellular Carcinoma.

PubMed

Kuczynski, Elizabeth A; Yin, Melissa; Bar-Zion, Avinoam; Lee, Christina R; Butz, Henriett; Man, Shan; Daley, Frances; Vermeulen, Peter B; Yousef, George M; Foster, F Stuart; Reynolds, Andrew R; Kerbel, Robert S

2016-08-01

The anti-angiogenic Sorafenib is the only approved systemic therapy for advanced hepatocellular carcinoma (HCC). However, acquired resistance limits its efficacy. An emerging theory to explain intrinsic resistance to other anti-angiogenic drugs is 'vessel co-option,' ie, the ability of tumors to hijack the existing vasculature in organs such as the lungs or liver, thus limiting the need for sprouting angiogenesis. Vessel co-option has not been evaluated as a potential mechanism for acquired resistance to anti-angiogenic agents. To study sorafenib resistance mechanisms, we used an orthotopic human HCC model (n = 4-11 per group), where tumor cells are tagged with a secreted protein biomarker to monitor disease burden and response to therapy. Histopathology, vessel perfusion assessed by contrast-enhanced ultrasound, and miRNA sequencing and quantitative real-time polymerase chain reaction were used to monitor changes in tumor biology. While sorafenib initially inhibited angiogenesis and stabilized tumor growth, no angiogenic 'rebound' effect was observed during development of resistance unless therapy was stopped. Instead, resistant tumors became more locally infiltrative, which facilitated extensive incorporation of liver parenchyma and the co-option of liver-associated vessels. Up to 75% (±10.9%) of total vessels were provided by vessel co-option in resistant tumors relative to 23.3% (±10.3%) in untreated controls. miRNA sequencing implicated pro-invasive signaling and epithelial-to-mesenchymal-like transition during resistance development while functional imaging further supported a shift from angiogenesis to vessel co-option. This is the first documentation of vessel co-option as a mechanism of acquired resistance to anti-angiogenic therapy and could have important implications including the potential therapeutic benefits of targeting vessel co-option in conjunction with vascular endothelial growth factor receptor signaling. © The Author 2016. Published by Oxford University Press.

Nudging, informed consent and bullshit.

PubMed

Simkulet, William

2017-11-18

Some philosophers have argued that during the process of obtaining informed consent, physicians should try to nudge their patients towards consenting to the option the physician believes best, where a nudge is any influence that is expected to predictably alter a person's behaviour without (substantively) restricting her options. Some proponents of nudging even argue that it is a necessary and unavoidable part of securing informed consent. Here I argue that nudging is incompatible with obtaining informed consent. I assume informed consent requires that a physician tells her patient the truth about her options and argue that nudging is incompatible with truth-telling. Instead, nudging satisfies Harry Frankfurt's account of bullshit. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Exploring Opioid-Sparing Multimodal Analgesia Options in Trauma: A Nursing Perspective

PubMed Central

Lyons, Mary; Montgomery, Robert; Quinlan-Colwell, Ann

2016-01-01

Challenges with opioids (e.g., adverse events, misuse and abuse with long-term administration) have led to a renewed emphasis on opioid-sparing multimodal management of trauma pain. To assess the extent to which currently available evidence supports the efficacy and safety of various nonopioid analgesics and techniques to manage trauma pain, a literature search of recently published references was performed. Additional citations were included on the basis of authors' knowledge of the literature. Effective options for opioid-sparing analgesics include oral and intravenous (IV) acetaminophen; nonsteroidal anti-inflammatory drugs available via multiple routes; and anticonvulsants, which are especially effective for neuropathic pain associated with trauma. Intravenous routes (e.g., IV acetaminophen, IV ketorolac) may be associated with a faster onset of action than oral routes. Additional adjuvants for the treatment of trauma pain are muscle relaxants and alpha-2 adrenergic agonists. Ketamine and regional techniques play an important role in multimodal therapy but require medical and nursing support. Nonpharmacologic treatments (e.g., cryotherapy, distraction techniques, breathing and relaxation, acupuncture) supplement pharmacologic analgesics and can be safe and easy to implement. In conclusion, opioid-sparing multimodal analgesia addresses concerns associated with high doses of opioids, and many pharmacologic and nonpharmacologic options are available to implement this strategy. Nurses play key roles in comprehensive patient assessment; administration of patient-focused, opioid-sparing, multimodal analgesia in trauma; and monitoring for safety concerns. PMID:27828892

Exploring Opioid-Sparing Multimodal Analgesia Options in Trauma: A Nursing Perspective.

PubMed

Sullivan, Denise; Lyons, Mary; Montgomery, Robert; Quinlan-Colwell, Ann

Challenges with opioids (e.g., adverse events, misuse and abuse with long-term administration) have led to a renewed emphasis on opioid-sparing multimodal management of trauma pain. To assess the extent to which currently available evidence supports the efficacy and safety of various nonopioid analgesics and techniques to manage trauma pain, a literature search of recently published references was performed. Additional citations were included on the basis of authors' knowledge of the literature. Effective options for opioid-sparing analgesics include oral and intravenous (IV) acetaminophen; nonsteroidal anti-inflammatory drugs available via multiple routes; and anticonvulsants, which are especially effective for neuropathic pain associated with trauma. Intravenous routes (e.g., IV acetaminophen, IV ketorolac) may be associated with a faster onset of action than oral routes. Additional adjuvants for the treatment of trauma pain are muscle relaxants and alpha-2 adrenergic agonists. Ketamine and regional techniques play an important role in multimodal therapy but require medical and nursing support. Nonpharmacologic treatments (e.g., cryotherapy, distraction techniques, breathing and relaxation, acupuncture) supplement pharmacologic analgesics and can be safe and easy to implement. In conclusion, opioid-sparing multimodal analgesia addresses concerns associated with high doses of opioids, and many pharmacologic and nonpharmacologic options are available to implement this strategy. Nurses play key roles in comprehensive patient assessment; administration of patient-focused, opioid-sparing, multimodal analgesia in trauma; and monitoring for safety concerns.

Soviet short-range nuclear forces: flexible response or flexible aggression. Student essay

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

Smith, T.R.

1987-03-23

This essay takes a critical look at Soviet short-range nuclear forces in an effort to identify Soviet capabilities to fight a limited nuclear war with NATO. From an analysis of Soviet military art, weapon-system capabilities and tactics, the author concludes that the Soviets have developed a viable limited-nuclear-attack option. Unless NATO reacts to this option, the limited nuclear attack may become favored Soviet option and result in the rapid defeat of NATO.

77 FR 52703 - Notice of Submission for OMB Review; Federal Student Aid; Electronic Debit Payment Option for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-30

... the bank account information needed by ED to debit the applicant's account. The authority for the PDA... Payment Option for Student Loans SUMMARY: The Preauthorized Debit Account (PDA) Application is used to... debt payments debited from their bank accounts. DATES: Interested persons are invited to submit...

77 FR 52319 - Notice of Submission for OMB Review; Federal Student Aid; Electronic Debit Payment Option for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-29

... the bank account information needed by ED to debit the applicant's account. The authority for the PDA... Payment Option for Student Loans SUMMARY: The Preauthorized Debit Account (PDA) Application is used to... debt payments debited from their bank accounts. DATES: Interested persons are invited to submit...

77 FR 71650 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-03

... authorizes the Exchange to restrict access to the Disaster Recovery Facility if necessitated by system... the event that it needs to operate in disaster recovery mode on account of its primary data systems on...-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and Order Granting...

76 FR 72989 - Options Price Reporting Authority; Notice of Filing and Immediate Effectiveness of Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-28

... Options Last Sale Reports and Quotation Information (``OPRA Plan'').\\3\\ The proposed amendment would... OPRA Plan provides for the collection and dissemination of last sale and quotation information on... determine the fees that are payable to OPRA by Vendors' and Professional Subscribers. The second and third...

75 FR 69477 - Options Price Reporting Authority; Notice of Filing and Immediate Effectiveness of Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-12

...-Based Professional Subscriber Fees Charged by OPRA for its Basic Service November 8, 2010. Pursuant to... Options Last Sale Reports and Quotation Information (``OPRA Plan'').\\3\\ The proposed amendment would revise the device-based professional subscriber fees charged by OPRA in respect of its Basic Service. A...

Putting Bandits into Context: How Function Learning Supports Decision Making

ERIC Educational Resources Information Center

Schulz, Eric; Konstantinidis, Emmanouil; Speekenbrink, Maarten

2018-01-01

The authors introduce the contextual multi-armed bandit task as a framework to investigate learning and decision making in uncertain environments. In this novel paradigm, participants repeatedly choose between multiple options in order to maximize their rewards. The options are described by a number of contextual features which are predictive of…

The Elementary and Secondary Education Consolidation Act of 1981: SEA Policy Options.

ERIC Educational Resources Information Center

Hansen, Kenneth H.

The responsibilities and prerogatives of state departments of education regarding the allocation of federal funds authorized under provisions of the draft version of the Education Consolidation and Improvement Act of 1981 are clarified in this report, and the resulting policy options available to state education agencies are examined. The law…

78 FR 6382 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-30

... shares other than 100.\\8\\ Moreover, the concept of listing and trading parallel options products of... terms of the Options Disclosure Document. With regard to the impact of this proposal on system capacity... Authority (``OPRA'') have the necessary systems capacity to handle the potential additional traffic...

78 FR 6391 - Self-Regulatory Organizations; NASDAQ OMX BX, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-30

... shares other than 100.\\8\\ Moreover, the concept of listing and trading parallel options products of... system capacity, the Exchange has analyzed its capacity and represents that it and the Options Price Reporting Authority (``OPRA'') have the necessary systems capacity to handle the potential additional...

Do School Boards Still Have Options? The Erosion of Management Authority.

ERIC Educational Resources Information Center

Lieberman, Myron

1997-01-01

School boards are woefully unprepared to deal with "make or buy" issues, due to massive union efforts to eliminate or restrict board freedom to contract for services. Teachers neither understand nor support a market economy. School boards' contracting out ability will not be secure until favorable legislative options are considered and…

Coupling of FM Systems to Individuals with Unilateral Hearing Loss.

ERIC Educational Resources Information Center

Kopun, Judy G.; And Others

1992-01-01

This study examined the attenuation characteristics of 5 Frequency Modulation system sound delivery options for 25 adults and children (ages 5-13). Degree of ear canal occlusion was a major factor in degree of attenuation. For children with unilateral hearing impairments, the most acoustically appropriate option was the tube-fitting. (Author/JDD)

Tetomilast: new promise for phosphodiesterase-4 inhibitors?

PubMed

Bickston, Stephen J; Snider, Kenneth R; Kappus, Matthew R

2012-12-01

Tetomilast is a novel thiazole phosphodiesterase-4 (PDE-4) inhibitor, which may prove useful in both the treatment of inflammatory bowel disease (IBD) and chronic obstructive pulmonary disease (COPD). Here, the authors review the pharmacology of the drug, and offer critical review of the available data for use of tetomilast in the treatment of IBD. Peer-reviewed publications, including Phase I and II clinical trials, all other formats included. Tetomilast may be beneficial in IBD. Small differences in molecules and in recombinant proteins can translate into substantial differences in clinical effects and toxicity in IBD. This is a reasonable approach when exploring new options like tetomilast.

48 CFR 552.217-71 - Notice Regarding Option(s).

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Notice Regarding Option(s... Notice Regarding Option(s). As prescribed in 517.208(b), insert the following provision: Notice Regarding Option(s) (NOV 1992) The General Services Administration (GSA) has included an option to [Insert...

The European hospital exemption clause-new option for gene therapy?

PubMed

Buchholz, Christian J; Sanzenbacher, Ralf; Schüle, Silke

2012-01-01

Gene-therapy medicinal products are currently applied to patients enrolled in authorized clinical trials to demonstrate safety and efficacy. Given a positive outcome, marketing authorization can subsequently be achieved via the centralized procedure coordinated by the European Medicines Agency. With Regulation (EC) No. 1394/2007 in force, advanced therapy medicinal products, including gene- and cell-therapy products, can be excepted from the obligation of obtaining a marketing authorization via the centralized procedure under specific conditions (so-called "hospital exemption"). This hospital exemption allows the application of gene-therapy medicinal products prepared on a non-routine basis for an individual patient and used under the exclusive professional responsibility of a medical practitioner. Here, we explain the requirements to be fulfilled in order to fall under this exemption, the implementation of this regulation into the German national legislation, and its impact on gene-therapy product development in the future.

An educational rationale for deaf students with multiple disabilities.

PubMed

Ewing, Karen M; Jones, Thomas W

2003-01-01

Deaf students with with multiple disabilities have a long history of limited opportunity, including limited access to educational opportunities available to their deaf peers. This article places the individual needs of deaf students with multiple disabilities in the context that guides much of deaf education--the importance of language acquisition. That emphasis provides a basis for placement and curriculum options for deaf students with multiple disabilities. The authors review the evolution of placement options, describe assumptions that should guide placement and curriculum decisions, and recommend practices for optimizing these students' education. Descriptions of three service delivery models--multidisciplinary, interdisciplinary, and transdisciplinary--are provided, as well as an overview of the effectiveness of person-centered planning for deaf students with multiple disabilities. Disability-specific resources are highlighted that relate to mental retardation, autism, visual impairments, learning disabilities, attention deficit hyperactivity disorder, emotional disorders, medical issues, and general resources.

Medical and Endoscopic Management of Gastric Varices

PubMed Central

Al-Osaimi, Abdullah M. S.; Caldwell, Stephen H.

2011-01-01

In the past 20 years, our understanding of the pathophysiology and management options among patients with gastric varices (GV) has changed significantly. GV are the most common cause of upper gastrointestinal bleeding in patients with portal hypertension after esophageal varices (EV) and generally have more severe bleeding than EV. In the United States, the majority of GV patients have underlying portal hypertension rather than splenic vein thrombosis. The widely used classifications are the Sarin Endoscopic Classification and the Japanese Vascular Classifications. The former is based on the endoscopic appearance and location of the varices, while the Japanese classification is based on the underlying vascular anatomy. In this article, the authors address the current concepts of classification, epidemiology, pathophysiology, and emerging management options of gastric varices. They describe the stepwise approach to patients with gastric varices, including the different available modalities, and the pearls, pitfalls, and stop-gap measures useful in managing patients with gastric variceal bleed. PMID:22942544

Ceftaroline fosamil salvage therapy: an option for reduced-vancomycin-susceptible MRSA bacteraemia.

PubMed

Espedido, Björn A; Jensen, Slade O; van Hal, Sebastiaan J

2015-03-01

To examine the activity of ceftaroline against reduced-vancomycin-susceptible MRSA isolates. One-hundred and three MRSA blood culture isolates (predominantly ST239-MRSA-III), with varying vancomycin phenotypes, had their ceftaroline MICs determined by broth microdilution and MIC Evaluator strip (Oxoid-Thermo Fisher). Statistical analyses were performed that examined relationships with vancomycin and daptomycin MICs. Mutations in mecA were also examined. All 103 isolates (including 60 heteroresistant vancomycin-intermediate Staphylococcus aureus/vancomycin-intermediate S. aureus) were susceptible to ceftaroline, with one isolate displaying heteroresistance that may be related to a mecA mutation. Higher ceftaroline MICs were associated with vancomycin-susceptible S. aureus isolates. This study highlights that ceftaroline fosamil is an option for salvage therapy based on in vitro activity. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

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

Kaufmann, John R.; Hand, James R.; Halverson, Mark A.

This report evaluates how and when to best integrate renewable energy requirements into building energy codes. The basic goals were to: (1) provide a rough guide of where we’re going and how to get there; (2) identify key issues that need to be considered, including a discussion of various options with pros and cons, to help inform code deliberations; and (3) to help foster alignment among energy code-development organizations. The authors researched current approaches nationally and internationally, conducted a survey of key stakeholders to solicit input on various approaches, and evaluated the key issues related to integration of renewable energymore » requirements and various options to address those issues. The report concludes with recommendations and a plan to engage stakeholders. This report does not evaluate whether the use of renewable energy should be required on buildings; that question involves a political decision that is beyond the scope of this report.« less

Stable Meniscal Tears Left In Situ at the Time of Arthroscopic Anterior Cruciate Ligament Reconstruction: A Systematic Review.

PubMed

Rothermich, Marcus A; Cohen, Jared A; Wright, Rick

2016-04-01

Meniscal tears can be incidentally encountered at the time of anterior cruciate ligament (ACL) reconstruction. In these cases, the surgeon has several treatment options that include benign neglect, debridement, trephination, and repair. The authors performed a systematic review of the literature studying the various treatment options for meniscal tears discovered at the time of ACL reconstruction. This systematic review included eight articles that had relevant data regarding benign neglect compared with debridement, trephination, or repair of incidentally encountered meniscal tears. Combined data from these studies resulted in a total of 646 meniscal tears treated with benign neglect with follow-up information available. Importantly, there were differences in reoperation rates between medial and lateral meniscal tears left in situ. However, stable medial and lateral meniscal tears treated with benign neglect did not have different subjective or objective outcomes than those treated with surgical intervention. This systematic review concludes that when stable meniscal tears are encountered at the time of arthroscopic ACL reconstruction, benign neglect can be used for a successful outcome. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

78 FR 24456 - Self-Regulatory Organizations; C2 Options Exchange, Incorporated; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-25

... guarantee or authorization on file with the Exchange; Provide that any written revocation of a letter of... letter of guarantee or authorization otherwise becomes invalid pursuant to Exchange rules. A written... Rule Change Amending C2 Rules Governing Letters of Guarantee and Authorization April 19, 2013. Pursuant...

77 FR 76320 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-27

... letter of guarantee or authorization on file with the Exchange; Provide that any written revocation of a... letter of authorization otherwise becomes invalid under CBOE's rules. In the event a written notice of... Various CBOE Rules Governing Letters of Guarantee and Authorization December 20, 2012. Pursuant to Section...

Angina pectoris: current therapy and future treatment options.

PubMed

Parikh, Raj; Kadowitz, Philip J

2014-02-01

Angina pectoris is the consequence of an inequality between the demand and supply of blood to the heart. Angina manifests itself as chest pain or discomfort and is a common complaint of patients in the hospital and in the clinic. There are, in fact, roughly half a million new cases of angina per year. Chest pain, while having many etiologies, is generally considered to be most lethal when related to a cardiac cause. In this review, the authors outline the current medical and surgical therapies that are used in the management of angina. Highlights of the various clinical trials that have assisted in the investigation of these therapies are summarized also. Then, the authors provide a focused review of the novel therapy options for angina that are currently being explored. From new medical treatments to revised surgical techniques to the discovery of stem cell therapy, many innovative options are being investigated for the treatment of angina.

75 FR 71773 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-24

... securities index options, index futures, and options on index futures to be included along with the ETF in an... hedged not only with SPY shares, but with S&P 500 options, S&P 500 futures, options on S&P 500 futures or... on a delta basis. \\9\\ ``Other units of trade'' would include, for example, options or futures...

Options for Staging Orbits in Cis-Lunar Space

NASA Technical Reports Server (NTRS)

Whitley, Ryan; Martinez, Roland

2015-01-01

NASA has been studying options to conduct missions beyond Low Earth Orbit, but within the Earth-Moon system, in preparation for deep space exploration including human missions to Mars. Referred to as the Proving Ground, this arena of exploration activities will enable the development of human spaceflight systems and operations to satisfy future exploration objectives beyond the cis-lunar environment. One option being considered includes the deployment of a habitable element or elements, which could be used as a central location for aggregation of supplies and resources for human missions in cis-lunar space and beyond. Characterizing candidate orbit locations for this asset and the impacts on system design and mission operations is important in the overall assessment of the options being considered. The orbits described in this paper were initially selected by taking advantage of previous studies conducted by NASA and the work of other authors. In this paper orbits are assessed for their relative attractiveness based on various factors. First, a set of constraints related to the capability of the combined Orion and SLS system to deliver humans and cargo to and from the orbit are evaluated. Second, the ability to support potential lunar surface activities is considered. Finally, deployed assets intended to spend multiple years in the Proving Ground would ideally require minimal station keeping costs to reduce the mass budget allocated to this function. Additional mission design drivers include potential for uninterrupted communication with deployed assets, thermal, communications, and other operational implications. The results of the characterization and evaluation of the selected orbits indicate a Near Rectilinear Orbit (NRO) is an attractive candidate as an aggregation point or staging location for operations. In this paper, the NRO is further described in terms which balance a number of key attributes that favor a variety of mission classes to meet multiple, sometimes competing, constraints.

Options for Staging Orbits in Cis-Lunar Space

NASA Technical Reports Server (NTRS)

Martinez, Roland; Whitley, Ryan

2016-01-01

NASA has been studying options to conduct missions beyond Low Earth Orbit, but within the Earth-Moon system, in preparation for deep space exploration including human missions to Mars. Referred to as the Proving Ground, this arena of exploration activities will enable the development of human spaceflight systems and operations to satisfy future exploration objectives beyond the cis-lunar environment. One option being considered includes the deployment of a habitable element or elements, which could be used as a central location for aggregation of supplies and resources for human missions in cis-lunar space and beyond. Characterizing candidate orbit locations for this asset and the impacts on system design and mission operations is important in the overall assessment of the options being considered. The orbits described in this paper were initially selected by taking advantage of previous studies conducted by NASA and the work of other authors. In this paper orbits are assessed for their relative attractiveness based on various factors. A set of constraints related to the capability of the combined Orion and SLS system to deliver humans and cargo to and from the orbit are evaluated. Deployed assets intended to spend multiple years in the Proving Ground would ideally require minimal station keeping costs to reduce the mass budget allocated to this function. Additional mission design drivers include eclipse frequency, potential for uninterrupted communication with deployed assets, thermal, attitude control, communications, and other operational implications. Also the ability to support potential lunar surface activities and excursion missions beyond Earth-Moon space is considered. The results of the characterization and evaluation of the selected orbits indicate a Near Rectilinear Orbit (NRO) is an attractive candidate as an aggregation point or staging location for operations. In this paper, the NRO is further described in terms which balance a number of key attributes that favor a variety of mission classes to meet multiple, sometimes competing, constraints.

The "None of the Above" Option in Multiple-Choice Testing: An Experimental Study

ERIC Educational Resources Information Center

DiBattista, David; Sinnige-Egger, Jo-Anne; Fortuna, Glenda

2014-01-01

The authors assessed the effects of using "none of the above" as an option in a 40-item, general-knowledge multiple-choice test administered to undergraduate students. Examinees who selected "none of the above" were given an incentive to write the correct answer to the question posed. Using "none of the above" as the…

76 FR 20784 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-13

... Brazil Index Fund (``EWZ''), the Market Vectors Gold Miners ETF (``GDX''), and the Energy Select Sector... volatility.\\6\\ \\6\\ CBOE will be the reporting authority for any Vol Index. CBOE will compute values for Vol... price or the calculated forward value of the respective Vol index. Transactions in Vol Index options may...

77 FR 70517 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-26

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-68262; File No. SR-CBOE-2012-108] Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Proposed Rule Change To Address Authority To Cancel Orders When a Technical or Systems Issue Occurs and To Describe the Operation of Routing Service Error Accounts November 19...

77 FR 70511 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-26

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-68265; File No. SR-CBOE-2012-109] Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Proposed Rule Change Related to CBSX To Address Authority To Cancel Orders When a Technical or Systems Issue Occurs and To Describe the Operation of Routing Service Error...

75 FR 14646 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-26

... Organizations; International Securities Exchange, LLC; Notice of Filing of Proposed Rule Change To List and... ``Commission'') authorized ISE to list and trade options on the SPDR Gold Trust,\\3\\ the iShares COMEX Gold... Exchange proposes to list and trade options on the ETFS Palladium Trust and the ETFS Platinum Trust. \\3...

Promoting Psychiatry as a Career Option for Ghanaian Medical Students through a Public-Speaking Competition

ERIC Educational Resources Information Center

Agyapong, Vincent Israel Opoku; McLoughlin, Declan

2012-01-01

Objectives: Authors assessed the impact of a public-speaking competition on the level of interest in psychiatry of Ghanaian medical students. Method: An inter-medical school public-speaking competition was organized to promote psychiatry as a fulfilling career option for Ghanaian medical students. Feedback questionnaires were completed by the…

23 CFR 1327.6 - Conditions and procedures for other authorized users of the NDR.

Code of Federal Regulations, 2010 CFR

2010-04-01

... shall sign a written consent authorizing the third party to act in this role. The written consent must.../or Social Security Number (SSN) (provision of SSN is optional); (ix) Full address; (x) Signature; (xi...

42 CFR 413.170 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Payment for End-Stage Renal Disease (ESRD... the principles and authorities under which CMS is authorized to establish a prospective payment system...

Geant4-DNA example applications for track structure simulations in liquid water: a report from the Geant4-DNA Project.

PubMed

Incerti, S; Kyriakou, I; Bernal, M A; Bordage, M C; Francis, Z; Guatelli, S; Ivanchenko, V; Karamitros, M; Lampe, N; Lee, S B; Meylan, S; Min, C H; Shin, W G; Nieminen, P; Sakata, D; Tang, N; Villagrasa, C; Tran, H; Brown, J M C

2018-06-14

This Special Report presents a description of Geant4-DNA user applications dedicated to the simulation of track structures (TS) in liquid water and associated physical quantities (e.g. range, stopping power, mean free path…). These example applications are included in the Geant4 Monte Carlo toolkit and are available in open access. Each application is described and comparisons to recent international recommendations are shown (e.g. ICRU, MIRD), when available. The influence of physics models available in Geant4-DNA for the simulation of electron interactions in liquid water is discussed. Thanks to these applications, the authors show that the most recent sets of physics models available in Geant4-DNA (the so-called "option4″ and "option 6″ sets) enable more accurate simulation of stopping powers, dose point kernels and W-values in liquid water, than the default set of models ("option 2″) initially provided in Geant4-DNA. They also serve as reference applications for Geant4-DNA users interested in TS simulations. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

A Qualitative Study on Factors that Influence Turkish Medical Students’ Decisions to Become Family Physicians After the Health Transformation Programme

PubMed Central

Tanriover, Ozlem; Hidiroglu, Seyhan; Akan, Hulya; Ay, Pinar; Erdogan, Yalcin; Karavus, Melda; Vitrinel, Ayca; Hayran, Osman

2014-01-01

Background: In Turkey, general practitioners were authorized to work as family physicians without specialization, within the scope of the Health Transformation Programme, due to inadequate number of family medicine specialists since 2004. With this new implementation Family Medicine specialty became a less preferable option for medical students. Aims: The study was to investigate the perspectives of medical students and understand the issues to choose Family Medicine specialty as a career option. Materials and Methods: This qualitative study was performed with 48 final year medical students using a convenience sample from two medical universities. Results: Three main categories emerged from the data viewing Family Medicine ‘as a specialty’, ‘as an employment’, and finally ‘as a system’. Very few students stated that Family Medicine would be their choice for specialty. Conclusions: Family Medicine does not seem to be an attractive option in career planning by medical students. Several factors that may constrain students from choosing Family Medicine include: not perceiving Family Medicine as a field of expertise, and the adverse conditions at work which may originate from duality in the system. PMID:25006564

The Perceived Value of Passive Animal Health Surveillance: The Case of Highly Pathogenic Avian Influenza in Vietnam.

PubMed

Delabouglise, A; Antoine-Moussiaux, N; Phan, T D; Dao, D C; Nguyen, T T; Truong, B D; Nguyen, X N T; Vu, T D; Nguyen, K V; Le, H T; Salem, G; Peyre, M

2016-03-01

Economic evaluations are critical for the assessment of the efficiency and sustainability of animal health surveillance systems and the improvement of their efficiency. Methods identifying and quantifying costs and benefits incurred by public and private actors of passive surveillance systems (i.e. actors of veterinary authorities and private actors who may report clinical signs) are needed. This study presents the evaluation of perceived costs and benefits of highly pathogenic avian influenza (HPAI) passive surveillance in Vietnam. Surveys based on participatory epidemiology methods were conducted in three provinces in Vietnam to collect data on costs and benefits resulting from the reporting of HPAI suspicions to veterinary authorities. A quantitative tool based on stated preference methods and participatory techniques was developed and applied to assess the non-monetary costs and benefits. The study showed that poultry farmers are facing several options regarding the management of HPAI suspicions, besides reporting the following: treatment, sale or destruction of animals. The option of reporting was associated with uncertain outcome and transaction costs. Besides, actors anticipated the release of health information to cause a drop of markets prices. This cost was relevant at all levels, including farmers, veterinary authorities and private actors of the upstream sector (feed, chicks and medicine supply). One benefit associated with passive surveillance was the intervention of public services to clean farms and the environment to limit the disease spread. Private actors of the poultry sector valued information on HPAI suspicions (perceived as a non-monetary benefit) which was mainly obtained from other private actors and media. © 2015 The Authors. Zoonoses and Public Health Published by Blackwell Verlag GmbH.

42 CFR 435.201 - Individuals included in optional groups.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Individuals included in optional groups. 435.201... optional groups. (a) The agency may choose to cover as optional categorically needy any group or groups of... eligibility criteria for groups specified in the separate sections of this subpart: (1) Aged individuals (65...

78 FR 75642 - Self-Regulatory Organizations; NYSE MKT LLC; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-12

... Amending the NYSE Amex Options Fee Schedule To Include FLEX Option Transactions in the Strategy Execution...'') to include FLEX Option transactions in the strategy execution fee cap. The Exchange proposes to... Option transactions in the strategy execution fee cap. The Exchange proposes to implement the fee change...

Author Languages, Authoring Systems, and Their Relation to the Changing Focus of Computer-Aided Language Learning.

ERIC Educational Resources Information Center

Sussex, Roland

1991-01-01

Considers how the effectiveness of computer-assisted language learning (CALL) has been hampered by language teachers who lack programing and software engineering expertise, and explores the limitations and potential contributions of author languages, programs, and environments in increasing the range of options for language teachers who are not…

An Analysis of the General Services Administration Board of Contract Appeals Bid Protest Decisions and the Effect on Automated Data Processing Equipment/Federal Information Processing Resources Procurements

DTIC Science & Technology

1991-12-01

associated with ADP/FIP protests. Navy and Marine Corps contracting agencies w\\ere contacted to determine their current experience in ADP/’FIP contracting...an emphasis on the GSBCA. A protestor has many options in vhich to "avenge" their wrong. A Contracting Officer can therefore expect a variety of...subject to their exclusive procurement authority. The term ADPE and ADP/FIP will be used somewhat loosely. In most cases, the acronyms include

Care Practice #2: Freedom of Movement Throughout Labor

PubMed Central

Shilling, Teri; Romano, Amy M.; DiFranco, Joyce T.

2007-01-01

This updated edition of Care Practice Paper #2 presents the evidence for the benefits of allowing freedom of movement in labor. Physiologic and anatomical principles that support the benefits of movement are explained. The authors review common obstacles to movement in labor, including the routine use of interventions that inhibit women's ability to walk or change position. Women are encouraged to plan to be active in labor and to select care providers and birth settings that provide the full range of options for using movement in labor. PMID:18566644

Rice hull energy uses in the Philippines

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

Waddle, D.B.

1985-01-01

As a rice producing country, the Philippines produces a tremendous amount of rice hulls which when converted to energy could displace a substantial amount of imported energy. Realizing this possibility needs a thorough evaluation of both resources and demand characteristics of particular industry where immediate applicability of technical option awaits. This document presents the Philippines' past activities in fuelizing rice hulls and future action plans where its economic relevance could be enhanced. Descriptions of four power plants are included with the author's analysis of their probable market impact and projections of future applications.

Understanding new media. Trends and issues in electronic distribution of information

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

Compaine, B.M.

The authors provide an indepth look at the changes facing information businesses, which have expanded from the traditional publishing and broadcasting companies to include financial service businesses, retailers, and telecommunications carriers. Offering a unique conceptual framework - the information business map - this book stresses the political and regulatory forces that are reshaping the information industry's structure, identifies the issues that face strategic planners and policymakers, and suggests policy options and their potential consequences for the future. Each article provides a selected bibliography. 37 figures, 10 tables.

Sound therapy for tinnitus management: practicable options.

PubMed

Hoare, Derek J; Searchfield, Grant D; El Refaie, Amr; Henry, James A

2014-01-01

The authors reviewed practicable options of sound therapy for tinnitus, the evidence base for each option, and the implications of each option for the patient and for clinical practice. To provide a general guide to selecting sound therapy options in clinical practice. Practicable sound therapy options. Where available, peer-reviewed empirical studies, conference proceedings, and review studies were examined. Material relevant to the purpose was summarized in a narrative. The number of peer-reviewed publications pertaining to each sound therapy option reviewed varied significantly (from none to over 10). Overall there is currently insufficient evidence to support or refute the routine use of individual sound therapy options. It is likely, however, that sound therapy combined with education and counseling is generally helpful to patients. Clinicians need to be guided by the patient's point of care, patient motivation and expectations of sound therapy, and the acceptability of the intervention both in terms of the sound stimuli they are to use and whether they are willing to use sound extensively or intermittently. Clinicians should also clarify to patients the role sound therapy is expected to play in the management plan. American Academy of Audiology.

Authorial and institutional stratification in open access publishing: the case of global health research.

PubMed

Siler, Kyle; Haustein, Stefanie; Smith, Elise; Larivière, Vincent; Alperin, Juan Pablo

2018-01-01

Using a database of recent articles published in the field of Global Health research, we examine institutional sources of stratification in publishing access outcomes. Traditionally, the focus on inequality in scientific publishing has focused on prestige hierarchies in established print journals. This project examines stratification in contemporary publishing with a particular focus on subscription vs. various Open Access (OA) publishing options. Findings show that authors working at lower-ranked universities are more likely to publish in closed/paywalled outlets, and less likely to choose outlets that involve some sort of Article Processing Charge (APCs; gold or hybrid OA). We also analyze institutional differences and stratification in the APC costs paid in various journals. Authors affiliated with higher-ranked institutions, as well as hospitals and non-profit organizations pay relatively higher APCs for gold and hybrid OA publications. Results suggest that authors affiliated with high-ranked universities and well-funded institutions tend to have more resources to choose pay options with publishing. Our research suggests new professional hierarchies developing in contemporary publishing, where various OA publishing options are becoming increasingly prominent. Just as there is stratification in institutional representation between different types of publishing access, there is also inequality within access types.

Establishing public health security in a postwar Iraq: constitutional obstacles and lessons for other federalizing states.

PubMed

Wilson, Kumanan; Fidler, David P; McDougall, Christopher W; Lazar, Harvey

2009-06-01

The public health consequences of the conflict in Iraq will likely continue after the violence has subsided. Reestablishing public health security will require large investments in infrastructure and the creation of effective systems of governance. On the question of governance, the allocation of powers in the new constitution of Iraq is critical. Given the ease with which public health threats cross borders, the constitution needs to grant to the federal government the legal authority to manage such threats and simultaneously meet international requirements. Unfortunately, the draft constitution does not accomplish this objective. If politically possible, the constitution should be amended to provide the federal government with this authority. If not possible, the Iraqi federal government would have two options. It could attempt to use alternative constitutional powers, such as national security powers. This option would be contentious and the results uncertain. Alternatively, the federal government could attempt to establish collaborative relationships with regional governments. Residual sectarian tensions create potential problems for this option, however. Reflecting on the Iraqi situation, we conclude that other federalizing countries emerging from conflict should ensure that their constitutions provide the federal government with the necessary authority to manage threats to public health security effectively.

Mitigating amphibian chytridiomycoses in nature.

PubMed

Garner, Trenton W J; Schmidt, Benedikt R; Martel, An; Pasmans, Frank; Muths, Erin; Cunningham, Andrew A; Weldon, Che; Fisher, Matthew C; Bosch, Jaime

2016-12-05

Amphibians across the planet face the threat of population decline and extirpation caused by the disease chytridiomycosis. Despite consensus that the fungal pathogens responsible for the disease are conservation issues, strategies to mitigate their impacts in the natural world are, at best, nascent. Reducing risk associated with the movement of amphibians, non-amphibian vectors and other sources of infection remains the first line of defence and a primary objective when mitigating the threat of disease in wildlife. Amphibian-associated chytridiomycete fungi and chytridiomycosis are already widespread, though, and we therefore focus on discussing options for mitigating the threats once disease emergence has occurred in wild amphibian populations. All strategies have shortcomings that need to be overcome before implementation, including stronger efforts towards understanding and addressing ethical and legal considerations. Even if these issues can be dealt with, all currently available approaches, or those under discussion, are unlikely to yield the desired conservation outcome of disease mitigation. The decision process for establishing mitigation strategies requires integrated thinking that assesses disease mitigation options critically and embeds them within more comprehensive strategies for the conservation of amphibian populations, communities and ecosystems.This article is part of the themed issue 'Tackling emerging fungal threats to animal health, food security and ecosystem resilience'. © 2016 The Author(s).

Dornase Alfa for Non-Cystic Fibrosis Pediatric Pulmonary Atelectasis.

PubMed

Thornby, Krisy-Ann; Johnson, Ashley; Axtell, Samantha

2014-08-01

To review the literature evaluating the efficacy of dornase alfa for non-cystic fibrosis pediatric patients with pulmonary atelectasis. Articles were retrieved after a search of MEDLINE/PubMed (1946 to April 2014), and International Pharmaceutical Abstracts (1970-April 2014) was performed using the terms dornase alfa, recombinant human deoxyribonuclease, pulmonary, persistent, and atelectasis. Other relevant articles referenced from the MEDLINE search were also utilized. Data sources were limited to English language clinical trials and case studies including only children; 8 clinical trials and 12 case reports met the criteria. Dornase alfa is used as an off-label treatment option for pulmonary atelectasis because limited treatment modalities exist after conventional therapy has failed. We evaluated 8 clinical trials and 12 case reports involving this pediatric population with varying primary diagnoses. The majority of patients experienced improvement in atelectasis, suggesting benefit after receiving treatment with dornase alfa. However, the outcomes were possibly confounded by those receiving combination therapies, varying primary diagnoses, and varying end points evaluated. Dornase alfa was overall well tolerated, with only a few patients experiencing worsening atelectasis posttreatment. Dornase alfa may be considered as a therapeutic option in non-cystic fibrosis pediatric patients with pulmonary atelectasis, who require treatment intervention when conventional therapy is unsuccessful. © The Author(s) 2014.

Moral case deliberation.

PubMed

Tan, Daniel Y B; Ter Meulen, Bastiaan C; Molewijk, Albert; Widdershoven, Guy

2018-06-01

Ethical dilemmas in general are characterised by a choice between two mutually excluding options neither of which is satisfactory, because there always will be a form of moral damage. Within the context of medicine several ethics support services have been developed to support healthcare professionals in dealing with ethical dilemmas, including moral case deliberation. In this article, we describe how moral case deliberation works in daily practice, illustrated with a case example from the neurology ward. The article is meant as an introduction to moral case deliberation according to the dilemma method. We show its relevance to the clinic and the context needed to put it into practice. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Verbalizing facial memory: criterion effects in verbal overshadowing.

PubMed

Clare, Joseph; Lewandowsky, Stephan

2004-07-01

This article investigated the role of the recognition criterion in the verbal overshadowing effect (VOE). In 3 experiments, people witnessed an event, verbally described a perpetrator, and then attempted identification. The authors found in Experiment 1, which included a "not present" response option and both perpetrator-present (PP) and perpetrator-absent (PA) lineups, an increased reluctance to identify a person from both lineup types after verbalization. Experiment 2 incorporated a forced-choice procedure, and the authors found no effect of verbalization on identification performance. Experiment 3 replicated the essential aspects of these results. Consequently, the VOE may reflect a change in recognition criterion rather than a changed processing style or alteration of the underlying memory trace. This conclusion was confirmed by computational modeling of the data. Copyright 2004 APA, all rights reserved

Patient Perceptions About Prediabetes and Preferences for Diabetes Prevention.

PubMed

O'Brien, Matthew J; Moran, Margaret R; Tang, Joyce W; Vargas, Maria C; Talen, Mary; Zimmermann, Laura J; Ackermann, Ronald T; Kandula, Namratha R

2016-12-01

The purpose of this study was to explore how adults with prediabetes perceive their risk of developing diabetes and examine their preferences for evidence-based treatment options to prevent diabetes. A qualitative study was conducted in 2 large Midwest primary care practices, involving in-depth semistructured interviews with 35 adult patients with prediabetes. This ethnically diverse (77% nonwhite) sample of middle-aged primary care patients exhibited multiple diabetes risk factors. Knowledge gaps about prediabetes and its medical management were pervasive. Most patients overestimated the risk of developing diabetes and were not familiar with evidence-based treatment options for prediabetes. They suggested that receiving brief, yet specific information about these topics during the study interview motivated them to act. The majority of participants considered both intensive lifestyle intervention and metformin acceptable treatment options. Many preferred initial treatment with intensive lifestyle intervention but would take metformin if their efforts at lifestyle change failed and their primary care physician recommended it. Some participants expressed wanting to combine both treatments. This qualitative study highlights potential opportunities to promote patient-centered dialogue about prediabetes in primary care settings. Providing patients specific information about the risk of developing diabetes and evidence-based treatment options to prevent or delay its onset may encourage action. Physicians' prediabetes counseling efforts should be informed by the finding that most patients consider both intensive lifestyle intervention and metformin acceptable treatment options. © 2016 The Author(s).

Changing state structures: Outside in

PubMed Central

Krasner, Stephen D.

2011-01-01

In explaining the development of institutional structures within states, social science analysis has focused on autochthonous factors and paid less attention to the way in which external factors, especially purposive agent-directed as opposed to more general environmental factors, can influence domestic authority structures. For international relations scholarship, this lacunae is particularly troubling or perhaps, just weird. If the international system is anarchical, then political leaders can pursue any policy option. In some cases, the most attractive option would be conventional state to state interactions, diplomacy, or war. In other instances, however, changing the domestic authority structures of other states might be more appealing. In some cases, domestic authority structures have been influenced through bargaining, and in others through power. Power may reflect either explicit agent-oriented decisions or social processes that reflect the practices, values, and norms of more powerful entities. PMID:22198756

76 FR 53516 - Self-Regulatory Organizations; NYSE Amex LLC; Notice of Filing of Proposed Rule Change Amending...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-26

... the Text of NYSE Amex Options Rule 993NY(b)(1)(B) To More Accurately Reflect the Regulatory Services... exchange (with the attendant obligations and conditions) and to clarify the text of NYSE Amex Options Rule... Exchange and the Financial Industry Regulatory Authority (``FINRA''). The text of the proposed rule change...

76 FR 53515 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing of Proposed Rule Change Amending...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-26

... Clarify the Text of NYSE Arca Options Rule 6.96(b)(1)(B) To More Accurately Reflect the Regulatory... attendant obligations and conditions) and to clarify the text of NYSE Arca Options Rule 6.96(b)(1)(B) to... Financial Industry Regulatory Authority (``FINRA''). The text of the proposed rule change is available at...

78 FR 25500 - Options Price Reporting Authority; Notice of Filing and Immediate Effectiveness of Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-01

... chain. \\4\\ The term ``quote packet'' is defined in footnote 6 to OPRA's Fee Schedule as consisting of..., bid/ask and related market data. The term ``options chain'' is also defined in footnote 6 to OPRA's... essence, an OPRA Subscriber may obtain access to OPRA data in one of two ways: Either by signing a...

46 CFR Appendix E to Subpart C of... - Optional Rider for Additional NVOCC Financial Responsibility (Optional Rider to Form FMC-48...

Code of Federal Regulations, 2013 CFR

2013-10-01

... and penalties for activities in the U.S.-China trades imposed by the Ministry of Communications of the People's Republic of China (“MOC”) or its authorized competent communications department of the people's... China on International Maritime Transportation and the Implementing Rules of the Regulations of the PRC...

46 CFR Appendix E to Subpart C of... - Optional Rider for Additional NVOCC Financial Responsibility (Optional Rider to Form FMC-48...

Code of Federal Regulations, 2014 CFR

2014-10-01

... and penalties for activities in the U.S.-China trades imposed by the Ministry of Communications of the People's Republic of China (“MOC”) or its authorized competent communications department of the people's... China on International Maritime Transportation and the Implementing Rules of the Regulations of the PRC...

46 CFR Appendix F to Subpart C of... - Optional Rider for Additional NVOCC Financial Responsibility for Group Bonds [Optional Rider to...

Code of Federal Regulations, 2011 CFR

2011-10-01

... penalties for activities in the U.S.-China trades imposed by the Ministry of Communications of the People's Republic of China (“MOC”) or its authorized competent communications department of the people's government... Administration of Industry and Commerce pursuant to the Regulations of the People's Republic of China on...

46 CFR Appendix F to Subpart C of... - Optional Rider for Additional NVOCC Financial Responsibility for Group Bonds [Optional Rider to...

Code of Federal Regulations, 2010 CFR

2010-10-01

... penalties for activities in the U.S.-China trades imposed by the Ministry of Communications of the People's Republic of China (“MOC”) or its authorized competent communications department of the people's government... Administration of Industry and Commerce pursuant to the Regulations of the People's Republic of China on...

76 FR 74105 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Notice of Filing...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-30

... call options.\\10\\ Like options, the price of rights and warrants are affected by the price of the... of rights and warrants may move more dramatically than the price of the underlying stock, even when.... Given the fact that the price of rights and warrants may move more dramatically than the prices of the...

77 FR 74520 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-14

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-68393; File No. SR-Phlx-2012-134] Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness of a Proposal with Respect to the Authority of the Exchange or Nasdaq Options Services LLC (``NOS'') To Cancel Options Orders when a Technical or System Issue Occurs...

77 FR 74530 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-14

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-68395; File No. SR-NASDAQ-2012-134] Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate Effectiveness of Proposed Rule Change for the NASDAQ Options Market (``NOM'') With Respect to the Authority of the Exchange or Nasdaq Options Services LLC (``NOS'') To...

77 FR 74524 - Self-Regulatory Organizations; NASDAQ OMX BX, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-14

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-68394; File No. SR-BX-2012-073] Self-Regulatory Organizations; NASDAQ OMX BX, Inc.; Notice of Filing and Immediate Effectiveness of Proposed Rule Change With Respect to the Authority of the Exchange or Nasdaq Options Services LLC (``NOS'') To Cancel Options Orders When a Technical or System Issu...

77 FR 70496 - Self-Regulatory Organizations; C2 Options Exchange, Incorporated; Notice of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-26

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-68260; File No. SR-C2-2012-038] Self-Regulatory Organizations; C2 Options Exchange, Incorporated; Notice of Proposed Rule Change To Address Authority To Cancel Orders When a Technical or Systems Issue Occurs and To Describe the Operation of Routing Service Error Accounts November 19, 2012....

Energy supply and demand in California

NASA Technical Reports Server (NTRS)

Griffith, E. D.

1978-01-01

The author expresses his views on future energy demand on the west coast of the United States and how that energy demand translates into demand for major fuels. He identifies the major uncertainties in determining what future demands may be. The major supply options that are available to meet projected demands and the policy implications that flow from these options are discussed.

78 FR 51255 - Self-Regulatory Organizations; BATS Y-Exchange, Inc.; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-20

... Rule Change To Eliminate Rule Related to CYCLE Routing August 14, 2013. Pursuant to Section 19(b)(1) of... the CYCLE Routing option, effective as of September 3, 2013. The text of the proposed rule change is... proposing to eliminate Rule 11.13(a)(3)(A), which is the provision that authorizes the CYCLE Routing option...

78 FR 28911 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Order Approving...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-16

... core business hours (e.g., New York Stock Exchange Rule 51(a) and BATS Exchange Rule 1.5(w) mentions... Book Official to suspend trading in an option if the underlying security is halted or suspended in the primary market. The Exchange proposes to expand the authority of the Post Director or Order Book Official...

Patients' views on the use of an Option Grid for knee osteoarthritis in physiotherapy clinical encounters: An interview study.

PubMed

Kinsey, Katharine; Firth, Jill; Elwyn, Glyn; Edwards, Adrian; Brain, Katherine; Marrin, Katy; Nye, Alan; Wood, Fiona

2017-12-01

Patient decision support tools have been developed as a means of providing accurate and accessible information in order for patients to make informed decisions about their care. Option Grids ™ are a type of decision support tool specifically designed to be used during clinical encounters. To explore patients' views of the Option Grid encounter tool used in clinical consultations with physiotherapists, in comparison with usual care, within a patient population who are likely to be disadvantaged by age and low health literacy. Semi-structured interviews with 72 patients (36 who had been given an Option Grid in their consultation and 36 who had not). Thematic analysis explored patients' understanding of treatment options, perceptions of involvement, and readability and utility of the Option Grid. Interviews suggested that the Option Grid facilitated more detailed discussion about the risks and benefits of a wider range of treatment options for osteoarthritis of the knee. Participants indicated that the Option Grid was clear and aided their understanding of a structured progression of the options as their condition advanced, although it was not clear whether the Option Grid facilitated greater engagement in shared decision making. The Option Grid for osteoarthritis of the knee was well received by patient participants who reported that it helped them to understand their options, and made the notion of choice explicit. Use of Option Grids should be considered within routine consultations. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Job Hunting in Tougher Times.

ERIC Educational Resources Information Center

Ross, Steven S.

1985-01-01

Several resources to consider are offered to ease the squeeze created by the computer market downturn. Areas addressed include: job-shop option; other-industries option; overseas option; graduate school option; entrepreneurial option; military option; job fairs; and weighing locations. Notes that colleges are looking for engineering teachers,…

Tachycardia detection in ICDs by Boston Scientific : Algorithms, pearls, and pitfalls.

PubMed

Zanker, Norbert; Schuster, Diane; Gilkerson, James; Stein, Kenneth

2016-09-01

The aim of this study was to summarize how implantable cardioverter defibrillators (ICDs) by Boston Scientific sense, detect, discriminate rhythms, and classify episodes. Modern devices include multiple programming selections, diagnostic features, therapy options, memory functions, and device-related history features. Device operation includes logical steps from sensing, detection, discrimination, therapy delivery to history recording. The program is designed to facilitate the application of the device algorithms to the individual patient's clinical needs. Features and functions described in this article represent a selective excerpt by the authors from Boston Scientific publicly available product resources. Programming of ICDs may affect patient outcomes. Patient-adapted and optimized programming requires understanding of device operation and concepts.

[Management of acute and subacute clinical situations by interventional radiology: non-vascular interventions and treatment for hemoptysis].

PubMed

Nemes, Balázs; Doros, Attila

2015-04-26

Interventional radiology provides fast, straightforward and tolerable solutions for many medical problems including acute and subacute situations. Aspiration and drainage of fluid collections, biliary and endourologic interventions and gastrointestinal interventions are parts of non-vascular interventions. In addition, the authors discuss in detail interventional radiological treatment options in patients with hemoptysis. In acute cases interventions must be performed within 12-24 hours. For background, an everyday 24 hours service should be provided with well-trained personnel, high quality equipment and devices, and a reasonable financial reimbursement should be included, too. Multidisciplinary teamwork, consultations, consensus in indications and structured education should make these centers function most effectively.

32 CFR 644.166 - Authority and applicability.

Code of Federal Regulations, 2011 CFR

2011-07-01

....166 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE HANDBOOK Acquisition Procurement of Options Prior to Real Estate Directives (military... parcel of real property before or after its acquisition is authorized by law, if he considers it suitable...

Municipal solid waste management health risk assessment from air emissions for China by applying life cycle analysis.

PubMed

Li, Hua; Nitivattananon, Vilas; Li, Peng

2015-05-01

This study is to quantify and objectively evaluate the extent of environmental health risks from three waste treatment options suggested by the national municipal solid waste management enhancing strategy (No [2011] 9 of the State Council, promulgated on 19 April 2011), which includes sanitary landfill, waste-to-energy incineration and compost, together with the material recovery facility through a case study in Zhangqiu City of China. It addresses potential chronic health risks from air emissions to residential receptors in the impacted area. It combines field survey, analogue survey, design documents and life cycle inventory methods in defining the source strength of chemicals of potential concern. The modelling of life cycle inventory and air dispersion is via integrated waste management(IWM)-2 and Screening Air Dispersion Model (Version 3.0) (SCREEN3). The health risk assessment is in accordance with United States Environmental Protection Agency guidance Risk Assessment Guidance for Superfund (RAGS), Volume I: Human Health Evaluation Manual (Part F, Supplemental Guidance for Inhalation Risk Assessment). The exposure concentration is based on long-term exposure to the maximum ground level contaminant in air under the 'reasonable worst situation' emissions and then directly compared with reference for concentration and unit risk factor/cancer slope factor derived from the national air quality standard (for a conventional pollutant) and toxicological studies (for a specific pollutant). Results from this study suggest that the option of compost with material recovery facility treatment may pose less negative health impacts than other options; the sensitivity analysis shows that the landfill integrated waste management collection rate has a great influence on the impact results. Further investigation is needed to validate or challenge the findings of this study. © The Author(s) 2015.

Impulse Control Disorders and Related Complications of Parkinson’s Disease Therapy

PubMed Central

Lopez, Alexander M.; Weintraub, Daniel; Claassen, Daniel O.

2017-01-01

Impulsive and compulsive behaviors in Parkinson’s disease (PD) patients are most often attributed to dopamine agonist therapy; dysregulation of the mesocorticolimbic system accounts for this behavioral phenotype. The clinical presentation is commonly termed impulse control disorder (ICD): Behaviors include hypersexuality, compulsive eating, shopping, pathological gambling, and compulsive hobby participation. However, not all PD individuals taking dopamine agonists develop these behavioral changes. In this review, the authors focus on the similarities between the phenotypic presentation of ICDs with that of other reward-based behavioral disorders, including binge eating disorder, pathological gambling, and substance use disorders. With this comparison, we emphasize that the transition from an impulsive to compulsive behavior likely follows a ventral to dorsal striatal pattern, where an altered dopaminergic reward system underlies the emergence of these problematic behaviors. The authors discuss the neurobiological similarities between these latter disorders and ICDs, emphasizing similar pathophysiological processes and discussing treatment options that have potential for translation to PD patients. PMID:28511259

Naloxegol: A Novel Therapy in the Management of Opioid-Induced Constipation.

PubMed

Jones, Rachel; Prommer, Eric; Backstedt, David

2016-11-01

Opioid-related bowel dysfunction is a common and potentially severe adverse effect from treatment with opioid analgesics. Its development is not dose related, nor do patients develop tolerance. Opioid-induced constipation (OIC) can lead to fecal impaction, bowel obstruction, and bowel perforation as well as noncompliance with opioid analgesics and poor quality of life. Routine administration of laxatives is necessary to maintain bowel function, and, in refractory cases, other modalities must be pursued. Available options are limited but include peripherally acting μ-opioid receptor antagonists (PAMORAs), including methylnaltrexone. Naloxegol is a newly developed PAMORA that is available through the oral route. At the therapeutic dose of 25 mg daily, naloxegol is effective and safe, with a limited side effect profile and is associated with preservation of centrally mediated analgesia. In this article, we discuss the pharmacokinetics, pharmacodynamics, adverse effects, clinical trials, and cost considerations of naloxegol. Finally, we discuss its potential role as a novel key treatment for OIC in palliative medicine patients. © The Author(s) 2015.

76 FR 38237 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-29

... Change To Include Text in Its Options Rules Governing the Use of Its Affiliate Broker-Dealer, Archipelago Securities LLC for Outbound Routing of Option Orders, and To Adopt Text in Its Options Rules To Permit the... include text in its options rules governing the use of its affiliate broker-dealer, Archipelago Securities...

Where on earth to publish? A sample survey comparing traditional and open access publishing in the oncological field.

PubMed

Poltronieri, Elisabetta; Bravo, Elena; Camerini, Tiziana; Ferri, Maurizio; Rizzo, Roberto; Solimini, Renata; Cognetti, Gaetana

2013-01-22

The paper intends to help scientific authors to make the best choice of journals in which to publish, by describing and comparing journal features in the area of oncology. For this purpose, the authors identified impact factor (IF) ranking, cost options and copyright conditions offered to authors wishing to publish in full open access (OA), subscription-based or hybrid journals. Data referring to articles published in 2010 by three Italian research institutions (National Institute of Health - Rome (ISS), Regina Elena National Cancer Institute - Rome (IRE), National Cancer Institute - Milan (INT) in journals (78) managed according to different business models, all listed in the Journal Citation Reports, subject category Oncology, were collected and analysed. The journals surveyed were ranked according to IF, position in quartiles, publication charges, usage rights in published articles, self-archiving conditions in OAI-compliant repositories digital archives. Almost half (34) the journals surveyed were included in the first quartile, thus revealing authors' preference for journals with a high IF. The prevalent journal business model was the hybrid formula (based on subscriptions but also offering a paid OA option) with 51 journals, followed by subscription-based only journals accounting for 22, while just 5 full OA journals were identified. In general, no relationship was found between IF and article publication charges, in terms of correspondence between more expensive fees and higher IF. The issue of OA journals as compared with traditional subscription-based journals is highly debated among stakeholders: library administrators facing financial restrictions, authors seeking to locate the best outlet for their research, publishers wishing to increase their revenues by offering journals with wider appeal. Against this background, factors such as the quest for alternatives to high-cost business models, investments in setting up institutional repositories hosting the published versions of articles and efforts to overcome copyright barriers and gain free access to scientific literature are all crucial.

Development of Internet algorithms and some calculations of power plant COP

NASA Astrophysics Data System (ADS)

Ustjuzhanin, E. E.; Ochkov, V. F.; Znamensky, V. E.

2017-11-01

The authors have analyzed Internet resources containing information on some thermodynamic properties of technically important substances (the water, the air etc.). There are considered databases those possess such resources and are hosted in organizations (Joint Institute for High Temperatures (Russian Academy of Sciences), Standartinform (Russia), National Institute of Standards and Technology (USA), Institute for Thermal Physics (Siberian Branch of the Russian Academy of Sciences), etc.). Currently, a typical form is an Internet resource that includes a text file, for example, it is a file containing tabulated properties, R = (ρ, s, h…), here ρ - the density, s - the entropy, h - the enthalpy of a substance. It is known a small number of Internet resources those have the following characteristic. The resource allows a customer to realize a number of options, for example: i) to enter the input data, Y = (p, T), here p - the pressure, T - the temperature, ii) to calculate R property using “an exe-file” program, iii) to copy the result X = (p, T, ρ, h, s, …). Recently, some researchers (including the authors of this report) have requested a software (SW) that is designed for R property calculations and has a form of an open interactive (OI) Internet resource (“a client function”, “template”). A computing part of OI resource is linked: 1) with a formula, which is applied to calculate R property, 2) with a Mathcad program, Code_1(R,Y). An interactive part of OI resource is based on Informatics and Internet technologies. We have proposed some methods and tools those are related to this part and let us: a) to post OI resource on a remote server, b) to link a client PC with the remote server, c) to implement a number of options to clients. Among these options, there are: i) to calculate R property at given Y arguments, ii) to copy mathematical formulas, iii) to copy Code_1(R,Y) as a whole. We have developed some OI - resources those are focused on sharing: a) SW that is used to design power plants, for an example, Code - GTP_1(Z,R,Y) and b) client functions those are aimed to determine R properties of the working fluid at fixed points of the thermodynamic cycle. The program let us calculate energy criteria, Z, including the internal coefficient of performance (COP) for a power plant. We have discussed OI resources, among them OI resource that includes Code - GTP_1(Z,R,Y) and connected with a complex power plant included: i) several gas turbines, i) several compressors etc.

Effects of Contextual Information on Seeing Pareidolic Religious Inscriptions on an Artifact: Implications for the Shroud of Turin.

PubMed

Sheen, Mercedes; Jordan, Timothy R

2015-12-01

Several reports suggest that images of the Shroud of Turin contain faint religious inscriptions that support the view that the Shroud has special religious significance. Against this background, we investigated effects of contextual information on detecting religious inscriptions using an image of plain modern linen with no religious provenance and containing no writing. The image was viewed in three contexts: In the Neutral Context, participants were told that the image was of a simple piece of linen; in the Religious Context, participants were told that the image was of an important religious artifact; and in the Religious Context + Options condition, participants were also given plausible word options. Very few words were detected in the Neutral Context, significantly more in the Religious Context, and most in the Religious Context+Options condition. Some implications of these findings for reports of inscriptions in the context-laden conditions surrounding the Shroud of Turin are discussed. © The Author(s) 2015.

Deliberative Mapping of options for tackling climate change: Citizens and specialists 'open up' appraisal of geoengineering.

PubMed

Bellamy, Rob; Chilvers, Jason; Vaughan, Naomi E

2016-04-01

Appraisals of deliberate, large-scale interventions in the earth's climate system, known collectively as 'geoengineering', have largely taken the form of narrowly framed and exclusive expert analyses that prematurely 'close down' upon particular proposals. Here, we present the findings from the first 'upstream' appraisal of geoengineering to deliberately 'open up' to a broader diversity of framings, knowledges and future pathways. We report on the citizen strand of an innovative analytic-deliberative participatory appraisal process called Deliberative Mapping. A select but diverse group of sociodemographically representative citizens from Norfolk (United Kingdom) were engaged in a deliberative multi-criteria appraisal of geoengineering proposals relative to other options for tackling climate change, in parallel to symmetrical appraisals by diverse experts and stakeholders. Despite seeking to map divergent perspectives, a remarkably consistent view of option performance emerged across both the citizens' and the specialists' deliberations, where geoengineering proposals were outperformed by mitigation alternatives. © The Author(s) 2014.

The Application of the Real Options Method for the Evaluation of High-Rise Construction Projects

NASA Astrophysics Data System (ADS)

Izotov, Aleksandr; Rostova, Olga; Dubgorn, Alissa

2018-03-01

The paper is devoted to the problem of evaluation of high-rise construction projects in a rapidly changing environment. The authors proposed an algorithm for constructing and embedding real options in high-rise construction projects, which makes it possible to increase the flexibility of managing multi-stage projects that have the ability to adapt to changing conditions of implementation.

46 CFR Appendix E to Subpart C of... - Optional Rider for Additional NVOCC Financial Responsibility (Optional Rider to Form FMC-48...

Code of Federal Regulations, 2010 CFR

2010-10-01

... available to pay any fines and penalties for activities in the U.S.-China trades imposed by the Ministry of Communications of the People's Republic of China (“MOC”) or its authorized competent communications department of... Republic of China on International Maritime Transportation and the Implementing Rules of the Regulations of...

46 CFR Appendix E to Subpart C of... - Optional Rider for Additional NVOCC Financial Responsibility (Optional Rider to Form FMC-48...

Code of Federal Regulations, 2011 CFR

2011-10-01

... available to pay any fines and penalties for activities in the U.S.-China trades imposed by the Ministry of Communications of the People's Republic of China (“MOC”) or its authorized competent communications department of... Republic of China on International Maritime Transportation and the Implementing Rules of the Regulations of...

People, Things, and Places for Young Children. Selecting Toys for Handicapped Children [and] Playgrounds for Exceptional Children: Considering the Options.

ERIC Educational Resources Information Center

Kemnitzer, Ronald B.; Williams, Ronald R.

The two papers focus on methods of selecting toys for handicapped children and options in playground equipment for this population. The qualities of a good toy, such as stimulation and safety, are examined. The author discusses various considerations in selecting toys for different handicaps; for example, toys for visually impaired children should…

Surgical Treatment as a First Option of the Lower Eyelid Xanthelasma.

PubMed

Obradovic, Bojan

2017-10-01

Xanthelasma palpebrarum represents yellowish plaques, which mostly appear near the inner cantus of the eyelid. In most patients, cosmetic reasons are the main purpose for their removal.The author presents a patient with a lower eyelid xanthelasma where surgical excision was used as a first treatment option. Cosmetic reasons, fast recovery, and possibility of a 1-stage procedure were the main requests of the patient for the removal of xanthelasma. Treatment and postrecovery period were routine.In the treatment of xanthelasma palpebrarum of the lower eyelids, it is necessary to consider surgical excision as a first treatment option.

Compete, coordinate, and cooperate: How to exploit uncertain environments with social interaction.

PubMed

Schulze, Christin; Newell, Ben R

2015-10-01

Countless decisions, from the trivial to the crucial, are made in complex social contexts while facing uncertain consequences. Yet a large portion of decision making research focuses on either the effects of social interaction or the effects of environmental uncertainty by examining strategic games against others or individual games against nature. Drawing a connection between these approaches, the authors extend a standard individual choice paradigm to include social interaction with 1 other person. In this paradigm, 2 competing decision makers repeatedly select among 2 options, each offering a particular probability of a fixed payoff. When both players choose the same, correct option, the payoff is evenly split; when they choose different options, the player choosing the correct option receives the full payoff. The addition of this social dimension gives players an opportunity to fully exploit an uncertain environment via cooperation: By consistently choosing opposite options, two players can exploit the uncertain environment more effectively than a single player could. We present 2 experiments that manipulate environmental (Experiment 1) and social (Experiment 2) aspects of the paradigm. In Experiment 1, the outcome probabilities were either known or unknown to participants; in Experiment 2, participants' attention was drawn to individual or group gains by introducing either within- or between-group competition. Efficient cooperation did not emerge spontaneously in Experiment 1. Instead, most people probability maximized, mirroring the behavior observed in individual choice. By contrast, between--group competition in Experiment 2 facilitated efficient-but not always equitable--exploitation of uncertain environments. This work links the concepts of individual risky choice and strategic decision making under both environmental and social uncertainty. (c) 2015 APA, all rights reserved).

Comparative efficacy and safety of treatment options for MDR and XDR Acinetobacter baumannii infections: a systematic review and network meta-analysis.

PubMed

Kengkla, Kirati; Kongpakwattana, Khachen; Saokaew, Surasak; Apisarnthanarak, Anucha; Chaiyakunapruk, Nathorn

2018-01-01

To comprehensively compare and rank the efficacy and safety of available treatment options for patients with MDR and XDR Acinetobacter baumannii (AB) infection. We searched PubMed, Embase and the Cochrane register of trials systematically for studies that examined treatment options for patients with MDR- and XDR-AB infections until April 2016. Network meta-analysis (NMA) was performed to estimate the risk ratio (RR) and 95% CI from both direct and indirect evidence. Primary outcomes were clinical cure and microbiological cure. Secondary outcomes were all-cause mortality and nephrotoxic and non-nephrotoxic adverse events. A total of 29 studies with 2529 patients (median age 60 years; 65% male; median APACHE II score 19.0) were included. Although there were no statistically significant differences between treatment options, triple therapy with colistin, sulbactam and tigecycline had the highest clinical cure rate. Colistin in combination with sulbactam was associated with a significantly higher microbiological cure rate compared with colistin in combination with tigecycline (RR 1.23; 95% CI 1.03-1.47) and colistin monotherapy (RR 1.21; 95% CI 1.06-1.38). No significant differences in all-cause mortality were noted between treatment options. Tigecycline-based therapy also appeared less effective for achieving a microbiological cure and is not appropriate for treating bloodstream MDR- and XDR-AB infections. Combination therapy of colistin with sulbactam demonstrates superiority in terms of microbiological cure with a safety profile similar to that of colistin monotherapy. Thus, our findings support the use of this combination as a treatment for MDR- and XDR-AB infections. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

Myers, C.W.; Giraud, K.M.

Newcomer countries expected to develop new nuclear power programs by 2030 are being encouraged by the International Atomic Energy Agency to explore the use of shared facilities for spent fuel storage and geologic disposal. Multinational underground nuclear parks (M-UNPs) are an option for sharing such facilities. Newcomer countries with suitable bedrock conditions could volunteer to host M-UNPs. M-UNPs would include back-end fuel cycle facilities, in open or closed fuel cycle configurations, with sufficient capacity to enable M-UNP host countries to provide for-fee waste management services to partner countries, and to manage waste from the M-UNP power reactors. M-UNP potential advantagesmore » include: the option for decades of spent fuel storage; fuel-cycle policy flexibility; increased proliferation resistance; high margin of physical security against attack; and high margin of containment capability in the event of beyond-design-basis accidents, thereby reducing the risk of Fukushima-like radiological contamination of surface lands. A hypothetical M-UNP in crystalline rock with facilities for small modular reactors, spent fuel storage, reprocessing, and geologic disposal is described using a room-and-pillar reference-design cavern. Underground construction cost is judged tractable through use of modern excavation technology and careful site selection. (authors)« less

Human papillomavirus-related oropharyngeal cancer.

PubMed

Taberna, M; Mena, M; Pavón, M A; Alemany, L; Gillison, M L; Mesía, R

2017-10-01

High-risk human papillomavirus (HPV) is now recognised as the principal cause of the increasing incidence rates of oropharyngeal squamous cell carcinoma (OPSCC) in some parts of the world. The primary risk factor for developing HPV-related OPSCC is oral HPV-infection and the majority of oral HPV-infections are acquired by oral sex. Progression into an OPSCC includes persistent infection with evasion of immune response in the microenvironment, the activation of viral early genes (E6, E7) in basal epithelial cells, the deregulation of cell cycle and the accumulation of chromosomal instability. Patients affected by HPV-related OPSCC tend to be younger and have better outcomes. This observation has lead current research to evaluate treatment de-escalation options to reduce long-term associated morbidity. Moreover, a different molecular profile for HPV-related OPSCC has been described, opening new options for targeted therapy and immunotherapy approaches. This paper comprehensively reviews our accumulated knowledge regarding the role of HPV in OPSCC spanning from infection to cancer development, including its clinical diagnosis, management and preventive strategies. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Failure Is Not an Option: A Root Cause Analysis of Failed Acquisition Programs

DTIC Science & Technology

2017-12-01

Kendall (2012, 2015). ..................................................................................4 Table 3. Description and Decision Authority...Assessment and Program Evaluation DAE Defense Acquisition Executive DAMIR Defense Acquisition Management Information Retrieval DARPA Defense Advanced...and evaluation OTA other transactions authority PARCA performance assessments and root cause analyses PBD program budget decisions PDR preliminary

Academic Advocacy for Gifted Children: A Parent's Complete Guide

ERIC Educational Resources Information Center

Gilman, Barbara J.

2008-01-01

Formerly titled "Empowering Gifted Minds: Educational Advocacy That Works", the author believes this book is the definitive manual on gifted advocacy for gifted students. The author tells parents and teachers how to document a child's abilities to provide reasonable educational options year by year. This book provides imperative information on…

Slavic and Italian Canadian Attitudes towards Authority.

ERIC Educational Resources Information Center

Ryan, Michael G.

Predicting that Italian Canadians would hold attitudes of greater hostility and anxiety toward authority than Slavic Canadians, this study, using 58 part-time summer students (29 Italians and 29 Slavs) at three universities in Canada, analyzed the subjects' responses to the five-response option Likert type scale. Results confirmed the early…

Problem Patrons: Reviewing Your Options.

ERIC Educational Resources Information Center

Shuman, Bruce A.

2002-01-01

Considers possible options for public librarians dealing with problem patrons. Highlights include considering the safety of the patrons and staff; general considerations of library security, including security guards, legal responsibility for patrons and staff safety; and working through possible options ahead of time to be more prepared. (LRW)

Authorial and institutional stratification in open access publishing: the case of global health research

PubMed Central

Haustein, Stefanie; Smith, Elise; Larivière, Vincent; Alperin, Juan Pablo

2018-01-01

Using a database of recent articles published in the field of Global Health research, we examine institutional sources of stratification in publishing access outcomes. Traditionally, the focus on inequality in scientific publishing has focused on prestige hierarchies in established print journals. This project examines stratification in contemporary publishing with a particular focus on subscription vs. various Open Access (OA) publishing options. Findings show that authors working at lower-ranked universities are more likely to publish in closed/paywalled outlets, and less likely to choose outlets that involve some sort of Article Processing Charge (APCs; gold or hybrid OA). We also analyze institutional differences and stratification in the APC costs paid in various journals. Authors affiliated with higher-ranked institutions, as well as hospitals and non-profit organizations pay relatively higher APCs for gold and hybrid OA publications. Results suggest that authors affiliated with high-ranked universities and well-funded institutions tend to have more resources to choose pay options with publishing. Our research suggests new professional hierarchies developing in contemporary publishing, where various OA publishing options are becoming increasingly prominent. Just as there is stratification in institutional representation between different types of publishing access, there is also inequality within access types. PMID:29479492

The price of being seen to be just: an intention signalling strategy for indirect reciprocity.

PubMed

Tanaka, Hiroki; Ohtsuki, Hisashi; Ohtsubo, Yohsuke

2016-07-27

Cooperation among strangers is a marked characteristic of human sociality. One prominent evolutionary explanation for this form of human cooperation is indirect reciprocity, whereby each individual selectively helps people with a 'good' reputation, but not those with a 'bad' reputation. Some evolutionary analyses have underscored the importance of second-order reputation information (the reputation of a current partner's previous partner) for indirect reciprocity as it allows players to discriminate justified 'good' defectors, who selectively deny giving help to 'bad' partners, from unjustified 'bad' defectors. Nevertheless, it is not clear whether people in fact make use of second-order information in indirect reciprocity settings. As an alternative, we propose the intention signalling strategy, whereby defectors are given the option to abandon a resource as a means of expunging their 'bad' reputation. Our model deviates from traditional modelling approaches in the indirect reciprocity literature in a crucial way-we show that first-order information is sufficient to maintain cooperation if players are given an option to signal their intention. Importantly, our model is robust against invasion by both unconditionally cooperative and uncooperative strategies, a first step towards demonstrating its viability as an evolutionarily stable strategy. Furthermore, in two behavioural experiments, when participants were given the option to abandon a resource so as to mend a tarnished reputation, participants not only spontaneously began to use this option, they also interpreted others' use of this option as a signal of cooperative intent. © 2016 The Author(s).

Boon or bane: 401(k) loans and employee contributions.

PubMed

Wenger, Jeffrey B; Weller, Christian E

2014-09-01

Economic and behavioral theories arrive at different conclusions about the effect of being allowed to borrow from one's defined-contribution (DC) retirement plan on people's contributions to DC plans. Traditional life-cycle models unambiguously suggest that the borrowing option makes people better off than not being able to borrow. Households consequently contribute more to their DC plans than they would absent the borrowing option. Previous research finds that the ability to borrow from a DC plan increases contemporaneous contributions, consistent with traditional models. Behavioral finance, in contrast, suggests that some workers may operate with nonlinear time discounting. They plan on saving more in the future but change their mind and save less than initially planned as time passes. These workers may enjoy higher lifetime utility if they have no loan option because DC plans serve as commitment devices for retirement saving. The money cannot be used prior to retirement. Absent this commitment device, contributions may be lower for some households than would be the case without a DC loan option. We study DC plan contributions for households with heterogeneous preferences about discounting. We separate households into those that demonstrate inconsistent (or paradoxical) borrowing behavior, which may reflect nonlinear time discounting, and those with more consistent borrowing behavior. We find that a DC loan option raises current savings, but does so more for households with consistent borrowing behavior than for those with inconsistent borrowing behavior. © The Author(s) 2013.

Targeting the taqueria: implementing healthy food options at Mexican American restaurants.

PubMed

Hanni, Krista D; Garcia, Elan; Ellemberg, Cheryl; Winkleby, Marilyn

2009-04-01

As part of a 5-year community-based intervention in Salinas, California, the Steps to a Healthier Salinas team developed a taqueria intervention addressing obesity and diabetes among Mexican Americans. The authors present: (a) a comparison of service/entrée options for Salinas taquerias (n = 35) and fast-food restaurants ( n = 38) at baseline, (b) a case study of one taqueria, (c) a description of a healthy nutrition tool kit tailored to taquerias, and (d) an evaluation of the intervention at Year 3. It was found that traditional Mexican American-style menu offerings at taquerias tended to be healthier than American-style fast-food restaurant offerings. In addition, the initial response to the intervention has shown positive changes, which include the taqueria owners promoting available healthy menu items and modifying other menu offerings to reduce fats and increase fruit and vegetable availability. This, in turn, has led to a transition of the owners' perceptions of themselves as gatekeepers for a healthy community.

Current and future medical treatments for patients with acromegaly.

PubMed

Maffezzoni, Filippo; Formenti, Anna Maria; Mazziotti, Gherardo; Frara, Stefano; Giustina, Andrea

2016-08-01

Acromegaly is a relatively rare condition of growth hormone (GH) excess associated with significant morbidity and, when left untreated, high mortality. Therapy for acromegaly is targeted at decreasing GH and insulin-like growth hormone 1 levels, ameliorating patients' symptoms and decreasing any local compressive effects of the pituitary adenoma. The therapeutic options for acromegaly include surgery, medical therapies (such as dopamine agonists, somatostatin receptor ligands and the GH receptor antagonist pegvisomant) and radiotherapy. However, despite all these treatments option, approximately 50% of patients are not adequately controlled. In this paper, the authors discuss: 1) efficacy and safety of current medical therapy 2) the efficacy and safety of the new multireceptor-targeted somatostatin ligand pasireotide 3) medical treatments currently under clinical investigation (oral octreotide, ITF2984, ATL1103), and 4) preliminary data on the use of new injectable and transdermal/transmucosal formulations of octreotide. This expert opinion supports the need for new therapeutic agents and modalities for patients with acromegaly.

A focus group study investigating medical decision making in octogenarians of high socioeconomic status with successful outcomes following cardiac surgery.

PubMed

Oldroyd, John C; Levinson, Michele R; Stephenson, Gemma; Rouse, Alice; Leeuwrik, Tina

2014-09-01

To explore medical decision making in octogenarians having cardiac surgery. Five focus groups conducted in a private hospital setting with octogenarians of high socioeconomic status who had successful cardiac surgery in the previous 3-13 months. Octogenarian's motivations for having cardiac surgery include survival, relief of symptoms, convenience and improving quality of life. The decision to have surgery involved clinical advice by doctors that the time had come to take up a surgical option. Patient's decisions did not take into account alternative treatment options either because these had not been presented by doctors or because medical management had failed. The final decision was made by patients. Decisions to have cardiac surgery in octogenarians are made by patients after discussions with family based on their risks as communicated by their doctors. This underlines the importance of effective risk communication by doctors to help patients make appropriate medical decisions. © 2013 The Authors. Australasian Journal on Ageing © 2013 ACOTA.

Increasing Transparency Through a Multiverse Analysis.

PubMed

Steegen, Sara; Tuerlinckx, Francis; Gelman, Andrew; Vanpaemel, Wolf

2016-09-01

Empirical research inevitably includes constructing a data set by processing raw data into a form ready for statistical analysis. Data processing often involves choices among several reasonable options for excluding, transforming, and coding data. We suggest that instead of performing only one analysis, researchers could perform a multiverse analysis, which involves performing all analyses across the whole set of alternatively processed data sets corresponding to a large set of reasonable scenarios. Using an example focusing on the effect of fertility on religiosity and political attitudes, we show that analyzing a single data set can be misleading and propose a multiverse analysis as an alternative practice. A multiverse analysis offers an idea of how much the conclusions change because of arbitrary choices in data construction and gives pointers as to which choices are most consequential in the fragility of the result. © The Author(s) 2016.

Use of altered informed consent in pragmatic clinical research.

PubMed

McKinney, Ross E; Beskow, Laura M; Ford, Daniel E; Lantos, John D; McCall, Jonathan; Patrick-Lake, Bray; Pletcher, Mark J; Rath, Brian; Schmidt, Hollie; Weinfurt, Kevin

2015-10-01

There are situations in which the requirement to obtain conventional written informed consent can impose significant or even insurmountable barriers to conducting pragmatic clinical research, including some comparative effectiveness studies and cluster-randomized trials. Although certain federal regulations governing research in the United States (45 CFR 46) define circumstances in which any of the required elements may be waived, the same standards apply regardless of whether any single element is to be waived or whether consent is to be waived in its entirety. Using the same threshold for a partial or complete waiver limits the options available to institutional review boards as they seek to optimize a consent process. In this article, we argue that new standards are necessary in order to enable important pragmatic clinical research while at the same time protecting patients' rights and interests. © The Author(s) 2015.

Accommodations quality for students who are d/Deaf or hard of hearing.

PubMed

Cawthon, Stephanie W; Leppo, Rachel

2013-01-01

Students who are d/Deaf or hard of hearing often receive accommodations that are intended to increase access to the educational environment. The authors provide the results of a large national study of accommodations use in secondary and postsecondary settings. The article focuses on three aspects of accommodations use: access, quality, and consistency. The participants were 1,350 professionals working with a diverse group of students who were d/Deaf or hard of hearing in a variety of roles, including educators, administrators, interpreters, vocational rehabilitation agency staff, and allied service providers. Data were collected from both a national survey and a series of focus groups conducted over a 1-year period. The authors discuss the results in light of the crucial nature of accommodations during the transition into a variety of educational, training, and employment options.

Framing Options as Choice or Opportunity: Does the Frame Influence Decisions?

PubMed

Abhyankar, Purva; Summers, Barbara A; Velikova, Galina; Bekker, Hilary L

2014-07-01

Health professionals must enable patients to make informed decisions about health care choices through unbiased presentation of all options. This study examined whether presenting the decision as "opportunity" rather than "choice" biased individuals' preferences in the context of trial participation for cancer treatment. Self-selecting healthy women (N = 124) were randomly assigned to the following decision frames: opportunity to take part in the trial (opt-in), opportunity to be removed from the trial (opt-out), and choice to have standard treatment or take part in the trial (choice). The computer-based task required women to make a hypothetical choice about a real-world cancer treatment trial. The software presented the framed scenario, recorded initial preference, presented comprehensive and balanced information, traced participants' use of information during decision making, and recorded final decision. A posttask paper questionnaire assessed perceived risk, attitudes, subjective norm, perceived behavioral control, and satisfaction with decision. Framing influenced women's immediate preferences. Opportunity frames, whether opt-in or opt-out, introduced a bias as they discouraged women from choosing standard treatment. Using the choice frame avoided this bias. The opt-out opportunity frame also affected women's perceived social norm; women felt that others endorsed the trial option. The framing bias was not present once participants had had the opportunity to view detailed information on the options within a patient decision aid format. There were no group differences in information acquisition and final decisions. Sixteen percent changed their initial preference after receiving full information. A "choice" frame, where all treatment options are explicit, is less likely to bias preferences. Presentation of full information in parallel, option-by-attribute format is likely to "de-bias" the decision frame. Tailoring of information to initial preferences would be ill-advised as preferences may change following detailed information. © The Author(s) 2014.

Use of evidence to support healthy public policy: a policy effectiveness–feasibility loop

PubMed Central

Bowman, Sarah; Critchley, Julia; Capewell, Simon; Husseini, Abdullatif; Maziak, Wasim; Zaman, Shahaduz; Ben Romdhane, Habiba; Fouad, Fouad; Phillimore, Peter; Unal, Belgin; Khatib, Rana; Shoaibi, Azza; Ahmad, Balsam

2012-01-01

Abstract Public policy plays a key role in improving population health and in the control of diseases, including non-communicable diseases. However, an evidence-based approach to formulating healthy public policy has been difficult to implement, partly on account of barriers that hinder integrated work between researchers and policy-makers. This paper describes a “policy effectiveness–feasibility loop” (PEFL) that brings together epidemiological modelling, local situation analysis and option appraisal to foster collaboration between researchers and policy-makers. Epidemiological modelling explores the determinants of trends in disease and the potential health benefits of modifying them. Situation analysis investigates the current conceptualization of policy, the level of policy awareness and commitment among key stakeholders, and what actually happens in practice, thereby helping to identify policy gaps. Option appraisal integrates epidemiological modelling and situation analysis to investigate the feasibility, costs and likely health benefits of various policy options. The authors illustrate how PEFL was used in a project to inform public policy for the prevention of cardiovascular diseases and diabetes in four parts of the eastern Mediterranean. They conclude that PEFL may offer a useful framework for researchers and policy-makers to successfully work together to generate evidence-based policy, and they encourage further evaluation of this approach. PMID:23226897

The combined endonasal and transoral approach for the management of skull base and nasopharyngeal pathology: a case series.

PubMed

Sreenath, Satyan B; Rawal, Rounak B; Zanation, Adam M

2014-01-01

The posterior skull base and the nasopharynx have historically represented technically difficult regions to approach surgically given their central anatomical locations. Through continued improvements in endoscopic instrumentation and technology, the expanded endonasal approach (EEA) has introduced a new array of surgical options in the management of pathology involving these anatomically complex areas. Similarly, the transoral robotic surgical (TORS) approach was introduced as a minimally invasive surgical option to approach tongue base, nasopharyngeal, parapharyngeal, and laryngeal lesions. Although both the EEA and the TORS approach have been extensively described as viable surgical options in managing nasopharyngeal and centrally located head and neck pathology, both endonasal and transoral techniques have inherent limitations. Given these limitations, several institutions have published feasibility studies with the combined EEA and TORS approaches for a variety of skull base and nasopharyngeal pathologies. In this article, the authors present their clinical experience with the combined endonasal and transoral approach through a case series presentation, and discuss advantages and limitations of this approach for surgical management of the middle and posterior skull base and nasopharynx. In addition, a presentation is included of a unique, simultaneous endonasal and transoral dissection of the nasopharynx through an innovative intraoperative setup.

Clinical management of achondroplasia.

PubMed

Wright, M J; Irving, M D

2012-02-01

Achondroplasia, one of the skeletal dysplasias and the commonest form of disproportionate short stature, has a different developmental and growth profile compared to average stature children. In addition, a specific group of complications occur more frequently in children with achondroplasia. These include common but usually relatively minor complications such as recurrent otitis media, and rarer but more severe problems such as cervicomedullary compression. Knowledge of these complications, appropriate surveillance strategies and treatment options is essential for the paediatrician. The authors review the published literature in this area and provide a system based approach to the management of the healthcare needs of the child with achondroplasia.

Coal and peat in the sub-Saharan region of Africa: alternative energy options?

USGS Publications Warehouse

Weaver, J.N.; Landis, E.R.

1990-01-01

Coal and peat are essentially unused and in some cases unknown in sub-Saharan Africa. However, they might comprise valuable alternative energy sources in some or all of the developing nations of the region. The 11 countries considered in this appraisal reportedly contain coal and peat. On the basis of regional geology, another five countries might also contain coal-bearing rocks. If the resource potential is adequate, coal and peat might be utilized in a variety of ways including substituting for fuelwood, generating electricity, supplying process heat for local industry and increasing agricultural productivity. -from Author

Development of an intervention to support patients and clinicians with advanced lung cancer when considering systematic anticancer therapy: protocol for the PACT study.

PubMed

Anagnostou, Despina; Sivell, Stephanie; Noble, Simon; Lester, Jason; Byrne, Anthony; Sampson, Catherine; Longo, Mirella; Nelson, Annmarie

2017-07-12

Patient-centred care is essential to the delivery of healthcare; however, this necessitates direct patient involvement in clinical decision-making and can be challenging for patients diagnosed with advanced non-small cell lung cancer where there may be misunderstanding of the extent of disease, prognosis and aims of treatment. In this context, decisions are complex and there is a need to balance the risks and benefits, including treatment with palliative intent. The aim of the PACT study is to identify the information and decision support needs of patients, leading to the development of an intervention to support patients with advanced lung cancer when considering treatment options. PACT is a five-stage, multimethod and multicentre study. Participants : Patients and health professionals will be recruited from three health boards. Methods : Non-participant observation of multidisciplinary team meetings (n=12) will be used to determine patients' allocation to treatment pathways (stage I). Non-participant observation of patient-clinician consultations (n=20-30) will be used to explore communication of treatment options and decision-making. Extent of participation in decision-making will be assessed using the Observing Patient Involvement in Shared Decision-Making tool. Interviews with patients (stage III) and their clinicians (stage IV) will explore the perception of treatment options and involvement in decision-making. Based on stages I-IV, an expert consensus meeting will finalise the content and format of the intervention. Cognitive interviews with patients will then determine the face validity of the intervention (stage V). Analysis : analysis will be according to data type and research question and will include mediated discourse analysis, thematic analysis, framework analysis and interpretative phenomenological analysis. Ethical approval has been granted. The study findings will contribute to and promote shared and informed decision-making in the best interest of patients and prudent healthcare. We therefore aim to disseminate results via relevant respiratory, oncology and palliative care journals and conferences. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Inadequate management of pregnancy-associated listeriosis: lessons from four case reports.

PubMed

Charlier, C; Goffinet, F; Azria, E; Leclercq, A; Lecuit, M

2014-03-01

Listeria monocytogenes infection during pregnancy can lead to dramatic fetal or neonatal outcomes. No clinical trial has evaluated treatment options, and retrospective studies of cases are therefore important to define optimal regimens. We report four cases of materno-neonatal listeriosis illustrating inadequate antimicrobial therapy management and discuss recommended treatment options. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

Long-term care financing: options for the future.

PubMed

Mulvey, Janemarie; Li, Annelise

2002-01-01

The aging of the baby boomers will have an enormous impact on the future of long-term care costs. This article projects the magnitude of that impact, discusses sources of financing, and considers the cost and feasibility of three options for financing future long-term care services. The authors investigate the alternatives of increasing personal savings, raising payroll taxes and expanding employer-sponsored private long-term care insurance coverage, respectively.

Bonobos and chimpanzees exhibit human-like framing effects.

PubMed

Krupenye, Christopher; Rosati, Alexandra G; Hare, Brian

2015-02-01

Humans exhibit framing effects when making choices, appraising decisions involving losses differently from those involving gains. To directly test for the evolutionary origin of this bias, we examined decision-making in humans' closest living relatives: bonobos (Pan paniscus) and chimpanzees (Pan troglodytes). We presented the largest sample of non-humans to date (n = 40) with a simple task requiring minimal experience. Apes made choices between a 'framed' option that provided preferred food, and an alternative option that provided a constant amount of intermediately preferred food. In the gain condition, apes experienced a positive 'gain' event in which the framed option was initially presented as one piece of food but sometimes was augmented to two. In the loss condition, apes experienced a negative 'loss' event in which they initially saw two pieces but sometimes received only one. Both conditions provided equal pay-offs, but apes chose the framed option more often in the positive 'gain' frame. Moreover, male apes were more susceptible to framing than were females. These results suggest that some human economic biases are shared through common descent with other apes and highlight the importance of comparative work in understanding the origins of individual differences in human choice. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Electronic journal access: how does it affect the print subscription price?*

PubMed Central

Chen, Frances L.; Wrynn, Paul; Rieke, Judith L.

2001-01-01

Objective: This study examined the rates of print journal subscription price increases according to the type of available electronic access. The types of access included: electronic priced separately from the print, combination print with “free online” access, and aggregated, defined here as electronic access purchased as part of a collection. The percentages of print price increases were compared to each other and to that for titles available only in print. The authors were not aware of prior objective research in this area. Methods: The authors analyzed the percentage print price increases of 300 journals over a five-year time period. The titles were grouped according to type of available electronic access. The median and mean percentage print price increases were calculated and plotted for all titles within each group. Results: Using both the median and the mean to look at the percentage print price increases over five years, it was obvious that print prices for journals with electronic access exceeded journals that did not offer an electronic option. Electronic priced separately averaged 3% to 5% higher than print only titles using both measures. Combination print with “free online” access had higher increases from 1996 to 1999, but, in 2000, their percentage increases were about the same as print only titles. The rate of price increases for aggregated titles consistently went down over the past five years. Journals with no electronic option showed the lowest percentage rates of print price increase. Conclusions: The authors' findings reveal that the increases of print prices for their sample of titles were higher if a type of electronic access was offered. According to the results of this study, aggregated collections currently represent the electronic option whose percentage price increase for print prices was lowest. However, the uneven fluctuations in rates of subscription prices revealed that the pricing of journals with electronic access is still evolving. More study is recommended to see if the trends observed in this study are sustained over a longer time period. PMID:11837258

The experiences of close persons caring for people with chronic kidney disease stage 5 on conservative kidney management: contested discourses of ageing.

PubMed

Low, Joe; Myers, Jason; Smith, Glenn; Higgs, Paul; Burns, Aine; Hopkins, Katherine; Jones, Louise

2014-11-01

Chronic kidney disease stage 5 is a global health challenge in the context of population ageing across the world. The range of treatment options available to patients at all ages has increased and includes transplantation and dialysis. However, these options are often seen as inappropriate for older frailer patients who are now offered the option of conservative kidney management, which is presented as a non-invasive alternative to dialysis, involving symptom management and addressing psychosocial needs. In this study, we conducted qualitative interviews with 26 close persons caring for someone with chronic kidney disease stage 5 in the United Kingdom to investigate how conservative kidney management interacted with implicit ideas of ageing, in both the experience of conservative kidney management and the understanding of the prognosis and future care of the kidney disease. Our findings highlighted participant confusion about the nature of conservative kidney management, which stems from an initial lack of clarity about how conservative kidney management differed from conventional treatments for chronic kidney disease stage 5. In particular, some respondents were not aware of the implicit palliative nature of the intervention or indeed the inevitable end-of-life issues. Although these findings can be situated within the context of communication failure, we would further argue that they also bring to the surface tensions in the discourses surrounding ageing and old age, drawing on the use of a 'natural' and a 'normal' paradigm of ageing. In the context of chronic kidney disease stage 5, more patients are being dialysed at older ages, but conservative kidney management is being advanced as a better option than dialysis in terms of quality of life and experience. However, in doing so, conservative kidney management implicitly draws on a notion of older age that echoes natural ageing rather than advocate a more interventionist approach. The role of discourses of ageing in the provision of treatments for conservative kidney management has not previously been acknowledged, and this article addresses this gap. © The Author(s) 2014.

48 CFR 17.202 - Use of options.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Use of options. 17.202... AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 17.202 Use of options. (a) Subject to the..., the contracting officer may include options in contracts when it is in the Government's interest. When...

42 CFR 436.229 - Optional targeted low-income children.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Optional targeted low-income children. 436.229... Options for Coverage as Categorically Needy Options for Coverage of Families and Children and Aged, Blind, and Disabled Individuals, Including Pregnant Women § 436.229 Optional targeted low-income children...

42 CFR 436.229 - Optional targeted low-income children.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Optional targeted low-income children. 436.229... Options for Coverage as Categorically Needy Options for Coverage of Families and Children and Aged, Blind, and Disabled Individuals, Including Pregnant Women § 436.229 Optional targeted low-income children...

42 CFR 436.229 - Optional targeted low-income children.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Optional targeted low-income children. 436.229... Options for Coverage as Categorically Needy Options for Coverage of Families and Children and Aged, Blind, and Disabled Individuals, Including Pregnant Women § 436.229 Optional targeted low-income children...

42 CFR 436.229 - Optional targeted low-income children.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Optional targeted low-income children. 436.229... Options for Coverage as Categorically Needy Options for Coverage of Families and Children and Aged, Blind, and Disabled Individuals, Including Pregnant Women § 436.229 Optional targeted low-income children...

42 CFR 436.229 - Optional targeted low-income children.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Optional targeted low-income children. 436.229... Options for Coverage as Categorically Needy Options for Coverage of Families and Children and Aged, Blind, and Disabled Individuals, Including Pregnant Women § 436.229 Optional targeted low-income children...

Space station data system analysis/architecture study. Task 2: Options development, DR-5. Volume 2: Design options

NASA Technical Reports Server (NTRS)

1985-01-01

The primary objective of Task 2 is the development of an information base that will support the conduct of trade studies and provide sufficient data to make key design/programmatic decisions. This includes: (1) the establishment of option categories that are most likely to influence Space Station Data System (SSDS) definition; (2) the identification of preferred options in each category; and (3) the characterization of these options with respect to performance attributes, constraints, cost and risk. This volume contains the options development for the design category. This category comprises alternative structures, configurations and techniques that can be used to develop designs that are responsive to the SSDS requirements. The specific areas discussed are software, including data base management and distributed operating systems; system architecture, including fault tolerance and system growth/automation/autonomy and system interfaces; time management; and system security/privacy. Also discussed are space communications and local area networking.

Observation model and parameter partials for the JPL VLBI parameter estimation software MASTERFIT-1987

NASA Technical Reports Server (NTRS)

Sovers, O. J.; Fanselow, J. L.

1987-01-01

This report is a revision of the document of the same title (1986), dated August 1, which it supersedes. Model changes during 1986 and 1987 included corrections for antenna feed rotation, refraction in modelling antenna axis offsets, and an option to employ improved values of the semiannual and annual nutation amplitudes. Partial derivatives of the observables with respect to an additional parameter (surface temperature) are now available. New versions of two figures representing the geometric delay are incorporated. The expressions for the partial derivatives with respect to the nutation parameters have been corrected to include contributions from the dependence of UTI on nutation. The authors hope to publish revisions of this document in the future, as modeling improvements warrant.

Observation model and parameter partials for the JPL VLBI parameter estimation software MASTERFIT-1987

NASA Astrophysics Data System (ADS)

Sovers, O. J.; Fanselow, J. L.

1987-12-01

This report is a revision of the document of the same title (1986), dated August 1, which it supersedes. Model changes during 1986 and 1987 included corrections for antenna feed rotation, refraction in modelling antenna axis offsets, and an option to employ improved values of the semiannual and annual nutation amplitudes. Partial derivatives of the observables with respect to an additional parameter (surface temperature) are now available. New versions of two figures representing the geometric delay are incorporated. The expressions for the partial derivatives with respect to the nutation parameters have been corrected to include contributions from the dependence of UTI on nutation. The authors hope to publish revisions of this document in the future, as modeling improvements warrant.

Is gerontology ready for accreditation?

PubMed

Haley, William E; Ferraro, Kenneth F; Montgomery, Rhonda J V

2012-01-01

The authors review widely accepted criteria for program accreditation and compare gerontology with well-established accredited fields including clinical psychology and social work. At present gerontology lacks many necessary elements for credible professional accreditation, including defined scope of practice, applied curriculum, faculty with applied professional credentials, and resources necessary to support professional credentialing review. Accreditation with weak requirements will be dismissed as "vanity" accreditation, and strict requirements will be impossible for many resource-poor programs to achieve, putting unaccredited programs at increased risk for elimination. Accreditation may be appropriate in the future, but it should be limited to professional or applied gerontology, perhaps for programs conferring bachelor's or master's degrees. Options other than accreditation to enhance professional skills and employability of gerontology graduates are discussed.

47 CFR 32.5002 - Optional extended area revenue.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Optional extended area revenue. 32.5002 Section... Optional extended area revenue. This account shall include total revenue derived from the provision of optional extended area service. ...

47 CFR 32.5002 - Optional extended area revenue.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false Optional extended area revenue. 32.5002 Section... Optional extended area revenue. This account shall include total revenue derived from the provision of optional extended area service. ...

47 CFR 32.5002 - Optional extended area revenue.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 2 2012-10-01 2012-10-01 false Optional extended area revenue. 32.5002 Section... Optional extended area revenue. This account shall include total revenue derived from the provision of optional extended area service. ...

47 CFR 32.5002 - Optional extended area revenue.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Optional extended area revenue. 32.5002 Section... Optional extended area revenue. This account shall include total revenue derived from the provision of optional extended area service. ...

Bayesian hierarchical Poisson models with a hidden Markov structure for the detection of influenza epidemic outbreaks.

PubMed

Conesa, D; Martínez-Beneito, M A; Amorós, R; López-Quílez, A

2015-04-01

Considerable effort has been devoted to the development of statistical algorithms for the automated monitoring of influenza surveillance data. In this article, we introduce a framework of models for the early detection of the onset of an influenza epidemic which is applicable to different kinds of surveillance data. In particular, the process of the observed cases is modelled via a Bayesian Hierarchical Poisson model in which the intensity parameter is a function of the incidence rate. The key point is to consider this incidence rate as a normal distribution in which both parameters (mean and variance) are modelled differently, depending on whether the system is in an epidemic or non-epidemic phase. To do so, we propose a hidden Markov model in which the transition between both phases is modelled as a function of the epidemic state of the previous week. Different options for modelling the rates are described, including the option of modelling the mean at each phase as autoregressive processes of order 0, 1 or 2. Bayesian inference is carried out to provide the probability of being in an epidemic state at any given moment. The methodology is applied to various influenza data sets. The results indicate that our methods outperform previous approaches in terms of sensitivity, specificity and timeliness. © The Author(s) 2011 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Shoulder reconstruction after tumor resection by pedicled scapular crest graft.

PubMed

Amin, Sherif N; Ebeid, Walid A

2002-04-01

The current authors present and evaluate a technique for reconstructing proximal humeral defects that result after resection of malignant bone tumors. Sixteen patients were included in this study with an average followup of 3 years (range, 12-76 months). Twelve patients had intraarticular resections, two had extraarticular resections, and two had intercalary resections. Reconstruction was done at the lateral border of the scapula (based on the circumflex scapular vessels) that was osteotomized and mobilized to bridge the resultant defect. Shoulder arthrodesis was done in 14 patients and the shoulder was spared in the two patients who had intercalary resections. Function was evaluated according to the Musculoskeletal Tumor Society scoring system. The average time for union of the graft proximally and distally was 6 months after which the graft started to hypertrophy. The average functional score was 22.5 points (75%) with a minimum score of 18 points (60%) and a maximum score of 27 points (90%). Nonunion of the distal host-graft junction occurred in two patients; both patients required iliac crest bone grafting and both achieved clinical and radiographic union without additional intervention. In three patients, the proximal fixation became loose but had no effect on function. The authors conclude that this technique is inexpensive, effective, and a durable reconstructive option for proximal humeral defects that are less than 15 cm. It has a predictable functional outcome (60%-90%) that is comparable with other reconstructive options.

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

Klimsiak, Tomasz, E-mail: tomas@mat.umk.pl; Rozkosz, Andrzej, E-mail: rozkosz@mat.umk.pl

In the paper we consider the problem of valuation of American options written on dividend-paying assets whose price dynamics follow the classical multidimensional Black and Scholes model. We provide a general early exercise premium representation formula for options with payoff functions which are convex or satisfy mild regularity assumptions. Examples include index options, spread options, call on max options, put on min options, multiply strike options and power-product options. In the proof of the formula we exploit close connections between the optimal stopping problems associated with valuation of American options, obstacle problems and reflected backward stochastic differential equations.

Evaluation and management of adolescent idiopathic scoliosis: a review.

PubMed

Jada, Ajit; Mackel, Charles E; Hwang, Steven W; Samdani, Amer F; Stephen, James H; Bennett, James T; Baaj, Ali A

2017-10-01

Adolescent idiopathic scoliosis (AIS) is a 3D spinal deformity affecting children between the ages of 11 and 18, without an identifiable etiology. The authors here reviewed the available literature to provide spine surgeons with a summary and update on current management options. Smaller thoracic and thoracolumbar curves can be managed conservatively with observation or bracing, but corrective surgery may be indicated for rapidly growing or larger curves. The authors summarize the atypical features to look for in patients who may warrant further investigation with MRI during diagnosis and review the fundamental principles of the surgical management of AIS. Patients with AIS can be managed very well with a combination of conservative and surgical options. Outcomes for these children are excellent with sustained longer-term results.

77 FR 2983 - Medicare, Medicaid, and Children's Health Insurance Programs; Meeting of the Advisory Panel on...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-20

... order to promote an active, informed selection among such options.'' The Panel is also authorized by... Central Texas Council of Governments' Area Agency on Aging; Warren Jones, Executive Director, Mississippi... Authority; Sandy Markwood, Chief Executive Officer, National Association of Area Agencies on Aging; Miriam...

Planning and Implementing Augmentative Communication Service Delivery, 2: Proceedings of the National Planners Conference on Assistive Device Service Delivery.

ERIC Educational Resources Information Center

Coston, Caroline A., Ed.

The document consists of 30 author contributed chapters concerned with augmentative communication service delivery. Chapter titles and authors are: "Communication Options for Persons Who Cannot Speak: Planning for Service Delivery" (David Beukelman); "Planning Service Delivery Systems" (Roland Hahn II); "Planning Ohio's…

78 FR 43810 - State of Kansas; Authorization of State Hazardous Waste Management Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-22

... seeking authorization for the National Environmental Performance Track Program (April 22, 2004, 69 FR... terminated the National Environmental Performance Track Program. (c) Kansas has not adopted the optional... or more hazardous waste containers are stored, on a monthly basis. (c) At 28-31-262a(f)(2)(B)(i) and...

Selection of antibiotics for meticillin-resistant Staphylococcus pseudintermedius: time to revisit some old drugs?

PubMed

Papich, Mark G

2012-08-01

The aim of this review is to consider systemic therapy options for meticillin-resistant Staphylococcus pseudintermedius (MRSP). Infections caused by MRSP in small animals--particularly dogs--have been frustrating veterinarians in recent years. After a susceptibility test is performed, veterinarians are left to select from drugs that have not been frequently encountered on a susceptibility report. Some of these are old drugs that have not been used regularly by veterinary dermatologists. As MRSP is, by definition, resistant to all β-lactam antibiotics, including cephalosporins, penicillins and amoxicillin-clavulanate combinations, the β-lactam drugs are not an option for systemic treatment. As most MRSPs are multidrug resistant, familiar drugs, such as trimethoprim-sulfonamides, fluoroquinolones, macrolides and lincosamides (clindamycin), are also not usually an option for treatment. Therefore, veterinarians are left with drugs such as rifampicin, chloramphenicol, tetracyclines, aminoglycosides and vancomycin to choose from on the basis of an in vitro susceptibility test. Some of these drugs were originally approved over 50 years ago and may not be familiar to some veterinarians. Each of these drugs possesses unique properties and has particular advantages and disadvantages. Veterinarians should be particularly aware of the adverse effects, limitations and precautions when using these drugs. New drugs also have been developed for meticillin-resistant Staphylococcus aureus in humans. These include linezolid, ceftaroline, daptomycin and tigecycline. Although these drugs are very infrequently--if ever--considered for veterinary use, the properties of these drugs should also be known to veterinary dermatologists. © 2012 The Author. Veterinary Dermatology. © 2012 ESVD and ACVD.

Treatment of osteitis pubis and osteomyelitis of the pubic symphysis in athletes: a systematic review

PubMed Central

Choi, Haemi; McCartney, Michael; Best, Thomas M

2013-01-01

Objectives The authors examined the most current evidence for treatment options in athletes with osteitis pubis and osteomyelitis pubis, attempting to determine which options provide optimal pain relief with rapid return to sport and prevention of symptom reoccurrence. Methods Three databases—MEDLINE, Cochrane Database of Systematic Reviews and CINAHL—were searched using the OVID interface for all years between 1985 and May 2008. References were analysed from included studies, and additional relevant articles were obtained for inclusion. Inclusion criteria included (1) humans only, (2) subjects had no apparent risk factors for development of osteitis pubis or osteomyelitis of the pubic symphysis other than athletic involvement, (3) both physical exam findings and diagnostic imaging were used to confirm either diagnosis, and (4) a definitive treatment strategy was identifiable for management of osteitis pubis or osteomyelitis of the pubic symphysis. In total, 25 articles were included in the review. Results There were no randomised controlled trials identified with this study’s search strategy. A total of 195 athletes were diagnosed as having osteitis pubis (186 males, nine females) and treated with either conservative measures/physical therapy, local injection with corticosteroids and/or local anaesthetic, dextrose prolotherapy, surgery or antibiotic therapy. Six case reports/series described conservative treatment measures (physical therapy, rest, non-steroid anti-inflammatory drugs). Four case series explored the use of corticosteroid injections in treatment. One case series described the use of dextrose prolotherapy as a treatment modality. Six case series described various surgical techniques (pubic symphysis curettage, polypropylene mesh placement and pubic bone stabilisation) in treatment. Ten case reports/ series (10 subjects) outlined antibiotic treatment of osteomyelitis of the pubic symphysis. Conclusions The current medical literature shows only level 4 evidence of the treatment for osteitis pubis in 24 case reports/series in athletes. Without any direct comparison of treatment modalities, it is difficult to determine which individual treatment option is the most efficacious. Further study comparing the different treatment options is necessary to determine which modality provides the fastest return to sport. PMID:18812419

Adaptive Distributed Environment for Procedure Training (ADEPT)

NASA Technical Reports Server (NTRS)

Domeshek, Eric; Ong, James; Mohammed, John

2013-01-01

ADEPT (Adaptive Distributed Environment for Procedure Training) is designed to provide more effective, flexible, and portable training for NASA systems controllers. When creating a training scenario, an exercise author can specify a representative rationale structure using the graphical user interface, annotating the results with instructional texts where needed. The author's structure may distinguish between essential and optional parts of the rationale, and may also include "red herrings" - hypotheses that are essential to consider, until evidence and reasoning allow them to be ruled out. The system is built from pre-existing components, including Stottler Henke's SimVentive? instructional simulation authoring tool and runtime. To that, a capability was added to author and exploit explicit control decision rationale representations. ADEPT uses SimVentive's Scalable Vector Graphics (SVG)- based interactive graphic display capability as the basis of the tool for quickly noting aspects of decision rationale in graph form. The ADEPT prototype is built in Java, and will run on any computer using Windows, MacOS, or Linux. No special peripheral equipment is required. The software enables a style of student/ tutor interaction focused on the reasoning behind systems control behavior that better mimics proven Socratic human tutoring behaviors for highly cognitive skills. It supports fast, easy, and convenient authoring of such tutoring behaviors, allowing specification of detailed scenario-specific, but content-sensitive, high-quality tutor hints and feedback. The system places relatively light data-entry demands on the student to enable its rationale-centered discussions, and provides a support mechanism for fostering coherence in the student/ tutor dialog by including focusing, sequencing, and utterance tuning mechanisms intended to better fit tutor hints and feedback into the ongoing context.

75 FR 40005 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Order Granting...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-13

... including, but not limited to, stock index futures contracts, options on futures, options on securities and... holding and/ or managing portfolios or baskets of securities, commodity futures contracts, options on commodity futures contracts, swaps, forward contracts and/or options on physical commodities and/or non-U.S...

77 FR 20867 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-06

... Index, Equity and Currency Options) to extend a pilot program that eliminates minimum value sizes for... FLEX Options, FLEX currency options are also traded on the Exchange. These flexible index, equity, and currency options provide investors the ability to customize basic option features including size...

77 FR 33796 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-07

... Index, Equity and Currency Options) to extend a pilot program that eliminates minimum value sizes for... FLEX Options, FLEX currency options are also traded on the Exchange. These flexible index, equity, and currency options provide investors the ability to customize basic option features including size...

Including safety-net providers in integrated delivery systems: issues and options for policymakers.

PubMed

Witgert, Katherine; Hess, Catherine

2012-08-01

Health care reform legislation has spurred efforts to develop integrated health care delivery systems that seek to coordinate the continuum of health services. These systems may be of particular benefit to patients who face barriers to accessing care or have multiple health conditions. But it remains to be seen how safety-net providers, including community health centers and public hospitals--which have long experience in caring for these vulnerable populations--will be included in integrated delivery systems. This issue brief explores key considerations for incorporating safety-net providers into integrated delivery systems and discusses the roles of state and federal agencies in sup­porting and testing models of integrated care delivery. The authors conclude that the most important principles in creating integrated delivery systems for vulnerable populations are: (1) an emphasis on primary care; (2) coordination of all care, including behavioral, social, and public health services; and (3) accountability for population health outcomes.

An expanded conceptual framework for solution-focused management of chemical pollution in European waters.

PubMed

Munthe, John; Brorström-Lundén, Eva; Rahmberg, Magnus; Posthuma, Leo; Altenburger, Rolf; Brack, Werner; Bunke, Dirk; Engelen, Guy; Gawlik, Bernd Manfred; van Gils, Jos; Herráez, David López; Rydberg, Tomas; Slobodnik, Jaroslav; van Wezel, Annemarie

2017-01-01

This paper describes a conceptual framework for solutions-focused management of chemical contaminants built on novel and systematic approaches for identifying, quantifying and reducing risks of these substances. The conceptual framework was developed in interaction with stakeholders representing relevant authorities and organisations responsible for managing environmental quality of water bodies. Stakeholder needs were compiled via a survey and dialogue. The content of the conceptual framework was thereafter developed with inputs from relevant scientific disciplines. The conceptual framework consists of four access points: Chemicals, Environment, Abatement and Society, representing different aspects and approaches to engaging in the issue of chemical contamination of surface waters. It widens the scope for assessment and management of chemicals in comparison to a traditional (mostly) perchemical risk assessment approaches by including abatement- and societal approaches as optional solutions. The solution-focused approach implies an identification of abatement- and policy options upfront in the risk assessment process. The conceptual framework was designed for use in current and future chemical pollution assessments for the aquatic environment, including the specific challenges encountered in prioritising individual chemicals and mixtures, and is applicable for the development of approaches for safe chemical management in a broader sense. The four access points of the conceptual framework are interlinked by four key topics representing the main scientific challenges that need to be addressed, i.e.: identifying and prioritising hazardous chemicals at different scales; selecting relevant and efficient abatement options; providing regulatory support for chemicals management; predicting and prioritising future chemical risks. The conceptual framework aligns current challenges in the safe production and use of chemicals. The current state of knowledge and implementation of these challenges is described. The use of the conceptual framework, and addressing the challenges, is intended to support: (1) forwarding sustainable use of chemicals, (2) identification of pollutants of priority concern for cost-effective management, (3) the selection of optimal abatement options and (4) the development and use of optimised legal and policy instruments.

Solar PV leasing in Singapore: enhancing return on investments with options

NASA Astrophysics Data System (ADS)

Song, Shuang; Poh, K. L.

2017-05-01

Renewable energy is getting more important nowadays as an alternative to traditional energies. Solar energy, according to Energy Market Authority, is the most viable in the context of Singapore compared to other renewable energy sources due to land constraints. In light of the increasing adoption of solar power in Singapore, this paper focuses on solar PV leasing using a case study. This paper assesses the prospect for solar PV leasing companies in Singapore through the lens of embedded real options. The recent news that solar power is becoming the cheapest form of new electricity presents the leasing company an option to expand the scale of solar PV system. Taking into account this option, the Net Present Value (NPV) of the investment increased significantly compared to the case without real options. Technological developments result in a continuously changing environment with uncertainties. Thus, decision makers need to be aware of the inherent risk associated and identify options to maximize NPV. This upside potential is realized by exercising the managerial flexibility and exploiting the uncertainty. The paper enables solar energy planners to consider possible managerial flexibilities under uncertainties, showing how option thinking can be incorporated in the valuation of solar energy.

Long term outcomes of pharmacological treatments for opioid dependence: does methadone still lead the pack?

PubMed Central

Garcia-Portilla, Maria Paz; Bobes-Bascaran, Maria Teresa; Bascaran, Maria Teresa; Saiz, Pilar Alejandra; Bobes, Julio

2014-01-01

The aim of this review was to update and summarize the scientific knowledge on the long term outcomes of the different pharmacological treatment options for opioid dependence currently available and to provide a critical discussion on the different treatment options based on these results. We performed a literature search using the PubMed databases and the reference lists of the identified articles. Data from research show that the three pharmacological options reviewed are effective treatments for opioid dependence with positive long term outcomes. However, each one has its specific target population and setting. While methadone and buprenorphine are first line options, heroin-assisted treatment is a second line option for those patients refractory to treatment with methadone with concomitant severe physical, mental, social and/or functional problems. Buprenorphine seems to be the best option for use in primary care offices. The field of opioid dependence treatment is poised to undergo a process of reinforcement and transformation. Further efforts from researchers, clinicians and authorities should be made to turn new pharmacological options into clinical reality and to overcome the structural and functional obstacles that maintenance programmes face in combatting opioid dependence. PMID:23145768

Obesity prevention advocacy in Australia: an analysis of policy impact on autonomy.

PubMed

Haynes, Emily; Hughes, Roger; Reidlinger, Dianne P

2017-06-01

To explore obesity policy options recommended by stakeholders and identify their impact on individual autotomy. Qualitative and quantitative methods were used. A content analysis of submissions to the Australian Government's Inquiry into Obesity was conducted. Each recommendation was categorised by its impact on autonomy, according to existing frameworks. Chi-square test for independence was used to explore the association between autonomy and stakeholder support defined as frequency of recommendation. The extent of support for a policy option was significantly associated with impact on autonomy (p<0.001). Options that reduce autonomy were least frequently recommended in every setting; but more likely in schools (27%) than other settings (<1%). Recommendations to provide incentives (9%) were more common than disincentives (2%) or restrictions (3%), and those that enhance autonomy were most widely recommended (46%). Stakeholders advocated policy options that enhance individual autonomy to a greater extent than those that diminish autonomy. Implications for public health: Targeting obesity policy options that enhance rather than diminish autonomy may be more politically acceptable across most settings, with the exception of schools where more restrictive policy options are appropriate. Re-framing options accordingly may improve leadership by government in obesity policy. © 2017 The Authors.

Strategies for Faculty Development.

ERIC Educational Resources Information Center

Hynes, William J.

1984-01-01

The successful Career Redirection Program of Regis College is described and placed in the context of a multiple-option faculty development program, with its accompanying theoretical rationale. (Author/MLW)

You Want Me to Learn How?: Today's Teachers Have a Range of Personalized Learning Options Available to Them, Often for Free. Which Will You Choose in Your Quest to Be a Better Teacher?

ERIC Educational Resources Information Center

Dill, Dennis

2015-01-01

Today's teachers have many personalized learning options available to them, and several are free. The author discusses how to use social media for professional learning, describes edcamps where much of the focus is on teaching best practices, technology usage, and connecting and collaborating with other education professionals, and the advantages…

The "new genetics": an ethical perspective from family practice.

PubMed

Sugiyama, J

1988-04-01

The new genetic technologies are becoming increasingly applicable to clinical medicine. At present, however, diagnostic capabilities far exceed treatment options. Pregnancy termination, with its attendant moral-ethical problems, remains the major therapeutic option for mothers bearing fetuses with genetic abnormalities. In this article, the author outlines the major ethical issues facing family physicians, in the context of our expanding genetic diagnostic and therapeutic capabilities, and their possible effects on the traditional physician-patient relationship.

Children’s recalls from five dietary-reporting validation studies: Intrusions in correctly reported and misreported options in school breakfast reports

PubMed Central

Baxter, Suzanne Domel; Hardin, James W.; Royer, Julie A.; Guinn, Caroline H.; Smith, Albert F.

2008-01-01

For school breakfast each day, many elementary schools offer a choice between a cold option that includes ready-to-eat (RTE) cereal and a hot option that includes a non-RTE-cereal entrée such as waffles. For breakfast reports, intrusions (reports of uneaten items) in correctly reported and misreported breakfast options were examined using data from five dietary-reporting validation studies. In each study, fourth-grade children were observed eating school breakfast and school lunch and then interviewed to obtain a dietary recall. A breakfast option was correctly reported in 240 breakfast reports for 203 intrusions total, and misreported in 97 breakfast reports for 189 intrusions total. Asymmetry was evident in misreported options; specifically, children observed eating a cold option almost never misreported a hot option, but children observed eating a hot option often misreported a cold option. Proportionately more breakfast reports were intrusion-free when a breakfast option was correctly reported than misreported. Linking of intrusions (i.e., multiple intrusions from the same option in a breakfast report) was especially evident with misreported breakfast options. Methodological aspects of dietary recalls such as target period (prior 24 hours; previous day), interview time (morning; afternoon; evening), and interview format (meal; open) had implications for intrusions and misreported breakfast options. PMID:18501992

Expensing stock options: a fair-value approach.

PubMed

Kaplan, Robert S; Palepu, Krishna G

2003-12-01

Now that companies such as General Electric and Citigroup have accepted the premise that employee stock options are an expense, the debate is shifting from whether to report options on income statements to how to report them. The authors present a new accounting mechanism that maintains the rationale underlying stock option expensing while addressing critics' concerns about measurement error and the lack of reconciliation to actual experience. A procedure they call fair-value expensing adjusts and eventually reconciles cost estimates made at grant date with subsequent changes in the value of the options, and it does so in a way that eliminates forecasting and measurement errors over time. The method captures the chief characteristic of stock option compensation--that employees receive part of their compensation in the form of a contingent claim on the value they are helping to produce. The mechanism involves creating entries on both the asset and equity sides of the balance sheet. On the asset side, companies create a prepaid-compensation account equal to the estimated cost of the options granted; on the owners'-equity side, they create a paid-in capital stock-option account for the same amount. The prepaid-compensation account is then expensed through the income statement, and the stock option account is adjusted on the balance sheet to reflect changes in the estimated fair value of the granted options. The amortization of prepaid compensation is added to the change in the option grant's value to provide the total reported expense of the options grant for the year. At the end of the vesting period, the company uses the fair value of the vested option to make a final adjustment on the income statement to reconcile any difference between that fair value and the total of the amounts already reported.

Antibiotic management of methicillin-resistant Staphylococcus aureus--associated acute pulmonary exacerbations in cystic fibrosis.

PubMed

Fusco, Nicholas M; Toussaint, Kimberly A; Prescott, William Allan

2015-04-01

To review the treatment of methicillin-resistant Staphylococcus aureus (MRSA)-associated acute pulmonary exacerbations (APEs) in cystic fibrosis (CF). A search of PubMed, MEDLINE, Cochrane Library and Clinicaltrials.gov databases through November 2014 was conducted using the search terms Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, pulmonary exacerbations, and cystic fibrosis. All English-language research articles, case reports, and case series were evaluated. A total of 185 articles were identified related to MRSA and CF; 30 articles that studied treatments of MRSA APE in CF were included. The persistent presence of MRSA in the respiratory tract of patients with CF has been associated with higher morbidity and an increased risk of death. Limited clinical data exist supporting the efficacy of any specific antimicrobial currently available for the treatment of APE secondary to MRSA. Data extrapolated from other populations suggest that vancomycin and linezolid are appropriate first-line treatment options for the treatment of APE secondary to MRSA. Second-line options include doxycycline or minocycline and trimethoprim/sulfamethoxazole, each of which may be useful in patients coinfected with other respiratory pathogens, for which they may provide overlapping coverage. Ceftaroline and ceftobiprole are newer antibiotics that appear to have a potential role in the treatment of APE in CF, but the latter is not currently available to the US market. Although potentially useful, clindamycin is limited by high rates of resistance, telavancin is limited by its toxicity profile, and tigecycline is limited by a lack of demonstrated efficacy for infections that are similar to that seen in the CF population. Studies investigating the clinical utility of the above-cited antibiotics for APE in CF secondary to MRSA are desperately needed to broaden the treatment armamentarium for this medical condition. © The Author(s) 2015.

Risk Factor Analysis of Freestyle Propeller Flaps.

PubMed

Paik, Joo Myong; Pyon, Jai-Kyong

2017-01-01

Background  Freestyle propeller flaps have been widely used as a reconstructive option for both trunk and extremities. It offers the advantage of "like-with-like" reconstruction with an adjacent tissue with no dissection to the source vessels. However, there is the risk of vascular complications. In the present study, the authors investigated the incidence of vascular complications and their risk factors following freestyle propeller flap in the trunk and extremities. Methods  The authors conducted a retrospective review of 50 patients who underwent soft tissue reconstruction of the trunk and the extremities with 55 freestyle propeller flaps from 2004 to 2015. Data regarding patient demographics, surgical details, including the arc of rotation, and flap complications were collected from a prospectively maintained database and analyzed. Results  There were 10 flap complications (18.2%), including 7 superficial partial necrosis, 2 full-thickness partial necrosis, and 1 total necrosis from the 55 freestyle propeller flaps harvested. Previous irradiation was a significant risk factor for flap complications and the propeller flap harvested from the extremities showed a significantly higher rate of complications compared with those harvested from the trunk. Complication rates were higher in flaps with the arc of rotation between 150 and 180 degrees with marginal significance compared with flaps with the arc of rotation less than 150 degrees. Conclusions  Freestyle propeller flaps proved to be a valid and reliable option for reconstruction of defects in the trunk, while complication rate was quite high in the extremities. A prudent preoperative evaluation and preparation may be necessary before performing this surgical technique in the extremities. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Patient-family agreement on values and preferences for life-sustaining treatment: results of a multicentre observational study.

PubMed

Abdul-Razzak, Amane; Heyland, Daren K; Simon, Jessica; Ghosh, Sunita; Day, Andrew G; You, John J

2017-07-22

To quantify agreement between patients and their family members on their own values and preferences for use or non-use of life-sustaining treatments for the patient. Hospitalised patients aged 55 years or older with advanced pulmonary, cardiac, liver disease or metastatic cancer or aged 80 years or older from medical wards at 16 Canadian hospitals and their family members completed a questionnaire including eight items about values related to life-sustaining treatment and a question about preferences for life-sustaining treatments. We recruited a total of 313 patient-family member dyads. Crude agreement between patients and family members about values related to life-sustaining treatment was 42% across all eight items but varied widely: 20% when asking how important it was for the patient to respect the wishes of family members regarding their care; 72% when asking how important it was for the patient to be kept comfortable and suffer as little as possible. Crude agreement on preferences for life-sustaining treatment was 91% (kappa 0.60; 95%CI 0.45 to 0.75) when looking at preferences for cardiopulmonary resuscitation (CPR) versus no CPR but fell to 56% when including all five response options with varying degrees of resuscitative, medical or comfort options (kappa 0.39; 95%CI 0.31 to 0.47). There is appreciable disagreement between seriously ill hospitalised patients and family members in their values and preferences for life-sustaining treatment. Strategies are needed to improve the quality of advance care planning, so that surrogates are better able to honour patient's wishes at the end of life. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Patient specific actual size 3D printed models for patient education in glioma treatment: first experiences.

PubMed

van de Belt, Tom H; Nijmeijer, Hugo; Grim, David; Engelen, Lucien Jlpg; Vreeken, Rinaldo; van Gelder, Marleen Mmj; Laan, Mark Ter

2018-06-02

Cancer patients need high quality information about the disease stage, treatment options and side effects. High quality information can also improve health literacy, shared decision-making and satisfaction. We created patient-specific 3D models of tumours including surrounding functional areas, and assessed what patients with glioma actually value (or fear) about these models when they are used to educate them about the relation between their tumour and specific brain parts, the surgical procedure, and risks. We carried out an explorative study with adult glioma patients, who underwent functional MRI and DTi as part of the pre-operative work-up. All participants received an actual size 3D model, printed based on fMRI and DTi imaging. Semi-structured interviews were held to identify facilitators and barriers for using the model, and perceived effects. A model was successfully created for all 11 participants. A total of 18 facilitators and 8 barriers were identified. The model improved patients' understanding about their situation, that it was easier to ask questions to their neurosurgeon based on their model and that it supported their decision about the preferred treatment. A perceived barrier for using the 3D model was that it could be emotionally confronting, particularly in an early phase of the disease process. Positive effects were related to psychological domains including coping, learning effects and communication. Patient-specific 3D models are promising and simple tools that could help patients with glioma to better understand their situation, treatment options and risks. They have the potential to improve shared decision-making. Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.

Cost-effectiveness of Chagas disease screening in Latin American migrants at primary health-care centres in Europe: a Markov model analysis.

PubMed

Requena-Méndez, Ana; Bussion, Sheila; Aldasoro, Edelweiss; Jackson, Yves; Angheben, Andrea; Moore, David; Pinazo, Maria-Jesús; Gascón, Joaquim; Muñoz, Jose; Sicuri, Elisa

2017-04-01

Chagas disease is currently prevalent in European countries hosting large communities from Latin America. Whether asymptomatic individuals at risk of Chagas disease living in Europe should be screened and treated accordingly is unclear. We performed an economic evaluation of systematic Chagas disease screening of the Latin American population attending primary care centres in Europe. We constructed a decision tree model that compared the test option (screening of asymptomatic individuals, treatment, and follow-up of positive cases) with the no-test option (screening, treating, and follow-up of symptomatic individuals). The decision tree included a Markov model with five states, related to the chronic stage of the disease: indeterminate, cardiomyopathy, gastrointestinal, response to treatment, and death. The model started with a target population of 100 000 individuals, of which 4·2% (95% CI 2·2-6·8) were estimated to be infected by Trypanosoma cruzi. The primary outcome was the incremental cost-effectiveness ratio (ICER) between test and no-test options. Deterministic and probabilistic analyses (Monte Carlo simulations) were performed. In the deterministic analysis, total costs referred to 100 000 individuals in the test and no-test option were €30 903 406 and €6 597 403 respectively, with a difference of €24 306 003. The respective number of quality-adjusted life-years (QALYs) gained in the test and no-test option were 61 820·82 and 57 354·42. The ICER was €5442. In the probabilistic analysis, total costs for the test and no-test option were €32 163 649 (95% CI 31 263 705-33 063 593) and €6 904 764 (6 703 258-7 106 270), respectively. The respective number of QALYs gained was 64 634·35 (95% CI 62 809·6-66 459·1) and 59 875·73 (58 191·18-61 560·28). The difference in QALYs gained between the test and no test options was 4758·62 (95% CI 4618·42-4898·82). The incremental cost-effectiveness ratio (ICER) was €6840·75 (95% CI 2545-2759) per QALY gained for a treatment efficacy of 20% and €4243 per QALY gained for treatment efficacy of 50%. Even with a reduction in Chagas disease prevalence to 0·05% and with large variations in all the parameters, the test option would still be more cost-effective than the no-test option (less than €30000 per QALY). Screening for Chagas disease in asymptomatic Latin American adults living in Europe is a cost-effective strategy. Findings of our model provide an important element to support the implementation of T cruzi screening programmes at primary health centres in European countries hosting Latin American migrants. European Commission 7th Framework Program. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

Partner choice creates fairness in humans.

PubMed

Debove, Stéphane; André, Jean-Baptiste; Baumard, Nicolas

2015-06-07

Many studies demonstrate that partner choice has played an important role in the evolution of human cooperation, but little work has tested its impact on the evolution of human fairness. In experiments involving divisions of money, people become either over-generous or over-selfish when they are in competition to be chosen as cooperative partners. Hence, it is difficult to see how partner choice could result in the evolution of fair, equal divisions. Here, we show that this puzzle can be solved if we consider the outside options on which partner choice operates. We conduct a behavioural experiment, run agent-based simulations and analyse a game-theoretic model to understand how outside options affect partner choice and fairness. All support the conclusion that partner choice leads to fairness only when individuals have equal outside options. We discuss how this condition has been met in our evolutionary history, and the implications of these findings for our understanding of other aspects of fairness less specific than preferences for equal divisions of resources. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

78 FR 77185 - Self-Regulatory Organizations; BOX Options Exchange LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-20

... options, including NDX. Rule 6090 permits the Exchange to list up to seven expiration months at any one...) specifically references options on NDX as one of the European-style index options approved for trading on BOX...

Space station data system analysis/architecture study. Task 2: Options development, DR-5. Volume 3: Programmatic options

NASA Technical Reports Server (NTRS)

1985-01-01

Task 2 in the Space Station Data System (SSDS) Analysis/Architecture Study is the development of an information base that will support the conduct of trade studies and provide sufficient data to make design/programmatic decisions. This volume identifies the preferred options in the programmatic category and characterizes these options with respect to performance attributes, constraints, costs, and risks. The programmatic category includes methods used to administrate/manage the development, operation and maintenance of the SSDS. The specific areas discussed include standardization/commonality; systems management; and systems development, including hardware procurement, software development and system integration, test and verification.

How health technology assessment agencies address the issue of unpublished data.

PubMed

Kreis, Julia; Panteli, Dimitra; Busse, Reinhard

2014-01-01

Reporting bias potentially threatens the validity of results in health technology assessment (HTA) reports. Our study aimed to explore policies and practices of HTA agencies regarding strategies to include previously unpublished data in their assessments, focusing on requests to industry for unpublished data. We included international HTA agencies with publicly available methods papers as well as HTA reports. From the methods papers and recent reports we extracted information on requests to industry and on searches in trial registries, regulatory authority Web sites and for conference abstracts. Eighteen HTA agencies and seventy-three reports were included. Agencies' methods papers showed variability regarding requests to industry (requests are routinely carried out in seven cases, not mentioned in six, at the discretion of HTA authors in three, and based on manufacturer applications in two), which were reflected in the reports investigated. As reporting of requests was limited, it often remained unclear whether unpublished data had been received. Searches in trial registries, at regulatory authorities or for conference abstracts are described as a routine or optional part of the search strategy in the methods papers of 9, 11, and 8 included agencies, respectively. A total of 52 percent, 39 percent, and 16 percent of reports described searches in trial registries, at regulatory agencies, and hand searching of conference proceedings. International HTA agencies currently differ considerably in their efforts to address the issue of unpublished data. Requests to industry may constitute one strategy to access and include unpublished data, while agencies can learn from each other concerning successful practice.

A Systematic Review of the Safety and Effect of Neurofeedback on Fatigue and Cognition.

PubMed

Luctkar-Flude, Marian; Groll, Dianne

2015-07-01

Many cancer survivors continue to experience ongoing symptoms, such as fatigue and cognitive impairment, which are poorly managed and have few effective, evidence-based treatment options. Neurofeedback is a noninvasive, drug-free form of brain training that may alleviate long-term symptoms reported by cancer patients. The purpose of this systematic review of the literature was to describe the effectiveness and safety of neurofeedback for managing fatigue and cognitive impairment. A systematic review of the literature was conducted using Joanna Briggs Institute (JBI) methodology. A comprehensive search of 5 databases was conducted: Medline, CINAHL, AMED, PsycInfo, and Embase. Randomized and nonrandomized controlled trials, controlled before and after studies, cohort, case control studies, and descriptive studies were included in this review. Twenty-seven relevant studies were included in the critical appraisals. The quality of most studies was poor to moderate based on the JBI critical appraisal checklists. Seventeen studies were deemed of sufficient quality to be included in the review: 10 experimental studies and 7 descriptive studies. Of these, only 2 were rated as high-quality studies and the remaining were rated as moderate quality. All 17 included studies reported positive results for at least one fatigue or cognitive outcome in a variety of populations, including 1 study with breast cancer survivors. Neurofeedback interventions were well tolerated with only 3 studies reporting any side effects. Despite issues with methodological quality, the overall positive findings and few reported side effects suggest neurofeedback could be helpful in alleviating fatigue and cognitive impairment. Currently, there is insufficient evidence that neurofeedback is an effective therapy for management of these symptoms in cancer survivors, however, these promising results support the need for further research with this patient population. More information about which neurofeedback technologies, approaches, and protocols could be successfully used with cancer survivors and with minimal side effects is needed. This research will have significance to nurses and physicians in oncology and primary care settings who provide follow-up care and counseling to cancer survivors experiencing debilitating symptoms in order to provide information and education related to evidence-based therapy options. © The Author(s) 2015.

Using Distributed Operations to Enable Science Research on the International Space Station

NASA Technical Reports Server (NTRS)

Bathew, Ann S.; Dudley, Stephanie R. B.; Lochmaier, Geoff D.; Rodriquez, Rick C.; Simpson, Donna

2011-01-01

In the early days of the International Space Station (ISS) program, and as the organization structure was being internationally agreed upon and documented, one of the principal tenets of the science program was to allow customer-friendly operations. One important aspect of this was to allow payload developers and principle investigators the flexibility to operate their experiments from either their home sites or distributed telescience centers. This telescience concept was developed such that investigators had several options for ISS utilization support. They could operate from their home site, the closest telescience center, or use the payload operations facilities at the Marshall Space Flight Center in Huntsville, Alabama. The Payload Operations Integration Center (POIC) processes and structures were put into place to allow these different options to its customers, while at the same time maintain its centralized authority over NASA payload operations and integration. For a long duration space program with many scientists, researchers, and universities expected to participate, it was imperative that the program structure be in place to successfully facilitate this concept of telescience support. From a payload control center perspective, payload science operations require two major elements in order to make telescience successful within the scope of the ISS program. The first element is decentralized control which allows the remote participants the freedom and flexibility to operate their payloads within their scope of authority. The second element is a strong ground infrastructure, which includes voice communications, video, telemetry, and commanding between the POIC and the payload remote site. Both of these elements are important to telescience success, and both must be balanced by the ISS program s documented requirements for POIC to maintain its authority as an integration and control center. This paper describes both elements of distributed payload operations and discusses the benefits and drawbacks.

78 FR 30948 - Self-Regulatory Organizations; Fixed Income Clearing Corporation; Notice of Filing of Advance...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

... Options on Interest Rate Futures Contracts With Maturities Not Longer Than Two Years in the One- Pot Cross... allow FICC to include options on interest rate futures contracts with maturities not longer than two...) The purpose of the advance notice is to include options on interest rate futures contracts with...

Where on earth to publish? A sample survey comparing traditional and open access publishing in the oncological field

PubMed Central

2013-01-01

Background The paper intends to help scientific authors to make the best choice of journals in which to publish, by describing and comparing journal features in the area of oncology. For this purpose, the authors identified impact factor (IF) ranking, cost options and copyright conditions offered to authors wishing to publish in full open access (OA), subscription-based or hybrid journals. Methods Data referring to articles published in 2010 by three Italian research institutions (National Institute of Health – Rome (ISS), Regina Elena National Cancer Institute – Rome (IRE), National Cancer Institute – Milan (INT) in journals (78) managed according to different business models, all listed in the Journal Citation Reports, subject category Oncology, were collected and analysed. The journals surveyed were ranked according to IF, position in quartiles, publication charges, usage rights in published articles, self-archiving conditions in OAI-compliant repositories digital archives. Results Almost half (34) the journals surveyed were included in the first quartile, thus revealing authors’ preference for journals with a high IF. The prevalent journal business model was the hybrid formula (based on subscriptions but also offering a paid OA option) with 51 journals, followed by subscription-based only journals accounting for 22, while just 5 full OA journals were identified. In general, no relationship was found between IF and article publication charges, in terms of correspondence between more expensive fees and higher IF. Conclusions The issue of OA journals as compared with traditional subscription-based journals is highly debated among stakeholders: library administrators facing financial restrictions, authors seeking to locate the best outlet for their research, publishers wishing to increase their revenues by offering journals with wider appeal. Against this background, factors such as the quest for alternatives to high-cost business models, investments in setting up institutional repositories hosting the published versions of articles and efforts to overcome copyright barriers and gain free access to scientific literature are all crucial. PMID:23339627

California's "Free" Universities

ERIC Educational Resources Information Center

Cudhea, David

1974-01-01

Heliotrope, Orpheus, and Communiversity, San Francisco's three free universities, offer curricula with combinations of alchemy, magic, Volkswagen repairs, options in education, dance, conversational Mandarin, basic plumbing, and brain wave experiences. (Author/PG)

Portal vein thrombosis: a clinician-oriented and practical review.

PubMed

Handa, Pankaj; Crowther, Mark; Douketis, James D

2014-07-01

With advances in modern imaging techniques, portal vein thrombosis (PVT) is being increasingly diagnosed. It has a wide ranging clinical spectrum from being an asymptomatic state to a potentially life-threatening situation. It is not unusual to find it as an incidental finding in the abdominal imagings done for other reasons. It is commonly associated with cirrhosis and abdominal malignancies and also has a strong association with prothrombotic disorders. It is often difficult for the clinicians to decide whether PVT is acute or chronic. This poses great challenges to its management strategies that include anticoagulants, thrombolysis, and surgical options. Timely diagnosis and appropriate management have great bearings on its outcomes of morbidity and mortality. In this clinician-oriented review, we have provided a concise review of clinical aspects of PVT and discussed various management strategies while addressing the common questions that come to a physician's mind dealing with such a patient. © The Author(s) 2013.

Continuous Trailing-Edge Flaps for Primary Flight Control of a Helicopter Main Rotor

NASA Technical Reports Server (NTRS)

Thornburgh, Robert P.; Kreshock, Andrew R.; Wilbur, Matthew L.; Sekula, Martin K.; Shen, Jinwei

2014-01-01

The use of continuous trailing-edge flaps (CTEFs) for primary flight control of a helicopter main rotor is studied. A practical, optimized bimorph design with Macro-Fiber Composite actuators is developed for CTEF control, and a coupled structures and computational fluid dynamics methodology is used to study the fundamental behavior of an airfoil with CTEFs. These results are used within a comprehensive rotorcraft analysis model to study the control authority requirements of the CTEFs when utilized for primary flight control of a utility class helicopter. A study of the effect of blade root pitch index (RPI) on CTEF control authority is conducted, and the impact of structural and aerodynamic model complexity on the comprehensive analysis results is presented. The results show that primary flight control using CTEFs is promising; however, a more viable option may include the control of blade RPI, as well.

77 FR 16712 - Endangered and Threatened Wildlife and Plants; Establishment of a Nonessential Experimental...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-22

... of designated critical habitat. Section 7 of the Act does not affect activities undertaken on private... optional as the agencies carry out, fund, or authorize activities. Because the NEP is, by definition, not.... Activities that are not carried out, funded, or authorized by Federal agencies are not subject to provisions...

78 FR 2308 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Order Approving a...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-10

... Change To Address the Authority To Cancel Orders When a Technical or Systems Issue Occurs and To Describe... authority of the Exchange to cancel orders (or release routing-related orders) when a technical or systems... Exchange may encounter situations that make it necessary to cancel orders (or release routing- related...

76 FR 62457 - Tennessee Valley Authority (Bellefonte Nuclear Plant, Unit 1)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-07

... (Bellefonte Nuclear Plant, Unit 1) Order I. The Tennessee Valley Authority (TVA, or the applicant) is the... Nuclear Plant (BLN), Units 1 and 2, respectively. The CPs for CPPR-122 and CPPR-123 expire on October 1... option for future power generation at BLN Unit 1. In the letter dated April 25, 2011, TVA informed the...

Failure Is Not an Option (TM). Six Principles That Guide Student Achievement in High-Performing Schools

ERIC Educational Resources Information Center

Blankstein, Alan M.

2004-01-01

The author builds upon a foundation which identifies courageous school leadership and the professional learning community as the center of effective school reform. The author offers six guiding principles steps for creating and sustaining a high-performing school: (1) Common mission, vision, values, and goals: (2) Systems for prevention and…

Coast Guard Deepwater Program: Background, Oversight Issues, and Options for Congress

DTIC Science & Technology

2007-10-10

PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES...112 Appendix E. NGSS Testimony...Lockheed Martin and Northrop Grumman Ship Systems ( NGSS ). ICGS was awarded an indefinite delivery, indefinite quantity (ID/IQ) contract for the Deepwater

Back to the Future: Professional Development

ERIC Educational Resources Information Center

Cox, Marge

2015-01-01

As an educator for thirty-four years, the author describes several great changes she has seen in the field of education since she started in the 1970s. The author gives advice to educators just beginning their careers. Old and new ways of receiving professional development are explained along with the limitations and benefits of these options.…

Community Colleges and the State Budget: The Nuts and Bolts.

ERIC Educational Resources Information Center

Lay, Scott

2003-01-01

This article provides insight into the California state budget process and gives an overview of California's growing deficit. The author examines the decline in personal income gained from stock options and capital gains as a means of illustrating the economic factors that resulted in a $28 billion deficit. Next, the author turns his attention to…

48 CFR 17.107 - Options.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Options. 17.107 Section 17... CONTRACT TYPES SPECIAL CONTRACTING METHODS Multiyear Contracting 17.107 Options. Benefits may accrue by including options in a multiyear contract. In that event, contracting officers must follow the requirements...

The role of Social Media and internet search engines in information provision and dissemination to patients with Kidney Stone Disease (KSD): A systematic review from EAU Young Academic Urologists (YAU).

PubMed

Jamnadass, Enakshee; Aboumarzouk, Omar; Kallidonis, Panagiotis; Emiliani, Esteban; Tailly, Thomas; Hruby, Stephan; Sanguedolce, Francesco; Atis, Gokhan; Özsoy, Mehmet; Greco, Francesco; Somani, Bhaskar K

2018-06-21

Kidney stone disease (KSD) affects millions of people worldwide and has an increasing incidence. Social media (SoMe) and search engines are both gaining in usage, whilst also being used by patients to research their conditions and aid in managing them. With this in mind, many authors have expressed the belief that SoMe and search engines can be used by patients and healthcare professionals to improve treatment compliance, and to help counselling and management of conditions such as KSD. We wanted to determine whether SoMe and search engines play a role in the management and/or prevention of KSD. The databases MEDLINE, Embase, CINAHL, Scopus and Cochrane Library were used to search for relevant English language literature from inception to December 2017. Results were screened by title, abstract, and then full text, according to the inclusion and exclusion criteria. The data was then analysed independently by the authors not involved in the original study. After initial identification of 2137 records and screening of 42 articles, 10 studies met the inclusion and exclusion criteria. The papers included focused on a variety of SoMe forms including two papers each on twitter, YouTube, smartphone apps and google search engine and one paper on google insights and google analytics. Regarding patient centered advice, while 2 papers covered advice on dietary, fluid intake and management options, two additional papers each covered advice on fluid advice and management options only, while no such advice was given by 3 of the SoMe published papers. SoMe and search engines provide valuable information to patients with kidney stone disease. However, whilst the information provided regarding dietary aspects and fluid management was good, it was not comprehensive enough to include advice on other aspects of KSD prevention.

Community-based preparedness programmes and the 2009 Australian bushfires: policy implications derived from applying theory.

PubMed

MacDougall, Colin; Gibbs, Lisa; Clark, Rachel

2014-04-01

The Victorian Country Fire Authority in Australia runs the Community Fireguard (CFG) programme to assist individuals and communities in preparing for fire. The objective of this qualitative research was to understand the impact of CFG groups on their members' fire preparedness and response during the 2009 Australian bushfires. Social connectedness emerged as a strong theme, leading to an analysis of data using social capital theory. The main strength of the CFG programme was that it was driven by innovative community members; however, concerns arose regarding the extent to which the programme covered all vulnerable areas, which led the research team to explore the theory of diffusion of innovation. The article concludes by stepping back from the evaluation and using both applied theories to reflect on broad options for community fire preparedness programmes in general. The exercise produced two contrasting options for principles underlying community fire preparedness programmes. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

Outcome measures in coeliac disease trials: the Tampere recommendations.

PubMed

Ludvigsson, Jonas F; Ciacci, Carolina; Green, Peter Hr; Kaukinen, Katri; Korponay-Szabo, Ilma R; Kurppa, Kalle; Murray, Joseph A; Lundin, Knut Erik Aslaksen; Maki, Markku J; Popp, Alina; Reilly, Norelle R; Rodriguez-Herrera, Alfonso; Sanders, David S; Schuppan, Detlef; Sleet, Sarah; Taavela, Juha; Voorhees, Kristin; Walker, Marjorie M; Leffler, Daniel A

2018-02-13

A gluten-free diet is the only treatment option of coeliac disease, but recently an increasing number of trials have begun to explore alternative treatment strategies. We aimed to review the literature on coeliac disease therapeutic trials and issue recommendations for outcome measures. Based on a literature review of 10 062 references, we (17 researchers and 2 patient representatives from 10 countries) reviewed the use and suitability of both clinical and non-clinical outcome measures. We then made expert-based recommendations for use of these outcomes in coeliac disease trials and identified areas where research is needed. We comment on the use of histology, serology, clinical outcome assessment (including patient-reported outcomes), quality of life and immunological tools including gluten immunogenic peptides for trials in coeliac disease. Careful evaluation and reporting of outcome measures will increase transparency and comparability of coeliac disease therapeutic trials, and will benefit patients, healthcare and the pharmaceutical industry. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Systems Analysis of Life Support for Long-Duration Missions

NASA Technical Reports Server (NTRS)

Drysdale, Alan E.; Maxwell, Sabrina; Ewert, Michael K.; Hanford, Anthony J.

2000-01-01

Work defining advanced life support (ALS) technologies and evaluating their applicability to various long-duration missions has continued. Time-dependent and time-invariant costs have been estimated for a variety of life support technology options, including International Space Station (ISS) environmental control and life support systems (ECLSS) technologies and improved options under development by the ALS Project. These advanced options include physicochemical (PC) and bioregenerative (BIO) technologies, and may in the future include in-situ resource utilization (ISRU) in an attempt to reduce both logistics costs and dependence on supply from Earth. PC and bioregenerative technologies both provide possibilities for reducing mission equivalent system mass (ESM). PC technologies are most advantageous for missions of up to several years in length, while bioregenerative options are most appropriate for longer missions. ISRU can be synergistic with both PC and bioregenerative options.

Gynecomastia Management: An Evolution and Refinement in Technique at UT Southwestern Medical Center

PubMed Central

Bailey, Steven H.; Guenther, Dax; Constantine, Fadi

2016-01-01

Summary: Gynecomastia is a benign proliferation of male breast glandular tissue. Gynecomastia can affect men at any stage of life. Traditional treatment options involved excisional surgeries with periareolar or T-shaped scars, which can leave more visible scars on the chest. The technique presented represents a technique used by the senior author, which relies on ultrasonic liposuction and pull-through technique to remove breast tissue. A retrospective chart review was performed, including all patients who were treated, from 2000 to 2013 by the senior author, for gynecomastia. A deidentified database was created to record patient characteristics, including age, height, weight, ptosis, stage of gynecomastia, and gynecomastia classification. Surgical approaches, complications, and revisions were also recorded. Our experience includes 75 patients with all grades of gynecomastia from 2000 to 2013. These cases span the evolution of our technique to include direct pull-through excision with ultrasound-assisted liposuction. The distribution of the grades I, II, III, and IV ptosis was 30.6%, 36 %, 22.6%, and 10.6% respectively. There were no complications in this series. Only one patient with grade III ptosis required revision surgery. This technique provides a safe and aesthetically pleasing way to treat gynecomastia with a low need for revision. PMID:27482482

Mars Together 2001: Joint US-Russian Team

NASA Technical Reports Server (NTRS)

Ulrich, P.; Kremnev, R.; Boyce, J.; Eremenko, A.; Bourke, R.; Linkin, V.; Campbell, J.; Martynov, B.; Haynes, N.; Mitrofanov, I.;

Defense Contracting in Iraq: Issues and Options for Congress

DTIC Science & Technology

2007-11-15

minimum value of $613,677 with a contract period of one base year followed by up to four one- year options with CRS-4 12 U.S. Army Sustainment Command...ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S) 11. SPONSOR/MONITOR’S REPORT NUMBER(S) 12 . DISTRIBUTION/AVAILABILITY STATEMENT Approved for public release...Iraq. The proposed Fiscal Year (FY) 2008 Defense Authorization bill, H.R. 1585, contains provisions which, as an example, would broaden legal

Parents’ Online Portrayals of Pediatric Treatment and Research Options

PubMed Central

Schaffer, Rebecca; Henderson, Gail E.; Churchill, Larry R.; King, Nancy M. P.; Rothschild, Barbra B.; Lohser, Sara; Davis, Arlene M.

2012-01-01

Parents of seriously ill children face difficult decisions when standard therapies are limited or ineffective. In their search for information, they may turn to websites created by other parents facing similar experiences. We conducted a qualitative content analysis of 21 websites created by families with children affected by cancer or genetic disease, two serious conditions with a range of treatment and clinical trial options. Our research questions address how parent authors portray serious pediatric illness, available options, parties to decision making, and sources of influence. In addition, we examine what these sites reveal about family vulnerability to various risks, particularly the risk of misunderstanding the distinction between standard treatment and research and the risk of overestimating the likely benefits of research participation, as well as whether vulnerability varies by type of condition. Our results demonstrate typically favorable views on research, but with inadequate distinctions between research and treatment and a complex set of trade-offs in consideration of research risks and potential benefits. While portraits of vulnerability emerge for both parents and children, so do portraits of strength and resilience. As a result, parents describe frustration with both under- and over-protection from research participation. Our discussion of these findings clarifies the potential for parent-authored websites to inform and influence families considering research and treatment options for their seriously ill children. PMID:19754237

Science and society: some "made-in-Canada" options for improving integration.

PubMed

Kosseim, Patricia; Chapman, Sheila

2011-05-01

In this article, the authors describe relatively recent efforts by scientific research agencies to promote, through various funding programs, the integration of social sciences and humanities with the natural sciences. This "integrated" approach seeks to study science through a broader interdisciplinary lens in order to better anticipate, understand, and address its ethical, legal, and social implications. The authors review the origins and evolution of this trend, as well the arguments which have been formulated by both proponents and critics of integration. By using Genome Canada's "GE(3)LS" Research Program as a case study, the authors discuss the successes and continuing challenges of this model based on evaluation results available to date. The authors then go on to examine and compare three possible models for improving the future success of the GE(3)LS research program, including: 1) enhancing the current integrated research approach through incremental refinements based on concrete evidence and lessons learned; 2) promoting greater interaction and synergy across GE(3)LS research projects through a deliberate, systematic and coordinated "hub and spoke" approach; and 3) taking a broad programmatic approach to GE(3)LS research by creating a central resource of available expertise and advisory capacity.

75 FR 63870 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-18

.... The proposed rule would allow financial products such as securities index options, index futures, and options on index futures to be included along with the ETF in an equity option's net delta calculation. So... S&P 500 options, S&P 500 futures, options on S&P 500 futures or any other instrument that tracks the...

Flexibility and Project Value: Interactions and Multiple Real Options

NASA Astrophysics Data System (ADS)

Čulík, Miroslav

2010-06-01

This paper is focused on a project valuation with embedded portfolio of real options including their interactions. Valuation is based on the criterion of Net Present Value on the simulation basis. Portfolio includes selected types of European-type real options: option to expand, contract, abandon and temporarily shut down and restart a project. Due to the fact, that in reality most of the managerial flexibility takes the form of portfolio of real options, selected types of options are valued not only individually, but also in combination. The paper is structured as follows: first, diffusion models for forecasting of output prices and variable costs are derived. Second, project value is estimated on the assumption, that no real options are present. Next, project value is calculated with the presence of selected European-type options; these options and their impact on project value are valued first in isolation and consequently in different combinations. Moreover, intrinsic value evolution of given real options with respect to the time of exercising is analysed. In the end, results are presented graphically; selected statistics and risk measures (Value at Risk, Expected Shortfall) of the NPV's distributions are calculated and commented.

Document Delivery: Evaluating the Options.

ERIC Educational Resources Information Center

Ward, Suzanne M.

1997-01-01

Discusses options available to libraries for document delivery. Topics include users' needs; cost; copyright compliance; traditional interlibrary loan; types of suppliers; selection criteria, including customer service; new developments in interlibrary loan, including outsourcing arrangements; and the need to evaluate suppliers. (LRW)

Possible co-option of engrailed during brachiopod and mollusc shell development.

PubMed

Shimizu, Keisuke; Luo, Yi-Jyun; Satoh, Noriyuki; Endo, Kazuyoshi

2017-08-01

In molluscs, two homeobox genes, engrailed ( en ) and distal-less ( dlx ), are transcription factors that are expressed in correlation with shell development. They are expressed in the regions between shell-forming and non-shell-forming cells, likely defining the boundaries of shell-forming fields. Here we investigate the expression of two transcription factors in the brachiopod Lingula anatina We find that en is expressed in larval mantle lobes, whereas dlx is expressed in larval tentacles. We also demonstrate that the embryonic shell marker mantle peroxidase ( mpox ) is specifically expressed in mantle lobes. Our results suggest that en and mpox are possibly involved in brachiopod embryonic shell development. We discuss the evolutionary developmental origin of lophotrochozoan biomineralization through independent gene co-option. © 2017 The Author(s).

Can prospect theory explain risk-seeking behavior by terminally ill patients?

PubMed

Rasiel, Emma B; Weinfurt, Kevin P; Schulman, Kevin A

2005-01-01

Patients with life-threatening conditions sometimes appear to make risky treatment decisions as their condition declines, contradicting the risk-averse behavior predicted by expected utility theory. Prospect theory accommodates such decisions by describing how individuals evaluate outcomes relative to a reference point and how they exhibit risk-seeking behavior over losses relative to that point. The authors show that a patient's reference point for his or her health is a key factor in determining which treatment option the patient selects, and they examine under what circumstances the more risky option is selected. The authors argue that patients' reference points may take time to adjust following a change in diagnosis, with implications for predicting under what circumstances a patient may select experimental or conventional therapies or select no treatment.

An option space for early neural evolution.

PubMed

Jékely, Gáspár; Keijzer, Fred; Godfrey-Smith, Peter

2015-12-19

The origin of nervous systems has traditionally been discussed within two conceptual frameworks. Input-output models stress the sensory-motor aspects of nervous systems, while internal coordination models emphasize the role of nervous systems in coordinating multicellular activity, especially muscle-based motility. Here we consider both frameworks and apply them to describe aspects of each of three main groups of phenomena that nervous systems control: behaviour, physiology and development. We argue that both frameworks and all three aspects of nervous system function need to be considered for a comprehensive discussion of nervous system origins. This broad mapping of the option space enables an overview of the many influences and constraints that may have played a role in the evolution of the first nervous systems. © 2015 The Author(s).

CIDR

Science.gov Websites

Genotyping General Information Genome Wide Association Custom FFPE Sample Options Methylation Linkage Enrichment Options 51 Mb 51 Mb plus 6.8 - 24Mb custom option 54 Mb Clinical Exome 71 Mb (includes UTRs) Next Generation Sequencing Platform Illumina HiSeq sequencers Options for Formalin-Fixed Paraffin-Embedded (FFPE

76 FR 38240 - Self-Regulatory Organizations; NYSE Amex LLC; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-29

... To Include Text in Its Options Rules Governing the Use of Its Affiliate Broker-Dealer, Archipelago Securities LLC for Outbound Routing of Option Orders, and To Adopt Text in Its Options Rules To Permit the... Statement of the Terms of Substance of the Proposed Rule Change The Exchange proposes (1) To include text in...

Clinical and pharmacokinetic drug evaluation of delafloxacin for the treatment of acute bacterial skin and skin structure infections.

PubMed

Bassetti, Matteo; Pecori, Davide; Cojutti, Piergiorgio; Righi, Elda; Pea, Federico

2017-11-01

In the era of multi-drug resistant pathogens, the adequate treatment of skin and skin structure infections remains a challenge for clinicians. Delafloxacin, with its broad spectrum against Gram-positive, Gram-negative and anaerobic organisms, represents a new therapeutic option in this setting, especially when coverage of methicillin-resistant Staphylococcus aureus is required in the empirical or targeted approach. Areas covered: In this drug evaluation, the Authors have reviewed the pharmacokinetic and pharmacodynamic characteristics of delafloxacin. In addition, recent data on clinical efficacy and safety from clinical trials have been included. Expert opinion: Delafloxacin represents an attractive therapeutic option due to a broad antimicrobial and favorable pharmacokinetic and pharmacodynamic profile. Several in vitro studies have demonstrated the low potential for resistance selection if used in empirical regimens. Delafloxacin is a promising candidate for the treatment of Gram-positive infections, especially if co-infection with other pathogens is suspected. This is because of the very low MIC of the agent for Gram-positive (including MRSA) and anaerobic bacteria and because of the wide spectrum of activity against Gram-negative organisms. For these interesting microbiological and PK/PD characteristics we expect future uses of this drug in other indications such as diabetic foot infection, osteomyelitis, prosthetic joint infections, abdominal infections and central nervous system infections.

Pharmacotherapy of retinal disease with visual cycle modulators.

PubMed

Hussain, Rehan M; Gregori, Ninel Z; Ciulla, Thomas A; Lam, Byron L

2018-04-01

Pharmacotherapy with visual cycle modulators (VCMs) is under investigation for retinitis pigmentosa (RP), Leber congenital amaurosis (LCA), Stargardt macular dystrophy (SMD) and nonexudative age-related macular degeneration (AMD), all blinding diseases that lack effective treatment options. Areas covered: The authors review investigational VCMs, including oral retinoids, 9-cis-retinyl-acetate (zuretinol) and 9-cis-β-carotene, which restore 11-cis-retinal levels in RP and LCA caused by LRAT and RPE65 gene mutations, and may improve visual acuity and visual fields. Therapies for SMD aiming to decrease accumulation of toxic Vitamin A dimers and lipofuscin in the retina and retinal pigment epithelium (RPE) include C20-D3-vitamin A (ALK-001), isotretinoin, VM200, emixustat, and A1120. Mouse models of SMD show promising data for these treatments, though proof of efficacy in humans is currently lacking. Fenretinide and emixustat are investigational VCMs for dry AMD, though neither has been shown to reduce geographic atrophy or improve vision in human trials. A1120 prevents retinol transport into the RPE and may spare the side effects typically seen in VCMs (nyctalopia and chromatopsia) per mouse studies. Expert opinion: Oral VCMs may be feasible treatment options for degenerative retinal diseases based on pre-clinical and some early clinical studies. Further trials are warranted to assess their efficacy and safety in humans.

Identification of the condition of crops based on geospatial data embedded in graph databases

NASA Astrophysics Data System (ADS)

Idziaszek, P.; Mueller, W.; Górna, K.; Okoń, P.; Boniecki, P.; Koszela, K.; Fojud, A.

2017-07-01

The Web application presented here supports plant production and works with the graph database Neo4j shell to support the assessment of the condition of crops on the basis of geospatial data, including raster and vector data. The adoption of a graph database as a tool to store and manage the data, including geospatial data, is completely justified in the case of those agricultural holdings that have a wide range of types and sizes of crops. In addition, the authors tested the option of using the technology of Microsoft Cognitive Services at the level of produced application that enables an image analysis using the services provided. The presented application was designed using ASP.NET MVC technology and a wide range of leading IT tools.

Streamlining workflow and automation to accelerate laboratory scale protein production.

PubMed

Konczal, Jennifer; Gray, Christopher H

2017-05-01

Protein production facilities are often required to produce diverse arrays of proteins for demanding methodologies including crystallography, NMR, ITC and other reagent intensive techniques. It is common for these teams to find themselves a bottleneck in the pipeline of ambitious projects. This pressure to deliver has resulted in the evolution of many novel methods to increase capacity and throughput at all stages in the pipeline for generation of recombinant proteins. This review aims to describe current and emerging options to accelerate the success of protein production in Escherichia coli. We emphasize technologies that have been evaluated and implemented in our laboratory, including innovative molecular biology and expression vectors, small-scale expression screening strategies and the automation of parallel and multidimensional chromatography. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Supervised space robots are needed in space exploration

NASA Technical Reports Server (NTRS)

Erickson, Jon D.

1994-01-01

High level systems engineering models were developed to simulate and analyze the types, numbers, and roles of intelligent systems, including supervised autonomous robots, which will be required to support human space exploration. Conventional and intelligent systems were compared for two missions: (1) a 20-year option 5A space exploration; and (2) the First Lunar Outpost (FLO). These studies indicate that use of supervised intelligent systems on planet surfaces will 'enable' human space exploration. The author points out that space robotics can be considered a form of the emerging technology of field robotics and solutions to many space applications will apply to problems relative to operating in Earth-based hazardous environments.

Long-term Energy and Emissions Savings Potential in New York City Buildings

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

Bhatt, Vatsal; Lee, John; Klein, Yehuda

2012-09-30

The New York State Energy Research and Development Authority (NYSERDA) partnered with the Brookhaven National Laboratory (BNL) and the City University of New York (CUNY) to develop an integrated methodology that is capable of quantifying the impact of energy efficiency and load management options in buildings, including CUNY’s campus buildings, housing projects, hospitals, and hotels, while capturing the synergies and offsets in a complex and integrated energy-environmental system. The results of this work serve as a guideline in implementing urban energy efficiency and other forms of urban environmental improvement through cost-effective planning at the institutional and local level.

Diagnostic approach to cardiac amyloidosis: A case report.

PubMed

Fernandes, Andreia; Caetano, Francisca; Almeida, Inês; Paiva, Luís; Gomes, Pedro; Mota, Paula; Trigo, Joana; Botelho, Ana; Cachulo, Maria do Carmo; Alves, Joana; Francisco, Luís; Leitão Marques, António

2016-05-01

The authors present a case of systemic amyloidosis with cardiac involvement. We discuss the need for a high level of suspicion to establish a diagnosis, diagnostic techniques and treatment options. Our patient was a 78-year-old man with chronic renal disease and atrial fibrillation admitted with acute decompensated heart failure of unknown cause. The transthoracic echocardiogram revealed severely impaired left ventricular function with phenotypic overlap between hypertrophic and restrictive cardiomyopathy. After an extensive diagnostic workup, which included an abdominal fat pad biopsy, the final diagnosis was amyloidosis. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Opinion and Special Articles: Loan forgiveness options for young neurologists: Current landscape and practice implications.

PubMed

George, Benjamin P; Dorsey, E Ray; Grischkan, Justin A

2017-04-11

Increasing education debt has led to the availability of a variety of loan forgiveness options including the Department of Education's Public Service Loan Forgiveness (PSLF) program. This article discusses the current landscape of loan forgiveness options including trends in PSLF for rising neurology trainees, and implications for choices in specialization, employment, practice location, and the pursuit of an academic career. We further provide guidance on how to navigate the various loan forgiveness options that neurology residents and fellows may consider. © 2017 American Academy of Neurology.

48 CFR 52.217-3 - Evaluation Exclusive of Options.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Options. 52.217-3 Section 52.217-3 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION....217-3 Evaluation Exclusive of Options. As prescribed in 17.208(a), insert a provision substantially the same as the following in solicitations when the solicitation includes an option clause and does...

Making real options really work.

PubMed

van Putten, Alexander B; MacMillan, Ian C

2004-12-01

As a way to value growth opportunities, real options have had a difficult time catching on with managers. Many CFOs believe the method ensures the overvaluation of risky projects. This concern is legitimate, but abandoning real options as a valuation model isn't the solution. Companies that rely solely on discounted cash flow (DCF) analysis underestimate the value of their projects and may fail to invest enough in uncertain but highly promising opportunities. CFOs need not--and should not--choose one approach over the other. Far from being a replacement for DCF analysis, real options are an essential complement, and a project's total value should encompass both. DCF captures a base estimate of value; real options take into account the potential for big gains. This is not to say that there aren't problems with real options. As currently applied, they focus almost exclusively on the risks associated with revenues, ignoring the risks associated with a project's costs. It's also true that option valuations almost always ignore assets that an initial investment in a subsequently abandoned project will often leave the company. In this article, the authors present a simple formula for combining DCF and option valuations that addresses these two problems. Using an integrated approach, managers will, in the long run, select better projects than their more timid competitors while keeping risk under control. Thus, they will outperform their rivals in both the product and the capital markets.

What Women Want from Their Health Care Providers about Pregnancy Options Counseling: A Qualitative Study.

PubMed

French, Valerie A; Steinauer, Jody E; Kimport, Katrina

Unintended pregnancy is common in the United States, yet scant research has evaluated women's preferences on pregnancy options counseling. This study explores pregnant women's preferences for pregnancy options counseling from health care providers. We conducted semistructured interviews with pregnant women at a prenatal clinic and an abortion clinic. We asked women about recent discussions-or lack thereof-about pregnancy options (parenting, adoption, and abortion) with a clinician, and what they would want their provider to discuss about pregnancy options. We analyzed transcripts using modified grounded theory. We interviewed 10 women in prenatal care and 18 women seeking abortion. In both settings, most said clinicians should discuss pregnancy options with pregnant women and 1) respect patient autonomy, 2) avoid assumptions about a woman's desired pregnancy outcome, and 3) consider the patient-including her health and fertility intentions-beyond her pregnancy. Participants wanted their doctors to assess a pregnancy's individual circumstances to determine the appropriateness of options counseling. A few participants, including women who did and did not receive options counseling, reported they personally preferred not to receive such counseling. Explaining this preference, they cited preservation of privacy, having already made a decision for the pregnancy, or just not wanting to discuss abortion. Regarding best practices for providing options counseling, participants said it should be done in a routine manner, with discretion, and early in pregnancy. Pregnant women seeking both prenatal and abortion care broadly support options counseling. Discussion of pregnancy options, including abortion, provides patient-centered care and supports women's preferences. Copyright © 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Coordinating ecological restoration options analysis and risk assessment to improve environmental outcomes.

PubMed

Kapustka, Lawrence A; Bowers, Keith; Isanhart, John; Martinez-Garza, Cristina; Finger, Susan; Stahl, Ralph G; Stauber, Jenny

2016-04-01

Ecological risk assessment as currently practiced has hindered consideration of ecosystem services endpoints and restoration goals in the environmental management process. Practitioners have created barriers between procedures to clean up contaminated areas and efforts to restore ecosystem functions. In this article, we examine linkages between contaminant risk assessment approaches and restoration efforts with the aim of identifying ways to improve environmental outcomes. We advocate that project managers and other stakeholders use an ecological planning framework, with restoration options included upfront in the risk assessment. We also considered the opportunities to incorporate ecosystem services as potential assessment endpoints in the Problem Formulation stages of a risk assessment. Indeed, diverse perspectives of stakeholders are central to understand the relevance of social, cultural, economic, and regional ecology as influences on future use options for the landscape being restored. The measurement endpoints used to characterize the existing ecological conditions for selected ecosystem services can also be used to evaluate restoration success. A regional, landscape, or seascape focus is needed throughout the risk assessment process, so that restoration efforts play a more prominent role in enhancing ecosystem services. In short, we suggest that practitioners begin with the question of "how can the ecological risk assessment inform the decision on how best to restore the ecosystem?" © 2015 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of SETAC.

Factors influencing infant-feeding choices selected by HIV-infected mothers: perspectives from Zimbabwe.

PubMed

Marembo, Joan; Zvinavashe, Mathilda; Nyamakura, Rudo; Shaibu, Sheila; Mogobe, Keitshokile Dintle

2014-10-01

To assess factors influencing infant-feeding methods selected by HIV-infected mothers. A descriptive quantitative study was conducted among 80 mothers with babies aged 0-6 months who were randomly selected and interviewed. Descriptive statistics were used to summarize the findings. Factors considered by women in choosing the infant-feeding methods included sociocultural acceptability (58.8%), feasibility and support from significant others (35%), knowledge of the selected method (55%), affordability (61.2%), implementation of the infant-feeding method without interference (62.5%), and safety (47.5%). Exclusive breast-feeding was the most preferred method of infant feeding. Disclosure of HIV status by a woman to her partner is a major condition for successful replacement feeding method, especially within the African cultural context. However, disclosure of HIV status to the partner was feared by most women as only 16.2% of the women disclosed their HIV status to partners. The factors considered by women in choosing the infant-feeding option were ability to implement the options without interference from significant others, affordability, and sociocultural acceptability. Knowledge of the selected option, its advantages and disadvantages, safety, and feasibility were also important factors. Nurses and midwives have to educate clients and support them in their choice of infant-feeding methods. © 2013 The Authors. Japan Journal of Nursing Science © 2013 Japan Academy of Nursing Science.

Prevention of spread of communicable disease by air travel.

PubMed

Evans, Anthony D; Thibeault, Claude

2009-07-01

Mathematical modeling suggests that travel restrictions are likely to have only a limited effect on minimizing the spread of disease. Nevertheless, medical screening of travelers remains an option to be considered in a risk-reduction strategy. Screening of departing and/or arriving travelers are possibilities, although the World Health Organization (WHO) favors the former as it is normally easier to geographically contain a disease prior to its transmission outside the outbreak area. Apart from airport screening, several other related issues require consideration, including: transmission of disease on board aircraft; transmission of disease in airport terminal buildings; and contact tracing. A major challenge is to ensure adequate resources are devoted to pandemic preparedness planning in the aviation sector, which may not be fully considered in a national preparedness plan. This is because the prevention of accidents occupies most of the attention of regulatory aviation authorities, and public health authorities do not always see aviation as a priority area. Chief medical officers of regulatory authorities may be in a position to facilitate collaboration between the many stakeholders involved in preparedness planning for aviation.

44 CFR 201.6 - Local Mitigation Plans.

Code of Federal Regulations, 2011 CFR

2011-10-01

... agencies that have the authority to regulate development, as well as businesses, academia and other private... and development trends within the community so that mitigation options can be considered in future...

78 FR 2302 - Self-Regulatory Organizations; C2 Options Exchange, Incorporated; Order Approving a Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-10

... Authority To Cancel Orders When a Technical or Systems Issue Occurs and To Describe the Operation of Routing...,\\2\\ a proposed rule change to (i) address the authority of the Exchange to cancel orders (or release... that make it necessary to cancel orders (or release routing- related orders),\\6\\ and to resolve error...

Coast Guard Deepwater Program: Background, Oversight Issues, and Options for Congress

DTIC Science & Technology

2007-02-20

NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Congressional...Appendix E: NGSS Testimony . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Appendix F: Lockheed Martin Testimony...stopped at eight hulls (rather than the entire fleet of 49) due to deck cracking, hull buckling, and shaft alignment problems. These patrol boat

Coast Guard Deepwater Program: Background, Oversight Issues, and Options for Congress

DTIC Science & Technology

2007-04-30

NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Congressional Research...Northrop Grumman Ship Systems ( NGSS ). On April 18, 2007, it was reported that the Justice Department is conducting an investigation of the Deepwater...59 Appendix E. NGSS Testimony . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66 February 14, 2007

Rural Runaways: Rurality and Its Implications for Services to Children and Young People Who Run Away

ERIC Educational Resources Information Center

Franks, Myfanwy; Goswami, Haridhan

2010-01-01

This article debates options for service provision to young rural runaways in the UK. Using data drawn from two national surveys and follow-on qualitative studies, the authors trace urban myths of rurality and their effects on runaway provision. The authors review models of rural refuge, systemic advocacy and mobile services for rural runaways.…

Teacher Supply and Demand in the ACT Schools Authority: Implications of Enrollment Projections 1981-1986. Research Report.

ERIC Educational Resources Information Center

Burkhardt, Geoffrey

An analysis of policy options concerning teacher supply and demand in the A.C.T. [Australian Capital Territory] Schools Authority from 1981 to 1986 is presented. Projections have indicated declining demand for primary school teachers, fewer promotions in primary schools, and the necessity of relocating teachers to areas of expansion. However,…

Investigating the Experiences of Childhood Cancer Patients and Parents Participating in Optional Nontherapeutic Clinical Research Studies in the UK.

PubMed

Errington, Julie; Malik, Ghada; Evans, Julie; Baston, Jenny; Parry, Annie; Price, Lisa; Johnstone, Hina; Peters, Selena; Oram, Victoria; Howe, Karen; Whiteley, Emma; Tunnacliffe, Jane; Veal, Gareth J

2016-07-01

While the majority of childhood cancer clinical trials are treatment related, additional optional research investigations may be carried out that do not directly impact on treatment. It is essential that these studies are conducted ethically and that the experiences of families participating in these studies are as positive as possible. A questionnaire study was carried out to investigate the key factors that influence why families choose to participate in optional nontherapeutic research studies, the level of understanding of the trials involved, and the experiences of participation. A total of 100 participants from six UK centers were studied; 77 parents, 10 patients >16 years, and 13 patients aged 8-15 years. Ninety-seven percent of parents and 90% of patients felt that information provided prior to study consent was of the right length, with 52% of parents and 65% of patients fully understanding the information provided. Seventy-four percent of parents participated in research studies in order to "do something important", while 74% of patients participated "to help medical staff". Encouragingly, <5% of participants felt that their clinical care would be negatively affected if they did not participate. Positive aspects of participation included a perception of increased attention from medical staff. Negative aspects included spending longer periods in hospital and the requirement for additional blood samples. Ninety-six percent of parents and 87% of patients would participate in future studies. The study provides an insight into the views of childhood cancer patients and their parents participating in nontherapeutic clinical research studies. Overwhelmingly, the findings suggest that participation is seen as a positive experience. © 2016 The Authors. Pediatric Blood & Cancer, published by Wiley Periodicals, Inc.

Co-option of bacteriophage lysozyme genes by bivalve genomes.

PubMed

Ren, Qian; Wang, Chunyang; Jin, Min; Lan, Jiangfeng; Ye, Ting; Hui, Kaimin; Tan, Jingmin; Wang, Zheng; Wyckoff, Gerald J; Wang, Wen; Han, Guan-Zhu

2017-01-01

Eukaryotes have occasionally acquired genetic material through horizontal gene transfer (HGT). However, little is known about the evolutionary and functional significance of such acquisitions. Lysozymes are ubiquitous enzymes that degrade bacterial cell walls. Here, we provide evidence that two subclasses of bivalves (Heterodonta and Palaeoheterodonta) acquired a lysozyme gene via HGT, building on earlier findings. Phylogenetic analyses place the bivalve lysozyme genes within the clade of bacteriophage lysozyme genes, indicating that the bivalves acquired the phage-type lysozyme genes from bacteriophages, either directly or through intermediate hosts. These bivalve lysozyme genes underwent dramatic structural changes after their co-option, including intron gain and fusion with other genes. Moreover, evidence suggests that recurrent gene duplication occurred in the bivalve lysozyme genes. Finally, we show the co-opted lysozymes exhibit a capacity for antibacterial action, potentially augmenting the immune function of related bivalves. This represents an intriguing evolutionary strategy in the eukaryote-microbe arms race, in which the genetic materials of bacteriophages are co-opted by eukaryotes, and then used by eukaryotes to combat bacteria, using a shared weapon against a common enemy. © 2017 The Authors.

Holographic memories with encryption-selectable function

NASA Astrophysics Data System (ADS)

Su, Wei-Chia; Lee, Xuan-Hao

2006-03-01

Volume holographic storage has received increasing attention owing to its potential high storage capacity and access rate. In the meanwhile, encrypted holographic memory using random phase encoding technique is attractive for an optical community due to growing demand for protection of information. In this paper, encryption-selectable holographic storage algorithms in LiNbO 3 using angular multiplexing are proposed and demonstrated. Encryption-selectable holographic memory is an advance concept of security storage for content protection. It offers more flexibility to encrypt the data or not optionally during the recording processes. In our system design, the function of encryption and non-encryption storage is switched by a random phase pattern and a uniform phase pattern. Based on a 90-degree geometry, the input patterns including the encryption and non-encryption storage are stored via angular multiplexing with reference plane waves at different incident angles. Image is encrypted optionally by sliding the ground glass into one of the recording waves or removing it away in each exposure. The ground glass is a key for encryption. Besides, it is also an important key available for authorized user to decrypt the encrypted information.

Reducing emissions from agriculture to meet the 2 °C target.

PubMed

Wollenberg, Eva; Richards, Meryl; Smith, Pete; Havlík, Petr; Obersteiner, Michael; Tubiello, Francesco N; Herold, Martin; Gerber, Pierre; Carter, Sarah; Reisinger, Andrew; van Vuuren, Detlef P; Dickie, Amy; Neufeldt, Henry; Sander, Björn O; Wassmann, Reiner; Sommer, Rolf; Amonette, James E; Falcucci, Alessandra; Herrero, Mario; Opio, Carolyn; Roman-Cuesta, Rosa Maria; Stehfest, Elke; Westhoek, Henk; Ortiz-Monasterio, Ivan; Sapkota, Tek; Rufino, Mariana C; Thornton, Philip K; Verchot, Louis; West, Paul C; Soussana, Jean-François; Baedeker, Tobias; Sadler, Marc; Vermeulen, Sonja; Campbell, Bruce M

2016-12-01

More than 100 countries pledged to reduce agricultural greenhouse gas (GHG) emissions in the 2015 Paris Agreement of the United Nations Framework Convention on Climate Change. Yet technical information about how much mitigation is needed in the sector vs. how much is feasible remains poor. We identify a preliminary global target for reducing emissions from agriculture of ~1 GtCO 2 e yr -1 by 2030 to limit warming in 2100 to 2 °C above pre-industrial levels. Yet plausible agricultural development pathways with mitigation cobenefits deliver only 21-40% of needed mitigation. The target indicates that more transformative technical and policy options will be needed, such as methane inhibitors and finance for new practices. A more comprehensive target for the 2 °C limit should be developed to include soil carbon and agriculture-related mitigation options. Excluding agricultural emissions from mitigation targets and plans will increase the cost of mitigation in other sectors or reduce the feasibility of meeting the 2 °C limit. © 2016 The Authors Global Change Biology Published by John Wiley & Sons Ltd.

Strengthening Building Retrofit Markets

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

Templeton, Mary; Jackson, Robert

2014-04-15

The Business Energy Financing (BEF) program offered commercial businesses in Michigan affordable financing options and other incentives designed to support energy efficiency improvements. We worked through partnerships with Michigan utilities, lenders, building contractors, trade associations, and other community organizations to offer competitive interest rates and flexible financing terms to support energy efficiency projects that otherwise would not have happened. The BEF program targeted the retail food market, including restaurants, grocery stores, convenience stores, and wholesale food vendors, with the goal of achieving energy efficiency retrofits for 2 percent of the target market. We offered low interest rates, flexible payments, easymore » applications and approval processes, and access to other incentives and rebates. Through these efforts, we sought to help customers strive for energy savings retrofits that would save 20 percent or more on their energy use. This program helped Michigan businesses reduce costs by financing energy efficient lighting, heating and cooling systems, insulation, refrigeration, equipment upgrades, and more. Businesses completed the upgrades with the help of our authorized contractors, and, through our lending partners, we provided affordable financing options.« less

Utilising integrated urban water management to assess the viability of decentralised water solutions.

PubMed

Burn, Stewart; Maheepala, Shiroma; Sharma, Ashok

2012-01-01

Cities worldwide are challenged by a number of urban water issues associated with climate change, population growth and the associated water scarcity, wastewater flows and stormwater run-off. To address these problems decentralised solutions are increasingly being considered by water authorities, and integrated urban water management (IUWM) has emerged as a potential solution to most of these urban water challenges, and as the key to providing solutions incorporating decentralised concepts at a city wide scale. To incorporate decentralised options, there is a need to understand their performance and their impact on a city's total water cycle under alternative water and land management options. This includes changes to flow, nutrient and sediment regimes, energy use, greenhouse gas emissions, and the impacts on rivers, aquifers and estuaries. Application of the IUWM approach to large cities demands revisiting the fundamental role of water system design in sustainable city development. This paper uses the extended urban metabolism model (EUMM) to expand a logical definition for the aims of IUWM, and discusses the role of decentralised systems in IUWM and how IUWM principles can be incorporated into urban water planning.

Critical care of the hematopoietic stem cell transplant recipient.

PubMed

Afessa, Bekele; Azoulay, Elie

2010-01-01

An estimated 50,000 to 60,000 patients undergo hematopoietic stem cell transplantation (HSCT) worldwide annually, of which 15.7% are admitted to the intensive care unit (ICU). The most common reason for ICU admission is respiratory failure and almost all develop single or multiorgan failure. Most HSCT recipients admitted to ICU receive invasive mechanical ventilation (MV). The overall short-term mortality rate of HSCT recipients admitted to ICU is 65%, and 86.4% for those receiving MV. Patient outcome has improved over time. Poor prognostic indicators include advanced age, poor functional status, active disease at transplant, allogeneic transplant, the severity of acute illness, and the development of multiorgan failure. ICU resource limitations often lead to triage decisions for admission. For HSCT recipients, the authors recommend (1) ICU admission for full support during their pre-engraftment period and when there is no evidence of disease recurrence; (2) no ICU admission for patients who refuse it and those who are bedridden with disease recurrence and without treatment options except palliation; (3) a trial ICU admission for patients with unknown status of disease recurrence with available treatment options.

Intervention strategies to reduce human Toxoplasma gondii disease burden.

PubMed

Opsteegh, Marieke; Kortbeek, Titia M; Havelaar, Arie H; van der Giessen, Joke W B

2015-01-01

Infection with Toxoplasma gondii is acquired through consumption of undercooked infected meat, or by uptake of cat-shed oocysts. Although congenital toxoplasmosis is generally considered to contribute most to the disease burden of T. gondii, ocular disease from acquired infection was recently shown to add substantially to the burden. In addition, toxoplasmosis in immune-compromised individuals usually results from reactivation of an infection acquired earlier in life. Nevertheless, prevention of toxoplasmosis commonly targets mainly pregnant women. We summarize current prevention strategies of congenital toxoplasmosis and evaluate options to improve protection of the general population (including pregnant women). To protect the general population, freezing of meat destined for raw or undercooked consumption is the most readily applicable option, especially when limited to meat from animals originating from nonbiosecure husbandry systems. In the long term, more health benefits are expected from cat vaccination; therefore, development of a cat vaccine and evaluation of its implementation is a research priority. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Objective Comparison of Commercially Available Breast Implant Devices.

PubMed

Henderson, Peter W; Nash, David; Laskowski, Marta; Grant, Robert T

2015-10-01

Breast implants are frequently used for both cosmetic breast augmentation and breast reconstruction after mastectomy. Three companies currently offer FDA-approved breast implants (Allergan, Mentor, and Sientra), but their product offerings-including permanent breast implants, breast tissue expanders, sizers, and post-operative warranty-can be difficult to compare because of brand names and company-specific jargon. The ability to have a brand-agnostic understanding of all available options is important for both the surgical trainee as well as the surgeon in clinical practice. After a brief review of the history of breast implant devices, this review utilizes a unique conceptual framework based on variables such as fill material, shape, relative dimensions, and surface coating to facilitate a better understanding of the similarities and differences between the different company's offerings. Specifically, we identify which types of devices are offered by all three companies, those that are offered by only one company, those that have very limited product offerings, and those combinations that are not available at all. Finally, clinical implications are drawn from this framework that can be used by both cosmetic and reconstructive surgeons to counsel patients about all available options. Importantly, this project is entirely independent of any company's funding, support, or input. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

When teams can't decide. Are stalemates on your leadership team making you a dictator by default? Stop blaming your people--start fixing the process.

PubMed

Frisch, Bob

2008-11-01

Leadership teams that can't reach consensus wait for the CEO to make the final call--and often are disappointed by the outcome. Frisch calls this phenomenon the dictator-by-default syndrome. Many companies turn to team-building and communication exercises to try to fix the situation. But that won't work, the author argues, because the trouble is not with the people, it's with the decision-making process. Attempting to arrive at a collective preference on the basis of individual opinions is inherently problematic. Once leadership teams realize that voting-system mathematics are the culprit, they can stop wasting time on irrelevant psychological exercises and instead adopt practical measures designed to break the impasse. They must begin by acknowledging the problem and understanding what causes it. When more than two options are on the table, the scene is set for the CEO to become a dictator by default. Even yes-or-no choices present difficulties, because they always include a third, implied alternative: "Neither of the above." When the CEO and the team understand why they have trouble making decisions, they can adopt the following tactics to minimize dysfunction: Clearly articulate the desired outcome, generate a range of options for achieving it, test "fences" (which can be moved) and "walls" (which cannot), surface preferences early, state each option's pros and cons, and devise new options that preserve the best features of existing ones, Teams using such tactics need to adhere to two ground rules. First, they must deliberate confidentially, because a secure climate for conversation allows members to float trial balloons and cut deals. And second, members must be given enough time to study their options and assess the counterarguments. Only then can they achieve genuine alignment.

Distributed Energy Implementation Options

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

Shah, Chandralata N

2017-09-13

This presentation covers the options for implementing distributed energy projects. It distinguishes between options available for distributed energy that is government owned versus privately owned, with a focus on the privately owned options including Energy Savings Performance Contract Energy Sales Agreements (ESPC ESAs). The presentation covers the new ESPC ESA Toolkit and other Federal Energy Management Program resources.

77 FR 5073 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-01

... features including size, expiration date, exercise style, and certain exercise prices. FLEX option trading... cleared by The Options Clearing Corporation (``OCC'') \\17\\ and would be European style.\\18\\ Upon exercise... of the Exchange's WCOs or FCOs). \\18\\ Unlike American style options, European style options may be...

75 FR 75526 - Self-Regulatory Organizations; BATS Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-03

... Change To Extend the Penny Pilot Program November 29, 2010. Pursuant to Section 19(b)(1) of the... Options'') to extend the Penny Pilot Program (``Penny Pilot'') in options classes in certain issues... BATS Options, including rules applicable to BATS Options' participation in the Penny Pilot, were...

Guaranteed Student Loans: Potential Default and Cost Reduction Options. Briefing Report to Congressional Requesters.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. Div. of Human Resources.

Thirty options for reducing guaranteed student loan defaults and related federal costs are provided by the General Accounting Office (GAO). The options are presented by groups of program participants: students, schools, lenders, guaranty agencies, and the Department of Education. These options include: adopt GAO's past recommendation to increase…

Legal Rights

ERIC Educational Resources Information Center

Baril, Cecile; Couchman, Ian S. B.

1976-01-01

The legal processes following a rape charge mortify, denigrate and transfer guilt to the victim. Rape laws reinforce traditional sex roles and restrict the options available to women in defining their personal and sexual careers. (Author/AM)

Mainstreaming: Is It in the Best Interest of All Children?

ERIC Educational Resources Information Center

Simon, Libby

1992-01-01

This paper argues that the behaviorally disruptive child with aggressive tendencies might function better in a nonmainstreamed situation than in a mainstreamed classroom. Alternative options are presented. (Author/JDD)

New Options for AV in Telecommunications

ERIC Educational Resources Information Center

Gelman, Morrie

1974-01-01

A discussion of MDS, a multi-point distribution service which is a recently evolved supplementary telecommunications service that suggests new possibilities for improving the reach, impact and effectiveness of audio-visual communications. (Author)

A comparison of linear interpolation models for iterative CT reconstruction.

PubMed

Hahn, Katharina; Schöndube, Harald; Stierstorfer, Karl; Hornegger, Joachim; Noo, Frédéric

2016-12-01

Recent reports indicate that model-based iterative reconstruction methods may improve image quality in computed tomography (CT). One difficulty with these methods is the number of options available to implement them, including the selection of the forward projection model and the penalty term. Currently, the literature is fairly scarce in terms of guidance regarding this selection step, whereas these options impact image quality. Here, the authors investigate the merits of three forward projection models that rely on linear interpolation: the distance-driven method, Joseph's method, and the bilinear method. The authors' selection is motivated by three factors: (1) in CT, linear interpolation is often seen as a suitable trade-off between discretization errors and computational cost, (2) the first two methods are popular with manufacturers, and (3) the third method enables assessing the importance of a key assumption in the other methods. One approach to evaluate forward projection models is to inspect their effect on discretized images, as well as the effect of their transpose on data sets, but significance of such studies is unclear since the matrix and its transpose are always jointly used in iterative reconstruction. Another approach is to investigate the models in the context they are used, i.e., together with statistical weights and a penalty term. Unfortunately, this approach requires the selection of a preferred objective function and does not provide clear information on features that are intrinsic to the model. The authors adopted the following two-stage methodology. First, the authors analyze images that progressively include components of the singular value decomposition of the model in a reconstructed image without statistical weights and penalty term. Next, the authors examine the impact of weights and penalty on observed differences. Image quality metrics were investigated for 16 different fan-beam imaging scenarios that enabled probing various aspects of all models. The metrics include a surrogate for computational cost, as well as bias, noise, and an estimation task, all at matched resolution. The analysis revealed fundamental differences in terms of both bias and noise. Task-based assessment appears to be required to appreciate the differences in noise; the estimation task the authors selected showed that these differences balance out to yield similar performance. Some scenarios highlighted merits for the distance-driven method in terms of bias but with an increase in computational cost. Three combinations of statistical weights and penalty term showed that the observed differences remain the same, but strong edge-preserving penalty can dramatically reduce the magnitude of these differences. In many scenarios, Joseph's method seems to offer an interesting compromise between cost and computational effort. The distance-driven method offers the possibility to reduce bias but with an increase in computational cost. The bilinear method indicated that a key assumption in the other two methods is highly robust. Last, strong edge-preserving penalty can act as a compensator for insufficiencies in the forward projection model, bringing all models to similar levels in the most challenging imaging scenarios. Also, the authors find that their evaluation methodology helps appreciating how model, statistical weights, and penalty term interplay together.

Acceptance criteria for urban dispersion model evaluation

NASA Astrophysics Data System (ADS)

Hanna, Steven; Chang, Joseph

2012-05-01

The authors suggested acceptance criteria for rural dispersion models' performance measures in this journal in 2004. The current paper suggests modified values of acceptance criteria for urban applications and tests them with tracer data from four urban field experiments. For the arc-maximum concentrations, the fractional bias should have a magnitude <0.67 (i.e., the relative mean bias is less than a factor of 2); the normalized mean-square error should be <6 (i.e., the random scatter is less than about 2.4 times the mean); and the fraction of predictions that are within a factor of two of the observations (FAC2) should be >0.3. For all data paired in space, for which a threshold concentration must always be defined, the normalized absolute difference should be <0.50, when the threshold is three times the instrument's limit of quantification (LOQ). An overall criterion is then applied that the total set of acceptance criteria should be satisfied in at least half of the field experiments. These acceptance criteria are applied to evaluations of the US Department of Defense's Joint Effects Model (JEM) with tracer data from US urban field experiments in Salt Lake City (U2000), Oklahoma City (JU2003), and Manhattan (MSG05 and MID05). JEM includes the SCIPUFF dispersion model with the urban canopy option and the urban dispersion model (UDM) option. In each set of evaluations, three or four likely options are tested for meteorological inputs (e.g., a local building top wind speed, the closest National Weather Service airport observations, or outputs from numerical weather prediction models). It is found that, due to large natural variability in the urban data, there is not a large difference between the performance measures for the two model options and the three or four meteorological input options. The more detailed UDM and the state-of-the-art numerical weather models do provide a slight improvement over the other options. The proposed urban dispersion model acceptance criteria are satisfied at over half of the field experiments.

Fundamental concerns of women living with HIV around the implementation of Option B+

PubMed Central

Matheson, Rebecca; Moses-Burton, Suzette; Hsieh, Amy C; Dilmitis, Sophie; Happy, Margaret; Sinyemu, Eunice; Brion, Sophie O; Sharma, Aditi

2015-01-01

Introduction In 2011, the Global Plan towards the Elimination of New HIV Infections among Children by 2015 and Keeping Their Mothers Alive was launched to scale up efforts to comprehensively end vertical HIV transmission and support mothers living with HIV in remaining healthy. Amidst excitement around using treatment as prevention, Malawi's Ministry of Health conceived Option B+, a strategy used to prevent vertical transmission by initiating all pregnant and breastfeeding women living with HIV on lifelong antiretroviral therapy, irrespective of CD4 count. In 2013, for programmatic and operational reasons, the WHO officially recommended Option B+ to countries with generalized epidemics, limited access to CD4 testing, limited partner testing, long breastfeeding duration or high fertility rates. Discussion While acknowledging the opportunity to increase treatment access globally and its potential, this commentary reviews the concerns of women living with HIV about human rights, community-based support and other barriers to service uptake and retention in the Option B+ context. Option B+ intensifies many of the pre-existing challenges of HIV prevention and treatment programmes. As women seek comprehensive services to prevent vertical transmission, they can experience various human rights violations, including lack of informed consent, involuntary or coercive HIV testing, limited treatment options, termination of pregnancy or coerced sterilization and pressure to start treatment. Yet, peer and community support strategies can promote treatment readiness, uptake, adherence and lifelong retention in care; reduce stigma and discrimination; and mitigate potential violence stemming from HIV disclosure. Ensuring available and accessible quality care, offering food support and improving linkages to care could increase service uptake and retention. With the heightened focus on interventions to reach pregnant and breastfeeding women living with HIV, a parallel increase in vigilance to secure their health and rights is critical. Conclusion The authors conclude that real progress towards reducing vertical transmission and achieving viral load suppression can only be made by upholding the human rights of women living with HIV, investing in community-based responses, and ensuring universal access to quality healthcare. Only then will the opportunity of accessing lifelong treatment result in improving the health, dignity and lives of women living with HIV, their children and families. PMID:26643459

Fundamental concerns of women living with HIV around the implementation of Option B+.

PubMed

Matheson, Rebecca; Moses-Burton, Suzette; Hsieh, Amy C; Dilmitis, Sophie; Happy, Margaret; Sinyemu, Eunice; Brion, Sophie O; Sharma, Aditi

2015-01-01

In 2011, the Global Plan towards the Elimination of New HIV Infections among Children by 2015 and Keeping Their Mothers Alive was launched to scale up efforts to comprehensively end vertical HIV transmission and support mothers living with HIV in remaining healthy. Amidst excitement around using treatment as prevention, Malawi's Ministry of Health conceived Option B+, a strategy used to prevent vertical transmission by initiating all pregnant and breastfeeding women living with HIV on lifelong antiretroviral therapy, irrespective of CD4 count. In 2013, for programmatic and operational reasons, the WHO officially recommended Option B+ to countries with generalized epidemics, limited access to CD4 testing, limited partner testing, long breastfeeding duration or high fertility rates. While acknowledging the opportunity to increase treatment access globally and its potential, this commentary reviews the concerns of women living with HIV about human rights, community-based support and other barriers to service uptake and retention in the Option B+ context. Option B+ intensifies many of the pre-existing challenges of HIV prevention and treatment programmes. As women seek comprehensive services to prevent vertical transmission, they can experience various human rights violations, including lack of informed consent, involuntary or coercive HIV testing, limited treatment options, termination of pregnancy or coerced sterilization and pressure to start treatment. Yet, peer and community support strategies can promote treatment readiness, uptake, adherence and lifelong retention in care; reduce stigma and discrimination; and mitigate potential violence stemming from HIV disclosure. Ensuring available and accessible quality care, offering food support and improving linkages to care could increase service uptake and retention. With the heightened focus on interventions to reach pregnant and breastfeeding women living with HIV, a parallel increase in vigilance to secure their health and rights is critical. The authors conclude that real progress towards reducing vertical transmission and achieving viral load suppression can only be made by upholding the human rights of women living with HIV, investing in community-based responses, and ensuring universal access to quality healthcare. Only then will the opportunity of accessing lifelong treatment result in improving the health, dignity and lives of women living with HIV, their children and families.

Mars lander survey

NASA Technical Reports Server (NTRS)

Stump, William R.; Babb, Gus R.; Davis, Hubert P.

1986-01-01

The requirements, issues, and design options are reviewed for manned Mars landers. Issues such as high 1/d versus low 1/d shape, parking orbit, and use of a small Mars orbit transfer vehicle to move the lander from orbit to orbit are addressed. Plots of lander mass as a function of Isp, destination orbit, and cargo up and down, plots of initial stack mass in low Earth orbit as a function of lander mass and parking orbit, detailed weight statements, and delta V tables for a variety of options are included. Lander options include a range from minimum landers up to a single stage reusable design. Mission options include conjunction and Venus flyby trajectories using all-cryogenic, hybrid, NERVA, and Mars orbit aerobraking propulsion concepts.

Modulation of Saccade Vigor during Value-Based Decision Making.

PubMed

Reppert, Thomas R; Lempert, Karolina M; Glimcher, Paul W; Shadmehr, Reza

2015-11-18

During value-based decision-making, individuals consider the various options and select the one that provides the maximum subjective value. Although the brain integrates abstract information to compute and compare these values, the only behavioral outcome is often the decision itself. However, if the options are visual stimuli, during deliberation the brain moves the eyes from one stimulus to the other. Previous work suggests that saccade vigor, i.e., peak velocity as a function of amplitude, is greater if reward is associated with the visual stimulus. This raises the possibility that vigor during the free viewing of options may be influenced by the valuation of each option. Here, humans chose between a small, immediate monetary reward and a larger but delayed reward. As the deliberation began, vigor was similar for the saccades made to the two options but diverged 0.5 s before decision time, becoming greater for the preferred option. This difference in vigor increased as a function of the difference in the subjective values that the participant assigned to the delayed and immediate options. After the decision was made, participants continued to gaze at the options, but with reduced vigor, making it possible to infer timing of the decision from the sudden drop in vigor. Therefore, the subjective value that the brain assigned to a stimulus during decision-making affected the motor system via the vigor with which the eyes moved toward that stimulus. We find that, as individuals deliberate between two rewarding options and arrive at a decision, the vigor with which they make saccades to each option reflects a real-time evaluation of that option. With deliberation, saccade vigor diverges between the two options, becoming greater for the option that the individual will eventually choose. The results suggest a shared element between the network that assigns value to a stimulus during the process of decision-making and the network that controls vigor of movements toward that stimulus. Copyright © 2015 the authors 0270-6474/15/3515369-10$15.00/0.

Chemical Engineering at NASA

NASA Technical Reports Server (NTRS)

Collins, Jacob

2008-01-01

This viewgraph presentation is a review of the career paths for chemicals engineer at NASA (specifically NASA Johnson Space Center.) The author uses his personal experience and history as an example of the possible career options.

The Rights of the Child at School.

ERIC Educational Resources Information Center

Manley-Casimir, Michael E.

1979-01-01

The author argues for the delineation of children's and student's rights in Canada's proposed new federal constitution. He discusses the traditional legal status of schoolchildren and defines their welfare and option rights. (SJL)

High Technology and International Labour Markets.

ERIC Educational Resources Information Center

Carnoy, Martin

1985-01-01

The author examines the impact of "high-tech" industries on labor markets, the division of labor and the organization of work, and the policy options open to societies for dealing with the effects. (CT)

14 CFR 21.251 - Limits of applicability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... operation of those aircraft for the purpose of research and development, crew training, market surveys, or... option authorizations may be used for— (1) Type certification; (2) Changes in the type design of products...

An introduction to anorexia nervosa and bulimia nervosa.

PubMed

Murphy, Beverley; Manning, Yvonne

2003-12-17

Nurses may come into contact with patients who have anorexia nervosa and bulimia nervosa. The authors discuss the signs and symptoms of these illnesses and outline treatment options for patients with eating disorders.

Education and Opportunity: Some Economic Perspectives

ERIC Educational Resources Information Center

Bowman, Mary Jean

1975-01-01

A few of the interactive effects between schooling and patterns of options in life before and after experience in schooling are singled out for comment in their relation to education in economic terms. (Author/KM)

When maths trumps logic: probabilistic judgements in chimpanzees.

PubMed

Hanus, Daniel; Call, Josep

2014-12-01

When searching for hidden food, do chimpanzees take into account both the number of hidden items and the number of potential hiding locations? We presented chimpanzees with two trays, each of them containing a different food/cup ratio and therefore a different likelihood of finding a baited cup among empty alternatives. Subjects' performance was directly influenced by the relative difference (probability ratio (PR)) between the two given probabilities. Interestingly, however, they did not appreciate the special value of a truly safe option (with P = 1.0). Instead, they seemed to 'blindly' rely on the PR between the two options, systematically preferring the more likely one once a certain threshold had been reached. A control condition ruled out the possibility of low-level learning explanations for the observed performance. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

Treatment of Linear Scleroderma (en Coup de Sabre) With Dermal Fat Grafting.

PubMed

Barin, Ensar Zafer; Cinal, Hakan; Cakmak, Mehmet Akif; Tan, Onder

2016-05-01

Linear scleroderma, also known as "en coup de sabre," is a subtype of localized scleroderma that warrants aesthetic correction because it appears on the forehead region in children. To report dermal fat grafting as a novel and effective surgical treatment option in linear scleroderma. Under local anesthesia, a dermal fat graft was successfully placed into a subcutaneous pocket that was prepared underneath the depressed scar. The donor site was closed primarily. No early or late complications developed postoperatively. After 1-year follow-up, the dermal fat graft was viable, the depressed scar was adequately augmented, and a good aesthetic result and patient satisfaction were obtained. We believe that dermal fat grafting is a cost-effective option and provides a long-lasting aesthetic outcome in the management of linear scleroderma. © The Author(s) 2015.

Local peoples' knowledge, aptitude and perceptions of planning and management issues in nanda devi biosphere reserve, India.

PubMed

Rao, Kottapalli S; Nautiyal, Sunil; Maikhuri, Rakesh K; Saxena, Krishna G

2003-02-01

Local peoples' knowledge, aptitude, and perceptions of planning and management issues were investigated in Nanda Devi Biosphere Reserve (NDBR) in Uttaranchal State of India. Conflicts ensued between local inhabitants and the management authority due to lack of community participation. Although most respondents seem to claim the knowledge of the objectives of Nanda Devi Biosphere Reserve, the source of information indicates their interaction with the management authority is not frequent. While local population seem to agree on reduced intensity of agriculture with compensation equal to loss of net income, there is a perceptible difference in responses among different age groups. While the younger generation seems to agree to move away to other areas with suitable compensation packages, the older generation prefer those options that require some adjustments in use and access to natural resources. The option of ecotourism as a source of income is acceptable to most respondents, but young and old respondents disagreed about impact of such activity on social behavior of local inhabitants. Among those groups studied, only the "self-employed group" seem to be more interested in ecotourism in comparison to other occupation classes. Gender differences in perceptions are prominent with reference to development options. While the men preferred economic opportunities, the women preferred improved living conditions. An evaluation mechanism similar to the one described in this paper will be helpful to the management authority to assess and modify their management plans to mitigate conflicts with local people.

Adherence to Antiretroviral Therapy During and After Pregnancy: Cohort Study on Women Receiving Care in Malawi's Option B+ Program.

PubMed

Haas, Andreas D; Msukwa, Malango T; Egger, Matthias; Tenthani, Lyson; Tweya, Hannock; Jahn, Andreas; Gadabu, Oliver J; Tal, Kali; Salazar-Vizcaya, Luisa; Estill, Janne; Spoerri, Adrian; Phiri, Nozgechi; Chimbwandira, Frank; van Oosterhout, Joep J; Keiser, Olivia

2016-11-01

 Adherence to antiretroviral therapy (ART) is crucial to preventing mother-to-child transmission of human immunodeficiency virus (HIV) and ensuring the long-term effectiveness of ART, yet data are sparse from African routine care programs on maternal adherence to triple ART.  We analyzed data from women who started ART at 13 large health facilities in Malawi between September 2011 and October 2013. We defined adherence as the percentage of days "covered" by pharmacy claims. Adherence of ≥90% was deemed adequate. We calculated inverse probability of censoring weights to adjust adherence estimates for informative censoring. We used descriptive statistics, survival analysis, and pooled logistic regression to compare adherence between pregnant and breastfeeding women eligible for ART under Option B+, and nonpregnant and nonbreastfeeding women who started ART with low CD4 cell counts or World Health Organization clinical stage 3/4 disease.  Adherence was adequate for 73% of the women during pregnancy, for 66% in the first 3 months post partum, and for about 75% during months 4-21 post partum. About 70% of women who started ART during pregnancy and breastfeeding adhered adequately during the first 2 years of ART, but only about 30% of them had maintained adequate adherence at every visit. Risk factors for inadequate adherence included starting ART with an Option B+ indication, at a younger age, or at a district hospital or health center.  One-third of women retained in the Option B+ program adhered inadequately during pregnancy and breastfeeding, especially soon after delivery. Effective interventions to improve adherence among women in this program should be implemented. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.

Retirement Options to Offer College Faculty.

ERIC Educational Resources Information Center

Felicetti, Daniel A.

1982-01-01

Retirement options available to institutions are outlined, including early retirement incentives, phased retirement, facilitating consulting opportunities, travel and outplacement services, maintaining community involvement, annuities, and pensions. Suggestions are made for increasing cost-effectiveness and fitting the options to local…

75 FR 33882 - Self-Regulatory Organizations; NYSE Amex LLC and NYSE Arca, Inc.; Order Granting Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-15

... contracts, options on commodity futures contracts, swaps, forward contracts and/or options on physical.... \\8\\ 17 CFR 242.600. \\9\\ NYSE Amex Rule 915 also includes stock index futures contracts and options on... Approval of Proposed Rule Changes Relating to Listing and Trading Options on the ETFS Palladium Trust and...

77 FR 77176 - Self-Regulatory Organizations; BATS Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-31

... Change To Extend the Penny Pilot Program December 21, 2012. Pursuant to Section 19(b)(1) \\1\\ of the... Options'') to extend through June 30, 2013, the Penny Pilot Program (``Penny Pilot'') in options classes... Options, including rules applicable to BATS Options' participation in the Penny Pilot, were approved on...

77 FR 51088 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-23

... Forex Options can be found at Rule 1000C et seq. Rules applicable to Treasury security options are being... databases providing bond information, including information regarding the listing and/or trading location of... of options on foreign exchange (``forex'') currencies (``PHLX FOREX options'').\\15\\ In 2010 and 2011...

Surgical options for treatment of traumatic subdural hematomas in children younger than 2 years of age.

PubMed

Melo, José Roberto Tude; Di Rocco, Federico; Bourgeois, Marie; Puget, Stephanie; Blauwblomme, Thomas; Sainte-Rose, Christian; Meyer, Philippe G; Zerah, Michel

2014-04-01

Subdural hematoma (SDH) is the most common finding on cranial CT in pediatric victims of abusive head trauma (AHT). The hematomas are commonly bilateral and sometimes associated with interhemispheric hyperdensity and/or convexity hemorrhages. There is no consensus regarding the best surgical treatment in such cases nor are there standardized surgical protocols. The authors report their experience and discuss the routine surgical options in the management of traumatic SDH at a Level 1 Pediatric Trauma Center. In this paper, the authors describe a cross-sectional study with consecutive revision of data described in the medical records of Hôpital Universitaire Necker-Enfants Malades between January 2008 and January 2013. During this period, all children younger than 2 years of age who were admitted with a traumatic SDH identified on CT scans were included in this study. One hundred eighty-four children who had SDH and were younger than 2 years of age were included. Their median age was 5.8 months (range 5 days-23 months), and 70% of the children were male. On admission CT scans, the SDH was bilateral in 52% of cases and homogeneously hypodense in 77%. Neurosurgical treatment was undertaken in 111 children (60%) with an admission Glasgow Coma Scale score of 12 or less, bulging fontanels, or other signs suggestive of intracranial hypertension. The first surgical option was craniotomy in 1.8% (2) of these 111 cases, decompressive craniectomy in 1.8% (2), transcutaneous subdural puncture in 15% (17), external subdural drainage in 16% (18), subdural-subgaleal shunt placement in 17% (19), and subdural-peritoneal shunt placement in 48% (53). In 82% of the children initially treated with transcutaneous subdural puncture and in 50% of those treated with external subdural drainage, increase or persistence of the SDH, CSF or skin infection, or shunt system malfunction was observed and further surgical intervention was required. There was a 26% rate of complications in patients initially treated with a subdural-peritoneal shunt. Although 52% of the patients had bilateral SDH, bilateral drainage was only required in 9.4%. The choice of treatment should be determined by the clinical and radiological characteristics of the individual case. Although effective on an emergency basis, subdural puncture and external subdural drainage are frequently insufficient to obtain complete resolution of SDH, and temporary placement of a subdural-peritoneal shunt is needed in most cases.

Successful Surgical Treatment for Elephantiasis Nostras Verrucosa Using a New Designed Column Flap.

PubMed

Han, Hyun Ho; Lim, Soo Yeon; Oh, Deuk Young

2015-09-01

Elephantiasis nostras verrucosa is a chronic lymphedema that causes enlarged and disfigured extremities. There are plenty of treatment options. However, there is no complete treatment. Preventive or symptomatic therapy is the basis for treating elephantiasis. In this article, we report a case of elephantiasis nostras verrucosa treated successfully by surgical reconstruction using a newly designed column flap. © The Author(s) 2015.

Coast Guard Deepwater Program: Background, Oversight Issues, and Options for Congress

DTIC Science & Technology

2007-06-22

PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES...had been performed by Integrated Coast Guard Systems (ICGS) — an industry team led by Lockheed Martin and Northrop Grumman Ship Systems ( NGSS ). On...98 Appendix E. NGSS Testimony . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 May 17, 2007, Testimony

WITHDRAWN: The Optimal Treatment Options of Septated Chronic Subdural Hematoma: A Retrospective Comparison of Craniotomy Versus Endoscopic-Assisted Burr-Hole Craniostomy.

PubMed

Zhang, Jibo; Fan, Xingyue; Liu, Xuemeng; Chen, Jincao; Wang, Wei; Fu, Kai

2017-11-11

This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal. Copyright © 2017 Elsevier Inc. All rights reserved.

Nursing student clinical shift completion as a predictor of NCLEX failure.

PubMed

Woodworth, Julie A

2014-01-01

As competition for clinical sites increases, hospitals and nursing schools report the use of nontraditional student placements such as one 12-hour clinical shift; that was an option offered by the author's school. The author discusses implementation of 12-hour shifts and compared NCLEX fail rates of students on one 12-hour shift with students who had 2 weekly 6-hour shifts.

The costs and benefits of Option B+ for the prevention of mother-to-child transmission of HIV.

PubMed

Gopalappa, Chaitra; Stover, John; Shaffer, Nathan; Mahy, Mary

2014-01-01

Most countries follow WHO 2010 guidelines for the prevention of mother-to-child transmission (PMTCT) of HIV using either Option A or B for women not yet eligible for antiretroviral therapy (ART). Both of these approaches involve the use of antiretrovirals during pregnancy and breastfeeding. Some countries have adopted a new strategy, Option B+, in which HIV-positive pregnant women are started immediately on ART and continued for life. Option B+ is more costly than Options A or B, but provides additional health benefits. In this article, we estimate the additional costs and effectiveness of Option B+. We developed a deterministic model to simulate births, breastfeeding, and HIV infection in women in four countries, Kenya, Zambia, South Africa, and Vietnam that differ in fertility rate, birth interval, age at first birth, and breastfeeding patterns, but have similar age at HIV infection. We estimated the total PMTCT costs and new child infections under Options A, B, and B+, and measured cost-effectiveness as the incremental PMTCT-related costs per child infection averted. We included adult sexual transmissions averted from ART, the corresponding costs saved, and estimated the total incremental cost per transmission (child and adult) averted. When considering PMTCT-related costs and child infections, Option B+ was the most cost-effective strategy costing between $6000 and $23 000 per infection averted compared with Option A. Option B+ averted more child infections compared with Option B in all four countries and cost less than Option B in Kenya and Zambia. When including adult sexual transmissions averted, Option B+ cost less and averted more infections than Options A and B.

Space station data system analysis/architecture study. Task 2: Options development DR-5. Volume 1: Technology options

NASA Technical Reports Server (NTRS)

1985-01-01

The second task in the Space Station Data System (SSDS) Analysis/Architecture Study is the development of an information base that will support the conduct of trade studies and provide sufficient data to make key design/programmatic decisions. This volume identifies the preferred options in the technology category and characterizes these options with respect to performance attributes, constraints, cost, and risk. The technology category includes advanced materials, processes, and techniques that can be used to enhance the implementation of SSDS design structures. The specific areas discussed are mass storage, including space and round on-line storage and off-line storage; man/machine interface; data processing hardware, including flight computers and advanced/fault tolerant computer architectures; and software, including data compression algorithms, on-board high level languages, and software tools. Also discussed are artificial intelligence applications and hard-wire communications.

Electrical power systems for Mars

NASA Technical Reports Server (NTRS)

Giudici, Robert J.

1986-01-01

Electrical power system options for Mars Manned Modules and Mars Surface Bases were evaluated for both near-term and advanced performance potential. The power system options investigated for the Mission Modules include photovoltaics, solar thermal, nuclear reactor, and isotope power systems. Options discussed for Mars Bases include the above options with the addition of a brief discussion of open loop energy conversion of Mars resources, including utilization of wind, subsurface thermal gradients, and super oxides. Electrical power requirements for Mission Modules were estimated for three basic approaches: as a function of crew size; as a function of electric propulsion; and as a function of transmission of power from an orbiter to the surface of Mars via laser or radio frequency. Mars Base power requirements were assumed to be determined by production facilities that make resources available for follow-on missions leading to the establishment of a permanently manned Base. Requirements include the production of buffer gas and propellant production plants.

Electrical power systems for Mars

NASA Astrophysics Data System (ADS)

Giudici, Robert J.

1986-05-01

Electrical power system options for Mars Manned Modules and Mars Surface Bases were evaluated for both near-term and advanced performance potential. The power system options investigated for the Mission Modules include photovoltaics, solar thermal, nuclear reactor, and isotope power systems. Options discussed for Mars Bases include the above options with the addition of a brief discussion of open loop energy conversion of Mars resources, including utilization of wind, subsurface thermal gradients, and super oxides. Electrical power requirements for Mission Modules were estimated for three basic approaches: as a function of crew size; as a function of electric propulsion; and as a function of transmission of power from an orbiter to the surface of Mars via laser or radio frequency. Mars Base power requirements were assumed to be determined by production facilities that make resources available for follow-on missions leading to the establishment of a permanently manned Base. Requirements include the production of buffer gas and propellant production plants.

Some Thoughts on Applied Geography.

ERIC Educational Resources Information Center

Gritzner, Charles F.

1979-01-01

The geography student should be offered the option of applied geography courses as well as the more conservative humanistic approach, in order to respond to the challenges presented by existing societal needs and vocational opportunities. (Author/CK)

7 CFR 245.1 - General purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the National School Lunch Program (7 CFR part 210), the School Breakfast Program (7 CFR part 220), the... applicable, free and reduced price lunches, breakfasts, and at the option of the School Food Authority for...

7 CFR 245.1 - General purpose and scope.

Code of Federal Regulations, 2011 CFR

2011-01-01

... the National School Lunch Program (7 CFR part 210), the School Breakfast Program (7 CFR part 220), the... applicable, free and reduced price lunches, breakfasts, and at the option of the School Food Authority for...

[Delayed reconstructions of soft tissue defects of the face].

PubMed

Mest'ák, J

2007-06-01

The author describes a non-standard approach to the management of facial soft tissue defects. Significance of delayed reconstructions in defect face injuries and options for their employment in indicated cases are highlighted.

Modeling of Solid Waste Processing Options in BIO-Plex

NASA Technical Reports Server (NTRS)

Rodriguez, Luis F.; Finn, Cory; Kang, Sukwon; Hogan, John; Luna, Bernadette (Technical Monitor)

2000-01-01

BIO-Plex is a ground-based test bed currently under development by NASA for testing technologies and practices that may be utilized in future long-term life support missions. All aspects of such an Advanced Life Support (ALS) System must be considered to confidently construct a reliable system, which will not only allow the crew to survive in harsh environments, but allow the crew time to perform meaningful research. Effective handling of solid wastes is a critical aspect of the system, especially when recovery of resources contained in the waste is required. This is particularly important for ALS Systems configurations that include a Biomass Production Chamber. In these cases, significant amounts of inedible biomass waste may be produced, which can ultimately serve as a repository of necessary resources for sustaining life, notably carbon, water, and plant nutrients. Numerous biological and physicochemical solid waste processing options have been considered. Biological options include composting, aerobic digestion, and anaerobic digestion. Physicochemical options include pyrolysis, SCWO (supercritical water oxidation), various incineration configurations, microwave incineration, magnetically assisted gasification, and low temperature plasma reaction. Modeling of these options is a necessary step to assist in the design process. A previously developed top-level model of BIO-Plex implemented in MATLAB Simulink (r) for the use of systems analysis and design has been adopted for this analysis. Presently, this model only considered incineration for solid waste processing. Present work, reported here, includes the expansion of this model to include a wider array of solid waste processing options selected from the above options, bearing in mind potential, near term solid waste treatment systems. Furthermore, a trade study has also been performed among these solid waste processing technologies in an effort to determine the ideal technology for long-term life support missions.

Considerations on the role of buprenorphine in recovery from heroin addiction from a UK perspective.

PubMed

Nutt, David J

2015-01-01

The United Kingdom Drug Strategy emphasises recovery as a key focus in the treatment of drug dependence. A framework for recovery is defined in the Recovery-Orientated Drug Treatment report, written by an expert working group, and comprises four key phases: engagement and stabilisation, including the establishment of treatment goals; preparation for change, involving engagement in psychosocial and pharmacological interventions; active change, including detoxification and medical withdrawal; and completion, including interventions that strengthen community integration. A body of evidence supports the benefits of buprenorphine, a partial agonist at mu opioid receptors, in supporting individualised recovery based on this framework, specifically in relation to the potential for rapid stabilisation, flexibility to transition to other treatment options or achieve abstinence, effective blocking of on-top use of illicit drugs, the treatment of comorbidities through the minimisation of drug-drug interactions, and a good safety profile. In addition, the newer abuse-deterrent formulation of buprenorphine combined with the opioid antagonist naloxone is likely to strengthen recovery-orientated systems of care due to its potential to reduce misuse and diversion. Progress through the recovery journey and the ability to sustain recovery will depend on individual needs and goals and on the amount of recovery capital that individuals have developed. © The Author(s) 2014.

A Case of Severe, Prolonged, Refractory Hypophosphatemia After Zoledronic Acid Administration.

PubMed

Clark, Sarah L; Nystrom, Erin M

2016-04-01

Zoledronic acid (ZA) administration has been associated with electrolyte abnormalities, including hypocalcemia, hypomagnesemia, hypokalemia, and hypophosphatemia. We describe a case of severe, refractory hypophosphatemia in a patient who received ZA for hypercalcemia of malignancy (HCM). Little data are available that describe the incidence or degree of severity of hypophosphatemia that can occur following ZA administration. In addition, no formal recommendations exist to guide monitoring for or management of electrolyte derangements in the setting of bisphosphonate use. Our patient required daily, high-dose phosphorus replacement beginning day 4 following ZA administration. The average daily dose of phosphorus, including both intravenous and enteral administration, was highest in the first 2 weeks after ZA, averaging 77 mmol/d days 4 through 15, and does not include sources of phosphorus from the patient's nutrition support. Despite this high amount of supplementation, which was well beyond what meets normal daily requirements and the amount expected to treat "usual" hypophosphatemia, the patient did not achieve sustained normal serum phosphorus levels for over 30 days after ZA. ZA is a favorable option for treating HCM because of its longer duration of action, potent serum calcium-lowering effects, and favorable safety profile. The risk of hypophosphatemia with ZA use is reviewed. © The Author(s) 2016.

Advanced policy options to regulate sugar-sweetened beverages to support public health.

PubMed

Pomeranz, Jennifer L

2012-02-01

Consumption of sugar-sweetened beverages (SSBs) has increased worldwide. As public health studies expose the detrimental impact of SSBs, consumer protection and public health advocates have called for increased government control. A major focus has been on restricting marketing of SSBs to children, but many innovative policy options--legally defensible ways to regulate SSBs and support public health--are largely unexplored. We describe the public health, economic, and retail marketing research related to SSBs (including energy drinks). We review policy options available to governments, including mandatory factual disclosures, earmarked taxation, and regulating sales, including placement within retail and food service establishments, and schools. Our review describes recent international initiatives and classifies options available in the United States by jurisdiction (federal, state, and local) based on legal viability.

Local government: The sleeping giant in electric industry restructuring

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

Ridley, S.

1997-11-01

Public power has long been a cornerstone of consumer leverage in the electric industry. But its foundation consists of a much broader and deeper consumer authority. Understanding that authority - and present threats to it - is critical to restructuring of the electric industry as well as to the future of public power. The country has largely forgotten the role that local governments have played and continue to play in the development of the electric industry. Moreover, we risk losing sight of the options local governments may offer to protect consumers, to advance competition in the marketplace, and to enhancemore » opportunities for technology and economic development. The future role of local government is one of the most important issues in the restructuring discussion. The basic authority of consumers rests at the local level. The resulting options consumers have to act as more than just respondents to private brokers and telemarketing calls are at the local level. And the ability for consumers to shape the marketplace and standards for what it will offer exists at the local level as well.« less

Greenhouse Gas Mitigation Options Database(GMOD)and Tool

EPA Science Inventory

Greenhouse Gas Mitigation Options Database (GMOD) is a decision support database and tool that provides cost and performance information for GHG mitigation options for the power, cement, refinery, landfill and pulp and paper sectors. The GMOD includes approximately 450 studies fo...

Analyzing lease/purchase options.

PubMed

Ciolek, D; Mace, J D

1998-01-01

The authors' previous article, "Equipment Acquisition Using Various Forms of Leasing," covers information necessary for selecting among the different kinds of leases. This article explains how to reach a proper financial analysis, preferably using two phases. Using a representative example, the article guides the reader through the first phase and introduces the elements needing review in the second phase. Key elements include pretax aftertax and cash flow analyses. Different organizations use different yardsticks to measure the financials of a transaction, but in general, cash is king. Therefore, the most widely used comparison is the purchase versus lease IRR (internal rate of return) produced by measuring the cash flow of the purchase case compared to the cash flow of the lease case.

Going Beyond Antidepressant Monotherapy for Incomplete Response in Non-Psychotic Late-Life Depression: A Critical Review

PubMed Central

Maust, Donovan T.; Oslin, David W.; Thase, Michael E.

2012-01-01

Many older adults with Major Depressive Disorder (MDD) do not respond to antidepressant monotherapy. While there are evidence-based treatment options to support treatment beyond monotherapy for adults, the evidence for such strategies specifically in late-life MDD is relatively scarce. This review examines the published data describing strategies for antidepressant augmentation or acceleration studied specifically in older adults, including lithium, stimulants, and second-generation antipsychotics. In addition, the authors suggest strategies for future research, such as study of specific agents, refining understanding of the impact of medical or cognitive comorbidity in late-life depression, and comparative effectiveness to examine methods already used in clinical practice. PMID:23567381

PROJECT W-551 INTERIM PRETREATMENT SYSTEM PRECONCEPTUAL CANDIDATE TECHNOLOGY DESCRIPTIONS

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

MAY TH

The Office of River Protection (ORP) has authorized a study to recommend and select options for interim pretreatment of tank waste and support Waste Treatment Plant (WTP) low activity waste (LAW) operations prior to startup of all the WTP facilities. The Interim Pretreatment System (IPS) is to be a moderately sized system which separates entrained solids and 137Cs from tank waste for an interim time period while WTP high level waste vitrification and pretreatment facilities are completed. This study's objective is to prepare pre-conceptual technology descriptions that expand the technical detail for selected solid and cesium separation technologies. This revisionmore » includes information on additional feed tanks.« less

Adjuvant treatment of stage IB NSCLC: the problem of stage subset heterogeneity.

PubMed

Calhoun, Royce; Jablons, David; Lau, Derick; Gandara, David R

2008-04-30

While 5-year survival rates in patients with stage IB non-small-cell lung cancer (NSCLC) are historically modest (40% to 67%), adjuvant chemotherapy trials including this subgroup have shown little evidence of chemotherapeutic benefit. This article reviews the available data regarding adjuvant chemotherapy following surgically resected stage IB NSCLC, framed within the context of present and future proposed definitions of this diagnosis. The discussion addresses limitations of the current staging system and how this contributes to the mixed results seen with adjuvant treatment. In addition, the authors consider current treatment options for stage IB NSCLC and review planned clinical trials for stage I disease designed to exploit new pharmacogenomic findings.

The decision making process on public health measures related to passenger ships: the example of influenza pandemic 2009.

PubMed

Mouchtouri, V A; Bartlett, C L R; Jaremin, Bogdan; Nichols, G; Paux, T; Riemer, T; Black, N; Varela-Martinez, C; Swaan, C M; Schlaich, C; Rachiotis, G; Kremastinou, J; Hadjichristodoulou, C

2010-01-01

Public health measures at sea ports have posed a challenge for public health competent authorities, especially in the context of the influenza pandemic of 2009. This paper discusses the response of authorities to notifications of infectious diseases on passenger ships and the importance of assessing the risks related to cases of influenza. It further provides options for health measures and considerations for decision making during a pandemic such as the influenza pandemic of 2009. Prevention and control of influenza have included action taken by both competent port authorities and ships' crews. Assessing the public health risk of each event reported from ships to competent authorities at ports is important before advice is given on implementation of control measures. Public health risk assessment involves appraisal of threats to passengers and crew on board the ship as well as to the population in the community. Any public health measures taken should be necessary and proportional to the threat. Measures at ports cannot alone be effective in the prevention of the spread of a disease to the community since other means of transport play a major role. Measures taken on board ships can be effective in containing the disease. Consistent policy based on common protocols and carried out by competent authorities at local, national, European, or international levels are essential.

Supporting shared decision making using an Option Grid for osteoarthritis of the knee in an interface musculoskeletal clinic: A stepped wedge trial.

PubMed

Elwyn, Glyn; Pickles, Tim; Edwards, Adrian; Kinsey, Katharine; Brain, Kate; Newcombe, Robert G; Firth, Jill; Marrin, Katy; Nye, Alan; Wood, Fiona

2016-04-01

To evaluate whether introducing tools, specifically designed for use in clinical encounters, namely Option Grids, into a clinical practice setting leads to higher levels of shared decision making. A stepped wedge trial design where 6 physiotherapists at an interface clinic in Oldham, UK, were sequentially instructed in how to use an Option Grid for osteoarthritis of the knee. Patients with suspected or confirmed osteoarthritis of the knee were recruited, six per clinician prior to instruction, and six per clinician afterwards. We measured shared decision making, patient knowledge, and readiness to decide. A total of 72 patients were recruited; 36 were allocated to the intervention group. There was an 8.4 point (95% CI 4.4 to 12.2) increase in the Observer OPTION score (range 0-100) in the intervention group. The mean gain in knowledge was 0.9 points (score range 0-5, 95% CI, 0.3 to 1.5). There was no increase in encounter duration. Shared decision making increased when clinicians used the knee osteoarthritis Option Grid. Tools designed to support collaboration and deliberation about treatment options lead to increased levels of shared decision making. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Funding technology: evaluating and exercising the leasing option.

PubMed

McIntire, Mark; Waldron, David J

2006-11-01

Tax-exempt capital leases, when structured through the appropriate conduit authority, are an excellent option for financing equipment that the hospital wants to own. Operating leases offer the benefits of immediate cash flow savings when compared with buying equipment, fewer complications and lower upfront costs when compared with bond issues, and the ability to match short-term assets with short-term liabilities. A best-practice leasing process involves nine steps progressing from assessing needs and soliciting bids from equipment manufacturers to implementing the lease and providing continuing disclosure.

Cockpit Resource Management (CRM) and human factors training: What Air New Zealand is doing about it

NASA Technical Reports Server (NTRS)

Scott-Milligan, Fionna; Wyness, Bryan

1987-01-01

The authors have played an integral role in Air New Zealand's evaluation of CRM and Human Factors training options available to date. As the final decision as to which course is best suited to Air New Zealand's needs has yet to be made, briefly outlined are: (1) why this form of training was considered necessary; (2) the approach taken to evaluating the options available; (3) some of the problems encountered on the way; and (4) some plans for the future.

Saugus River and Tributaries Flood Damage Reduction Study: Lynn, Malden, Revere and Saugus, Massachusetts. Volume 7. Appendix J. Feasibility Study and EIS/EIR Comments and Responses. Section C. Final Report Review,

DTIC Science & Technology

1990-04-01

There are significant differences between the social , economic and environ- mental impacts associated with Option 1, as described in the report when...Engineers, the project is authorized Sink# Pinka by the U.S. Congress. and after the completion of plans and specifications, Stone Memoria zoos which...project. The individuals and businesses who will derive cV act social and economic benefits from this option are not being required to contribute to

How well do websites concerning children's anxiety answer parents' questions about treatment choices?

PubMed

Reynolds, Kristin A; Walker, John R; Walsh, Kate

2015-10-01

The goals of this study were to evaluate the quality of information concerning anxiety disorders in children that is available on the Internet and to evaluate changes in the quality of website information over time. The authors identified websites addressing child anxiety disorders (N = 26) using a Google search and recommendations from an expert in child anxiety. Each website was evaluated on the extent to which it addressed questions that parents consider important, the quality of information, and the reading level. All websites provided adequate information describing treatment options; however, fewer websites had information addressing many questions that are important to parents, including the duration of treatment, what happens when treatment stops, and the benefits and risks of various treatments. Many websites provided inadequate information on pharmacological treatment. Most websites were of moderate quality and had more difficult reading levels than is recommended. Five years after the initial assessment, authors re-analyzed the websites in order to investigate changes in content over time. The content of only six websites had been updated since the original analysis, the majority of which improved on the three aforementioned areas of evaluation. Websites could be strengthened by providing important information that would support parent decision-making. © The Author(s) 2014.

TANK SPACE ALTERNATIVES ANALYSIS REPORT

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

TURNER DA; KIRCH NW; WASHENFELDER DJ

2010-04-27

This report addresses the projected shortfall of double-shell tank (DST) space starting in 2018. Using a multi-variant methodology, a total of eight new-term options and 17 long-term options for recovering DST space were evaluated. These include 11 options that were previously evaluated in RPP-7702, Tank Space Options Report (Rev. 1). Based on the results of this evaluation, two near-term and three long-term options have been identified as being sufficient to overcome the shortfall of DST space projected to occur between 2018 and 2025.

Surgical options for lumbosacral fusion: biomechanical stability, advantage, disadvantage and affecting factors in selecting options.

PubMed

Yoshihara, Hiroyuki

2014-07-01

Numerous surgical procedures and instrumentation techniques for lumbosacral fusion (LSF) have been developed. This is probably because of its high mechanical demand and unique anatomy. Surgical options include anterior column support (ACS) and posterior stabilization procedures. Biomechanical studies have been performed to verify the stability of those options. The options have their own advantage but also disadvantage aspects. This review article reports the surgical options for lumbosacral fusion, their biomechanical stability, advantages/disadvantages, and affecting factors in option selection. Review of literature. LSF has lots of options both for ACS and posterior stabilization procedures. Combination of posterior stabilization procedures is an option. Furthermore, combinations of ACS and posterior stabilization procedures are other options. It is difficult to make a recommendation or treatment algorithm of LSF from the current literature. However, it is important to know all aspects of the options and decision-making of surgical options for LSF needs to be tailored for each patient, considering factors such as biomechanical stress and osteoporosis.

Senioritis: Some Paths to Sanity

ERIC Educational Resources Information Center

O'Neal, Roland

1978-01-01

A social studies course for high school seniors combines a problems of democracy content with options emphasizing long-term accountability. Each student has a faculty adviser who encourages the student to pursue a specialized social studies topic. (Author/DB)

76 FR 50796 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Notice of Filing...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-16

... designed to minimize the potential for mini-manipulations and for corners or squeezes of the underlying... movements by automated surveillance techniques to identify unusual activity in both options and underlying...

Health Care Delivery.

ERIC Educational Resources Information Center

Starfield, Barbara

1987-01-01

The article reviews emerging health care delivery options for handicapped children. Cost structures, quality of care, and future prospects are considered for Health Maintenance Organizations, Preferred Provider Organizations, Tax Supported Direct Service Programs, Hospital-Based Services, and Ambulatory Care Organizations. (Author/DB)

Low-Cost Planetary Missions Enabled by the Deep Space Gateway

NASA Astrophysics Data System (ADS)

Berinstain, A.; Richards, R. D.

2018-02-01

The authors will present options for discussion among participants of how low-cost lunar and planetary missions using the Moon Express family of spacecraft can be enabled by the presence of the Deep Space Gateway.

Sexism: A Tri-Dimensional Phenomenon.

ERIC Educational Resources Information Center

Rombough, Shirley; Ventimiglia, Joseph C.

1981-01-01

Discusses the development of a Likert format scale with a Guttman Scoring option which measures attitudes toward sex roles in three broad areas: internal familial division of labor; external (economic) division of labor; and perceived sex differences. (Author/MK)

38 CFR 21.4504 - Promissory note.

Code of Federal Regulations, 2010 CFR

2010-07-01

... result of a mistake of fact or law. (Authority: 38 U.S.C. 3698 (e)(1)) (e) Death or disability. If the... or part of the loan, without penalty, at the option of the borrower. (b) Interest. The promissory...

4 CFR 201.5 - Requests for Board records.

Code of Federal Regulations, 2011 CFR

2011-01-01

... about each record sought, such as date, title or name, author, recipient, and subject. (g) If the FOIA... must state, in writing: (1) Your full name, (2) Address, (3) Telephone number, and (4) At your option...

Risky decision making across three arenas of choice: are younger and older adults differently susceptible to framing effects?

PubMed

Rönnlund, Michael; Karlsson, Erik; Laggnäs, Erica; Larsson, Lisa; Lindström, Therese

2005-01-01

In the present study, the authors investigated the effects of framing of options on risky decision making in groups of younger adults (M = 23.8 years, n = 192) and older adults (M = 69.1 years, n = 192). The participants were assigned to one of three scenarios varying in the goods at stake (human lives, paintings, money). The authors observed a majority preference in favor of the risky options after negative, but not positive framing. They also found, as they had predicted, that the type of framing effect varied across scenarios, with a bidirectional framing effect for the life-death scenario and unidirectional (risk averse) framing effects when public property (paintings) or personal property (money) were at stake. It is important to note that these choice preference patterns were highly similar across the age groups, which reinforced the conclusion that younger and older adults are equally susceptible to framing effects.

Facing the challenges of new melanoma-targeted therapies: Treatment of severe fevers associated with dabrafenib/trametinib combination therapy.

PubMed

Lindsay, Julian N; Barras, Michael

2015-08-01

With the emergence of new oral therapies for metastatic melanoma to the market, as well as ongoing pre-marketing trials and special access schemes, it is important to keep up to date with the side effect profiles of these medications. A common side effect associated with the BRAF inhibitor dabrafenib is severe fever symptoms such as pyrexia and rigors/chills; however, treatment options are limited. We report a patient who was debilitated by severe pyrexia and rigors caused by dabrafenib used in combination with trametinib to treat metastatic melanoma, who was treated with low-dose steroids. To our knowledge, the use of prednisolone for the treatment and prevention of further dabrafenib-associated pyrexia is not published; however, it is a low risk and low cost option that was very effective in this case. © The Author(s) 2014.

Update on treatment modalities for optic nerve sheath meningiomas.

PubMed

Liu, James K; Forman, Scott; Moorthy, Chitti R; Benzil, Deborah L

2003-05-15

Optic nerve sheath meningiomas (ONSMs) represent 1 to 2% of all meningiomas and one third of all optic nerve tumors. The management of ONSMs is controversial. Traditional surgical removal often results in postoperative blindness in the affected eye and thus has been abandoned as a treatment option in most patients. Surgery may be unnecessarily aggressive, especially if the patient has useful vision. When these tumors are left untreated, however, ensuing progressive visual impairment may lead to complete blindness. More recently, radiotherapy has gained wider acceptance as a treatment for these lesions. The authors of some reports have suggested that fractionated stereotactic radiosurgery (SRS) may be the best option for treating primary ONSMs. In patients with documented progressive visual deterioration, fractionated SRS may be effective in improving or stabilizing remaining functional vision. The authors review the clinical presentation, radiographic characteristics, and management of ONSMs, emphasizing the use of fractionated SRS.

An Efficient, Noniterative Method of Identifying the Cost-Effectiveness Frontier.

PubMed

Suen, Sze-chuan; Goldhaber-Fiebert, Jeremy D

2016-01-01

Cost-effectiveness analysis aims to identify treatments and policies that maximize benefits subject to resource constraints. However, the conventional process of identifying the efficient frontier (i.e., the set of potentially cost-effective options) can be algorithmically inefficient, especially when considering a policy problem with many alternative options or when performing an extensive suite of sensitivity analyses for which the efficient frontier must be found for each. Here, we describe an alternative one-pass algorithm that is conceptually simple, easier to implement, and potentially faster for situations that challenge the conventional approach. Our algorithm accomplishes this by exploiting the relationship between the net monetary benefit and the cost-effectiveness plane. To facilitate further evaluation and use of this approach, we also provide scripts in R and Matlab that implement our method and can be used to identify efficient frontiers for any decision problem. © The Author(s) 2015.

Targeted Killing, An Option for the Operational Commander

DTIC Science & Technology

2007-11-06

punishment. In Peru , authorities had significant success derailing the brutal Shining Path terrorist group with the capture and display of a...demoralized Abimael Guzman in 1992. The once feared terrorist was described as an overweight pensioner when publicly displayed in prison garb by Peruvian...authorities.64 The Shining Path still exists but it has not recaptured its place as a real threat to Peru .65 Similarly, Turkey’s capture of Kurdish

The Costs and Risks of Maturing Technologies, Traditionally vs. Evolutionary Approaches

DTIC Science & Technology

2008-04-23

Acquiring Combat Capability via Public-Private Partnerships (PPPs) Knowledge Value Added (KVA) + Real Options (RO) Applied to Shipyard Planning Processes...NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Tennenbaum Institute...a candid environment where high-ranking Department of Defense (DoD) officials, industry officials, accomplished faculty and military students are

Helping Water Utilities Grapple with Climate Change

NASA Astrophysics Data System (ADS)

Yates, D.; Gracely, B.; Miller, K.

2008-12-01

The Water Research Foundation (WRF), serving the drinking water industry and the National Center for Atmospheric Research (NCAR) are collaborating on an effort to develop and implement locally-relevant, structured processes to help water utilities consider the impacts and adaptation options that climate variability and change might have on their water systems. Adopting a case-study approach, the structured process include 1) a problem definition phase, focused on identifying goals, information needs, utility vulnerabilities and possible adaptation options in the face of climate and hydrologic uncertainty; 2) developing and/or modifying system-specific Integrated Water Resource Management (IWRM) models and conducting sensitivity analysis to identify critical variables; 3) developing probabilistic climate change scenarios focused on exploring uncertainties identified as important in the sensitivity analysis in step 2; and 4) implementing the structured process and examining approaches decision making under uncertainty. Collaborators include seven drinking water utilities and two state agencies: 1) The Inland Empire Utility Agency, CA; 2) The El Dorado Irrigation District, Placerville CA; 2) Portland Water Bureau, Portland OR; 3) Colorado Springs Utilities, Colo Spgs, CO; 4) Cincinnati Water, Cincinnati, OH; 5) Massachusetts Water Resources Authority (MWRA), Boston, MA; 6) Durham Water, Durham, NC; and 7) Palm Beach County Water (PBCW), Palm Beach, FL. The California Department of Water Resources and the Colorado Water Conservation Board were the state agencies that we have collaborated with.

The International College of Neuropsychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 1: Background and Methods of the Development of Guidelines.

PubMed

Fountoulakis, Konstantinos N; Young, Allan; Yatham, Lakshmi; Grunze, Heinz; Vieta, Eduard; Blier, Pierre; Moeller, Hans Jurgen; Kasper, Siegfried

2017-02-01

This paper includes a short description of the important clinical aspects of Bipolar Disorder with emphasis on issues that are important for the therapeutic considerations, including mixed and psychotic features, predominant polarity, and rapid cycling as well as comorbidity. The workgroup performed a review and critical analysis of the literature concerning grading methods and methods for the development of guidelines. The workgroup arrived at a consensus to base the development of the guideline on randomized controlled trials and related meta-analyses alone in order to follow a strict evidence-based approach. A critical analysis of the existing methods for the grading of treatment options was followed by the development of a new grading method to arrive at efficacy and recommendation levels after the analysis of 32 distinct scenarios of available data for a given treatment option. The current paper reports details on the design, method, and process for the development of CINP guidelines for the treatment of Bipolar Disorder. The rationale and the method with which all data and opinions are combined in order to produce an evidence-based operationalized but also user-friendly guideline and a specific algorithm are described in detail in this paper. © The Author 2016. Published by Oxford University Press on behalf of CINP.

The tale of hearts and reason: the influence of mood on decision making.

PubMed

Laborde, Sylvain; Raab, Markus

2013-08-01

In decision-making research, one important aspect of real-life decisions has so far been neglected: the mood of the decision maker when generating options. The authors tested the use of the take-the-first (TTF) heuristic and extended the TTF model to understand how mood influences the option-generation process of individuals in two studies, the first using a between-subjects design (30 nonexperts, 30 near-experts, and 30 experts) and the second conceptually replicating the first using a within-subject design (30 nonexperts). Participants took part in an experimental option-generation task, with 31 three-dimensional videos of choices in team handball. Three moods were elicited: positive, neutral, and negative. The findings (a) replicate previous results concerning TTF and (b) show that the option-generation process was associated with the physiological component of mood, supporting the neurovisceral integration model. The extension of TTF to processing emotional factors is an important step forward in explaining fast choices in real-life situations.

The visual and functional impacts of astigmatism and its clinical management.

PubMed

Read, Scott A; Vincent, Stephen J; Collins, Michael J

2014-05-01

To provide a comprehensive overview of research examining the impact of astigmatism on clinical and functional measures of vision, the short and longer term adaptations to astigmatism that occur in the visual system, and the currently available clinical options for the management of patients with astigmatism. The presence of astigmatism can lead to substantial reductions in visual performance in a variety of clinical vision measures and functional visual tasks. Recent evidence demonstrates that astigmatic blur results in short-term adaptations in the visual system that appear to reduce the perceived impact of astigmatism on vision. In the longer term, uncorrected astigmatism in childhood can also significantly impact on visual development, resulting in amblyopia. Astigmatism is also associated with the development of spherical refractive errors. Although the clinical correction of small magnitudes of astigmatism is relatively straightforward, the precise, reliable correction of astigmatism (particularly high astigmatism) can be challenging. A wide variety of refractive corrections are now available for the patient with astigmatism, including spectacle, contact lens and surgical options. Astigmatism is one of the most common refractive errors managed in clinical ophthalmic practice. The significant visual and functional impacts of astigmatism emphasise the importance of its reliable clinical management. With continued improvements in ocular measurement techniques and developments in a range of different refractive correction technologies, the future promises the potential for more precise and comprehensive correction options for astigmatic patients. © 2014 The Authors Ophthalmic & Physiological Optics © 2014 The College of Optometrists.

Recommendations to Facilitate Expanded Access to Investigational Therapies for Seriously Ill Patients

PubMed Central

Jerome, Rebecca N.; Edwards, Terri L.; Boswell, Haley C.; Bernard, Gordon R.; Harris, Paul A.; Pulley, Jill M.

2015-01-01

When clinical trial enrollment is not an option for seriously ill patients whose illnesses have not responded to approved treatment options, those patients and their physicians may consider gaining access to investigational therapies through a pathway established by the Food and Drug Administration (FDA) called expanded access. However, recent events have highlighted the challenging dynamics involved in accessing investigational therapies through expanded access that include a complex interplay of factors involving the patient, physician, drug company, FDA, and, increasingly, social media. The authors offer several potential strategies to streamline what is otherwise an arduous process for all involved. (1) The drug company should prospectively determine whether it will establish an expanded access program for specific drugs. (2) A central clearinghouse for companies should support registration of expanded access drugs for suitable patients. (3) The determination of whether a patient fits criteria would be made by an independent review board of clinicians. (4) An independent coordinating center is needed; academic health centers are ideally suited for that role. (5) Adequate financing of the costs of therapy need to be in place to make expanded access a reality, given frequent lack of payor coverage for therapies. (6) Further enhancement of regulatory pathways, approaches, or rules would promote expanded access. (7) Patients should explicitly acknowledge the limited data available. (8) There should be a shared, secure, technical platform to facilitate expanded access. All the authors’ strategies present important prospects for improving treatment options for the most seriously ill patients. PMID:26445080

Photovoltaic solar array technology required for three wide scale generating systems for terrestrial applications: rooftop, solar farm, and satellite

NASA Technical Reports Server (NTRS)

Berman, P. A.

1972-01-01

Three major options for wide-scale generation of photovoltaic energy for terrestrial use are considered: (1) rooftop array, (2) solar farm, and (3) satellite station. The rooftop array would use solar cell arrays on the roofs of residential or commercial buildings; the solar farm would consist of large ground-based arrays, probably in arid areas with high insolation; and the satellite station would consist of an orbiting solar array, many square kilometers in area. The technology advancement requirements necessary for each option are discussed, including cost reduction of solar cells and arrays, weight reduction, resistance to environmental factors, reliability, and fabrication capability, including the availability of raw materials. The majority of the technology advancement requirements are applicable to all three options, making possible a flexible basic approach regardless of the options that may eventually be chosen. No conclusions are drawn as to which option is most advantageous, since the feasibility of each option depends on the success achieved in the technology advancement requirements specified.

Evaluation of knowledge resources for public health reporting logic: Implications for knowledge authoring and management

PubMed Central

Staes, Catherine J; Altamore, Rita; Han, EunGyoung; Mottice, Susan; Rajeev, Deepthi; Bradshaw, Richard

2011-01-01

To control disease, laboratories and providers are required to report conditions to public health authorities. Reporting logic is defined in a variety of resources, but there is no single resource available for reporters to access the list of reportable events and computable reporting logic for any jurisdiction. In order to develop evidence-based requirements for authoring such knowledge, we evaluated reporting logic in the Council of State and Territorial Epidemiologist (CSTE) position statements to assess its readiness for automated systems and identify features that should be considered when designing an authoring interface; we evaluated codes in the Reportable Condition Mapping Tables (RCMT) relative to the nationally-defined reporting logic, and described the high level business processes and knowledge required to support laboratory-based public health reporting. We focused on logic for viral hepatitis. We found that CSTE tabular logic was unnecessarily complex (sufficient conditions superseded necessary and optional conditions) and was sometimes true for more than one reportable event: we uncovered major overlap in the logic between acute and chronic hepatitis B (52%), acute and Past and Present hepatitis C (90%). We found that the RCMT includes codes for all hepatitis criteria, but includes addition codes for tests not included in the criteria. The proportion of hepatitis variant-related codes included in RCMT that correspond to a criterion in the hepatitis-related position statements varied between hepatitis A (36%), acute hepatitis B (16%), chronic hepatitis B (64%), acute hepatitis C (96%), and past and present hepatitis C (96%). Public health epidemiologists have the need to communicate parameters other than just the name of a disease or organism that should be reported, such as the status and specimen sources. Existing knowledge resources should be integrated, harmonized and made computable. Our findings identified functionality that should be provided by future knowledge management systems to support epidemiologists as they communicate reporting rules for their jurisdiction. PMID:23569619

Non-melanoma Skin Cancer in Canada Chapter 1: Introduction to the Guidelines.

PubMed

Guenther, Lyn C; Barber, Kirk; Searles, Gordon E; Lynde, Charles W; Janiszewski, Peter; Ashkenas, John

2015-01-01

Non-melanoma skin cancer (NMSC), including basal and squamous cell carcinoma, represents the most common malignancy. The aim of this document is to provide guidance to Canadian health care practitioners on NMSC management. After conducting a literature review, the group developed recommendations for prevention, management, and treatment of basal cell carcinomas, squamous cell carcinomas, and actinic keratoses. These tumour types are considered separately in the accompanying articles. The Grading of Recommendations Assessment, Development and Evaluation system was used to assign strength to each recommendation. This introduction describes the scope and structure of the guidelines and the methods used to develop them. The epidemiology of NMSC is reviewed, as are the pathophysiologic changes occurring with damage to the skin, which lead to the formation of actinic keratoses and invasive squamous or basal cell carcinomas. This introduction describes the need for primary prevention and offers an overview of treatment options that are discussed in later chapters of the guidelines. © The Author(s) 2015.

How do you keto? Survey of North American pediatric ketogenic diet centers.

PubMed

Jung, Da Eun; Joshi, Sucheta M; Berg, Anne T

2015-06-01

We surveyed ketogenic diet centers in North America about their practices surrounding the ketogenic diet. An internet survey was disseminated via REDCap(©) to North American ketogenic diet centers identified from the Charlie Foundation and Ketocal(©) websites. Fifty-six centers responded. In addition to physicians, nurses and dieticians, ketogenic teams included social workers (39%), feeding specialists (14%), educational liaisons (4%), psychologists (5%), and pharmacists (36%). A child attending school (2%), non-English speaking family (19%), single-parent family (0%), and oral feeding (6%) were rarely considered barriers. Overall, the diet was considered the first or second (0%), third or fourth (67%), fifth or sixth (29%), and last resort treatment (4%) by centers. It was considered the first or second treatment for GLUT1 disease (86%) and third or fourth for Dravet (63%), West (71%), and Doose (65%) syndromes. Ketogenic diet is no longer a last resort option. Traditional barriers do not influence its use. © The Author(s) 2014.

Climate change and pastoralism: impacts, consequences and adaptation.

PubMed

Herrero, M; Addison, J; Bedelian, C; Carabine, E; Havlík, P; Henderson, B; Van De Steeg, J; Thornton, P K

2016-11-01

The authors discuss the main climate change impacts on pastoralist societies, including those on rangelands, livestock and other natural resources, and their extended repercussions on food security, incomes and vulnerability. The impacts of climate change on the rangelands of the globe and on the vulnerability of the people who inhabit them will be severe and diverse, and will require multiple, simultaneous responses. In higher latitudes, the removal of temperature constraints might increase pasture production and livestock productivity, but in tropical arid lands, the impacts are highly location specific, but mostly negative. The authors outline several adaptation options, ranging from implementing new technical practices and diversifying income sources to finding institutional support and introducing new market mechanisms, all of which are pivotal for enhancing the capacity of pastoralists to adapt to climate variability and change. Due to the dynamism of all the changes affecting pastoral societies, strategies that lock pastoral societies into specified development pathways could be maladaptive. Flexible and evolving combinations of practices and policies are the key to successful pastoral adaptation.

The management of gastric volvulus in elderly patients.

PubMed

Zuiki, Toru; Hosoya, Yoshinori; Lefor, Alan Kawarai; Tanaka, Hiroyuki; Komatsubara, Toshihide; Miyahara, Yuzo; Sanada, Yukihiro; Ohki, Jun; Sekiguchi, Chuji; Sata, Naohiro

2016-01-01

Gastric volvulus is torsion of the stomach and requires immediate treatment. The optimal treatment strategy for patients with gastric volvulus is not established, because of significant variations in the cause and clinical course of this condition. We describe our experience with six elderly patients with gastric volvulus caused by different conditions using various approaches. This includes two patients managed with endoscopic reduction, followed by endoscopic or laparoscopic gastropexy. Endoscopy is a necessary first step to determine the optimal treatment strategy, and endoscopic reduction is often effective. The indications for surgical repair of gastric volvulus depend on the patient's overall condition, and several options are available. In some elderly patients with severe comorbidities, major surgery may have an unacceptably high risk. We propose a novel treatment strategy for gastric volvulus in the elderly and a review of the literature. Early endoscopy is necessary in patients with gastric volvulus. Endoscopic or laparoscopic gastropexy may be adequate therapy in selected elderly patients. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

"Making Do" Decisions: How Home Healthcare Personnel Manage Their Exposure to Home Hazards.

PubMed

Wills, Celia E; Polivka, Barbara J; Darragh, Amy; Lavender, Steven; Sommerich, Carolyn; Stredney, Donald

2016-04-01

This study describes the decision-making processes home healthcare personnel (HHP) use to manage their personal health and safety when managing hazards in client homes. A professionally diverse national sample of 68 HHP participated in individual semi-structured interviews and focus group discussions, and described their decision making and strategies for hazard management in their work environments. HHP described 353 hazard management dilemmas within 394 specifically identified hazards, which were clustered within three broader categories: electrical/fire, slip/trip/lift, and environmental exposures. HHP described multiple types of "making do" decisions for hazard management solutions in which perceived and actual resource limitations constrained response options. A majority of hazard management decisions in the broader hazards categories (72.5%, 68.5%, and 63.5%, respectively) were classifiable as less than optimal. These findings stress the need for more support of HHPs, including comprehensive training, to improve HHP decision making and hazard management strategies, especially in context of resource constraints. © The Author(s) 2015.

Electronic reporting of all reference laboratory results: An important step toward a truly all-encompassing, integrated health record.

PubMed

Kratz, Alexander

2016-09-01

Results from reference laboratories are often not easily available in electronic health records. This article describes a multi-pronged, long-term approach that includes bringing send-out tests in-house, upgrading the laboratory information system, interfacing more send-out tests and more reference laboratories, utilizing the "miscellaneous assay" option offered by some reference laboratories, and scanning all remaining paper reports from reference laboratories for display in the electronic health record. This allowed all laboratory results obtained in association with a patient visit, whether performed in-house or at a reference laboratory, to be available in the integrated electronic health record. This was achieved without manual data entry of reference laboratory results, thereby avoiding the risk of transcription errors. A fully integrated electronic health record that contains all laboratory results can be achieved by maximizing the number of interfaced reference laboratory assays and making all non-interfaced results available as scanned documents. © The Author(s) 2015.

Effects of Living Alone on Social Capital and Health Among Older Adults in China.

PubMed

Xu, Qingwen; Norstrand, Julie A; Du, Yan

2015-12-01

Social capital has been connected with positive health outcomes across countries, including China. Given the rise in the number of seniors living alone, there is a need to examine the health benefits of social capital, accounting for living arrangements. Data from the 2005 Chinese General Social Survey were used to test research hypotheses. Controlling for demographics, elders living alone possessed similar level of social capital compared with elders living with others. While bonding and linking social capital were significant factors in urban areas and linking social capital was a significant factor in rural areas, the relationship between living alone and health did not differ based on the level of social capital possession. When the traditional intergenerational living arrangement has not been a valid option for many older adults in China, seeking new way of family caring, and developing appropriate social and institutional structures to assist elders living alone, becomes critical. © The Author(s) 2016.

Technology advances in hospital practices: robotics in treatment of patients.

PubMed

Rosiek, Anna; Leksowski, Krzysztof

2015-06-01

Laparoscopic cholecystectomy is widely considered as the treatment of choice for acute cholecystitis. The safety of the procedure and its minimal invasiveness made it a valid treatment option for a patient not responding to antibiotic therapy. Our research shows that patients positively assess this treatment method, but the world's tendency is to turn to a more sophisticated method utilizing robot-assisted surgery as a gold standard. Providing patient with minimally invasive surgical procedures that utilize the state-of-the-art equipment like the da Vinci Robotic Surgical System underscores the commitment to high-quality patient care while enhancing patient safety. The advantages include minimal invasive scarring, less pain and bleeding, faster recovery time, and shorter hospital stay. The move toward less invasive and less morbid procedures and a need to re-create the true open surgical experience have paved the way for the development and application of robotic and computer-assisted systems in surgery in Poland as well as the rest of the world. © The Author(s) 2014.

FDA perspective on objective performance goals and clinical trial design for evaluating catheter-based treatment of critical limb ischemia.

PubMed

Kumar, Allison; Brooks, Steven S; Cavanaugh, Kenneth; Zuckerman, Bram

2009-12-01

The article by Conte et al.(1) on behalf of the Society for Vascular Surgery (SVS) in this issue of the Journal of Vascular Surgery provides guidelines for improving the consistency and interpretability of clinical trials intended to evaluate treatment options for patients with critical limb ischemia (CLI). This article identifies a number of key challenges with conducting and comparing CLI trials, including the wide spectrum of clinical presentations that CLI encompasses, the use of disparate eligibility criteria and endpoint measurements, and logistical and economic considerations that can limit study initiation and completion. The authors propose definitions for a number of performance goals derived from historical surgical literature as a means of reducing the negative impact of these factors. The current editorial reviews aspects of this proposal from the perspective of the authors in terms of their understanding of the statutory obligations of the U.S. Food and Drug Administration (FDA) to regulate the marketing of cardiovascular devices based on valid scientific evidence.