Sample records for options include observation
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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
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Couët, Nicolas; Desroches, Sophie; Robitaille, Hubert; Vaillancourt, Hugues; Leblanc, Annie; Turcotte, Stéphane; Elwyn, Glyn; Légaré, France
2015-08-01
We have no clear overview of the extent to which health-care providers involve patients in the decision-making process during consultations. The Observing Patient Involvement in Decision Making instrument (OPTION) was designed to assess this. To systematically review studies that used the OPTION instrument to observe the extent to which health-care providers involve patients in decision making across a range of clinical contexts, including different health professions and lengths of consultation. We conducted online literature searches in multiple databases (2001-12) and gathered further data through networking. (i) OPTION scores as reported outcomes and (ii) health-care providers and patients as study participants. For analysis, we only included studies using the revised scale. Extracted data included: (i) study and participant characteristics and (ii) OPTION outcomes (scores, statistical associations and reported psychometric results). We also assessed the quality of OPTION outcomes reporting. We found 33 eligible studies, 29 of which used the revised scale. Overall, we found low levels of patient-involving behaviours: in cases where no intervention was used to implement shared decision making (SDM), the mean OPTION score was 23 ± 14 (0-100 scale). When assessed, the variables most consistently associated with higher OPTION scores were interventions to implement SDM (n = 8/9) and duration of consultations (n = 8/15). Whatever the clinical context, few health-care providers consistently attempt to facilitate patient involvement, and even fewer adjust care to patient preferences. However, both SDM interventions and longer consultations could improve this. © 2013 John Wiley & Sons Ltd.
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Preis, Heidi; Eisner, Michal; Chen, Rony; Benyamini, Yael
2018-05-09
Birth preferences, such as mode and place of birth and other birth options, have important individual and societal implications, yet few studies have investigated the mechanism which predicts a wide range of childbirth options simultaneously. Basic beliefs about birth as a natural and as a medical process are both predictive factors for childbirth preferences. Studies investigating birth beliefs, preferences, and actual birth are rare. To test a predictive model of how these beliefs translate into birth preferences and into actual birth related-options. Longitudinal observational study including 342 first-time expectant mothers recruited at women's health centres and natural birth communities in Israel. All women filled out questionnaires including basic birth beliefs and preferred birth options. Two months postpartum, they filled out a questionnaire including detailed questions regarding actual birth. Stronger beliefs about birth being natural were related to preferring a more natural place and mode of birth and preferring more natural birth-related options. Stronger beliefs about birth being medical were associated with opposite options. The preferences mediated the association between the birth beliefs and actual birth. The beliefs predicted the preferences better than they predicted actual birth. Birth beliefs are pivotal in the decision-making process regarding preferred and actual birth options. In a medicalized obstetric system, where natural birth is something women need to actively seek out and insist on, the predictive powers of beliefs and of preferences decrease. Women's beliefs should be recognized and birth preferences respected. Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
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NASA Technical Reports Server (NTRS)
Justh, H. L.; Justus, C. G.
2008-01-01
The Mars Global Reference Atmospheric Model (Mars-GRAM) is an engineering-level atmospheric model widely used for diverse mission applications. Mars-GRAM s perturbation modeling capability is commonly used, in a Monte-Carlo mode, to perform high fidelity engineering end-to-end simulations for entry, descent, and landing (EDL) [1]. From the surface to 80 km altitude, Mars-GRAM is based on the NASA Ames Mars General Circulation Model (MGCM). Mars-GRAM and MGCM use surface topography from Mars Global Surveyor Mars Orbiter Laser Altimeter (MOLA), with altitudes referenced to the MOLA areoid, or constant potential surface. Traditional Mars-GRAM options for representing the mean atmosphere along entry corridors include: (1) Thermal Emission Spectrometer (TES) mapping years 1 and 2, with Mars-GRAM data coming from NASA Ames Mars General Circulation Model (MGCM) results driven by observed TES dust optical depth or (2) TES mapping year 0, with user-controlled dust optical depth and Mars-GRAM data interpolated from MGCM model results driven by selected values of globally-uniform dust optical depth. Mars-GRAM 2005 has been validated [2] against Radio Science data, and both nadir and limb data from TES [3]. There are several new features included in Mars-GRAM 2005. The first is the option to use input data sets from MGCM model runs that were designed to closely simulate conditions observed during the first two years of TES observations at Mars. The TES Year 1 option includes values from April 1999 through January 2001. The TES Year 2 option includes values from February 2001 through December 2002. The second new feature is the option to read and use any auxiliary profile of temperature and density versus altitude. In exercising the auxiliary profile Mars-GRAM option, values from the auxiliary profile replace data from the original MGCM databases. Some examples of auxiliary profiles include data from TES nadir or limb observations and Mars mesoscale model output at a particular location and time. The final new feature is the addition of two Mars-GRAM parameters that allow standard deviations of Mars-GRAM perturbations to be adjusted. The parameter rpscale can be used to scale density perturbations up or down while rwscale can be used to scale wind perturbations.
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Why Contextual Preference Reversals Maximize Expected Value
2016-01-01
Contextual preference reversals occur when a preference for one option over another is reversed by the addition of further options. It has been argued that the occurrence of preference reversals in human behavior shows that people violate the axioms of rational choice and that people are not, therefore, expected value maximizers. In contrast, we demonstrate that if a person is only able to make noisy calculations of expected value and noisy observations of the ordinal relations among option features, then the expected value maximizing choice is influenced by the addition of new options and does give rise to apparent preference reversals. We explore the implications of expected value maximizing choice, conditioned on noisy observations, for a range of contextual preference reversal types—including attraction, compromise, similarity, and phantom effects. These preference reversal types have played a key role in the development of models of human choice. We conclude that experiments demonstrating contextual preference reversals are not evidence for irrationality. They are, however, a consequence of expected value maximization given noisy observations. PMID:27337391
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Comparison in the quality of distractors in three and four options type of multiple choice questions
Rahma, Nourelhouda A A; Shamad, Mahdi M A; Idris, Muawia E A; Elfaki, Omer Abdelgadir; Elfakey, Walyedldin E M; Salih, Karimeldin M A
2017-01-01
Introduction The number of distractors needed for high quality multiple choice questions (MCQs) will be determined by many factors. These include firstly whether English language is their mother tongue or a foreign language; secondly whether the instructors who construct the questions are experts or not; thirdly the time spent on constructing the options is also an important factor. It has been observed by Tarrant et al that more time is often spent on constructing questions than on tailoring sound, reliable, and valid distractors. Objectives Firstly, to investigate the effects of reducing the number of options on psychometric properties of the item. Secondly, to determine the frequency of functioning distractors among three or four options in the MCQs examination of the dermatology course in University of Bahri, College of Medicine. Materials and methods This is an experimental study which was performed by means of a dermatology exam, MCQs type. Forty MCQs, with one correct answer for each question were constructed. Two sets of this exam paper were prepared: in the first one, four options were given, including one key answer and three distractors. In the second set, one of the three distractors was deleted randomly, and the sequence of the questions was kept in the same order. Any distracter chosen by less than 5% of the students was regarded as non-functioning. Kuder-Richardson Formula 20 (Kr-20) measures the internal consistency and reliability of an examination with an acceptable range 0.8–1.0. Chi square test was used to compare the distractors in the two exams. Results A significant difference was observed in discrimination and difficulty indexes for both sets of MCQs. More distractors were non-functional for set one (of four options), but slightly more reliable. The reliability (Kr-20) was slightly higher for set one (of four options). The average marks in option three and four were 34.163 and 33.140, respectively. Conclusion Compared to set 1 (four options), set 2 (of three options) was more discriminating and associated with low difficulty index but its reliability was low. PMID:28442942
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Rahma, Nourelhouda A A; Shamad, Mahdi M A; Idris, Muawia E A; Elfaki, Omer Abdelgadir; Elfakey, Walyedldin E M; Salih, Karimeldin M A
2017-01-01
The number of distractors needed for high quality multiple choice questions (MCQs) will be determined by many factors. These include firstly whether English language is their mother tongue or a foreign language; secondly whether the instructors who construct the questions are experts or not; thirdly the time spent on constructing the options is also an important factor. It has been observed by Tarrant et al that more time is often spent on constructing questions than on tailoring sound, reliable, and valid distractors. Firstly, to investigate the effects of reducing the number of options on psychometric properties of the item. Secondly, to determine the frequency of functioning distractors among three or four options in the MCQs examination of the dermatology course in University of Bahri, College of Medicine. This is an experimental study which was performed by means of a dermatology exam, MCQs type. Forty MCQs, with one correct answer for each question were constructed. Two sets of this exam paper were prepared: in the first one, four options were given, including one key answer and three distractors. In the second set, one of the three distractors was deleted randomly, and the sequence of the questions was kept in the same order. Any distracter chosen by less than 5% of the students was regarded as non-functioning. Kuder-Richardson Formula 20 (Kr-20) measures the internal consistency and reliability of an examination with an acceptable range 0.8-1.0. Chi square test was used to compare the distractors in the two exams. A significant difference was observed in discrimination and difficulty indexes for both sets of MCQs. More distractors were non-functional for set one (of four options), but slightly more reliable. The reliability (Kr-20) was slightly higher for set one (of four options). The average marks in option three and four were 34.163 and 33.140, respectively. Compared to set 1 (four options), set 2 (of three options) was more discriminating and associated with low difficulty index but its reliability was low.
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Multifractal analysis of implied volatility in index options
NASA Astrophysics Data System (ADS)
Oh, GabJin
2014-06-01
In this paper, we analyze the statistical and the non-linear properties of the log-variations in implied volatility for the CAC40, DAX and S& P500 daily index options. The price of an index option is generally represented by its implied volatility surface, including its smile and skew properties. We utilize a Lévy process model as the underlying asset to deepen our understanding of the intrinsic property of the implied volatility in the index options and estimate the implied volatility surface. We find that the options pricing models with the exponential Lévy model can reproduce the smile or sneer features of the implied volatility that are observed in real options markets. We study the variation in the implied volatility for at-the-money index call and put options, and we find that the distribution function follows a power-law distribution with an exponent of 3.5 ≤ γ ≤ 4.5. Especially, the variation in the implied volatility exhibits multifractal spectral characteristics, and the global financial crisis has influenced the complexity of the option markets.
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Starlings uphold principles of economic rationality for delay and probability of reward.
Monteiro, Tiago; Vasconcelos, Marco; Kacelnik, Alex
2013-04-07
Rationality principles are the bedrock of normative theories of decision-making in biology and microeconomics, but whereas in microeconomics, consistent choice underlies the notion of utility; in biology, the assumption of consistent selective pressures justifies modelling decision mechanisms as if they were designed to maximize fitness. In either case, violations of consistency contradict expectations and attract theoretical interest. Reported violations of rationality in non-humans include intransitivity (i.e. circular preferences) and lack of independence of irrelevant alternatives (changes in relative preference between options when embedded in different choice sets), but the extent to which these observations truly represent breaches of rationality is debatable. We tested both principles with starlings (Sturnus vulgaris), training subjects either with five options differing in food delay (exp. 1) or with six options differing in reward probability (exp. 2), before letting them choose repeatedly one option out of several binary and trinary sets of options. The starlings conformed to economic rationality on both tests, showing strong stochastic transitivity and no violation of the independence principle. These results endorse the rational choice and optimality approaches used in behavioural ecology, and highlight the need for functional and mechanistic enquiring when apparent violations of such principles are observed.
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Starlings uphold principles of economic rationality for delay and probability of reward
Monteiro, Tiago; Vasconcelos, Marco; Kacelnik, Alex
2013-01-01
Rationality principles are the bedrock of normative theories of decision-making in biology and microeconomics, but whereas in microeconomics, consistent choice underlies the notion of utility; in biology, the assumption of consistent selective pressures justifies modelling decision mechanisms as if they were designed to maximize fitness. In either case, violations of consistency contradict expectations and attract theoretical interest. Reported violations of rationality in non-humans include intransitivity (i.e. circular preferences) and lack of independence of irrelevant alternatives (changes in relative preference between options when embedded in different choice sets), but the extent to which these observations truly represent breaches of rationality is debatable. We tested both principles with starlings (Sturnus vulgaris), training subjects either with five options differing in food delay (exp. 1) or with six options differing in reward probability (exp. 2), before letting them choose repeatedly one option out of several binary and trinary sets of options. The starlings conformed to economic rationality on both tests, showing strong stochastic transitivity and no violation of the independence principle. These results endorse the rational choice and optimality approaches used in behavioural ecology, and highlight the need for functional and mechanistic enquiring when apparent violations of such principles are observed. PMID:23390098
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Childhood Extracranial Germ Cell Tumors Treatment (PDQ®)—Patient Version
Childhood extracranial germ cell tumors treatment options include surgery, observation, and chemotherapy. Learn more about newly diagnosed and recurrent extracranial germ cell tumors in this expert-reviewed summary.
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NASA Technical Reports Server (NTRS)
1983-01-01
Mission areas analyzed for input to the baseline mission model include: (1) commercial materials processing, including representative missions for producing metallurgical, chemical and biological products; (2) commercial Earth observation, represented by a typical carry-on mission amenable to commercialization; (3) solar terrestrial and resource observations including missions in geoscience and scientific land observation; (4) global environment, including representative missions in meteorology, climatology, ocean science, and atmospheric science; (5) materials science, including missions for measuring material properties, studying chemical reactions and utilizing the high vacuum-pumping capacity of space; and (6) life sciences with experiments in biomedicine and animal and plant biology.
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Overview of the Ocean Observer Satellite Study
NASA Astrophysics Data System (ADS)
Cunningham, J. D.; McGuire, J. P.; Pichel, W. G.; Gerber, A. J.
2002-12-01
A two-year study of ocean satellite remote sensing requirements and instrument/satellite options is nearing completion. This Ocean Observer Study was sponsored by the U.S. Dept. of Commerce/Dept. of Defense/National Aeronautics and Space Administration Integrated Program Office, whose mission is to develop the future U.S. National Polar-Orbiting Operational Environmental Satellite System (NPOESS). A comprehensive Ocean Observer User Requirements Document has been drafted by a team of over 150 government, academic, and private sector scientists, engineers, and administrators. Included are requirements for open and coastal ocean surface, cryospheric, hydrologic, and some land/hazard and atmospheric boundary layer parameters. This document was then used as input to the instrument and satellite study (conducted by the Jet Propulsion Laboratory) which produced five different instrument/satellite configuration options designed to address the maximum number of requirements which will not be met with the already-approved NPOESS instruments. Instruments studied include a synthetic aperture radar (SAR), an altimeter, and a hyper-spectral coastal infrared/visible imager. After analyzing the alternatives, it appears that one of the best options is a two-satellite system consisting of (1) an altimeter mission in the Topex/Poseidon orbit carrying both wide-swath and delayed doppler altimeters, and (2) a multi-polarization, multi-frequency, multi-mode interferometric SAR mission including a coastal imager in a polar sun-synchronous orbit. This paper summarizes the user requirements process, briefly describes the notional satellite configuration, and presents some of the capabilities of the instruments.
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[Treatment of early onset scoliosis : How far can we go?].
Studer, D; Hasler, C C; Schulze, A
2015-11-01
Recently, inconsistent definitions of early onset scoliosis (EOS) and a wide variety of treatment options have been observed. To clearly define the term EOS, to depict non-operative and operative treatment options, and to present the limitations of the boundaries of these techniques. Review of the literature, including conference presentations and expert opinions, in addition to personal experiences. Early onset scoliosis (EOS) refers to spine deformity that is present before 10 years of age, regardless of etiology. All existing operative treatment options share a high risk of complications. Therefore, non-operative treatment should act as a time-buying approach to postpone surgery. Awareness of treatment options and their specific indications, in addition to respecting each patient's individual needs and feasibilities, are crucial for the optimal outcome.
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Kleynen, Melanie; Moser, Albine; Haarsma, Frederike A; Beurskens, Anna J; Braun, Susy M
2017-08-01
The goal of this study was to examine which motor learning options are applied by experienced physiotherapists in neurological rehabilitation, and how they choose between the different options. A descriptive qualitative approach was used. A purposive sample of five expert physiotherapists from the neurological ward of a rehabilitation center participated. Data were collected using nine videotaped therapy situations. During retrospective think-aloud interviews, the physiotherapists were instructed to constantly "think aloud" while they were watching their own videos. Five "operators" were identified: "act", "know", "observe", "assess" and "argue". The "act" operator consisted of 34 motor learning options, which were clustered into "instruction", "feedback" and "organization". The "know", "observe", "assess" and "argue" operators explained how therapists chose one of these options. The four operators seem to be interrelated and together lead to a decision to apply a particular motor learning option. Results show that the participating physiotherapists used a great variety of motor learning options in their treatment sessions. Further, the decision-making process with regard to these motor learning options was identified. Results may support future intervention studies that match the content and process of therapy in daily practice. The study should be repeated with other physiotherapists. Implications for Rehabilitation The study provided insight into the way experienced therapist handle the great variety of possible motor learning options, including concrete ideas on how to operationalize these options in specific situations. Despite differences in patients' abilities, it seems that therapists use the same underlying clinical reasoning process when choosing a particular motor learning option. Participating physiotherapists used more than the in guidelines suggested motor learning options and considered more than the suggested factors, hence adding practice based options of motor learning to the recommended ones in the guidelines. A think-aloud approach can be considered for peer-to-peer and student coaching to enhance discussion on the motor learning options applied and the underlying choices and to encourage research by practicing clinicians.
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Intraocular (Eye) Melanoma Treatment (PDQ®)—Health Professional Version
Intraocular (uveal) melanoma treatment options include observation, surgery, radiation therapy, and transpupillary thermotherapy. Get detailed information about the diagnosis and treatment of newly diagnosed and recurrent intraocular melanoma in this summary for clinicians.
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Childhood Astrocytoma Treatment (PDQ®)—Patient Version
Childhood astrocytoma treatment options include surgery, observation, radiation therapy, chemotherapy, high-dose chemotherapy with stem cell transplant, and targeted therapy. Learn more about the treatment of newly diagnosed and recurrent astrocytoma in this expert-reviewed summary.
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Salvage of locally recurrent prostate cancer after definitive radiotherapy.
Mendenhall, William M; Henderson, Randal H; Hoppe, Bradford S; Nichols, Romaine C; Mendenhall, Nancy P
2014-08-01
Although a significant proportion of patients with localized prostate cancer are cured after definitive radiotherapy, solitary local recurrence is observed in a subset of patients and poses a management challenge. Curative-intent treatment options include prostatectomy, reirradiation, cryotherapy, and high-intensity-focused ultrasound. Outcomes data after any of these options are relatively limited. The 5-year biochemical progression-free survival rate is approximately 50% after salvage prostatectomy. However, the morbidity rate of the procedure is significantly higher compared with that observed in previously untreated patients. The likelihood of cure after low dose rate brachytherapy is similar to that observed after salvage prostatectomy, and the morbidity, although significant is less. Although cryotherapy and high-intensity-focused ultrasound may be less morbid than a prostatectomy, the probability of cure is probably lower.
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Marrin, Katy; Wood, Fiona; Firth, Jill; Kinsey, Katharine; Edwards, Adrian; Brain, Kate E; Newcombe, Robert G; Nye, Alan; Pickles, Timothy; Hawthorne, Kamila; Elwyn, Glyn
2014-04-07
Despite policy interest, an ethical imperative, and evidence of the benefits of patient decision support tools, the adoption of shared decision making (SDM) in day-to-day clinical practice remains slow and is inhibited by barriers that include culture and attitudes; resources and time pressures. Patient decision support tools often require high levels of health and computer literacy. Option Grids are one-page evidence-based summaries of the available condition-specific treatment options, listing patients' frequently asked questions. They are designed to be sufficiently brief and accessible enough to support a better dialogue between patients and clinicians during routine consultations. This paper describes a study to assess whether an Option Grid for osteoarthritis of the knee (OA of the knee) facilitates SDM, and explores the use of Option Grids by patients disadvantaged by language or poor health literacy. This will be a stepped wedge exploratory trial involving 72 patients with OA of the knee referred from primary medical care to a specialist musculoskeletal service in Oldham. Six physiotherapists will sequentially join the trial and consult with six patients using usual care procedures. After a period of brief training in using the Option Grid, the same six physiotherapists will consult with six further patients using an Option Grid in the consultation. The primary outcome will be efficacy of the Option Grid in facilitating SDM as measured by observational scores using the OPTION scale. Comparisons will be made between patients who have received the Option Grid and those who received usual care. A Decision Quality Measure (DQM) will assess quality of decision making. The health literacy of patients will be measured using the REALM-R instrument. Consultations will be observed and audio-recorded. Interviews will be conducted with the physiotherapists, patients and any interpreters present to explore their views of using the Option Grid. Option Grids offer a potential solution to the barriers to implementing traditional decision aids into routine clinical practice. The study will assess whether Option Grids can facilitate SDM in day-to-day clinical practice and explore their use with patients disadvantaged by language or poor health literacy. Current Controlled Trials ISRCTN94871417.
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Thyroid Cancer Treatment (PDQ®)—Health Professional Version
Thyroid cancer treatments include surgery, radiation therapy, radioactive iodine therapy, chemotherapy, hormone therapy, targeted therapy, and observation. Get detailed information about the treatment options for newly diagnosed and recurrent thyroid cancer in this summary for clinicians.
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Childhood Brain Stem Glioma Treatment (PDQ®)—Patient Version
Childhood brain stem glioma treatment options can include surgery, radiation therapy, chemotherapy, cerebral spinal fluid diversion, observation, and targeted therapy. Learn more about newly diagnosed and recurrent childhood brain stem glioma in this expert-reviewed summary.
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Chronic Myeloproliferative Neoplasms Treatment (PDQ®)—Health Professional Version
Chronic Myeloproliferative Neoplasms (MPN) treatment varies widely depending on the specific diagnosis. Treatment options may include observation, phlebotomy, steroids, chemotherapy, immunotherapy, and stem cell transplant. Get detailed information about MPNs in this summary for clinicians.
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Chronic Lymphocytic Leukemia Treatment (PDQ®)—Health Professional Version
Chronic lymphocytic leukemia (CLL) treatment options can include observation, steroids, chemotherapy, targeted therapy, and/or stem cell transplant. Get detailed information about newly diagnosed and recurrent CLL and available treatment modalities in this summary for clinicians.
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The psychometric properties of Observer OPTION(5), an observer measure of shared decision making.
Barr, Paul J; O'Malley, Alistair James; Tsulukidze, Maka; Gionfriddo, Michael R; Montori, Victor; Elwyn, Glyn
2015-08-01
Observer OPTION(5) was designed as a more efficient version of OPTION(12), the most commonly used measure of shared decision making (SDM). The current paper assesses the psychometric properties of OPTION(5). Two raters used OPTION(5) to rate recordings of clinical encounters from two previous patient decision aid (PDA) trials (n=201; n=110). A subsample was re-rated two weeks later. We assessed discriminative validity, inter-rater reliability, intra-rater reliability, and concurrent validity. OPTION(5) demonstrated discriminative validity, with increases in SDM between usual care and PDA arms. OPTION(5) also demonstrated concurrent validity with OPTION(12), r=0.61 (95%CI 0.54, 0.68) and intra-rater reliability, r=0.93 (0.83, 0.97). The mean difference in rater score was 8.89 (95% Credibility Interval, 7.5, 10.3), with intraclass correlation (ICC) of 0.67 (95% Credibility Interval, 0.51, 0.91) for the accuracy of rater scores and 0.70 (95% Credibility Interval, 0.56, 0.94) for the consistency of rater scores across encounters, indicating good inter-rater reliability. Raters reported lower cognitive burden when using OPTION(5) compared to OPTION(12). OPTION(5) is a brief, theoretically grounded observer measure of SDM with promising psychometric properties in this sample and low burden on raters. OPTION(5) has potential to provide reliable, valid assessment of SDM in clinical encounters. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
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Neuroblastoma Treatment (PDQ®)—Health Professional Version
Neuroblastoma treatment generally is based on whether the tumor is low, intermediate, or high risk. Treatment options include surgery, observation, radiation therapy, chemotherapy, stem cell rescue, and targeted therapy. Get detailed neuroblastoma treatment information in this summary for clinicians.
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Hanigan, Ivan; Hall, Gillian; Dear, Keith B G
2006-09-13
To explain the possible effects of exposure to weather conditions on population health outcomes, weather data need to be calculated at a level in space and time that is appropriate for the health data. There are various ways of estimating exposure values from raw data collected at weather stations but the rationale for using one technique rather than another; the significance of the difference in the values obtained; and the effect these have on a research question are factors often not explicitly considered. In this study we compare different techniques for allocating weather data observations to small geographical areas and different options for weighting averages of these observations when calculating estimates of daily precipitation and temperature for Australian Postal Areas. Options that weight observations based on distance from population centroids and population size are more computationally intensive but give estimates that conceptually are more closely related to the experience of the population. Options based on values derived from sites internal to postal areas, or from nearest neighbour sites--that is, using proximity polygons around weather stations intersected with postal areas--tended to include fewer stations' observations in their estimates, and missing values were common. Options based on observations from stations within 50 kilometres radius of centroids and weighting of data by distance from centroids gave more complete estimates. Using the geographic centroid of the postal area gave estimates that differed slightly from the population weighted centroids and the population weighted average of sub-unit estimates. To calculate daily weather exposure values for analysis of health outcome data for small areas, the use of data from weather stations internal to the area only, or from neighbouring weather stations (allocated by the use of proximity polygons), is too limited. The most appropriate method conceptually is the use of weather data from sites within 50 kilometres radius of the area weighted to population centres, but a simpler acceptable option is to weight to the geographic centroid.
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Childhood Soft Tissue Sarcoma Treatment (PDQ®)—Patient Version
Childhood soft tissue sarcoma treatment options include surgery, radiation therapy, chemotherapy, observation, targeted therapy, immunotherapy and other medications. Learn more about the diagnosis and treatment of the many types of childhood soft tissue sarcoma in this expert-reviewed summary.
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ERIC Educational Resources Information Center
Henry, Beverly W.; Ozier, Amy D.; Johnson, Amy
2011-01-01
This study aimed to assess the impact of pre-professional education on students' knowledge and attitudes about aging, including the option of a simulated learning activity. Using a mixed design, groups of nursing and nutrition students (n = 127) were randomly assigned to experience the Aging Game. Pre- and posttest observations included measures…
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Beyond usual care: the economic consequences of expanding treatment options in early pregnancy loss.
Dalton, Vanessa K; Liang, Angela; Hutton, David W; Zochowski, Melissa K; Fendrick, A Mark
2015-02-01
The objective of this study was to estimate the economic consequences of expanding options for early pregnancy loss (EPL) treatment beyond expectant management and operating room surgical evacuation (usual care). We constructed a decision model using a hypothetical cohort of women undergoing EPL management within a 30 day horizon. Treatment options under the usual care arm include expectant management and surgical uterine evacuation in an operating room (OR). Treatment options under the expanded care arm included all evidence-based safe and effective treatment options for EPL: expectant management, misoprostol treatment, surgical uterine evacuation in an office setting, and surgical uterine evacuation in an OR. Probabilities of entering various treatment pathways were based on previously published observational studies. The cost per case was US $241.29 lower for women undergoing treatment in the expanded care model as compared with the usual care model (US $1033.29 per case vs US $1274.58 per case, expanded care and usual care, respectively). The model was the most sensitive to the failure rate of the expectant management arm, the cost of the OR surgical procedure, the proportion of women undergoing an OR surgical procedure under usual care, and the additional cost per patient associated with implementing and using the expanded care model. This study demonstrates that expanding women's treatment options for EPL beyond what is typically available can result in lower direct medical expenditures. Copyright © 2015 Elsevier Inc. All rights reserved.
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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...
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Ozturk, Orgul D; McInnes, Melayne M; Blake, Christine E; Frongillo, Edward A; Jones, Sonya J
2016-01-01
The objective of this study is to develop a structured observational method for the systematic assessment of the food-choice architecture that can be used to identify key points for behavioral economic intervention intended to improve the health quality of children's diets. We use an ethnographic approach with observations at twelve elementary schools to construct our survey instrument. Elements of the structured observational method include decision environment, salience, accessibility/convenience, defaults/verbal prompts, number of choices, serving ware/method/packaging, and social/physical eating environment. Our survey reveals important "nudgeable" components of the elementary school food-choice architecture, including precommitment and default options on the lunch line.
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Potts, Lisa G; Kolb, Kelly A
2014-04-01
Difficulty understanding speech in the presence of background noise is a common report among cochlear implant (CI) recipients. Several speech-processing options designed to improve speech recognition, especially in noise, are currently available in the Cochlear Nucleus CP810 speech processor. These include adaptive dynamic range optimization (ADRO), autosensitivity control (ASC), Beam, and Zoom. The purpose of this study was to evaluate CI recipients' speech-in-noise recognition to determine which currently available processing option or options resulted in best performance in a simulated restaurant environment. Experimental study with one study group. The independent variable was speech-processing option, and the dependent variable was the reception threshold for sentences score. Thirty-two adult CI recipients. Eight processing options were tested: Beam, Beam + ASC, Beam + ADRO, Beam + ASC + ADRO, Zoom, Zoom + ASC, Zoom + ADRO, and Zoom + ASC + ADRO. Participants repeated Hearing in Noise Test sentences presented at a 0° azimuth, with R-Space restaurant noise presented from a 360° eight-loudspeaker array at 70 dB sound pressure level. A one-way repeated-measures analysis of variance was used to analyze differences in Beam options, Zoom options, and Beam versus Zoom options. Among the Beam options, Beam + ADRO was significantly poorer than Beam only, Beam + ASC, and Beam + ASC + ADRO. A 1.6-dB difference was observed between the best (Beam only) and poorest (Beam + ADRO) options. Among the Zoom options, Zoom only and Zoom + ADRO were significantly poorer than Zoom + ASC. A 2.2-dB difference was observed between the best (Zoom + ASC) and poorest (Zoom only) options. The comparison between Beam and Zoom options showed one significant difference, with Zoom only significantly poorer than Beam only. No significant difference was found between the other Beam and Zoom options (Beam + ASC vs Zoom + ASC, Beam + ADRO vs Zoom + ADRO, and Beam + ASC + ADRO vs Zoom + ASC + ADRO). The best processing option varied across subjects, with an almost equal number of participants performing best with a Beam option (n = 15) compared with a Zoom option (n = 17). There were no significant demographic or audiological moderating variables for any option. The results showed no significant differences between adaptive directionality (Beam) and fixed directionality (Zoom) when ASC was active in the R-Space environment. This finding suggests that noise-reduction processing is extremely valuable in loud semidiffuse environments in which the effectiveness of directional filtering might be diminished. However, there was no significant difference between the Beam-only and Beam + ASC options, which is most likely related to the additional noise cancellation performed by the Beam option (i.e., two-stage directional filtering and noise cancellation). In addition, the processing options with ADRO resulted in the poorest performances. This could be related to how the CI recipients were programmed or the loud noise level used in this study. The best processing option varied across subjects, but the majority performed best with directional filtering (Beam or Zoom) in combination with ASC. Therefore in a loud semidiffuse environment, the use of either Beam + ASC or Zoom + ASC is recommended. American Academy of Audiology.
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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...
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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...
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NASA Astrophysics Data System (ADS)
Chai, Tianfeng; Crawford, Alice; Stunder, Barbara; Pavolonis, Michael J.; Draxler, Roland; Stein, Ariel
2017-02-01
Currently, the National Oceanic and Atmospheric Administration (NOAA) National Weather Service (NWS) runs the HYSPLIT dispersion model with a unit mass release rate to predict the transport and dispersion of volcanic ash. The model predictions provide information for the Volcanic Ash Advisory Centers (VAAC) to issue advisories to meteorological watch offices, area control centers, flight information centers, and others. This research aims to provide quantitative forecasts of ash distributions generated by objectively and optimally estimating the volcanic ash source strengths, vertical distribution, and temporal variations using an observation-modeling inversion technique. In this top-down approach, a cost functional is defined to quantify the differences between the model predictions and the satellite measurements of column-integrated ash concentrations weighted by the model and observation uncertainties. Minimizing this cost functional by adjusting the sources provides the volcanic ash emission estimates. As an example, MODIS (Moderate Resolution Imaging Spectroradiometer) satellite retrievals of the 2008 Kasatochi volcanic ash clouds are used to test the HYSPLIT volcanic ash inverse system. Because the satellite retrievals include the ash cloud top height but not the bottom height, there are different model diagnostic choices for comparing the model results with the observed mass loadings. Three options are presented and tested. Although the emission estimates vary significantly with different options, the subsequent model predictions with the different release estimates all show decent skill when evaluated against the unassimilated satellite observations at later times. Among the three options, integrating over three model layers yields slightly better results than integrating from the surface up to the observed volcanic ash cloud top or using a single model layer. Inverse tests also show that including the ash-free region to constrain the model is not beneficial for the current case. In addition, extra constraints on the source terms can be given by explicitly enforcing
no-ash
for the atmosphere columns above or below the observed ash cloud top height. However, in this case such extra constraints are not helpful for the inverse modeling. It is also found that simultaneously assimilating observations at different times produces better hindcasts than only assimilating the most recent observations. -
NASA Technical Reports Server (NTRS)
1983-01-01
User requirements for space station use are presented for the following areas: space environments, astrophysics, Earth observations, and life science. Also included are a summary of study tasks and final reports, a topical cross reference, key team members, and acronyms and abbreviations.
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NASA Extends Chandra Science and Operations Support Contract
NASA Astrophysics Data System (ADS)
2010-01-01
NASA has extended a contract with the Smithsonian Astrophysical Observatory in Cambridge, Mass., to provide science and operational support for the Chandra X-ray Observatory, a powerful tool used to better understand the structure and evolution of the universe. The contract extension with the Smithsonian Astrophysical Observatory provides continued science and operations support to Chandra. This approximately 172 million modification brings the total value of the contract to approximately 545 million for the base effort. The base effort period of performance will continue through Sept. 30, 2013, except for the work associated with the administration of scientific research grants, which will extend through Feb. 28, 2016. The contract type is cost reimbursement with no fee. In addition to the base effort, the contract includes two options for three years each to extend the period of performance for an additional six years. Option 1 is priced at approximately 177 million and Option 2 at approximately 191 million, for a total possible contract value of about $913 million. The contract covers mission operations and data analysis, which includes observatory operations, science data processing and astronomer support. The operations tasks include monitoring the health and status of the observatory and developing and uplinking the observation sequences during Chandra's communication coverage periods. The science data processing tasks include the competitive selection, planning and coordination of science observations and processing and delivery of the resulting scientific data. NASA's Marshall Space Flight Center in Huntsville, Ala, manages the Chandra program for the agency's Science Mission Directorate in Washington. The Smithsonian Astrophysical Observatory controls Chandra's science and flight operations. For more information about the Chandra X-ray Observatory visit: http://chandra.nasa.gov
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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.
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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...
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Trial-Type Dependent Frames of Reference for Value Comparison
Hunt, Laurence T.; Woolrich, Mark W.; Rushworth, Matthew F. S.; Behrens, Timothy E. J.
2013-01-01
A central question in cognitive neuroscience regards the means by which options are compared and decisions are resolved during value-guided choice. It is clear that several component processes are needed; these include identifying options, a value-based comparison, and implementation of actions to execute the decision. What is less clear is the temporal precedence and functional organisation of these component processes in the brain. Competing models of decision making have proposed that value comparison may occur in the space of alternative actions, or in the space of abstract goods. We hypothesized that the signals observed might in fact depend upon the framing of the decision. We recorded magnetoencephalographic data from humans performing value-guided choices in which two closely related trial types were interleaved. In the first trial type, each option was revealed separately, potentially causing subjects to estimate each action's value as it was revealed and perform comparison in action-space. In the second trial type, both options were presented simultaneously, potentially leading to comparison in abstract goods-space prior to commitment to a specific action. Distinct activity patterns (in distinct brain regions) on the two trial types demonstrated that the observed frame of reference used for decision making indeed differed, despite the information presented being formally identical, between the two trial types. This provides a potential reconciliation of conflicting accounts of value-guided choice. PMID:24068906
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Career Field Experience: A Look at On-site Usage by High School Communication Class.
ERIC Educational Resources Information Center
Kaye, Thomas
The career field experience program at a midwestern high school places broadcasting students on location for observation of the profession and optional job training or work. In addition to radio and television stations, field locations include advertising agencies with production studios, corporate production facilities, recording studios, cable…
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USDA-ARS?s Scientific Manuscript database
Managing cropping systems to sequester soil organic carbon (SOC) improves soil health and a system’s resiliency to impacts of changing climate. Our objectives were to 1) monitor SOC from a bio-energy cropping study in central Pennsylvania that included a corn-soybean-alfalfa rotation, switchgrass, a...
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USDA-ARS?s Scientific Manuscript database
Managing cropping systems to sequester soil organic carbon (SOC) improves soil health and a system’s resiliency to impacts of changing climate. Our objectives were to 1) monitor SOC from a bio-energy cropping study in central Pennsylvania that included a corn-soybean-alfalfa rotation, switchgrass, ...
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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...
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Aneurysms of the petrous internal carotid artery: anatomy, origins, and treatment.
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.
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Kvande, Monica; Lykkeslet, Else; Storli, Sissel Lisa
2017-12-01
Nurses and physicians work side-by-side in the intensive care unit (ICU). Effective exchanges of patient information are essential to safe patient care in the ICU. Nurses often rate nurse-physician communication lower than physicians and report that it is difficult to speak up, that disagreements are not resolved and that their input is not well received. Therefore, this study explored nurses' dialogue with physicians regarding patients' clinical status and the prerequisites for effective and accurate exchanges of information. We adopted a qualitative approach, conducting three focus group discussions with five to six nurses and physicians each (14 total). Two themes emerged. The first theme highlighted nurses' contributions to dialogues with physicians; nurses' ongoing observations of patients were essential to patient care discussions. The second theme addressed the prerequisites of accurate and effective dialogue regarding care options, comprising three subthemes: nurses' ability to speak up and present clinical changes, establishment of shared goal and clinical understanding, and open dialogue and willingness to listen to each other. Nurses should understand their essential role in conducting ongoing observations of patients and their right to be included in care-related decision-making processes. Physicians should be willing to listen to and include nurses' clinical observations and concerns.
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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...
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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...
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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.
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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.
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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…
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Schnack, Alexandra; Rempis, Eva; Decker, Sarah; Braun, Vera; Rubaihayo, John; Busingye, Priscilla; Tumwesigye, Nazarius Mbona; Harms, Gundel; Theuring, Stefanie
2016-03-01
Since 2012, lifelong antiretroviral therapy for all HIV-positive pregnant women ("Option B+") is recommended by WHO for the prevention of mother-to-child transmission of HIV (PMTCT). Many sub-Saharan African countries have since introduced this regimen, but to date, longer-term outcome evaluations are scarce. We conducted an observational study in Fort Portal Municipality, Uganda, to describe uptake and adherence of Option B+ during pregnancy. HIV-positive women approaching antenatal care (ANC) services in two hospitals were enrolled and followed-up at monthly routine ANC visits until delivery. At each visit, next to sociodemographic and clinical data, we assessed drug adherence through pill counts. In total, 124 HIV-positive pregnant women were enrolled in our study; from these, 80.8% had not been aware of their positive serostatus before. Forty-five PMTCT clients (36.3%) never returned to ANC after their first visit. Protective factors (p < 0.05) for immediate loss to care included previous HIV status knowledge, status disclosure before or at first ANC visit, and tertiary education. Among those clients starting Option B+, the median adherence during pregnancy was 95.7% pill intake. Rather low adherence (<80%) was observed in 21.1% of clients, while more than half achieved an adherence level of ≥95%, with 40.8% of all clients being 100% adherent. The cohort's median adherence remained stable throughout the course of pregnancy. Healthcare providers should place high emphasis on individual PMTCT counseling at first ANC encounter, and pay special attention to those women previously unaware of their HIV status. However, after initial uptake, high adherence seems to be feasible for Option B+.
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Dyadic OPTION: Measuring perceptions of shared decision-making in practice.
Melbourne, Emma; Roberts, Stephen; Durand, Marie-Anne; Newcombe, Robert; Légaré, France; Elwyn, Glyn
2011-04-01
Current models of the medical consultation emphasize shared decision-making (SDM), whereby the expertise of both the doctor and the patient are recognised and seen to equally contribute to the consultation. The evidence regarding the desirability and effectiveness of the SDM approach is often conflicting. It is proposed that the conflicts are due to the nature of assessment, with current assessments from the perspective of an outside observer. To empirically assess perceived involvement in the medical consultation using the dyadic OPTION instrument. 36 simulated medical consultations were organised between general practitioners and standardized- patients, using the observer OPTION and the newly developed dyadic OPTION instruments. SDM behaviours observed in the consultations were seen to depend on both members of the doctor and patient dyad, rather than each in isolation. Thus a dyadic approach to measurement is supported. This current study highlights the necessity for a dyadic approach to assessment and introduces a novel research instrument: the dyadic OPTION instrument. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
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Evaluation of low wind modeling approaches for two tall-stack databases.
Paine, Robert; Samani, Olga; Kaplan, Mary; Knipping, Eladio; Kumar, Naresh
2015-11-01
The performance of the AERMOD air dispersion model under low wind speed conditions, especially for applications with only one level of meteorological data and no direct turbulence measurements or vertical temperature gradient observations, is the focus of this study. The analysis documented in this paper addresses evaluations for low wind conditions involving tall stack releases for which multiple years of concurrent emissions, meteorological data, and monitoring data are available. AERMOD was tested on two field-study databases involving several SO2 monitors and hourly emissions data that had sub-hourly meteorological data (e.g., 10-min averages) available using several technical options: default mode, with various low wind speed beta options, and using the available sub-hourly meteorological data. These field study databases included (1) Mercer County, a North Dakota database featuring five SO2 monitors within 10 km of the Dakota Gasification Company's plant and the Antelope Valley Station power plant in an area of both flat and elevated terrain, and (2) a flat-terrain setting database with four SO2 monitors within 6 km of the Gibson Generating Station in southwest Indiana. Both sites featured regionally representative 10-m meteorological databases, with no significant terrain obstacles between the meteorological site and the emission sources. The low wind beta options show improvement in model performance helping to reduce some of the over-prediction biases currently present in AERMOD when run with regulatory default options. The overall findings with the low wind speed testing on these tall stack field-study databases indicate that AERMOD low wind speed options have a minor effect for flat terrain locations, but can have a significant effect for elevated terrain locations. The performance of AERMOD using low wind speed options leads to improved consistency of meteorological conditions associated with the highest observed and predicted concentration events. The available sub-hourly modeling results using the Sub-Hourly AERMOD Run Procedure (SHARP) are relatively unbiased and show that this alternative approach should be seriously considered to address situations dominated by low-wind meander conditions. AERMOD was evaluated with two tall stack databases (in North Dakota and Indiana) in areas of both flat and elevated terrain. AERMOD cases included the regulatory default mode, low wind speed beta options, and use of the Sub-Hourly AERMOD Run Procedure (SHARP). The low wind beta options show improvement in model performance (especially in higher terrain areas), helping to reduce some of the over-prediction biases currently present in regulatory default AERMOD. The SHARP results are relatively unbiased and show that this approach should be seriously considered to address situations dominated by low-wind meander conditions.
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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,…
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Lack of tolerable treatment options for patients with schizophrenia.
Citrome, Leslie; Eramo, Anna; Francois, Clement; Duffy, Ruth; Legacy, Susan N; Offord, Steve J; Krasa, Holly B; Johnston, Stephen S; Guiraud-Diawara, Alice; Kamat, Siddhesh A; Rohman, Patricia
2015-01-01
Atypical antipsychotics (AAs), an effective treatment for schizophrenia, have a range of pharmacologic properties leading to differences in tolerability as well as heterogeneity in treatment response. Individual patient characteristics must be considered when making treatment choices, especially from an adverse event (AE) or tolerability perspective. Despite the availability of numerous AAs, after appraising patient characteristics at the time of treatment selection, physicians may quickly run out of tolerable treatment options. AE risk factors, defined as having either a prior history of an AE or a risk factor for that AE, were determined for Medicaid-insured and Commercially insured patients using database analysis. Patients receiving AA treatment between January 1, 2010 and December 31, 2012 defined the index date of first observed AA prescription during this period. Nine AAs were evaluated for association with AE risk factors as informed by drug prescribing information from the different manufacturers and published meta-analyses. The proportion of patients with pre-index AE risk factors prescribed an AA associated with that risk factor was then determined. A high proportion of patients (>80%) were prescribed an AA associated with extrapyramidal symptoms or akathisia despite experiencing extrapyramidal symptoms or akathisia prior to AA treatment initiation. Similar trends were observed among patients with diabetes (>60%) and obesity (>40%). From the nine treatment options available, the number of optimal choices for individual patient segments were limited based on their prior history, including those with cardiometabolic and cardiovascular comorbidities (four); experiencing prolactin elevation-related problems (seven); needing to avoid excessive sedation (four); or at risk of extrapyramidal symptoms or akathisia (two). Options were then further restricted among patients in more than one segment when multiple pre-index AE risk factors were combined. When combining patient risk profile with antipsychotic AE profile, physicians may quickly run out of tolerable treatment options for individual patients, despite the availability of many AAs, suggesting a need for additional treatment options with better tolerability and without compromising efficacy.
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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...
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Distal Hemorrhoidectomy With ALTA Injection: A New Method for Hemorrhoid Surgery
Abe, Tatsuya; Hachiro, Yoshikazu; Ebisawa, Yoshiaki; Hishiyama, Houhei; Kunimoto, Masao
2014-01-01
Aluminum potassium sulfate and tannic acid injection (ALTA) is a useful and less-invasive treatment for internal hemorrhoids. However, it is not a treatment option for external hemorrhoidal diseases, including mixed hemorrhoids. Distal hemorrhoidectomy with ALTA injection involves surgical resection of external piles, followed by injection therapy on internal piles. We report technical details and the short-term results of this procedure in patients with mixed hemorrhoids. Seventy-two patients with mixed hemorrhoids treated between 2010 and 2011 were included. The main outcome measures were the short-term response and complication rates. At 28 days after surgery, the disappearance rate of prolapse was 100%. Three patients (4%) had postoperative complications, all minor in nature. No prolapse recurrence was observed within a median follow-up period of 6 months. Distal hemorrhoidectomy with ALTA injection appears to be a promising treatment option for patients with mixed hemorrhoids. PMID:24833156
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Goldhagen, Brian E; Goldhardt, Raquel
2017-06-01
The goal of this paper is to provide a comprehensive review of the management options for central serous chorioretinopathy (CSCR). The majority of cases of acute CSCR may be managed with observation and cessation of corticosteroids, if possible, as well as life-style modifications including stress reduction and control of hypertension. The management of chronic disease is more challenging and may include either medication or laser-based treatment. Management of CSCR necessitates an individualized and selective treatment approach. There is overall poor evidence for the use of systemic and intravitreal medications. From this class of treatments, mineralocorticoid receptor antagonists appear to have the greatest potential. Although conventional thermal photocoagulation may be used in select cases, the most promising treatment options at this time for chronic CSCR are photodynamic therapy, either half-dose or half-fluence, and non-damaging (subthreshold) retinal laser therapy.
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Smith, Kortnye; Desai, Jayesh; Lazarakis, Smaro; Gyorki, David
2018-06-01
Desmoid tumors (DT) are rare clonal proliferations that arise from mesenchymal cells. These tumors do not metastasize but are locally aggressive, and their growth may lead to significant morbidity. Their clinical course is both variable and unpredictable; tumors may rapidly progress but in other instances remain stable or regress without intervention. To examine current treatment of DT and assist with decision-making at time of presentation. A literature search was conducted of MEDLINE and Cochrane databases for published studies (1995-July 2015) using the search terms fibromatosis aggressive, desmoid with drug therapy, radiation therapy, prevention and control, radiotherapy, surgery, and therapy. Articles were categorized as surgery, radiation, surgery + radiation, systemic therapy, and front-line observation. Articles were included if they reported a retrospective or prospective comparative or observational study with an analyzed sample size of 10 patients or more with confirmed diagnosis of desmoid tumor and described one of the following clinical outcomes: relapse- or progression-free survival, local control rate, response rate. 258 articles were reviewed; following screening for eligibility, 54 were identified; following full-text screen, 31 were included in final evaluation. The control rate for patients treated with a "wait and see" observational approach compared favorably with management with surgery and resulted in disease control rates of between 60 and 92%. Decision-making in this rare tumor is complicated by the range of treatment options available. Our evidence supports use of an upfront observational approach.
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Geessink, Noralie H; Ofstad, Eirik H; Olde Rikkert, Marcel G M; van Goor, Harry; Kasper, Jürgen; Schoon, Yvonne
2018-06-13
To identify determinants of older patients' perceptions of involvement in decision-making on colorectal (CRC) or pancreatic cancer (PC) treatment, and to compare these with determinants of observers' perceptions. Patients' perceptions of involvement were constructed by the 9-item SDM questionnaire (SDM-Q-9) and a Visual Analogue Scale for Involvement (VAS-I). Observers' perceptions were constructed by the OPTION5, OPTION12, and MAPPIN'SDM. Convergent validities were calculated between the patient-sided and observer instruments using Spearman's correlation coefficient. Linear regression was used to identify determinants per criterion. 58 CRC and 22 PC patients were included (mean age: 71.8 ± 5.2 years, 45.0% female). No significant correlations were found between the patient-sided and observer instruments. Patients' impression of involvement was influenced by patient characteristics such as quality of life and satisfaction, while observers' perceptions mainly referred to encounter characteristics such as the mean duration of consultations and general communication skills. Due to evident differences in determinants, older CRC/PC patients' and observers' perceptions of involvement should both be collected in evaluating the quality of medical decision-making. General communication skills should be integrated in SDM training interventions. New SDM measurement tools for patients are needed to sufficiently discriminate between the constructs of involvement and satisfaction. Copyright © 2018 Elsevier B.V. All rights reserved.
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Waldenstrom macroglobulinemia: prognosis and management
Oza, A; Rajkumar, S V
2015-01-01
Waldenstrom macroglobulinemia (WM) is a B-cell lymphoplasmacytic lymphoma characterized by monoclonal immunoglobulin M protein in the serum and infiltration of bone marrow with lymphoplasmacytic cells. Asymptomatic patients can be observed without therapy. First-line therapy should consist of the monoclonal anti-CD20 antibody, rituximab, given typically in combination with other agents. We prefer dexamethasone, rituximab, cyclophosphamide (DRC) as initial therapy for most patients with symptomatic WM. Other reasonable options are bortezomib, rituximab, dexamethasone (BoRD) or bendamustine plus rituximab (BR). All of these regimens are associated with excellent response and tolerability. Initial therapy is usually administered for 6 months, followed by observation. Response to therapy is assessed using the standard response criteria developed by the International Working Group on Waldenstrom macroglobulinemia. Relapse is almost inevitable in WM but may occur years after initial therapy. In symptomatic patients relapsing more than 1–2 years after initial therapy, the original treatment can be repeated. For relapse occurring sooner, an alternative regimen is used. In select patients, high-dose chemotherapy followed by autologous hematopoietic cell transplantation may be an option at relapse. Options for therapy of relapsed WM besides regimens used in the front-line setting include ibrutinib, purine nucleoside analogs (cladribine, fludarabine), carfilzomib and immunomodulatory agents (thalidomide, lenalidomide). PMID:25815903
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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)
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Design of a Lunar Farside Observatory
NASA Technical Reports Server (NTRS)
1989-01-01
The design of a mantendable lunar farside observatory and science base is presented. A farside observatory will allow high accuracy astronomical observations, as well as the opportunity to perform geological and low gravity studies on the Moon. The requirements of the observatory and its support facilities are determined, and a preliminary timeline for the project development is presented. The primary areas of investigation include observatory equipment, communications, habitation, and surface operations. Each area was investigated to determine the available options, and each option was evaluated to determine the advantages and disadvantages. The options selected for incorporation into the design of the farside base are presented. The observatory equipment deemed most suitable for placement on the lunar farside consist of large optical and radio arrays and seismic equipment. A communications system consisting of a temporary satellite about the L sub 2 libration point and followed by a satellite at the stable L sub 5 libration point was selected. A space station common module was found to be the most practical option for housing the astronauts at the base. Finally, a support system based upon robotic construction vehicles and the use of lunar materials was determined to be a necessary component of the base.
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MacMillan, M; Cummins, K; Fujioka, K
2016-12-01
Since the 1990s, a number of weight loss medications have been removed from the USA and or European market because of adverse events associated with these medications. These medications include fenfluramine (heart valve thickening), sibutramine (cardiovascular risk) and rimonabant (depression). This history may affect a patient's desire to consider weight loss medications as an option for weight management. This descriptive study was designed to observe what treatment options the geriatric patient (age 65 or higher) seeking weight loss would like to consider, as well as the reasons they felt they struggled with overweight or obesity. A questionnaire was given to 102 geriatric patients with overweight or obesity before starting a weight loss programme at a weight management centre. The questionnaire asked the patient why they felt they were overweight or obese and what treatment options they wished to consider. The geriatric patients were matched with younger patients in body mass index and sex. The three most common perceptions that geriatric patients felt were causes of their increased weight were 'lack of exercise' (76.2%), 'poor food choices' (59.4%) and 'cravings' (47.5%). When geriatric patients were asked what treatment options they would like to discuss, the four most common options requested were 'diet and healthy eating' (67.3%), weight loss medications (57.4%), a request for a 'metabolic work up' (55.4%) and 'exercise' (53.5%). These responses were no different from their younger cohorts. When geriatric patients with a body mass index of 35 or higher were given bariatric surgery as a treatment option, 21.9% marked it as a treatment option they would like to consider. Over half of geriatric patients desired to discuss weight loss medications as a treatment option. Diet and exercise were also of strong interest, which is in line with current weight management guidelines.
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Abdalla, Fayrouz Mohammed; Omar, Maye Abu; Badr, Elsheikh Elsiddig
2016-06-30
Medical diaspora options, including the engagement of expatriate physicians in development efforts within their home country, are being called for to reverse the effects of brain drain from developing countries. This paper presents the results of a study exploring the potential contributions for the Sudanese Medial Diaspora Options to the healthcare delivery system (HCDS) in Sudan, focusing on the options of temporal and permanent returns and the likely obstacles faced in their implementation. This was a cross-sectional study using a mixed methods design including quantitative and qualitative approaches. For the quantitative approach, the study, which focused on the possible contribution of the diaspora to healthcare delivery in Sudan, was based on an online survey using random purposive and snowballing sampling techniques involving 153 Sudanese physicians working in Saudi Arabia and other Gulf States, the United Kingdom, the Republic of Ireland, and the United States of America. The qualitative approach involved in-depth interviews with returnee physicians and key informants in Sudan, focusing on the return experiences, the barriers for return, and the options to improve future contributions. Despite contributions of the Sudanese medical diaspora being of a small scale considering the size of the phenomenon, as well as infrequent and not appropriately organized, their inputs to academia and the links built with overseas institutions and specialist clinical services were nevertheless remarkable. The main barrier to temporal return was inappropriate organization by the local counterparts, while those for permanent return of physicians were poor work environment, insufficient financial payment, unsecured accommodation, and offspring education. The study identified short-term return as a feasible option considering the country's current conditions. Proper coordination mechanisms for short-term returns and facilitation of permanent return through stakeholders' collaboration were proposed to improve diaspora contributions. The potentials of Sudanese medial diaspora contributions to the HCDS in Sudan are promising. Short-term contributions were observed as the best option for the current country situation. Creation of a coordinating body from within the healthcare sector in Sudan to effectively coordinate diaspora contributions is recommended.
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Identification of atypical flight patterns
NASA Technical Reports Server (NTRS)
Statler, Irving C. (Inventor); Ferryman, Thomas A. (Inventor); Amidan, Brett G. (Inventor); Whitney, Paul D. (Inventor); White, Amanda M. (Inventor); Willse, Alan R. (Inventor); Cooley, Scott K. (Inventor); Jay, Joseph Griffith (Inventor); Lawrence, Robert E. (Inventor); Mosbrucker, Chris (Inventor)
2005-01-01
Method and system for analyzing aircraft data, including multiple selected flight parameters for a selected phase of a selected flight, and for determining when the selected phase of the selected flight is atypical, when compared with corresponding data for the same phase for other similar flights. A flight signature is computed using continuous-valued and discrete-valued flight parameters for the selected flight parameters and is optionally compared with a statistical distribution of other observed flight signatures, yielding atypicality scores for the same phase for other similar flights. A cluster analysis is optionally applied to the flight signatures to define an optimal collection of clusters. A level of atypicality for a selected flight is estimated, based upon an index associated with the cluster analysis.
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GPU-accelerated computational tool for studying the effectiveness of asteroid disruption techniques
NASA Astrophysics Data System (ADS)
Zimmerman, Ben J.; Wie, Bong
2016-10-01
This paper presents the development of a new Graphics Processing Unit (GPU) accelerated computational tool for asteroid disruption techniques. Numerical simulations are completed using the high-order spectral difference (SD) method. Due to the compact nature of the SD method, it is well suited for implementation with the GPU architecture, hence solutions are generated at orders of magnitude faster than the Central Processing Unit (CPU) counterpart. A multiphase model integrated with the SD method is introduced, and several asteroid disruption simulations are conducted, including kinetic-energy impactors, multi-kinetic energy impactor systems, and nuclear options. Results illustrate the benefits of using multi-kinetic energy impactor systems when compared to a single impactor system. In addition, the effectiveness of nuclear options is observed.
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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...
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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...
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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...
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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...
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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...
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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...
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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.
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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. ...
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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. ...
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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. ...
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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. ...
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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.
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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...
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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...
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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...
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Rodríguez-Díez, María Cristina; Alegre, Manuel; Díez, Nieves; Arbea, Leire; Ferrer, Marta
2016-02-03
The main factor that determines the selection of a medical specialty in Spain after obtaining a medical degree is the MIR ("médico interno residente", internal medical resident) exam. This exam consists of 235 multiple-choice questions with five options, some of which include images provided in a separate booklet. The aim of this study was to analyze the technical quality of the multiple-choice questions included in the MIR exam over the last five years. All the questions included in the exams from 2009 to 2013 were analyzed. We studied the proportion of questions including clinical vignettes, the number of items related to an image and the presence of technical flaws in the questions. For the analysis of technical flaws, we adapted the National Board of Medical Examiners (NBME) guidelines. We looked for 18 different issues included in the manual, grouped into two categories: issues related to testwiseness and issues related to irrelevant difficulties. The final number of questions analyzed was 1,143. The percentage of items based on clinical vignettes increased from 50% in 2009 to 56-58% in the following years (2010-2013). The percentage of items based on an image increased progressively from 10% in 2009 to 15% in 2012 and 2013. The percentage of items with at least one technical flaw varied between 68 and 72%. We observed a decrease in the percentage of items with flaws related to testwiseness, from 30% in 2009 to 20% in 2012 and 2013. While most of these issues decreased dramatically or even disappeared (such as the imbalance in the correct option numbers), the presence of non-plausible options remained frequent. With regard to technical flaws related to irrelevant difficulties, no improvement was observed; this is especially true with respect to negative stem questions and "hinged" questions. The formal quality of the MIR exam items has improved over the last five years with regard to testwiseness. A more detailed revision of the items submitted, checking systematically for the presence of technical flaws, could improve the validity and discriminatory power of the exam, without increasing its difficulty.
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Public option and private profits: what do markets expect?
Milani, Fabio
2010-01-01
The debate on US healthcare reform has largely focused on the introduction of a public health plan option. While supporters stress various beneficial effects that would arise from increased competition in the health insurance market, opponents often contend that a public plan would drive insurers out of the market and potentially lead to the 'collapse' of the private health insurance industry. To contribute to the US healthcare reform debate by inferring, from financial market data, the effect that the public option is likely to have on the private health insurance market. The study utilized daily data on the price of a security that was traded in a prediction market from June 2009 and whose pay-off was tied to the event that a federal government-run healthcare plan - the 'public option' - would be approved by 31 December 2009 (100 daily observations). These data were combined with data on stock returns of health insurance companies (1500 observations from 100 trading days and 15 companies) to evaluate the expected effect of the public option on private health insurers. The impact on hospital companies (1000 observations) was also estimated. The results suggested that daily stock returns of health insurance companies significantly responded to the changing probability regarding the public option. A 10% increase in the probability that the public option would pass, on average, reduced the stock returns of health insurance companies by 1.28% (p < 0.001). Hospital company stock returns were also affected (0.9% reduction; p < 0.001). The results reveal the market expectation of a negative effect of the public option on the value of health insurance companies. The magnitude of the effect suggests a downward adjustment in the expected profits of health insurers of around 13%, but it does not support more calamitous scenarios.
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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.
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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...
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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.
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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...
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Weiss, H-R; Goodall, D
2008-06-01
Traditionally, the treatment options for adolescent idiopathic scoliosis (AIS), the most common form of scoliosis, are exercises; in-patient rehabilitation; braces and surgery. The outcomes of treatments are usually compared with the natural history or observation (non-intervention). The aim of this paper was to provide a synopsis of all treatment options in the light of evidence based practice (EBP). A systematic review was carried out using the most encompassing databases available. Literature has been searched for the outcome parameter ''rate of progression'' and only prospective controlled studies that have considered the treatment versus the natural history have been included. The search strategy included the following terms: ''adolescent idiopathic scoliosis''; ''idiopathic scoliosis''; ''natural history''; ''observation''; ''physiotherapy''; ''physical therapy''; ''rehabilitation''; ''bracing''; ''orthotics'' and ''surgery''. Prospective short-term studies have been found to support outpatient physiotherapy. One prospective controlled study was found to support scoliosis in-patient rehabilitation (SIR). One prospective multi-centre study, a long-term prospective controlled study and a meta-analysis have been found to support bracing. No controlled study, neither short, mid nor long-term, was found to reveal any substantial evidence to support surgery as a treatment for this condition. There is some evidence supporting the conservative treatment for AIS. No substantial evidence has been found in terms of prospective controlled studies to support surgical intervention. In light of the unknown long-term effects of surgery, a randomised controlled trial (RCT) seems necessary. Due to the presence of evidence to support conservative treatments, a plan to compose a RCT for conservative treatment options seems unethical. But it is also important to conclude that the evidence for conservative treatments is weak in number and length.
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How New Caledonian crows solve novel foraging problems and what it means for cumulative culture.
Logan, Corina J; Breen, Alexis J; Taylor, Alex H; Gray, Russell D; Hoppitt, William J E
2016-03-01
New Caledonian crows make and use tools, and tool types vary over geographic landscapes. Social learning may explain the variation in tool design, but it is unknown to what degree social learning accounts for the maintenance of these designs. Indeed, little is known about the mechanisms these crows use to obtain information from others, despite the question's importance in understanding whether tool behavior is transmitted via social, genetic, or environmental means. For social transmission to account for tool-type variation, copying must utilize a mechanism that is action specific (e.g., pushing left vs. right) as well as context specific (e.g., pushing a particular object vs. any object). To determine whether crows can copy a demonstrator's actions as well as the contexts in which they occur, we conducted a diffusion experiment using a novel foraging task. We used a nontool task to eliminate any confounds introduced by individual differences in their prior tool experience. Two groups had demonstrators (trained in isolation on different options of a four-option task, including a two-action option) and one group did not. We found that crows socially learn about context: After observers see a demonstrator interact with the task, they are more likely to interact with the same parts of the task. In contrast, observers did not copy the demonstrator's specific actions. Our results suggest it is unlikely that observing tool-making behavior transmits tool types. We suggest it is possible that tool types are transmitted when crows copy the physical form of the tools they encounter.
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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.
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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...
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ERIC Educational Resources Information Center
McCall, Steve; Douglas, Graeme; McLinden, Mike
2007-01-01
Dotted Moon is a useful and important resource to complement the range of options available to those teaching and learning Moon. Observation of a variety of Moon readers (including those at early stages of literacy as well as more advanced readers) showed that all participants were able to decode dotted Moon characters and engage in educational…
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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.
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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.
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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.
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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...
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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.
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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)
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An inverse problem of determining the implied volatility in option pricing
NASA Astrophysics Data System (ADS)
Deng, Zui-Cha; Yu, Jian-Ning; Yang, Liu
2008-04-01
In the Black-Scholes world there is the important quantity of volatility which cannot be observed directly but has a major impact on the option value. In practice, traders usually work with what is known as implied volatility which is implied by option prices observed in the market. In this paper, we use an optimal control framework to discuss an inverse problem of determining the implied volatility when the average option premium, namely the average value of option premium corresponding with a fixed strike price and all possible maturities from the current time to a chosen future time, is known. The issue is converted into a terminal control problem by Green function method. The existence and uniqueness of the minimum of the control functional are addressed by the optimal control method, and the necessary condition which must be satisfied by the minimum is also given. The results obtained in the paper may be useful for those who engage in risk management or volatility trading.
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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
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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.
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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...
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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.
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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...
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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.
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Safety, Efficacy, and Patient Acceptability of Everolimus in the Treatment of Breast Cancer.
Lousberg, Laurence; Jerusalem, Guy
2016-01-01
Everolimus combined with exemestane is an important treatment option for patients suffering from estrogen receptor-positive, human epidermal growth factor receptor 2-negative, advanced breast cancer (ABC) who have been previously treated with a nonsteroidal aromatase inhibitor (NSAI). After presentation of phase III registration trial BOLERO-2, several phase IIIb trials have been started to evaluate this regimen in a more real-world setting. Here, we review the efficacy and safety data published or presented at selected international meetings. These studies confirmed the outcome observed in the BOLERO-2 trial. Patient acceptance rate is also discussed by focusing on the permanent everolimus discontinuation rate in these trials. Factors influencing the safety profile are also reported, including the impact of age. The optimal sequence of combined therapy approaches associating targeted and endocrine therapy (ET) has yet to be determined as new treatment options such as cyclin-dependent kinase inhibitors become available. However, everolimus-exemestane remains an important treatment option with a major impact on progression-free survival (PFS) and an acceptable safety profile.
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Safety, Efficacy, and Patient Acceptability of Everolimus in the Treatment of Breast Cancer
Lousberg, Laurence; Jerusalem, Guy
2016-01-01
Everolimus combined with exemestane is an important treatment option for patients suffering from estrogen receptor-positive, human epidermal growth factor receptor 2-negative, advanced breast cancer (ABC) who have been previously treated with a nonsteroidal aromatase inhibitor (NSAI). After presentation of phase III registration trial BOLERO-2, several phase IIIb trials have been started to evaluate this regimen in a more real-world setting. Here, we review the efficacy and safety data published or presented at selected international meetings. These studies confirmed the outcome observed in the BOLERO-2 trial. Patient acceptance rate is also discussed by focusing on the permanent everolimus discontinuation rate in these trials. Factors influencing the safety profile are also reported, including the impact of age. The optimal sequence of combined therapy approaches associating targeted and endocrine therapy (ET) has yet to be determined as new treatment options such as cyclin-dependent kinase inhibitors become available. However, everolimus–exemestane remains an important treatment option with a major impact on progression-free survival (PFS) and an acceptable safety profile. PMID:28096680
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Pietrolongo, Erika; Giordano, Andrea; Kleinefeld, Monica; Confalonieri, Paolo; Lugaresi, Alessandra; Tortorella, Carla; Pugliatti, Maura; Radice, Davide; Goss, Claudia; Heesen, Christoph; Solari, Alessandra
2013-01-01
To assess decision-making in multiple sclerosis (MS) from third observer and patient perspectives. Audio recordings of first-ever consultations with a participating physician (88 outpatients, 10 physicians) at four tertiary MS care clinics in Italy, were rated by a third observer using the Observing Patient Involvement in Shared Decision Making (OPTION) and by patients using the Perceived Involvement in Care Scale (PICS). Mean patient age was 37.5, 66% were women, 72% had MS, and 28% had possible MS or other disease. Mean PICS subscale scores (range 0 poor, 100 best possible) were 71.9 (SD 24.3) for "physician facilitation" (PICS-F); 74.6 (SD 22.9) for "patient information exchange" (PICS-I); and only 22.5 (SD 16.2) for "patient decision making" (PICS-DM). Mean OPTION total score (0 poor, 100 best possible) was 29.6 (SD 10.3). Poorest OPTION scores were found for items assessing "preferred patient approach to receiving information" and "preferred patient level of involvement." Highest scores were for "clinician drawing attention to identified problem", "indicating need for decision making," and "need to review the decision." Consultation time, woman physician, patient-physician gender concordance and PICS-F were associated with higher OPTION total score; older physician and second opinion consultation were associated with lower OPTION score. In line with findings in other settings, our third observer findings indicated limited patient involvement abilities of MS physicians during first consultations. Patient perceptions of physician skills were better than third observers', although they correlated. Consultations with women physicians, and younger physicians, were associated with higher third observer and patient-based scores. Our findings reveal a need to empower Italian MS physicians with better communication and shared decision-making skills, and show in particular that attention to MS patient preferences for reception of information and involvement in health decisions, need to be improved.
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Susanto, Christopher; Kooman, J; Courtens, A M; Konings, C J A M
2018-01-01
Conservative care for patients aged 75 years and older with CKD stage 5 as a treatment option besides dialysis was proposed officially in the Netherlands in October 2016. This national survey showed the current implementation of this option in Netherlands nephrology departments. A web-based survey was sent to medical managers of 60 nephrology departments in the Netherlands in August 2016. Twenty-one medical managers (35%) completed the survey. The term "conservative care" is frequently used and well known. The estimated number of patients in whom the decision for maximal conservative care was made in 2015 was 310 of 2249 patients with CKD stage 5 age 75 years and older (range 5-50 patients per department). 164 patients became symptomatic and received no dialysis. There is no official registration for this treatment option and patient category. The practice patterns vary widely. Only one of 21 respondents reported a conservative care outpatient clinic. Formal training or education regarding conservative care is not available in most of departments. 95% of respondents discussed this treatment option with their patients. General practitioners are always being informed about their patient's decision. Their main role is providing or organizing palliative care support at the end of life and discussing advance care planning. Most respondents (86%) considered to include their patients in a prospective multicentre observational study, conservative care versus dialysis. Conservative care as a treatment option for patients with CKD stage 5 aged 75 years and older is well established. The practice patterns are varied in the Netherlands. Follow-up studies are needed to see whether the new multidisciplinary guideline facilitates harmonization of practice pattern. Funding is needed to optimize the implementation of conservative care.
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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.
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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...
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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...
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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…
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Bock, Karl Walter
2017-04-01
Metabolism of aryl hydrocarbons and toxicity of dioxins led to the discovery of the aryl hydrocarbon receptor (AHR). Tremendous advances have been made on multiplicity of AHR signaling and identification of endogenous ligands including the tryptophan metabolites FICZ and kynurenine. However, human AHR functions are still poorly understood due to marked species differences as well as cell-type- and cell context-dependent AHR functions. Observations in dioxin-poisoned individuals may provide hints to physiologic AHR functions in humans. Based on these observations three human AHR functions are discussed: (1) Chemical defence and homeostasis of endobiotics. The AHR variant Val381 in modern humans leads to reduced AHR affinity to aryl hydrocarbons in comparison with Neanderthals and primates expressing the Ala381 variant while affinity to indoles remains unimpaired. (2) Homeostasis of stem/progenitor cells. Dioxins dysregulate homeostasis in sebocyte stem cells. (3) Modulation of immunity. In addition to microbial defence, AHR may be involved in a 'disease tolerance defence pathway'. Further characterization of physiologic AHR functions may lead to therapeutic options.
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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.
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Syamal, Mausumi N; Bryson, Paul C
2017-02-01
Stress velopharyngeal insufficiency (SVPI) is an uncommon but often career-threatening condition affecting professional brass and woodwind musicians. To review the evaluation of and treatment for SVPI in professional musicians with lipoinjection to the posterior pharyngeal wall. A retrospective medical record and literature review. Two professional musicians with SVPI treated with autologous lipoinjection to the posterior pharyngeal wall were included. Nasopharyngoscopy was performed while patients played their instrument both before and after injection. To assess the effectiveness of autologous fat injection to the posterior pharyngeal wall to treat stress velopharyngeal insufficiency in 2 professional instrumentalists. Successful treatment was the absence of VPI during playing as visualized by flexible nasopharyngoscopy. After autologous lipoinjection of the posterior pharyngeal wall, 1 patient resumed full play with complete resolution, now 3 years after lipoinjection pharyngoplasty. The other patient received temporary resolution. Both had no surgical complications. Stress VPI is often a career-threatening condition for professional brass and woodwind musicians, with a cited incidence of 34%. Various treatment options in the literature include observation, speech and language pathology referral for pharyngeal strengthening, lipoinjection of the soft palate, and more invasive options, such as sphincter pharyngoplasty, pharyngeal flaps and V-Y pushback. Autologous fat injection pharyngoplasty of the posterior pharyngeal wall may be a less invasive treatment option for musicians with SVPI.
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Triple-negative breast cancer: treatment challenges and solutions
Collignon, Joëlle; Lousberg, Laurence; Schroeder, Hélène; Jerusalem, Guy
2016-01-01
Triple-negative breast cancers (TNBCs) are defined by the absence of estrogen and progesterone receptors and the absence of HER2 overexpression. These cancers represent a heterogeneous breast cancer subtype with a poor prognosis. Few systemic treatment options exist besides the use of chemotherapy (CT). The heterogeneity of the disease has limited the successful development of targeted therapy in unselected patient populations. Currently, there are no approved targeted therapies for TNBC. However, intense research is ongoing to identify specific targets and develop additional and better systemic treatment options. Standard adjuvant and neoadjuvant regimens include anthracyclines, cyclophosphamide, and taxanes. Platinum-based CT has been proposed as another CT option of interest in TNBC. We review the role of this therapy in general, and particularly in patients carrying BRCA germ-line mutations. Available data concerning the role of platinum-based CT in TNBC were acquired primarily in the neoadjuvant setting. The routine use of platinum-based CT is not yet recommended by available guidelines. Many studies have reported the molecular characterization of TNBCs. Several actionable targets have been identified. Novel therapeutic strategies are currently being tested in clinical trials based on promising results observed in preclinical studies. These targets include androgen receptor, EGFR, PARP, FGFR, and the angiogenic pathway. We review the recent data on experimental drugs in this field. We also discuss the recent data concerning immunologic checkpoint inhibitors. PMID:27284266
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The Earth Phenomena Observing System: Intelligent Autonomy for Satellite Operations
NASA Technical Reports Server (NTRS)
Ricard, Michael; Abramson, Mark; Carter, David; Kolitz, Stephan
2003-01-01
Earth monitoring systems of the future may include large numbers of inexpensive small satellites, tasked in a coordinated fashion to observe both long term and transient targets. For best performance, a tool which helps operators optimally assign targets to satellites will be required. We present the design of algorithms developed for real-time optimized autonomous planning of large numbers of small single-sensor Earth observation satellites. The algorithms will reduce requirements on the human operators of such a system of satellites, ensure good utilization of system resources, and provide the capability to dynamically respond to temporal terrestrial phenomena. Our initial real-time system model consists of approximately 100 satellites and large number of points of interest on Earth (e.g., hurricanes, volcanoes, and forest fires) with the objective to maximize the total science value of observations over time. Several options for calculating the science value of observations include the following: 1) total observation time, 2) number of observations, and the 3) quality (a function of e.g., sensor type, range, slant angle) of the observations. An integrated approach using integer programming, optimization and astrodynamics is used to calculate optimized observation and sensor tasking plans.
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NASA Technical Reports Server (NTRS)
Zhang, Qingyuan; Cheng, Yen-Ben; Lyapustin, Alexei I.; Wang, Yujie; Xiao, Xiangming; Suyker, Andrew; Verma, Shashi; Tan, Bin; Middleton, Elizabeth M.
2014-01-01
Accurate estimation of gross primary production (GPP) is essential for carbon cycle and climate change studies. Three AmeriFlux crop sites of maize and soybean were selected for this study. Two of the sites were irrigated and the other one was rainfed. The normalized difference vegetation index (NDVI), the enhanced vegetation index (EVI), the green band chlorophyll index (CIgreen), and the green band wide dynamic range vegetation index (WDRVIgreen) were computed from the moderate resolution imaging spectroradiometer (MODIS) surface reflectance data. We examined the impacts of the MODIS observation footprint and the vegetation bidirectional reflectance distribution function (BRDF) on crop daily GPP estimation with the four spectral vegetation indices (VIs - NDVI, EVI, WDRVIgreen and CIgreen) where GPP was predicted with two linear models, with and without offset: GPP = a × VI × PAR and GPP = a × VI × PAR + b. Model performance was evaluated with coefficient of determination (R2), root mean square error (RMSE), and coefficient of variation (CV). The MODIS data were filtered into four categories and four experiments were conducted to assess the impacts. The first experiment included all observations. The second experiment only included observations with view zenith angle (VZA) = 35? to constrain growth of the footprint size,which achieved a better grid cell match with the agricultural fields. The third experiment included only forward scatter observations with VZA = 35?. The fourth experiment included only backscatter observations with VZA = 35?. Overall, the EVI yielded the most consistently strong relationships to daily GPP under all examined conditions. The model GPP = a × VI × PAR + b had better performance than the model GPP = a × VI × PAR, and the offset was significant for most cases. Better performance was obtained for the irrigated field than its counterpart rainfed field. Comparison of experiment 2 vs. experiment 1 was used to examine the observation footprint impact whereas comparison of experiment 4 vs. experiment 3 was used to examine the BRDF impact. Changes in R2, RMSE,CV and changes in model coefficients "a" and "b" (experiment 2 vs. experiment 1; and experiment 4 vs. experiment 3) were indicators of the impacts. The second experiment produced better performance than the first experiment, increasing R2 (?0.13) and reducing RMSE (?0.68 g C m-2 d-1) and CV (?9%). For each VI, the slope of GPP = a × VI × PAR in the second experiment for each crop type changed little while the slope and intercept of GPP = a × VI × PAR + b varied field by field. The CIgreen was least affected by the MODIS observation footprint in estimating crop daily GPP (R2, ?0.08; RMSE, ?0.42 g C m-2 d-1; and CV, ?7%). Footprint most affected the NDVI (R2, ?0.15; CV, ?10%) and the EVI (RMSE, ?0.84 g C m-2 d-1). The vegetation BRDF impact also caused variation of model performance and change of model coefficients. Significantly different slopes were obtained for forward vs. backscatter observations, especially for the CIgreen and the NDVI. Both the footprint impact and the BRDF impact varied with crop types, irrigation options, model options and VI options.
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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…
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Option price and market instability
NASA Astrophysics Data System (ADS)
Baaquie, Belal E.; Yu, Miao
2017-04-01
An option pricing formula, for which the price of an option depends on both the value of the underlying security as well as the velocity of the security, has been proposed in Baaquie and Yang (2014). The FX (foreign exchange) options price was empirically studied in Baaquie et al., (2014), and it was found that the model in general provides an excellent fit for all strike prices with a fixed model parameters-unlike the Black-Scholes option price Hull and White (1987) that requires the empirically determined implied volatility surface to fit the option data. The option price proposed in Baaquie and Cao Yang (2014) did not fit the data during the crisis of 2007-2008. We make a hypothesis that the failure of the option price to fit data is an indication of the market's large deviation from its near equilibrium behavior due to the market's instability. Furthermore, our indicator of market's instability is shown to be more accurate than the option's observed volatility. The market prices of the FX option for various currencies are studied in the light of our hypothesis.
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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...
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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...
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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...
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Flexibility in Flood Management Design: Proactive Planning Under Climate Change Uncertainty
NASA Astrophysics Data System (ADS)
Smet, K.; de Neufville, R.; van der Vlist, M.
2015-12-01
This paper presents an innovative, value-enhancing procedure for effective planning and design of long-lived flood management infrastructure given uncertain future flooding threats due to climate change. Designing infrastructure that can be adapted over time is a method to safeguard the efficacy of current design decisions given uncertainty about rates and future impacts of climate change. This paper explores the value of embedding "options" in a physical structure, where an option is the right but not the obligation to do something at a later date (e.g. over-dimensioning a floodwall foundation now facilitates a future height addition in response to observed increases in sea level; building of extra pump bays in a pumping station now enables the addition of pumping capacity whenever increased precipitation warrants an expansion.) The proposed procedure couples a simulation model that captures future climate induced changes to the hydrologic operating environment of a structure, with an economic model that estimates the lifetime economic performance of alternative investments. The economic model uses Real "In" Options analysis, a type of cash flow analysis that quantifies the implicit value of options and the flexibility they provide. This procedure is demonstrated using replacement planning for the multi-functional pumping station IJmuiden on the North Sea Canal in the Netherlands. Flexibility in design decisions is modelled, varying the size and specific options included in the new structure. Results indicate that the incorporation of options within the structural design has the potential to improve its economic performance, as compared to more traditional, "build it once and build it big" designs where flexibility is not an explicit design criterion. The added value resulting from the incorporation of flexibility varies with the range of future conditions considered, as well as the options examined. This procedure could be applied more broadly to explore investment strategies for the design of other flood management structures.
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Flexibility in flood management design: proactive planning under uncertainty
NASA Astrophysics Data System (ADS)
Smet, K.; de Neufville, R.; van der Vlist, M.
2016-12-01
This paper presents a value-enhancing approach for proactive planning and design of long-lived flood management infrastructure given uncertain future flooding threats. Designing infrastructure that can be adapted over time is a method to safeguard the efficacy of current design decisions given future uncertainties. We explore the value of embedding "options" in a physical structure, where an option is the right but not the obligation to do something at a later date (e.g. over-dimensioning a floodwall foundation now facilitates a future height addition in response to observed increases in sea level; building extra pump bays in a drainage pumping station enables the easy addition of pumping capacity whenever increased precipitation warrants an expansion.) The proposed approach couples a simulation model that captures future climate induced changes to the hydrologic operating environment of a structure, with an economic model that estimates the lifetime economic performance of alternative investment strategies. The economic model uses Real "In" Options analysis, a type of cash flow analysis that quantifies the implicit value of options and the flexibility they provide. We demonstrate the approach using replacement planning for the multi-functional pumping station IJmuiden on the North Sea Canal in the Netherlands. The analysis models flexibility in design decisions, varying the size and specific options included in the new structure. Results indicate that the incorporation of options within the structural design has the potential to improve its economic performance, as compared to more traditional, "build it once and build it big" designs where flexibility is not an explicit design criterion. The added value resulting from the incorporation of flexibility varies with the range of future conditions considered, and the specific options examined. This approach could be applied to explore investment strategies for the design of other flood management structures, as well as be expanded to look more at flexibility within an infrastructure network rather than a single structure. Flexibility in flood management design:proactive planning under uncertainty
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NASA Astrophysics Data System (ADS)
Proffitt, Charles R.; Birkmann, Stephan; Ferruit, Pierre; Guilbert, Aurelie; Holler, Bryan J.; Stansberry, John
2017-10-01
The NIRSpec Instrument on the James Webb Space Telescope will allow near-IR spectroscopy in the wavelength range between 0.6 and 5.3 microns with resolving power of ~100, 1000, or 2700. We review strategies for performing spectral observations of solar system objects using each of NIRSpec's available observing modes, including the integral field unit (IFU), multi-Object Spectroscopy (MOS), and fixed slit (FS) templates, and discuss how the choice of mode affects the limiting target brightness as well as the detailed wavelength and spatial coverage obtained. We also discuss the expected pointing accuracy and target acquisition options for moving targets, including the use and limitations of the Wide Aperture Target Acquisition (WATA) capability and of the pre-defined field points that will be available for use with the MOS template to enable the use of custom micro-shutter patterns including ones emulating very long slits.
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System and method for confining an object to a region of fluid flow having a stagnation point
NASA Technical Reports Server (NTRS)
Schroeder, Charles M. (Inventor); Babcock, Hazen P. (Inventor); Shaqfeh, Eric S. G. (Inventor); Chu, Steven (Inventor)
2006-01-01
A device for confining an object to a region proximate to a fluid flow stagnation point includes one or more inlets for carrying the fluid into the region, one or more outlets for carrying the fluid out of the region, and a controller, in fluidic communication with the inlets and outlets, for adjusting the motion of the fluid to produce a stagnation point in the region, thereby confining the object to the region. Applications include, for example, prolonged observation of the object, manipulation of the object, etc. The device optionally may employ a feedback control mechanism, a sensing apparatus (e.g., for imaging), and a storage medium for storing, and a computer for analyzing and manipulating, data acquired from observing the object. The invention further provides methods of using such a device and system in a number of fields, including biology, chemistry, physics, material science, and medical science.
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The costs and benefits of Option B+ for the prevention of mother-to-child transmission of HIV.
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.
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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.
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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.
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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.
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Stubenrouch, Fabienne E; Pieterse, Arwen H; Falkenberg, Rijan; Santema, T Katrien B; Stiggelbout, Anne M; van der Weijden, Trudy; Aarts, J Annemijn W M; Ubbink, Dirk T
2016-06-01
The 12-item "observing patient involvement" (OPTION(12))-instrument is commonly used to assess the extent to which healthcare providers involve patients in health-related decision-making. The five-item version (OPTION(5)) claims to be a more efficient measure. In this study we compared the Dutch versions of the OPTION-instruments in terms of inter-rater agreement and correlation in outpatient doctor-patient consultations in various settings, to learn if we can safely switch to the shorter OPTION(5)-instrument. Two raters coded 60 audiotaped vascular surgery and oncology patient consultations using OPTION(12) and OPTION(5). Unweighted Cohen's kappa was used to compute inter-rater agreement on item-level. The association between the total scores of the two OPTION-instruments was investigated using Pearson's correlation coefficient (r) and a Bland & Altman plot. After fine-tuning the OPTION-manuals, inter-rater agreement for OPTION(12) and OPTION(5) was good to excellent (kappa range 0.69-0.85 and 0.63-0.72, respectively). Mean total scores were 23.7 (OPTION(12); SD=7.8) and 39.3 (OPTION(5); SD=12.7). Correlation between the total scores was high (r=0.71; p=0.01). OPTION(5) scored systematically higher with a wider range than OPTION(12). Both OPTION-instruments had a good inter-rater agreement and correlated well. OPTION(5) seems to differentiate better between various levels of patient involvement. The OPTION(5)-instrument is recommended for clinical application. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
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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.
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NASA Astrophysics Data System (ADS)
Van Den Broeke, Matthew S.; Kalin, Andrew; Alavez, Jose Abraham Torres; Oglesby, Robert; Hu, Qi
2017-11-01
In climate modeling studies, there is a need to choose a suitable land surface model (LSM) while adhering to available resources. In this study, the viability of three LSM options (Community Land Model version 4.0 [CLM4.0], Noah-MP, and the five-layer thermal diffusion [Bucket] scheme) in the Weather Research and Forecasting model version 3.6 (WRF3.6) was examined for the warm season in a domain centered on the central USA. Model output was compared to Parameter-elevation Relationships on Independent Slopes Model (PRISM) data, a gridded observational dataset including mean monthly temperature and total monthly precipitation. Model output temperature, precipitation, latent heat (LH) flux, sensible heat (SH) flux, and soil water content (SWC) were compared to observations from sites in the Central and Southern Great Plains region. An overall warm bias was found in CLM4.0 and Noah-MP, with a cool bias of larger magnitude in the Bucket model. These three LSMs produced similar patterns of wet and dry biases. Model output of SWC and LH/SH fluxes were compared to observations, and did not show a consistent bias. Both sophisticated LSMs appear to be viable options for simulating the effects of land use change in the central USA.
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Advanced policy options to regulate sugar-sweetened beverages to support public health.
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.
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Orbitofrontal cortical activity during repeated free choice.
Campos, Michael; Koppitch, Kari; Andersen, Richard A; Shimojo, Shinsuke
2012-06-01
Neurons in the orbitofrontal cortex (OFC) have been shown to encode subjective values, suggesting a role in preference-based decision-making, although the precise relation to choice behavior is unclear. In a repeated two-choice task, subjective values of each choice can account for aggregate choice behavior, which is the overall likelihood of choosing one option over the other. Individual choices, however, are impossible to predict with knowledge of relative subjective values alone. In this study we investigated the role of internal factors in choice behavior with a simple but novel free-choice task and simultaneous recording from individual neurons in nonhuman primate OFC. We found that, first, the observed sequences of choice behavior included periods of exceptionally long runs of each of two available options and periods of frequent switching. Neither a satiety-based mechanism nor a random selection process could explain the observed choice behavior. Second, OFC neurons encode important features of the choice behavior. These features include activity selective for exceptionally long runs of a given choice (stay selectivity) as well as activity selective for switches between choices (switch selectivity). These results suggest that OFC neural activity, in addition to encoding subjective values on a long timescale that is sensitive to satiety, also encodes a signal that fluctuates on a shorter timescale and thereby reflects some of the statistically improbable aspects of free-choice behavior.
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Orbitofrontal cortical activity during repeated free choice
Koppitch, Kari; Andersen, Richard A.; Shimojo, Shinsuke
2012-01-01
Neurons in the orbitofrontal cortex (OFC) have been shown to encode subjective values, suggesting a role in preference-based decision-making, although the precise relation to choice behavior is unclear. In a repeated two-choice task, subjective values of each choice can account for aggregate choice behavior, which is the overall likelihood of choosing one option over the other. Individual choices, however, are impossible to predict with knowledge of relative subjective values alone. In this study we investigated the role of internal factors in choice behavior with a simple but novel free-choice task and simultaneous recording from individual neurons in nonhuman primate OFC. We found that, first, the observed sequences of choice behavior included periods of exceptionally long runs of each of two available options and periods of frequent switching. Neither a satiety-based mechanism nor a random selection process could explain the observed choice behavior. Second, OFC neurons encode important features of the choice behavior. These features include activity selective for exceptionally long runs of a given choice (stay selectivity) as well as activity selective for switches between choices (switch selectivity). These results suggest that OFC neural activity, in addition to encoding subjective values on a long timescale that is sensitive to satiety, also encodes a signal that fluctuates on a shorter timescale and thereby reflects some of the statistically improbable aspects of free-choice behavior. PMID:22423007
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Greenhouse Gas Mitigation Options Database(GMOD)and Tool
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...
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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.
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Valuing options in shot noise market
NASA Astrophysics Data System (ADS)
Laskin, Nick
2018-07-01
A new exactly solvable option pricing model has been introduced and elaborated. It is assumed that a stock price follows a Geometric shot noise process. An arbitrage-free integro-differential option pricing equation has been obtained and solved. The new Greeks have been analytically calculated. It has been shown that in diffusion approximation the developed option pricing model incorporates the well-known Black-Scholes equation and its solution. The stochastic dynamic origin of the Black-Scholes volatility has been uncovered. To model the observed market stock price patterns consisting of high frequency small magnitude and low frequency large magnitude jumps, the superposition of two Geometric shot noises has been implemented. A new generalized option pricing equation has been obtained and its exact solution was found. Merton's jump-diffusion formula for option price was recovered in diffusion approximation. Despite the non-Gaussian nature of probability distributions involved, the new option pricing model has the same degree of analytical tractability as the Black-Scholes model and the Merton jump-diffusion model. This attractive feature allows one to derive exact formulas to value options and option related instruments in the market with jump-like price patterns.
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Management of extrapulmonary sarcoidosis: challenges and solutions
Al-Kofahi, Khalid; Korsten, Peter; Ascoli, Christian; Virupannavar, Shanti; Mirsaeidi, Mehdi; Chang, Ian; Qaqish, Naim; Saketkoo, Lesley A; Baughman, Robert P; Sweiss, Nadera J
2016-01-01
Background Sarcoidosis is a chronic multisystem disease of unknown etiology characterized by noncaseating granulomas that most often involves the lungs, but frequently has extrapulmonary manifestations, which might be difficult to treat in individual patients. Objective To review different disease manifestations, focusing on extrapulmonary organ systems, and to provide treatment options for refractory cases. Materials and methods We performed a literature search using Medline and Google Scholar for individual or combined keywords of “sarcoidosis, extrapulmonary, treatment, kidney, neurosarcoidosis, cardiovascular, gastrointestinal, transplantation, musculoskeletal, rheumatology, arthritis, and skin”. Peer-reviewed articles, including review articles, clinical trials, observational trials, and case reports that were published in English were included. References from retrieved articles were also manually searched for relevant articles. Results and conclusion Isolated involvement of a single organ or organ system is rare in sarcoidosis, and thus all patients must be thoroughly evaluated for additional disease manifestations. Cardiac sarcoidosis and neurosarcoidosis may be life-threatening. Clinicians need to assess patients comprehensively using clinical, laboratory, imaging, and histopathological data to recommend competently the best and least toxic treatment option for the individual patient. PMID:27853374
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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.
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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.
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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.
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Management of statin-intolerant high-risk patients.
Tziomalos, Konstantinos; Athyros, Vasilios G; Karagiannis, Asterios; Mikhailidis, Dimitri P
2010-09-01
Statins are an essential part of the management of patients at high vascular risk and are generally well-tolerated. However, statin intolerance will be observed more frequently as more stringent low density lipoprotein cholesterol (LDL-C) targets are pursued in an ever increasing number of patients. We review the management options for high-risk patients intolerant to statin treatment. Potential strategies include switching to a different statin, reducing the frequency of statin administration, substituting statins with other LDL-C-lowering agents (e.g. ezetimibe, colesevelam or nicotinic acid) and combining low-dose statin treatment with other lipid-modifying drugs. A limited number of studies specifically assessed statin-intolerant patients and most were small and of short duration. It is therefore difficult to make evidence-based recommendations for the management of this population. In addition, all treatment options have limitations in terms of safety and/or efficacy.
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Nurse Delegation in Home Care: Research Guiding Policy Change.
Young, Heather M; Farnham, Jennifer; Reinhard, Susan C
2016-09-01
The current study evaluated nurse delegation in home care, a pilot program introduced in 2007 in New Jersey to promote home care options for consumers needing assistance with medical/nursing tasks. Findings on readiness for the program, barriers and facilitating factors, experience with the program, and recommendations are summarized and presented. Methods included surveys and interviews with participants in nurse delegation, observations of planning and implementation meetings, and review meeting minutes. Major findings were no negative outcomes for consumers, improvements in quality of life and quality of care for consumers, high readiness and increasing satisfaction with experience in delegation, perception of nurse delegation in home care as a valued option, and the challenges of ensuring adequate staffing. Subsequent changes in regulation in New Jersey are underway, translating this research into policy. [Journal of Gerontological Nursing, 42(9), 7-15.]. Copyright 2016, SLACK Incorporated.
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Supersonic CO electric-discharge lasers
NASA Technical Reports Server (NTRS)
Hason, R. K.; Mitchner, M.; Stanton, A.
1975-01-01
Laser modeling activity is described which involved addition of an option allowing N2 as a second diatomic gas. This option is now operational and a few test cases involving N2/CO mixtures were run. Results from these initial test cases are summarized. In the laboratory, a CW double-discharge test facility was constructed and tested. Features include: water-cooled removable electrodes, O-ring construction to facilitate cleaning and design modifications, increased discharge length, and addition of a post-discharge observation section. Preliminary tests with this facility using N2 yielded higher power loadings than obtained in the first-generation facility. Another test-section modification, recently made and as yet untested, will permit injection of secondary gases into the cathode boundary layer. The objective will be to vary and enhance the UV emission spectrum from the auxiliary discharge, thereby influencing the level of photoionization in the main discharge region.
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Green Power Marketing in the United States. A Status Report (2008 Data)
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bird, Lori; Kreycik, Claire; Friedman, Barry
Voluntary consumer decisions to buy electricity supplied from renewable energy sources represent a powerful market support mechanism for renewable energy development. In the early 1990s, a small number of U.S. utilities began offering 'green power' options to their customers. Since then, these products have become more prevalent, both from traditional utilities and from renewable energy marketers operating in states that have introduced competition into their retail electricity markets or offering renewable energy certificates (RECs) online. Today, more than half of all U.S. electricity customers have an option to purchase some type of green power product directly from a retail electricitymore » provider, while all consumers have the option to purchase RECs. This report documents green power marketing activities and trends in the United States including utility green pricing programs offered in regulated electricity markets; green power marketing activity in competitive electricity markets, as well as green power sold to voluntary purchasers in the form of RECs; and renewable energy sold as greenhouse gas offsets in the United States. These sections are followed by a discussion of key market trends and issues. The final section offers conclusions and observations.« less
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Green Power Marketing in the United States: A Status Report (2008 Data)
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bird, L.; Kreycik, C.; Friedman, B.
Voluntary consumer decisions to buy electricity supplied from renewable energy sources represent a powerful market support mechanism for renewable energy development. In the early 1990s, a small number of U.S. utilities began offering 'green power' options to their customers. Since then, these products have become more prevalent, both from traditional utilities and from renewable energy marketers operating in states that have introduced competition into their retail electricity markets or offering renewable energy certificates (RECs) online. Today, more than half of all U.S. electricity customers have an option to purchase some type of green power product directly from a retail electricitymore » provider, while all consumers have the option to purchase RECs. This report documents green power marketing activities and trends in the United States including utility green pricing programs offered in regulated electricity markets; green power marketing activity in competitive electricity markets, as well as green power sold to voluntary purchasers in the form of RECs; and renewable energy sold as greenhouse gas offsets in the United States. These sections are followed by a discussion of key market trends and issues. The final section offers conclusions and observations.« less
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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.
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Benefits and work-schedule options in hospital pharmacy practice.
Gaither, C A; Mason, N A; Diokno, D A; Hoffman, E J
1994-03-15
Hospital pharmacy directors were surveyed to determine whether their departments offered specific family-related benefits and work-schedule options and how their attitudes about these options compared with those of female hospital pharmacists. Questionnaires were mailed to 300 randomly selected hospital pharmacy directors to collect the following information: vacancy rates and male:female ratios in hospital pharmacy positions, which of 13 selected benefits and work-schedule options were offered, barriers that prevented the other options from being offered, and attitudes about the listed options. The options included in the survey were selected because they represent ways of balancing home and work (e.g., maternity leave, job sharing, day care). The pharmacy directors' responses were compared with those from a similar survey of female hospital pharmacists. The usable response rate was 50.3%. Position vacancy rates ranged from 5.5% for directors to 35.8% for clinical supervisors. All full-time positions had an even distribution of men and women except for director and assistant or associate director positions. Of 13 options, only maternity leave, part-time schedules, and flexible schedules were offered by more than half of the hospitals. These three were also the only listed options that the respondents considered important in recruiting and retaining pharmacists. Barriers to offering other options included the perception that current benefits and work-schedule options were adequate, lack of staff coverage, lack of funds, and the perception that some positions are not compatible with alternative schedules. Respondents' ratings of the importance of the listed benefits and work-schedule options were significantly lower than ratings given by female hospital pharmacists in a separate survey.(ABSTRACT TRUNCATED AT 250 WORDS)
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Risky business: rhesus monkeys exhibit persistent preferences for risky options.
Xu, Eric R; Kralik, Jerald D
2014-01-01
Rhesus monkeys have been shown to prefer risky over safe options in experiential decision-making tasks. These findings might be due, however, to specific contextual factors, such as small amounts of fluid reward and minimal costs for risk-taking. To better understand the factors affecting decision-making under risk in rhesus monkeys, we tested multiple factors designed to increase the stakes including larger reward amounts, distinct food items rather than fluid reward, a smaller number of trials per session, and risky options with greater variation that also included non-rewarded outcomes. We found a consistent preference for risky options, except when the expected value of the safe option was greater than the risky option. Thus, with equivalent mean utilities between the safe and risky options, rhesus monkeys appear to have a robust preference for the risky options in a broad range of circumstances, akin to the preferences found in human children and some adults in similar tasks. One account for this result is that monkeys make their choices based on the salience of the largest payoff, without integrating likelihood and value across trials. A related idea is that they fail to override an impulsive tendency to select the option with the potential to obtain the highest possible outcome. Our results rule out strict versions of both accounts and contribute to an understanding of the diversity of risky decision-making among primates.
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Writing about Clients: Ethical Considerations and Options
ERIC Educational Resources Information Center
Sperry, Len; Pies, Ronald
2010-01-01
Today, the decision to prepare clinical case material for publication is a decision that cannot be taken lightly. The decision involves reviewing ethical considerations and choosing among various options to safeguard client privacy. Such options include seeking the client's permission, disguising case material, and developing composite case…
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Griffith, Jennifer M; Fichter, Marlie; Fowler, Floyd J; Lewis, Carmen; Pignone, Michael P
2008-01-01
Background An important question in the development of decision aids about colon cancer (CRC) screening is whether to include an explicit discussion of the option of not being screened. We examined the effect of including or not including an explicit discussion of the option of deciding not to be screened in a CRC screening decision aid on subjective measures of decision aid content; interest in screening; and knowledge. Methods Adults ages 50–85 were assigned to view one of two versions of the decision aid. The two versions differed only in the inclusion of video segments of two men, one of whom decided against being screened. Participants completed questionnaires before and after viewing the decision aid to compare subjective measures of content, screening interest and intent, and knowledge between groups. Likert response categories (5-point) were used for subjective measures of content (eg. clarity, balance in favor/against screening, and overall rating), and screening interest. Knowledge was measured with a three item index and individual questions. Higher scores indicated favorable responses for subjective measures, greater interest, and better knowledge. For the subjective balance, lower numbers were associated with the impression of the decision aid favoring CRC screening. Results 57 viewed the "with" version which included the two segments and 49 viewed the "without" version. After viewing, participants found the "without" version to have better subjective clarity about benefits of screening ("with" 3.4, "without" 4.1, p < 0.01), and to have greater clarity about downsides of screening ("with" 3.2, "without" 3.6, p = 0.03). The "with" version was considered to be less strongly balanced in favor of screening. ("with" 1.8, "without" 1.6, p = 0.05); but the "without" version received a better overall rating ("with" 3.5, "without" 3.8, p = 0.03). Groups did not differ in screening interest after viewing a decision aid or knowledge. Conclusion A decision aid with the explicit discussion of the option of deciding not to be screened appears to increase the impression that the program was not as strongly in favor of screening, but decreases the impression of clarity and resulted in a lower overall rating. We did not observe clinically important or statistically significant differences in interest in screening or knowledge. PMID:18321377
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Canine aggression toward people: a guide for practitioners.
Sueda, Karen Lynn C; Malamed, Rachel
2014-05-01
This article reviews the various causes of human-directed aggression in dogs and provides a step-by-step plan guiding the general practitioner through history taking, behavior observations, diagnosis, consultation, treatment, and follow-up care. Charts summarizing how to obtain behavioral information, the client's management options, treatment recommendations, diagnosis and treatment of human-directed aggression, and the clinician's role in preventing human-directed aggression are included. A graphic illustration of canine body language is also provided. Copyright © 2014 Elsevier Inc. All rights reserved.
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Planetary entry, descent, and landing technologies
NASA Astrophysics Data System (ADS)
Pichkhadze, K.; Vorontsov, V.; Polyakov, A.; Ivankov, A.; Taalas, P.; Pellinen, R.; Harri, A.-M.; Linkin, V.
2003-04-01
Martian meteorological lander (MML) is intended for landing on the Martian surface in order to monitor the atmosphere at landing point for one Martian year. MMLs shall become the basic elements of a global network of meteorological mini-landers, observing the dynamics of changes of the atmospheric parameters on the Red Planet. The MML main scientific tasks are as follows: (1) Study of vertical structure of the Martian atmosphere throughout the MML descent; (2) On-surface meteorological observations for one Martian year. One of the essential factors influencing the lander's design is its entry, descent, and landing (EDL) sequence. During Phase A of the MML development, five different options for the lander's design were carefully analyzed. All of these options ensure the accomplishment of the above-mentioned scientific tasks with high effectiveness. CONCEPT A (conventional approach): Two lander options (with a parachute system + airbag and an inflatable airbrake + airbag) were analyzed. They are similar in terms of fulfilling braking phases and completely analogous in landing by means of airbags. CONCEPT B (innovative approach): Three lander options were analyzed. The distinguishing feature is the presence of inflatable braking units (IBU) in their configurations. SELECTED OPTION (innovative approach): Incorporating a unique design approach and modern technologies, the selected option of the lander represents a combination of the options analyzed in the framework of Concept B study. Currently, the selected lander option undergoes systems testing (Phase D1). Several MMLs can be delivered to Mars in frameworks of various missions as primary or piggybacking payload: (1) USA-led "Mars Scout" (2007); (2) France-led "NetLander" (2007/2009); (3) Russia-led "Mars-Deimos-Phobos sample return" (2007); (4) Independent mission (currently under preliminary study); etc.
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ERIC Educational Resources Information Center
Kemp, Wayne
2009-01-01
This publication describes options for designing and equipping middle and high school music education suites, and suggests ways of gaining community support for including full service music suites in new and renovated school facilities. In addition to basic music suites, and practice rooms, other options detailed include: (1) small ensemble…
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Soylemez, Haluk; Penbegül, Necmettin; Utangac, Mehmet Mazhar; Dede, Onur; Çakmakçı, Süleyman; Hatipoglu, Namık Kemal
2016-08-01
Pelvic kidney stones remain a unique challenge to the endourologists. Treatment options include open surgery, extracorporeal shockwave lithotripsy, percutaneous nephrolithotomy (PNL), retrograde intrarenal surgery, and laparoscopy assisted PNL (LA-PNL). As a minimal invasive option, LA-PNL can decrease the risk for bowel and major vessel injury. Here, we describe our experience using the LA-PNL procedures with different combinations, to treat kidney stones in multiple patients with a pelvic ectopic kidney (PEK). Eight patients, with PEK, kidney stones, and no other treatment choice, but open surgery, were included in the study. Two different laparoscopic techniques such as mesocolon dissection and transmesocolic, and four different percutaneous procedures such as standard-PNL, mini-PNL, micro-PNL, and a PNL through the renal pelvis were used for stone extraction in these patients. The mean age of patients was 25.6 ± 12.9 years and mean stone size was 524.1 ± 430.3 mm(2). Mean operation time was 150.5 ± 40.0 (77-210) min which was composed of retrograde catheterization (14.8 ± 2.9 min), laparoscopic procedure (48.7 ± 20.6 min) and PNL procedure (86.8 ± 31.1 min). Residual stones were seen in two patients (no additional treatment was need), while a 'stone-free' procedure was achieved in six patients (75.0 %). On the post-operative first month visit, a stone was observed on radiological examinations in only one patient (87.5 % stone-free). Mean hospitalization time was 2.8 ± 0.9 days. No perioperative or post-operative complication was observed in all patients. LA-PNL surgery is a safe and effective option for treatment of PEK stones, and has several alternative approaches.
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-06-27
... described in the Exchange's option rules at subsection (a)(3)(A) of Chapter VI, Section 1 as a data package... (a)(3)(B) of Chapter VI, Section 1 as a data package that includes the BX Best Bid and Offer (``BX... for options market data known as BX Top of Market Options (``BX Top'') and BX Depth of Market Options...
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Code of Federal Regulations, 2011 CFR
2011-04-01
... transactions being offered including: (i) The duration of the commodity options being offered and the total quantity and quality of the commodities which may be purchased or sold upon exercise of the options being... PERSON SHOULD NOT PURCHASE A COMMODITY OPTION UNLESS HE IS PREPARED TO SUSTAIN A TOTAL LOSS OF THE...
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Tug fleet and ground operations schedules and controls. Volume 3: Program cost estimates
NASA Technical Reports Server (NTRS)
1975-01-01
Cost data for the tug DDT&E and operations phases are presented. Option 6 is the recommended option selected from seven options considered and was used as the basis for ground processing estimates. Option 6 provides for processing the tug in a factory clean environment in the low bay area of VAB with subsequent cleaning to visibly clean. The basis and results of the trade study to select Option 6 processing plan is included. Cost estimating methodology, a work breakdown structure, and a dictionary of WBS definitions is also provided.
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Reconstruction Options for Pancreaticoduodenectomy in Patients with Prior Roux-en-Y Gastric Bypass.
Shah, Mihir M; Martin, Benjamin M; Stetler, Jamil L; Patel, Ankit D; Davis, S Scott; Sarmiento, Juan M; Lin, Edward
2017-11-01
Patients with prior Roux-en-Y gastric bypass (RYGB) operations for weight loss present reconstruction challenges during a pancreaticoduodenectomy (PD). With over 60,000 RYGB performed annually, the increasing odds of encountering such patients during a PD make it imperative to understand the RYGB anatomy and anticipate reconstruction options. This article describes the possible reconstruction options and their rationale. We reviewed our PD reconstruction options, compared them to what have been described in the literature, and derived a consensus from internal conferences comprising bariatric and hepatopancreatobiliary surgeons to describe known reconstruction options. In general, reconstruction options can include one of three options: (1) remnant gastrectomy, (2) preservation of gastric remnant, or (3) reversal of gastric bypass. This article describes individualized reconstruction options for RYGB patients undergoing PD. The reconstruction options can be tailored to the needs of the patient.
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Clark, Nicholas J; Desai, Vishal S; Dines, Joshua D; Morrey, Mark E; Camp, Christopher L
2018-03-01
This review aims to describe the nonreconstructive options for treating ulnar collateral ligament (UCL) injuries ranging from nonoperative measures, including physical therapy and biologic injections, to ligament repair with and without augmentation. Nonoperative options for UCL injuries include guided physical therapy and biologic augmentation with platelet-rich plasma (PRP). In some patients, repair of the UCL has shown promising return to sport rates by using modern suture and suture anchor techniques. Proximal avulsion injuries have shown the best results after repair. Currently, there is growing interest in augmentation of UCL repair with an internal brace. The treatment of UCL injuries involves complex decision making. UCL reconstruction remains the gold standard for attritional injuries and complete tears, which occur commonly in professional athletes. However, nonreconstructive options have shown promising results for simple avulsion or partial thickness UCL injuries. Future research comparing reconstructive versus nonreconstructive options is necessary.
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Global change - Geoengineering and space exploration
NASA Technical Reports Server (NTRS)
Jenkins, Lyle M.
1992-01-01
Geoengineering options and alternatives are proposed for mitigating the effects of global climate change and depletion of the ozone layer. Geoengineering options were discussed by the National Academy of Science Panel on the Policy Implications of Greenhouse Warming. Several of the ideas conveyed in their published report are space-based or depend on space systems for implementation. Among the geoengineering options using space that are discussed include the use of space power systems as an alternative to fossil fuels for generating electricity, the use of lunar He-3 to aid in the development of fusion energy, and the establishment of a lunar power system for solar energy conversion and electric power beaming back to earth. Other geoengineering options are discussed. They include the space-based modulation of hurricane forces and two space-based approaches in dealing with ozone layer depletion. The engineering challenges and policy implementation issues are discussed for these geongineering options.
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NASA Astrophysics Data System (ADS)
Brown, Casey; Carriquiry, Miguel
2007-11-01
This paper explores the performance of a system of economic instruments designed to facilitate the reduction of hydroclimatologic variability-induced impacts on stakeholders of shared water supply. The system is composed of bulk water option contracts between urban water suppliers and agricultural users and insurance indexed on reservoir inflows. The insurance is designed to cover the financial needs of the water supplier in situations where the option is likely to be exercised. Insurance provides the irregularly needed funds for exercising the water options. The combined option contract - reservoir index insurance system creates risk sharing between sectors that is currently lacking in many shared water situations. Contracts are designed for a shared agriculture - urban water system in Metro Manila, Philippines, using optimization and Monte Carlo analysis. Observed reservoir inflows are used to simulate contract performance. Results indicate the option - insurance design effectively smooths water supply costs of hydrologic variability for both agriculture and urban water.
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Improving Rural Teachers' Attitudes towards Acceleration
ERIC Educational Resources Information Center
Olthouse, Jill M.
2015-01-01
Gifted students see both educational benefits and barriers as a result of living in rural communities. Benefits include increased individual attention and community engagement; barriers include limited curricular options (Lawrence, 2009). Acceleration is an option that has positive academic outcomes but is underused, especially in rural areas.…
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25 CFR 162.412 - What must the lease include if it contains an option to renew?
Code of Federal Regulations, 2014 CFR
2014-04-01
... WATER LEASES AND PERMITS Business Leases Lease Requirements § 162.412 What must the lease include if it..., if any, that will be due upon the exercise of the option to renew or the start of the renewal term...
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25 CFR 162.312 - What must the lease include if it contains an option to renew?
Code of Federal Regulations, 2013 CFR
2013-04-01
... WATER LEASES AND PERMITS Residential Leases Lease Requirements § 162.312 What must the lease include if... any, that will be due upon the exercise of the option to renew or the start of the renewal term; and...
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25 CFR 162.312 - What must the lease include if it contains an option to renew?
Code of Federal Regulations, 2014 CFR
2014-04-01
... WATER LEASES AND PERMITS Residential Leases Lease Requirements § 162.312 What must the lease include if... any, that will be due upon the exercise of the option to renew or the start of the renewal term; and...
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25 CFR 162.412 - What must the lease include if it contains an option to renew?
Code of Federal Regulations, 2013 CFR
2013-04-01
... WATER LEASES AND PERMITS Business Leases Lease Requirements § 162.412 What must the lease include if it..., if any, that will be due upon the exercise of the option to renew or the start of the renewal term...
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Dissociation from beloved unhealthy brands decreases preference for and consumption of vegetables.
Trump, Rebecca K; Connell, Paul M; Finkelstein, Stacey R
2015-09-01
Many people form strong bonds with brands, including those for unhealthy foods. Thus, prompting people to dissociate from beloved but unhealthy food brands is an intuitively appealing means to shift consumption away from unhealthy options and toward healthy options. Contrary to this position, we demonstrate that dissociating from unhealthy but beloved brands diminishes people's interest in consuming vegetables because the dissociation depletes self-regulatory resources. Across three experimental studies, we manipulate dissociation from two beloved brands both implicitly (studies 1-2) and explicitly (study 3) and observe effects on both preference for vegetables (studies 2-3) and actual vegetable consumption (study 1). In study 1, participants consumed fewer vegetables following dissociation from (vs. association with) a beloved candy brand. Study 2 demonstrates that the effect of depletion on preference for vegetables is more pronounced for those who strongly identify with the brand, as these individuals are most depleted by the dissociation attempt. Finally, study 3 illustrates that the difficulty experienced when trying to dissociate from beloved brands drives the observed effects on vegetable preference and consumption for those who strongly (vs. weakly) identify with the brand. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Puget Sound Area Electric Reliability Plan : Appendix E, Transmission Reinforcement Analysis.
DOE Office of Scientific and Technical Information (OSTI.GOV)
United States. Bonneville Power Administration.
1992-04-01
The purpose of this appendix to the draft environmental impact statement (EIS) report is to provide an update of the latest study work done on transmission system options for the Puget Sound Area Electric Reliability Plan. Also included in the attachments to the EIS are 2 reports analyzing the voltage stability of the Puget Sound transmission system and a review by Power Technologies, Inc. of the BPA voltage stability analysis and reactive options. Five transmission line options and several reactive options are presently being considered as possible solutions to the PSAFRP by the Transmission Team. The first two line optionsmore » would be built on new rights-of way adjacent (as much as possible) to existing corridors. The reactive options would optimize the existing transmission system capability by adding new stations for series capacitors and/or switchgear. The other three line options are rebuilds or upgrades of existing cross mountain transmission lines. These options are listed below and include a preliminary assessment of the additional transmission system reinforcement required to integrate the new facilities into the existing transmission system. Plans were designed to provide at least 500 MVAR reactive margin.« less
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Comparing apples and oranges: the Community Intercomparison Suite
NASA Astrophysics Data System (ADS)
Schutgens, Nick; Stier, Philip; Pascoe, Stephen
2014-05-01
Visual representation and comparison of geoscientific datasets presents a huge challenge due to the large variety of file formats and spatio-temporal sampling of data (be they observations or simulations). The Community Intercomparison Suite attempts to greatly simplify these tasks for users by offering an intelligent but simple command line tool for visualisation and colocation of diverse datasets. In addition, CIS can subset and aggregate large datasets into smaller more manageable datasets. Our philosophy is to remove as much as possible the need for specialist knowledge by the user of the structure of a dataset. The colocation of observations with model data is as simple as: "cis col
: : " which will resample the simulation data to the spatio-temporal sampling of the observations, contingent on a few user-defined options that specify a resampling kernel. CIS can deal with both gridded and ungridded datasets of 2, 3 or 4 spatio-temporal dimensions. It can handle different spatial coordinates (e.g. longitude or distance, altitude or pressure level). CIS supports both HDF, netCDF and ASCII file formats. The suite is written in Python with entirely publicly available open source dependencies. Plug-ins allow a high degree of user-moddability. A web-based developer hub includes a manual and simple examples. CIS is developed as open source code by a specialist IT company under supervision of scientists from the University of Oxford as part of investment in the JASMIN superdatacluster facility at the Centre of Environmental Data Archival. -
Chen, Shu-Wen; Hutchinson, Alison M; Nagle, Cate; Bucknall, Tracey K
2018-01-17
Vaginal birth after caesarean (VBAC) is an alternative option for women who have had a previous caesarean section (CS); however, uptake is limited because of concern about the risks of uterine rupture. The aim of this study was to explore women's decision-making processes and the influences on their mode of birth following a previous CS. A qualitative approach was used. The research comprised three stages. Stage I consisted of naturalistic observation at 33-34 weeks' gestation. Stage II involved interviews with pregnant women at 35-37 weeks' gestation. Stage III consisted of interviews with the same women who were interviewed postnatally, 1 month after birth. The research was conducted in a private medical centre in northern Taiwan. Using a purposive sampling, 21 women and 9 obstetricians were recruited. Data collection involved in-depth interviews, observation and field notes. Constant comparative analysis was employed for data analysis. Ensuring the safety of mother and baby was the focus of women's decisions. Women's decisions-making influences included previous birth experience, concern about the risks of vaginal birth, evaluation of mode of birth, current pregnancy situation, information resources and health insurance. In communicating with obstetricians, some women complied with obstetricians' recommendations for repeat caesarean section (RCS) without being informed of alternatives. Others used four step decision-making processes that included searching for information, listening to obstetricians' professional judgement, evaluating alternatives, and making a decision regarding mode of birth. After birth, women reflected on their decisions in three aspects: reflection on birth choices; reflection on factors influencing decisions; and reflection on outcomes of decisions. The health and wellbeing of mother and baby were the major concerns for women. In response to the decision-making influences, women's interactions with obstetricians regarding birth choices varied from passive decision-making to shared decision-making. All women have the right to be informed of alternative birthing options. Routine provision of explanations by obstetricians regarding risks associated with alternative birth options, in addition to financial coverage for RCS from National Health Insurance, would assist women's decision-making. Establishment of a website to provide women with reliable information about birthing options may also assist women's decision-making.
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Compete, coordinate, and cooperate: How to exploit uncertain environments with social interaction.
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).
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Brom, Linda; De Snoo-Trimp, Janine C; Onwuteaka-Philipsen, Bregje D; Widdershoven, Guy A M; Stiggelbout, Anne M; Pasman, H Roeline W
2017-02-01
Patients' preferences and expectations should be taken into account in treatment decision making in the last phase of life. Shared decision making (SDM) is regarded as a way to give the patient a central role in decision making. Little is known about how SDM is used in clinical practice in advanced cancer care. To examine whether and how the steps of SDM can be recognized in decision making about second- and third-line chemotherapy. Fourteen advanced cancer patients were followed over time using face-to-face in-depth interviews and observations of the patients' out-clinic visits. Interviews and outpatient clinic visits in which treatment options were discussed or decisions made were transcribed verbatim and analysed using open coding. Patients were satisfied with the decision-making process, but the steps of SDM were barely seen in daily practice. The creation of awareness about available treatment options by physicians was limited and not discussed in an equal way. Patients' wishes and concerns were not explicitly assessed, which led to different expectations about improved survival from subsequent lines of chemotherapy. To reach SDM in daily practice, physicians should create awareness of all treatment options, including forgoing treatment, and communicate the risk of benefit and harm. Open and honest communication is needed in which patients' expectations and concerns are discussed. Through this, the difficult process of decision making in the last phase of life can be facilitated and the focus on the best care for the specific patient is strengthened. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.
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Atanga, Pascal N; Ndetan, Harrison T; Achidi, Eric A; Meriki, Henry D; Hoelscher, Michael; Kroidl, Arne
2017-02-01
To assess linkage and retention in care along the PMTCT cascade in HIV-positive pregnant and breastfeeding women initiating Option B+ in Cameroon. We prospectively determined uptake of HIV testing and counselling (HTC), uptake of ART and retention in care after Option B+ initiation between October 2013 and December 2014 in pregnant and breastfeeding women from five sites within the Kumba Health District. Retention in care was assessed over at least 12 months follow-up and estimated by Kaplan-Meier analysis. During follow-up, tracing outcomes and reasons for discontinuing treatment were documented. The uptake of HTC of 5813 women with unknown HIV status was 98.5%, 251 (4.4%) were newly diagnosed HIV positive, and ART uptake in women eligible to start Option B+ was 96.8%. We enrolled 268 women initiating lifelong ART in the follow-up. Overall, 65 (24.3%) discontinued treatment, either defined by loss to follow-up (44.6%) or actively stopped treatment (55.8%). Retention in care was 88.0% and 81.1% at 6 and 12 months, respectively. Discontinuation was significantly associated in multivariate analysis with small sites and high staff turnover [aOR 2.5 (95% CI 1.6, 3.9), P < 0.001]. Main reasons for stopping treatment were HIV status denial and stigma (52.8%), religious reasons (25.0%) and lack of transport fare (11.1%). We observed good uptake of HTC, ART and retention in care, which declined over time. Discontinuation of Option B+ was highest at small sites with a high staff turnover. Improved staffing, adequate task shifting and community interventions to track defaulters including reducing stigma and religious beliefs may improve Option B+ retention. © 2016 John Wiley & Sons Ltd.
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VanDeusen, Adam; Paintsil, Elijah; Agyarko-Poku, Thomas; Long, Elisa F
2015-03-18
Achieving the goal of eliminating mother-to-child HIV transmission (MTCT) necessitates increased access to antiretroviral therapy (ART) for HIV-infected pregnant women. Option B provides ART through pregnancy and breastfeeding, whereas Option B+ recommends continuous ART regardless of CD4 count, thus potentially reducing MTCT during future pregnancies. Our objective was to compare maternal and pediatric health outcomes and cost-effectiveness of Option B+ versus Option B in Ghana. A decision-analytic model was developed to simulate HIV progression in mothers and transmission (in utero, during birth, or through breastfeeding) to current and all future children. Clinical parameters, including antenatal care access and fertility rates, were estimated from a retrospective review of 817 medical records at two hospitals in Ghana. Additional parameters were obtained from published literature. Modeled outcomes include HIV infections averted among newborn children, quality-adjusted life-years (QALYs), and cost-effectiveness ratios. HIV-infected women in Ghana have a lifetime average of 2.3 children (SD 1.3). Projected maternal life expectancy under Option B+ is 16.1 years, versus 16.0 years with Option B, yielding a gain of 0.1 maternal QALYs and 3.2 additional QALYs per child. Despite higher initial ART costs, Option B+ costs $785/QALY gained, a value considered very cost-effective by World Health Organization benchmarks. Widespread implementation of Option B+ in Ghana could theoretically prevent up to 668 HIV infections among children annually. Cost-effectiveness estimates remained favorable over robust sensitivity analyses. Although more expensive than Option B, Option B+ substantially reduces MTCT in future pregnancies, increases both maternal and pediatric QALYs, and is a cost-effective use of limited resources in Ghana.
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DISPOSITION PATHS FOR ROCKY FLATS GLOVEBOXES: EVALUATING OPTIONS
DOE Office of Scientific and Technical Information (OSTI.GOV)
Lobdell, D.; Geimer, R.; Larsen, P.
2003-02-27
The Kaiser-Hill Company, LLC has the responsibility for closure activities at the Rocky Flats Environmental Technology Site (RFETS). One of the challenges faced for closure is the disposition of radiologically contaminated gloveboxes. Evaluation of the disposition options for gloveboxes included a detailed analysis of available treatment capabilities, disposal facilities, and lifecycle costs. The Kaiser-Hill Company, LLC followed several processes in determining how the gloveboxes would be managed for disposition. Currently, multiple disposition paths have been chosen to accommodate the needs of the varying styles and conditions of the gloveboxes, meet the needs of the decommissioning team, and to best managemore » lifecycle costs. Several challenges associated with developing a disposition path that addresses both the radiological and RCRA concerns as well as offering the most cost-effective solution were encountered. These challenges included meeting the radiological waste acceptance criteria of available disposal facilities, making a RCRA determination, evaluating treatment options and costs, addressing void requirements associated with disposal, and identifying packaging and transportation options. The varying disposal facility requirements affected disposition choices. Facility conditions that impacted decisions included radiological and chemical waste acceptance criteria, physical requirements, and measurement for payment options. The facility requirements also impacted onsite activities including management strategies, decontamination activities, and life-cycle cost.« less
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Observation model and parameter partials for the JPL geodetic GPS modeling software GPSOMC
NASA Technical Reports Server (NTRS)
Sovers, O. J.; Border, J. S.
1988-01-01
The physical models employed in GPSOMC and the modeling module of the GIPSY software system developed at JPL for analysis of geodetic Global Positioning Satellite (GPS) measurements are described. Details of the various contributions to range and phase observables are given, as well as the partial derivatives of the observed quantities with respect to model parameters. A glossary of parameters is provided to enable persons doing data analysis to identify quantities in the current report with their counterparts in the computer programs. There are no basic model revisions, with the exceptions of an improved ocean loading model and some new options for handling clock parametrization. Such misprints as were discovered were corrected. Further revisions include modeling improvements and assurances that the model description is in accord with the current software.
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Guaranteed Access to Campus Network Resources: Policies and Issues.
ERIC Educational Resources Information Center
Hassler, Ardoth A.
1998-01-01
Reports on a options and issues discussion at a December 1997 Orlando (Florida) meeting of CAUSE97 on providing access to campus technology resources. Options discussed included departmentally and/or university-owned modems, third-party provider contracts, and using wireless access. Issues included providing authentication, assuring network…
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DOE Office of Scientific and Technical Information (OSTI.GOV)
None
This document provides guidance for retrofitting existing fluorescent troffers including the LED and associated control options available, the pro/cons and costs/benefits of each option, and agency specific requirements (where applicable).
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Optimizing spacecraft design - optimization engine development : progress and plans
NASA Technical Reports Server (NTRS)
Cornford, Steven L.; Feather, Martin S.; Dunphy, Julia R; Salcedo, Jose; Menzies, Tim
2003-01-01
At JPL and NASA, a process has been developed to perform life cycle risk management. This process requires users to identify: goals and objectives to be achieved (and their relative priorities), the various risks to achieving those goals and objectives, and options for risk mitigation (prevention, detection ahead of time, and alleviation). Risks are broadly defined to include the risk of failing to design a system with adequate performance, compatibility and robustness in addition to more traditional implementation and operational risks. The options for mitigating these different kinds of risks can include architectural and design choices, technology plans and technology back-up options, test-bed and simulation options, engineering models and hardware/software development techniques and other more traditional risk reduction techniques.
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Variable step random walks, self-similar distributions, and pricing of options (Invited Paper)
NASA Astrophysics Data System (ADS)
Gunaratne, Gemunu H.; McCauley, Joseph L.
2005-05-01
A new theory for pricing of options is presented. It is based on the assumption that successive movements depend on the value of the return. The solution to the Fokker-Planck equation is shown to be an asymmetric exponential distribution, similar to those observed in intra-day currency markets. The "volatility smile", used by traders to correct the Black-Scholes pricing is shown to be a heuristic mechanism to implement options pricing formulae derived from our theory.
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[Drooling therapy in children with neurological disorders].
Táboas-Pereira, M Andrea; Paredes-Mercado, Cecilia; Alonso-Curcó, Xènia; Badosa-Pagès, Joaquim; Muchart, Jordi; Póo, Pilar
2015-07-16
Drooling is the inability to retain saliva in the mouth and its progression to the digestive tract, being a common problem in pediatric patients with neurological disorders. Three different treatment options are available. To assess the effectiveness and safety of trihexyphenidyl, scopolamine and botulinum toxin infiltration in the treatment of drooling in children with neurological disorders. This is an open and prospective type study. We include patients treated in the Neurology Service that present excessive drooling, affecting their quality of life, between 2009 and 2013. We enrolled 46 patients in the study. The treatment with oral trihexyphenidyl was indicated in 46, obtaining good result in 15 (32.6%), three with temporary effect and the rest with lasting effect. Three patients presented side effects (6.5%). Four out of 11 (36.36%) patients treated with scopolamine patch had beneficial effects. One was withdrawn due to lack of efficacy and six due to side effects. Twenty-five patients were infiltrated with botulinum toxin, with a significant decrease of drooling in 16 patients (64%) after the first injection. We observed no significant changes in nine patients. Only one out of 25 showed side effects (mild dysphagia). Currently there is not a fully effective therapeutic option for drooling. We recommend starting treatment with trihexyphenidyl. A second option could be the scopolamine patch and botulinum toxin as a third option. Botulinum toxin infiltration in salivary glands is shown as an effective and safe alternative in our study.
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Using simulation to improve wildlife surveys: Wintering mallards in Mississippi, USA
Pearse, A.T.; Reinecke, K.J.; Dinsmore, S.J.; Kaminski, R.M.
2009-01-01
Wildlife conservation plans generally require reliable data about population abundance and density. Aerial surveys often can provide these data; however, associated costs necessitate designing and conducting surveys efficiently. We developed methods to simulate population distributions of mallards (Anas platyrhynchos) wintering in western Mississippi, USA, by combining bird observations from three previous strip-transect surveys and habitat data from three sets of satellite images representing conditions when surveys were conducted. For each simulated population distribution, we compared 12 primary survey designs and two secondary design options by using coefficients of variation (CV) of population indices as the primary criterion for assessing survey performance. In all, 3 of the 12 primary designs provided the best precision (CV???11.7%) and performed equally well (WR08082E1d.gif diff???0.6%). Features of the designs that provided the largest gains in precision were optimal allocation of sample effort among strata and configuring the study area into five rather than four strata, to more precisely estimate mallard indices in areas of consistently high density. Of the two secondary design options, we found including a second observer to double the size of strip transects increased precision or decreased costs, whereas ratio estimation using auxiliary habitat data from satellite images did not increase precision appreciably. We recommend future surveys of mallard populations in our study area use the strata we developed, optimally allocate samples among strata, employ PPS or EPS sampling, and include two observers when qualified staff are available. More generally, the methods we developed to simulate population distributions from prior survey data provide a cost-effective method to assess performance of alternative wildlife surveys critical to informing management decisions, and could be extended to account for effects of detectability on estimates of true abundance. ?? 2009 CSIRO.
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Management of complications of Dupuytren contracture.
Cheung, Kevin; Walley, Kempland C; Rozental, Tamara D
2015-05-01
This evidence-based article discusses the current management options of Dupuytren disease and strategies to avoid and manage any potential complications. Treatment options include fasciectomy, needle fasciotomy/aponeurotomy, and collagenase injection. Complications include digital nerve and artery injury, flexor tendon injury, skin fissures and wound healing complications, hematoma, infection, flare reaction/complex regional pain syndrome, and recurrence. Complication rates, prevention, and management differ with each treatment modality. A detailed understanding of each of these options allows hand surgeons to select the most appropriate treatment for each patient. Copyright © 2015 Elsevier Inc. All rights reserved.
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17 CFR 240.3a51-1 - Definition of “penny stock”.
Code of Federal Regulations, 2010 CFR
2010-04-01
...), including hybrid products and derivative securities products, the national securities exchange or registered... Company Act of 1940; (c) That is a put or call option issued by the Options Clearing Corporation; (d... that are not warrants, options, rights, or similar securities must be five dollars or more, as...
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-09-21
... approving expansion of STO Program)[sic]. \\9\\ These include, without limitation, options, equities, futures... hedging strategies across various investment platforms (e.g. equity and ETF, index, derivatives, futures... Web site, strike prices for options on futures may be at an interval of $.05, $.10, and $.25 per...
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-10-13
... Exchange's proposal does not address or impact any priority relationship for Professional as opposed to... traded by Options Members (which may include trades on behalf of Public Customers) \\8\\ on BATS Options, a... Members representing as agent Customer Orders on BATS Options and those non- Market Maker Members...
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An Employer's Guide to Child Care Consultants.
ERIC Educational Resources Information Center
Eichman, Caroline
This guide is designed to help employers hire a qualified child care consultant who will evaluate child care options in light of employees' needs and help develop and implement appropriate child care options. These options include: (1) establishment of a child care facility; (2) financial assistance; (3) a resource and referral service; (4)…
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Helping Working Parents: Child Care Options for Business.
ERIC Educational Resources Information Center
North Carolina State Dept. of Administration, Raleigh.
Seven models representing the existing range of options of employer involvement in day care are described in this paper. The range of options are grouped into two categories: (1) company owned, operated, or subsidized child day care; and (2) employee assistance services, benefits, and policies. The models included in the first category are the…
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12 CFR Appendix B to Part 37 - Long Form Disclosures
Code of Federal Regulations, 2011 CFR
2011-01-01
... AND DEBT SUSPENSION AGREEMENTS Pt. 37, App. B Appendix B to Part 37—Long Form Disclosures • This product is optional Your purchase of [PRODUCT NAME] is optional. Whether or not you purchase [PRODUCT NAME... contract is a residential mortgage loan] You have the option to purchase [PRODUCT NAME] that includes a...
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12 CFR Appendix B to Part 37 - Long Form Disclosures
Code of Federal Regulations, 2010 CFR
2010-01-01
... AND DEBT SUSPENSION AGREEMENTS Pt. 37, App. B Appendix B to Part 37—Long Form Disclosures • This product is optional Your purchase of [PRODUCT NAME] is optional. Whether or not you purchase [PRODUCT NAME... contract is a residential mortgage loan] You have the option to purchase [PRODUCT NAME] that includes a...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-07-12
..., Inc. To List Options on Trust Issued Receipts in $1 Strike Intervals July 6, 2010. Pursuant to Section... strike price intervals for options on Trust Issued Receipts. The text of the proposed rule change is... strike price intervals for options on Trust Issued Receipts (``TIRs''), including Holding Company...
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42 CFR 417.155 - How the HMO option must be included in the health benefits plan.
Code of Federal Regulations, 2011 CFR
2011-10-01
... HMO or of transfer from HMO to non-HMO coverage, or exclusions, or limitations based on health status... this selection, lose their eligibility for free-standing dental, optical, or prescription drug benefits... option.) - (ii) The non-HMO option provides free-standing coverage for optical services (such as...
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Effects of Intranasal Oxytocin on Aggressive Responding in Antisocial Personality Disorder.
Alcorn, Joseph L; Rathnayaka, Nuvan; Swann, Alan C; Moeller, F Gerard; Lane, Scott D
2015-12-01
The oxytocin receptor is important in several domains of social behavior, and administration of oxytocin modulates social responding in several mammalian species, including humans. Oxytocin has both therapeutic and scientific potential for elucidating the neural and behavioral mechanisms governing social behavior. In the present study, operationally-defined aggressive behavior of six males with Antisocial Personality Disorder (ASPD) was measured following acute intranasal oxytocin dosing (12, 24, and 48 international units) and placebo, using a well-validated laboratory task of human aggression (Point-Subtraction Aggression Paradigm, or PSAP). The PSAP provides participants with concurrently available monetary-earning and operationally-defined aggressive response options, maintained by fixed ratio schedules of consequences. Shifts in response rates and inter-response time (IRT) distributions were observed on the aggressive response option following oxytocin doses, relative to placebo. Few changes were observed in monetary-reinforced responding. However, across participants the direction and magnitude of changes in aggressive responding were not systematically related to dose. No trends were observed between psychometric or physiological data and oxytocin dosing or aggressive behavior. While this report is to our knowledge the first to examine the acute effects of oxytocin in this population at high risk for violence and other forms of antisocial behavior, several limitations in the experimental design and the results cast the study as a preliminary report. Strategies for more extensive future projects are discussed.
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Comparing apples and oranges: the Community Intercomparison Suite
NASA Astrophysics Data System (ADS)
Schutgens, Nick; Stier, Philip; Kershaw, Philip; Pascoe, Stephen
2015-04-01
Visual representation and comparison of geoscientific datasets presents a huge challenge due to the large variety of file formats and spatio-temporal sampling of data (be they observations or simulations). The Community Intercomparison Suite attempts to greatly simplify these tasks for users by offering an intelligent but simple command line tool for visualisation and colocation of diverse datasets. In addition, CIS can subset and aggregate large datasets into smaller more manageable datasets. Our philosophy is to remove as much as possible the need for specialist knowledge by the user of the structure of a dataset. The colocation of observations with model data is as simple as: "cis col
: : " which will resample the simulation data to the spatio-temporal sampling of the observations, contingent on a few user-defined options that specify a resampling kernel. As an example, we apply CIS to a case study of biomass burning aerosol from the Congo. Remote sensing observations, in-situe observations and model data are shown in various plots, with the purpose of either comparing different datasets or integrating them into a single comprehensive picture. CIS can deal with both gridded and ungridded datasets of 2, 3 or 4 spatio-temporal dimensions. It can handle different spatial coordinates (e.g. longitude or distance, altitude or pressure level). CIS supports both HDF, netCDF and ASCII file formats. The suite is written in Python with entirely publicly available open source dependencies. Plug-ins allow a high degree of user-moddability. A web-based developer hub includes a manual and simple examples. CIS is developed as open source code by a specialist IT company under supervision of scientists from the University of Oxford and the Centre of Environmental Data Archival as part of investment in the JASMIN superdatacluster facility. -
Costa, Paulo Dias; Reis, A Hipólito; Rodrigues, Pedro P
2013-02-01
Traditional follow-up of patients with cardiovascular devices is still an activity that, in addition to serving an increasing population, requires a considerable amount of time and specialized human and technical resources. Our aim was to evaluate the applicability of the CareLink(®) (Medtronic, Minneapolis, MN) remote monitoring system as a complementary option to the follow-up of patients with implanted devices, between in-office visits. Evaluated outcomes included both clinical (event detection and time to diagnosis) and nonclinical (patient's satisfaction and economic costs) aspects. An observational, longitudinal, prospective study was conducted with patients from a Portuguese central hospital sampled by convenience during 1 week (43 patients). Data were collected in four moments: two in-office visits and two remote evaluations, reproducing 1 year of clinical follow-up. Data sources included health records, implant reports, initial demographic data collection, follow-up printouts, and a questionnaire. After selection criteria were verified, 15 patients (11 men [73%]) were included, 63.4±10.8 years old, representing 14.0±6.3 implant months. Clinically, 15 events were detected (9 by remote monitoring and 6 by patient-initiated activation), of which only 9 were symptomatic. We verified that remote monitoring could detect both symptomatic and asymptomatic events, whereas patient-initiated activation only detected symptomatic ones (p=0.028). Moreover, the mean diagnosis anticipation in patients with events was approximately 58 days (p<0.001). In nonclinical terms, we observed high or very high satisfaction (67% and 33%, respectively) with using remote monitoring technology, but still 8 patients (53%) stated they preferred in-office visits. Finally, the introduction of remote monitoring technology has the ability to reduce total follow-up costs for patients by 25%. We conclude that the use of this system constitutes a viable complementary option to the follow-up of patients with implantable devices, between in-office visits.
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Rempis, Eva M; Schnack, Alexandra; Decker, Sarah; Braun, Vera; Rubaihayo, John; Tumwesigye, Nazarius Mbona; Busingye, Priscilla; Harms, Gundel; Theuring, Stefanie
2017-03-07
While most Sub-Saharan African countries are now implementing the WHO-recommended Option B+ protocol for prevention of vertical HIV transmission, there is a lack of knowledge regarding the influence of Option B+ exposure on adverse birth outcomes (ABOs). Against this background, we assessed ABOs among delivering women in Western Uganda. A cross-sectional, observational study was performed within a cohort of 412 mother-newborn-pairs in Virika Hospital, Fort Portal in 2013. The occurrence of stillbirth, pre-term delivery, and small size for gestational age (SGA) was analysed, looking for influencing factors related to HIV-status, antiretroviral drug exposure and duration, and other sociodemographic and clinical parameters. Among 302 HIV-negative and 110 HIV-positive women, ABOs occurred in 40.5%, with stillbirth in 6.3%, pre-term delivery in 28.6%, and SGA in 12.2% of deliveries. For Option B+ intake (n = 59), no significant association was found with stillbirth (OR 0.48, p = 0.55), pre-term delivery (OR 0.97, p = 0.92) and SGA (OR 1.5, p = 0.3) compared to seronegative women. Women enrolled on antiretroviral therapy (ART) before conception (n = 38) had no different risk for ABOs than women on Option B+ or HIV-negative women. Identified risk factors for stillbirth included lack of formal education, poor socio-economic status, long travel distance, hypertension and anaemia. Pre-term delivery risk was increased with poor socio-economic status, primiparity, Malaria and anaemia. The occurrence of SGA was influenced by older age and Malaria. In our study, women on Option B+ showed no difference in ABOs compared to HIV-negative women and to women on ART. We identified several non-HIV/ART-related influencing factors, suggesting an urgent need for improving early risk assessment mechanisms in antenatal care through better screening and triage systems. Our results are encouraging with regard to continued universal scale-up of Option B+ and ART programmes.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Denholm, Paul; Novacheck, Joshua; Jorgenson, Jennie
In this study, we attempt to quantify the benefits of various options of grid flexibility by measuring their impact on two measures: economic carrying capacity and system costs. Flexibility can increase ECC and reduce overall system costs. In some cases, options that provide a limited increase in ECC can provide significant operational savings, thus demonstrating the need to evaluate flexibility options using multiple metrics. The value of flexibility options varies regionally due to different generation mixes and types of renewables. The more rapid decline in PV value compared to wind makes PV more dependent on adding flexibility options, including transmissionmore » and energy storage.« less
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25 CFR 162.541 - What must the lease include if it contains an option to renew?
Code of Federal Regulations, 2013 CFR
2013-04-01
... 25 Indians 1 2013-04-01 2013-04-01 false What must the lease include if it contains an option to renew? 162.541 Section 162.541 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER LEASES AND PERMITS Wind and Solar Resource Leases Wsr Leases § 162.541 What must the lease include...
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25 CFR 162.541 - What must the lease include if it contains an option to renew?
Code of Federal Regulations, 2014 CFR
2014-04-01
... 25 Indians 1 2014-04-01 2014-04-01 false What must the lease include if it contains an option to renew? 162.541 Section 162.541 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER LEASES AND PERMITS Wind and Solar Resource Leases Wsr Leases § 162.541 What must the lease include...
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Using Option Grids: steps toward shared decision-making for neonatal circumcision.
Fay, Mary; Grande, Stuart W; Donnelly, Kyla; Elwyn, Glyn
2016-02-01
To assess the impact, acceptability and feasibility of a short encounter tool designed to enhance the process of shared decision-making and parental engagement. We analyzed video-recordings of clinical encounters, half undertaken before and half after a brief intervention that trained four clinicians how to use Option Grids, using an observer-based measure of shared decision-making. We also analyzed semi-structured interviews conducted with the clinicians four weeks after their exposure to the intervention. Observer OPTION(5) scores were higher at post-intervention, with a mean of 33.9 (SD=23.5) compared to a mean of 16.1 (SD=7.1) for pre-intervention, a significant difference of 17.8 (95% CI: 2.4, 33.2). Prior to using the intervention, clinicians used a consent document to frame circumcision as a default practice. Encounters with the Option Grid conferred agency to both parents and clinicians, and facilitated shared decision-making. Clinician reported recognizing the tool's positive effect on their communication process. Tools such as Option Grids have the potential to make it easier for clinicians to achieve shared decision-making. Encounter tools have the potential to change practice. More research is needed to test their feasibility in routine practice. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
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Mohr, Peter N C; Heekeren, Hauke R; Rieskamp, Jörg
2017-08-21
Individuals make decisions under risk throughout daily life. Standard models of economic decision making typically assume that people evaluate choice options independently. There is, however, substantial evidence showing that this independence assumption is frequently violated in decision making without risk. The present study extends these findings to the domain of decision making under risk. To explain the independence violations, we adapted a sequential sampling model, namely Multialternative Decision Field Theory (MDFT), to decision making under risk and showed how this model can account for the observed preference shifts. MDFT not only better predicts choices compared with the standard Expected Utility Theory, but it also explains individual differences in the size of the observed context effect. Evidence in favor of the chosen option, as predicted by MDFT, was positively correlated with brain activity in the medial orbitofrontal cortex (mOFC) and negatively correlated with brain activity in the anterior insula (aINS). From a neuroscience perspective, the results of the present study show that specific brain regions, such as the mOFC and aINS, not only code the value or risk of a single choice option but also code the evidence in favor of the best option compared with other available choice options.
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-03
... Include Options on Interest Rate Futures Contracts With Maturities Not Longer Than Two Years In The One... of the proposed rule change is to include options on interest rate futures contracts with maturities... Futures Trading Commission (``CFTC'') as a derivatives clearing organization (``DCO'') pursuant to Section...
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ERIC Educational Resources Information Center
Hendley, Tom
1995-01-01
Discussion of digital document image processing focuses on issues and options associated with greyscale and color image processing. Topics include speed; size of original document; scanning resolution; markets for different categories of scanners, including photographic libraries, publishing, and office applications; hybrid systems; data…
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-09-20
... Options Transaction Charge (including the Cabinet Options Transaction Charge) as well as the Broker-Dealer FLEX transaction fee, for members executing facilitation orders pursuant to Exchange Rule 1064 when... average daily volume (including both FLEX and non-FLEX transactions) exceeds 10,000 contracts per day in a...
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46 CFR 307.7 - Information required in report.
Code of Federal Regulations, 2010 CFR
2010-10-01
... information, and (viii) The keyword “MAREP”. If optional remarks are included, they must follow at the end of... (vi) The keyword “MAREP”. If optional remarks are included, they must follow at the end of the text... Radio Call Sign, (iii) Time at reported position, (iv) Latitude and longitude, and (v) The keyword...
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User's Guide to the Stand Prognosis Model
William R. Wykoff; Nicholas L. Crookston; Albert R. Stage
1982-01-01
The Stand Prognosis Model is a computer program that projects the development of forest stands in the Northern Rocky Mountains. Thinning options allow for simulation of a variety of management strategies. Input consists of a stand inventory, including sample tree records, and a set of option selection instructions. Output includes data normally found in stand, stock,...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-14
... interview, or other public speaking activity, or the writing of a print media article, concerning options..., that is published, or used in any electronic or other public media, including any Web site, newspaper... correspondence, that is generally available to customers or the public, including circulars, research reports...
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Nail Psoriasis: A Review of Treatment Options.
Pasch, Marcel C
2016-04-01
Nail involvement affects 80-90 % of patients with plaque psoriasis, and is even more prevalent in patients with psoriatic arthritis. This review is the result of a systemic approach to the literature and covers topical, intralesional, conventional systemic, and biologic systemic treatments, as well as non-pharmacological treatment options for nail psoriasis. The available evidence suggests that all anti-tumor necrosis factor-α, anti-interleukin (IL)-17, and anti-IL-12/23 antibodies which are available for plaque psoriasis and psoriatic arthritis are highly effective treatments for nail psoriasis. Conventional systemic treatments, including methotrexate, cyclosporine, acitretin, and apremilast, as well as intralesional corticosteroids, can also be effective treatments for nail psoriasis. Topical treatments, including corticosteroids, calcipotriol, tacrolimus, and tazarotene, have also been shown to have a position in the treatment of nail psoriasis, particularly in mild cases. Finally, non-pharmacological treatment options, including phototherapy, photodynamic therapy, laser therapy, and several radiotherapeutic options, are also reviewed but cannot be advised as first-line treatment options. Another conclusion of this review is that the lack of a reliable core set of outcomes measures for trials in nail psoriasis hinders the interpretation of results, and is urgently needed.
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Smaldino, Paul E; Richerson, Peter J
2012-01-01
Most research on decision making has focused on how human or animal decision makers choose between two or more options, posed in advance by the researchers. The mechanisms by which options are generated for most decisions, however, are not well understood. Models of sequential search have examined the trade-off between continued exploration and choosing one's current best option, but still cannot explain the processes by which new options are generated. We argue that understanding the origins of options is a crucial but untapped area for decision making research. We explore a number of factors which influence the generation of options, which fall broadly into two categories: psycho-biological and socio-cultural. The former category includes factors such as perceptual biases and associative memory networks. The latter category relies on the incredible human capacity for culture and social learning, which doubtless shape not only our choices but the options available for choice. Our intention is to start a discussion that brings us closer toward understanding the origins of options.
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Smaldino, Paul E.; Richerson, Peter J.
2012-01-01
Most research on decision making has focused on how human or animal decision makers choose between two or more options, posed in advance by the researchers. The mechanisms by which options are generated for most decisions, however, are not well understood. Models of sequential search have examined the trade-off between continued exploration and choosing one’s current best option, but still cannot explain the processes by which new options are generated. We argue that understanding the origins of options is a crucial but untapped area for decision making research. We explore a number of factors which influence the generation of options, which fall broadly into two categories: psycho-biological and socio-cultural. The former category includes factors such as perceptual biases and associative memory networks. The latter category relies on the incredible human capacity for culture and social learning, which doubtless shape not only our choices but the options available for choice. Our intention is to start a discussion that brings us closer toward understanding the origins of options. PMID:22514515
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ExpandED Options: Learning beyond High School Walls
ERIC Educational Resources Information Center
ExpandED Schools, 2014
2014-01-01
Through ExpandED Options by TASC, New York City high school students get academic credit for learning career-related skills that lead to paid summer jobs. Too many high school students--including those most likely to drop out--are bored or see classroom learning as irrelevant. ExpandED Options students live the connection between mastering new…
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-10-01
... the Exchange on each ATP Holder for all options transactions, including mini-options, executed or cleared by the ATP Holder that are cleared by The Options Clearing Corporation (``OCC'') in the customer range (i.e., transactions that clear in the customer account of the ATP Holder's clearing firm at OCC...
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ERIC Educational Resources Information Center
Hart, Debra; Grigal, Meg; Weir, Cate
2010-01-01
This article will provide an overview of postsecondary education (PSE) options for students with Autism Spectrum Disorder (ASD) and other Intellectual Disabilities (ID). Topics include a historical and philosophical discussion outlining how students with ASD and ID can benefit from postsecondary opportunities, a description of current PSE options,…
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Valuing the Student Loan Consolidation Option. Congressional Budget Office Background Paper
ERIC Educational Resources Information Center
Weinberg, Steven
2006-01-01
Federal student loans include a complex consolidation option that gives borrowers the opportunity to combine several loans into a single loan with a longer term to maturity and, for loans originated before July 2006, to convert from a variable- to a fixed-rate loan. The consolidation option adds substantial costs to the federal student loan…
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-11-06
... transaction fee for executions in standard option contracts and $0.008 transaction fee for Mini Option... Exchange for purposes of the transaction fee and Section 1(a)(i) of the Fee Schedule include: (i... (``DPLMM''). See MIAX Options Fee Schedule, Section 1(a)(i)--Market Maker Transaction Fees. The current...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-12-10
... options transactions executed or cleared by the member that are cleared by The Options Clearing... imposed upon all transactions executed by a member, even if such transactions do not take place on the Exchange.\\3\\ The ORF also includes options transactions that are not executed by an Exchange member but are...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-07-13
... LLC To List Options on Trust Issued Receipts in $1 Strike Intervals July 6, 2010. Pursuant to section... strike price intervals for options on Trust Issued Receipts. The text of the proposed rule change is... establish strike price intervals for options on Trust Issued Receipts (``TIRs''), including Holding Company...
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The Option To Work at Home: Another Privilege for the Favoured Few?
ERIC Educational Resources Information Center
Felstead, Alan; Jewson, Nick; Phizacklea, Annie; Walters, Sally
2002-01-01
Data from the Workplace Employee Relations Survey and Labour Force Survey identified employees who have the option of working at home and those required to work at home. Opportunity to choose is associated with higher-skilled, higher-paying occupations. Those required to work at home or denied the option include some of the most disadvantaged…
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42 CFR 417.155 - How the HMO option must be included in the health benefits plan.
Code of Federal Regulations, 2012 CFR
2012-10-01
... enrollment in the HMO or of transfer from HMO to non-HMO coverage, or exclusions, or limitations based on..., because of this selection, lose their eligibility for free-standing dental, optical, or prescription drug... option.) - (ii) The non-HMO option provides free-standing coverage for optical services (such as...
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42 CFR 417.155 - How the HMO option must be included in the health benefits plan.
Code of Federal Regulations, 2013 CFR
2013-10-01
... enrollment in the HMO or of transfer from HMO to non-HMO coverage, or exclusions, or limitations based on..., because of this selection, lose their eligibility for free-standing dental, optical, or prescription drug... option.) - (ii) The non-HMO option provides free-standing coverage for optical services (such as...
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42 CFR 417.155 - How the HMO option must be included in the health benefits plan.
Code of Federal Regulations, 2014 CFR
2014-10-01
... enrollment in the HMO or of transfer from HMO to non-HMO coverage, or exclusions, or limitations based on..., because of this selection, lose their eligibility for free-standing dental, optical, or prescription drug... option.) - (ii) The non-HMO option provides free-standing coverage for optical services (such as...
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The Effects of Framing Vocational Choices on Young Adults' Sets of Career Options
ERIC Educational Resources Information Center
Feldman, Daniel C.; Whitcomb, Kathleen M.
2005-01-01
Purpose: The present paper examines the effects of two decision-framing inductions on young adults' set of career options: first, whether young adults use abilities or interests as the grounds for their vocational choices and, second, whether young adults approach the decision-making task by including all career options to which they feel…
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Working with interpreters: The challenges of introducing Option Grid patient decision aids.
Wood, Fiona; Phillips, Katie; Edwards, Adrian; Elwyn, Glyn
2017-03-01
We aimed to observe how an Option Grid™ decision aid for clinical encounters might be used where an interpreter is present, and to assess the impact of its use on shared decision making. Data were available from three clinical consultations between patient, clinician (a physiotherapist), and interpreter about knee osteoarthritis. Clinicians were trained in the use of an Option Grid decision aid and the tool was used. Consultations were audio-recorded, transcribed, and translated by independent translators into English. Analysis revealed the difficulties with introducing a written decision aid into an interpreted consultation. The extra discussion needed between the clinician and interpreter around the principles and purpose of shared decision making and instructions regarding the Option Grid decision aid proved challenging and difficult to manage. Discussion of treatment options while using an Option Grid decision aid was predominantly done between clinician and interpreter. The patient appeared to have little involvement in discussion of treatment options. Patients were not active participants within the discussion. Further work needs to be done on how shared decision making can be achieved within interpreted consultations. Option Grid decision aids are not being used as intended in interpreted consultations. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
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NASA Technical Reports Server (NTRS)
Miller, R. H.; Minsky, M. L.; Smith, D. B. S.
1982-01-01
Potential applications of automation, robotics, and machine intelligence systems (ARAMIS) to space activities, and to their related ground support functions are explored. The specific tasks which will be required by future space projects are identified. ARAMIS options which are candidates for those space project tasks and the relative merits of these options are defined and evaluated. Promising applications of ARAMIS and specific areas for further research are identified. The ARAMIS options defined and researched by the study group span the range from fully human to fully machine, including a number of intermediate options (e.g., humans assisted by computers, and various levels of teleoperation). By including this spectrum, the study searches for the optimum mix of humans and machines for space project tasks.
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Carmel, Maude; Lebel, Michel; Tu, Le Mai
2010-05-01
Refractory chronic pelvi-perineal pain (RCPPP) is a challenging entity that has devastating consequences for patient's quality of life. Many etiologies have been proposed including pudendal neuralgia. Multiple treatment options are used but the reported results are sub-optimal and temporary. In this article, we present the technique of pudendal nerve neuromodulation with neurophysiology guidance as a treatment option for RCPPP. This technique is a two-step procedure that includes electrode implantation under neurophysiology guidance followed by the implantation of a permanent generator after a successful trial period. We report the cases of three women who underwent this procedure as a last-resort treatment option. After 2 years of follow-up, their symptoms are still significantly improved. No major complication occurred.
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A hybrid modeling approach for option pricing
NASA Astrophysics Data System (ADS)
Hajizadeh, Ehsan; Seifi, Abbas
2011-11-01
The complexity of option pricing has led many researchers to develop sophisticated models for such purposes. The commonly used Black-Scholes model suffers from a number of limitations. One of these limitations is the assumption that the underlying probability distribution is lognormal and this is so controversial. We propose a couple of hybrid models to reduce these limitations and enhance the ability of option pricing. The key input to option pricing model is volatility. In this paper, we use three popular GARCH type model for estimating volatility. Then, we develop two non-parametric models based on neural networks and neuro-fuzzy networks to price call options for S&P 500 index. We compare the results with those of Black-Scholes model and show that both neural network and neuro-fuzzy network models outperform Black-Scholes model. Furthermore, comparing the neural network and neuro-fuzzy approaches, we observe that for at-the-money options, neural network model performs better and for both in-the-money and an out-of-the money option, neuro-fuzzy model provides better results.
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Lunar-based optical telescopes: Planning astronomical tools of the twenty-first century
NASA Astrophysics Data System (ADS)
Hilchey, J. D.; Nein, M. E.
1995-02-01
A succession of optical telescopes, ranging in aperture from 1 to 16 m or more, can be deployed and operated on the lunar surface over the next half-century. These candidates to succeed NASA's Great Observatories would capitalize on the unique observational advantages offered by the Moon. The Lunar Telescope Working Group and the LUTE Task Team of the George C. Marshall Space Flight Center (MSFC) have assessed the feasibility of developing and deploying these facilities. Studies include the 16-m Large Lunar Telescope (LLT); the Lunar Cluster Telescope Experiment (LCTE), a 4-m precursor to the LLT; the 2-m Lunar Transit Telescope (LTT); and its precursor, the 1-m Lunar Ultraviolet Telescope Experiment (LUTE). The feasibility of developing and deploying each telescope was assessed and system requirements and options for supporting technologies, subsystems, transportation, and operations were detailed. Influences of lunar environment factors and site selection on telescope design and operation were evaluated, and design approaches and key tradeoffs were established. This paper provides an overview of the study results. Design concepts and brief system descriptions are provided, including subsystem and mission options selected for the concepts.
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Zika Virus: Medical Countermeasure Development Challenges
Malone, Robert W.; Homan, Jane; Callahan, Michael V.; Glasspool-Malone, Jill; Damodaran, Lambodhar; Schneider, Adriano De Bernardi; Zimler, Rebecca; Talton, James; Cobb, Ronald R.; Ruzic, Ivan; Smith-Gagen, Julie; Janies, Daniel; Wilson, James
2016-01-01
Introduction Reports of high rates of primary microcephaly and Guillain–Barré syndrome associated with Zika virus infection in French Polynesia and Brazil have raised concerns that the virus circulating in these regions is a rapidly developing neuropathic, teratogenic, emerging infectious public health threat. There are no licensed medical countermeasures (vaccines, therapies or preventive drugs) available for Zika virus infection and disease. The Pan American Health Organization (PAHO) predicts that Zika virus will continue to spread and eventually reach all countries and territories in the Americas with endemic Aedes mosquitoes. This paper reviews the status of the Zika virus outbreak, including medical countermeasure options, with a focus on how the epidemiology, insect vectors, neuropathology, virology and immunology inform options and strategies available for medical countermeasure development and deployment. Methods Multiple information sources were employed to support the review. These included publically available literature, patents, official communications, English and Lusophone lay press. Online surveys were distributed to physicians in the US, Mexico and Argentina and responses analyzed. Computational epitope analysis as well as infectious disease outbreak modeling and forecasting were implemented. Field observations in Brazil were compiled and interviews conducted with public health officials. PMID:26934531
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Human papillomavirus-related oropharyngeal cancer.
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.
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NASA Astrophysics Data System (ADS)
Schingler, Robert; Villasenor, J. N.; Ricker, G. R.; Latham, D. W.; Vanderspek, R. K.; Ennico, K. A.; Lewis, B. S.; Bakos, G.; Brown, T. M.; Burgasser, A. J.; Charbonneau, D.; Clampin, M.; Deming, L. D.; Doty, J. P.; Dunham, E. W.; Elliot, J. L.; Holman, M. J.; Ida, S.; Jenkins, J. M.; Jernigan, J. G.; Kawai, N.; Laughlin, G. P.; Lissauer, J. J.; Martel, F.; Sasselov, D. D.; Seager, S.; Torres, G.; Udry, S.; Winn, J. N.; Worden, S. P.
2010-01-01
The Transiting Exoplanet Survey Satellite (TESS) will perform an all-sky survey in a low-inclination, low-Earth orbit. TESS's 144 GB of raw data collected each orbit will be stacked, cleaned, cut, compressed and downloaded. The Community Observer Program is a Science Enhancement Option (SEO) that takes advantage of the low-radiation environment, technology advances in flash memory, and the vast amount of astronomical data collected by TESS. The Community Observer Program requires the addition of a 12 TB "SEO Box” inside the TESS Bus. The hardware can be built using low-cost Commercial Off-The-Shelf (COTS) components and fits within TESS's margins while accommodating GSFC gold rules. The SEO Box collects and stores a duplicate of the TESS camera data at a "raw” stage ( 4.3 GB/orbit, after stacking and cleaning) and makes them available for on-board processing. The sheer amount of onboard storage provided by the SEO Box allows the stacking and storing of several months of data, allowing the investigator to probe deeper in time prior to a given event. Additionally, with computation power and data in standard formats, investigators can utilize data-mining techniques to investigate serendipitous phenomenon, including pulsating stars, eclipsing binaries, supernovae or other transient phenomena. The Community Observer Program enables ad-hoc teams of citizen scientists to propose, test, refine and rank algorithms for on-board analysis to support serendipitous science. Combining "best practices” of online collaboration, with careful moderation and community management, enables this `crowd sourced’ participatory exploration with a minimal risk and impact on the core TESS Team. This system provides a powerful and independent tool opening a wide range of opportunity for science enhancement and secondary science. Support for this work has been provided by NASA, the Kavli Foundation, Google, and the Smithsonian Institution.
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NASA Technical Reports Server (NTRS)
McGuire, Robert E.; Candey, Robert M.; Bilitza, D.
2006-01-01
The Sun-Earth Connection Active Archive (SECAA) project of NASA's Space Physics Data Facility operates a range of unique and heavily used multi-mission data services in support of the large-scale science objectives of the Great Observatory, including services such as CDAWeb, the CDAWeb Plus client, SSCWeb, OMNIweb and the CDF data format. In developing and operating these services, we have encountered and continue to struggle with a wide range of issues such as balancing scope and functionality with simplicity and ease of use, understanding the effectiveness of our choices and identifying areas most important for further improvement. In this paper, we will review our key services and then discuss some of our observations and new approaches to understanding and meeting user data service requirements. Some observations are obvious but may still have substantial implications; e.g. functionality without information content is of little user interest, which has led to our recent emphasis on development of web services interfaces, so the content and functionality we already serve is readily and fully available as a building block for new services. Some observations require careful design and tradeoffs; e.g. users will complain when they are offered interfaces with limited options but users are also easily intimidated and become lost when offered extensive options for customization. Some observations remain highly challenging; e.g. a comprehensive multi-mission, multi-source view of all data and services available easily produces a daunting list, but a more selective view can easily lead users to overlook available and relevant data. It is often difficult to obtain and meaningfully interpret measures of true productive usage and overall user satisfaction, even with a variety of techniques including statistics, citations, case studies, user feedback and advisory committees. Most of these issues will apply to and may even be more acute for distributed implementation architectures.
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Energy in transition 1985 to 2010: overview. Final report
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1979-01-01
This study by the Committee on Nuclear and Alternative Energy Systems (CONAES) examines in detail all aspects of the nations energy situation. Some technical and economic observation that decision makers may find useful as they develop energy policy in the larger context of the future of society are offered. The observations focusing on the prime importance of energy conservation; the critical near-term problem of fluid fuel supply; the desirability of a balanced combination of coal and nuclear fission as the only large-scale intermediate-term options for electricity generation; the need to keep the breeder option open; and the importance of investingmore » now in research and development to ensure the availability of a strong range of new energy options sustainable over the long term are discussed in detail. (MCW)« less
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A Study of Phased Array Antennas for NASA's Deep Space Network
NASA Technical Reports Server (NTRS)
Jamnejad, Vahraz; Huang, John; Cesarone, Robert J.
2001-01-01
In this paper we briefly discuss various options but focus on the feasibility of the phased arrays as a viable option for this application. Of particular concern and consideration will be the cost, reliability, and performance compared to the present 70-meter antenna system, particularly the gain/noise temperature levels in the receive mode. Many alternative phased arrays including planar horizontal arrays, hybrid mechanically/electronically steered arrays, phased array of mechanically steered reflectors, multi-faceted planar arrays, phased array-fed lens antennas, and planar reflect-arrays are compared and their viability is assessed. Although they have many advantages including higher reliability, near-instantaneous beam switching or steering capability, the cost of such arrays is presently prohibitive and it is concluded that the only viable array options at the present are the arrays of a few or many small reflectors. The active planar phased arrays, however, may become feasible options in the next decade and can be considered for deployment in smaller configurations as supplementary options.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Denholm, Paul; Novacheck, Joshua; Jorgenson, Jennie
In this study, we attempt to quantify the benefits of various options of grid flexibility by measuring their impact on two measures: economic carrying capacity and system costs. Flexibility can increase economic carrying capacity and reduce overall system costs. In some cases, options that provide a limited increase in economic carrying capacity can provide significant operational savings, thus demonstrating the need to evaluate flexibility options using multiple metrics. The value of flexibility options varies regionally due to different generation mixes and types of renewables. The more rapid decline in PV value compared to wind makes PV more dependent on addingmore » flexibility options, including transmission and energy storage.« less
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NASA Astrophysics Data System (ADS)
Baaquie, Belal E.
2007-01-01
European options on coupon bonds are studied in a quantum field theory model of forward interest rates. Swaptions are briefly reviewed. An approximation scheme for the coupon bond option price is developed based on the fact that the volatility of the forward interest rates is a small quantity. The field theory for the forward interest rates is Gaussian, but when the payoff function for the coupon bond option is included it makes the field theory nonlocal and nonlinear. A perturbation expansion using Feynman diagrams gives a closed form approximation for the price of coupon bond option. A special case of the approximate bond option is shown to yield the industry standard one-factor HJM formula with exponential volatility.
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Centralized vs decentralized lunar power system study
NASA Astrophysics Data System (ADS)
Metcalf, Kenneth; Harty, Richard B.; Perronne, Gerald E.
1991-09-01
Three power-system options are considered with respect to utilization on a lunar base: the fully centralized option, the fully decentralized option, and a hybrid comprising features of the first two options. Power source, power conditioning, and power transmission are considered separately, and each architecture option is examined with ac and dc distribution, high and low voltage transmission, and buried and suspended cables. Assessments are made on the basis of mass, technological complexity, cost, reliability, and installation complexity, however, a preferred power-system architecture is not proposed. Preferred options include transmission based on ac, transmission voltages of 2000-7000 V with buried high-voltage lines and suspended low-voltage lines. Assessments of the total cost associated with the installations are required to determine the most suitable power system.
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Baaquie, Belal E
2007-01-01
European options on coupon bonds are studied in a quantum field theory model of forward interest rates. Swaptions are briefly reviewed. An approximation scheme for the coupon bond option price is developed based on the fact that the volatility of the forward interest rates is a small quantity. The field theory for the forward interest rates is Gaussian, but when the payoff function for the coupon bond option is included it makes the field theory nonlocal and nonlinear. A perturbation expansion using Feynman diagrams gives a closed form approximation for the price of coupon bond option. A special case of the approximate bond option is shown to yield the industry standard one-factor HJM formula with exponential volatility.
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Goodman, Michael; Dana Flanders, W
2007-04-01
We compare methodological approaches for evaluating gene-environment interaction using a planned study of pediatric leukemia as a practical example. We considered three design options: a full case-control study (Option I), a case-only study (Option II), and a partial case-control study (Option III), in which information on controls is limited to environmental exposure only. For each design option we determined its ability to measure the main effects of environmental factor E and genetic factor G, and the interaction between E and G. Using the leukemia study example, we calculated sample sizes required to detect and odds ratio (OR) of 2.0 for E alone, an OR of 10 for G alone and an interaction G x E of 3. Option I allows measuring both main effects and interaction, but requires a total sample size of 1,500 cases and 1,500 controls. Option II allows measuring only interaction, but requires just 121 cases. Option III allows calculating the main effect of E, and interaction, but not the main effect of G, and requires a total of 156 cases and 133 controls. In this case, the partial case-control study (Option III) appears to be more efficient with respect to its ability to answer the research questions for the amount of resources required. The design options considered in this example are not limited to observational epidemiology and may be applicable in studies of pharmacogenomics, survivorship, and other areas of pediatric ALL research.
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Fibromyalgia Pathogenesis and Treatment Options Update.
Chinn, Steven; Caldwell, William; Gritsenko, Karina
2016-04-01
This review article presents and summarizes up-to-date literature on the clinical manifestations, diagnosis, pathophysiological mechanisms, and treatment options for fibromyalgia patients. First, the most recent diagnostic criteria for fibromyalgia, as put forth by the American College of Rheumatology will be summarized. Clinical features, including chronic widespread pain, hyperalgesia, mood disorders, anxiety, and disturbed sleep patterns will be explored in-depth. The pathogenesis and pathophysiology of fibromyalgia involves alterations in multiple ascending and descending central nervous system pathways, as well as peripheral pathways, leading to heightened pain sensitivity. Risk factors have been studied extensively, and the most recent research focuses on various genetic influences and the contributions of stress and poor sleep. Lastly, the discussion in this article focuses on treatment options for fibromyalgia; some have been mainstay options for many years. Pharmacological agents include tricyclic antidepressants, anti-epileptic drugs, selective serotonin reuptake inhibitors, norepinephrine/serotonin reuptake inhibitors, as well as some investigational agents. The evidence behind non-pharmacologic treatments, including massage therapy, exercise, and acupuncture, are discussed.
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NASA Technical Reports Server (NTRS)
Ortiz, James N.; Scott,Kelly; Smith, Harold
2004-01-01
The assembly and operation of the ISS has generated significant challenges that have ultimately impacted resources available to the program's primary mission: research. To address this, program personnel routinely perform trade-off studies on alternative options to enhance research. The approach, content level of analysis and resulting outputs of these studies vary due to many factors, however, complicating the Program Manager's job of selecting the best option. To address this, the program requested a framework be developed to evaluate multiple research-enhancing options in a thorough, disciplined and repeatable manner, and to identify the best option on the basis of cost, benefit and risk. The resulting framework consisted of a systematic methodology and a decision-support toolset. The framework provides quantifiable and repeatable means for ranking research-enhancing options for the complex and multiple-constraint domain of the space research laboratory. This paper describes the development, verification and validation of this framework and provides observations on its operational use.
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Observational methods in comparative effectiveness research.
Concato, John; Lawler, Elizabeth V; Lew, Robert A; Gaziano, J Michael; Aslan, Mihaela; Huang, Grant D
2010-12-01
Comparative effectiveness research (CER) may be defined informally as an assessment of available options for treating specific medical conditions in selected groups of patients. In this context, the most prominent features of CER are the various patient populations, medical ailments, and treatment options involved in any particular project. Yet, each research investigation also has a corresponding study design or "architecture," and in patient-oriented research a common distinction used to describe such designs are randomized controlled trials (RCTs) versus observational studies. The purposes of this overview, with regard to CER, are to (1) understand how observational studies can provide accurate results, comparable to RCTs; (2) recognize strategies used in selected newer methods for conducting observational studies; (3) review selected observational studies from the Veterans Health Administration; and (4) appreciate the importance of fundamental methodological principles when conducting or evaluating individual studies. Published by Elsevier Inc.
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Cullen, M. H.; Billingham, L. J.; Cook, J.; Woodroffe, C. M.
1996-01-01
Increasingly, treatment choices leading to the same survival outcome can be offered to cancer patients (e.g. mastectomy or conservative surgery in early breast cancer). Two approaches available for post-orchidectomy, stage I patients with non-seminomatous germ cell tumours of the testis (NSGCTT), particularly those at high risk of relapse, include immediate adjuvant chemotherapy (two courses) or surveillance, with chemotherapy (typically four courses) given only on relapse. The aim of this study was to investigate which approach patients prefer. Questionnaires were given to newly diagnosed NSGCTT patients, to patients with previous experience of the two options and to non-cancer controls, including specialist testicular tumour oncologists. Participants were asked to choose between immediate chemotherapy, surveillance or for the doctor to decide, at recurrence risk levels ranging from 10% to 90%. Questionnaires were returned by 207 subjects in nine different groups. The risk thresholds at which subjects' management preference changed, within apparently homogeneous groups, varied greatly, although at least one subject in each group selected adjuvant chemotherapy at the lowest (10%) level of risk. Subjects tended to favour options of which they had previous experience. Cancer patients wanted the doctor to decide more frequently than controls. The wide variability observed makes it difficult to predict which option an individual will select. Personality factors and personal circumstances, other than specific experience and knowledge, are obviously influential. Many patients would prefer their doctor to decide, but variability among oncologists is as great as that among their patients. PMID:8912550
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Religiousness, Spirituality, and Salivary Cortisol in Breast Cancer Survivorship: A Pilot Study.
Hulett, Jennifer M; Armer, Jane M; Leary, Emily; Stewart, Bob R; McDaniel, Roxanne; Smith, Kandis; Millspaugh, Rami; Millspaugh, Joshua
Psychoneuroimmunological theory suggests a physiological relationship exists between stress, psychosocial-behavioral factors, and neuroendocrine-immune outcomes; however, evidence has been limited. The primary aim of this pilot study was to determine feasibility and acceptability of a salivary cortisol self-collection protocol with a mail-back option for breast cancer survivors. A secondary aim was to examine relationships between religiousness/spirituality (R/S), perceptions of health, and diurnal salivary cortisol (DSC) as a proxy measure for neuroendocrine activity. This was an observational, cross-sectional study. Participants completed measures of R/S, perceptions of health, demographics, and DSC. The sample was composed of female breast cancer survivors (n = 41). Self-collection of DSC using a mail-back option was feasible; validity of mailed salivary cortisol biospecimens was established. Positive spiritual beliefs were the only R/S variable associated with the peak cortisol awakening response (rs = 0.34, P = .03). Poorer physical health was inversely associated with positive spiritual experiences and private religious practices. Poorer mental health was inversely associated with spiritual coping and negative spiritual experiences. Feasibility, validity, and acceptability of self-collected SDC biospecimens with an optional mail-back protocol (at moderate temperatures) were demonstrated. Positive spiritual beliefs were associated with neuroendocrine-mediated peak cortisol awakening response activity; however, additional research is recommended. Objective measures of DSC sampling that include enough collection time points to assess DSC parameters would increase the rigor of future DSC measurement. Breast cancer survivors may benefit from nursing care that includes spiritual assessment and therapeutic conversations that support positive spiritual beliefs.
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Zeng, Chao; Wei, Jie; Li, Hui; Wang, Yi-lun; Xie, Dong-xing; Yang, Tuo; Gao, Shu-guang; Li, Yu-sheng; Luo, Wei; Lei, Guang-hua
2015-01-01
This study aimed to investigate the effectiveness and safety of glucosamine, chondroitin, the two in combination, or celecoxib in the treatment of knee osteoarthritis (OA). PubMed, Embase and Cochrane Library were searched through from inception to February 2015. A total of 54 studies covering 16427 patients were included. Glucosamine plus chondroitin, glucosamine alone, and celecoxib were all more effective than placebo in pain relief and function improvement. Specifically, celecoxib is most likely to be the best treatment option, followed by the combination group. All treatment options showed clinically significant improvement from baseline pain, but only glucosamine plus chondroitin showed clinically significant improvement from baseline function. In terms of the structure-modifying effect, both glucosamine alone and chondroitin alone achieved a statistically significant reduction in joint space narrowing. Although no significant difference was observed among the five options with respect to the three major adverse effects (withdrawal due to adverse events, serious adverse events and the number of patients with adverse events), the additional classical meta-analysis showed that celecoxib exhibited a higher rate of gastrointestinal adverse effect comparing with the placebo group. The present study provided evidence for the symptomatic efficacy of glucosamine plus chondroitin in the treatment of knee OA. PMID:26576862
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COMOC 2: Two-dimensional aerodynamics sequence, computer program user's guide
NASA Technical Reports Server (NTRS)
Manhardt, P. D.; Orzechowski, J. A.; Baker, A. J.
1977-01-01
The COMOC finite element fluid mechanics computer program system is applicable to diverse problem classes. The two dimensional aerodynamics sequence was established for solution of the potential and/or viscous and turbulent flowfields associated with subsonic flight of elementary two dimensional isolated airfoils. The sequence is constituted of three specific flowfield options in COMOC for two dimensional flows. These include the potential flow option, the boundary layer option, and the parabolic Navier-Stokes option. By sequencing through these options, it is possible to computationally construct a weak-interaction model of the aerodynamic flowfield. This report is the user's guide to operation of COMOC for the aerodynamics sequence.
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Urban Options Solar Greenhouse Demonstration Project. Final report
DOE Office of Scientific and Technical Information (OSTI.GOV)
Cipparone, L.
1980-10-15
The following are included: the design process, construction, thermal performance, horticulture, educational activities, and future plans. Included in appendices are: greenhouse blueprints, insulating curtain details, workshop schedules, sample data forms, summary of performance calculations on the Urban Options Solar Greenhouse, data on vegetable production, publications, news articles on th Solar Greenhouse Project, and the financial statement. (MHR)
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Libraries and Desktop Storage Options: Results of a Web-Based Survey.
ERIC Educational Resources Information Center
Hendricks, Arthur; Wang, Jian
2002-01-01
Reports the results of a Web-based survey that investigated what plans, if any, librarians have for dealing with the expected obsolescence of the floppy disk and still retain effective library service. Highlights include data storage options, including compact disks, zip disks, and networked storage products; and a copy of the Web survey.…
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-07-09
... behavior is included in the econometric models underlying STANS, time series of proportional changes in... included in the econometric models underlying STANS, time series of proportional changes in implied... calculate daily margin requirements. OCC has proposed at this time to clear only OTC Options on the S&P 500...
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Research planning criteria for regenerative life-support systems applicable to space habitats
NASA Technical Reports Server (NTRS)
Spurlock, J.; Cooper, W.; Deal, P.; Harlan, A.; Karel, M.; Modell, M.; Moe, P.; Phillips, J.; Putnam, D.; Quattrone, P.
1979-01-01
The second phase of analyses that were conducted by the Life Support Systems Group of the 1977 NASA Ames Summer Study is described. This phase of analyses included a preliminary review of relevant areas of technology that can contribute to the development of closed life-support systems for space habitats, the identification of research options in these areas of technology, and the development of guidelines for an effective research program. The areas of technology that were studied included: (1) nutrition, diet, and food processing; (2) higher plant agriculture; (3) animal agriculture; (4) waste conversion and resource recovery; and (5) system stability and safety. Results of these analyses, including recommended research options and criteria for establishing research priorities among these many options, are discussed.
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Chronic orchialgia: Review of treatments old and new
Tojuola, Bayo; Layman, Jeffrey; Kartal, Ibrahim; Gudelogul, Ahmet; Brahmbhatt, Jamin; Parekattil, Sijo
2016-01-01
Introduction: Chronic orchialgia is historically and currently a challenging disease to treat. It is a diagnostic and therapeutic challenge for physicians. Conservative therapy has served as the first line of treatment. For those who fail conservative therapy, surgical intervention may be required. We aim to provide a review of currently available surgical options and novel surgical treatment options. Methods: A review of current literature was performed using PubMed. Literature discussing treatment options for chronic orchialgia were identified. The following search terms were used to identify literature that was relevant to this review: Chronic orchialgia, testicular pain, scrotal content pain, and microsurgical denervation of the spermatic cord (MDSC). Results: The incidence of chronic orchialgia has been increasing over time. In the USA, it affects up to 100,000 men per year due to varying etiologies. The etiology of chronic orchialgia can be a confounding problem. Conservative therapy should be viewed as the first line therapy. Studies have reported poor success rates. Current surgical options for those who fail conservative options include varicocelectomy, MDSC, epididymectomy, and orchiectomy. Novel treatment options include microcryoablation of the peri-spermatic cord, botox injection, and amniofix injection. Conclusion: Chronic orchialgia has been and will continue to be a challenging disease to treat due to its multiple etiologies and variable treatment outcomes. Further studies are needed to better understand the problem. Treatment options for patients with chronic orchialgia are improving. Additional studies are warranted to better understand the long-term durability of this treatment options. PMID:26941490
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Solar pumped laser technology options for space power transmission
NASA Technical Reports Server (NTRS)
Conway, E. J.
1986-01-01
An overview of long-range options for in-space laser power transmission is presented. The focus is on the new technology and research status of solar-pumped lasers and their solar concentration needs. The laser options include gas photodissociation lasers, optically-pumped solid-state lasers, and blackbody-pumped transfer lasers. The paper concludes with a summary of current research thrusts.
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ERIC Educational Resources Information Center
General Accounting Office, Washington, DC.
In this report GAO recommends that the Secretary of Education assess the advantages of consolidation loans for borrowers and the government in light of program costs and identify options for reducing federal costs. Options could include targeting the program to borrowers at risk of default and extending existing consolidation alternatives to more…
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Analysis of Shroud Options in Support of the Human Exploration of Mars
NASA Technical Reports Server (NTRS)
Feldman, Stuart; Borowski, Stanley; Engelund, Walter; Hundley, Jason; Monk, Timothy; Munk, Michelle
2010-01-01
In support of the Mars Design Reference Architecture (DRA) 5.0, the NASA study team analyzed several shroud options for use on the Ares V launch vehicle.1,2 These shroud options included conventional "large encapsulation" shrouds with outer diameters ranging from 8.4 to 12.9 meters (m) and overall lengths of 22.0 to 54.3 meters, along with a "nosecone-only" shroud option used for Mars transfer vehicle component delivery. Also examined was a "multi-use" aerodynamic encapsulation shroud used for launch, Mars aerocapture, and entry, descent, and landing of the cargo and habitat landers. All conventional shroud options assessed for use on the Mars launch vehicles were the standard biconic design derived from the reference shroud utilized in the Constellation Program s lunar campaign. It is the purpose of this paper to discuss the technical details of each of these shroud options including material properties, structural mass, etc., while also discussing both the volume and mass of the various space transportation and surface system payload elements required to support a "minimum launch" Mars mission strategy, as well as the synergy, potential differences and upgrade paths that may be required between the Lunar and Mars mission shrouds.
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EPA is working with federal, state, tribal and local agencies to find and promote viable funding options to replace wood-burning appliances with cleaner home heating. Includes Guide to Financing Options for Wood-burning Appliance Changeouts.
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The Nature of Belief-Directed Exploratory Choice in Human Decision-Making
Knox, W. Bradley; Otto, A. Ross; Stone, Peter; Love, Bradley C.
2011-01-01
In non-stationary environments, there is a conflict between exploiting currently favored options and gaining information by exploring lesser-known options that in the past have proven less rewarding. Optimal decision-making in such tasks requires considering future states of the environment (i.e., planning) and properly updating beliefs about the state of the environment after observing outcomes associated with choices. Optimal belief-updating is reflective in that beliefs can change without directly observing environmental change. For example, after 10 s elapse, one might correctly believe that a traffic light last observed to be red is now more likely to be green. To understand human decision-making when rewards associated with choice options change over time, we develop a variant of the classic “bandit” task that is both rich enough to encompass relevant phenomena and sufficiently tractable to allow for ideal actor analysis of sequential choice behavior. We evaluate whether people update beliefs about the state of environment in a reflexive (i.e., only in response to observed changes in reward structure) or reflective manner. In contrast to purely “random” accounts of exploratory behavior, model-based analyses of the subjects’ choices and latencies indicate that people are reflective belief updaters. However, unlike the Ideal Actor model, our analyses indicate that people’s choice behavior does not reflect consideration of future environmental states. Thus, although people update beliefs in a reflective manner consistent with the Ideal Actor, they do not engage in optimal long-term planning, but instead myopically choose the option on every trial that is believed to have the highest immediate payoff. PMID:22319503
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AgeFactDB--the JenAge Ageing Factor Database--towards data integration in ageing research.
Hühne, Rolf; Thalheim, Torsten; Sühnel, Jürgen
2014-01-01
AgeFactDB (http://agefactdb.jenage.de) is a database aimed at the collection and integration of ageing phenotype data including lifespan information. Ageing factors are considered to be genes, chemical compounds or other factors such as dietary restriction, whose action results in a changed lifespan or another ageing phenotype. Any information related to the effects of ageing factors is called an observation and is presented on observation pages. To provide concise access to the complete information for a particular ageing factor, corresponding observations are also summarized on ageing factor pages. In a first step, ageing-related data were primarily taken from existing databases such as the Ageing Gene Database--GenAge, the Lifespan Observations Database and the Dietary Restriction Gene Database--GenDR. In addition, we have started to include new ageing-related information. Based on homology data taken from the HomoloGene Database, AgeFactDB also provides observation and ageing factor pages of genes that are homologous to known ageing-related genes. These homologues are considered as candidate or putative ageing-related genes. AgeFactDB offers a variety of search and browse options, and also allows the download of ageing factor or observation lists in TSV, CSV and XML formats.
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AgeFactDB—the JenAge Ageing Factor Database—towards data integration in ageing research
Hühne, Rolf; Thalheim, Torsten; Sühnel, Jürgen
2014-01-01
AgeFactDB (http://agefactdb.jenage.de) is a database aimed at the collection and integration of ageing phenotype data including lifespan information. Ageing factors are considered to be genes, chemical compounds or other factors such as dietary restriction, whose action results in a changed lifespan or another ageing phenotype. Any information related to the effects of ageing factors is called an observation and is presented on observation pages. To provide concise access to the complete information for a particular ageing factor, corresponding observations are also summarized on ageing factor pages. In a first step, ageing-related data were primarily taken from existing databases such as the Ageing Gene Database—GenAge, the Lifespan Observations Database and the Dietary Restriction Gene Database—GenDR. In addition, we have started to include new ageing-related information. Based on homology data taken from the HomoloGene Database, AgeFactDB also provides observation and ageing factor pages of genes that are homologous to known ageing-related genes. These homologues are considered as candidate or putative ageing-related genes. AgeFactDB offers a variety of search and browse options, and also allows the download of ageing factor or observation lists in TSV, CSV and XML formats. PMID:24217911
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Reiter, Andrea M F; Deserno, Lorenz; Kallert, Thomas; Heinze, Hans-Jochen; Heinz, Andreas; Schlagenhauf, Florian
2016-10-26
Addicted individuals continue substance use despite the knowledge of harmful consequences and often report having no choice but to consume. Computational psychiatry accounts have linked this clinical observation to difficulties in making flexible and goal-directed decisions in dynamic environments via consideration of potential alternative choices. To probe this in alcohol-dependent patients (n = 43) versus healthy volunteers (n = 35), human participants performed an anticorrelated decision-making task during functional neuroimaging. Via computational modeling, we investigated behavioral and neural signatures of inference regarding the alternative option. While healthy control subjects exploited the anticorrelated structure of the task to guide decision-making, alcohol-dependent patients were relatively better explained by a model-free strategy due to reduced inference on the alternative option after punishment. Whereas model-free prediction error signals were preserved, alcohol-dependent patients exhibited blunted medial prefrontal signatures of inference on the alternative option. This reduction was associated with patients' behavioral deficit in updating the alternative choice option and their obsessive-compulsive drinking habits. All results remained significant when adjusting for potential confounders (e.g., neuropsychological measures and gray matter density). A disturbed integration of alternative choice options implemented by the medial prefrontal cortex appears to be one important explanation for the puzzling question of why addicted individuals continue drug consumption despite negative consequences. In addiction, patients maintain substance use despite devastating consequences and often report having no choice but to consume. These clinical observations have been theoretically linked to disturbed mechanisms of inference, for example, to difficulties when learning statistical regularities of the environmental structure to guide decisions. Using computational modeling, we demonstrate disturbed inference on alternative choice options in alcohol addiction. Patients neglecting "what might have happened" was accompanied by blunted coding of inference regarding alternative choice options in the medial prefrontal cortex. An impaired integration of alternative choice options implemented by the medial prefrontal cortex might contribute to ongoing drug consumption in the face of evident negative consequences. Copyright © 2016 the authors 0270-6474/16/3610935-14$15.00/0.
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48 CFR 52.217-2 - Cancellation Under Multiyear Contracts.
Code of Federal Regulations, 2010 CFR
2010-10-01
... precluded anticipated benefits of Contractor or subcontractor learning. (g) The claim shall not include— (1...) This contract may include an Option clause with the period for exercising the option limited to the...
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How Do You Know When It's Time to Give up the Keys?
... older adults. http: / / www. eldercare. gov/ ELDERCARE. NET/ Public/ Resources/ Brochures/ docs/ Trans_ Options_ Panels. pdf National Center on Senior Transportation (NCST) Includes resources on transportation options for older ...
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Adult Primary Liver Cancer Treatment (PDQ®)—Health Professional Version
Adult primary liver cancer treatment options include surveillance, surgery, liver transplant, ablation, embolization, targeted therapy, and radiation. Get comprehensive information about liver cancer and treatment options in this clinician summary
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Options for Heart Valve Replacement
... which may include human or animal donor tissue) Ross Procedure — “Borrowing” your healthy valve and moving it ... Considerations for Surgery Medications Valve Repair Valve Replacement - Ross Procedure - Newer Surgery Options - What is TAVR? - Types ...
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Trajectory Design of the Lunar Impactor Mission Concept
NASA Technical Reports Server (NTRS)
Chung, Min-Kun J.; McElrath, Timothy P.; Roncoli, Ralph B.
2006-01-01
The National Aeronautics and Space Administration (NASA) solicited proposals in 2006 for an opportunity to include a small secondary payload with the launch of the Lunar Reconnaissance Orbiter (LRO) scheduled for October 2008. The cost cap of the proposal was between $50 and $80M, and the mass cap was 1,000 kilograms. JPL proposed a Lunar Impactor (LI) concept for this solicitation. The mission objective of LI was to impact the permanently shadowed region of a South polar crater ultimately to detect the presence of water. The detection of water ice would prove to be an important factor on future lunar exploration. NASA Ames Research Center also proposed a similar concept, the Lunar Crater observation and Sensing Satellite (LCROSS), which was selected by NASA for the mission. However, in this paper, the trajectory design of the LI proposed by JPL is considered. Since the LI spacecraft was to be launched on the LRO launch vehicle as a secondary payload, its initial trajectory must be diverted at some later time from the LRO trans-lunar trajectory for the subsequent impact. Several such trajectories have been considered, where each trajectory option fields some specific values for the mission parameters. The mission parameters include the availability of LRO instruments at the time of impact for the observation by LRO, the mission duration, the impact velocity, the impact angle, etc. It is possible for the LI to be deflected with a relatively low delta-V to impact a South polar crater at a reasonable impact velocity and impact angle directly with no delay. However, the instruments on-board LRO may not be ready for observation. Thus, several delayed trajectory options have been considered further. The lunar phase at the time of impact may also play an important factor for observation, especially from Earth. Several lunar flyby trajectory maneuvers have been identified to arrive at the Moon for impact at the desired lunar phase. By using a combination of these successive lunar flyby maneuvers, the impact lunar phase may be adjusted to the desired location. A few such trajectories have been suggested. Also, some attempts have been made to maximize the impact velocity by converting the impact trajectory into a retrograde orbit with respect to Earth. Since these types of trajectories take advantage of the Sun-Earth three-body region to minimize the delta-V, the mission duration is relatively long. A few such trajectories are suggested. Also, an attempt has been made to adjust the lunar impact within a desired time period for the optimum Earth observation for the above trajectories. The mission parameters resulting from each trajectory option above are considered and weighed against the cost and robustness of the mission in a brief summary.
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Surgical options in benign parotid tumors: a proposal for classification.
Quer, Miquel; Vander Poorten, Vincent; Takes, Robert P; Silver, Carl E; Boedeker, Carsten C; de Bree, Remco; Rinaldo, Alessandra; Sanabria, Alvaro; Shaha, Ashok R; Pujol, Albert; Zbären, Peter; Ferlito, Alfio
2017-11-01
Different surgical options are currently available for treating benign tumors of the parotid gland, and the discussion on optimal treatment continues despite several meta-analyses. These options include more limited resections (extracapsular dissection, partial lateral parotidectomy) versus more extensive and traditional options (lateral parotid lobectomy, total parotidectomy). Different schools favor one option or another based on their experience, skills and tradition. This review provides a critical analysis of the literature regarding these options. The main limitation of all the studies is the bias of selection for different surgical approaches. For this reason, we propose a staging system that could facilitate clinical decision making and the comparison of results. We propose four categories based on the size of the tumor and its location within the parotid gland. Category I includes tumors up to 3 cm, which are mobile, close to the outer surface and close to the parotid borders. Category II includes deeper tumors up to 3 cm. Category III comprises tumors greater than 3 cm involving two levels of the parotid gland, and category IV tumors are greater than 3 cm and involve more than 2 levels. For each category and for the various pathologic types, a guideline of surgical extent is proposed. The objective of this classification is to facilitate prospective multicentric studies on surgical techniques in the treatment of benign parotid tumors and to enable the comparison of results of different clinical studies.
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ART attrition and risk factors among Option B+ patients in Haiti: A retrospective cohort study.
Puttkammer, Nancy; Domerçant, Jean Wysler; Adler, Michelle; Yuhas, Krista; Myrtil, Martine; Young, Paul; François, Kesner; Grand'Pierre, Reynold; Lowrance, David
2017-01-01
In October 2012, the Haitian Ministry of Health endorsed the "Option B+" strategy to eliminate mother-to-child transmission of HIV and achieve HIV epidemic control. The objective of this paper is to assess and identify risk factors for attrition from the national ART program among Option B+ patients in the 12 months after ART initiation. This retrospective cohort study included patients newly initiating ART from October 2012-August 2013 at 68 ART sites covering 45% of all newly enrolled ART patients in all regions of Haiti. With data from electronic medical records, we carried out descriptive analysis of sociodemographic, clinical, and pregnancy-related correlates of ART attrition, and used a modified Poisson regression approach to estimate relative risks in a multivariable model. There were 2,166 Option B+ patients who initiated ART, of whom 1,023 were not retained by 12 months (47.2%). One quarter (25.3%) dropped out within 3 months of ART initiation. Protective factors included older age, more advanced HIV disease progression, and any adherence counseling prior to ART initiation, while risk factors included starting ART late in gestation, starting ART within 7 days of HIV testing, and using an atypical ART regimen. Our study demonstrates early ART attrition among Option B+ patients and contributes evidence on the characteristics of women who are most at risk of attrition in Haiti. Our findings highlight the importance of targeted strategies to support retention among Option B+ patients.
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Open Access Journal Policies: A Systematic Analysis of Radiology Journals.
Narayan, Anand; Lobner, Katie; Fritz, Jan
2018-02-01
The open access movement has pushed for greater access to scientific knowledge by expanding access to scientific journal articles. There is limited information about the extent to which open access policies have been adopted by radiology journals. We performed a systematic analysis to ascertain the proportion of radiology journals with open access options. A search was performed with the assistance of a clinical informationist. Full and mixed English-language diagnostic and interventional radiology Web of Science journals (impact factors > 1.0) were included. Nuclear medicine, radiation oncology, physics, and solicitation-only journals were excluded. Primary outcome was open access option (yes or no) with additional outcomes including presence or absence of embargo, complete or partial copyright transfer, publication fees, and self-archiving policies. Secondary outcomes included journal citations, journal impact factors, immediacy, Eigenfactor, and article influence scores. Independent double readings were performed with differences resolved by consensus, supplemented by contacting editorial staff at each journal. In all, 125 journals were identified; review yielded 49 journals (39%, mean impact factor of 2.61). Thirty-six of the journals had open access options (73.4%), and four journals were exclusively open access (8.2%). Twelve-month embargoes were most commonly cited (90.6%) with 28.6% of journals stating that they did not require a complete transfer of copyright. Prices for open access options ranged from $750 to $4,000 (median $3,000). No statistically significant differences were found in journal impact measures comparing journals with open access options to journals without open access options. Diagnostic and interventional radiology journals have widely adopted open access options with a few radiology journals being exclusively open access. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.
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Nigrovic, Peter A; Beukelman, Timothy; Tomlinson, George; Feldman, Brian M; Schanberg, Laura E; Kimura, Yukiko
2018-06-01
Systemic juvenile idiopathic arthritis is a rare febrile arthritis of childhood characterized by a potentially severe course, including prolonged glucocorticoid exposure, growth failure, destructive arthritis, and life-threatening macrophage activation syndrome. Early cytokine-blocking biologic therapy may improve long-term outcomes, although some systemic juvenile idiopathic arthritis patients respond well to non-biologic treatment, leaving optimal management undefined. Consequently, treatment of new-onset systemic juvenile idiopathic arthritis by expert clinicians varies widely. To describe a pragmatic, observational comparative effectiveness study that takes advantage of diversity in the management of a rare disease: FiRst-Line Options for Systemic juvenile idiopathic arthritis Treatment (FROST), comparing non-biologic and biologic consensus treatment plans for new-onset systemic juvenile idiopathic arthritis within the 60-center Childhood Arthritis and Rheumatology Research Alliance Registry (CARRA). FiRst-Line Options for Systemic juvenile idiopathic arthritis Treatment (FROST) is a multicenter, prospective, non-randomized study that compares four Childhood Arthritis and Rheumatology Research Alliance (CARRA) consensus treatment plans for new-onset systemic juvenile idiopathic arthritis: (1) glucocorticoids alone, (2) methotrexate, (3) interleukin-1 blockade, and (4) interleukin-6 blockade. Patients consenting to participation in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry are started on one of four Consensus Treatment Plans at the discretion of the treating physician. The outcome of primary interest is clinically inactive disease off glucocorticoids at 9 months, comparing non-biologic (Consensus Treatment Plans 1 + 2) versus biologic (Consensus Treatment Plans 3 + 4) strategies. Bayesian analytic methods will be employed to evaluate response rates, using propensity scoring to balance treatment groups for potential confounding. With 200 patients in a 2:1 ratio of biologic to non-biologic, there is a >90% probability of finding biologic consensus treatment plans more effective if the rate of clinically inactive disease is 30% higher than for non-biologic therapy. Additional outcomes include Patient-Reported Outcomes Measurement Information System measures and other parent-/patient-reported outcomes reported in real time using smartphone technology. Routine operation of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry will allow assessment of outcomes over at least 10 years. FiRst-Line Options for Systemic juvenile idiopathic arthritis Treatment (FROST) began enrollment in November 2016. The observational design may not provide balance in measured and unmeasured confounders. Use of consensus treatment plan (CTP) strategies at frequencies more unbalanced than predicted could reduce the chance of finding differences in efficacy. FiRst-Line Options for Systemic juvenile idiopathic arthritis Treatment (FROST) will provide the first prospective comparison of Childhood Arthritis and Rheumatology Research Alliance's (CARRA's) consensus-derived non-biologic versus biologic management strategies in systemic juvenile idiopathic arthritis, performed in a real-world setting wherein each patient receives standard-of-care treatment selected by the treating physician. Outcomes include clinician- and patient-/family-reported outcomes, empowering both physician and patient decision making in new-onset systemic juvenile idiopathic arthritis.
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Ho, Won Jin; Rooper, Lisa; Sagorsky, Sarah; Kang, Hyunseok
2018-05-09
Human papillomavirus-related small cell carcinoma of the head and neck is an extremely rare, aggressive subtype with poor outcomes. Therapeutic options are limited and are largely adopted from small cell lung cancer treatment paradigms. This report describes a 69-year old male who was diagnosed of HPV-related oropharyngeal cancer with mixed small cell and squamous cell pathology which was clinically aggressive and progressed through multimodal platinum-based therapies. Upon manifestation of worsening metastatic disease, the patient was initiated on a combination of ipilimumab and nivolumab. Within 2 months of starting immunotherapy, a robust partial response was observed. During the treatment course, the patient developed immune-related adverse effects including new diabetes mellitus, colitis, and hypothyroidism. The disease-specific survival was 26 months. Combination immunotherapy may be an attractive option for HPV-related small cell head and neck cancers resistant to other treatment modalities and thus warrants further evaluation.
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Dunn, Jennifer; Zhang, Qingning; Weeks, Margaret R; Li, Jianghong; Liao, Susu; Li, Fei
2017-07-01
New interventions to reduce HIV and sexually transmitted infections (STI) among female sex workers are introduced into the context of women's existing prevention beliefs and practices. These indigenous practices affected implementation of our program to introduce female condoms to women in sex-work establishments in southern China. We used ethnographic field observations and in-depth interviews to document common prevention methods women reported using to protect themselves before and during intervention implementation. Individual, sex-work establishment, and other contextual factors, including sources of information and social and economic pressures to use or reject prevention options, shaped their perceptions and selection of these methods and affected adoption of female condoms as an additional tool. Efforts to improve uptake of effective prevention methods among low-income sex workers require attention to the context and spectrum of women's HIV/STI prevention practices when introducing innovations such as female condoms, microbicides, pre-exposure prophylaxis pills, and others, as they become available.
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Oral manifestations of inflammatory bowel disease.
Mortada, I; Leone, A; Gerges Geagea, A; Mortada, R; Matar, C; Rizzo, M; Hajj Hussein, I; Massaad-Massade, L; Jurjus, A
2017-01-01
Inflammatory bowel diseases (IBD), including Crohn’s disease and ulcerative colitis, have important extraintestinal manifestations, notably in the oral cavity. These oral manifestations can constitute important clinical clues in the diagnosis and management of IBD, and include changes at the immune and bacterial levels. Aphthous ulcers, pyostomatitis vegetans, cobblestoning and gingivitis are important oral findings frequently observed in IBD patients. Their presentations vary considerably and might be well diagnosed and distinguished from other oral lesions. Infections, drug side effects, deficiencies in some nutrients and many other diseases involved with oral manifestations should also be taken into account. This article discusses the most recent findings on the oral manifestations of IBD with a focus on bacterial modulations and immune changes. It also includes an overview on options for management of the oral lesions of IBD.
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Verwoerd, Annemieke J H; Mens, Jan; El Barzouhi, Abdelilah; Peul, Wilco C; Koes, Bart W; Verhagen, Arianne P
2016-05-01
To test whether the localization of worsening of pain during coughing, sneezing and straining matters in the assessment of lumbosacral nerve root compression or disc herniation on MRI. Recently the diagnostic accuracy of history items to assess disc herniation or nerve root compression on magnetic resonance imaging (MRI) was investigated. A total of 395 adult patients with severe sciatica of 6-12 weeks duration were included in this study. The question regarding the influence of coughing, sneezing and straining on the intensity of pain could be answered on a 4 point scale: no worsening of pain, worsening of back pain, worsening of leg pain, worsening of back and leg pain. Diagnostic odds ratio's (DORs) were calculated for the various dichotomization options. The DOR changed into significant values when the answer option was more narrowed to worsening of leg pain. The highest DOR was observed for the answer option 'worsening of leg pain' with a DOR of 2.28 (95 % CI 1.28-4.04) for the presence of nerve root compression and a DOR of 2.50 (95 % CI 1.27-4.90) for the presence of a herniated disc on MRI. Worsening of leg pain during coughing, sneezing or straining has a significant diagnostic value for the presence of nerve root compression and disc herniation on MRI in patients with sciatica. This study also highlights the importance of the formulation of answer options in history taking.
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The history and progression of treatments for allergic rhinitis.
Ostrom, Nancy K
2014-01-01
This article intends to place new treatments in the context of allergic rhinitis (AR) treatment history. The medical literature was searched for significant advances and changes in AR treatment. Historical data on AR treatment options and management were selected. Reviews of AR management published throughout the 20th century were included to provide context for treatment advances. Modern AR treatment began in the early 20th century with immunotherapy and was soon followed by the emergence of antihistamine therapy in the 1930s. Numerous treatments for AR have been used over the ensuing decades, including decongestants, mast cell stabilizers, and leukotriene receptor antagonists. Topical corticosteroid options were developed the 1950s, and, added to baseline antihistamine therapy, became the foundation of AR treatment. Treatment options were significantly impacted after the 1987 Montreal Protocol, which phased out the use of chlorofluorocarbon propellant aerosols because of environmental concerns. From the mid-1990s until recently, this left only aqueous solution options for intranasal corticosteroids (INSs). The approval of the first hydrofluoroalkane propellant aerosol INSs for AR in 2012 restored a "dry" aerosol treatment option. The first combination intranasal antihistamine/INSs was also approved in 2012, providing a novel treatment option for AR. Treatment of AR has progressed with new therapeutic options now available. This should continue to move forward with agents to alter the allergic mechanism itself and impact the disease burden that has a significant impact on patient outcomes.
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The Elasticity of Preferences.
Simon, Dan; Spiller, Stephen A
2016-12-01
We explore how preferences for attributes are constructed when people choose between multiattribute options. As found in prior research, we observed that while people make decisions, their preferences for the attributes in question shift to support the emerging choice, thus enabling confident decisions. The novelty of the studies reported here is that participants repeated the same task 6 to 8 weeks later. We found that between tasks, preferences returned to near their original levels, only to shift again to support the second choice, regardless of which choice participants made. Similar patterns were observed in a free-choice task (Study 1) and when the favorableness of options was manipulated (Study 2). It follows that preferences behave in an elastic manner: In the absence of situational pressures, they rest at baseline levels, but during the process of reaching a decision, they morph to support the chosen options. This elasticity appears to facilitate confident decision making in the face of decisional conflict.
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Clinically localized prostate cancer in 2017: A review of comparative effectiveness.
Lavery, Hugh J; Cooperberg, Matthew R
2017-02-01
Introducing the topic of comparative effectiveness for prostate cancer treatments with a reminder of the disease's heterogeneity risks tautology. However, the profound variation both in this cancer's biology and its clinical course is increasingly widely recognized, while management alternatives for clinically localized prostate cancer have exploded. Available options now include active surveillance, multiple surgical approaches to prostatectomy, various forms of external-beam and interstitial radiation, and a growing list of energy ablative technologies. Each treatment option has its own efficacy rate as well as its own set of complications, side effects and financial costs. Difficulties comparing these options, together with the high prevalence of the disease, led the Institute of Medicine to include localized prostate cancer among the top 25 priority conditions for future comparative effectiveness research. The sheer volume of possible treatment options, with their individual risks and benefits, can be confusing for patients and clinicians to research, understand and explain. To help clinicians navigate these treatment options, we have assembled this Urologic Oncology Seminar on the comparative effectiveness of treatments for clinically localized prostate cancer. The articles focus on high quality evidence-based medicine and most have included useful tables summarizing seminal trials and available resources. Copyright © 2017 Elsevier Inc. All rights reserved.
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Patel, Maxine X; Sethi, Faisil N; Barnes, Thomas Re; Dix, Roland; Dratcu, Luiz; Fox, Bernard; Garriga, Marina; Haste, Julie C; Kahl, Kai G; Lingford-Hughes, Anne; McAllister-Williams, Hamish; O'Brien, Aileen; Parker, Caroline; Paterson, Brodie; Paton, Carol; Posporelis, Sotiris; Taylor, David M; Vieta, Eduard; Völlm, Birgit; Wilson-Jones, Charlotte; Woods, Laura
2018-06-01
The British Association for Psychopharmacology and the National Association of Psychiatric Intensive Care and Low Secure Units developed this joint evidence-based consensus guideline for the clinical management of acute disturbance. It includes recommendations for clinical practice and an algorithm to guide treatment by healthcare professionals with various options outlined according to their route of administration and category of evidence. Fundamental overarching principles are included and highlight the importance of treating the underlying disorder. There is a focus on three key interventions: de-escalation, pharmacological interventions pre-rapid tranquillisation and rapid tranquillisation (intramuscular and intravenous). Most of the evidence reviewed relates to emergency psychiatric care or acute psychiatric adult inpatient care, although we also sought evidence relevant to other common clinical settings including the general acute hospital and forensic psychiatry. We conclude that the variety of options available for the management of acute disturbance goes beyond the standard choices of lorazepam, haloperidol and promethazine and includes oral-inhaled loxapine, buccal midazolam, as well as a number of oral antipsychotics in addition to parenteral options of intramuscular aripiprazole, intramuscular droperidol and intramuscular olanzapine. Intravenous options, for settings where resuscitation equipment and trained staff are available to manage medical emergencies, are also included.
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-25
... when reporting the sale of securities to the IRS to include the customer's adjusted basis in the sold... sale of a covered security to include in the return the customer's adjusted basis in the security and.... Under the regulations, if a customer exercises a compensation-related option, a broker is permitted, but...
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21 CFR 1.233 - What optional items are included in the registration form?
Code of Federal Regulations, 2010 CFR
2010-04-01
... extracts) and 11b (e.g., grain products, amino acids); (i) Type of storage, if the facility is primarily a... 21 Food and Drugs 1 2010-04-01 2010-04-01 false What optional items are included in the registration form? 1.233 Section 1.233 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND...
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21 CFR 1.233 - What optional items are included in the registration form?
Code of Federal Regulations, 2011 CFR
2011-04-01
... extracts) and 11b (e.g., grain products, amino acids); (i) Type of storage, if the facility is primarily a... 21 Food and Drugs 1 2011-04-01 2011-04-01 false What optional items are included in the registration form? 1.233 Section 1.233 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND...
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Tsulukidze, Maka; Grande, Stuart W; Gionfriddo, Michael R
2015-07-01
To assess the feasibility of Option Grids(®)for facilitating shared decision making (SDM) in simulated clinical consultations and explore clinicians' views on their practicability. We used mixed methods approach to analyze clinical consultations using the Observer OPTION instrument and thematic analysis for follow-up interviews with clinicians. Clinicians achieved high scores on information sharing and low scores on preference elicitation and integration. Four themes were identified: (1) Barriers affect practicability of Option Grids(®); (2) Option Grids(®) facilitate the SDM process; (3) Clinicians are aware of the gaps in their practice of SDM; (4) Training and ongoing feedback on the optimal use of Option Grids(®) are necessary. Use of Option Grids(®) by clinicians with background knowledge in SDM did not facilitate optimal levels of competency on the SDM core concepts of preference elicitation and integration. Future research must evaluate the impact of training on the use of Option Grids(®), and explore how best to help clinicians bridge the gap between knowledge and action. Clinicians proficiently imparting information in simulations struggled to elicit and integrate patient preferences - understanding this gap and developing strategies to close it are the next steps for implementing SDM into clinical practice. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
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A capital idea. Bonds and nontraditional financing options.
Wareham, Therese L
2004-05-01
Not-for-profit healthcare organizations have four basic sources of capital: internal sources, philanthropy, asset sales, and external sources. External sources, in particular, offer a wealth of options that are important for such organizations--especially those facing significant capital shortfalls--to consider. External sources include bond offerings and nontraditional offerings, such as receivables financing, off-balance-sheet options, real estate investment trusts, and subordinated securities.
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A computer program for the design and analysis of low-speed airfoils, supplement
NASA Technical Reports Server (NTRS)
Eppler, R.; Somers, D. M.
1980-01-01
Three new options were incorporated into an existing computer program for the design and analysis of low speed airfoils. These options permit the analysis of airfoils having variable chord (variable geometry), a boundary layer displacement iteration, and the analysis of the effect of single roughness elements. All three options are described in detail and are included in the FORTRAN IV computer program.
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Balancing Work and Family through Flexible Work Options. Monograph. Volume 9, Number 1.
ERIC Educational Resources Information Center
Sachs, Sharon
More than 58 percent of all women working in the U.S. labor force, many of them sole supports of their families, and 67 percent of women with children under age 18 are working. Therefore, more flexible work options are being made to allow a balance of work and family. Increasingly available options include work at home, compressed workweeks,…
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40 CFR 141.715 - Microbial toolbox options for meeting Cryptosporidium treatment requirements.
Code of Federal Regulations, 2013 CFR
2013-07-01
... criteria are in § 141.716(b). Pre Filtration Toolbox Options (3) Presedimentation basin with coagulation 0... separate granular media filtration stage if treatment train includes coagulation prior to first filter...
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40 CFR 141.715 - Microbial toolbox options for meeting Cryptosporidium treatment requirements.
Code of Federal Regulations, 2014 CFR
2014-07-01
... criteria are in § 141.716(b). Pre Filtration Toolbox Options (3) Presedimentation basin with coagulation 0... separate granular media filtration stage if treatment train includes coagulation prior to first filter...
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TECHNOLOGICAL OPTIONS FOR ACID RAIN CONTROL
Discussed are acid rain control options available to the electric utility industry. They include coal switching, flue gas desulfurization, and such emerging lower cost technologies as Limestone Injection Multistage Burners (LIMB) and Advanced Silicate (ADVACATE), both developed ...
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Radiotherapy for Vestibular Schwannomas: A Critical Review
DOE Office of Scientific and Technical Information (OSTI.GOV)
Murphy, Erin S., E-mail: murphye3@ccf.or; Suh, John H.
2011-03-15
Vestibular schwannomas are slow-growing tumors of the myelin-forming cells that cover cranial nerve VIII. The treatment options for patients with vestibular schwannoma include active observation, surgical management, and radiotherapy. However, the optimal treatment choice remains controversial. We have reviewed the available data and summarized the radiotherapeutic options, including single-session stereotactic radiosurgery, fractionated conventional radiotherapy, fractionated stereotactic radiotherapy, and proton beam therapy. The comparisons of the various radiotherapy modalities have been based on single-institution experiences, which have shown excellent tumor control rates of 91-100%. Both stereotactic radiosurgery and fractionated stereotactic radiotherapy have successfully improved cranial nerve V and VII preservation tomore » >95%. The mixed data regarding the ideal hearing preservation therapy, inherent biases in patient selection, and differences in outcome analysis have made the comparison across radiotherapeutic modalities difficult. Early experience using proton therapy for vestibular schwannoma treatment demonstrated local control rates of 84-100% but disappointing hearing preservation rates of 33-42%. Efforts to improve radiotherapy delivery will focus on refined dosimetry with the goal of reducing the dose to the critical structures. As future randomized trials are unlikely, we suggest regimented pre- and post-treatment assessments, including validated evaluations of cranial nerves V, VII, and VIII, and quality of life assessments with long-term prospective follow-up. The results from such trials will enhance the understanding of therapy outcomes and improve our ability to inform patients.« less
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Small Satellite Propulsion Options
NASA Technical Reports Server (NTRS)
Myers, Roger M.; Oleson, Steven R.; Curran, Francis M.; Schneider, Steven J.
1994-01-01
Advanced chemical and low power electric propulsion offer attractive options for small satellite propulsion. Applications include orbit raising, orbit maintenance, attitude control, repositioning, and deorbit of both Earth-space and planetary spacecraft. Potential propulsion technologies for these functions include high pressure Ir/Re bipropellant engines, very low power arcjets, Hall thrusters, and pulsed plasma thrusters, all of which have been shown to operate in manners consistent with currently planned small satellites. Mission analyses show that insertion of advanced propulsion technologies enables and/or greatly enhances many planned small satellite missions. Examples of commercial, DoD, and NASA missions are provided to illustrate the potential benefits of using advanced propulsion options on small satellites.
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Sexual assault reporting procedures at Ohio colleges.
Krivoshey, Mira S; Adkins, Rachel; Hayes, Rebecca; Nemeth, Julianna M; Klein, Elizabeth G
2013-01-01
To assess how Ohio colleges conform to recommendations that address barriers to reporting sexual assault. A study sample of Ohio 4-year colleges (N = 105). College Web sites were examined between March and November 2011 for their availability of sexual assault policies using 8 measures. Of the colleges in the sample, 66% had an online sexual assault policy. Less than 1% of colleges included definitions for applicable sexual offenses in the Ohio Revised Code. All colleges with a policy included on-campus personnel to whom a victim could report. Approximately 25% and 31% of colleges included confidential or 24/7 reporting options, respectively. Many colleges are failing to offer basic reporting options to victims of sexual assault. Having a clearly labeled sexual assault policy on a campus Web site that includes 24/7 reporting options and defines acts of sexual assault can aid victims in the reporting process.
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Single agent vinorelbine in pediatric patients with progressive optic pathway glioma.
Cappellano, Andrea Maria; Petrilli, Antonio Sergio; da Silva, Nasjla Saba; Silva, Frederico Adolfo; Paiva, Priscila Mendes; Cavalheiro, Sergio; Bouffet, Eric
2015-01-01
The management of progressive unresectable low-grade glioma remains controversial. Treatment options have included radiotherapy, and more recently chemotherapy, usually following an initial period of observation. Within this context, we evaluated vinorelbine, a semi-synthetic vinca alkaloid that has shown evidence of activity against glioma. From July 2007 an institutional protocol with vinorelbine (30 mg/m(2) days 0, 8, 22) for a total of 18 cycles, has been conducted at IOP/GRAACC/UNIFESP for children with optic pathway glioma (OPG). The main objectives were clinical and radiological response, as well as toxicity profile. Twenty-three patients with progressive OPG with a mean age of 69 months (4-179) were enrolled. Three patients had a diagnosis of neurofibromatosis type 1. Twenty-two patients were assessable for response with an overall objective response rate of 63 %, with eight patients showing stable disease. The most important toxicity was hematologic (grade III/IV neutropenia) observed in four patients. Gastrointestinal toxicity (grade I/II vomiting) was observed in seven patients and only 1 patient showed grade I peripheral neuropathy. The median progression-free survival (PFS) was 33 months (6.9-69) with a 3 and 5 year PFS of 64 ± 19 and 37 ± 20 %, respectively, for an overall 3 and 5 year-survival of 95 ± 10 %. This study suggests that vinorelbine may be an interesting option for pediatric low-grade gliomas, showing low toxicity profile and providing a good quality of life for patients with such chronic disease.
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NASA Astrophysics Data System (ADS)
Lichtenstein, Yossi; Cucuy, Shy; Fink, Lior
2017-03-01
The effective deployment of enterprise systems has been a major challenge for many organisations. Customising the new system, changing business processes, and integrating multiple information sources are all difficult tasks. As such, they are typically done in carefully planned stages in a process known as phased implementation. Using ideas from Option Theory, this article critiques aspects of phased implementation. One customer relationship management (CRM) project and its phased implementation are described in detail and ten other enterprise system deployments are summarised as a basis for the observation that almost all deployment stages are pre-defined operational steps rather than decision points. However, Option Theory suggests that optional stages, to be used only when risk materialises, should be integral parts of project plans. Although such optional stages are often more valuable than pre-defined stages, the evidence presented in this article shows that they are only rarely utilised. Therefore, a simple framework is presented; it first identifies risks related to the deployment of enterprise systems, then identifies optional stages that can mitigate these risks, and finally compares the costs and benefits of both pre-defined and optional stages.
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Corp, Nadia; Watt, Fiona E.; Felson, David T.; O’Neill, Terence W.; Holt, Cathy A.; Jones, Richard K.; Conaghan, Philip G.; Arden, Nigel K.
2016-01-01
Objective. Treatment of OA by stratifying for commonly used and novel therapies will likely improve the range of effective therapy options and their rational deployment in this undertreated, chronic disease. In order to develop appropriate datasets for conducting post hoc analyses to inform approaches to stratification for OA, our aim was to develop recommendations on the minimum data that should be recorded at baseline in all future OA interventional and observational studies. Methods. An Arthritis Research UK study group comprised of 32 experts used a Delphi-style approach supported by a literature review of systematic reviews to come to a consensus on core data collection for OA studies. Results. Thirty-five systematic reviews were used as the basis for the consensus group discussion. For studies with a primary structural endpoint, core domains for collection were defined as BMI, age, gender, racial origin, comorbidities, baseline OA pain, pain in other joints and occupation. In addition to the items generalizable to all anatomical sites, joint-specific domains included radiographic measures, surgical history and anatomical factors, including alignment. To demonstrate clinical relevance for symptom studies, the collection of mental health score, self-efficacy and depression scales were advised in addition to the above. Conclusions. Currently it is not possible to stratify patients with OA into therapeutic groups. A list of core and optional data to be collected in all OA interventional and observational studies was developed, providing a basis for future analyses to identify predictors of progression or response to treatment. PMID:27084310
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A plant-based diet for overweight and obesity prevention and treatment
Turner-McGrievy, Gabrielle; Mandes, Trisha; Crimarco, Anthony
2017-01-01
The goal of this paper is to review the evidence related to the effect of plant-based dietary patterns on obesity and weight loss, including both observational and intervention trials. Literature from plant-based diets (PBDs) epidemiological and clinical trial research was used to inform this review. In addition, data on dietary quality, adherence, and acceptability were evaluated and are presented. Both clinical trials and observational research indicate an advantage to adoption of PBDs for preventing overweight and obesity and promoting weight loss. PBDs may also confer higher levels of diet quality than are observed with other therapeutic diet approaches, with similar levels of adherence and acceptability. Future studies should utilize health behavior theory to inform intervention development and delivery of PBDs studies and new technologies to bring interventions to scale for greater public health impact. Research examining PBDs and weight loss is also needed with more diverse populations, including older adults. Based on the available evidence, PBDs should be considered a viable option for the treatment and prevention of overweight and obesity. PMID:28630616
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A plant-based diet for overweight and obesity prevention and treatment.
Turner-McGrievy, Gabrielle; Mandes, Trisha; Crimarco, Anthony
2017-05-01
The goal of this paper is to review the evidence related to the effect of plant-based dietary patterns on obesity and weight loss, including both observational and intervention trials. Literature from plant-based diets (PBDs) epidemiological and clinical trial research was used to inform this review. In addition, data on dietary quality, adherence, and acceptability were evaluated and are presented. Both clinical trials and observational research indicate an advantage to adoption of PBDs for preventing overweight and obesity and promoting weight loss. PBDs may also confer higher levels of diet quality than are observed with other therapeutic diet approaches, with similar levels of adherence and acceptability. Future studies should utilize health behavior theory to inform intervention development and delivery of PBDs studies and new technologies to bring interventions to scale for greater public health impact. Research examining PBDs and weight loss is also needed with more diverse populations, including older adults. Based on the available evidence, PBDs should be considered a viable option for the treatment and prevention of overweight and obesity.
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Pimecrolimus 1% cream for anogenital lichen sclerosus in childhood
Boms, Stefanie; Gambichler, Thilo; Freitag, Marcus; Altmeyer, Peter; Kreuter, Alexander
2004-01-01
Background Lichen sclerosus is a chronic inflammatory disease with a predilection of the anogenital region. Because of the potential side effects of repeated local application of potent glucocorticosteroids, equally-effective, safer therapeutic options are required, especially in the treatment of children. Case presentations We report on the efficacy of twice-daily application of pimecrolimus 1% cream in four prepubertal girls (range of age: 4 to 9 years) who suffered from anogenital lichen sclerosus. After three to four-month treatment, all patients had almost complete clinical remission including relief from itch, pain and inflammation. Only minor improvement was observed for the white sclerotic lesions. No significant side effects have been observed. Conclusions Topical pimecrolimus appears to be an effective and safe treatment for children with anogenital lichen sclerosus. The clinical benefits observed in the four patient presented particularly include relief of pruritus, pain and inflammation. Vehicle-controlled studies on a larger number of patients are now warranted to substantiate our promising findings, and to investigate long-term efficacy and safety of topical pimecrolimus in anogenital lichen sclerosus. PMID:15485581
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Rework of the ERA software system: ERA-8
NASA Astrophysics Data System (ADS)
Pavlov, D.; Skripnichenko, V.
2015-08-01
The software system that has been powering many products of the IAA during decades has undergone a major rework. ERA has capabilities for: processing tables of observations of different kinds, fitting parameters to observations, integrating equations of motion of the Solar system bodies. ERA comprises a domain-specific language called SLON, tailored for astronomical tasks. SLON provides a convenient syntax for reductions of observations, choosing of IAU standards to use, applying rules for filtering observations or selecting parameters for fitting. Also, ERA includes a table editor and a graph plotter. ERA-8 has a number of improvements over previous versions such as: integration of the Solar system and TT xA1 TDB with arbitrary number of asteroids; option to use different ephemeris (including DE and INPOP); integrator with 80-bit floating point. The code of ERA-8 has been completely rewritten from Pascal to C (for numerical computations) and Racket (for running SLON programs and managing data). ERA-8 is portable across major operating systems. The format of tables in ERA-8 is based on SQLite. The SPICE format has been chosen as the main format for ephemeris in ERA-8.
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The food environment of youth baseball.
Irby, Megan B; Drury-Brown, Marcie; Skelton, Joseph A
2014-06-01
Sports, such as youth baseball (YB), are popular outlets for increasing activity, yet there has been no investigation of food environments surrounding them. The aim of this study was to observe the types of foods available and consumed by players and spectators at YB events. This was an observational assessment, by environmental scan, of foods consumed by players and family members at a YB field in northwest North Carolina. Participants included boys from six YB teams (n=51) between 8 and 11 years of age and families. A total of 12 YB games were observed. Most team snacks (72%) consisted of high-calorie food items, including French fries, candy, and cookies; most beverages (53%) consumed by players were sugar sweetened. We observed 313 spectators and players, who consumed a total of 249 foods and 276 beverages. Most food and beverage items (89%) were purchased from the concession stand, of which 73% were considered less-healthy options. High-calorie snacks and sugar-sweetened beverages dominate the YB environment. Despite the benefits of participating in sports, families of children participating in sports leagues may be increasing their risk for poor nutritional habits as a result of increased exposure to unhealthy foods and disruption of meal times.
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Tweya, Hannock; Keiser, Olivia; Haas, Andreas D; Tenthani, Lyson; Phiri, Sam; Egger, Matthias; Estill, Janne
2016-03-27
To estimate the cost-effectiveness of prevention of mother-to-child transmission (MTCT) of HIV with lifelong antiretroviral therapy (ART) for pregnant and breastfeeding women ('Option B+') compared with ART during pregnancy or breastfeeding only unless clinically indicated ('Option B'). Mathematical modelling study of first and second pregnancy, informed by data from the Malawi Option B+ programme. Individual-based simulation model. We simulated cohorts of 10 000 women and their infants during two subsequent pregnancies, including the breastfeeding period, with either Option B+ or B. We parameterized the model with data from the literature and by analysing programmatic data. We compared total costs of antenatal and postnatal care, and lifetime costs and disability-adjusted life-years of the infected infants between Option B+ and Option B. During the first pregnancy, 15% of the infants born to HIV-infected mothers acquired the infection. With Option B+, 39% of the women were on ART at the beginning of the second pregnancy, compared with 18% with Option B. For second pregnancies, the rates MTCT were 11.3% with Option B+ and 12.3% with Option B. The incremental cost-effectiveness ratio comparing the two options ranged between about US$ 500 and US$ 1300 per DALY averted. Option B+ prevents more vertical transmissions of HIV than Option B, mainly because more women are already on ART at the beginning of the next pregnancy. Option B+ is a cost-effective strategy for PMTCT if the total future costs and lost lifetime of the infected infants are taken into account.
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Review of Systemic Treatment Options for Adult Atopic Dermatitis.
Gooderham, Melinda; Lynde, Charles W; Papp, Kim; Bourcier, Marc; Guenther, Lyn; Gulliver, Wayne; Hong, Chih-Ho; Poulin, Yves; Sussman, Gordon; Vender, Ronald
Atopic dermatitis (AD) is a chronic, pruritic inflammatory skin disease resulting from defects in skin barrier and aberrant immune responses. AD significantly affects the quality of life. Not all patients respond to topical therapies, and often systemic therapy is required to control the disease. To review the treatment options for adult AD patients including those options for patients who do not respond adequately or have contraindications to oral systemic therapy. A working group of clinicians with experience managing AD was convened to review the current literature on treatment options for adult AD patients. This review is based on the best available evidence from a published systematic review and an additional literature search. Current treatments for AD are reviewed, including options for adult AD patients who do not respond or have contraindications to current systemic therapies. A new approach with targeted therapies is reviewed based on best available evidence. Many AD patients respond satisfactorily to topical or systemic treatments, but for those patients who do not respond or have contraindications, new biologic agents appear to be promising therapies.
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Distinct encoding of risk and value in economic choice between multiple risky options☆
Wright, Nicholas D.; Symmonds, Mkael; Dolan, Raymond J.
2013-01-01
Neural encoding of value-based stimuli is suggested to involve representations of summary statistics, including risk and expected value (EV). A more complex, but ecologically more common, context is when multiple risky options are evaluated together. However, it is unknown whether encoding related to option evaluation in these situations involves similar principles. Here we employed fMRI during a task that parametrically manipulated EV and risk in two simultaneously presented lotteries, both of which contained either gains or losses. We found representations of EV in medial prefrontal cortex and anterior insula, an encoding that was dependent on which option was chosen (i.e. chosen and unchosen EV) and whether the choice was over gains or losses. Parietal activity reflected whether the riskier or surer option was selected, whilst activity in a network of regions that also included parietal cortex reflected both combined risk and difference in risk for the two options. Our findings provide support for the idea that summary statistics underpin a representation of value-based stimuli, and further that these summary statistics undergo distinct forms of encoding. PMID:23684860
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Scope Complexity Options Risks Excursions (SCORE) Factor Mathematical Description.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Gearhart, Jared Lee; Samberson, Jonell Nicole; Shettigar, Subhasini
The purpose of the Scope, Complexity, Options, Risks, Excursions (SCORE) model is to estimate the relative complexity of design variants of future warhead options, resulting in scores. SCORE factors extend this capability by providing estimates of complexity relative to a base system (i.e., all design options are normalized to one weapon system). First, a clearly defined set of scope elements for a warhead option is established. The complexity of each scope element is estimated by Subject Matter Experts (SMEs), including a level of uncertainty, relative to a specific reference system. When determining factors, complexity estimates for a scope element canmore » be directly tied to the base system or chained together via comparable scope elements in a string of reference systems that ends with the base system. The SCORE analysis process is a growing multi-organizational Nuclear Security Enterprise (NSE) effort, under the management of the NA-12 led Enterprise Modeling and Analysis Consortium (EMAC). Historically, it has provided the data elicitation, integration, and computation needed to support the out-year Life Extension Program (LEP) cost estimates included in the Stockpile Stewardship Management Plan (SSMP).« less
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Transportation: Destination Mars
NASA Technical Reports Server (NTRS)
Eoff, Bill
1998-01-01
As the agency space transportation lead center, Marshall Space Flight Center has been conducting transportation assessments for future robotic and human Mars missions to identify critical technologies. Five human Mars options are currently under assessment with each option including all transportation requirements from Earth to Mars and return. The primary difference for each option is the propulsion source from Earth to Mars. In case any of the options require heavy launch capability that is not currently projected as available, an in-house study has been initiated to determine the most cost effective means of providing such launch capability. This assessment is only considering launch architectures that support the overall human Mars mission cost goal of $25B. The guidelines for the launch capability study included delivery of 80 metric ton (176 KLB) payloads, 25 feet diameter x 92 feet long, to 220 nmi orbits at 28.5 degrees. The launch vehicle concept of the study was designated "Magnum" to differentiate from prior heavy launch vehicle assessments. This assessment along with the assessment of options for all transportation phases of a Mars mission are on-going.
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Assessment for advanced fuel cycle options in CANDU
DOE Office of Scientific and Technical Information (OSTI.GOV)
Morreale, A.C.; Luxat, J.C.; Friedlander, Y.
2013-07-01
The possible options for advanced fuel cycles in CANDU reactors including actinide burning options and thorium cycles were explored and are feasible options to increase the efficiency of uranium utilization and help close the fuel cycle. The actinide burning TRUMOX approach uses a mixed oxide fuel of reprocessed transuranic actinides from PWR spent fuel blended with natural uranium in the CANDU-900 reactor. This system reduced actinide content by 35% and decreased natural uranium consumption by 24% over a PWR once through cycle. The thorium cycles evaluated used two CANDU-900 units, a generator and a burner unit along with a drivermore » fuel feedstock. The driver fuels included plutonium reprocessed from PWR, from CANDU and low enriched uranium (LEU). All three cycles were effective options and reduced natural uranium consumption over a PWR once through cycle. The LEU driven system saw the largest reduction with a 94% savings while the plutonium driven cycles achieved 75% savings for PWR and 87% for CANDU. The high neutron economy, online fuelling and flexible compact fuel make the CANDU system an ideal reactor platform for many advanced fuel cycles.« less
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Instance-Based Learning: Integrating Sampling and Repeated Decisions from Experience
ERIC Educational Resources Information Center
Gonzalez, Cleotilde; Dutt, Varun
2011-01-01
In decisions from experience, there are 2 experimental paradigms: sampling and repeated-choice. In the sampling paradigm, participants sample between 2 options as many times as they want (i.e., the stopping point is variable), observe the outcome with no real consequences each time, and finally select 1 of the 2 options that cause them to earn or…
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Education, Poverty, and Development. Bank Staff Working Paper No. 188.
ERIC Educational Resources Information Center
Simmons, John
One purpose of this paper is to suggest appropriate policy options for investment in education. While the discussion of issues and options is based on the research literature, field observations, and interviews, this is not a review of the state of the art. It is an attempt to define and focus the debate on investment choices. Section 1 of the…
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17 CFR 210.4-08 - General notes to financial statements.
Code of Federal Regulations, 2010 CFR
2010-04-01
..., options, and other financial instruments with similar characteristics. (ii) Derivative commodity... futures, commodity forwards, commodity swaps, commodity options, and other commodity instruments with... policies for certain derivative instruments. Disclosures regarding accounting policies shall include...
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RESIDUALS, QUANTITIES, CHARACTERISTICS AND DISPOSAL OPTIONS
Presentation will describe the characteristics and quantitites of residuals generated by the various arsenic removal technologies including adsorptive media, coagulation filtration and iron removal. Information is also presented on the disposal options for the various types of re...
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NASA Technical Reports Server (NTRS)
Miller, R. H.; Minsky, M. L.; Smith, D. B. S.
1982-01-01
Potential applications of automation, robotics, and machine intelligence systems (ARAMIS) to space activities, and to their related ground support functions, in the years 1985-2000, so that NASA may make informed decisions on which aspects of ARAMIS to develop. The study first identifies the specific tasks which will be required by future space projects. It then defines ARAMIS options which are candidates for those space project tasks, and evaluates the relative merits of these options. Finally, the study identifies promising applications of ARAMIS, and recommends specific areas for further research. The ARAMIS options defined and researched by the study group span the range from fully human to fully machine, including a number of intermediate options (e.g., humans assisted by computers, and various levels of teleoperation). By including this spectrum, the study searches for the optimum mix of humans and machines for space project tasks.
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Low acid producing solid propellants
NASA Technical Reports Server (NTRS)
Bennett, Robert R.
1995-01-01
The potential environmental effects of the exhaust products of conventional rocket propellants have been assessed by various groups. Areas of concern have included stratospheric ozone, acid rain, toxicity, air quality and global warming. Some of the studies which have been performed on this subject have concluded that while the impacts of rocket use are extremely small, there are propellant development options which have the potential to reduce those impacts even further. This paper discusses the various solid propellant options which have been proposed as being more environmentally benign than current systems by reducing HCI emissions. These options include acid neutralized, acid scavenged, and nonchlorine propellants. An assessment of the acid reducing potential and the viability of each of these options is made, based on current information. Such an assessment is needed in order to judge whether the potential improvements justify the expenditures of developing the new propellant systems.
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Strategies for achieving global collective action on antimicrobial resistance
Caleo, Grazia M; Daulaire, Nils; Elbe, Stefan; Matsoso, Precious; Mossialos, Elias; Rizvi, Zain; Røttingen, John-Arne
2015-01-01
Abstract Global governance and market failures mean that it is not possible to ensure access to antimicrobial medicines of sustainable effectiveness. Many people work to overcome these failures, but their institutions and initiatives are insufficiently coordinated, led and financed. Options for promoting global collective action on antimicrobial access and effectiveness include building institutions, crafting incentives and mobilizing interests. No single option is sufficient to tackle all the challenges associated with antimicrobial resistance. Promising institutional options include monitored milestones and an inter-agency task force. A global pooled fund could be used to craft incentives and a special representative nominated as an interest mobilizer. There are three policy components to the problem of antimicrobials – ensuring access, conservation and innovation. To address all three components, the right mix of options needs to be matched with an effective forum and may need to be supported by an international legal framework. PMID:26668439
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Calcific tendinitis of the rotator cuff: management options.
Suzuki, Kentaro; Potts, Aaron; Anakwenze, Oke; Singh, Anshu
2014-11-01
Calcific tendinitis of the rotator cuff tendons is a common cause of shoulder pain in adults and typically presents as activity-related shoulder pain. It is thought to be an active, cell-mediated process, although the exact pathophysiology remains unclear. Nonsurgical management continues to be the mainstay of treatment; most patients improve with modalities such as oral anti-inflammatory medication, physical therapy, and corticosteroid injections. Several options are available for patients who fail nonsurgical treatment, including extracorporeal shock wave therapy, ultrasound-guided needle lavage, and surgical débridement. These modalities alleviate pain by eliminating the calcific deposit, and several recent studies have demonstrated success with the use of these treatment options. Surgical management options include arthroscopic procedures to remove calcific deposits and subacromial decompression; however, the role of subacromial decompression and repair of rotator cuff defects created by removing these deposits remains controversial. Copyright 2014 by the American Academy of Orthopaedic Surgeons.
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Options for change in the NHS consultant contract.
Clarke, R W; Gray, C
The lead negotiators for the management and consultant sides in an NHS trust in northern England responded to debate in their trust about consultant contracts by offering to research the attitudes of their peers towards a variety of contract options. The options tested included the current contract; models already examined in the trust and elsewhere, such as time sensitive and mild performance related contracts; and some more radical and speculative possibilities, including consultants franchising their services to the trust. Beyond the predictable conclusion that consultants would prefer no change while managers desired it, a time sensitive contract emerged as having potential for successful negotiation. On the other hand, neither consultants nor managers favoured a strict performance related contract or a fee for service contract. There was a strong similarity of opinion between the two groups on the relative salary values of the options, though the consultants consistently priced these higher than the managers.
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Options for change in the NHS consultant contract.
Clarke, R. W.; Gray, C.
1994-01-01
The lead negotiators for the management and consultant sides in an NHS trust in northern England responded to debate in their trust about consultant contracts by offering to research the attitudes of their peers towards a variety of contract options. The options tested included the current contract; models already examined in the trust and elsewhere, such as time sensitive and mild performance related contracts; and some more radical and speculative possibilities, including consultants franchising their services to the trust. Beyond the predictable conclusion that consultants would prefer no change while managers desired it, a time sensitive contract emerged as having potential for successful negotiation. On the other hand, neither consultants nor managers favoured a strict performance related contract or a fee for service contract. There was a strong similarity of opinion between the two groups on the relative salary values of the options, though the consultants consistently priced these higher than the managers. PMID:8086915
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Pricing American Asian options with higher moments in the underlying distribution
NASA Astrophysics Data System (ADS)
Lo, Keng-Hsin; Wang, Kehluh; Hsu, Ming-Feng
2009-01-01
We develop a modified Edgeworth binomial model with higher moment consideration for pricing American Asian options. With lognormal underlying distribution for benchmark comparison, our algorithm is as precise as that of Chalasani et al. [P. Chalasani, S. Jha, F. Egriboyun, A. Varikooty, A refined binomial lattice for pricing American Asian options, Rev. Derivatives Res. 3 (1) (1999) 85-105] if the number of the time steps increases. If the underlying distribution displays negative skewness and leptokurtosis as often observed for stock index returns, our estimates can work better than those in Chalasani et al. [P. Chalasani, S. Jha, F. Egriboyun, A. Varikooty, A refined binomial lattice for pricing American Asian options, Rev. Derivatives Res. 3 (1) (1999) 85-105] and are very similar to the benchmarks in Hull and White [J. Hull, A. White, Efficient procedures for valuing European and American path-dependent options, J. Derivatives 1 (Fall) (1993) 21-31]. The numerical analysis shows that our modified Edgeworth binomial model can value American Asian options with greater accuracy and speed given higher moments in their underlying distribution.
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ERIC Educational Resources Information Center
McKinney, Stephen J.; Hill, Robert J.
2010-01-01
Catholic schools are called to model themselves on gospel values including the exercise of a preferential option for the poor. This article seeks to recover the true sense of preferential option for the poor from the gospel of Luke and apply it to the state-funded Catholic schools in Scotland, which were historically established to serve the poor…
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Treatment options for Primary CNS Lymphoma.
Laghari, Altaf Ali; Ahmed, Syed Ijlal; Jabbar, Adnan; Shamim, Muhammad Shahzad
2018-03-01
Primary CNS lymphoma (PCNSL) is a rare and aggressive brain tumour that is uniformly fatal. The rarity of the disease and the poor response to treatment makes it difficult to reach a consensus with regards to treatment options. In this review, the authors have discussed different treatment modalities used in the management of PCNSL including chemotherapy, surgery and radiation, as well as the results of recent clinical trials on treatment options for PCNSL.
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Treatment options for demodex blepharitis: patient choice and efficacy.
Hirsch-Hoffmann, S; Kaufmann, C; Bänninger, P B; Thiel, M A
2015-04-01
Demodex mites are microscopic parasites that live around hair follicles or sebaceous glands and may cause chronic blepharitis. The aim of this outcome analysis was to assess the efficacy and patient preferences with regard to the currently recommended treatment options. All patients with microscopic evidence for Demodex blepharitis were informed about the currently published treatments and instructed about daily lid hygiene. Additional topical treatment options included tea tree oil (TTO) 5%, a cleansing foam containing 0.02% TTO (Naviblef®), and metronidazole 2% ointment. Systemic treatment options included oral ivermectin 6 mg on day 1 and 14 and metronidazole 500 mg twice daily for 10 days. All patients were reviewed after 2 months for symptoms and for a mite count on 10 epilated lashes. Ninety-four of 96 patients with Demodex blepharitis opted for an additional treatment. The mean mite count after 2 months of treatment were 13.3 with 5% TTO (n=6), 12.0 with 0.02% TTO (n=38), 9.4 with metronidazole ointment (n=5), 12.8 with ivermectin (n=27) and 22.0 with oral metronidazole (n=5). While there are several published treatment options available, none of these options seem to be clearly effective in Demodex blepharitis. Georg Thieme Verlag KG Stuttgart · New York.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1977-11-01
Ford, Bacon and Davis Utah Inc. has performed an engineering assessment of the problems resulting from the existence of radioactive uranium mill tailings at Durango, Colorado. The Phase II, Title I services include the preparation of topographic maps, the performance of core drillings and radiometric measurements sufficient to determine areas and volumes of tailings and other radium-contaminated materials, the evaluation of resulting radiation exposures of individuals and nearby populations, the investigation of site hydrology and meteorology and the evaluation and costing of alternative corrective actions. Radon gas release from the 1.555 million tons of tailings at the Durango site constitutesmore » the most significant environmental impact, although windblown tailings and external gamma radiation are also factors. The eight alternative actions presented range from vegetative stabilization (Option I), to contouring and stabilizing in-place with varying depths of cover material (Options II and III), to removal to an isolated long-term disposal site (Options V to VIII). All options include remedial action costs for offsite locations where tailings have been placed. Costs estimated for the eight options range from $4,340,000 to $13,590,000. Reprocessing the tailings for uranium is sufficiently economically attractive to justify reprocessing in conjunction with each of the options.« less
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1977-11-01
Ford, Bacon and Davis Utah Inc. has performed an engineering assessment of the problems resulting from the existence of radioactive uranium mill tailings at Durango, Colorado. The Phase II, Title I services include the preparation of topographic maps, the performance of core drillings and radiometric measurements sufficient to determine areas and volumes of tailings and other radium-contaminated materials, the evaluation of resulting radiation exposures of individuals and nearby populations, the investigation of site hydrology and meteorology and the evaluation and costing of alternative corrective actions. Radon gas release from the 1.555 million tons of tailings at the Durango site constitutesmore » the most significant environmental impact, although windblown tailings and external gamma radiation are also factors. The eight alternative actions presented range from vegetative stabilization (Option I), to contouring and stabilizing in-place with varying depths of cover material (Options II and III), to removal to an isolated long-term disposal site (Options V to VIII). All options include remedial action costs for offsite locations where tailings have been placed. Costs estimated for the eight options range from $4,340,000 to $13,590,000. Reprocessing the tailings for uranium is sufficiently economically attractive to justify reprocessing in conjunction with each of the options.« less
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Military Space Doctrine: the Great Frontier.
1981-04-03
Hall 0745 Conference Registration Fairchild Hall H-1 (Continental breakfast served in conference area included in registration fee 0810 Movie : (optional...roundtable sign-ups 1200 Cadet Lunch Formation Review Eagle and Fledglings 1220 Lunch with Cadet Wing Mitchell Hall (cost collected at registration...Continental breakfast at conference area (included in the registration fee) 0755 Movie : (optional) Space - The New Ocean Fairchild Hall H-i 0800 Opening
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Squeezing the funding you need from today's capital sources.
Gordon, Deborah C
2010-04-01
Healthcare providers need to understand traditional and nontraditional financing options and other potential strategies for accessing capital. Common financing options include bonds, commercial lending, acquisition financing, and financing through the Department of Housing and Urban Development's Section 232 program. Alternative strategies for accessing capital include joint ventures, equity, sale of assets, fund-raising, capital leases, internal capital, public grants, and grants from foundations.
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Voysey, Merryn; Tavana, Rahele; Farooq, Yama; Heath, Paul T; Bonhoeffer, Jan; Snape, Matthew D
2015-12-16
Serious adverse events (SAEs) in clinical trials require reporting within 24h, including a judgment of whether the SAE was related to the investigational product(s). Such assessments are an important component of pharmacovigilance, however classification systems for assigning relatedness vary across study protocols. This on-line survey evaluated the consistency of SAE causality assessment among professionals with vaccine clinical trial experience. Members of the clinical advisory forum of experts (CAFÉ), a Brighton Collaboration online-forum, were emailed a survey containing SAEs from hypothetical vaccine trials which they were asked to classify. Participants were randomised to either two classification options (related/not related to study immunisation) or three options (possibly/probably/unrelated). The clinical scenarios, were (i) leukaemia diagnosed 5 months post-immunisation with a live RSV vaccine, (ii) juvenile idiopathic arthritis (JIA) 3 months post-immunisation with a group A streptococcal vaccine, (iii) developmental delay diagnosed at age 10 months after infant capsular group B meningococcal vaccine, (iv) developmental delay diagnosed at age 10 months after maternal immunisation with a group B streptococcal vaccine. There were 140 respondents (72 two options, 68 three options). Across all respondents, SAEs were considered related to study immunisation by 28% (leukaemia), 74% (JIA), 29% (developmental delay after infant immunisation) and 42% (developmental delay after maternal immunisation). Having only two options made respondents significantly less likely to classify the SAE as immunisation-related for two scenarios (JIA p=0.0075; and maternal immunisation p=0.045). Amongst study investigators (n=43) this phenomenon was observed for three of the four scenarios: (JIA p=0.0236; developmental delay following infant immunisation p=0.0266; and developmental delay after maternal immunisation p=0.0495). SAE causality assessment is inconsistent amongst study investigators and can be influenced by the classification systems available to them. There is a pressing need for SAE classification systems to be standardised across study protocols. Copyright © 2015 Elsevier Ltd. All rights reserved.
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NASA Astrophysics Data System (ADS)
Dhanya, M.; Chandrasekar, A.
2016-02-01
The background error covariance structure influences a variational data assimilation system immensely. The simulation of a weather phenomenon like monsoon depression can hence be influenced by the background correlation information used in the analysis formulation. The Weather Research and Forecasting Model Data assimilation (WRFDA) system includes an option for formulating multivariate background correlations for its three-dimensional variational (3DVar) system (cv6 option). The impact of using such a formulation in the simulation of three monsoon depressions over India is investigated in this study. Analysis and forecast fields generated using this option are compared with those obtained using the default formulation for regional background error correlations (cv5) in WRFDA and with a base run without any assimilation. The model rainfall forecasts are compared with rainfall observations from the Tropical Rainfall Measurement Mission (TRMM) and the other model forecast fields are compared with a high-resolution analysis as well as with European Centre for Medium-Range Weather Forecasts (ECMWF) ERA-Interim reanalysis. The results of the study indicate that inclusion of additional correlation information in background error statistics has a moderate impact on the vertical profiles of relative humidity, moisture convergence, horizontal divergence and the temperature structure at the depression centre at the analysis time of the cv5/cv6 sensitivity experiments. Moderate improvements are seen in two of the three depressions investigated in this study. An improved thermodynamic and moisture structure at the initial time is expected to provide for improved rainfall simulation. The results of the study indicate that the skill scores of accumulated rainfall are somewhat better for the cv6 option as compared to the cv5 option for at least two of the three depression cases studied, especially at the higher threshold levels. Considering the importance of utilising improved flow-dependent correlation structures for efficient data assimilation, the need for more studies on the impact of background error covariances is obvious.
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-26
... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration Proposed Information Collection; Comment Request; Observer Programs' Information that Can Be Gathered Only Through Questions... options; and (5) ensure that the observer programs can safely and efficiently collect the information...
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Addition of flexible body option to the TOLA computer program, part 1
NASA Technical Reports Server (NTRS)
Dick, J. W.; Benda, B. J.
1975-01-01
This report describes a flexible body option that was developed and added to the Takeoff and Landing Analysis (TOLA) computer program. The addition of the flexible body option to TOLA allows it to be used to study essentially any conventional type airplane in the ground operating environment. It provides the capability to predict the total motion of selected points on the analytical methods incorporated in the program and operating instructions for the option are described. A program listing is included along with several example problems to aid in interpretation of the operating instructions and to illustrate program usage.
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SEATSAT programs option analysis
NASA Technical Reports Server (NTRS)
Luckl, L.
1976-01-01
A preliminary analysis of the costs of SEASAT follow-on options is presented. All the options assume the existence of SEASAT-A as currently defined in the SEASAT Economic Assessment. It is assumed that each option will continue through the year 2000 and approach operational system status in the 1983-1986 period, depending upon the sensor package selected. The launch vehicle assumed through 1983 is the Atlas Agena. After 1983, it is assumed SEASAT-A will switch to the use of the Space Shuttle. All cost estimates are 1976 dollars for fiscal year cost accounting, with no inflation rate included.
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-06-25
... banks and savings associations with different options for measuring the credit exposures of derivative... additional option for measuring credit exposure of derivative transactions. The CEM is used under the Federal... credit'' to include certain credit exposures arising from derivative transactions, repurchase agreements...
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43 CFR 3137.50 - What optional terms may I include in a unit agreement?
Code of Federal Regulations, 2012 CFR
2012-10-01
... following optional terms for a unit agreement if they promote additional development or enhanced production... modification; or (d) Other terms that BLM determines will promote the greatest economic recovery of oil and gas...
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43 CFR 3137.50 - What optional terms may I include in a unit agreement?
Code of Federal Regulations, 2013 CFR
2013-10-01
... following optional terms for a unit agreement if they promote additional development or enhanced production... modification; or (d) Other terms that BLM determines will promote the greatest economic recovery of oil and gas...
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Frankenfeld, Cara L; Leslie, Timothy F; Makara, Matthew A
2015-05-14
Social and spatial factors are an important part of individual and community health. The objectives were to identify food establishment sub-types and evaluate prevalence of diabetes, obesity, and recommended fruit and vegetable consumption in relation to these sub-types in the Washington DC metropolitan area. A cross-sectional study design was used. A measure of retail food environment was calculated as the ratio of number of sources of unhealthier food options (fast food, convenience stores, and pharmacies) to healthier food options (grocery stores and specialty food stores). Two categories were created: ≤ 1.0 (healthier options) and > 1.0 (unhealthier options). k-means clustering was used to identify clusters based on proportions of grocery stores, restaurants, specialty food, fast food, convenience stores, and pharmacies. Prevalence data for county-level diabetes, obesity, and consumption of five or more fruits or vegetables per day (FV5) was obtained from the Behavioral Risk Factor Surveillance System. Multiple imputation was used to predict block-group level health outcomes with US Census demographic and economic variables as the inputs. The healthier options category clustered into three sub-types: 1) specialty food, 2) grocery stores, and 3) restaurants. The unhealthier options category clustered into two sub-types: 1) convenience stores, and 2) restaurants and fast food. Within the healthier options category, diabetes prevalence in the sub-types with high restaurants (5.9 %, p = 0.002) and high specialty food (6.1 %, p = 0.002) was lower than the grocery stores sub-type (7.1 %). The high restaurants sub-type compared to the high grocery stores sub-type had significantly lower obesity prevalence (28.6 % vs. 31.2 %, p < 0.001) and higher FV5 prevalence (25.2 % vs. 23.1 %, p < 0.001). Within the larger unhealthier options category, there were no significant differences in diabetes, obesity, or higher FV5 prevalence across the two sub-types. However, restaurants (including fast food) sub-type was significantly associated with lower diabetes and obesity, and higher FV prevalence compared to grocery store sub-type. These results suggest that there are sub-types within larger categories of food environments that are differentially associated with adverse health outcomes. These observations support the specific food establishment composition of an area may be an important component of the food establishment-health relationship.
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Graft-Sparing Strategy for Thoracic Prosthetic Graft Infection.
Uchino, Gaku; Yoshida, Takeshi; Kakii, Bunpachi; Furui, Masato
2018-04-01
Thoracic prosthetic graft infection is a rare but serious complication with no standard management. We reported our surgical experience on graft-sparing strategy for thoracic prosthetic graft infection. This study included patients who underwent graft-sparing surgery for thoracic prosthetic graft infection at Matsubara Tokushukai Hospital in Japan from January 2000 to October 2017. There were 17 patients included in the analyses, with a mean age at surgery of 71.0 ± 10.5 years; 11 were men. In-hospital mortality was observed in five patients (29.4%). Graft-sparing surgery for thoracic prosthetic graft infection is an alternative option particularly for early graft infection after hemiarch replacement. Georg Thieme Verlag KG Stuttgart · New York.
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Scope Complexity Options Risks Excursions (SCORE) Version 3.0 Mathematical Description.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Gearhart, Jared Lee; Samberson, Jonell Nicole; Shettigar, Subhasini
The purpose of the Scope, Complexity, Options, Risks, Excursions (SCORE) model is to estimate the relative complexity of design variants of future warhead options. The results of this model allow those considering these options to understand the complexity tradeoffs between proposed warhead options. The core idea of SCORE is to divide a warhead option into a well- defined set of scope elements and then estimate the complexity of each scope element against a well understood reference system. The uncertainty associated with estimates can also be captured. A weighted summation of the relative complexity of each scope element is used tomore » determine the total complexity of the proposed warhead option or portions of the warhead option (i.e., a National Work Breakdown Structure code). The SCORE analysis process is a growing multi-organizational Nuclear Security Enterprise (NSE) effort, under the management of the NA- 12 led Enterprise Modeling and Analysis Consortium (EMAC), that has provided the data elicitation, integration and computation needed to support the out-year Life Extension Program (LEP) cost estimates included in the Stockpile Stewardship Management Plan (SSMP).« less
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2011-01-01
Background The increasing popularity and use of the internet makes it an attractive option for providing health information and treatment, including alcohol/other drug use. There is limited research examining how people identify and access information about alcohol or other drug (AOD) use online, or how they assess the usefulness of the information presented. This study examined the strategies that individuals used to identify and navigate a range of AOD websites, along with the attitudes concerning presentation and content. Methods Members of the general community in Brisbane and Roma (Queensland, Australia) were invited to participate in a 30-minute search of the internet for sites related to AOD use, followed by a focus group discussion. Fifty one subjects participated in the study across nine focus groups. Results Participants spent a maximum of 6.5 minutes on any one website, and less if the user was under 25 years of age. Time spent was as little as 2 minutes if the website was not the first accessed. Participants recommended that AOD-related websites should have an engaging home or index page, which quickly and accurately portrayed the site's objectives, and provided clear site navigation options. Website content should clearly match the title and description of the site that is used by internet search engines. Participants supported the development of a portal for AOD websites, suggesting that it would greatly facilitate access and navigation. Treatment programs delivered online were initially viewed with caution. This appeared to be due to limited understanding of what constituted online treatment, including its potential efficacy. Conclusions A range of recommendations arise from this study regarding the design and development of websites, particularly those related to AOD use. These include prudent use of text and information on any one webpage, the use of graphics and colours, and clear, uncluttered navigation options. Implications for future website development are discussed. PMID:21545748
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The option value of innovative treatments in the context of chronic myeloid leukemia.
Sanchez, Yuri; Penrod, John R; Qiu, Xiaoli Lily; Romley, John; Thornton Snider, Julia; Philipson, Tomas
2012-11-01
To quantify in the context of chronic myeloid leukemia (CML) the additional value patients receive when innovative treatments enable them to survive until the advent of even more effective future treatments (ie, the "option value"). Observational study using data from the Surveillance, Epidemiology and End Results (SEER) cancer registry comprising all US patients with CML diagnosed between 2000 and 2008 (N = 9,760). We quantified the option value of recent breakthroughs in CML treatment by first conducting retrospective survival analyses on SEER data to assess the effectiveness of TKI treatments, and then forecasting survival from CML and other causes to measure expected future medical progress. We then developed an analytical framework to calculate option value of innovative CML therapies, and used an economic model to value these gains. We calculated the option value created both by future innovations in CML treatment and by medical progress in reducing background mortality. For a recently diagnosed CML patient, the option value of innovative therapies from future medical innovation amounts to 0.76 life-years. This option value is worth $63,000, equivalent to 9% of the average survival gains from existing treatments. Future innovations in CML treatment jointly account for 96% of this benefit. The option value of innovative treatments has significance in the context of CML and, more broadly, in disease areas with rapid innovation. Incorporating option value into traditional valuations of medical innovations is both a feasible and a necessary practice in health technology assessment.
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A Range-Normalization Model of Context-Dependent Choice: A New Model and Evidence
Camerer, Colin
2012-01-01
Most utility theories of choice assume that the introduction of an irrelevant option (called the decoy) to a choice set does not change the preference between existing options. On the contrary, a wealth of behavioral data demonstrates the dependence of preference on the decoy and on the context in which the options are presented. Nevertheless, neural mechanisms underlying context-dependent preference are poorly understood. In order to shed light on these mechanisms, we design and perform a novel experiment to measure within-subject decoy effects. We find within-subject decoy effects similar to what have been shown previously with between-subject designs. More importantly, we find that not only are the decoy effects correlated, pointing to similar underlying mechanisms, but also these effects increase with the distance of the decoy from the original options. To explain these observations, we construct a plausible neuronal model that can account for decoy effects based on the trial-by-trial adjustment of neural representations to the set of available options. This adjustment mechanism, which we call range normalization, occurs when the nervous system is required to represent different stimuli distinguishably, while being limited to using bounded neural activity. The proposed model captures our experimental observations and makes new predictions about the influence of the choice set size on the decoy effects, which are in contrast to previous models of context-dependent choice preference. Critically, unlike previous psychological models, the computational resource required by our range-normalization model does not increase exponentially as the set size increases. Our results show that context-dependent choice behavior, which is commonly perceived as an irrational response to the presence of irrelevant options, could be a natural consequence of the biophysical limits of neural representation in the brain. PMID:22829761
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Therapeutic options for intractable hematuria in advanced bladder cancer.
Abt, Dominik; Bywater, Mirjam; Engeler, Daniel Stephan; Schmid, Hans-Peter
2013-07-01
Intractable hematuria is a common and severe complication in patients with inoperable bladder carcinoma. The aim was to provide an overview of therapeutic options for such cases, and analyze their effectiveness and risk profile, so a systematic literature search of peer-reviewed papers published up to September 2012 was carried out. Various options are available to treat hematuria in patients with inoperable bladder cancer; these include orally administered epsilon-aminocaproic acid, intravesical formalin, alum or prostaglandin irrigation, hydrostatic pressure, urinary diversion, radiotherapy, embolization and intraarterial mitoxantrone perfusion. These treatment options are associated with different prospects of success, risks and side-effects. Well-designed and large studies comparing options are completely lacking. Despite various treatment options, management of intractable hematuria in patients with inoperable bladder cancer remains a challenge, and most of the reported methods should be seen as experimental. Interventional radiology and alum instillation seem to be suitable alternative options for patients who, after critical consideration, cannot be treated by irrigation, transurethral resection or palliative cystectomy. © 2013 The Japanese Urological Association.
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Patient and Clinician Openness to Including a Broader Range of Healing Options in Primary Care
Hsu, Clarissa; Cherkin, Daniel C.; Hoffmeyer, Sylvia; Sherman, Karen J.; Phillips, William R.
2011-01-01
PURPOSE We studied the openness of patients and clinicians to introducing a broader range of healing options into primary care. METHODS Focus groups were conducted with primary care patients (4 groups) and clinicians (3 groups) from an integrated medical care system in 2008. Transcripts of discussions were analyzed using an immersion/crystallization approach. RESULTS Both patients (n = 44) and clinicians (n = 32) were open to including a wider variety of healing options in primary care. Patients desired some evidence of effectiveness, although there was wide variation in the type of evidence required. Many patients believed that the clinician’s personal and practice experience was an important form of evidence. Patients wanted to share in the decision to refer and the choice of options. Clinicians were most concerned with safety of specific treatments, including some of the herbs and dietary supplements. They also believed they lacked adequate information about the nature, benefits, and risks of many alternatives, and they were not aware of local practitioners and resources to whom they could confidently refer their patients. Both patients and clinicians were concerned that services recommended be covered by insurance or be affordable to patients. CONCLUSIONS Integrating additional healing options into primary care may be feasible and desirable, as well as help meet the needs of patients with conditions that have not been responsive to standard medical treatments. PMID:21911764
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Many-objective optimization and visual analytics reveal key trade-offs for London's water supply
NASA Astrophysics Data System (ADS)
Matrosov, Evgenii S.; Huskova, Ivana; Kasprzyk, Joseph R.; Harou, Julien J.; Lambert, Chris; Reed, Patrick M.
2015-12-01
In this study, we link a water resource management simulator to multi-objective search to reveal the key trade-offs inherent in planning a real-world water resource system. We consider new supplies and demand management (conservation) options while seeking to elucidate the trade-offs between the best portfolios of schemes to satisfy projected water demands. Alternative system designs are evaluated using performance measures that minimize capital and operating costs and energy use while maximizing resilience, engineering and environmental metrics, subject to supply reliability constraints. Our analysis shows many-objective evolutionary optimization coupled with state-of-the art visual analytics can help planners discover more diverse water supply system designs and better understand their inherent trade-offs. The approach is used to explore future water supply options for the Thames water resource system (including London's water supply). New supply options include a new reservoir, water transfers, artificial recharge, wastewater reuse and brackish groundwater desalination. Demand management options include leakage reduction, compulsory metering and seasonal tariffs. The Thames system's Pareto approximate portfolios cluster into distinct groups of water supply options; for example implementing a pipe refurbishment program leads to higher capital costs but greater reliability. This study highlights that traditional least-cost reliability constrained design of water supply systems masks asset combinations whose benefits only become apparent when more planning objectives are considered.
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Golparian, Daniel; Fernandes, Prabhavathi; Ohnishi, Makoto; Jensen, Jörgen S.
2012-01-01
Gonorrhea may become untreatable, and new treatment options are essential. We investigated the in vitro activity of the first fluoroketolide, solithromycin. Clinical Neisseria gonorrhoeae isolates and reference strains (n = 246), including the two extensively drug-resistant strains H041 and F89 and additional isolates with clinical cephalosporin resistance and multidrug resistance, were examined. The activity of solithromycin was mainly superior to that of other antimicrobials (n = 10) currently or previously recommended for gonorrhea treatment. Solithromycin might be an effective treatment option for gonorrhea. PMID:22354296
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Byrnett, D. S.; Mulholland, D.; Zinsmeister, E.
One renewable energy option that states frequently consider to meet their clean energy goals is the use of biomass resources to develop bioenergy. Bioenergy includes bioheat, biopower, biofuels, and bioproducts. This document provides an overview of biomass feedstocks, basic information about biomass conversion technologies, and a discussion of benefits and challenges of bioenergy options. The Primer includes a step-wise framework, resources, and tools for determining the availability of feedstocks, assessing potential markets for biomass, and identifying opportunities for action at the state level. Each chapter contains a list of selected resources and tools that states can use to explore topicsmore » in further detail.« less
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What are the determinants of food security among regional and remote Western Australian children?
Godrich, Stephanie L; Davies, Christina R; Darby, Jill; Devine, Amanda
2017-01-22
To explore how determinants of food security affect children in regional and remote Western Australia (WA), across food availability, access and utilisation dimensions. The Determinants of Food Security framework guided the thematic analysis (using NVivo 10) of semi-structured interviews with 20 key informants. Food availability factors included availability, price, promotion, quality, location of outlets and variety. Food access factors included social support, financial resources, transport to food outlets, distance to food outlets and mobility. Food utilisation factors included nutrition knowledge and skills, children's food preferences, storage facilities, preparation and cooking facilities and time to purchase food. Key food availability recommendations include increasing local food supply options. Food access recommendations include ensuring equitable formal social support and empowering informal support options. Food utilisation recommendations include prioritising food literacy programs focusing on quick, healthy food preparation and budgeting skills. Implications for public health: Policymakers should invest in local food supply options, equitable social support services and experiential food literacy programs. Practitioners should focus child/parent programs on improving attitude, knowledge and skills. © 2017 Public Health Association of Australia.
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Tweya, Hannock; Keiser, Olivia; Haas, Andreas D.; Tenthani, Lyson; Phiri, Sam; Egger, Matthias; Estill, Janne
2016-01-01
Objective To estimate the cost-effectiveness of prevention of mother to child transmission (MTCT) of HIV with lifelong antiretroviral therapy (ART) for pregnant and breastfeeding women (‘Option B+’) compared to ART during pregnancy or breastfeeding only unless clinically indicated (‘Option B’). Design Mathematical modelling study of first and second pregnancy, informed by data from the Malawi Option B+ programme. Methods Individual-based simulation model. We simulated cohorts of 10,000 women and their infants during two subsequent pregnancies, including the breastfeeding period, with either Option B+ or B. We parameterised the model with data from the literature and by analysing programmatic data. We compared total costs of ante-natal and post-natal care, and lifetime costs and disability-adjusted life-years (DALYs) of the infected infants between Option B+ and Option B. Results During the first pregnancy, 15% of the infants born to HIV-infected mothers acquired the infection. With Option B+, 39% of the women were on ART at the beginning of the second pregnancy, compared to 18% with Option B. For second pregnancies, the rates MTCT were 11.3% with Option B+ and 12.3% with Option B. The incremental cost-effectiveness ratio comparing the two options ranged between about US$ 500 and US$ 1300 per DALY averted. Conclusion Option B+ prevents more vertical transmissions of HIV than Option B, mainly because more women are already on ART at the beginning of the next pregnancy. Option B+ is a cost-effective strategy for PMTCT if the total future costs and lost lifetime of the infected infants are taken into account. PMID:26691682
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Schneider, Helgard; Koch, Michael; Künzel, Julian; Gillespie, M Boyd; Grundtner, Philipp; Iro, Heinrich; Zenk, Johannes
2014-02-01
There are several therapeutic approaches to treat juvenile recurrent parotitis. The aim of this study was to compare sialendoscopy, including prophylactic cortisone irrigation, with observation and a conservative approach of antibiotic therapy alone. Retrospective study, tertiary clinical center. The charts of patients treated for juvenile recurrent parotitis between November 2004 and June 2011 were reviewed. Initial acute flares were always treated with a course of antibiotics. Subsequent treatment consisted of either salivary gland endoscopy including cortisone irrigation or additional pure antibiotic therapy. Patients treated with salivary endoscopy were compared to patients treated with antibiotics alone with regard to the number of inflammatory episodes and pain intensity pre- and posttreatment. Thirty-six patients were treated during the period of study, 15 with salivary endoscopy with cortisone irrigation and 21 with antibiotic therapy alone. A significant reduction in recurrent episodes and pain intensity following therapy was found in both groups. With respect to these two outcomes, the comparison showed two therapeutic options of equal merit. Salivary gland endoscopy is an option in the management of juvenile recurrent parotitis that helps in confirming the diagnosis and that also provides therapeutic intervention. However, although there are further advantages, the definitive value of salivary gland endoscopy requires ongoing evaluation in further prospective studies. 4. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.
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Petroleum coke adsorption as a water management option for oil sands process-affected water.
Zubot, Warren; MacKinnon, Michael D; Chelme-Ayala, Pamela; Smith, Daniel W; Gamal El-Din, Mohamed
2012-06-15
Water is integral to both operational and environmental aspects of the oil sands industry. A water treatment option based on the use of petroleum coke (PC), a by-product of bitumen upgrading, was examined as an opportunity to reduce site oil sands process-affected water (OSPW) inventories and net raw water demand. Changes in OSPW quality when treated with PC included increments in pH levels and concentrations of vanadium, molybdenum, and sulphate. Constituents that decreased in concentration after PC adsorption included total acid-extractable organics (TAO), bicarbonate, calcium, barium, magnesium, and strontium. Changes in naphthenic acids (NAs) speciation were observed after PC adsorption. A battery of bioassays was used to measure the OSPW toxicity. The results indicated that untreated OSPW was toxic towards Vibrio fischeri and rainbow trout. However, OSPW treated with PC at appropriate dosages was not acutely toxic towards these test organisms. Removal of TAO was found to be an adsorption process, fitting the Langmuir and Langmuir-Freundlich isotherm models. For TAO concentrations of 60 mg/L, adsorption capacities ranged between 0.1 and 0.46 mg/g. This study demonstrates that freshly produced PC from fluid cokers provides an effective treatment of OSPW in terms of key constituents' removal and toxicity reduction. Copyright © 2012 Elsevier B.V. All rights reserved.
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Space station needs, attributes, and architectural options study
NASA Technical Reports Server (NTRS)
1983-01-01
The top level, time-phased total space program support system architecture is described including progress from the use of ground-based space shuttle, teleoperator system, extended duration orbiter, and multimission spacecraft, to an initial 4-man crew station at 29 deg inclination in 1991, to a growth station with an 8-man crew with capabilities for OTV high energy orbit payload placement and servicing, assembly, and construction of mission payloads in 1994. System Z, proposed for Earth observation missions in high inclination orbit, can be accommodated in 1993 using a space station derivative platform. Mission definition, system architecture, and benefits are discussed.
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Postoperative Complications of Dermis-Fat Autografts in the Anophthalmic Socket.
Starks, Victoria; Freitag, Suzanne K
2018-01-01
Reconstruction of the anophthalmic socket allows the use of an ocular prosthesis and rehabilitation of facial appearance. Dermis-fat grafting is one option in volume augmentation of the anophthalmic socket and presents unique benefits, including increased surface area within the socket and the ability to grow with pediatric patients. Postoperative complications of this procedure are relatively common. Minor complications, such as graft hirsutism, keratinization, and conjunctival cysts or granulomas, are managed easily by observation or simple intervention. Major complications, such as graft atrophy, infection, or ulceration, may prevent good prosthesis fit and may require return to the operating room.
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Toro, Giuseppe; Moretti, Antimo; Toro, Gabriella; Tirelli, Assunta; Calabrò, Giampiero; Toro, Antonio; Iolascon, Giovanni
2017-01-01
A clinical case of a 15-year-old cerebral palsy child with a Sandhu type 2 neglected femoral neck fracture is presented. The patient was treated using cannulated screws and cancellous bone graft augmented with mesenchymal stem cells. At 6 months after the surgery complete fracture healing was observed. To early diagnose this fractures, it is mandatory to perform a comprehensive clinical and radiological evaluation including also a second level imaging. The use of cannulated screws with cancellous bone graft and MSCs is a viable treatment option in these patients.
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Planetary Boundary Layer Simulation Using TASS
NASA Technical Reports Server (NTRS)
Schowalter, David G.; DeCroix, David S.; Lin, Yuh-Lang; Arya, S. Pal; Kaplan, Michael
1996-01-01
Boundary conditions to an existing large-eddy simulation model have been changed in order to simulate turbulence in the atmospheric boundary layer. Several options are now available, including the use of a surface energy balance. In addition, we compare convective boundary layer simulations with the Wangara and Minnesota field experiments as well as with other model results. We find excellent agreement of modelled mean profiles of wind and temperature with observations and good agreement for velocity variances. Neutral boundary simulation results are compared with theory and with previously used models. Agreement with theory is reasonable, while agreement with previous models is excellent.
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New features in McStas, version 1.5
NASA Astrophysics Data System (ADS)
Åstrand, P.-O.; Lefmann, K.; Farhi, E.; Nielsen, K.; Skårup, P.
The neutron ray-tracing simulation package McStas has attracted numerous users, and the development of the package continues with version 1.5 released at the ICNS 2001 conference. New features include: support for neutron polarisation, labelling of neutrons, realistic source and sample components, and interface to the Riso instrument-control software TASCOM. We give a general introduction to McStas and present the latest developments. In particular, we give an example of how the neutron-label option has been used to locate the origin of a spurious side-peak, observed in an experiment with RITA-1 at Riso.
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Options for Educating Students Attending Department of Defense Schools in the United States
2016-01-01
Middlemiss, Martha Brown, Stephen F. Hovanic, Joel Hansen, Frank O’Gara, Elaine Kanellis, Robert M. Brady, Claudia Shaw , Jessica Ray Huffman, Rita...could receive students. Chapter Three explains our methods and data sources for assessing options, including the business case analysis approach...account for these analyses. We also identify implementation issues and barriers for each option, based on work of previous studies with updates to
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Prostate Cancer: A Contemporary Approach to Treatment and Outcomes.
Weiner, Adam B; Kundu, Shilajit D
2018-03-01
Given the high incidence of prostate cancer and the need for shared decision-making before screening, it is imperative that primary care providers understand treatment options and treatment adverse effects. In this review article, the treatment options for the localized and metastatic prostate cancer are discussed, including the different modalities and their indications, adverse effects, oncologic outcomes, posttreatment monitoring, and potential treatment options following cancer recurrence. Copyright © 2017 Elsevier Inc. All rights reserved.
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The PPT presentation will provide information on the drinking water treatment options for small utilities to remove arsenic from ground water. The discussion will include information on the EPA BAT listed processes and on some of the newer technologies, such as the iron based ad...
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Mitigating GHG emissions in dairy production
USDA-ARS?s Scientific Manuscript database
Comprehensive inventories of greenhouse gas (GHG) mitigation options for animal agriculture have been published recently. For dairy production systems, management option include (1) manipulation of dietary components (e.g., forages, concentrates) and use of feed additives (e.g., oils, tannins) to re...
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Tips for Good Electronic Presentations.
ERIC Educational Resources Information Center
Strasser, Dennis
1996-01-01
Describes library uses of presentation graphics software and offers tips for creating electronic presentations. Tips include: audience retention; visual aid options; software package options; presentation planning; presentation showing; and use of text, colors, and graphics. Sidebars note common presentation errors and popular presentation…
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Low cost silicon solar cell array
NASA Technical Reports Server (NTRS)
Bartels, F. T. C.
1974-01-01
The technological options available for producing low cost silicon solar cell arrays were examined. A project value of approximately $250/sq m and $2/watt is projected, based on mass production capacity demand. Recommendations are included for the most promising cost reduction options.
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Healthy Option Preferences of Rural Restaurant Customers
Nothwehr, Faryle; Snetselaar, Linda; Dawson, Jeffrey D.; Hradek, Christine; Sepulveda, Marisol
2009-01-01
In preparation for an intervention study in three rural Iowa restaurants, 250 customers were surveyed regarding their interest in dietary change, perceptions of the restaurant, and interest in healthy options. Customers were ages 18 to 88, with a mean age of 52, and 53% were women. Most agreed that the restaurant offers healthy meals. Options customers stated they were most likely to order if available included meat that is baked or broiled, whole-wheat bread, fresh fruit or steamed vegetables, and regular salad dressing on the side. They were least interested in low-fat sour cream, low-fat salad dressing, low-fat milk, low-calorie dessert, and holding high-fat ingredients. Women were more likely to indicate interest in healthy options than were men. Interest in several options was also positively associated with age. Increasing the healthy options in restaurants may be especially effective in changing the dietary intake of women and older adults. PMID:19515859
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The Effect of Solution Heat Treatment on an Advanced Nickel-Base Disk Alloy
NASA Technical Reports Server (NTRS)
Gayda, J.; Gabb, T. P.; Kantzos, P. T.
2004-01-01
Five heat treat options for an advanced nickel-base disk alloy, LSHR, have been investigated. These included two conventional solution heat treat cycles, subsolvus/oil quench and supersolvus/fan cool, which yield fine grain and coarse grain microstructure disks respectively, as well as three advanced dual microstructure heat treat (DMHT) options. The DMHT options produce disks with a fine grain bore and a coarse grain rim. Based on an overall evaluation of the mechanical property data, it was evident that the three DMHT options achieved a desirable balance of properties in comparison to the conventional solution heat treatments for the LSHR alloy. However, one of the DMHT options, SUB/DMHT, produced the best set of properties, largely based on dwell crack growth data. Further evaluation of the SUB/DMHT option in spin pit experiments on a generic disk shape demonstrated the advantages and reliability of a dual grain structure at the component level.
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Nonlinear Schrödinger approach to European option pricing
NASA Astrophysics Data System (ADS)
Wróblewski, Marcin
2017-05-01
This paper deals with numerical option pricing methods based on a Schrödinger model rather than the Black-Scholes model. Nonlinear Schrödinger boundary value problems seem to be alternatives to linear models which better reflect the complexity and behavior of real markets. Therefore, based on the nonlinear Schrödinger option pricing model proposed in the literature, in this paper a model augmented by external atomic potentials is proposed and numerically tested. In terms of statistical physics the developed model describes the option in analogy to a pair of two identical quantum particles occupying the same state. The proposed model is used to price European call options on a stock index. the model is calibrated using the Levenberg-Marquardt algorithm based on market data. A Runge-Kutta method is used to solve the discretized boundary value problem numerically. Numerical results are provided and discussed. It seems that our proposal more accurately models phenomena observed in the real market than do linear models.
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Option pricing for stochastic volatility model with infinite activity Lévy jumps
NASA Astrophysics Data System (ADS)
Gong, Xiaoli; Zhuang, Xintian
2016-08-01
The purpose of this paper is to apply the stochastic volatility model driven by infinite activity Lévy processes to option pricing which displays infinite activity jumps behaviors and time varying volatility that is consistent with the phenomenon observed in underlying asset dynamics. We specially pay attention to three typical Lévy processes that replace the compound Poisson jumps in Bates model, aiming to capture the leptokurtic feature in asset returns and volatility clustering effect in returns variance. By utilizing the analytical characteristic function and fast Fourier transform technique, the closed form formula of option pricing can be derived. The intelligent global optimization search algorithm called Differential Evolution is introduced into the above highly dimensional models for parameters calibration so as to improve the calibration quality of fitted option models. Finally, we perform empirical researches using both time series data and options data on financial markets to illustrate the effectiveness and superiority of the proposed method.
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Prins, Fieke M; Kerkmeijer, Linda G W; Pronk, Anne A; Vonken, Evert-Jan P A; Meijer, Richard P; Bex, Axel; Barendrecht, Maurits M
2017-10-01
The standard treatment of T1 renal cell carcinoma (RCC) is (partial) nephrectomy. For patients where surgery is not the treatment of choice, for example in the elderly, in case of severe comorbidity, inoperability, or refusal of surgery, alternative treatment options are available. These treatment options include active surveillance (AS), radiofrequency ablation (RFA), cryoablation (CA), microwave ablation (MWA), or stereotactic body radiotherapy (SBRT). In the present overview, the efficacy, safety, and outcome of these different options are summarized, particularly focusing on recent developments. Databases of MEDLINE (through PubMed), EMBASE, and the Cochrane Library were systematically searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The search was performed in December 2016, and included a search period from 2010 to 2016. The terms and synonyms used were renal cell carcinoma, active surveillance, radiofrequency ablation, microwave ablation, cryoablation and stereotactic body radiotherapy. The database search identified 2806 records, in total 73 articles were included to assess the rationale and clinical evidence of alternative treatment modalities for small renal masses. The methodological quality of the included articles varied between level 2b and level 4. Alternative treatment modalities, such as AS, RFA, CA, MWA, and SBRT, are treatment options especially for those patients who are unfit to undergo an invasive treatment. There are no randomized controlled trials available comparing surgery and less invasive modalities, leading to a low quality on the reported articles. A case-controlled registry might be an alternative to compare outcomes of noninvasive treatment modalities in the future.
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Kalua, Thokozani; Tippett Barr, Beth A; van Oosterhout, Joep J; Mbori-Ngacha, Dorothy; Schouten, Erik J; Gupta, Sundeep; Sande, Amakobe; Zomba, Gerald; Tweya, Hannock; Lungu, Edgar; Kajoka, Deborah; Tih, Pius; Jahn, Andreas
2017-05-01
The acceleration of prevention of mother-to-child transmission (PMTCT) activities, coupled with the rollout of 2010 World Health Organization (WHO) guidelines, led to important discussions and innovations at global and country levels. One paradigm-shifting innovation was Option B+ in Malawi. It was later included in WHO guidelines and eventually adopted by all 22 Global Plan priority countries. This article presents Malawi's experience with designing and implementing Option B+ and provides complementary narratives from Cameroon and Tanzania. Malawi's HIV program started in 2002, but by 2009, the PMTCT program was lagging far behind the antiretroviral therapy (ART) program because of numerous health system challenges. When WHO recommended Option A and Option B for PMTCT in 2010, it was clear that Malawi's HIV program would not be able to successfully implement either option without increasing existing barriers to PMTCT services and potentially decreasing women's access to care. Subsequent stakeholder discussions led to the development of Option B+. Operationalizing Option B+ required several critical considerations, including the complete integration of ART and PMTCT programs, systematic reduction of barriers to facilitate doubling the number of ART sites in less than a year, building consensus with stakeholders, and securing additional resources for the new program. During the planning and implementation process, several lessons were learned which are considerations for countries transitioning to "treat-all": Comprehensive change requires effective government leadership and coordination; national clinical guidelines must accommodate health system limitations; ART services and commodities should be decentralized within facilities; the general public should be well informed about major changes in the national HIV program; and patients should be educated on clinic processes to improve program monitoring.
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Horesh, Danny; Glick, Ittai; Taub, Renen; Agmon-Levin, Nancy; Shoenfeld, Yehuda
2017-02-01
Psychological effects related to systemic lupus erythematosus (SLE) are tremendous. While a variety of psychological treatments have been applied to assist SLE patients, the effects of mindfulness practice were never documented in SLE. Mindfulness-based psychotherapy includes several techniques, including body-scan, breathing exercises, and full awareness during daily activities. In this case report, we present a first attempt at conducting mindfulness-based group therapy among SLE patients. Six female SLE patients participated in an 8-week program. Improvement was observed in several areas: patients' increased ability to differentiate between themselves and the disease; increased ability to accept, rather than to actively fight the fact that one must live with the disease; and decreased behavioral avoidance. These observations speak to the significant therapeutic potential of mindfulness practice among SLE patients. With its emphasis on acceptance of negative physical and emotional states, mindfulness practice is a promising treatment option, which needs to be further studied. Copyright © 2016. Published by Elsevier Ltd.
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What Do I Want and When Do I Want It: Brain Correlates of Decisions Made for Self and Other
Albrecht, Konstanze; Volz, Kirsten G.; Sutter, Matthias; von Cramon, D. Yves
2013-01-01
A number of recent functional Magnetic Resonance Imaging (fMRI) studies on intertemporal choice behavior have demonstrated that so-called emotion- and reward-related brain areas are preferentially activated by decisions involving immediately available (but smaller) rewards as compared to (larger) delayed rewards. This pattern of activation was not seen, however, when intertemporal choices were made for another (unknown) individual, which speaks to that activation having been triggered by self-relatedness. In the present fMRI study, we investigated the brain correlates of individuals who passively observed intertemporal choices being made either for themselves or for an unknown person. We found higher activation within the ventral striatum, medial prefrontal and orbitofrontal cortex, pregenual anterior cingulate cortex, and posterior cingulate cortex when an immediate reward was possible for the observer herself, which is in line with findings from studies in which individuals actively chose immediately available rewards. Additionally, activation in the dorsal anterior cingulate cortex, posterior cingulate cortex, and precuneus was higher for choices that included immediate options than for choices that offered only delayed options, irrespective of who was to be the beneficiary. These results indicate that (1) the activations found in active intertemporal decision making are also present when the same decisions are merely observed, thus supporting the assumption that a robust brain network is engaged in immediate gratification; and (2) with immediate rewards, certain brain areas are activated irrespective of whether the observer or another person is the beneficiary of a decision, suggesting that immediacy plays a more general role for neural activation. An explorative analysis of participants’ brain activation corresponding to chosen rewards, further indicates that activation in the aforementioned brain areas depends on the mere presence, availability, or actual reception of immediate rewards. PMID:23991196
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Biogeochemical Protocols and Diagnostics for the CMIP6 Ocean Model Intercomparison Project (OMIP)
NASA Technical Reports Server (NTRS)
Orr, James C.; Najjar, Raymond G.; Aumont, Olivier; Bopp, Laurent; Bullister, John L.; Danabasoglu, Gokhan; Doney, Scott C.; Dunne, John P.; Dutay, Jean-Claude; Graven, Heather;
2017-01-01
The Ocean Model Intercomparison Project (OMIP) focuses on the physics and biogeochemistry of the ocean component of Earth system models participating in the sixth phase of the Coupled Model Intercomparison Project (CMIP6). OMIP aims to provide standard protocols and diagnostics for ocean models, while offering a forum to promote their common assessment and improvement. It also offers to compare solutions of the same ocean models when forced with reanalysis data (OMIP simulations) vs. when integrated within fully coupled Earth system models (CMIP6). Here we detail simulation protocols and diagnostics for OMIP's biogeochemical and inert chemical tracers. These passive-tracer simulations will be coupled to ocean circulation models, initialized with observational data or output from a model spin-up, and forced by repeating the 1948-2009 surface fluxes of heat, fresh water, and momentum. These so-called OMIP-BGC simulations include three inert chemical tracers (CFC-11, CFC-12, SF [subscript] 6) and biogeochemical tracers (e.g., dissolved inorganic carbon, carbon isotopes, alkalinity, nutrients, and oxygen). Modelers will use their preferred prognostic BGC model but should follow common guidelines for gas exchange and carbonate chemistry. Simulations include both natural and total carbon tracers. The required forced simulation (omip1) will be initialized with gridded observational climatologies. An optional forced simulation (omip1-spunup) will be initialized instead with BGC fields from a long model spin-up, preferably for 2000 years or more, and forced by repeating the same 62-year meteorological forcing. That optional run will also include abiotic tracers of total dissolved inorganic carbon and radiocarbon, CTabio and 14CTabio, to assess deep-ocean ventilation and distinguish the role of physics vs. biology. These simulations will be forced by observed atmospheric histories of the three inert gases and CO2 as well as carbon isotope ratios of CO2. OMIP-BGC simulation protocols are founded on those from previous phases of the Ocean Carbon-Cycle Model Intercomparison Project. They have been merged and updated to reflect improvements concerning gas exchange, carbonate chemistry, and new data for initial conditions and atmospheric gas histories. Code is provided to facilitate their implementation.
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Biogeochemical protocols and diagnostics for the CMIP6 Ocean Model Intercomparison Project (OMIP)
NASA Astrophysics Data System (ADS)
Orr, James C.; Najjar, Raymond G.; Aumont, Olivier; Bopp, Laurent; Bullister, John L.; Danabasoglu, Gokhan; Doney, Scott C.; Dunne, John P.; Dutay, Jean-Claude; Graven, Heather; Griffies, Stephen M.; John, Jasmin G.; Joos, Fortunat; Levin, Ingeborg; Lindsay, Keith; Matear, Richard J.; McKinley, Galen A.; Mouchet, Anne; Oschlies, Andreas; Romanou, Anastasia; Schlitzer, Reiner; Tagliabue, Alessandro; Tanhua, Toste; Yool, Andrew
2017-06-01
The Ocean Model Intercomparison Project (OMIP) focuses on the physics and biogeochemistry of the ocean component of Earth system models participating in the sixth phase of the Coupled Model Intercomparison Project (CMIP6). OMIP aims to provide standard protocols and diagnostics for ocean models, while offering a forum to promote their common assessment and improvement. It also offers to compare solutions of the same ocean models when forced with reanalysis data (OMIP simulations) vs. when integrated within fully coupled Earth system models (CMIP6). Here we detail simulation protocols and diagnostics for OMIP's biogeochemical and inert chemical tracers. These passive-tracer simulations will be coupled to ocean circulation models, initialized with observational data or output from a model spin-up, and forced by repeating the 1948-2009 surface fluxes of heat, fresh water, and momentum. These so-called OMIP-BGC simulations include three inert chemical tracers (CFC-11, CFC-12, SF6) and biogeochemical tracers (e.g., dissolved inorganic carbon, carbon isotopes, alkalinity, nutrients, and oxygen). Modelers will use their preferred prognostic BGC model but should follow common guidelines for gas exchange and carbonate chemistry. Simulations include both natural and total carbon tracers. The required forced simulation (omip1) will be initialized with gridded observational climatologies. An optional forced simulation (omip1-spunup) will be initialized instead with BGC fields from a long model spin-up, preferably for 2000 years or more, and forced by repeating the same 62-year meteorological forcing. That optional run will also include abiotic tracers of total dissolved inorganic carbon and radiocarbon, CTabio and 14CTabio, to assess deep-ocean ventilation and distinguish the role of physics vs. biology. These simulations will be forced by observed atmospheric histories of the three inert gases and CO2 as well as carbon isotope ratios of CO2. OMIP-BGC simulation protocols are founded on those from previous phases of the Ocean Carbon-Cycle Model Intercomparison Project. They have been merged and updated to reflect improvements concerning gas exchange, carbonate chemistry, and new data for initial conditions and atmospheric gas histories. Code is provided to facilitate their implementation.
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Tadalafil - a therapeutic option in the management of BPH-LUTS.
Carson, C C; Rosenberg, M; Kissel, J; Wong, D G
2014-01-01
Men with signs of benign prostatic hyperplasia (BPH) may experience lower urinary tract symptoms (LUTS) such as urinary frequency, urgency, intermittence, nocturia, straining, incomplete emptying or a weak urinary stream. The effective management of LUTS suggestive of BPH (BPH-LUTS) requires careful consideration of several factors, including the severity of a patient's symptoms, concurrent or other coexisting medical conditions, the ability to improve symptoms and impact quality of life (QOL), as well as the potential side effects of available treatment options. Several clinical studies have assessed phosphodiesterase type 5 (PDE5) inhibitors in reducing LUTS; however, tadalafil is the only PDE5 inhibitor approved for the treatment of signs and symptoms of BPH, as well as in men with both erectile dysfunction (ED) and the signs and symptoms of BPH. This review examined articles that assessed tadalafil in patients with signs and symptoms of BPH, with or without erectile dysfunction (ED), which led to regulatory approval in the United States and Europe. In dose-ranging and confirmatory studies, results demonstrate that tadalafil significantly improved total International Prostate Symptom Score (IPSS) following 12 weeks of treatment with once daily tadalafil 5 mg. Statistically significant improvements in Benign Prostatic Hyperplasia Impact Index (BII), IPSS subscores, IPSS QOL and International Index of Erectile Function (IIEF) were also observed. Improvement in urinary symptoms occurred regardless of age, previous treatment with an α1 -adrenergic blocker, BPH-LUTS severity at baseline or ED status. While tadalafil is most frequently recognised as a standard treatment option for men with ED, it also represents a well-tolerated and effective treatment option in men with moderate to severe BPH-LUTS. © 2013 John Wiley & Sons Ltd.
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NASA Astrophysics Data System (ADS)
Longdon, Norman
From the early 1960's, European governments were aware that they had to take part in the exploration, and potential exploitation, of space, or be left behind in a field of high-technology that had far-reaching possibilities. It was also realized that financial and manpower constraints would limit the extent to which individual nations could carry out their own national programs. They, therefor, joined forces in two organizations: the European Space Research Organization (ESRO) and the European Launcher Development Organization (ELDO). By 1975, when the potential of space development had been more fully appreciated, the two organizations were merged into the Europeans Space Agency (ESA) of which Spain was a founding member. ESA looks after the interest of 13 member states, one associated member state (Finland), and one cooperating state (Canada) in the peaceful uses of space. Its programs center around a mandatory core of technological research and space science to which member states contribute on the basis of their Gross National Product. Spain in 1992 contributes 6.46% to this mandatory program budget. The member states then have the chance to join optional programs that include telecommunications, observation of the earth and its environment, space transportation systems, microgravity research, and participation in the European contribution to the International Space Station Freedom. Each government decides whether it is in its interest to join a particular optional program, and the percentage that it wishes to contribute to the budget. Although in the early days of ESA, Spain participated in only a few optional programs, today Spain makes a significant contribution to nearly all of ESA's optional programs. This document presents Spain's contributions to particular ESA Programs and discusses Spain's future involvement in ESA.
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Strategies to mitigate nitrous oxide emissions from herbivore production systems.
Schils, R L M; Eriksen, J; Ledgard, S F; Vellinga, Th V; Kuikman, P J; Luo, J; Petersen, S O; Velthof, G L
2013-03-01
Herbivores are a significant source of nitrous oxide (N(2)O) emissions. They account for a large share of manure-related N(2)O emissions, as well as soil-related N(2)O emissions through the use of grazing land, and land for feed and forage production. It is widely acknowledged that mitigation measures are necessary to avoid an increase in N(2)O emissions while meeting the growing global food demand. The production and emissions of N(2)O are closely linked to the efficiency of nitrogen (N) transfer between the major components of a livestock system, that is, animal, manure, soil and crop. Therefore, mitigation options in this paper have been structured along these N pathways. Mitigation technologies involving diet-based intervention include lowering the CP content or increasing the condensed tannin content of the diet. Animal-related mitigation options also include breeding for improved N conversion and high animal productivity. The main soil-based mitigation measures include efficient use of fertilizer and manure, including the use of nitrification inhibitors. In pasture-based systems with animal housing facilities, reducing grazing time is an effective option to reduce N(2)O losses. Crop-based options comprise breeding efforts for increased N-use efficiency and the use of pastures with N(2)-fixing clover. It is important to recognize that all N(2)O mitigation options affect the N and carbon cycles of livestock systems. Therefore, care should be taken that reductions in N(2)O emissions are not offset by unwanted increases in ammonia, methane or carbon dioxide emissions. Despite the abundant availability of mitigation options, implementation in practice is still lagging. Actual implementation will only follow after increased awareness among farmers and greenhouse gases targeted policies. So far, reductions in N(2)O emissions that have been achieved are mostly a positive side effect of other N-targeted policies.
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On the impact of power corrections in the prediction of B → K *μ+μ- observables
NASA Astrophysics Data System (ADS)
Descotes-Genon, Sébastien; Hofer, Lars; Matias, Joaquim; Virto, Javier
2014-12-01
The recent LHCb angular analysis of the exclusive decay B → K * μ + μ - has indicated significant deviations from the Standard Model expectations. Accurate predictions can be achieved at large K *-meson recoil for an optimised set of observables designed to have no sensitivity to hadronic input in the heavy-quark limit at leading order in α s . However, hadronic uncertainties reappear through non-perturbative ΛQCD /m b power corrections, which must be assessed precisely. In the framework of QCD factorisation we present a systematic method to include factorisable power corrections and point out that their impact on angular observables depends on the scheme chosen to define the soft form factors. Associated uncertainties are found to be under control, contrary to earlier claims in the literature. We also discuss the impact of possible non-factorisable power corrections, including an estimate of charm-loop effects. We provide results for angular observables at large recoil for two different sets of inputs for the form factors, spelling out the different sources of theoretical uncertainties. Finally, we comment on a recent proposal to explain the anomaly in B → K * μ + μ - observables through charm-resonance effects, and we propose strategies to test this proposal identifying observables and kinematic regions where either the charm-loop model can be disentangled from New Physics effects or the two options leave different imprints.
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Rivals in the dark: how competition influences search in decisions under uncertainty.
Phillips, Nathaniel D; Hertwig, Ralph; Kareev, Yaakov; Avrahami, Judith
2014-10-01
In choices between uncertain options, information search can increase the chances of distinguishing good from bad options. However, many choices are made in the presence of other choosers who may seize the better option while one is still engaged in search. How long do (and should) people search before choosing between uncertain options in the presence of such competition? To address this question, we introduce a new experimental paradigm called the competitive sampling game. We use both simulation and empirical data to compare search and choice between competitive and solitary environments. Simulation results show that minimal search is adaptive when one expects competitors to choose quickly or is uncertain about how long competitors will search. Descriptively, we observe that competition drastically reduces information search prior to choice. Copyright © 2014 Elsevier B.V. All rights reserved.
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Schema Versioning for Multitemporal Relational Databases.
ERIC Educational Resources Information Center
De Castro, Cristina; Grandi, Fabio; Scalas, Maria Rita
1997-01-01
Investigates new design options for extended schema versioning support for multitemporal relational databases. Discusses the improved functionalities they may provide. Outlines options and basic motivations for the new design solutions, as well as techniques for the management of proposed schema versioning solutions, includes algorithms and…
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14 CFR 21.293 - Current records.
Code of Federal Regulations, 2010 CFR
2010-01-01
... option authorization— (i) A technical data file that includes the type design drawings, specifications, reports on tests prescribed by this part, and the original type inspection report and amendments to that... his factory, for each product type certificated under a delegation option authorization, current...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-17
... and the halt is processed on PHLX will be nullified pursuant to PHLX Rule 1092(c)(iv)(B).\\5\\ \\5\\ PHLX Rule 1092(c)(iv)(B) states that, respecting equity options (including options overlying ETFs), trades...
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The report summarizes information gathered on emissions from the composite wood industry (also called the Plywood and particleboard industry) and potential pollution prevention options. Information was gathered during a literature search that included trade association publicatio...
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ERIC Educational Resources Information Center
Meyers, Paul A.; Witt, Frank C.
Presented is an analysis of alternatives available to the United States in dealing with energy problems. Options explained and evaluated include coal, solar, hydroelectric, nuclear, geothermal, wind, biomass, and energy conservation. The booklet is part of Project APEC (America's Possible Energy Choices), a nationally validated Title IVc project…
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Evaluation of Options for Interpreting Environmental ...
Report Secondary data from the BioResponse Operational Testing and Evaluation project were used to study six options for interpreting culture-based/microbial count data sets that include left censored data, or measurements that are less than established quantification limits and/or detection limits.
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Internet Access and Pricing: Sorting Out the Options.
ERIC Educational Resources Information Center
Fowler, Thomas B.
1997-01-01
Discusses Internet access and pricing options. Highlights include restructuring of the telecommunications industry; current methods of access; economics of high-speed access; the impact of cheap Internet access; long-term possibilities; and a table that provides a comparison of Internet access methods. (LRW)
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Valuing natural gas power generation assets in the new competitive marketplace
NASA Astrophysics Data System (ADS)
Hsu, Michael Chun-Wei
1999-10-01
The profitability of natural gas fired power plants depends critically on the spread between electricity and natural gas prices. The price levels of these two energy commodities are the key uncertain variables in determining the operating margin and therefore the value of a power plant. The owner of a generation unit has the decision of dispatching the plant only when profit margins are positive. This operating flexibility is a real option with real value. In this dissertation I introduce the spark spread call options and illustrate how such paper contracts replicate the uncertain payoff space facing power asset owners and, therefore, how the financial options framework can be applied in estimating the value of natural gas generation plants. The intrinsic value of gas power plants is approximated as the sum of a series of spark spread call options with succeeding maturity dates. The Black-Scholes spread option pricing model, with volatility and correlation term structure adjustments, is utilized to price the spark spread options. Sensitivity analysis is also performed on the BS spread option formulation to compare different asset types. In addition I explore the potential of using compound and compound-exchange option concepts to evaluate, respectively, the benefits of delaying investment in new generation and in repowering existing antiquated units. The compound option designates an option on top of another option. In this case the series of spark spread call options is the 'underlying' option while the option to delay new investments is the 'overlying.' The compound-exchange option characterizes the opportunity to 'exchange' the old power plant, with its series of spark spread call options, for a set of new spark spread call options that comes with the new generation unit. The strike price of the compound-exchange option is the repowering capital investment and typically includes the purchase of new steam generators and combustion turbines, as well as other facility upgrades. The pricing results using the proposed repowering option approach is compared to the sale prices from recent power plant auctions. Sensitivity of the repowering option model is also examined and the critical parameters al parameters identified.
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Option generation in decision making: ideation beyond memory retrieval
Del Missier, Fabio; Visentini, Mimì; Mäntylä, Timo
2015-01-01
According to prescriptive decision theories, the generation of options for choice is a central aspect of decision making. A too narrow representation of the problem may indeed limit the opportunity to evaluate promising options. However, despite the theoretical and applied significance of this topic, the cognitive processes underlying option generation are still unclear. In particular, while a cued recall account of option generation emphasizes the role of memory and executive control, other theoretical proposals stress the importance of ideation processes based on various search and thinking processes. Unfortunately, relevant behavioral evidence on the cognitive processes underlying option generation is scattered and inconclusive. In order to reach a better understanding, we carried out an individual-differences study employing a wide array of cognitive predictors, including measures of episodic memory, semantic memory, cognitive control, and ideation fluency. The criterion tasks consisted of three different poorly-structured decision-making scenarios, and the participants were asked to generate options to solve these problems. The main criterion variable of the study was the number of valid options generated, but also the diversity and the quality of generated options were examined. The results showed that option generation fluency and diversity in the context of ill-structured decision making are supported by ideation ability even after taking into account the effects of individual differences in several other aspects of cognitive functioning. Thus, ideation processes, possibly supported by search and thinking processes, seem to contribute to option generation beyond basic associative memory retrieval. The findings of the study also indicate that generating more options may have multifaceted consequences for choice, increasing the quality of the best option generated but decreasing the mean quality of the options in the generated set. PMID:25657628
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Option generation in decision making: ideation beyond memory retrieval.
Del Missier, Fabio; Visentini, Mimì; Mäntylä, Timo
2014-01-01
According to prescriptive decision theories, the generation of options for choice is a central aspect of decision making. A too narrow representation of the problem may indeed limit the opportunity to evaluate promising options. However, despite the theoretical and applied significance of this topic, the cognitive processes underlying option generation are still unclear. In particular, while a cued recall account of option generation emphasizes the role of memory and executive control, other theoretical proposals stress the importance of ideation processes based on various search and thinking processes. Unfortunately, relevant behavioral evidence on the cognitive processes underlying option generation is scattered and inconclusive. In order to reach a better understanding, we carried out an individual-differences study employing a wide array of cognitive predictors, including measures of episodic memory, semantic memory, cognitive control, and ideation fluency. The criterion tasks consisted of three different poorly-structured decision-making scenarios, and the participants were asked to generate options to solve these problems. The main criterion variable of the study was the number of valid options generated, but also the diversity and the quality of generated options were examined. The results showed that option generation fluency and diversity in the context of ill-structured decision making are supported by ideation ability even after taking into account the effects of individual differences in several other aspects of cognitive functioning. Thus, ideation processes, possibly supported by search and thinking processes, seem to contribute to option generation beyond basic associative memory retrieval. The findings of the study also indicate that generating more options may have multifaceted consequences for choice, increasing the quality of the best option generated but decreasing the mean quality of the options in the generated set.
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Ciaranello, Andrea L.; Perez, Freddy; Engelsmann, Barbara; Walensky, Rochelle P.; Mushavi, Angela; Rusibamayila, Asinath; Keatinge, Jo; Park, Ji-Eun; Maruva, Matthews; Cerda, Rodrigo; Wood, Robin; Dabis, Francois; Freedberg, Kenneth A.
2013-01-01
Background. In 2010, the World Health Organization (WHO) released revised guidelines for prevention of mother-to-child human immunodeficiency virus (HIV) transmission (PMTCT). We projected clinical impacts, costs, and cost-effectiveness of WHO-recommended PMTCT strategies in Zimbabwe. Methods. We used Zimbabwean data in a validated computer model to simulate a cohort of pregnant, HIV-infected women (mean age, 24 years; mean CD4 count, 451 cells/µL; subsequent 18 months of breastfeeding). We simulated guideline-concordant care for 4 PMTCT regimens: single-dose nevirapine (sdNVP); WHO-recommended Option A, WHO-recommended Option B, and Option B+ (lifelong maternal 3-drug antiretroviral therapy regardless of CD4). Outcomes included maternal and infant life expectancy (LE) and lifetime healthcare costs (2008 US dollars [USD]). Incremental cost-effectiveness ratios (ICERs, in USD per year of life saved [YLS]) were calculated from combined (maternal + infant) discounted costs and LE. Results. Replacing sdNVP with Option A increased combined maternal and infant LE from 36.97 to 37.89 years and would reduce lifetime costs from $5760 to $5710 per mother–infant pair. Compared with Option A, Option B further improved LE (38.32 years), and saved money within 4 years after delivery ($5630 per mother–infant pair). Option B+ (LE, 39.04 years; lifetime cost, $6620 per mother–infant pair) improved maternal and infant health, with an ICER of $1370 per YLS compared with Option B. Conclusions. Replacing sdNVP with Option A or Option B will improve maternal and infant outcomes and save money; Option B increases health benefits and decreases costs compared with Option A. Option B+ further improves maternal outcomes, with an ICER (compared with Option B) similar to many current HIV-related healthcare interventions. PMID:23204035
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Stable Local Volatility Calibration Using Kernel Splines
NASA Astrophysics Data System (ADS)
Coleman, Thomas F.; Li, Yuying; Wang, Cheng
2010-09-01
We propose an optimization formulation using L1 norm to ensure accuracy and stability in calibrating a local volatility function for option pricing. Using a regularization parameter, the proposed objective function balances the calibration accuracy with the model complexity. Motivated by the support vector machine learning, the unknown local volatility function is represented by a kernel function generating splines and the model complexity is controlled by minimizing the 1-norm of the kernel coefficient vector. In the context of the support vector regression for function estimation based on a finite set of observations, this corresponds to minimizing the number of support vectors for predictability. We illustrate the ability of the proposed approach to reconstruct the local volatility function in a synthetic market. In addition, based on S&P 500 market index option data, we demonstrate that the calibrated local volatility surface is simple and resembles the observed implied volatility surface in shape. Stability is illustrated by calibrating local volatility functions using market option data from different dates.
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Ballard, Sarah-Blythe; Salinger, Allison; Arguin, Paul M; Desai, Meghna; Tan, Kathrine R
2018-04-13
Malaria infection during pregnancy is associated with an increased risk for maternal and fetal complications. In the United States, treatment options for uncomplicated, chloroquine-resistant Plasmodium falciparum and P. vivax malaria in pregnant women are limited to mefloquine or quinine plus clindamycin (1). However, limited availability of quinine and increasing resistance to mefloquine restrict these options. Strong evidence now demonstrates that artemether-lumefantrine (AL) (Coartem) is effective and safe in the treatment of malaria in pregnancy. The World Health Organization (WHO) has endorsed artemisinin-based combination therapies (ACTs), such as AL, for treatment of uncomplicated malaria during the second and third trimesters of pregnancy and is currently considering whether to add ACTs, including AL, as an option for malaria treatment during the first trimester (2,3). This policy note reviews the evidence and updates CDC recommendations to include AL as a treatment option for uncomplicated malaria during the second and third trimesters of pregnancy and during the first trimester of pregnancy when other treatment options are unavailable. These updated recommendations reflect current evidence and are consistent with WHO treatment guidelines.
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Multi-attribute criteria applied to electric generation energy system analysis LDRD.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kuswa, Glenn W.; Tsao, Jeffrey Yeenien; Drennen, Thomas E.
2005-10-01
This report began with a Laboratory-Directed Research and Development (LDRD) project to improve Sandia National Laboratories multidisciplinary capabilities in energy systems analysis. The aim is to understand how various electricity generating options can best serve needs in the United States. The initial product is documented in a series of white papers that span a broad range of topics, including the successes and failures of past modeling studies, sustainability, oil dependence, energy security, and nuclear power. Summaries of these projects are included here. These projects have provided a background and discussion framework for the Energy Systems Analysis LDRD team to carrymore » out an inter-comparison of many of the commonly available electric power sources in present use, comparisons of those options, and efforts needed to realize progress towards those options. A computer aid has been developed to compare various options based on cost and other attributes such as technological, social, and policy constraints. The Energy Systems Analysis team has developed a multi-criteria framework that will allow comparison of energy options with a set of metrics that can be used across all technologies. This report discusses several evaluation techniques and introduces the set of criteria developed for this LDRD.« less
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Treatment options for the management of exercise-induced asthma and bronchoconstriction.
Millward, David T; Tanner, Lindsay G; Brown, Mark A
2010-12-01
Treatment for exercise-induced bronchospasm and exercise-induced asthma includes both pharmacologic and nonpharmacologic options. Pharmacologic agents that have been proven to be effective for treating these conditions include short- and long-acting β2-adrenoceptor agonists, mast cell-stabilizing agents, anticholinergics, leukotriene receptor antagonists, and inhaled corticosteroids (ICS). When selecting the most appropriate medication, factors to consider include the effectiveness of each, the duration of action, frequency of administration, potential side effects, and tolerance level. Long-acting β2-adrenoceptor agonists should not be used without ICS. Nonpharmacologic treatments include physical conditioning, incorporating a warm-up before and a cool-down period after exercise, performing nasal breathing, avoiding cold weather or environmental allergens, using a face mask or other aid to warm and humidify inhaled air, and modifying dietary intake. The data to support nonpharmacologic treatments are limited; however, they are routinely recommended because of the low risk associated with their use. This article highlights the advantages and limitations of each treatment option.
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Health financing options for Fiji's health system.
Pande, Madhukar
2003-09-01
Fiji is currently implementing health care reforms with the first phase of reforms focusing on decentralization of the health system. Part of this effort focuses on looking at financing options. Some options for financing health care include private health insurance, social insurance, community financing, user-pays system (out-of-pocket), health savings accounts, government taxation and subsidies, and overseas loans and aid funding. This paper addresses all these options in detail and provides an analysis into each of these options relevance to Fiji and in some instances to other nations in the South Pacific region. Given the relative small populations of Fiji and its neighbouring nations, a regional approach to financing could prove more viable in the longer-term, however political, social, economic, legal and cultural issues will need to seriously explored.
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Kong, Chui-Hua; Hu, Fei; Wang, Peng; Wu, Jing-Lun
2008-03-01
A number of techniques, including cultural management, allelopathy and bioherbicide, have been considered as alternatives for synthetic herbicides, but successful weed control will require the careful integration of these multiple techniques. This study was conducted to assess the use of allelopathic rice varieties in combination with cultural management options on paddy weeds, in order to develop an allelopathy-based technique to reduce herbicide use in paddies. The weed-suppressive effects of the rice varieties tested varied highly with allelopathic trait, planting pattern and cultural management including planting density, flooding depth and duration and supply of nitrogen. Allelopathic rice varieties PI312777 and Huagan-1 demonstrated much stronger weed suppression than the non-allelopathic variety Huajianxian under the same planting pattern and cultural management. Their weed-suppressive effect was increased with cultural management options. In particular, if integrated cultural management options of allelopathic rice varieties included a low-dose (bensulfuron-methyl, 25 g AI ha(-1), a third of the recommended dose) herbicide application, the emergence and growth of most weeds found in paddy fields was completely controlled. No grain yield reduction for allelopathic varieties occurred under integrated cultural management options, whereas with the non-allelopathic variety a reduction of up to 45-60% was measurable even with the low-dose herbicide application. The allelopathic potential of rice varieties will likely have a great impact on paddy weed control if integrated with cultural management options and application of low doses of herbicides. Therefore, it is feasible to reduce herbicide input in paddies if allelopathic rice is grown under integrated cultural management practices. (c) 2008 Society of Chemical Industry.
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Environmental and economic analyses of waste disposal options for traditional markets in Indonesia.
Aye, Lu; Widjaya, E R
2006-01-01
Waste from traditional markets in Indonesia is the second largest stream of municipal solid waste after household waste. It has a higher organic fraction and may have greater potential to be managed on a business scale compared to household wastes. The attributed reason is that in general the wastes generated from traditional markets are more uniform, more concentrated and less hazardous than waste from other sources. This paper presents the results of environmental and economic assessments to compare the options available for traditional market waste disposal in Indonesia. The options compared were composting in labour intensive plants, composting in a centralised plant that utilised a simple wheel loader, centralised biogas production and landfill for electricity production. The current open dumping practice was included as the baseline case. A life cycle assessment (LCA) was used for environmental analysis. All options compared have lower environmental impacts than the current practice of open dumping. The biogas production option has the lowest environmental impacts. A cost-benefit analysis, which considered greenhouse gas savings, was used for the economic assessment. It was found that composting at a centralised plant is the most economically feasible option under the present Indonesian conditions. The approach reported in this study could be applied for 'a pre-feasibility first cut comparison' that includes environmental aspects in a decision-making framework for developing countries even though European emission factors were used.
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Summary appraisals of the Nation's ground-water resources; Upper Colorado region
Price, Don; Arnow, Ted
1974-01-01
Options available for use of ground water in water-resources management·in the·region include conjunctive use with surface water or development of ground water as an independent supply. The latter option could be for & perennial supply or for a time-limited supply (mining ground water), depending on the need and the existing ground-water conditions. All options can be carried out so as to meet the requirements of the Colorado River Compact. The options could be implemented to optimally develop the Upper Colorado River Basin's allocation of Colorado River water while meeting the Compact commitments to the Lower Basin.
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Indications and interventional options for non-resectable tracheal stenosis
Bacon, Jenny Louise; Patterson, Caroline Marie
2014-01-01
Non-specific presentation and normal examination findings in early disease often result in tracheal obstruction being overlooked as a diagnosis until patients present acutely. Once diagnosed, surgical options should be considered, but often patient co-morbidity necessitates other interventional options. Non-resectable tracheal stenosis can be successfully managed by interventional bronchoscopy, with therapeutic options including airway dilatation, local tissue destruction and airway stenting. There are common aspects to the management of tracheal obstruction, tracheomalacia and tracheal fistulae. This paper reviews the pathogenesis, presentation, investigation and management of tracheal disease, with a focus on tracheal obstruction and the role of endotracheal intervention in management. PMID:24624290
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ERIC Educational Resources Information Center
Mendes, Salome; Severo, Milton; Lopes, Carla
2012-01-01
To compare two modes of administration (self-administered; by interviewer) and two response options format (using words; images of "facial-expressions") of the first question of SF-36 (Q1SF-36), and to test its validity. We included 825 participants (20-90 years). Q1SF-36, using words or images, was included in a global questionnaire interview and…
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NASA Exploration Team (NExT) In-Space Transportation Overview
NASA Technical Reports Server (NTRS)
Drake, Bret G.; Cooke, Douglas R.; Kos, Larry D.; Brady, Hugh J. (Technical Monitor)
2002-01-01
This presentation provides an overview of NASA Exploration Team's (NEXT) vision of in-space transportation in the future. Hurdles facing in-space transportation include affordable power sources, crew health and safety, optimized robotic and human operations and space systems performance. Topics covered include: exploration of Earth's neighborhood, Earth's neighborhood architecture and elements, Mars mission trajectory options, delta-v variations, Mars mission duration options, Mars mission architecture, nuclear electric propulsion advantages and miscellaneous technology needs.
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User's guide to noise data acquisition and analysis programs for HP9845: Nicolet analyzers
NASA Technical Reports Server (NTRS)
Mcgary, M. C.
1982-01-01
A software interface package was written for use with a desktop computer and two models of single channel Fast Fourier analyzers. This software features a portable measurement and analysis system with several options. Two types of interface hardware can alternately be used in conjunction with the software. Either an IEEE-488 Bus interface or a 16-bit parallel system may be used. Two types of storage medium, either tape cartridge or floppy disc can be used with the software. Five types of data may be stored, plotted, and/or printed. The data types include time histories, narrow band power spectra, and narrow band, one-third octave band, or octave band sound pressure level. The data acquisition programming includes a front panel remote control option for the FFT analyzers. Data analysis options include choice of line type and pen color for plotting.
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PCI-based WILDFIRE reconfigurable computing engines
NASA Astrophysics Data System (ADS)
Fross, Bradley K.; Donaldson, Robert L.; Palmer, Douglas J.
1996-10-01
WILDFORCE is the first PCI-based custom reconfigurable computer that is based on the Splash 2 technology transferred from the National Security Agency and the Institute for Defense Analyses, Supercomputing Research Center (SRC). The WILDFORCE architecture has many of the features of the WILDFIRE computer, such as field- programmable gate array (FPGA) based processing elements, linear array and crossbar interconnection, and high- performance memory and I/O subsystems. New features introduced in the PCI-based WILDFIRE systems include memory/processor options that can be added to any processing element. These options include static and dynamic memory, digital signal processors (DSPs), FPGAs, and microprocessors. In addition to memory/processor options, many different application specific connectors can be used to extend the I/O capabilities of the system, including systolic I/O, camera input and video display output. This paper also discusses how this new PCI-based reconfigurable computing engine is used for rapid-prototyping, real-time video processing and other DSP applications.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
2012-01-05
SandiaMCR was developed to identify pure components and their concentrations from spectral data. This software efficiently implements the multivariate calibration regression alternating least squares (MCR-ALS), principal component analysis (PCA), and singular value decomposition (SVD). Version 3.37 also includes the PARAFAC-ALS Tucker-1 (for trilinear analysis) algorithms. The alternating least squares methods can be used to determine the composition without or with incomplete prior information on the constituents and their concentrations. It allows the specification of numerous preprocessing, initialization and data selection and compression options for the efficient processing of large data sets. The software includes numerous options including the definition ofmore » equality and non-negativety constraints to realistically restrict the solution set, various normalization or weighting options based on the statistics of the data, several initialization choices and data compression. The software has been designed to provide a practicing spectroscopist the tools required to routinely analysis data in a reasonable time and without requiring expert intervention.« less
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A Non-Gaussian Stock Price Model: Options, Credit and a Multi-Timescale Memory
NASA Astrophysics Data System (ADS)
Borland, L.
We review a recently proposed model of stock prices, based on astatistical feedback model that results in a non-Gaussian distribution of price changes. Applications to option pricing and the pricing of debt is discussed. A generalization to account for feedback effects over multiple timescales is also presented. This model reproduces most of the stylized facts (ie statistical anomalies) observed in real financial markets.
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The Decoy Effect Within Alcohol Purchasing Decisions.
Monk, Rebecca L; Qureshi, Adam W; Leatherbarrow, Thomas; Hughes, Annalise
2016-08-23
The decoy effect is the phenomenon where the introduction of a third choice to a decision dyad changes the distribution of preferences between options. Examine whether this effect exists in alcohol purchasing decisions and whether testing context impacts this. Fifty-two participants tested in either a bar or library context and were asked to choose one of a series of beer and water deals presented for timed intervals. In some cases, two options were presented (with similar attractiveness) and in other cases a third, less preferable, decoy option was added. A basic decoy effect in both alcohol and water purchasing decisions. Specifically, there were reductions in the selection of both the original options when the decoy was added into choice dyads. A significant interaction demonstrated in the bar context there was a significant difference such that there was a slight increase in participants selecting the most cost effective option when the decoy was added, and a simultaneous decrease in those choosing the moderately cost effective option. There were no such differences observed in the library condition. The same product may be perceived differently across contexts and, as such, consumers in a pub environment may be particularly vulnerable to the decoy effect.
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De Luca, Andrea; Hamers, Raphael L; Schapiro, Jonathan M
2013-06-15
Antiretroviral treatment (ART) is expanding to human immunodeficiency virus type 1 (HIV-1)-infected persons in low-middle income countries, thanks to a public health approach. With 3 available drug classes, 2 ART sequencing lines are programmatically foreseen. The emergence and transmission of viral drug resistance represents a challenge to the efficacy of ART. Knowledge of HIV-1 drug resistance selection associated with specific drugs and regimens and the consequent activity of residual drug options are essential in programming ART sequencing options aimed at preserving ART efficacy for as long as possible. This article determines optimal ART sequencing options for overcoming HIV-1 drug resistance in resource-limited settings, using currently available drugs and treatment monitoring opportunities. From the perspective of drug resistance and on the basis of limited virologic monitoring data, optimal sequencing seems to involve use of a tenofovir-containing nonnucleoside reverse-transcriptase inhibitor-based first-line regimen, followed by a zidovudine-containing, protease inhibitor (PI)-based second-line regimen. Other options and their consequences are explored by considering within-class and between-class sequencing opportunities, including boosted PI monotherapies and future options with integrase inhibitors. Nucleoside reverse-transcriptase inhibitor resistance pathways in HIV-1 subtype C suggest an additional reason for accelerating stavudine phase out. Viral load monitoring avoids the accumulation of resistance mutations that significantly reduce the activity of next-line options. Rational use of resources, including broader access to viral load monitoring, will help ensure 3 lines of fully active treatment options, thereby increasing the duration of ART success.
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Internet Connections: Understanding Your Access Options.
ERIC Educational Resources Information Center
Notess, Greg R.
1994-01-01
Describes levels of Internet connectivity, physical connections, and connection speeds. Compares options for connecting to the Internet, including terminal accounts, dial-up terminal accounts, direct connections through a local area network, and direct connections using SLIP (Serial Line Internet Protocol) or PPP (Point-to-Point Protocol). (eight…
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Shungnak Energy Configuration Options.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Rosewater, David Martin; Eddy, John P.
Power systems in rural Alaska villages face a unique combination of challenges that can increase the cost of energy and lowers energy supply reliability. In the case of the remote village of Shungnak, diesel and heating fuel is either shipped in by barge or flown in by aircraft. This report presents a technical analysis of several energy infrastructure upgrade and modification options to reduce the amount of fuel consumed by the community of Shungnak. Reducing fuel usage saves money and makes the village more resilient to disruptions in fuel supply. The analysis considers demand side options, such as energy efficiency,more » alongside the installation of wind and solar power generation options. Some novel approaches are also considered including battery energy storage and the use of electrical home heating stoves powered by renewable generation that would otherwise be spilled and wasted. This report concludes with specific recommendations for Shungnak based on economic factors, and fuel price sensitivity. General conclusions are also included to support future work analyzing similar energy challenges in remote arctic regions.« less
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Analysis of edible oil processing options for the BIO-Plex advanced life support system
NASA Technical Reports Server (NTRS)
Greenwalt, C. J.; Hunter, J.
2000-01-01
Edible oil is a critical component of the proposed plant-based Advanced Life Support (ALS) diet. Soybean, peanut, and single-cell oil are the oil source options to date. In terrestrial manufacture, oil is ordinarily extracted with hexane, an organic solvent. However, exposed solvents are not permitted in the spacecraft environment or in enclosed human tests by National Aeronautics and Space Administration due to their potential danger and handling difficulty. As a result, alternative oil-processing methods will need to be utilized. Preparation and recovery options include traditional dehulling, crushing, conditioning, and flaking, extrusion, pressing, water extraction, and supercritical extraction. These processing options were evaluated on criteria appropriate to the Advanced Life Support System and BIO-Plex application including: product quality, product stability, waste production, risk, energy needs, labor requirements, utilization of nonrenewable resources, usefulness of by-products, and versatility and mass of equipment to determine the most appropriate ALS edible oil-processing operation.
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Nuclear Engine System Simulation (NESS). Version 2.0: Program user's guide
NASA Technical Reports Server (NTRS)
Pelaccio, Dennis G.; Scheil, Christine M.; Petrosky, Lyman
1993-01-01
This Program User's Guide discusses the Nuclear Thermal Propulsion (NTP) engine system design features and capabilities modeled in the Nuclear Engine System Simulation (NESS): Version 2.0 program (referred to as NESS throughout the remainder of this document), as well as its operation. NESS was upgraded to include many new modeling capabilities not available in the original version delivered to NASA LeRC in Dec. 1991, NESS's new features include the following: (1) an improved input format; (2) an advanced solid-core NERVA-type reactor system model (ENABLER 2); (3) a bleed-cycle engine system option; (4) an axial-turbopump design option; (5) an automated pump-out turbopump assembly sizing option; (6) an off-design gas generator engine cycle design option; (7) updated hydrogen properties; (8) an improved output format; and (9) personal computer operation capability. Sample design cases are presented in the user's guide that demonstrate many of the new features associated with this upgraded version of NESS, as well as design modeling features associated with the original version of NESS.
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NASA Technical Reports Server (NTRS)
Miller, R. H.; Minsky, M. L.; Smith, D. B. S.
1982-01-01
Applications of automation, robotics, and machine intelligence systems (ARAMIS) to space activities and their related ground support functions are studied, so that informed decisions can be made on which aspects of ARAMIS to develop. The specific tasks which will be required by future space project tasks are identified and the relative merits of these options are evaluated. The ARAMIS options defined and researched span the range from fully human to fully machine, including a number of intermediate options (e.g., humans assisted by computers, and various levels of teleoperation). By including this spectrum, the study searches for the optimum mix of humans and machines for space project tasks.
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2013-01-01
Background Bronchiolitis is a distressing respiratory condition and the most common cause of hospitalization during the first year of life. The hospitalization of an infant is a stressful event for parents and deserves careful consideration. The objective of this work was to develop and validate a self-administered instrument that comprehensively assesses the impact on parents of the hospitalization of their infant for bronchiolitis. Methods The Impact of Bronchiolitis Hospitalization Questionnaire (IBHQ©) was developed using a literature review and pre-study interviews with both parents and clinicians. For finalization and psychometric validation, it was included in a multicenter, longitudinal, observational study conducted in France. Parents of infants under the age of 1 year and hospitalized for bronchiolitis were asked to complete the questionnaire at hospital discharge, and 3 months after. Results Seven hundred and seven questionnaires were completed by the parents of the 463 eligible infants. After finalization, based on principal component analyses, the IBHQ included 30 core items allowing the calculation of 7 dimension core scores (Worries and distress; Fear for future; Guilt; Impact on daily organization; Physical impact; Impact on behavior with hospitalized infant; Financial impact), as well as 16 optional items, allowing the calculation of 5 optional dimension scores (Disturbed breastfeeding; Physical reaction of hospitalized infant; Impact on feeding; Impact on behavior with other infants; Siblings’ reaction). Internal consistency reliability and construct validity of the IBHQ were satisfactory. The highest impact was observed for “Worries and distress”, “Fear for future” and “Impact on daily organization” scores. Conclusions The IBHQ is a reliable and valid instrument for assessing the multifaceted impact on parents of the hospitalization of their infant for bronchiolitis. PMID:23849687
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Lin, Yansong; Wang, Chen; Gao, Wen; Cui, Ruixue; Liang, Jun
2017-06-27
Currently, patients with radioiodine refractory differentiated thyroid cancer (RAIR-DTC) have limited treatment options. In this study, we aimed to assess the short-term efficacy and safety of apatinib in RAIR-DTC. Ten adult patients were prospectively enrolled to receive oral apatinib (750 mg q.d). The primary endpoints were change in serum thyroglobulin (Tg) concentration, disease control rate (DCR) and objective response rate (ORR) based on RECIST 1.1 criteria. The secondary endpoints included change in glucose metabolism, evaluated by maximum standard uptake value (SUVmax), and safety. As early as 2 weeks after apatinib treatment, the serum Tg concentration decreased by 21.0% in 8 patients available for detection without interference, and a further sharp decline by 81.4% compared with the baseline level occurred at 8 weeks post-treatment. The DCR and ORR were 100% (10/10) and 90% (9/10), respectively. The sum of tumor diameter shrank to 22.8±8.1 mm from 38.8±15.7 mm (P=0.001). Moreover, a significant decrease in SUVmax was observed from 6.53±5.14 to 2.56±1.67 and 2.45±1.48 at 4-week and 8-week time-points after treatment (P=0.032 and 0.020), respectively. The common grade 3 adverse events (AEs) included hand-foot-skin reaction (50%), hypertension (30%), and hypocalcemia (20%). No severe AE related to apatinib was observed during treatment. Hence, apatinib seems to be a promising therapeutic option for RAIR-DTC patients. Apart from RECIST 1.1 criteria, the biochemical marker (Tg) and glucose metabolism index (SUVmax) could be adopted in assessing the early response to TKI in RAIR-DTC.
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Gao, Wen; Cui, Ruixue; Liang, Jun
2017-01-01
Currently, patients with radioiodine refractory differentiated thyroid cancer (RAIR-DTC) have limited treatment options. In this study, we aimed to assess the short-term efficacy and safety of apatinib in RAIR-DTC. Ten adult patients were prospectively enrolled to receive oral apatinib (750 mg q.d). The primary endpoints were change in serum thyroglobulin (Tg) concentration, disease control rate (DCR) and objective response rate (ORR) based on RECIST 1.1 criteria. The secondary endpoints included change in glucose metabolism, evaluated by maximum standard uptake value (SUVmax), and safety. As early as 2 weeks after apatinib treatment, the serum Tg concentration decreased by 21.0% in 8 patients available for detection without interference, and a further sharp decline by 81.4% compared with the baseline level occurred at 8 weeks post-treatment. The DCR and ORR were 100% (10/10) and 90% (9/10), respectively. The sum of tumor diameter shrank to 22.8±8.1 mm from 38.8±15.7 mm (P=0.001). Moreover, a significant decrease in SUVmax was observed from 6.53±5.14 to 2.56±1.67 and 2.45±1.48 at 4-week and 8-week time-points after treatment (P=0.032 and 0.020), respectively. The common grade 3 adverse events (AEs) included hand-foot-skin reaction (50%), hypertension (30%), and hypocalcemia (20%). No severe AE related to apatinib was observed during treatment. Hence, apatinib seems to be a promising therapeutic option for RAIR-DTC patients. Apart from RECIST 1.1 criteria, the biochemical marker (Tg) and glucose metabolism index (SUVmax) could be adopted in assessing the early response to TKI in RAIR-DTC. PMID:28178685
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Kingsbury, Sarah R; Corp, Nadia; Watt, Fiona E; Felson, David T; O'Neill, Terence W; Holt, Cathy A; Jones, Richard K; Conaghan, Philip G; Arden, Nigel K
2016-08-01
Treatment of OA by stratifying for commonly used and novel therapies will likely improve the range of effective therapy options and their rational deployment in this undertreated, chronic disease. In order to develop appropriate datasets for conducting post hoc analyses to inform approaches to stratification for OA, our aim was to develop recommendations on the minimum data that should be recorded at baseline in all future OA interventional and observational studies. An Arthritis Research UK study group comprised of 32 experts used a Delphi-style approach supported by a literature review of systematic reviews to come to a consensus on core data collection for OA studies. Thirty-five systematic reviews were used as the basis for the consensus group discussion. For studies with a primary structural endpoint, core domains for collection were defined as BMI, age, gender, racial origin, comorbidities, baseline OA pain, pain in other joints and occupation. In addition to the items generalizable to all anatomical sites, joint-specific domains included radiographic measures, surgical history and anatomical factors, including alignment. To demonstrate clinical relevance for symptom studies, the collection of mental health score, self-efficacy and depression scales were advised in addition to the above. Currently it is not possible to stratify patients with OA into therapeutic groups. A list of core and optional data to be collected in all OA interventional and observational studies was developed, providing a basis for future analyses to identify predictors of progression or response to treatment. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology.
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Stier, Christine; Chiappetta, Sonja
2016-08-01
Dumping syndrome is a long-term postoperative complication of Roux-en-Y gastric bypass procedures. Morphologically, dumping syndrome usually correlates with a dilatation of the gastroenterostomy with accelerated pouch emptying. Conservative therapy includes diet changes, complementary pharmacotherapy and, if symptoms persist, surgical revision. Surgical options include endoscopic, endoluminal surgery to constrict the gastrojejunostomy using a novel endoscopic suturing device (OverStitch(TM), Apollo). In our study, we aimed to assess the viability, safety and efficacy of this procedure in patients with late dumping; 14 patients who had developed late dumping syndrome underwent surgery using an endoscopic suturing technique (OverStitch(TM), Apollo). Late dumping was confirmed by Sigstad score and an oral glucose tolerance test (OGTT). Prior to surgery, objective analysis of pouch emptying speed was assessed by gastric scintigraphy. Surgery was performed under general anaesthesia. None of the 14 patients suffered intra- or postoperative complications. No postsurgical increase in inflammation parameters was observed. The postinterventional pain scale (visual analogue scale) showed a mean score of 0.5 (range 0-10). In 13 of the 14 patients, no dumping was observed 1-month postsurgery. The postoperative Sigstad score (3.07 ± 2.06; range 1-9) showed an impressive reduction compared with the preoperative score (12.71 ± 4.18; range 7-24) (p < 0.001). Postoperative upper gastrointestinal gastrografin swallow revealed regular emptying in all the patients. The endoluminal endoscopic suturing technique-applied here for surgical revision of gastroenterostomy following Roux-en-Y gastric bypass-represents a promising, novel therapeutic option in late dumping syndrome involving minimal trauma and offering rapid reconvalescence.
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Johns, Benjamin; Adam, Taghreed; Evans, David B
2006-01-01
Background National and international policy makers have been increasing their focus on developing strategies to enable poor countries achieve the millennium development goals. This requires information on the costs of different types of health interventions and the resources needed to scale them up, either singly or in combinations. Cost data also guides decisions about the most appropriate mix of interventions in different settings, in view of the increasing, but still limited, resources available to improve health. Many cost and cost-effectiveness studies include only the costs incurred at the point of delivery to beneficiaries, omitting those incurred at other levels of the system such as administration, media, training and overall management. The few studies that have measured them directly suggest that they can sometimes account for a substantial proportion of total costs, so that their omission can result in biased estimates of the resources needed to run a programme or the relative cost-effectiveness of different choices. However, prices of different inputs used in the production of health interventions can vary substantially within a country. Basing cost estimates on a single price observation runs the risk that the results are based on an outlier observation rather than the typical costs of the input. Methods We first explore the determinants of the observed variation in the prices of selected "non-traded" intermediate inputs to health programmes – printed matter and media advertising, and water and electricity – accounting for variation within and across countries. We then use the estimated relationship to impute average prices for countries where limited data are available with uncertainty intervals. Results Prices vary across countries with GDP per capita and a number of determinants of supply and demand. Media and printing were inelastic with respect to GDP per capita, with a positive correlation, while the utilities had a surprisingly negative relationship. All equations had relatively good fits with the data. Conclusion While the preferred option is to derive costs from a random sample of prices in each setting, this option is often not available to analysts. In this case, we suggest that the approach described in this paper could represent a better option than basing policy recommendations on results that are built on the basis of a single, or a few, price observations. PMID:16630364
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Johns, Benjamin; Adam, Taghreed; Evans, David B
2006-04-24
National and international policy makers have been increasing their focus on developing strategies to enable poor countries achieve the millennium development goals. This requires information on the costs of different types of health interventions and the resources needed to scale them up, either singly or in combinations. Cost data also guides decisions about the most appropriate mix of interventions in different settings, in view of the increasing, but still limited, resources available to improve health. Many cost and cost-effectiveness studies include only the costs incurred at the point of delivery to beneficiaries, omitting those incurred at other levels of the system such as administration, media, training and overall management. The few studies that have measured them directly suggest that they can sometimes account for a substantial proportion of total costs, so that their omission can result in biased estimates of the resources needed to run a programme or the relative cost-effectiveness of different choices. However, prices of different inputs used in the production of health interventions can vary substantially within a country. Basing cost estimates on a single price observation runs the risk that the results are based on an outlier observation rather than the typical costs of the input. We first explore the determinants of the observed variation in the prices of selected "non-traded" intermediate inputs to health programmes--printed matter and media advertising, and water and electricity--accounting for variation within and across countries. We then use the estimated relationship to impute average prices for countries where limited data are available with uncertainty intervals. Prices vary across countries with GDP per capita and a number of determinants of supply and demand. Media and printing were inelastic with respect to GDP per capita, with a positive correlation, while the utilities had a surprisingly negative relationship. All equations had relatively good fits with the data. While the preferred option is to derive costs from a random sample of prices in each setting, this option is often not available to analysts. In this case, we suggest that the approach described in this paper could represent a better option than basing policy recommendations on results that are built on the basis of a single, or a few, price observations.
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Antihistamines: Understanding Your OTC Options
... you can buy over the counter include: Brompheniramine (brand names include Children’s Dimetapp Cold) Chlorpheniramine (brand names include Chlor-Trimeton, Actifed Cold) Dimenhydrinate (brand ...
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Zeybek, Burak; Childress, Andrew; Kilic, Gokhan S.; Phelps, John; Pacheco, Luis; Carter, Michele; Borahay, Mostafa A.
2016-01-01
Importance Obstetricians and gynecologists frequently deal with hemorrhage so they should be familiar with management of patients who refuse blood transfusion. Although there are some reports in the literature about management of Jehovah’s Witness patients in obstetrics and gynecology, most of them are case reports and a comprehensive review about these patients including ethico-legal perspective is lacking. Objective This review outlines the medical, ethical and legal implications of management of Jehovah’s Witness patients in obstetrical and gynecological settings. Evidence Acquisition A search of published literature using Pubmed, Ovid Medline, EMBASE and Cochrane databases was conducted about physiology of oxygen delivery and response to tissue hypoxia, mortality rates at certain hemoglobin levels, medical management options for anemic patients who refuse blood transfusion and ethical/legal considerations in Jehovah’s Witness patients. Results Early diagnosis of anemia and immediate initiation of therapy is essential in patients who refuse blood transfusion. Medical management options include iron supplementation and erythropoietin. There are also some promising therapies that are in development such as anti-hepcidin antibodies and hemoglobin based oxygen carriers. Options to decrease blood loss include anti-fibrinolytics, desmopressin, recombinant Factor VII and factor concentrates. When surgery is the only option, every effort should be made to pursue minimally invasive approaches. Conclusion and Relevance All obstetricians and gynecologists should be familiar with alternatives and ‘less invasive’ options for patients who refuse blood transfusions. Target Audience Obstetricians and gynecologists, family physicians PMID:27526872
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Current treatment for vitreous floaters.
Sendrowski, David P; Bronstein, Mark A
2010-03-01
Vitreous floaters are a common complaint in the ophthalmic care setting. Patients seek explanation and advice regarding possible treatment options. Because the condition is considered benign, ophthalmic care practitioners have little to offer regarding treatment options. The majority of cases encountered are managed with patient education and reassurance. Although almost all patients accept the conservative management option, there is a small subset of patients who may desire a more aggressive treatment intervention for resolution of their visual symptoms. Information with regard to treatment options is readily available to patients through Internet searches and non-peer reviewed educational Web sites. The risks and benefits for these treatment options are not fully covered. Management of floaters should include education regarding "off-label" procedures as well as discussion about benefits and risks associated with such treatment options. It is vital that eye care practitioners advise and counsel patients with symptomatic floaters for optimum ocular health care. This article reviews the current conventional and "off-label" treatment options for symptomatic patients with vitreous floaters. Copyright (c) 2010 American Optometric Association. Published by Elsevier Inc. All rights reserved.
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NASA Technical Reports Server (NTRS)
Giddings, L.; Boston, S.
1976-01-01
A method for digitizing zone maps is presented, starting with colored images and producing a final one-channel digitized tape. This method automates the work previously done interactively on the Image-100 and Data Analysis System computers of the Johnson Space Center (JSC) Earth Observations Division (EOD). A color-coded map was digitized through color filters on a scanner to form a digital tape in LARSYS-2 or JSC Universal format. The taped image was classified by the EOD LARSYS program on the basis of training fields included in the image. Numerical values were assigned to all pixels in a given class, and the resulting coded zone map was written on a LARSYS or Universal tape. A unique spatial filter option permitted zones to be made homogeneous and edges of zones to be abrupt transitions from one zone to the next. A zoom option allowed the output image to have arbitrary dimensions in terms of number of lines and number of samples on a line. Printouts of the computer program are given and the images that were digitized are shown.
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Correlates of decisional dynamics in the dorsal anterior cingulate cortex
Hayden, Benjamin Y.
2017-01-01
We hypothesized that during binary economic choice, decision makers use the first option they attend as a default to which they compare the second. To test this idea, we recorded activity of neurons in the dorsal anterior cingulate cortex (dACC) of macaques choosing between gambles presented asynchronously. We find that ensemble encoding of the value of the first offer includes both choice-dependent and choice-independent aspects, as if reflecting a partial decision. That is, its responses are neither entirely pre- nor post-decisional. In contrast, coding of the value of the second offer is entirely decision dependent (i.e., post-decisional). This result holds even when offer-value encodings are compared within the same time period. Additionally, we see no evidence for 2 pools of neurons linked to the 2 offers; instead, all comparison appears to occur within a single functionally homogenous pool of task-selective neurons. These observations suggest that economic choices reflect a context-dependent evaluation of attended options. Moreover, they raise the possibility that value representations reflect, to some extent, a tentative commitment to a choice. PMID:29141002
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Kawaguchi, Tomohiro; Arakawa, Kazuya; Nomura, Kazuhiro; Ogawa, Yoshikazu; Katori, Yukio; Tominaga, Teiji
2017-12-01
Endoscopic endonasal surgery, an innovative surgical technique, is used to approach sinus lesions, lesions of the skull base, and intradural tumors. The cooperation of experienced otolaryngologists and neurosurgeons is important to achieve safe and reliable surgical results. The bath plug closure method is a treatment option for patients with cerebrospinal fluid(CSF)leakage. Although it includes dural and/or intradural procedures, surgery tends to be performed by otolaryngologists because its indications, detailed maneuvers, and pitfalls are not well recognized by neurosurgeons. We reviewed the cases of patients with CSF leakage treated by using the bath plug closure method with an endoscopic endonasal approach at our institution. Three patients were treated using the bath plug closure method. CSF leakage was caused by a meningocele in two cases and trauma in one case. No postoperative intracranial complications or recurrence of CSF leakage were observed. The bath plug closure method is an effective treatment strategy and allows neurosurgeons to gain in-depth knowledge of the treatment options for CSF leakage by using an endoscopic endonasal approach.
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Is the chronic Tier-1 effect assessment approach for insecticides protective for aquatic ecosystems?
Brock, Theo Cm; Bhatta, Ranjana; van Wijngaarden, René Pa; Rico, Andreu
2016-10-01
We investigated the appropriateness of several methods, including those recommended in the Aquatic Guidance Document of the European Food Safety Authority (EFSA), for the derivation of chronic Tier-1 regulatory acceptable concentrations (RACs) for insecticides and aquatic organisms. The insecticides represented different chemical classes (organophosphates, pyrethroids, benzoylureas, insect growth regulators, biopesticides, carbamates, neonicotinoids, and miscellaneous). Chronic Tier-1 RACs derived using toxicity data for the standard species Daphnia magna, Chironomus spp., and/or Americamysis bahia, were compared with Tier-3 RACs derived from micro- and mesocosm studies on basis of the ecological threshold option (ETO-RACs). ETO-RACs could be derived for 31 insecticides applied to micro- and mesocosms in single or multiple applications, yielding a total number of 36 cases for comparison. The chronic Tier-1 RACs calculated according to the EFSA approach resulted in a sufficient protection level, except for 1 neonicotinoid (slightly underprotective) and for several pyrethroids if toxicity data for A. bahia were not included. This latter observation can be explained by 1) the fact that A. bahia is the most sensitive standard test species for pyrethroids, 2) the hydrophobic properties of pyrethroids, and 3) the fact that long-term effects observed in (epi) benthic arthropods may be better explained by exposure via the sediment than via overlying water. Besides including toxicity data for A. bahia, the protection level for pyrethroids can be improved by selecting both D. magna and Chironomus spp. as standard test species for chronic Tier-1 derivation. Although protective in the majority of cases, the conservativeness of the recommended chronic Tier-1 RACs appears to be less than an order of magnitude for a relatively large proportion of insecticides when compared with their Tier-3 ETO-RACs. This may leave limited options for refinement of the chronic effect assessment using laboratory toxicity data for additional species. Integr Environ Assess Manag 2016;12:747-758. © 2015 SETAC. © 2015 SETAC.
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How federalism shapes public health financing, policy, and program options.
Ogden, Lydia L
2012-01-01
In the United States, fiscal and functional federalism strongly shape public health policy and programs. Federalism has implications for public health practice: it molds financing and disbursement options, including funding formulas, which affect allocations and program goals, and shapes how funding decisions are operationalized in a political context. This article explores how American federalism, both fiscal and functional, structures public health funding, policy, and program options, investigating the effects of intergovernmental transfers on public health finance and programs.
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Effect of increasing the choice of active options on children’s physical activity
USDA-ARS?s Scientific Manuscript database
Objectives: To determine whether increasing the choice of physical activity options increases the duration and intensity of children’s physical activity. Design: This cross-sectional laboratory study included gender (male, female) and choice group [single toy (no choice), three toys (low choice...
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Reusing remediated CCA-treated wood
Carol A. Clausen
2003-01-01
Options for recycling and reusing chromated-copper-arsenate- (CCA) treated material include dimensional lumber and round wood size reduction, composites, and remediation. Size reduction by remilling, shaving, or resawing CCA-treated wood reduces the volume of landfilled waste material and provides many options for reusing used treated wood. Manufacturing composite...
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Choices and Motivations of Infertile Couples.
ERIC Educational Resources Information Center
van Balen, Frank; Verdurmen, Jacqueline; Ketting, Evert
1997-01-01
Infertile couples' (N=131) consideration of options for dealing with infertility (medical help, adoption, fostering, alternative medicine, and focusing on other life goals) is studied. Options were related to specific motivations including altruistic motives for adoption or foster care. Results, timing of choices, and motivations are discussed.…
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Distributing the Wealth: Sliding CD-ROM into the Consumer Channel.
ERIC Educational Resources Information Center
Bowers, Richard A.
1994-01-01
Examines retail sales of CD-ROMs. Topics addressed include the current situation in CD-ROM retailing; channel distribution options; myths and realities of CD-ROM distribution; the distributor; affiliate labels; sales representatives; copublishers; distribution options; distributing resources; and recommendations for new CD-ROM publishers. (LRW)
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24 CFR 965.505 - Standards for allowances for utilities.
Code of Federal Regulations, 2010 CFR
2010-04-01
... PHA installs air conditioning, it shall provide, to the maximum extent economically feasible, systems... systems that offer each resident the option to choose air conditioning shall include retail meters or... allowances. For systems that offer residents the option to choose air conditioning but cannot be checkmetered...
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Placement of Students with Emotional and Behavioral Disorders
ERIC Educational Resources Information Center
Mathur, Sarup R.; Jolivette, Kristine
2012-01-01
Students with emotional and behavioral disorders (E/BD) receive educational and related services within a continuum of placement options per the Individual with Disabilities Education Act. The continuum of placement options ranges from fully included general education type classrooms to more restrictive environments such as alternative education…
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Note-Taking and Memory in Different Media Environments
ERIC Educational Resources Information Center
Lin, Lin; Bigenho, Chris
2011-01-01
Through this study the authors investigated undergraduate students' memory recall in three media environments with three note-taking options, following an A x B design with nine experiments. The three environments included no-distraction, auditory-distraction, and auditory-visual-distraction; while the three note-taking options included…
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Code of Federal Regulations, 2014 CFR
2014-07-01
... REGULATION Acid Rain Compliance Plan and Compliance Options § 72.40 General. (a) For each affected unit included in an Acid Rain permit application, a complete compliance plan shall: (1) For sulfur dioxide... of the Acid Rain compliance options. (2) For nitrogen oxides emissions, certify that the unit will...
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Code of Federal Regulations, 2010 CFR
2010-07-01
... REGULATION Acid Rain Compliance Plan and Compliance Options § 72.40 General. (a) For each affected unit included in an Acid Rain permit application, a complete compliance plan shall: (1) For sulfur dioxide... of the Acid Rain compliance options. (2) For nitrogen oxides emissions, certify that the unit will...
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Code of Federal Regulations, 2013 CFR
2013-07-01
... REGULATION Acid Rain Compliance Plan and Compliance Options § 72.40 General. (a) For each affected unit included in an Acid Rain permit application, a complete compliance plan shall: (1) For sulfur dioxide... of the Acid Rain compliance options. (2) For nitrogen oxides emissions, certify that the unit will...
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Code of Federal Regulations, 2012 CFR
2012-07-01
... REGULATION Acid Rain Compliance Plan and Compliance Options § 72.40 General. (a) For each affected unit included in an Acid Rain permit application, a complete compliance plan shall: (1) For sulfur dioxide... of the Acid Rain compliance options. (2) For nitrogen oxides emissions, certify that the unit will...
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Code of Federal Regulations, 2011 CFR
2011-07-01
... REGULATION Acid Rain Compliance Plan and Compliance Options § 72.40 General. (a) For each affected unit included in an Acid Rain permit application, a complete compliance plan shall: (1) For sulfur dioxide... of the Acid Rain compliance options. (2) For nitrogen oxides emissions, certify that the unit will...
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Consider Creating a Channel Management Strategy with Both Colleagues and Patients
Felkey, Bill G.; Fox, Brent I.
2013-01-01
Patient engagement is poised to provide considerable opportunities for reaching patients. The range of connectivity options should be considered to include the best option for each specific patient. In this article, we address this area of growing importance, telecommunication channel management. PMID:24421455
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Code of Federal Regulations, 2014 CFR
2014-04-01
... option customer, other than for a customer specified in § 1.55(f) of this chapter, unless the futures commission merchant or introducing broker first: (i) Furnishes the option customer with a separate written... includes either such statement in a booklet containing the customer account agreement and other disclosure...
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Automatic, Multiple Assessment Options in Undergraduate Meteorology Education
ERIC Educational Resources Information Center
Kahl, Jonathan D. W.
2017-01-01
Since 2008, automatic, multiple assessment options have been utilised in selected undergraduate meteorology courses at the University of Wisconsin--Milwaukee. Motivated by a desire to reduce stress among students, the assessment methodology includes examination-heavy and homework-heavy alternatives, differing by an adjustable 15% of the overall…
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Code of Federal Regulations, 2013 CFR
2013-04-01
... option customer, other than for a customer specified in § 1.55(f) of this chapter, unless the futures commission merchant or introducing broker first: (i) Furnishes the option customer with a separate written... includes either such statement in a booklet containing the customer account agreement and other disclosure...
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The Food Environment of Youth Baseball
Irby, Megan B.; Drury-Brown, Marcie
2014-01-01
Abstract Background: Sports, such as youth baseball (YB), are popular outlets for increasing activity, yet there has been no investigation of food environments surrounding them. The aim of this study was to observe the types of foods available and consumed by players and spectators at YB events. Methods: This was an observational assessment, by environmental scan, of foods consumed by players and family members at a YB field in northwest North Carolina. Results: Participants included boys from six YB teams (n=51) between 8 and 11 years of age and families. A total of 12 YB games were observed. Most team snacks (72%) consisted of high-calorie food items, including French fries, candy, and cookies; most beverages (53%) consumed by players were sugar sweetened. We observed 313 spectators and players, who consumed a total of 249 foods and 276 beverages. Most food and beverage items (89%) were purchased from the concession stand, of which 73% were considered less-healthy options. Conclusions: High-calorie snacks and sugar-sweetened beverages dominate the YB environment. Despite the benefits of participating in sports, families of children participating in sports leagues may be increasing their risk for poor nutritional habits as a result of increased exposure to unhealthy foods and disruption of meal times. PMID:24745374
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NASA Technical Reports Server (NTRS)
Tibbetts, J. G.
1980-01-01
Detailed instructions for using the near field cruise noise prediction program, a program listing, and a sample case with output are presented. The total noise for free field lossless conditions at selected observer locations is obtained by summing the contributions from up to nine acoustic sources. These noise sources, selected at the user's option, include the fan/compressor, turbine, core (combustion), jet, shock, and airframe (trailing edge and turbulent boundary layers). The effects of acoustic suppression materials such as engine inlet treatment may also be included in the noise prediction. The program is available for use on the NASA/Langley Research Center CDC computer. Comparisons of the program predictions with measured data are also given, and some possible reasons for their lack of agreement presented.
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AQUA-USERS: AQUAculture USEr Driven Operational Remote Sensing Information Services
NASA Astrophysics Data System (ADS)
Laanen, Marnix; Poser, Kathrin; Peters, Steef; de Reus, Nils; Ghebrehiwot, Semhar; Eleveld, Marieke; Miller, Peter; Groom, Steve; Clements, Oliver; Kurekin, Andrey; Martinez Vicente, Victor; Brotas, Vanda; Sa, Carolina; Couto, Andre; Brito, Ana; Amorim, Ana; Dale, Trine; Sorensen, Kai; Boye Hansen, Lars; Huber, Silvia; Kaas, Hanne; Andersson, Henrik; Icely, John; Fragoso, Bruno
2015-12-01
The FP7 project AQUA-USERS provides the aquaculture industry with user-relevant and timely information based on the most up-to-date satellite data and innovative optical in-situ measurements. Its key purpose is to develop an application that brings together satellite information on water quality and temperature with in-situ observations as well as relevant weather prediction and met-ocean data. The application and its underlying database are linked to a decision support system that includes a set of (user-determined) management options. Specific focus is on the development of indicators for aquaculture management including indicators for harmful algae bloom (HAB) events. The methods and services developed within AQUA-USERS are tested by the members of the user board, who represent different geographic areas and aquaculture production systems.
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Cranberries and lower urinary tract infection prevention
Hisano, Marcelo; Bruschini, Homero; Nicodemo, Antonio Carlos; Srougi, Miguel
2012-01-01
Lower urinary tract infections are very common diseases. Recurrent urinary tract infections remain challenging to treat because the main treatment option is long-term antibiotic prophylaxis; however, this poses a risk for the emergence of bacterial resistance. Some options to avoid this risk are available, including the use of cranberry products. This article reviews the key methods in using cranberries as a preventive measure for lower urinary tract infections, including in vitro studies and clinical trials. PMID:22760907
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Options Counseling for the Pregnant Adolescent Patient.
Hornberger, Laurie L
2017-09-01
Each year, more than 500 000 girls and young women younger than 20 years become pregnant. It is important for pediatricians to have the ability and the resources in their offices to make a timely pregnancy diagnosis in their adolescent patients and provide them with nonjudgmental pregnancy options counseling. Counseling includes an unbiased discussion of the adolescent's legal options to either continue or terminate her pregnancy, supporting the adolescent in the decision-making process, and referring the adolescent to appropriate resources and services. Pediatricians who choose not to provide such discussions should promptly refer pregnant adolescent patients to a health care professional who will offer developmentally appropriate pregnancy options counseling. This approach to pregnancy options counseling has not changed since the original 1989 American Academy of Pediatrics statement on this issue. Copyright © 2017 by the American Academy of Pediatrics.
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Evaluating State Options for Reducing Medicaid Churning
Swartz, Katherine; Short, Pamela Farley; Graefe, Deborah R.; Uberoi, Namrata
2015-01-01
Medicaid churning - the constant exit and re-entry of beneficiaries as their eligibility changes - has long been a problem for both Medicaid administrators and recipients. Churning will continue under the Affordable Care Act, because despite new federal rules, Medicaid eligibility will continue to be based on current monthly income. We developed a longitudinal simulation model to evaluate four policy options for modifying or extending Medicaid eligibility to reduce churning. The simulations suggest that two options, extending Medicaid eligibility either to the end of a calendar year or for twelve months after enrollment, would be far more effective in reducing churning than the other options of a three-month extension or eligibility based on projected annual income. States should consider implementation of the option that best balances costs, including both administration and services, with improved health of Medicaid enrollees. PMID:26153313
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Engineering Options Assessment Report. Nitrate Salt Waste Stream Processing
DOE Office of Scientific and Technical Information (OSTI.GOV)
Anast, Kurt Roy
2015-11-13
This report examines and assesses the available systems and facilities considered for carrying out remediation activities on remediated nitrate salt (RNS) and unremediated nitrate salt (UNS) waste containers at Los Alamos National Laboratory (LANL). The assessment includes a review of the waste streams consisting of 60 RNS, 29 above-ground UNS, and 79 candidate below-ground UNS containers that may need remediation. The waste stream characteristics were examined along with the proposed treatment options identified in the Options Assessment Report . Two primary approaches were identified in the five candidate treatment options discussed in the Options Assessment Report: zeolite blending and cementation.more » Systems that could be used at LANL were examined for housing processing operations to remediate the RNS and UNS containers and for their viability to provide repackaging support for remaining LANL legacy waste.« less
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Engineering Options Assessment Report: Nitrate Salt Waste Stream Processing
DOE Office of Scientific and Technical Information (OSTI.GOV)
Anast, Kurt Roy
2015-11-18
This report examines and assesses the available systems and facilities considered for carrying out remediation activities on remediated nitrate salt (RNS) and unremediated nitrate salt (UNS) waste containers at Los Alamos National Laboratory (LANL). The assessment includes a review of the waste streams consisting of 60 RNS, 29 aboveground UNS, and 79 candidate belowground UNS containers that may need remediation. The waste stream characteristics were examined along with the proposed treatment options identified in the Options Assessment Report . Two primary approaches were identified in the five candidate treatment options discussed in the Options Assessment Report: zeolite blending and cementation.more » Systems that could be used at LANL were examined for housing processing operations to remediate the RNS and UNS containers and for their viability to provide repackaging support for remaining LANL legacy waste.« less
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Energy Conversion and Storage Requirements for Hybrid Electric Aircraft
NASA Technical Reports Server (NTRS)
Misra, Ajay
2016-01-01
Among various options for reducing greenhouse gases in future large commercial aircraft, hybrid electric option holds significant promise. In the hybrid electric aircraft concept, gas turbine engine is used in combination with an energy storage system to drive the fan that propels the aircraft, with gas turbine engine being used for certain segments of the flight cycle and energy storage system being used for other segments. The paper will provide an overview of various energy conversion and storage options for hybrid electric aircraft. Such options may include fuel cells, batteries, super capacitors, multifunctional structures with energy storage capability, thermoelectric, thermionic or a combination of any of these options. The energy conversion and storage requirements for hybrid electric aircraft will be presented. The role of materials in energy conversion and storage systems for hybrid electric aircraft will be discussed.
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Fluconazole resistance in Candida species: a current perspective
Berkow, Elizabeth L; Lockhart, Shawn R
2017-01-01
Candida albicans and the emerging non-albicans Candida spp. have significant clinical relevance among many patient populations. Current treatment guidelines include fluconazole as a primary therapeutic option for the treatment of these infections, but it is only fungistatic against Candida spp. and both inherent and acquired resistance to fluconazole have been reported. Such mechanisms of resistance include increased drug efflux, alteration or increase in the drug target, and development of compensatory pathways for producing the target sterol, ergosterol. While many mechanisms of resistance observed in C. albicans are also found in the non-albicans species, there are also important and unexpected differences between species. Furthermore, mechanisms of fluconazole resistance in emerging Candida spp., including the global health threat Candida auris, are largely unknown. In order to preserve the utility of one of our fundamental antifungal drugs, fluconazole, it is essential that we fully appreciate the manner by which Candida spp. manifest resistance to it. PMID:28814889
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Bioremediation of oil-contaminated soils: A recipe for success
DOE Office of Scientific and Technical Information (OSTI.GOV)
Wittenbach, S.A.
1995-12-31
Bioremediation of land crude oil and lube oil spills is an effective and economical option. Other options include road spreading (where permitted), thermal desorption, and off-site disposal. The challenge for environment and operations managers is to select the best approach for each remediation site. Costs and liability for off-site disposal are ever increasing. Kerr-McGee`s extensive field research in eastern and western Texas provides the data to support bioremediation as a legitimate and valid option. Both practical and economical bioremediation as a legitimate and valid option. Both practical and economical, bioremediation also offers a lower risk of, for example, Superfund clean-upmore » exposure than off-site disposal.« less
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Medical management of heavy menstrual bleeding
Maybin, Jacqueline A; Critchley, Hilary OD
2016-01-01
Women with benign heavy menstrual bleeding have the choice of a number of medical treatment options to reduce their blood loss and improve quality of life. The role of the clinician is to provide information to facilitate women in making an appropriate choice. Unfortunately, many options can be associated with hormonal side effects, prevention of fertility and lack of efficacy, leading to discontinuation and progression to surgical interventions. Herein, we discuss the various options currently available to women, including antifibrinolytics, nonsteroidal anti-inflammatory preparations, oral contraceptive pills and oral, injectable and intrauterine progestogens. In addition, we describe the more novel option of selective progesterone receptor modulators and their current benefits and limitations. PMID:26695687
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First Scientific Working Group Meeting of Airborne Doppler Lidar Wind Velocity Measurement Program
NASA Technical Reports Server (NTRS)
Kaufman, J. W. (Editor)
1980-01-01
The purpose of the first scientific working group meeting was fourfold: (1) to identify flight test options for engineering verification of the MSFC Doppler Lidar; (2) to identify flight test options for gathering data for scientific/technology applications; (3) to identify additional support equipment needed on the CV 990 aircraft for the flight tests; and (4) to identify postflight data processing and data sets requirements. The working group identified approximately ten flight options for gathering data on atmospheric dynamics processes, including turbulence, valley breezes, and thunderstorm cloud anvil and cold air outflow dynamics. These test options will be used as a basis for planning the fiscal year 1981 tests of the Doppler Lidar system.
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ERIC Educational Resources Information Center
Boothe, Jennifer L.; Borrego, Joaquin
2004-01-01
The purpose of the study was to examine what parents find as acceptable treatment options for children with behavior problems in a communication disorders population. Parents' acceptability of seven treatment options, including positive reinforcement, time-out, response cost, spanking, overcorrection, differential attention, and medication were…
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Deborah G McCullough; Therese M. Poland; Phillip A. Lewis
2015-01-01
BACKGROUND: Economic and ecological impacts of ash (Fraxinus spp.) mortality resulting from emerald ash borer (EAB) (Agrilus planipennis Fairmaire) invasion are severe in forested, residential and urban areas. Management options include girdling ash trees to attract ovipositing adult beetles and then destroying infested trees...
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Competitive Effects of Means-Tested School Vouchers
ERIC Educational Resources Information Center
Figlio, David N.; Hart, Cassandra M. D.
2010-01-01
School choice options--including both voucher and neo-voucher options like tuition tax credit funded scholarship programs--have become increasingly prevalent in recent years (Howell, Peterson, Wolf and Campbell, 2006). One popular argument for school choice policies, drawing from economic theory, is that public schools will improve the education…
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Energy Services Company | Climate Neutral Research Campuses | NREL
different corporate and ownership structures. While many are large engineering or equipment manufacturers Services Company Options Performance-based contracts can take different forms including guaranteed energy different financing options for energy performance contracting, please refer to page 13 of the April 2009
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-06-24
..., with certain exceptions, are financial derivatives such as futures, options, interest rate swaps and... to evaluate any hedge transaction using derivatives must include the ability to capture all options... NATIONAL CREDIT UNION ADMINISTRATION 12 CFR Part 703 Financial Derivatives Transactions To Offset...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-02-13
...\\ These include, without limitation, options, equities, futures, derivatives, indexes, exchange traded... platforms (e.g. equity and ETF, index, derivatives, futures, foreign currency, and even commodities products... Rule Change To Modify the Short Term Options Series Program February 7, 2013. Pursuant to Section 19(b...
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The Traveler's Guide to E-mail Access.
ERIC Educational Resources Information Center
Clyde, Anne
1999-01-01
Presents options that travelers can use to keep in e-mail contact. Discusses equipment/access issues related to traveling with a laptop; Internet cafes; free e-mail services; accessing home mail via a Web page; and new options e-mail access for travelers. Includes Internet resources on Internet access providers. (AEF)
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78 FR 10249 - Environmental Impact Statement: Will and Kankakee Counties, IL and Lake County, IN
Federal Register 2010, 2011, 2012, 2013, 2014
2013-02-13
... design concepts. Alternatives to be evaluated will include (1) taking no action and (2) evaluating... design issues in a way that does not materially increase overall impacts. The primary environmental... or design options within the selected corridor, financing options, and construction sequencing...
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Excellence in Teacher Education: Options for a Federal Partnership.
ERIC Educational Resources Information Center
Florio, David H.
An overview of options available for Federal cooperation in the improvement of teacher education considers possible areas in which government support may be effective. These include: (1) recruitment of talented students; (2) financial support for prospective teachers; (3) improvement grants to schools of education; (4) grants supporting…
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Pregnancy outcomes in youth with type 2 diabetes: The TODAY Study experience
USDA-ARS?s Scientific Manuscript database
We evaluated pregnancy outcomes, maternal and fetal/neonatal, during the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study. The TODAY study was a randomized controlled trial comparing three treatment options for youth with type 2 diabetes. Informed consent included the req...
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Biomedical Engineering Education: A Conservative Approach
ERIC Educational Resources Information Center
Niemi, Eugene E., Jr.
1973-01-01
Describes the demand for graduates from biomedical engineering programs as being not yet fully able to absorb the supply. Suggests small schools interested in entering the field consider offering their programs at the undergraduate level via a minor or an option. Examples of such options and student projects are included. (CC)
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Effluent treatment for nuclear thermal propulsion ground testing
NASA Technical Reports Server (NTRS)
Shipers, Larry R.
1993-01-01
The objectives are to define treatment functions, review concept options, discuss PIPET effluent treatment system (ETS), and outline future activities. The topics covered include the following: reactor exhaust; effluent treatment functions; effluent treatment categories; effluent treatment options; concept evaluation; PIPETS ETS envelope; PIPET effluent treatment concept; and future activities.
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45 CFR 1306.35 - Family child care program option.
Code of Federal Regulations, 2012 CFR
2012-10-01
... cognitive, socio-emotional, and physical development, including both gross and fine motor. Family child care... 45 Public Welfare 4 2012-10-01 2012-10-01 false Family child care program option. 1306.35 Section 1306.35 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT...
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45 CFR 1306.35 - Family child care program option.
Code of Federal Regulations, 2014 CFR
2014-10-01
... cognitive, socio-emotional, and physical development, including both gross and fine motor. Family child care... 45 Public Welfare 4 2014-10-01 2014-10-01 false Family child care program option. 1306.35 Section 1306.35 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT...
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45 CFR 1306.35 - Family child care program option.
Code of Federal Regulations, 2013 CFR
2013-10-01
... cognitive, socio-emotional, and physical development, including both gross and fine motor. Family child care... 45 Public Welfare 4 2013-10-01 2013-10-01 false Family child care program option. 1306.35 Section 1306.35 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT...
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45 CFR 1306.35 - Family child care program option.
Code of Federal Regulations, 2011 CFR
2011-10-01
... cognitive, socio-emotional, and physical development, including both gross and fine motor. Family child care... 45 Public Welfare 4 2011-10-01 2011-10-01 false Family child care program option. 1306.35 Section 1306.35 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT...
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Achieving Balance: Secondary Physical Education Gender-Grouping Options
ERIC Educational Resources Information Center
Gabbei, Ritchie
2004-01-01
This article provides options and a rationale for expanding gender-grouping considerations to include single-gender, coed, and combination strategies for instruction in secondary physical education classes. This rationale is based on empirical evidence that suggests that female students are denied equal opportunity to achieve learning goals during…
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Multi-band gap and new solar cell options workshop
NASA Technical Reports Server (NTRS)
Hutchby, J.; Timmons, M.; Olson, J. M.
1993-01-01
Discussions of the multi-band gap (MBG) and new solar cell options workshop are presented. Topics discussed include: greater than 2 terminal cells; radiation damage preventing development of MBG cells for space; lattice matching; measurement of true performance; future of II-VI materials in MBG devices; and quaternaries.
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Accelerating Advancement in School and Work
ERIC Educational Resources Information Center
Pennington, Hilary
2003-01-01
The past decade has seen explosive growth in diverse learning options for young people, including new schools, vouchers, charter laws, and distance learning and dual-enrollment options that are blurring the lines between secondary and postsecondary institutions. The ways in which students move across and between the institutions of work and…
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Repaying Your Student Loans, 2003-2004. [Braille Version].
ERIC Educational Resources Information Center
Office of Federal Student Aid (ED), Washington, DC.
This Braille publication explores available options on federal student loans so that borrowers can avoid repayment problems and manage and repay their debts. The guide contains information on repayment plans for Perkins loans, Direct Loans, and Federal Family Education Loans. The repayment options discussed include consolidation, deferment, and…
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12 CFR 220.9 - Clearance of securities, options, and futures.
Code of Federal Regulations, 2010 CFR
2010-01-01
... security (including options on any security, certificate of deposit, securities index or foreign currency); or (ii) Guarantees performance of contracts for the purchase or sale of a commodity for future... Exchange Commission or is the clearing agency for a contract market regulated by the Commodity Futures...
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12 CFR 220.9 - Clearance of securities, options, and futures.
Code of Federal Regulations, 2011 CFR
2011-01-01
... security (including options on any security, certificate of deposit, securities index or foreign currency); or (ii) Guarantees performance of contracts for the purchase or sale of a commodity for future... Exchange Commission or is the clearing agency for a contract market regulated by the Commodity Futures...
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Space station needs, attributes and architectural options study
NASA Technical Reports Server (NTRS)
1983-01-01
All the candidate Technology Development missions investigated during the space station needs, attributes, and architectural options study are described. All the mission data forms plus additional information such as, cost, drawings, functional flows, etc., generated in support of these mission is included with a computer generated mission data form.
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Integrating Research and Practice: Distractions, Controversies, and Options for Moving Forward
ERIC Educational Resources Information Center
Gambrill, Eileen
2015-01-01
Integrating practice and research is vital in all helping professions in order to offer the most ethical, evidence-informed interventions to clients. This article describes some avoidable distractions that hinder integration, discusses controversies related to integration, and describes options for moving forward, including making wasted resources…
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Education for Entrepreneurship in the Curriculum at University Level.
ERIC Educational Resources Information Center
Fleming, Patricia
1999-01-01
An integrated entrepreneurship education program at the University of Limerick, Ireland, promotes awareness of business ownership as a career option. Based on a process model of entrepreneurship, the program includes an entrepreneurship minor option and a required core module for all in the business studies program. (SK)
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30 CFR 90.3 - Part 90 option; notice of eligibility; exercise of option.
Code of Federal Regulations, 2014 CFR
2014-07-01
... as measured by the Mining Research Establishment (MRE) instrument. When the approved sampling device... concentrations. Mechanized mining unit (MMU). A unit of mining equipment including hand loading equipment used for the production of material; or a specialized unit which uses mining equipment other than specified...
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ERIC Educational Resources Information Center
Poulsen, Joyce G.
This paper describes the Winnebago County (Wisconsin) Community Options Program, begun in January, 1982, which provides for a comprehensive assessment of all elderly persons within the target area who are at risk of becoming institutionalized. The paper focuses on the planning activities for the first year of the pilot program including community…
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Can Nutrition Information Increase Sales of Healthful Vended Snacks?
ERIC Educational Resources Information Center
Hoerr, Sharon Marshall; Louden, Victoria Ann
1993-01-01
A study was made of snack selections from unrefrigerated vending machines in relation to increased availabilty of nutrient-dense snack options and provision of nutrient information at four college sites. When snack options included more nutrient-dense choices, sales dropped. When nutrition information was posted on the machines, sales increased…
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Environmental and economic analyses of waste disposal options for traditional markets in Indonesia
DOE Office of Scientific and Technical Information (OSTI.GOV)
Aye, Lu; Widjaya, E.R.
2006-07-01
Waste from traditional markets in Indonesia is the second largest stream of municipal solid waste after household waste. It has a higher organic fraction and may have greater potential to be managed on a business scale compared to household wastes. The attributed reason is that in general the wastes generated from traditional markets are more uniform, more concentrated and less hazardous than waste from other sources. This paper presents the results of environmental and economic assessments to compare the options available for traditional market waste disposal in Indonesia. The options compared were composting in labour intensive plants, composting in amore » centralised plant that utilised a simple wheel loader, centralised biogas production and landfill for electricity production. The current open dumping practice was included as the baseline case. A life cycle assessment (LCA) was used for environmental analysis. All options compared have lower environmental impacts than the current practice of open dumping. The biogas production option has the lowest environmental impacts. A cost-benefit analysis, which considered greenhouse gas savings, was used for the economic assessment. It was found that composting at a centralised plant is the most economically feasible option under the present Indonesian conditions. The approach reported in this study could be applied for 'a pre-feasibility first cut comparison' that includes environmental aspects in a decision-making framework for developing countries even though European emission factors were used.« less
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Migliori, G. B.; Ambrosetti, M.; Besozzi, G.; Farris, B.; Nutini, S.; Saini, L.; Casali, L.; Nardini, S.; Bugiani, M.; Neri, M.; Raviglione, M. C.
1999-01-01
Although in developing countries the treatment of tuberculosis (TB) cases is among the most cost-effective health interventions, few studies have evaluated the cost-effectiveness of TB control in low-prevalence countries. The aim of the present study was to carry out an economic analysis in Italy that takes into account both the perspective of the resource-allocating authority (i.e. the Ministry of Health) and the broader social perspective, including a cost description based on current outcomes applied to a representative sample of TB patients nationwide (admission and directly observed treatment (DOT) during the initial intensive phase of treatment); a cost-comparison analysis of two alternative programmes: current policy based on available data (scenario 1) and an hypothetical policy oriented more towards outpatient care (scenario 2) (both scenarios included the option of including or not including DOT outside hospital admission, and incentives) were compared in terms of cost per case treated successfully. Indirect costs (such as loss of productivity) were included in considerations of the broader social perspective. The study was designed as a prospective monitoring activity based on the supervised collection of forms from a representative sample of Italian TB units. Individual data were collected and analysed to obtain a complete economic profile of the patients enrolled and to evaluate the effectiveness of the intervention. A separate analysis was done for each scenario to determine the end-point at different levels of cure rate (50-90%). The mean length of treatment was 6.6 months (i.e. patients hospitalized during the intensive phase; length of stay was significantly higher in smear-positive patients and in human immunodeficiency virus (HIV) seropositive patients). Roughly six direct smear and culture examinations were performed during hospital admission and three during ambulatory treatment. The cost of a single bed day was US$186.90, whereas that of a single outpatient visit ranged, according to the different options, from US$2.50 to US$11. Scenario 2 was consistently less costly than scenario 1. The cost per case cured for smear-positive cases was US$16,703 in scenario 1 and US$5946 in scenario 2. The difference in cost between the cheapest option (no DOT) and the more expensive option (DOT, additional staff, incentives) ranged from US$1407 (scenario 1, smear-negative and extrapulmonary cases) to US$1814 (scenario 2, smear-positive cases). The additional cost to society including indirect costs ranged from US$1800 to US$4200. The possible savings at the national level were in the order of US$50 million per year. In conclusion, cost-comparison analysis showed that a relatively minor change in policy can result in significant savings and that the adoption of DOT will represent a relatively modest economic burden, although the real gain in effectiveness resulting from DOT in Italy requires further evaluation. PMID:10427931
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Apparatus and method for the characterization of respirable aerosols
Clark, Douglas K.; Hodges, Bradley W.; Bush, Jesse D.; Mishima, Jofu
2016-05-31
An apparatus for the characterization of respirable aerosols, including: a burn chamber configured to selectively contain a sample that is selectively heated to generate an aerosol; a heating assembly disposed within the burn chamber adjacent to the sample; and a sampling segment coupled to the burn chamber and configured to collect the aerosol such that it may be analyzed. The apparatus also includes an optional sight window disposed in a wall of the burn chamber such that the sample may be viewed during heating. Optionally, the sample includes one of a Lanthanide, an Actinide, and a Transition metal.
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Blade loss transient dynamics analysis, volume 2. Task 2: TETRA 2 user's manual
NASA Technical Reports Server (NTRS)
Black, Gerald; Gallardo, Vincente C.
1986-01-01
This is the user's manual for the TETRA 2 Computer Code, a program developed in the NASA-Lewis Blade Loss Program. TETRA 2 calculates a turbine engine's dynamic structural response from applied stimuli. The calculation options are: (1) transient response; and (2) steady state forced response. Based on the method of modal syntheses, the program allows the use of linear, as well as nonlinear connecting elements. Both transient and steady state options can include: flexible Bladed Disk Module, and Nonlinear Connecting Elements (including deadband, hardening/softening spring). The transient option has the additional capability to calculate response with a squeeze film bearing module. TETRA 2 output is summarized in a plotfile which permits post processing such as FFT or graphical animation with the proper software and computer equipment.
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Toward a Safer and Cleaner Way: Dealing With Human Waste in Healthcare.
Apple, Michael
2016-07-01
Organizations must evaluate their infection control plans in a holistic and inclusive manner to continue reducing healthcare-associated infection (HAI) rates, including giving consideration to the manner of collecting and disposing of patient waste. Manual washing of bedpans and other containers poses a risk of spreading infection via caregivers, the environment, and the still-contaminated bedpan. Several alternative disposal methods are available and have been tested in some countries for decades, including options such as bedpan washer-disinfector machines, macerator machines, and disposable bedpans. This article reviews methods and issues related to human waste disposal in healthcare settings. Healthcare organizations must evaluate the options thoroughly and then consistently implement the option most in line with its goals and culture. © The Author(s) 2016.
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Parahus, S
1999-01-01
This article will discuss issues confronting plan sponsors in light of new Medicare+Choice options, and ways of responding to those issues. It will include a section with highlights of the "new" Medicare, including a brief description of new terminology and general descriptions of the different types of "coordinated care plans" and other options, e.g., POS, PPO, HMO, FFS, PSO and MSA. Its principal focus, however, will be on ways that plan sponsors can respond to--and capitalize on--the changes in Medicare and offer retirees a broader array of benefits while at the same time increasing their control over plan costs. The article will introduce the idea of plan sponsors constructing a retiree "flexible benefits" program comprising Medicare+Choice options.
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Study of Lyndon B. Johnson Space Center utility systems
NASA Technical Reports Server (NTRS)
Redding, T. E.; Huber, W. C.
1977-01-01
The results of an engineering study of potential energy saving utility system modifications for the NASA Lyndon B. Johnson Space Center are presented. The objective of the study was to define and analyze utility options that would provide facility energy savings in addition to the approximately 25 percent already achieved through an energy loads reduction program. A systems engineering approach was used to determine total system energy and cost savings resulting from each of the ten major options investigated. The results reported include detailed cost analyses and cost comparisons of various options. Cost are projected to the year 2000. Also included are a brief description of a mathematical model used for the analysis and the rationale used for a site survey to select buildings suitable for analysis.
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de Boer, Joop; de Witt, Annick; Aiking, Harry
2016-03-01
This paper explores how the transition to a low-carbon society to mitigate climate change can be better supported by a diet change. As climate mitigation is not the focal goal of consumers who are buying or consuming food, the study highlighted the role of motivational and cognitive background factors, including possible spillover effects. Consumer samples in the Netherlands (n = 527) and the United States (n = 556) were asked to evaluate food-related and energy-related mitigation options in a design that included three food-related options with very different mitigation potentials (i.e. eating less meat, buying local and seasonal food, and buying organic food). They rated each option's effectiveness and their willingness to adopt it. The outstanding effectiveness of the less meat option (as established by climate experts) was recognized by merely 12% of the Dutch and 6% of the American sample. Many more participants gave fairly positive effectiveness ratings and this was correlated with belief in human causation of climate change, personal importance of climate change, and being a moderate meat eater. Willingness to adopt the less meat option increased with its perceived effectiveness and, controlling for that, it was significantly related to various motivationally relevant factors. The local food option appealed to consumer segments with overlapping but partly different motivational orientations. It was concluded that a transition to a low carbon society can significantly benefit from a special focus on the food-related options to involve more consumers and to improve mitigation. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Perdue, Bonnie M; Bramlett, Jessica L; Evans, Theodore A; Beran, Michael J
2015-09-01
Self-control tasks used with nonhuman animals typically involve the choice between an immediate option and a delayed, but more preferred option. However, in many self-control scenarios, not only does the more impulsive option come sooner in time, it is often more concrete than the delayed option. For example, studies have presented children with the option of eating a visible marshmallow immediately, or foregoing it for a better reward that can only be seen later. Thus, the immediately available option is visible and concrete, whereas the delayed option is not visible and more abstract. We tested eight capuchin monkeys to better understand this potential effect by manipulating the visibility of the response options and the visibility of the baiting itself. Monkeys observed two food items (20 or 5 g pieces of banana) each being placed either on top of or inside of one of the two opaque containers attached to a revolving tray apparatus, either in full view of monkeys or occluded by a barrier. Trials ended when monkeys removed a reward from the rotating tray. To demonstrate self-control, monkeys should have allowed the smaller piece of food to pass if the larger piece was forthcoming. Overall, monkeys were successful on the task, allowing a smaller, visible piece of banana to pass from reach in order to access the larger, nonvisible banana piece. This was true even when the entire baiting process took place out of sight of the monkeys. This finding suggests that capuchin monkeys succeed on self-control tasks even when the delayed option is also more abstract than the immediate one-a situation likely faced by primates in everyday life.
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Bounds for Asian basket options
NASA Astrophysics Data System (ADS)
Deelstra, Griselda; Diallo, Ibrahima; Vanmaele, Michèle
2008-09-01
In this paper we propose pricing bounds for European-style discrete arithmetic Asian basket options in a Black and Scholes framework. We start from methods used for basket options and Asian options. First, we use the general approach for deriving upper and lower bounds for stop-loss premia of sums of non-independent random variables as in Kaas et al. [Upper and lower bounds for sums of random variables, Insurance Math. Econom. 27 (2000) 151-168] or Dhaene et al. [The concept of comonotonicity in actuarial science and finance: theory, Insurance Math. Econom. 31(1) (2002) 3-33]. We generalize the methods in Deelstra et al. [Pricing of arithmetic basket options by conditioning, Insurance Math. Econom. 34 (2004) 55-57] and Vanmaele et al. [Bounds for the price of discrete sampled arithmetic Asian options, J. Comput. Appl. Math. 185(1) (2006) 51-90]. Afterwards we show how to derive an analytical closed-form expression for a lower bound in the non-comonotonic case. Finally, we derive upper bounds for Asian basket options by applying techniques as in Thompson [Fast narrow bounds on the value of Asian options, Working Paper, University of Cambridge, 1999] and Lord [Partially exact and bounded approximations for arithmetic Asian options, J. Comput. Finance 10 (2) (2006) 1-52]. Numerical results are included and on the basis of our numerical tests, we explain which method we recommend depending on moneyness and time-to-maturity.
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Kamuyango, Alfred A.; Hirschhorn, Lisa R; Wang, Wenjia; Jansen, Perry; Hoffman, Risa M.
2015-01-01
Objective To compare one-year outcomes of women started on antiretroviral therapy (ART) during pregnancy in the pre-Option B+ era to those in the Option B+ era. Methods A retrospective chart review was performed at three sites in Malawi. Women were included in the ‘pre-Option B+’ cohort if they started ART during pregnancy for a CD4 count < 350 cells/mm3 or WHO 3/4 condition and in the ‘Option B+’ cohort if they started ART during pregnancy regardless of CD4 count or clinical stage. One-year outcomes were compared using Fisher's exact and ANOVA F-tests. Results A higher proportion of women in the pre-Option B+ cohort started ART at WHO stage 3/4 (11.9% versus 1.1%, P < 0.001), switched ART regimens (5.9% versus 0%, P = 0.002), or died in the first year after starting treatment (3.9% versus .5%, P = 0.05). While more women in the Option B+ cohort had poor adherence or defaulted, these differences were not significant. Conclusions At our study sites, the transition to Option B+ has been associated with ART initiation in women with less advanced HIV infection, improved medication tolerability, and lower mortality. Further research is needed to better understand outcomes of Option B+. PMID:25774326
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Kamuyango, Alfred A; Hirschhorn, Lisa R; Wang, Wenjia; Jansen, Perry; Hoffman, Risa M
2014-09-01
To compare one-year outcomes of women started on antiretroviral therapy (ART) during pregnancy in the pre-Option B+ era to those in the Option B+ era. A retrospective chart review was performed at three sites in Malawi. Women were included in the 'pre-Option B+' cohort if they started ART during pregnancy for a CD4 count < 350 cells/mm 3 or WHO 3/4 condition and in the 'Option B+' cohort if they started ART during pregnancy regardless of CD4 count or clinical stage. One-year outcomes were compared using Fisher's exact and ANOVA F-tests. A higher proportion of women in the pre-Option B+ cohort started ART at WHO stage 3/4 (11.9% versus 1.1%, P < 0.001), switched ART regimens (5.9% versus 0%, P = 0.002), or died in the first year after starting treatment (3.9% versus .5%, P = 0.05). While more women in the Option B+ cohort had poor adherence or defaulted, these differences were not significant. At our study sites, the transition to Option B+ has been associated with ART initiation in women with less advanced HIV infection, improved medication tolerability, and lower mortality. Further research is needed to better understand outcomes of Option B+.
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Generalization of value in reinforcement learning by humans.
Wimmer, G Elliott; Daw, Nathaniel D; Shohamy, Daphna
2012-04-01
Research in decision-making has focused on the role of dopamine and its striatal targets in guiding choices via learned stimulus-reward or stimulus-response associations, behavior that is well described by reinforcement learning theories. However, basic reinforcement learning is relatively limited in scope and does not explain how learning about stimulus regularities or relations may guide decision-making. A candidate mechanism for this type of learning comes from the domain of memory, which has highlighted a role for the hippocampus in learning of stimulus-stimulus relations, typically dissociated from the role of the striatum in stimulus-response learning. Here, we used functional magnetic resonance imaging and computational model-based analyses to examine the joint contributions of these mechanisms to reinforcement learning. Humans performed a reinforcement learning task with added relational structure, modeled after tasks used to isolate hippocampal contributions to memory. On each trial participants chose one of four options, but the reward probabilities for pairs of options were correlated across trials. This (uninstructed) relationship between pairs of options potentially enabled an observer to learn about option values based on experience with the other options and to generalize across them. We observed blood oxygen level-dependent (BOLD) activity related to learning in the striatum and also in the hippocampus. By comparing a basic reinforcement learning model to one augmented to allow feedback to generalize between correlated options, we tested whether choice behavior and BOLD activity were influenced by the opportunity to generalize across correlated options. Although such generalization goes beyond standard computational accounts of reinforcement learning and striatal BOLD, both choices and striatal BOLD activity were better explained by the augmented model. Consistent with the hypothesized role for the hippocampus in this generalization, functional connectivity between the ventral striatum and hippocampus was modulated, across participants, by the ability of the augmented model to capture participants' choice. Our results thus point toward an interactive model in which striatal reinforcement learning systems may employ relational representations typically associated with the hippocampus. © 2012 The Authors. European Journal of Neuroscience © 2012 Federation of European Neuroscience Societies and Blackwell Publishing Ltd.
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Karnon, Jonathan; Orji, Nneka
2016-10-01
To review the published literature on the cost effectiveness of Option B+ (lifelong antiretroviral therapy) for preventing mother-to-child transmission (PMTCT) of HIV during pregnancy and breastfeeding to inform decision making in low- and middle-income countries. PubMed, Scopus, Google scholar and Medline were searched to identify studies of the cost effectiveness of the World Health Organization (WHO) treatment guidelines for PMTCT. Study quality was appraised using the consolidated health economic evaluation reporting standards checklist. Eligible studies were reviewed in detail to assess the relevance and impact of alternative evaluation frameworks, assumptions and input parameter values. Five published cost effectiveness analyses of Option B+ for the PMTCT of HIV were identified. The reported cost-effectiveness of Option B+ varies substantially, with the results of different studies implying that Option B+ is dominant (lower costs, greater benefits), cost-effective (additional benefits at acceptable additional costs) or not cost-effective (additional benefits at unacceptable additional costs). This variation is due to significant differences in model structures and input parameter values. Structural differences were observed around the estimation of programme effects on infants, HIV-infected mothers and their HIV negative partners, over multiple pregnancies, as well assumptions regarding routine access to antiretroviral therapies. Significant differences in key input parameters were observed in transmission rates, intervention costs and effects and downstream cost savings. Across five model-based cost-effectiveness analyses of strategies for the PMTCT of HIV, the most comprehensive analysis reported that option B+ is highly likely to be cost-effective. This evaluation may have been overly favourable towards option B+ with respect to some input parameter values, but potentially important additional benefits were omitted. Decision makers might be best advised to review this analysis, with a view to requesting additional analyses of the model to inform local funding decisions around alternative strategies for the PMTCT of HIV. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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Drinkers and bettors: investigating the complementarity of alcohol consumption and problem gambling.
French, Michael T; Maclean, Johanna Catherine; Ettner, Susan L
2008-07-01
Regulated gambling is a multi-billion dollar industry in the United States with greater than 100% increases in revenue over the past decade. Along with this rise in gambling popularity and gaming options comes an increased risk of addiction and the associated social costs. This paper focuses on the effect of alcohol use on gambling-related problems. Variables correlated with both alcohol use and gambling may be difficult to observe, and the inability to include these items in empirical models may bias coefficient estimates. After addressing the endogeneity of alcohol use when appropriate, we find strong evidence that problematic gambling and alcohol consumption are complementary activities.
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Observation model and parameter partials for the JPL VLBI parameter estimation software MODEST/1991
NASA Technical Reports Server (NTRS)
Sovers, O. J.
1991-01-01
A revision is presented of MASTERFIT-1987, which it supersedes. Changes during 1988 to 1991 included introduction of the octupole component of solid Earth tides, the NUVEL tectonic motion model, partial derivatives for the precession constant and source position rates, the option to correct for source structure, a refined model for antenna offsets, modeling the unique antenna at Richmond, FL, improved nutation series due to Zhu, Groten, and Reigber, and reintroduction of the old (Woolard) nutation series for simulation purposes. Text describing the relativistic transformations and gravitational contributions to the delay model was also revised in order to reflect the computer code more faithfully.
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Deflection Missions for Asteroid 2011 AG5
NASA Technical Reports Server (NTRS)
Grebow, Daniel; Landau, Damon; Bhaskaran, Shyam; Chodas, Paul; Chesley, Steven; Yeomans, Don; Petropoulos, Anastassios; Sims, Jon
2012-01-01
The recently discovered asteroid 2011 AG5 currently has a 1-in-500 chance of impacting Earth in 2040. In this paper, we discuss the potential of future observations of the asteroid and their effects on the asteroid's orbital uncertainty. Various kinetic impactor mission scenarios, relying on both conventional chemical as well as solar-electric propulsion, are presented for deflecting the course of the asteroid safely away from Earth. The times for the missions range from pre-keyhole passage (pre-2023), and up to five years prior to the 2040 Earth close approach. We also include a brief discussion on terminal guidance, and contingency options for mission planning.
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NASA Technical Reports Server (NTRS)
Lowitz, Amy E.; Brown, Ari David; Stevenson, Thomas R.; Timbie, Peter T.; Wollack, Edward J.
2014-01-01
Kinetic inductance detectors (KIDs) are a promising technology for low-noise, highly-multiplexible mm- and submm-wave detection. KIDs have a number of advantages over other detector technologies, which make them an appealing option in the cosmic microwave background B-mode anisotropy search, including passive frequency domain multiplexing and relatively simple fabrication, but have suffered from challenges associated with noise control. Here we describe design and fabrication of a 20-pixel prototype array of lumped element molybdenum KIDs. We show Q, frequency and temperature measurements from the array under dark conditions. We also present evidence for a double superconducting gap in molybdenum.
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Uccioli, Luigi; Izzo, Valentina; Meloni, Marco; Vainieri, Erika; Ruotolo, Valeria; Giurato, Laura
2015-04-01
Medical knowledge about wound management has improved as recent studies have investigated the healing process and its biochemical background. Despite this, foot ulcers remain an important clinical problem, often resulting in costly, prolonged treatment. A non-healing ulcer is also a strong risk factor for major amputation. Many factors can interfere with wound healing, including the patient's general health status (i.e., nutritional condition indicated by albumin levels) or drugs such as steroids that can interfere with normal healing. Diabetic complications (i.e., renal insufficiency) may delay healing and account for higher amputation rates observed in diabetic patients under dialysis treatment. Wound environment (e.g., presence of neuropathy, ischaemia, and infection) may significantly influence healing by interfering with the physiological healing cascade and adding local release of factors that may worsen the wound. The timely and well-orchestrated release of factors regulating the healing process, observed in acute wounds, is impaired in non-healing wounds that are blocked in a chronic inflammatory phase without progressing to healing. This chronic phase is characterised by elevated protease activity (EPA) of metalloproteinases (MMPs) and serine proteases (e.g., human neutrophil elastase) that interfere with collagen synthesis, as well as growth factor release and action. EPA (mainly MMP 9, MMP-8 and elastase) and inflammatory factors present in the wound bed (such as IL-1, IL-6, and TNFa) account for the catabolic state of non-healing ulcers. The availability of wound dressings that modulate EPA has added new therapeutic options for treating non-healing ulcers. The literature confirms advantages obtained by reducing protease activity in the wound bed, with better outcomes achieved by using these dressings compared with traditional ones. New technologies also allow a physician to know the status of the wound bed environment, particularly EPA, in a clinical setting. These may be helpful in guiding a clinician's options in treating very difficult-to-heal ulcers.